Novel Insights Into the Interaction Between the Autonomic Nervous System and Inflammation on Coronary Physiology: A Quantitative Flow Ratio Study

Frontiers in Cardiovascular Medicine

article

Jun Wang¹  Chengzhe Liu¹  Meng Wang¹  Hu Chen¹  Huixin Zhou¹  Zhihao Liu¹  Song Zhang¹  Zhongyang Yu¹  Shoupeng Duan¹  Qiang Deng¹  Ji Sun¹  Hong Jiang¹  Lilei Yu¹ 

[1] Department of Cardiology, Renmin Hospital of Wuhan University, Cardiac Autonomic Nervous System Research Centre of Wuhan University, Cardiovascular Research Institute, Wuhan University, Hubei Key Laboratory of Cardiology

关键词: unstable angina pectoris;    quantitative flow ratio;    heart rate variability;    autonomic nerve;    inflammation;   

DOI  :  10.3389/fcvm.2021.700943

学科分类：地球科学(综合)

来源: Frontiers

【 摘 要 】

Background: Heart rate variability (HRV) was proposed as a noninvasive biomarker to stratify the risk of cardiovascular disease. However, it remains to be determined if HRV can be used as a surrogate for coronary artery physiology as analyzed by quantitative flow ratio (QFR) in patients with new-onset unstable angina pectoris (UAP). Methods: A total of 129 consecutive patients with new-onset UAP who underwent 24-h long-range 12-channel electrocardiography from June 2020 to December 2020 were included in this study. HRV, coronary angiography, and QFR information was retrieved from patient medical records, the severity of coronary lesions was evaluated using the Gensini score (GS), and total atherosclerotic burden was assessed using the three-vessel contrast QFR (3V-cQFR) calculated as the sum of cQFR in three vessels. Results: Multivariate logistic analysis showed that low-frequency power (LF) and high-sensitivity C-reactive protein (hs-CRP) were directly correlated with functional ischemia of target vessel, which were inversely correlated with total atherosclerotic burden as assessed by 3V-cQFR. Moreover, incorporation of the increase in LF into the existing model that uses clinical risk factors, GS, and hs-CRP significantly increased the discriminatory ability for evaluating coronary artery physiology of target vessel. Conclusions: LF and hs-CRP are independently associated with functional ischemia in patients with new-onset UAP. The relative increase of LF and hs-CRP could add value to the use of classical cardiovascular risk factors to predict the functional severity of coronary artery stenosis. Our results suggest a potential association between the autonomic nervous system, inflammation, and coronary artery physiology.

【 授权许可】

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