P803Relation between echocardiographic parameters, heart rate variability and frequency of ventricular arrhythmias in patients after myocardial infarction


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Abstract

Purpose: Patients after myocardial infarction are at high risk of new cardiovascular and arrhythmic events. Echocardiographic parameters of left ventricle systolic function and heart rate variability (HRV) are used to identify patients at risk for cardiovascular event or death. The aim of this study was to assess the relation between echocardiographic parameters, HRV and frequency of ventricular arrhythmias in patients after myocardial infarction (MI).Methods: We studied 273 patients after MI, in the sinus rhythm without AV blocks or branch blocks. Average age of patients was 58.5 years. Eighty-five patients were with frequent and complex ventricular arrhythmias and 188 were without arrhythmias or with infrequently premature ventricular complexes (PVCs<10/hour). There was no significant difference in age or sex between two groups of patients. In all subjects echocardiographic examination and 24-hour ECG recording were performed. From the holter record, the analysis of the heart rate variability was performed by software. Four parameters of the time domain heart rate variability were assessed: SDNN, SDANN, RMS-SD and NN>50ms.Results: Patients with frequent and complex ventricular arrhythmias had significantly higher values of left ventricular end-diastolic diameter (LVEDd: 57.2±6.8 vs 53.7±6.3mm; p<0.001), left ventricular end-systolic diameter (LVESd: 41.2±7.1 vs 37.8±6.6mm; p<0.001) and size of the left atrium (La: 41.4±6.6 vs 38.4±5.9mm; p<0.001) and significantly lower values of SDNN (82.4±29.2 vs 97.2±28.4ms; p<0.001), SDANN (75.3±25.4 vs 88.9±24.9ms; p<0.001) and left ventricular ejection fraction (LVEF: 46.2±13.2 vs 54.9±10.8%; p<0.001) in comparison to those without arrhythmias or with infrequently PVCs. There was no significant difference in RMS-SD and NN>50ms between two groups of patients. The study showed that there is a significant positive correlation of values SDNN and SDANN with LVEF and a significant negative correlation with LVESd, LVEDd and La, in patients with frequent and complex ventricular arrhythmias. Values of parameters RMS-SD and NN>50ms did not significantly correlate with LVEF and inside dimensions of the left ventricle in patients with frequent and complex ventricular arrhythmias.Conclusions: The study demonstrated that patients with frequent and complex ventricular arrhythmias have significantly higher degree of left ventricle systolic dysfunction, significantly lower values of SDNN and SDANN, in comparison to those without arrhythmias or with infrequently PVCs.

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