Survival Predictors of Heart Rate Variability After Myocardial Infarction With and Without Low Left Ventricular Ejection Fraction.
Survival Predictors of Heart Rate Variability After Myocardial Infarction With and Without Low Left Ventricular Ejection Fraction.
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DOI：
10.3389/fnins.2021.610955
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发表时间：
2021
影响因子：
4.3
通讯作者：
Blumenthal JA
中科院分区：
文献类型：
--
作者：
Hayano J;Ueda N;Kisohara M;Yuda E;Carney RM;Blumenthal JA
心率变异性 (HRV) 和心率 (HR) 动态用于预测急性心肌梗死 (AMI) 后患者的生存概率，但这种关联已在左心室射血分数 (LVEF) 混合水平的患者中建立。我们研究了 AMI 后 HRV 和 HR 动态的生存预测因子是否取决于 LVEF。我们研究了 687 名 AMI 后患者，其中 147 名 LVEF ≤ 35% 和 540 名 LVEF > 35%，其中 23 名 (16%) 和 22 名 (4%) 在 25 个月的随访期间分别死亡。没有人植入心脏复律除颤器。基线 24 小时心电图、标准差 (SDNN)、连续差值均方根 (rMSSD)、正常至正常 R-R 间期连续差值 >50 ms (pNN50) 的百分比、超低 (ULF)、极低 (VLF)、低 (LF) 和高 (HF) 频率功率、减速能力 (DC)、短期缩放指数 (α1)、非高斯指数(λ25s)和HR循环变化幅度(Acv)被计算。预测变量分为三类： DC、SDNN、α1、ULF、VLF、LF 和 Acv 作为聚类 1，λ25s 独立作为聚类 2，rMSSD、pNN50 和 HF 作为聚类 3。在单变量分析中，无论 LVEF 如何，通过属于聚类 1 的指数可以最好地预测死亡率。然而，在多变量分析中，低 LVEF 患者的死亡率最好通过簇 1 预测因子或簇 1 和 3 预测因子的组合来预测，而对于没有低 LVEF 的患者，最好通过簇 1 和 2 预测因子的组合来预测。具有低 LVEF 的 AMI 后患者的死亡风险是通过反映 HRV 或 HR 反应性下降以及心脏副交感功能障碍的指数来预测的，而在没有低 LVEF 的患者中，通过反映 HRV 或 HR 反应性下降的指数和反映提示交感神经受累的突然大幅 HR 变化的指数来预测风险。
Heart rate variability (HRV) and heart rate (HR) dynamics are used to predict the survival probability of patients after acute myocardial infarction (AMI), but the association has been established in patients with mixed levels of left ventricular ejection fraction (LVEF). We investigated whether the survival predictors of HRV and HR dynamics depend on LVEF after AMI. We studied 687 post-AMI patients including 147 with LVEF ≤35% and 540 with LVEF >35%, of which 23 (16%) and 22 (4%) died during the 25 month follow-up period, respectively. None had an implanted cardioverter-defibrillator. From baseline 24 h ECG, the standard deviation (SDNN), root mean square of successive difference (rMSSD), percentage of successive difference >50 ms (pNN50) of normal-to-normal R-R interval, ultra-low (ULF), very-low (VLF), low (LF), and high (HF) frequency power, deceleration capacity (DC), short-term scaling exponent (α1), non-Gaussianity index (λ25s), and the amplitude of cyclic variation of HR (Acv) were calculated. The predictors were categorized into three clusters; DC, SDNN, α1, ULF, VLF, LF, and Acv as Cluster 1, λ25s independently as Cluster 2, and rMSSD, pNN50, and HF as Cluster 3. In univariate analyses, mortality was best predicted by indices belonging to Cluster 1 regardless of LVEF. In multivariate analyses, however, mortality in patients with low LVEF was best predicted by the combinations of Cluster 1 predictors or Cluster 1 and 3 predictors, whereas in patients without low LVEF, it was best predicted by the combinations of Cluster 1 and 2 predictors. The mortality risk in post-AMI patients with low LVEF is predicted by indices reflecting decreased HRV or HR responsiveness and cardiac parasympathetic dysfunction, whereas in patients without low LVEF, the risk is predicted by a combination of indices that reflect decreased HRV or HR responsiveness and indicator that reflects abrupt large HR changes suggesting sympathetic involvement.
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DOI：
10.1093/europace/euw222
发表时间：
2017-08-01
期刊：
Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
影响因子：
--
作者：
Hayano J;Yasuma F;Watanabe E;Carney RM;Stein PK;Blumenthal JA;Arsenos P;Gatzoulis KA;Takahashi H;Ishii H;Kiyono K;Yamamoto Y;Yoshida Y;Yuda E;Kodama I
通讯作者：
Kodama I
影响因子：
4
作者：
Hayano J;Kiyono K;Struzik ZR;Yamamoto Y;Watanabe E;Stein PK;Watkins LL;Blumenthal JA;Carney RM
通讯作者：
Carney RM
影响因子：
4
作者：
Costa MD;Davis RB;Goldberger AL
通讯作者：
Goldberger AL
影响因子：
168.9
作者：
Bauer, Axel;Kantelhardt, Jan W.;Schmidt, Georg
通讯作者：
Schmidt, Georg
影响因子：
2.4
作者：
Kiyono, Ken;Struzik, Zbigniew R.;Yamamoto, Yoshiharu
通讯作者：
Yamamoto, Yoshiharu