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KMID : 0368119920220010087
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Korean Circulation Journal
1992 Volume.22 No. 1 p.87 ~ p.95
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Assessment of Autonomic Nervous Dysfunction by Heart Rate Spectral Analysis(HRSA) in Patients with Angina Pectoris
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이충기
이두하/김영조/심봉섭/이현우/이상학/이준하
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Abstract
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Background:
@EN The autonomic nervous control of the cardiovascular system has been thought to have a diurnal variation in its activity. This variation could be an important underlying mechanism for the circardian distribution of cardiac events such as
angina
pectoris attack, transient myocardial ischemia. and some arrhythmia. The vagal cardiac function is commonly impaired in patients with coronary artery disease. Recently. an assessment of parasympathetic and sympathetic activities is now possible
using
heart rate spectral analysis. The spectral density of R-R interval variability contains two major components. high frequency (HF) power sectral density (<0.25Hz) and low frequency (LF) power spectral density (<0.15Hz), which have magnitudes that
are
quantitative markers of cardiac vagal activity and sympathetic activity with vagal modulation. respectively.
@ES Methods:
@EN We analyzed the spectral components of R-R interval variability from 24 hour ambulatory holter monitoring in 20 controls and 20 patients with angina pectoris. The patients had no clinical evidence of hypertension. acute myocardial infarction.
heart
failure. arrhythmia or diagetes mellitus. Recording continued for 24 hours while the subject undertook his normal work and leisure activities. For power spectral analysis. 1024 heart beats was sampled at early morning. afternoon, evening and
during
sleeping.
@ES Results:
@EN The spectral component of R-R interval variability was unaffected by the time of day during the waking period. althought a significant decrease in LFCCV and HFCCV was observed during sleeping in controls (P<0.001). In comparison of two
groups.
patients with angina pectoris showed markedly diminished HFCCV values during waking period except during sleeping period. The R-R interval and LF/HFCCV ratio did not differe significantly in both groups. There were mrkedly increased in LFCCV and
LF/HFCCV ratio at transient ischemic attack in patients with angina pectoris.
@ES Conclusion:
@EN Autonomic cardiac control during the waking period shows little variation with the time of day in both groups. We observed that vagal cardiac function was reduced in patients with coronary artery disease by heart rate spectral analysis. It is
suggested that ischemic changes in patients with coronary artery disease underlying reduced vagal cardiac function is associated with increased sympathetic activity.
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