PSI - Issue 65

Mironov V.A. et al. / Procedia Structural Integrity 65 (2024) 152–157 Author name / Structural Integrity Procedia 00 (2024) 000–000

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2. Purpose

Assessment of the prognostic significance of the SAP presence for functional class 3 without intercurrent diseases, in comparison with SAP on the background of chronic infectious diseases, on the background of ACNP, on the indicators of heart rhythm autonomous regulation, influence on long-term results, the development of intermediate and end points, within three years after percutaneous coronary intervention (PCI).

3. Materials and methods

Patients suffering from SAP with "stable" anginal symptoms – ESC Guidelines (2020) were examined. These patients were referred to cardiology departments due to the lack of effect from the use of optimal drug therapy. Patients with SAP in combination with diabetes mellitus and clinically pronounced concomitant diseases of internal organs were not included in the research due to the possible effect of ACNP on heart rate variability (HRV). SAP with ACNP was diagnosed clinically in combination with HRV analysis data, a technique considered as a prognosis criterion in this research. Patients were referred for PCI after a standard examination with verifying coronary angiography (CAG). In addition to the basic non-invasive examination methods (electrocardiography (ECG) at rest and under load, daily monitoring, echocardiography, routine laboratory clinical and biochemical research methods, CAG), all patients underwent high-tech rhythmocardiography (HT-RCG) with electrocardiosignal sampling (ECS) 1000± 3 Hz, with synchronous ECG recording in real time, with using vegetative stress tests – Wein (2003) – with analysis of HRV at rest and samples before and after PCI. This research analyzes the data prior to the PCI. The research included 179 patients with SAP of functional class 3, of which 53 patients with typical symptoms of SAP (47.11±6.3 years old) – group I, 57 patients, having, in addition to symptoms of SAP, chronic infection foci (CIF) with obvious clinical signs (45.33±5.68 years old) – group II, 28 patients with SAP with clinical and HT-RCG with signs of ACNP – group III of the research. As a control, 41 people were examined who were urgently hospitalized in the cardiology department, with the absence of significant coronary artery stenosis in CAG and with negative stress tests. The main group was selected according to general criteria – clinically pronounced SAP, significant coronary artery stenosis according to CAG, insufficient effectiveness of optimal drug therapy, high risk of complications, patient consent. PCI was conducted with the HT-RCG examination. RR-intervals (the average systolic interval) and other indicators of HT-RCG were recorded in a sequence of real-life heart contractions on the horizontal abscissa axis with a number of intervals equal 300 and continued upward parallel to the ordinate axis with a second time scale. Accordingly, the main initial statistical time indicators of HT-RCG were measured with an accuracy of 0.001 seconds at rest and in samples with baroreflective, vagal, sympathetic stimulation, and in a load sample dosed at a heart rate (HR) equal 120 per 1 minute (Fig.1-4).