Alterations in heart rate variability are associated with abnormal myocardial perfusion.
Alterations in heart rate variability are associated with abnormal myocardial perfusion.
复制标题
DOI：
10.1016/j.ijcard.2020.01.069
复制
发表时间：
2020-04-15
影响因子：
3.5
通讯作者：
Shah AJ
中科院分区：
文献类型：
--
作者：
Shah AS;Lampert R;Goldberg J;Bremner JD;Li L;Thames MD;Vaccarino V;Shah AJ
自主神经系统的异常可能发生在缺血性心脏病中，但是在早晨，他们的心脏事件的风险并未完全定义。治疗。成像（MPI）。
我们对使用276个中年的退伍军人双胞胎对异常的心肌应力灌注与HRV进行了横断面研究，而没有已知的缺血性心脏病。线性和非线性（多极密度或DYX）HRV指标。腺苷对[13n] - ammonia肌心肌灌注成像，并带有正电子发射断层扫描。
平均年龄为53（3）年，55岁（20％）的灌注异常。 Dyx是4.8（95％CI，1.5-15.8）的优势比（或），对于Dyx <2.0，7 AM或MPI异常的MPI为11.8（95％CI，1.2 - 111.4）。
通过非线性HRV测量的自主功能障碍与MPI的增加或异常相关。
Abnormalities in the autonomic nervous system may occur in ischemic heart disease, but the mechanisms by which they are linked are not fully defined. The risk of cardiac events is increased during morning hours. Studying the contributions of autonomic mechanisms may yield insights into risk stratification and treatment. We hypothesize that autonomic dysfunction, measured by decreased heart rate variability (HRV), associates with abnormal stress myocardial perfusion imaging (MPI). We performed a cross-sectional study of the association between abnormal myocardial stress perfusion with HRV using 276 middle-aged veteran twins without known ischemic heart disease. The primary independent variable was cardiac autonomic regulation measured with 24-hour electrocardiogram (ECG) monitoring, using linear and non-linear (multipole density, or Dyx) HRV metrics. The primary outcome was abnormal perfusion (>5% affected myocardium) during adenosine stress on [13N]-ammonia myocardial perfusion imaging with positron emission tomography. The mean (SD) age was 53 (3) years and 55 (20%) had abnormal perfusion. HRV (by Dyx) was reduced during morning hours in subjects with abnormal perfusion. At 7 AM, each standard deviation (SD) decrease in Dyx was associated a 4.8 (95% CI, 1.5 — 15.8) odds ratio (OR) for abnormal MPI. With Dyx < 2.0, the 7 AM OR for abnormal MPI was 11.8 (95% CI, 1.2 — 111.4). Autonomic dysfunction, measured by non-linear HRV in the morning hours, was associated with an increased OR of abnormal MPI. These results suggest a potentially important role of ECG-based biomarkers in risk stratification for individuals with suspected ischemic heart disease.
登录
查看更多内容
影响因子：
4.8
作者：
Guo, YF;Stein, PK
通讯作者：
Stein, PK
影响因子：
56.9
作者：
AKSELROD, S;GORDON, D;COHEN, RJ
通讯作者：
COHEN, RJ
影响因子：
20.1
作者：
Hayashi M;Shimizu W;Albert CM
通讯作者：
Albert CM
影响因子：
3
作者：
Gimelli, Alessia;Marzullo, Paolo;Rovai, Daniele
通讯作者：
Rovai, Daniele
影响因子：
2.8
作者：
Goldkorn, Ronen;Naimushin, Alexey;Goldenberg, Ilan
通讯作者：
Goldenberg, Ilan