Acute Myocardial Infarction
Conditions
Keywords
noninvasive ventilation, autonomic nervous system
Brief summary
Cardiovascular diseases, especially acute myocardial infarction (AMI), represent the major cause of mortality and morbidity in the world. The myocardial ischemia is often the precipitating cause of pulmonary edema and noninvasive ventilation (NIV) with positive pressure has been used as a therapeutic modality. Objective: to evaluate the effects of NIV on heart rate variability (HRV) and on ventilatory and hemodynamic variables in patients with myocardial infarction. Materials and methods: ten patients with acute myocardial infarction, with Killip I classification, will use continuous positive airway pressure (CPAP) and Bilevel ventilation during 30 minutes, according randomization. Then ventilatory and hemodynamic variables will be registered and electrocardiogram signals will be recorded for posterior analyses of HRV. Data will be collected before, during and after positive pressure ventilation. Statistical Analysis: Data will be compared using One Way Anova Repeated Measures, followed by Tukey test.
Detailed description
The patients will be recruited in Bonsucesso Federal Hospital with diagnosis of myocardial infarction, confirmed by electrocardiogram and cardiac enzymes, between 24 and 72 hours after the event. Participation in the study protocol will be done according to eligibility criteria: The study will be a randomized and crossover clinical trial for evaluation and comparison of heart rate variability and ventilatory and hemodynamics variables during ventilation with CPAP and Bilevel. CPAP will be applied via a facial mask, with expiratory positive airway pressure of 10 cmH2O. Bilevel will be applied via facial mask, with inspiratory positive pressure (IPAP) of 20 cmH2O and expiratory positive airway pressure (EPAP) of 10 cmH2O.
Interventions
DEVICEBILEVEL (Respironics)
Bilevel was delivered by a Bipap® ventilator (Respironics Inc, Murrysville, PA), applied via facial mask, with inspiratory positive pressure (IPAP) of 20 cmH2O and expiratory positive airway pressure (EPAP) of 10 cmH2O.
DEVICEContinuos positive airway pressure (Respironics)
CPAP was delivered by a ventilator (Respironics Inc, Murrysville, PA), applied via a facial mask, with expiratory positive airway pressure of 10 cmH2O.
Sponsors
Centro Universitário Augusto Motta
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
45 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* acute myocardial infarction with Killip I classification, hemodynamic stability, between 24 and 72 hours post event; * agreement to participate in the study, according written informed consent; * 45 to 80 years old age.
Exclusion criteria
* unstable angina; * systolic blood pressure \< 80 mmHg; * patients who presented ST elevation \> 2 mm or with second-degree atrioventricular block; * presence of pacemaker.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| evaluate HRV during NIV after acute myocardial infarction | six months | The study consisted of randomized and crossover clinical trial for evaluation and comparison of heart rate variability and ventilatory and hemodynamics variables during ventilation with CPAP and Bilevel. |
Outcome results
None listed