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European Heart Journal 1996 17(3):388-393;
Copyright © 1996 by the European Society of Cardiology.
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© 1996 The European Society of Cardiology

Spectral analysis of heart rate variability before and during episodes of nocturnal ischaemia in patients with extensive coronary artery disease

P. E. Vardas, G. E. Kohiadakis, E. G. Manios, E. M. Kanoupakis, E. G. Zouridakis and G. I. Chlouverakis

Cardiology Department, University Hospital of Iraklion Crete, Greece

Received 24 March 1995; accepted 31 May 1995.

Correspondence:Prof. P. E. Vardas, MD, PhD (London), FESC, FACC, Cardiology Department, University Hospital of Crete, P.O. Box 1352, Iraklion, Crete, Greece

Abstract

Spectral analysis of heart rate variability was used to assess autonomic nervous system activity associated with episodes of nocturnal myocardial ischaemia in 32 patients (20 men, age 58 ± 9 years) with extensive coronary artery disease. Twenty-four hour Holter tape recordings were analysed and spectral indexes of heart rate variability were computed by fast Fourier analysis on 2 mm segments covering the period from 10 mm before to 10 mm after each nocturnal ischaemic episode, defined as ST segment depression ≥ 1 mm lasting at least 4 mm. Spectral power was measured at low frequencies (LF: 0·06–0·10 Hz) and high frequencies (HF: 0·15–0·40 Hz) and the ratio LF/HF was calculated.

RESULTS: A total of 30 episodes of nocturnal ischaemia were analysed. High frequency spectral power showed a clear decrease during the 10 mm before the onset of ischaemia, remained steady until the end of the episode, and returned to normal by 6 mm after. Low frequency spectral power fluctuated throughout the ischaemic episodes with no clear pattern of variation. The low/high frequency ratio reflected mainly the changes in high frequency.

CONCLUSIONS: Sympathetic predominance due to parasympathetic withdrawal is the principal change in autonomic nervous system activity associated with episodes of nocturnal ischaemia.

(Eur Heart J 1996; 17: 388–393)

Key Words: Nocturnal ischaemia • autonomic nervous system • heart rate variability


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