Survival Predictors of Heart Rate Variability After Myocardial Infarction With and Without Low Left Ventricular Ejection Fraction.
heart rate dynamics
heart rate variability
left ventricular ejection fraction
mortality
myocardial Infarction
redundancy
risk stratification
survival
Journal
Frontiers in neuroscience
ISSN: 1662-4548
Titre abrégé: Front Neurosci
Pays: Switzerland
ID NLM: 101478481
Informations de publication
Date de publication:
2021
2021
Historique:
received:
28
09
2020
accepted:
06
01
2021
entrez:
26
2
2021
pubmed:
27
2
2021
medline:
27
2
2021
Statut:
epublish
Résumé
Heart rate variability (HRV) and heart rate (HR) dynamics are used to predict the survival probability of patients after acute myocardial infarction (AMI), but the association has been established in patients with mixed levels of left ventricular ejection fraction (LVEF). We investigated whether the survival predictors of HRV and HR dynamics depend on LVEF after AMI. We studied 687 post-AMI patients including 147 with LVEF ≤35% and 540 with LVEF >35%, of which 23 (16%) and 22 (4%) died during the 25 month follow-up period, respectively. None had an implanted cardioverter-defibrillator. From baseline 24 h ECG, the standard deviation (SDNN), root mean square of successive difference (rMSSD), percentage of successive difference >50 ms (pNN50) of normal-to-normal R-R interval, ultra-low (ULF), very-low (VLF), low (LF), and high (HF) frequency power, deceleration capacity (DC), short-term scaling exponent (α The predictors were categorized into three clusters; DC, SDNN, α The mortality risk in post-AMI patients with low LVEF is predicted by indices reflecting decreased HRV or HR responsiveness and cardiac parasympathetic dysfunction, whereas in patients without low LVEF, the risk is predicted by a combination of indices that reflect decreased HRV or HR responsiveness and indicator that reflects abrupt large HR changes suggesting sympathetic involvement.
Sections du résumé
BACKGROUND
BACKGROUND
Heart rate variability (HRV) and heart rate (HR) dynamics are used to predict the survival probability of patients after acute myocardial infarction (AMI), but the association has been established in patients with mixed levels of left ventricular ejection fraction (LVEF).
OBJECTIVE
OBJECTIVE
We investigated whether the survival predictors of HRV and HR dynamics depend on LVEF after AMI.
METHODS
METHODS
We studied 687 post-AMI patients including 147 with LVEF ≤35% and 540 with LVEF >35%, of which 23 (16%) and 22 (4%) died during the 25 month follow-up period, respectively. None had an implanted cardioverter-defibrillator. From baseline 24 h ECG, the standard deviation (SDNN), root mean square of successive difference (rMSSD), percentage of successive difference >50 ms (pNN50) of normal-to-normal R-R interval, ultra-low (ULF), very-low (VLF), low (LF), and high (HF) frequency power, deceleration capacity (DC), short-term scaling exponent (α
RESULTS
RESULTS
The predictors were categorized into three clusters; DC, SDNN, α
CONCLUSION
CONCLUSIONS
The mortality risk in post-AMI patients with low LVEF is predicted by indices reflecting decreased HRV or HR responsiveness and cardiac parasympathetic dysfunction, whereas in patients without low LVEF, the risk is predicted by a combination of indices that reflect decreased HRV or HR responsiveness and indicator that reflects abrupt large HR changes suggesting sympathetic involvement.
Identifiants
pubmed: 33633535
doi: 10.3389/fnins.2021.610955
pmc: PMC7901937
doi:
Types de publication
Journal Article
Langues
eng
Pagination
610955Informations de copyright
Copyright © 2021 Hayano, Ueda, Kisohara, Yuda, Carney and Blumenthal.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Références
Front Physiol. 2017 May 09;8:255
pubmed: 28536533
Circulation. 1998 Aug 11;98(6):547-55
pubmed: 9714112
Phys Rev E Stat Nonlin Soft Matter Phys. 2007 Oct;76(4 Pt 1):041113
pubmed: 17994942
J Am Coll Cardiol. 2004 Aug 4;44(3):671-719
pubmed: 15358045
Lancet. 2006 May 20;367(9523):1674-81
pubmed: 16714188
J Cardiovasc Electrophysiol. 2001 Jan;12(1):26-32
pubmed: 11204080
Front Physiol. 2012 Feb 22;3:34
pubmed: 22371705
Front Physiol. 2018 Sep 03;9:1117
pubmed: 30233384
Circulation. 2014 Jun 10;129(23):2426-35
pubmed: 24914016
Front Psychol. 2017 Feb 20;8:213
pubmed: 28265249
Am J Physiol. 1989 Jan;256(1 Pt 2):H142-52
pubmed: 2912176
J Am Coll Cardiol. 1990 Oct;16(4):978-85
pubmed: 2212380
JAMA. 2008 Nov 5;300(17):2022-9
pubmed: 18984889
Am J Physiol. 1996 Oct;271(4 Pt 2):R1078-84
pubmed: 8898003
Lancet. 1984 Jan 21;1(8369):126-31
pubmed: 6140442
JAMA. 2003 Jun 18;289(23):3106-16
pubmed: 12813116
Am J Cardiol. 1996 Jun 15;77(15):1283-8
pubmed: 8677867
J Clin Invest. 1982 Jun;69(6):1286-92
pubmed: 7085875
Circulation. 1996 Aug 1;94(3):432-6
pubmed: 8759085
Arch Intern Med. 1989 Aug;149(8):1785-9
pubmed: 2788396
JAMA. 2006 Feb 15;295(7):809-18
pubmed: 16478904
Am J Cardiol. 1998 Dec 1;82(11):1323-8
pubmed: 9856913
Am J Cardiol. 1987 Feb 1;59(4):256-62
pubmed: 3812275
Circulation. 1996 Mar 1;93(5):1043-65
pubmed: 8598068
Europace. 2017 Aug 1;19(8):1392-1400
pubmed: 27789562
Ann Noninvasive Electrocardiol. 2021 Jan;26(1):e12790
pubmed: 33263196
Chaos. 2007 Mar;17(1):015112
pubmed: 17411269
Front Physiol. 2011 Sep 30;2:65
pubmed: 21994495
Circulation. 2005 Jul 19;112(3):314-9
pubmed: 16009791
Psychophysiology. 1997 Nov;34(6):623-48
pubmed: 9401419
Circulation. 1992 Jan;85(1):164-71
pubmed: 1728446
Phys Rev Lett. 2004 Oct 22;93(17):178103
pubmed: 15525130
Ann Noninvasive Electrocardiol. 2020 Nov;25(6):e12771
pubmed: 32633866
Heart. 2004 Feb;90(2):217-8
pubmed: 14729806
Lancet. 1998 Feb 14;351(9101):478-84
pubmed: 9482439
Circulation. 2020 Mar 3;141(9):e139-e596
pubmed: 31992061
N Engl J Med. 2002 Mar 21;346(12):877-83
pubmed: 11907286
Circulation. 1994 Feb;89(2):548-52
pubmed: 8313542
Circulation. 2000 Jan 4-11;101(1):47-53
pubmed: 10618303
JAMA. 2002 Apr 17;287(15):1943-51
pubmed: 11960536
Chaos. 1995;5(1):82-7
pubmed: 11538314
Clin Physiol. 2001 Sep;21(5):515-23
pubmed: 11576151
Ann Noninvasive Electrocardiol. 2002 Apr;7(2):133-8
pubmed: 12049685
Nat Commun. 2016 May 10;7:11437
pubmed: 27164184
Comput Cardiol. 1988;14:419-22
pubmed: 11542156
N Engl J Med. 2005 Jun 23;352(25):2581-8
pubmed: 15972864
Circ Arrhythm Electrophysiol. 2011 Feb;4(1):64-72
pubmed: 21075771
Heart Rhythm. 2008 Feb;5(2):261-8
pubmed: 18242551