Resposta à massagem do seio carotídeo em pacientessubmetidos a coronariografia e sua correlação com a doença coronariana

Abstract

Background: Previous studies have reported that carotid sinus massage responses are associated with advancing age and coronary artery disease. Hypothesis: This study was undertaken to investigate the potential role of carotid sinus hypersensitivity as a marker for the presence of coronary disease in patients who were referred for evaluation of chest pain. Methods and results: The carotid sinus stimulation with simultaneous recording of the electrocardiogram was performed before coronary arteriography in 73 selected consecutive participants (mean age 62±9,07) who were referred for evaluation of chest pain; 43 were menand 30 were women; a history of chest pain was classified using the grading of angina pectoris by the Canadian Cardiovascular Society (mean 1,70). Response studied during carotid sinus massage included change in heart rate. Change in heart rate was defined as maximal change from baseline electrocardiographic RR interval during carotid sinus masage, divided by the baseline RR, times 100. The Scoring Technique for Coronary Artery Stenosis was used to graduete the coronary stenosis (mean 1,55). No participant was in uncompensated congestive heart failure at the time of study. The frequency, magnitude and temporal relationship of heart rate changes after carotid sinus massage were analyzed in relation to angina class, severity, anatomic localization of coronary artery disease and others variables. We found 38participants (52%) with bradycardia; 9 (12,3%) with RR interval more than 3 seconds; 6 (0,08%) with advanced atrioventricular block and 23 (60,5%) had a decrease in heart rate > 10 beats/minute after carotid sinus massage. Conclusion: We did not find one significant relationship between carotid sinus hypersensitivity and angina class, coronary score disease, age and neither the severity of the coronary vessel stenosis; provably due to small size sample. We found a significantrelationship between carotid sinus hypersensitivity and males. The carotid sinus massage induced the fall in heart rate and was correlated with obstruction in the anterior descending coronary artery.