Home Monitoring of Heart Rate as a Predictor of Imminent Cardiovascular Events
Home Monitoring of Heart Rate as a Predictor of Imminent Cardiovascular Events
复制标题
家庭心率监测可预测即将发生的心血管事件
作者：
M. Tulppo;A. Kiviniemi;M. Junttila;H. Huikuri
简介：之前的研究已经证明，心率 (HR) 的日常变异对于一般人群的心血管 (CV) 事件具有预后意义。目前尚不清楚冠状动脉疾病 (CAD) 患者在即将发生心血管事件之前心率动态如何变化。我们的目的是研究最初稳定的 CAD 患者在发生 CV 事件之前心率动态的日常变化。方法：ARTEMIS 研究中 44 名患有血管造影记录的 CAD 患者每周在家测量 R-R 间隔，持续 2 年。家庭测量在受控条件下进行（仰卧和坐位 3 分钟），每周 1-2 次。 11 名患者在入组后 11 ± 7 个月内发生了心血管事件（7 名急性冠状动脉综合征、1 名心源性死亡、2 名新发心律失常需要住院治疗和 1 名中风）。根据家庭测量结果对平均 R-R 间隔进行前瞻性分析。对于发生新的 CV 事件的患者，计算 CV 事件前 8 周内的平均 R-R 间隔的平均值和标准差 (SD)。对于没有新的CV事件的患者，根据新的CV事件发生时的中位随访时间确定相应的时间。结果：在 8 周内分析的平均 R-R 间隔在有和没有新 CV 事件的患者之间没有差异。与没有新发 CV 事件的患者相比，在仰卧位（95 ± 34 vs. 59 ± 26 ms，p < 0.001）和坐位（92 ± 28 vs. 62 ± 24 ms，p < 0.001）时，发生新 CV 事件的患者的平均 R-R 间隔在 8 周内的变异性更大。结论：CAD 患者在新的 CV 事件之前，平均 R-R 间期的每日变异性较大，表明在这些事件之前心脏自主调节更加不稳定。
Introduction: Previous studies have documented that day-to-day variability of heart rate (HR) has prognostic significance for cardiovascular (CV) events in general population. It is unknown how HR dynamics variate before imminent CV event in patients with coronary artery disease (CAD). Our aim was to study day-to-day variation in HR dynamics before the occurrence of CV event in patients with initially stable CAD. Methods: Forty-four patients with angiographically documented CAD from ARTEMIS study measured R-R intervals on a weekly basis at home for 2 years. Home measurements were performed in controlled conditions (3 min at supine and sitting) 1–2 times per week. Eleven patients had a CV event (7 acute coronary syndromes, 1 cardiac death, 2 new onset of arrhythmia needing hospitalization and 1 stroke), which occurred 11 ± 7 months after enrolment. Mean R-R interval was analyzed prospectively from the home measurements. For the patients with new CV event, average, and standard deviation (SD) of the mean R-R interval over 8 weeks preceding the CV event were calculated. For the patients without new CV event, corresponding period was determined by the median follow-up at the occurrence of new CV event. Results: There were no differences in the mean R-R interval analyzed over 8 weeks between the patients with and without new CV event. The variability of mean R-R interval over 8 weeks was greater in the patients with new CV event compared to the patients without new CV event at the supine (95 ± 34 vs. 59 ± 26 ms, p < 0.001) and sitting positions (92 ± 28 vs. 62 ± 24 ms, p < 0.001). Conclusion: Day-to-day variability of mean R-R interval is greater before the new CV event in CAD patients suggesting to a more unstable cardiac autonomic regulation preceding these events.
影响因子：
37.8
作者：
P. V. D. Borne;N. Montano;M. Pagani;R. Oren;V. Somers
通讯作者：
P. V. D. Borne;N. Montano;M. Pagani;R. Oren;V. Somers
影响因子：
37.8
作者：
BIGGER, JT;FLEISS, JL;STEIN, PK
通讯作者：
STEIN, PK