title: Coronariographic significance of heart rate variation related to ischemic episodes in patients undergoing peripheral vascular surgery.
abstract: OBJECTIVE
  To evaluate the characteristics of myocardial ischemia during daily life and their coronariographic significance in a group of patients with proven coronary artery disease undergoing peripheral vascular surgery.
  
  
  METHODS
  Department of Cardiology--Central Hospital--Lisbon.
  
  
  METHODS
  In 14 patients undergoing peripheral vascular surgery and in whom coronariography revealed coronary significative lesions, Holter monitoring was performed during a 24-hour period. Two groups of ischemic episodes were considered: Group A constituted by 44 episodes detected in patients with left main or three vessel disease and group B by 12 episodes detected in patients with one ot two vessel disease. In each group the ischemic parameters were studied.
  
  
  RESULTS
  The incidence of myocardial ischemia was 64%. Statistically significant differences were observed between group A and B concerning the mean heart rate variation from two minutes before the onset of ST-segment depression to its onset (2.39 bpm vs 8.75 bpm; p < 0.05), from the onset of ST-segment depression to its maximal depression (4.43 bpm vs 16.67 bpm; p < 0.001) and from two minutes before St-segment depression to its maximal depression (6.82 bpm vs 25.4 bpm; p < 0.00001). No differences were found in duration and maximal ST-segment depression.
  
  
  CONCLUSIONS
  Particular characteristics of heart rate variation related to the ischemic episodes seem to have a relation with the severity of coronary artery disease in patients undergoing peripheral vascular surgery.
authors.affiliation: Department of Cardiology, Santa Marta Hospital, Lisbon, Portugal.
authors.forename: E
authors.initials: E
authors.lastname: Antunes
authors.forename: J
authors.initials: J
authors.lastname: Serra
authors.forename: C
authors.initials: C
authors.lastname: Catarino
authors.forename: R
authors.initials: R
authors.lastname: Ferreira
authors.forename: R M
authors.initials: RM
authors.lastname: Soares
authors.forename: L
authors.initials: L
authors.lastname: Ferreira
authors.forename: J
authors.initials: J
authors.lastname: Quininha
authors.forename: R
authors.initials: R
authors.lastname: Gracias
authors.forename: J A
authors.initials: JA
authors.lastname: Rato
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D011300:Preoperative Care