Celik A, Ozturk A, Ozbek K, Kadi H, Koc F, Ceyhan K, Erkorkmaz U.
Clin Invest Med. 2011 Dec 1;34(6):E349.
Purpose: STsegmentdepression without angina during an exercisestress test causes diagnostic problems, particularly in non-diabetic patients.Heartratevariability (HRV) and heartrateturbulence (HRT) are used to evaluate the changes in cardiac autonomic functions and are also both decreased in patients with coronaryarterydisease. The aim of this study was determine the values of HRV and HRT that discriminate truecoronaryarterydisease from false positive stress test results. Methods: Ninety non-diabetic patients who underwent diagnostic coronary angiography (CA) due to suspected coronaryarterydisease after STsegmentdepression without angina during an exercisestress test were enrolled in the study. Prior to CA, 24 hour ambulatory electrocardiogram recordings were taken and HRV and HRT parameters were calculated. Results: Patients were divided into three groups according to the severity of their coronary lesions: (group 1 normal, group 2 non-obstructive and group 3 obstructive. There were no differences among the groups with regards to age, sex, medical history, medications, systolic and diastolic blood pressures, body mass index, fasting glucose, anemia and thyroid status, lipid profile and creatinine clearance. HRV parameters and turbulence slope (TS) were significantly lower while turbulence onset (TO) was significantly higher in group 3 than groups 1 and 2. According to the cut-off values calculated using ROC analysis, SDNN≤69.63 msec, TO > 0.14%, and TS≤2.78 msec/RR have high diagnostic accuracy for predicting obstructive coronaryarterydisease. Conclusion: HRV and HRT parameters may provide additional information for discriminating between patients who do and do not truly need CA.