D.R. TAVKAEVA, S.D. MAYANSKAYA

Kazan State Medical Academy, 49 Butlerov St., Kazan, Russian Federation, 420012

Tavkaeva D.R. — postgraduate student of the Department of cardiology, X-ray endovascular and cardiovascular surgery, tel. +7-905-317-81-30, e-mail: dylyara@mail.ru

Mayanskaya S.D. — D. Med. Sc., Professor of the Department of cardiology, X-ray endovascular and cardiovascular surgery, tel. +7-905-316-99-66, e-mail: Smayanskaya@mail.ru

The aim of the work was to study the circadian rhythm variability indicators in patients with coronary heart disease (CHD) with episodes of silent myocardial ischemia (SMI). For this purpose 66 patients were examined and two groups were identified: patients with typical stable angina attacks and patients with alternating pain and with silent myocardial ischemia according to the 24-hour ambulatory ECG. The temporary values of heart rate variability (HRV): SDNN, SADNN, rMSSD, pNN50 and spectral characteristics: high-frequency (HF), low frequency (LF) and very low frequency (VLF) fluctuations were estimated, as well as the ratio of sympathetic and parasympathetic influences — LF/HF. Analysis of the results showed that in patients with SMI episodes the decrease of HRV is observed, which is characterized by a decrease of the temporal parameters and balance shift toward the low-frequency component in the spectral analysis of heart rate. The dominance of low-frequency component reflects the predominance of sympathetic activity of the autonomic nervous system in case of mixed myocardial ischemia (stable angina with episodes of asymptomatic ischemia), which seems to be reflected in the frequency of arrhythmias in this group of patients. The obtained data on the peculiarities of HRV in case of SMI has as the predictive value and allows you to select the appropriate therapy, for example using beta-blockers.

Key words: silent myocardial ischemia, heart rate variability, temporary and spectral values of rate variability, vegetative nervous system.

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