Abstract 10923: Heart Rate Turbulence and Severity of Atherosclerotic Coronary Lesion in Patients with History of Myocardial Infarction

Introduction: Prediction of adverse outcomes in patients after myocardial infarction (MI) remains a serious and not completely resolved problem, which pushes researchers to search for new technologies. One of the relatively promising non-invasive methods for predicting sudden coronary death in patients with coronary heart disease may be an assessment of heart rate turbulence (HRT). Hypothesis: to study the association between components of heart rate turbulence (HRT) and severity of atherosclerotic coronary lesion assessed by the SYNTAX and SYNTAX II Scores in patients with a history of myocardial infarction. Methods: study enrolled 106 patients with a history of MI in the mean age of 63.6±8.3 years (median age 64 [58; 69] years). The severity of coronary lesions was estimated by diagnostic selective coronary angiography with an assessment of SYNTAX and SYNTAX II Scores. All patients underwent 24-h Holter ECG monitoring. HRT was determined using two indicators: Turbulence Onset (To, %) and Turbulence Slope (Ts, ms/RRi). Results: after HRT quantification measurements were as follows: To= -1.28±1.75% (-1.09 [-2.21; -0.40]); Ts= 4.98±4.51 ms/RRi (3.66 [1.65; 7.24]). Mean SYNTAX Score was 16.8±8.5 (16.0 [10.0; 21.5]); SYNTAX Score II PCI - 30.8±8.9 (30.2 [24.7; 37.0]); SYNTAX Score II CABG - 23.8±7.7 (23.6 [19.0; 29.1]); 4 year PCI mortality - 9.4±9.1% (6.9 [4.4; 11.9]); 4 year CABG mortality - 5.0±3.7% (4.1 [2.8; 6.4]). Spearmen analysis revealed positive correlation between To (r=0.266; p=0.047) and SYNTAX Score II PCI and estimated 4-year PCI mortality rate (r=0.267; p=0.047). Negative correlation relationships were observed between Ts indicator and SYNTAX Score II PCI (r= -0.539; p<0.001), SYNTAX Score II CABG (r= -0.318; p=0.017), 4-year PCI mortality rate (r= -0.539; p<0.001) and 4-year CABG mortality rate (r= -0.348; p=0.008). There were no significant correlations between the rests of the analyzed indicators. Conclusions: Components of HRT have an association with SYNTAX and SYNTAX II scores. In patients with a history of MI, progressive impairment of baroreflex activity, as evidenced by changes in HRT parameters may indicate a more pronounced lesion of coronary arteries.

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