Key result
Ischemic episodes in stable CAD are linked to gradual parasympathetic withdrawal and increased LF:HF ratios.
Observational (n=38)
A gradual withdrawal of parasympathetic tone plays a significant role in triggering ischemic episodes during daily life in patients with stable coronary artery disease.
Parasympathetic withdrawal may trigger daily-life ischemia in stable CAD; leaves open whether autonomic modulation improves outcomes.
Spectral analysis of heart rate variability (HRV) was used to assess changes in the autonomic nervous system (ANS) 10 minutes before, during, and 10 minutes after 110 ischemic episodes (IEs) in 38 patients (25 men, age 61 +/- 10 years) with stable coronary artery disease. In 26 of 77 diurnal IEs (07:00-22:59) there were no changes in the spectral indexes (LF and HF) during the study period. In the remainder there was an increase in the LF:HF ratio due to HF withdrawal that started before the onset of the IE. All 33 nocturnal episodes also showed an increase in the LF:HF ratio, which was due not only to HF withdrawal, but also to a simultaneous increase in LF. Although it is not the only cause, the ANS plays a significant role in triggering IEs during daily life in patients with stable coronary artery disease. The common factor in all such episodes is a gradual withdrawal of parasympathetic tone.
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Kochiadakis et al. (2000) conducted an observational in Stable coronary artery disease (n=38). Ischemic episodes vs. Baseline (10 minutes before episode) was evaluated on Changes in spectral indexes (LF and HF) of heart rate variability. Ischemic episodes in stable coronary artery disease were associated with a gradual withdrawal of parasympathetic tone and an increased LF:HF ratio in 51 of 77 diurnal and all 33 nocturnal episodes.
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