Introduction Incomplete cardiac revascularisation (ICR) assessed by residual SYNTAX score (rSs) is associated with increased 5-year mortality. Furthermore, in the general population, our group has demonstrated that impaired autonomic function determined by heart rate recovery time between 10 and 20 s (HRR10–20) following an active stand is associated with increased all-cause mortality. Purpose We hypothesised that ICR would be associated with impaired autonomic function determined by HRR10–20. Methods After ethical approval and informed consent, consecutive patients attending cardiac rehabilitation in a tertiary referral centre were enrolled. All patients had percutaneous coronary revascularisation. During an active stand, real-time heart rate, blood pressure and ECG recordings were taken using non-invasive digital photoplethysmography and HRR10–20 determined. Assessment of autonomic function was performed by determining speed of HRR10–20 post-orthostatic challenge. Patients with an rSs >0 were considered incompletely revascularised and those with an rSs of 0 fully revascularised. Demographic data were recorded and statistical analysis performed. Results Patients (n=53) comprised those with complete revascularisation (CR) (n=37) and ICR (n=16). In the ICR group, mean rSs was 9.4. HRR10–20 was impaired in the ICR group (−3±0.60) compared with the CR cohort (−6.56±0.52) (p<0.0001). Completeness of revascularisation was strongly associated with HRR10–20 (Pearson’s correlation coefficient 0.529; p<0.0001). Baseline demographics did not differ significantly. Use of rate-limiting medication was similar between cohorts (beta blockers, calcium channel blockers, ivabradine). Conclusions Our data confirm significant correlation between ICR and impaired autonomic function determined by speed of heart rate recovery. Thus, determining autonomic dysfunction post-ICR may identify those at increased mortality risk. Data are available upon reasonable request. The data that support the findings of this study are available from the corresponding author (RA), upon reasonable request.

中文翻译：

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不完全血运重建后自主神经功能受损

介绍 由残余 SYNTAX 评分 (rSs) 评估的不完全心脏血运重建 (ICR) 与 5 年死亡率增加有关。此外，在一般人群中，我们的小组已经证明，由活动站立后 10 到 20 秒之间的心率恢复时间 (HRR10-20) 决定的自主神经功能受损与全因死亡率增加有关。目的 我们假设 ICR 与由 HRR10-20 确定的自主神经功能受损有关。方法经伦理批准和知情同意，连续入组在三级转诊中心接受心脏康复治疗的患者。所有患者均接受了经皮冠状动脉血运重建术。在主动站立期间，实时心率，使用无创数字光体积描记法采集血压和心电图记录，并确定 HRR10-20。通过确定 HRR10-20 后直立挑战的速度来评估自主神经功能。rSs > 0 的患者被认为是不完全血运重建，而 rSs 为 0 的患者被认为是完全血运重建。记录人口统计数据并进行统计分析。结果 患者 (n=53) 包括完全血运重建 (CR) (n=37) 和 ICR (n=16) 的患者。在 ICR 组中，平均 rSs 为 9.4。与 CR 组 (-6.56±0.52) 相比，ICR 组 (-3±0.60) 的 HRR10-20 受损 (p<0.0001)。血运重建的完整性与 HRR10-20 密切相关（Pearson 相关系数 0.529；p<0.0001）。基线人口统计学没有显着差异。组间限速药物的使用情况相似（β 受体阻滞剂、钙通道阻滞剂、伊伐布雷定）。结论 我们的数据证实了 ICR 与由心率恢复速度决定的自主神经功能受损之间存在显着相关性。因此，确定 ICR 后自主神经功能障碍可以识别那些死亡风险增加的人。可应合理要求提供数据。应合理要求，可从通讯作者 (RA) 处获得支持本研究结果的数据。可应合理要求提供数据。应合理要求，可从通讯作者 (RA) 处获得支持本研究结果的数据。可应合理要求提供数据。应合理要求，可从通讯作者 (RA) 处获得支持本研究结果的数据。