Coronariographic significance of heart rate variation related to ischemic episodes in patients undergoing peripheral vascular surgery.
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.
Antunes
E
E
Department of Cardiology, Santa Marta Hospital, Lisbon, Portugal.
Serra
J
J
Catarino
C
C
Ferreira
R
R
Soares
R M
RM
Ferreira
L
L
Quininha
J
J
Gracias
R
R
Rato
J A
JA
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