Very low frequency power of heart rate variability is a powerful predictor of clinical prognosis in patients with congestive heart failure
Very low frequency power of heart rate variability is a powerful predictor of clinical prognosis in patients with congestive heart failure
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DOI：
10.1253/circj.68.343
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发表时间：
2004-04-01
影响因子：
3.3
通讯作者：
Matsubara, H
中科院分区：
文献类型：
--
作者：
Hadase, M;Azuma, A;Matsubara, H
背景 本研究探讨了心率变异性 (HRV) 的极低频 (VLF) 功率是否可以预测充血性心力衰竭 (CHF) 患者的临床预后。 方法和结果 该研究连续招募了 54 名因肺充血恶化而紧急入院的 CHF 患者。肺充血改善后进行动态心电图监测。在频域中计算 HRV 的频率分量（VLF、低频（LF）、高频（HF）、总功率（TP）以及低频与高频功率之比）。计算左心室射血分数，并在出院时测量血浆脑钠肽（BNP）和去甲肾上腺素。在平均 19.8+/-11.7 个月的随访期内，18 名患者经历了心血管事件； 7 名患者死亡，11 名患者因 CHF 恶化而需要再次住院。在单变量分析中，糖尿病 (DM)、BNP 和纽约心脏协会 (NYHA) 功能分级是心脏事件的重要危险因素。 VLF 功率、LF 功率和 TP 是 HRV 中心脏事件的强预测因子。在多变量分析中，VLF 功率独立于 LF 功率、TP、DM、BNP 和 NYHA 功能分级预测心脏事件（卡方= 6.24，p=0.01）。 结论 VLF 功率是 CHF 患者的独立风险预测因子。
Background The present study examined whether the very low frequency (VLF) power of heart rate variability (HRV) is predictive of clinical prognosis in patients with congestive heart failure (CHF).Method and Results The study recruited 54 consecutive CHF patients with emergency admission because of exacerbation of pulmonary congestion. Holter monitoring was performed after improvement of pulmonary congestion. The frequency components of HRV were calculated in the frequency domain (VLF, low frequency (LF), high frequency (HF), total power (TP) and the ratio of LF to HF power). The left ventricular ejection fraction was calculated, and plasma brain natriuretic peptide (BNP) and norepinephrine were also measured at discharge. Within a mean follow-up period of 19.8+/-11.7 months, 18 patients experienced cardiovascular events; 7 patients died and 11 patients required rehospitalization because of worsening of CHF. In univariate analysis, diabetes mellitus (DM), BNP and New York Heart Association (NYHA) functional class were significant as risk factors for cardiac events. VLF power, LF power and TP were the strong predictors for cardiac events in HRV. In multivariate analysis, VLF power predicted cardiac events independently of LF power, TP, DM, BNP and NYHA functional class (chi-square= 6.24, p=0.01).Conclusions VLF power is an independent risk predictor in patients with CHF.