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      Autonomic Responses in Chest Pain Syndromes as Compared to Normal Subjects

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          Abstract

          The heart rate response to standing, cough, hand grip, and deep breathing were examined in normal subjects and coronary artery disease patients ( > 70% diameter narrowing). The heart rate responses to these maneuvers were reduced in coronary patients and in anginal patients with normal coronary angiograms, as compared to normals. Detection (with the heart rate response to standing) was determined by using an RR interval cutoff of 140 ms for males and 120 ms for females discriminated between normals and CAD patients. In men sensitivity was 0.58, specificity 0.87 and CCR 0.75, and in women sensitivity was 0.67, specificity 0.79 and CCR 0.75. These values are similar to those reported for ST segment depression in similar populations. When separating normals from those with 2 and 3 vessel disease – sensitivity is 0.67, specificity 0.87, predictive value 0.71 and CCR 0.80. The response to cough, hand grip, and deep breathing showed similar trends but had less specificity than the response to standing. Thus, the heart rate response to most autonomic maneuvers is blunted in subjects with coronary disease and in those with pain syndromes sent for coronary angiography. These findings need testing in larger populations but autonomic maneuvers fail to discriminate patients with coronary disease from those with normal angiograms presenting with chest pain syndromes.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          0008-6312
          1421-9751
          1987
          1987
          11 November 2008
          : 74
          : 1
          : 35-42
          Affiliations
          Memorial Medical Center of Long Beach, Division of Cardiology, Long Beach, Calif., USA
          Article
          174172 Cardiology 1987;74:35–42
          10.1159/000174172
          3815452
          © 1987 S. Karger AG, Basel

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          Page count
          Pages: 8
          Categories
          Original Paper

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