THE CAUSE-EFFECT RELATIONSHIP OF SYMPATHOVAGAL ACTIVITY AND THE OUTCOME OF PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY

We studied 25 patients who underwent percutaneous transluminal coronar y angioplasty (PTCA) to determine the association of sympathovagal imb alance and the outcome of coronary angioplasty. We examined the profil es of heart rate variability (HRV) using echocardiography, stress thal lium scanning and radionuclide angiography before, immediately after a nd 1 month after the procedure. Coronary angiography was followed up a t 6 months or if restenosis was suspected, to determine whether resten osis had occurred. Frequency domain (LF/HF) and time domain (SDNN, SDA NN-ind, and r-MSSD) parameters were analyzed. According to the evoluti on of each parameter, we classified the patients into Group Ax (improv ed in HRV profile) and Group Ex (deteriorated in HRV profile) [x = 1 f or LF/HF, 2 for SDNN, 3 for SDANN-ind, and 4 for r-MSSD]. We found tha t there was no definite association between Gensini score and HRV prof iles at the baseline for each group. No significant changes existed be tween the HRV profiles before and immediately after PTCA. For the LF/H F ratio, 5 of 11 in Group B1 had restenosis while 0 of 14 in Group B2 and 1 of 19 in Group A2 had restenosis (p < 0.01). There were no signi ficant predictive values for SDANN-ind and r-MSSD (p = 0.12 and 0.07, respectively). We conclude that the sympathovagal imbalance did not re flect the severity in coronary artery disease but was associated with restenosis after successful PTCA.