Predicting survival in heart failure case and control subjects by use of fully automated methods for deriving nonlinear and conventional indices of heart rate dynamics.
Predicting survival in heart failure case and control subjects by use of fully automated methods for deriving nonlinear and conventional indices of heart rate dynamics.
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DOI：
10.1161/01.cir.96.3.842
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发表时间：
1997-08
期刊：
影响因子：
37.8
通讯作者：
K. C. Ho;G. Moody;Chung-Kang Peng;J. Mietus;M. Larson;D. Levy;A. Goldberger
中科院分区：
文献类型：
--
作者：
K. C. Ho;G. Moody;Chung-Kang Peng;J. Mietus;M. Larson;D. Levy;A. Goldberger
背景尽管近来对心率变异性（HRV）的量化很感兴趣，但HRV的常规测量和基于非线性动力学的新指标的预后价值并没有被普遍接受。方法和结果我们设计了分析动态心电图记录和测量心率变异性的算法，无需人为干预，使用强大的方法获得时域测量（心率的平均值和SD），频域测量（0.001至0.01 Hz [VLF]、0.01至0.15 Hz [LF]和0.15至0.5 Hz [HF]频带中的功率以及所有这三个频带上的总频谱功率[TP]），以及基于非线性动力学的度量（近似熵[ApEn]，一种复杂性度量，以及去趋势波动分析[DFA]，一种长期相关性度量）。研究人群包括慢性充血性心力衰竭（CHF）病例患者和Frachial Heart研究中性别和年龄匹配的对照受试者。在排除技术上不充分的研究和房颤研究后，我们使用这些算法研究了69名参与者（平均年龄71.7 ± 8.1岁）2小时动态ECG记录的HRV。通过使用单独的考克斯比例风险模型，常规测量标准差（P. 3）不存在。在多变量模型中，校正CHF和SD的诊断后，DFA具有临界预测意义（P= 0.06）。结论：这些结果表明，基于全自动方法的动态心电图记录的HRV分析在基于人群的研究中具有预后价值，非线性HRV指标可能有助于补充传统HRV测量的预后价值。
BACKGROUND Despite much recent interest in quantification of heart rate variability (HRV), the prognostic value of conventional measures of HRV and of newer indices based on nonlinear dynamics is not universally accepted. METHODS AND RESULTS We have designed algorithms for analyzing ambulatory ECG recordings and measuring HRV without human intervention, using robust methods for obtaining time-domain measures (mean and SD of heart rate), frequency-domain measures (power in the bands of 0.001 to 0.01 Hz [VLF], 0.01 to 0.15 Hz [LF], and 0.15 to 0.5 Hz [HF] and total spectral power [TP] over all three of these bands), and measures based on nonlinear dynamics (approximate entropy [ApEn], a measure of complexity, and detrended fluctuation analysis [DFA], a measure of long-term correlations). The study population consisted of chronic congestive heart failure (CHF) case patients and sex- and age-matched control subjects in the Framingham Heart Study. After exclusion of technically inadequate studies and those with atrial fibrillation, we used these algorithms to study HRV in 2-hour ambulatory ECG recordings of 69 participants (mean age, 71.7+/-8.1 years). By use of separate Cox proportional-hazards models, the conventional measures SD (P.3), were not. In multivariable models, DFA was of borderline predictive significance (P=.06) after adjustment for the diagnosis of CHF and SD. CONCLUSIONS These results demonstrate that HRV analysis of ambulatory ECG recordings based on fully automated methods can have prognostic value in a population-based study and that nonlinear HRV indices may contribute prognostic value to complement traditional HRV measures.