The relation between heart rate variability and cardiac Troponin I in patiens with elective percutanous coronary intervation

summary:Introduction: Cardiac markers have been used to evaluate the success of PCI and it might predict of long-term clinical endpoints or hospitalization time. It is well known that cardiac troponins are superior among this markers. Especially, troponin I is a sensitive marker of myocardial necrosis and studies have confirmed the superiority of this marker over traditional cardiac enzymes. Heart rate variability (HRV) is a measure of the beat-to-beat variations in heart rate. It is well recognised that, there is relation with HRV and alterations in autonomic balance. Heart rate variability have been used to determine the cardiac autonomic neuropathy in diabetes mellitus and predict survival after acute myocardial infarction.Aim: We aimed to evaluate the relation between plasma troponin I levels and HRV in patients arter successful PCI.Material and methods: 33 (13 female, 20 male) patients have enrolled in this study before elective PCI. Mean age was 65,6±9 years. Clinical and angiographic parameters were recorded. 24 hour holter monitorisation was planned before precedure.Results: Plasma troponin I levels increased after PCI (p=<0,001). Minimum heart rate increased (P=0,04), APC?s decreased (P=0,001) and IVR increased (p=0,04) after PCI. SDNN, PNN50, total power and HF decreased (P=0,01), LF/HF increased (P=0,01). There was relation between gender and ?SDNN, ?SDANN, ?PNN50. There was relation between age and ?SDNN, ?PNN50, ?RMSSD, ?TAI, ?LF/HF. There was relation between abdominal obesity and ?LF/HF. There was relation between Hb levels and ?PNN50, also plasma kreatinin levels and ?HF. ?LF/HF was changed in troponin (+) group significantly (p=0,01). There was relation between troponin I levels and ?RMSSD (r=-0,38, p=0,02), ?LF/HF(r=0,47, p=0,005) in univariate analysis. ?LF/HF was found as independent variable (?R2 =0,22, p=0,006) in univariate analysis.Conclusion: Both holter and HRV parameters showed an increased sympathetic activity after PCI. The difference in HRV was significant in troponin (+) group. The relation with ?KHD and troponin I might provide to predict higher troponin I levels.