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Time-varying spectral analysis of heart rate and left ventricular pressure variability during balloon coronary occlusion in humans

A sympathoexcitatory response to myocardial ischemia

Shuji Joho, MD^*, Hidetsugu Asanoi, MD^*, Hosam A. Remah, MD^*, Akihiko Igawa, MD^*, Tomoki Kameyama, MD^*, Takashi Nozawa, MD^*, Katsumi Umeno, BS and Hiroshi Inoue, MD, FACC^*

^* Second Department of Internal Medicine, Toyama Medical and Pharmaceutical University, Toyama, Japan
the First Department of Physiology, Toyama Medical and Pharmaceutical University, Toyama, Japan

View larger version (49K): [in a new window]   Figure 1 Original tracing of HR and LVP during coronary occlusion (upper panel). ST segment was elevated during coronary occlusion. HR and LVP oscillation appeared at 55 s after the balloon inflation (Inf) and disappeared after the balloon deflation (Def). Wavelet analysis (lower panel) clearly demonstrates augmentation of low-frequency fluctuation (0.05–0.06 Hz) of RR and LVSP during coronary occlusion. HR = heart rate; LVSP = left ventricular systolic pressure; LVP = left ventricular pressure; RR = RR intervals.

View larger version (65K): [in a new window]   Figure 2 Three-dimensional continuous plots (wavelet transforms) of RR interval in patients who showed an augmentation of low-frequency component during coronary occlusion. The low-frequency power around 0.06 Hz gradually increased as the occlusion period progressed. Patient initials and target coronary lesion are indicated in each figure. Def = balloon deflation; Inf = balloon inflation; LAD = left anterior descending artery; LCX = left circumflex artery; RCA = right coronary artery.

View larger version (45K): [in a new window]   Figure 3 Three-dimensional continuous spectral plots (wavelet transform) of RR interval in patients who showed no augmentation of low-frequency component during coronary occlusion. Format and abbreviations are as in Figure 2.

View larger version (19K): [in a new window]   Figure 4 Serial changes in low-frequency (LF) component of RR variability (0.04–0.14 Hz). Two groups could be definitely identified by the study design. In seven patients, the LF component began to rise within 1 min after balloon inflation and reached a peak at about 80 s (closed squares). In contrast, there were no appreciable changes in spectral components of RR interval variability in the remaining seven patients (open circles). Following LF augmentation, high-frequency (HF) component (0.15 Hz) began to increase in the middle to late phase of coronary occlusion, but the changes did not reach statistical significance. Consequently, the ratio of LF to HF component rose to be significantly greater in the LF augmentation group than the no LF augmentation group. Data are expressed as mean ± standard error of percent changes from the control value. *p < 0.05 vs. baseline value, #p < 0.05 vs. open circles at the corresponding time.