Background and Aims: Analysis of spectral parameters of heart rate variability (HRV) depending on the postinfarction left ventricular (LV) remodeling and the effectiveness of atorvastatin therapy in STEMI patients.

Background and Aims: To study the dynamics of heart rate turbulence (HRT) and late ventricular potentials (LVP) depending on the postinfarction left ventricular (LV) remodeling and the effectiveness of atorvastatin therapy in STEMI patients.

Background and Aims: To assess the dynamics of heart rate variability (HRV) indicators depending on the postinfarction left ventricular (LV) remodeling and the effectiveness of atorvastatin in STEMI patients.

Abstract Purpose To assess the importance of highly effective lipid-lowering therapy with atorvastatin in the normalization of the autonomic regulation of cardiac activity in patients with myocardial infarction with ST segment elevation (STEMI). Methods The study included 130 patients with STEMI aged 51.3±8.9 years, the majority of males (91%). Inclusion criteria: age from 35 to 70 years, STEMI confirmed by ECG and the level of biomarkers (troponin I, CK-MB), the presence of hemodynamically significant stenosis of a culprit artery according to coronary angiography provided that other coronary arteries are occluded no more than 50%, left main coronary artery - not more than 30%. Exclusion criteria: a history of myocardial infarction, CHF III-IV NYHA, bundle branch block, atrial fibrillation, artificial pacemaker. All patients took atorvastatin at a dose of 40–80 mg/day for 48 weeks after STEMI. As part of a further study at the 7th-9th day and 48 weeks after STEMI, 24-hour ECG monitoring was performed with the Astrocard system. The spectral parameters of heart rate variability (HRV) were evaluated: TotP (ms2), ULF (ms2), VLF (ms2), LF (ms2), HF (ms2), LF / HF. By the 48th week of treatment, patients were divided into groups depending on the achievement of the target level of low density lipoproteins (LDL) of less than 1.4 mmol / l or less than 50% of the initial values: 64 people who reached target values of LDL and formed the group of high-effective lipid-lowering therapy “H”, the group of low effective treatment “L” included 66 patients whose LDL did not meet the recommended level. The groups were matched by gender, age, and anthropometric data. Results In the “H” group, by the 48th week, a pronounced power amplification of all spectral components was obtained. The TotP parameter increased from 13021 (95% CI 10967; 15076) ms2 to 20988 (95% CI 17617; 24358) ms2 (p=0.0001); HF - from 164 (95% CI 105; 222) ms2 to 249 (95% CI 178; 321) ms2 (p=0.003). An increase in the low-frequency components of HRV was observed: an increase in ULF from 10695 (95% CI 8985; 12406) ms2 to 20401 (95% CI 15099; 25703) ms2 (p=0.0001), VLF - from 1473 (95% CI 1212; 1734) ms2 to 1734 (95% CI 1478; 1990) ms2 (p=0.01), LF - from 761 (95% CI 573; 949) ms2 to 909 (95% CI 736; 1082) ms2 (p=0.02). Against the background of an increase in all parameters of the frequency spectrum, the sympathovagal balance coefficient LF / HF decreased from 6.6 (95% CI 5.7; 7.6) to 5.2 (95% CI 4.3; 6.1) ( p=0.004). An analysis of the HRV indicators dynamics in the L group revealed an increase in only the total spectrum power - TotP from 12740 (95% CI 10947; 14533) ms2 to 20195 (95% CI 16619; 23770) ms2. Conclusions Highly effective therapy with atorvastatin in STEMI patients helps to normalize the parameters of the autonomic regulation of heart rate in the post-infarction period due to the increased effects of parasympathetic activity. Funding Acknowledgement Type of funding source: None

Background and Aims: To study the effect of 48-week highly effective atorvastatin therapy on the spectral indices of heart rate variability (HRV) in STEMI patients.

Background and Aims: to evaluate the role of highly effective atorvastatin therapy on the dynamics of heart rate turbulence (HRT) and late ventricular potentials (LVP) in STEMI patients.

Background and Aims: To assess the effect of high-dose statin therapy on coronary blood flow and the development of rhythm disturbances in STEMI patients.

Background and Aims: To conduct an assessment of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) dynamics in STEMI patients who received long-term therapy with atorvastatin different dose.

Background and Aims: To evaluate the effect of long-term atorvastatin therapy in different doses on kidneys function in patients after STEMI.

Aim. To assess the dynamics of parameters of myocardial electrical instability in patients with ST-elevation (STE) myocardial infarction (MI) treated with various doses of atorvastatin. Materials and methods. Patients with STEMI (n=70), who received atorvastatin 20 or 80 mg/day for 48 weeks, were divided into two groups: group "E" - 38 patients (54.3%) in whom by 48-th week target values of low density lipoprotein cholesterol (LDLC) were achieved, and group "NE"- 32 patients (45.7%) in whom these levels were not achieved. On days 7-9, at 24th and 48th weeks after onset of MI the patients underwent 24-hour 12-leads ECG monitoring with subsequent analysis of parameters of myocardial electrical inhomogeneity: late ventricular potentials (LVP), dispersion of QT-interval duration, heart rate variability (HRV) and turbulence. Results. After of treatment with atorvastatin target value of LDLC was achieved in 73.5 and 36.1% of patients receiving 80 and 20 mg/day, respectively. In the group "E" we observed positive dynamics of LVP parameters (QRSf - p<0.01, HFLA - p<0.001, RMS - p<0.05), decreases of QTa disp (p<0.05) and sdQTa (p<0.01), favorable transformation of HRV temporal (SDNNi, pNNSO - p<0.05, RMSSD, TINN - p<0.01) and frequency indices (1-Ifp, L/H p<0.001). Most striking evolution in this group referred to HRV during night hours. Conclusion. Atorvastatin induced achievement of target LDLC values decreased myocardial arrhythmic readiness what was reflected by reduction of frequency of LVP registration and dispersion of QT duration, increase of activity of the parasympathetic link of vegetative regulation of cardiac activity.