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Autonomic balance and impedance cardiography analysis in patients undergoing leg revascularization
, 2, 1
Affiliations- Department of Vascular and Internal Diseases, Nicolaus Copernicus University in Torun, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Poland
- Department of Exercise Physiology and Functional Anatomy, Nicolaus Copernicus University in Torun, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Poland
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Abstract
Introduction: Changes in autonomic nervous system (ANS) balance associated with endovascular interventions may potentially cause haemodynamic abnormalities that lead to periprocedural cardiovascular complications. This study aimed to determine the relationships between changes in ANS balance and impedance cardiography (ICG) parameters after endovascular leg revascularization.
Material and methods: Before the procedure, and 1, 3 and 5h after the intervention, 5-min examinations of both ANS balance and ICG parameters were performed using a Task Force Monitor in 42 patients undergoing endovascular leg revascularization.
Results: When compared to patients with intermittent claudication, individuals with chronic limb-threatening ischaemia had a significantly shorter R-R interval and lower stroke volume (SV) and left ventricle ejection time (LVET) at the beginning of the study. During the 5h after endovascular leg revascularization, significant fluctuations were noted in the following: heart rate, frequency-domain parameters of heart rate variability, baroreflex effectiveness indices, and ICG parameters, such as total peripheral resistance, SV, LVET, and ejection rate. The deltas of ANS parameters correlated with the deltas of ICG parameters in the respective periods of measurement.
Conclusions: Dynamic fluctuations in ICG and ANS parameters that occurred in patients who had undergone endovascular leg revascularization might potentially affect the risk of the occurrence of a cardiovascular event in the periprocedural period. The correlations between the ANS and ICG parameters suggest that haemodynamic oscillations after endovascular leg revascularization are mediated by changes in ANS activity, most probably through a sympathoexcitatory effect of the procedure related to changes in skeletal muscle perfusion.
Abstract
Introduction: Changes in autonomic nervous system (ANS) balance associated with endovascular interventions may potentially cause haemodynamic abnormalities that lead to periprocedural cardiovascular complications. This study aimed to determine the relationships between changes in ANS balance and impedance cardiography (ICG) parameters after endovascular leg revascularization.
Material and methods: Before the procedure, and 1, 3 and 5h after the intervention, 5-min examinations of both ANS balance and ICG parameters were performed using a Task Force Monitor in 42 patients undergoing endovascular leg revascularization.
Results: When compared to patients with intermittent claudication, individuals with chronic limb-threatening ischaemia had a significantly shorter R-R interval and lower stroke volume (SV) and left ventricle ejection time (LVET) at the beginning of the study. During the 5h after endovascular leg revascularization, significant fluctuations were noted in the following: heart rate, frequency-domain parameters of heart rate variability, baroreflex effectiveness indices, and ICG parameters, such as total peripheral resistance, SV, LVET, and ejection rate. The deltas of ANS parameters correlated with the deltas of ICG parameters in the respective periods of measurement.
Conclusions: Dynamic fluctuations in ICG and ANS parameters that occurred in patients who had undergone endovascular leg revascularization might potentially affect the risk of the occurrence of a cardiovascular event in the periprocedural period. The correlations between the ANS and ICG parameters suggest that haemodynamic oscillations after endovascular leg revascularization are mediated by changes in ANS activity, most probably through a sympathoexcitatory effect of the procedure related to changes in skeletal muscle perfusion.
Keywords
peripheral artery disease, chronic lower limb ischaemia, impedance cardiography, heart rate variability, endovascular revascularization
About this articleTitle
Autonomic balance and impedance cardiography analysis in patients undergoing leg revascularization
Journal
Issue
Article type
Original article
Pages
101-108
Published online
2023-05-10
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1223
Article views/downloads
256
DOI
Bibliographic record
Medical Research Journal 2023;8(2):101-108.
Keywords
peripheral artery disease
chronic lower limb ischaemia
impedance cardiography
heart rate variability
endovascular revascularization
Authors
Artur Mieczkowski
Sławomir Kujawski
Paweł Zalewski
Jacek Budzyński
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