Resting, night-time, and 24 h heart rate as markers of cardiovascular risk in middle-aged and elderly men and women with no apparent heart disease
Resting, night-time, and 24 h heart rate as markers of cardiovascular risk in middle-aged and elderly men and women with no apparent heart disease
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DOI：
10.1093/eurheartj/ehs449
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发表时间：
2013-06-01
影响因子：
39.3
通讯作者：
Sajadieh, Ahmad
中科院分区：
文献类型：
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作者：
Johansen, Christine D.;Olsen, Rasmus H.;Sajadieh, Ahmad
目标 心率 (HR) 增加是全因死亡率和心血管 (CV) 死亡率的预测指标。我们测试了在没有明显心脏病的人群中哪种 HR 测量值具有最强的预后价值。 方法和结果 哥本哈根动态心电图研究纳入了 653 名年龄在 55 岁至 75 岁之间的男性和女性，并接受了 48 小时动态心电图 (ECG) 监测。休息至少 10 分钟后测量静息心率。 24 小时 HR 源自正常与正常 RR 间隔之间的平均时间 (MEANNN)。夜间 HR 源自凌晨 2:00 至 2:15 之间的 15 分钟序列。中位随访时间为 76 个月，不良结局定义为全因死亡率以及心血管死亡、急性心肌梗死 (AMI) 和血运重建的综合终点。所有三项 HR 指标均与全因死亡率显着相关，在调整传统风险因素后也是如此。在根据性别和年龄进行调整的分析中，我们发现 HR 和 CV 事件的所有三种测量值之间存在关联。然而，当调整心血管风险因素时，与静息心率和 24 小时心率的关联消失了。在完全调整的模型中，模型中仅保留夜间 HR，风险比 = 1.17 (1.05 - 1.30)，P = 0.005。 结论 在没有明显心脏病的中年受试者中，所有 HR 增加的测量值均与死亡率和 CV 风险增加相关。然而，夜间心率是经过多变量调整后唯一具有预后重要性的参数。
Aims Increased heart rate (HR) is a predictor of all-cause and cardiovascular (CV) mortality. We tested which measure of HR had the strongest prognostic value in a population with no apparent heart disease.Methods and results Six hundred and fifty-three men and women between the age of 55 and 75 years were included in the Copenhagen Holter Study and underwent 48 h ambulatory electrocardiographic (ECG) monitoring. Resting HR was measured after at least 10 min of rest. Twenty-four-hour HR was derived from the mean time between normal-to-normal RR intervals (MEANNN). Night-time HR was derived from a 15 min sequence between 2:00 and 2:15 a.m. The median follow-up time was 76 months, and an adverse outcome was defined as all-cause mortality and the combined endpoint of CV death, acute myocardial infarction (AMI), and revascularization. All three measures of HR were significantly associated with all-cause mortality, also after adjustment for conventional risk factors. We found an association between all three measures of HR and CV events in analyses adjusted for sex and age. However, when adjusting for CV risk factors, the association with resting HR and 24 h HR disappeared. In a fully adjusted model, only night-time HR remained in the model, hazard ratio = 1.17 (1.05 - 1.30), P = 0.005.Conclusion In middle-aged subjects with no apparent heart disease, all measures of increased HR were associated with increased mortality and CV risk. However, night-time HR was the only parameter with prognostic importance after multivariable adjustment.