Detection of the Mild Myocardial Injury during Percutaneous Coronary Intervention Using Evaluation of Minor Changes on Electrocardiogram and Heart Rate Variability

Abstract

Background As cardiovascular mortality continues to increase globally, Percutaneous Coronary Intervention (PCI) with stent placement stands out as a cutting-edge and highly effective treatment for severe cardiovascular diseases. However, the inherent invasiveness of any endovascular procedure introduces the risk of coronary vessel and myocardial damage. This study aimed to evaluate the utility of a novel electrocardiographic metric for detecting subtle myocardial injuries after coronary stenting. Materials and Methods This investigation was conducted in 2021 at the Kyiv Heart Institute of the Ministry of Healthcare of Ukraine. The study involved 23 patients who underwent PCI, each subject to a meticulous preoperative examination. A paired measurement approach was employed, encompassing 3-minute ECG recordings both before and several hours after the operation, using a compact ECG device. Each pair of electrocardiograms underwent thorough analysis, scrutinizing 240 primary and computed ECG parameters. Results The analysis delineated a distinct subgroup that exhibited significant myocardial damage after stenting. This subgroup was characterized by an older average age and more stents than their counterparts. Notably, a concurrent reduction in the psychoemotional state index was observed alongside ECG alterations in these patients, suggesting a correlation between myocardial damage and psychoemotional distress. Discussion The introduction of a new electrocardiographic index has illuminated the subtle myocardial damage incurred during PCI. The findings of this study underscore the complex interplay between physical cardiac trauma and psychological stress, highlighting the importance of a comprehensive approach to post-PCI patient assessment. Conclusions The newly devised electrocardiographic metric proved to be a significant advancement in the early detection of myocardial damage after PCI. The metric's ability to capture not only physiological but also psychoemotional changes is a pivotal step toward more integrative post-operative patient care, paving the way for enhanced recovery protocols and personalized treatment strategies in interventional cardiology.