Prognostic value of heart rate variability in acute coronary syndrome.

Q3 Pharmacology, Toxicology and Pharmaceutics
Smitha Pernaje Seetharam, Vinutha Shankar Ms, Kaviraja Udupa, Raveesha A, Niranjan Reddy
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引用次数: 2

Abstract

Objectives: To assess the predictive value of pre-discharge heart rate variability (HRV) parameters in patients with acute coronary syndrome (ACS) treated by percutaneous coronary intervention (PCI).

Methods: 145 consecutive male patients with ACS (aged 57.12 ± 10.81 years) were included in this study. Fifteen minutes electrocardiogram recording was done to measure time-domain [standard deviation of N-N intervals (SDNN), root-mean square differences of successive R-R intervals (rMSSD)] and frequency-domain [low-frequency (LF) power, high-frequency (HF) power and total power (TP)] HRV parameters before and after PCI. The primary end point was the occurrence of major clinical events (MCE) defined as death, sudden death or re-acute myocardial infarction at the end of 3 months follow-up.

Results: At a follow-up of 3 months, MCE occurred in 06 patients (4.14%) (Cardiac death was 3.01%, while that of sudden death was 1.13%). Out of six-MCE, four deaths and two re-AMIs occurred. Pre-discharge HRV values (SDNN, rMSSD, TP, LF and HF) were significantly lower in patients with ACS without MCE. Only total power HRV index (AUC=0.748; p=0.040) showed greater prognostic accuracy.

Conclusions: In conclusion, study showed an increase in SDNN, rMSSD, LF, HF and TP after successful revascularization with PCI in patients who had MCE. The resultant sensitivity, specificity of HRV is still limited in the present study. Particularly, its sensitivity is higher (33-83%) with a modest specificity (61-72%).

心率变异性对急性冠状动脉综合征的预后价值。
目的:探讨出院前心率变异性(HRV)参数对经皮冠状动脉介入治疗(PCI)急性冠脉综合征(ACS)患者的预测价值。方法:145例连续男性ACS患者(年龄57.12±10.81岁)作为研究对象。进行15分钟的心电图记录,测量PCI前后的时域[N-N区间标准差(SDNN)、连续R-R区间均方根差(rMSSD)]和频域[低频(LF)功率、高频(HF)功率和总功率(TP)] HRV参数。主要终点为随访3个月时主要临床事件(MCE)的发生,MCE定义为死亡、猝死或再急性心肌梗死。结果:随访3个月,MCE发生06例(4.14%),其中心源性死亡3.01%,猝死1.13%。在6个特派团中,有4人死亡,2人再次被杀害。无MCE的ACS患者出院前HRV值(SDNN、rMSSD、TP、LF和HF)显著降低。仅总功率HRV指数(AUC=0.748;P =0.040)显示更高的预后准确性。结论:研究表明,MCE患者行PCI血运重建术成功后,SDNN、rMSSD、LF、HF和TP均增加。在目前的研究中,HRV的敏感性和特异性仍然有限。其敏感性较高(33-83%),特异度适中(61-72%)。
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来源期刊
Journal of Basic and Clinical Physiology and Pharmacology
Journal of Basic and Clinical Physiology and Pharmacology Pharmacology, Toxicology and Pharmaceutics-Pharmacology
CiteScore
3.90
自引率
0.00%
发文量
53
期刊介绍: The Journal of Basic and Clinical Physiology and Pharmacology (JBCPP) is a peer-reviewed bi-monthly published journal in experimental medicine. JBCPP publishes novel research in the physiological and pharmacological sciences, including brain research; cardiovascular-pulmonary interactions; exercise; thermal control; haematology; immune response; inflammation; metabolism; oxidative stress; and phytotherapy. As the borders between physiology, pharmacology and biochemistry become increasingly blurred, we also welcome papers using cutting-edge techniques in cellular and/or molecular biology to link descriptive or behavioral studies with cellular and molecular mechanisms underlying the integrative processes. Topics: Behavior and Neuroprotection, Reproduction, Genotoxicity and Cytotoxicity, Vascular Conditions, Cardiovascular Function, Cardiovascular-Pulmonary Interactions, Oxidative Stress, Metabolism, Immune Response, Hematological Profile, Inflammation, Infection, Phytotherapy.
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