Impact of reduced heart rate variability on risk for cardiac events - The Framingham Heart Study
Impact of reduced heart rate variability on risk for cardiac events - The Framingham Heart Study
复制标题
DOI：
10.1161/01.cir.94.11.2850
复制
发表时间：
1996-12-01
期刊：
影响因子：
37.8
通讯作者：
Levy, D
中科院分区：
文献类型：
--
作者：
Tsuji, H;Larson, MG;Levy, D
背景 尽管心率变异性 (HRV) 在多种病理条件下发生改变，但尚未在大型社区人群中研究 HRV 降低与新发心脏事件风险之间的关系。 方法和结果 对弗雷明汉心脏研究中没有临床明显冠心病或充血性心力衰竭的受试者获得的前 2 小时动态心电图记录进行重新处理，以评估 HRV。获得了五个频域测量和三个时域测量。通过比例风险回归分析评估 HRV 测量值与新发心脏事件（心绞痛、心肌梗死、冠心病死亡或充血性心力衰竭）发生率之间的关联。有 2501 名符合条件的受试者，平均年龄为 53 岁。在平均 3.5 年的随访期间，58 名受试者发生了心脏事件。调整年龄、性别、吸烟、糖尿病、左心室肥厚和其他相关危险因素后，除低频与高频功率之比之外的所有 HRV 测量值均与心脏事件风险显着相关（P=.0016 至 .0496）。总正常 RR 间期（自然对数转换）的标准差减少一标准差与新发心脏事件的风险比 1.47 相关（95% 置信区间为 1.16 至 1.86）。结论 通过动态监测对 HRV 的估计提供了超出传统心血管疾病危险因素评估所提供的预后信息。
Background Although heart rate variability (HRV) is altered in a variety of pathological conditions, the association of reduced HRV with risk for new cardiac events has not been studied in a Large community-based population.Methods and Results The first 2 hours of ambulatory ECG recordings obtained on subjects of the Framingham Heart Study who were free of clinically apparent coronary heart disease or congestive heart failure were reprocessed to assess HRV. Five frequency-domain measures and three time-domain measures were obtained. The associations between HRV measures and the incidence of new cardiac events (angina pectoris, myocardial infarction, coronary heart disease death, or congestive heart failure) were assessed with proportional hazards regression analyses. There were 2501 eligible subjects with a mean age of 53 years. During a mean follow-up of 3.5 years, cardiac events occurred in 58 subjects. After adjustment for age, sex, cigarette smoking, diabetes, left ventricular hypertrophy, and other relevant risk factors, all HRV measures except the ratio of low-frequency to high-frequency power were significantly associated with risk for a cardiac event (P=.0016 to .0496). A one-standard deviation decrement in the standard deviation of total normal RR intervals (natural log transformed) was associated with a hazard ratio of 1.47 for new cardiac events (95% confidence interval of 1.16 to 1.86).Conclusions The estimation of HRV by ambulatory monitoring offers prognostic information beyond that provided by the evaluation of traditional cardiovascular disease risk factors.