Evaluation of five-year risk of lethal outcome and development of cardiovascular disorders in patients with acute myocardial infarction on basis of 0.1-Hz rhythms synchronization in cardiovascular system

• Main Authors: KiselevA.R., Gridnev V.I., KaravaevA.S., O.M. Posnenkova., V.I. Ponomarenko., M.D. Prokhorov., B.P. Bezruchko., V.A. Shvartz
• Format: Article
• Language: Russian
• Published: Saratov State Medical University 2010-06-01
• Series: Саратовский научно-медицинский журнал
• Subjects: 0.1 Hz-rhythm; heart; microcirculation; myocardial infarction; risk factors; synchronization
• Online Access: http://www.ssmj.ru/system/files/201002_328_338.pdf
• ISSN: 1995-0039; 2076-2518

The research goal is to evaluate the impact of autonomic heart control indices on five-year risk of lethal outcome and development of cardiovascular disorders in patients with acute myocardial infarction (AMI) and to study the dynam¬ics of indices in short- and long-term period. 125 patients with AMI (42% female), ages 30 to 83 years, were enrolled in prospective observational study. Observation period lasted 6 years. Control checking was carried out in 1 week, 3 weeks, 6 months, 1 year and then annually. The dynamics of heart rate variability (HRV) and the synchronization of 0.1-Hz rhythms of heart and microcirculation (S) were studied during the first year. Outcomes proved to be death, MI, stroke. Development of acute heart failure Killip 2-4 and indices S < 20% during the first week of AMI (х2 = 10,5, p = 0,005 for the Cox model) played a significant role in evaluation of five-year risk of death after AMI. Sensitivity (Se) and specificity (Sp) of index S < 20% during the first week of AMI were 76% and 43% correspondingly. The Cox model showed that indices of HRV and 0.1-Hz rhythms synchronization were not of great value in evaluation of five-year risk of death after AMI. The article concludes that indices S < 20% in patients with AMI possess better prognostic value than common clinical parameters