Evaluation of heart rate turbulence parameters according to localization of infarction in patients with st-elevation mi who underwent primary percutaneous coronary intervention

Coronary heart disease and its complications are the leading causes of morbidity and mortality in both developed and developing countries. Despite reduced mortality with the detection of modifiable risc factors in the Framingham study and the implementation of bypass surgery or percutaneous coronary revascularization instead of medical therapy in angina treatment, adverse effects of complications like pump failure, arrhythmias and reinfarction on early and late morbidity and mortality are ongoing. There are many factors that determine prognosis in early and late post-MI period. Patients should be assessed with risk stratification and appropriate further evaluation and treatment should be done. The prognostic markers include LVEF, age, gender, familial factors, comorbidity, electrical instability and response to non-invasive tests. Especially within the first 1 and 2 years after STEMI, development of sudden cardiac death due to severe ventriculer arrhythmias is likelly to occur. A number of techniques are designed to evaluate the electrical instability and validate the risk. These are the measurement of QT distribution and heart rate variability, ambulatory ECG recordings, signal avereged electrocardiogram, evaluation of the reduction in heart rate turbulence. The first time in the literature, heart rate turbulence, used by Schmidth at al. is defined as the physiological changes in sinus rate after ventriculer premature beats and is considered as an indicator of baroreflex sensitivity. It was shown in many studies that mortality is assosiated with impaired heart rate turbulence in heart disease. The normal values of the parameters of HRT has been identified as ≤ 0% for turbulence onset and ≥2.5 ms/RR for turbulence slope respectively. In our study, we aimed to evaluate heart rate turbulence parameters according to localization of infarction in patients with ST-elevation MI who underwent primary percutaneous coronary intervention. The study included a total of 48 patients. Parameters of heart rate turbulence was compared in patients who were grouped as anterior or inferior.9 patients (18.7 %) had an abnormal value of TO. TS was calculated as normal in all patients. We could not detect a statistically significant difference in terms of TS and TO values between the two groups (p:0.483 for TO and p:0.733 for TS).