{"title":"时间波动的超短期心率变异性与心房颤动的关系:来自MIMIC-IV的证据","authors":"Xiaodi Tang MD , Yue Wu MD , Xiaofei Zhang MD , Kexin Zhang MS , Ying Xie MD , Yangong Chao MD , Rong He MD, PhD , Ping Zhang MD, PhD","doi":"10.1016/j.hroo.2025.03.006","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Ultra-short-term heart rate variability (usHRV) has been found to be associated with atrial fibrillation (AF); however, research in this area is currently limited.</div></div><div><h3>Objective</h3><div>This study aimed to investigate the association between usHRV metrics and AF.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included 48,416 participants from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. UsHRV time domain and frequency domain metrics were also collected. We examined the connection between usHRV and AF in electrocardiogram samples collected from 08:00 to 18:00, 18:00 to 08:00, and all day to understand the impact of time on the findings. To address the research objectives, we used Cox regression analysis, stratified curve fitting, threshold effect analysis, subgroup analysis, and the assessment of interaction effects.</div></div><div><h3>Results</h3><div>During an average follow-up of 1.88 years, 3611 (7.5%) participants developed AF. UsHRV time domain metrics were unstable in a day, and the HR was more significant in those ≥55 years of age, with a statistically significant interaction. In contrast, the usHRV frequency metrics are more clinically significant and stable. The hazard ratios for the 08:00 to 18:00 samples were 0.79 (95% confidence interval [CI] 0.74–0.84) for log(ratio of low frequency and high frequency), 0.74 (95% CI 0.67–0.80) for log(low-frequency normalized units), and 2.26 (95% CI 1.80–2.84) for log(high-frequency normalized units), respectively.</div></div><div><h3>Conclusion</h3><div>The frequency domain metrics of usHRV exhibit strong stability, surpassing those derived from time domain metrics, and offer improved convenience compared with HRV. This makes them particularly notable for their clinical significance.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 6","pages":"Pages 818-826"},"PeriodicalIF":2.5000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Association between ultra-short-term heart rate variability of time fluctuation and atrial fibrillation: Evidence from MIMIC-IV\",\"authors\":\"Xiaodi Tang MD , Yue Wu MD , Xiaofei Zhang MD , Kexin Zhang MS , Ying Xie MD , Yangong Chao MD , Rong He MD, PhD , Ping Zhang MD, PhD\",\"doi\":\"10.1016/j.hroo.2025.03.006\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Ultra-short-term heart rate variability (usHRV) has been found to be associated with atrial fibrillation (AF); however, research in this area is currently limited.</div></div><div><h3>Objective</h3><div>This study aimed to investigate the association between usHRV metrics and AF.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included 48,416 participants from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. UsHRV time domain and frequency domain metrics were also collected. We examined the connection between usHRV and AF in electrocardiogram samples collected from 08:00 to 18:00, 18:00 to 08:00, and all day to understand the impact of time on the findings. To address the research objectives, we used Cox regression analysis, stratified curve fitting, threshold effect analysis, subgroup analysis, and the assessment of interaction effects.</div></div><div><h3>Results</h3><div>During an average follow-up of 1.88 years, 3611 (7.5%) participants developed AF. UsHRV time domain metrics were unstable in a day, and the HR was more significant in those ≥55 years of age, with a statistically significant interaction. In contrast, the usHRV frequency metrics are more clinically significant and stable. The hazard ratios for the 08:00 to 18:00 samples were 0.79 (95% confidence interval [CI] 0.74–0.84) for log(ratio of low frequency and high frequency), 0.74 (95% CI 0.67–0.80) for log(low-frequency normalized units), and 2.26 (95% CI 1.80–2.84) for log(high-frequency normalized units), respectively.</div></div><div><h3>Conclusion</h3><div>The frequency domain metrics of usHRV exhibit strong stability, surpassing those derived from time domain metrics, and offer improved convenience compared with HRV. This makes them particularly notable for their clinical significance.</div></div>\",\"PeriodicalId\":29772,\"journal\":{\"name\":\"Heart Rhythm O2\",\"volume\":\"6 6\",\"pages\":\"Pages 818-826\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Heart Rhythm O2\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666501825000923\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Heart Rhythm O2","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666501825000923","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
超短期心率变异性(usHRV)已被发现与心房颤动(AF)相关;然而,这方面的研究目前是有限的。目的探讨usHRV指标与af的相关性。方法回顾性队列研究纳入重症监护医学信息市场(MIMIC-IV)数据库中的48,416名受试者。同时采集了UsHRV时域和频域指标。我们检查了08:00 - 18:00、18:00 - 08:00以及全天采集的心电图样本中usHRV和AF之间的联系,以了解时间对结果的影响。为了实现研究目标,我们使用了Cox回归分析、分层曲线拟合、阈值效应分析、亚组分析和相互作用效应评估。结果在平均1.88年的随访期间,3611名(7.5%)参与者发生房颤。UsHRV时域指标在一天内不稳定,HR在年龄≥55岁的人群中更为显著,具有统计学意义上的显著相互作用。相比之下,usHRV频率指标更具临床意义和稳定性。08:00至18:00样本的风险比,log(低频与高频之比)为0.79(95%置信区间[CI] 0.74 - 0.84), log(低频归一化单位)为0.74 (95% CI 0.67-0.80), log(高频归一化单位)为2.26 (95% CI 1.80-2.84)。结论usHRV的频域指标具有较强的稳定性,优于时域指标,且与HRV相比具有更高的方便性。这使得它们的临床意义尤为显著。
Association between ultra-short-term heart rate variability of time fluctuation and atrial fibrillation: Evidence from MIMIC-IV
Background
Ultra-short-term heart rate variability (usHRV) has been found to be associated with atrial fibrillation (AF); however, research in this area is currently limited.
Objective
This study aimed to investigate the association between usHRV metrics and AF.
Methods
This retrospective cohort study included 48,416 participants from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. UsHRV time domain and frequency domain metrics were also collected. We examined the connection between usHRV and AF in electrocardiogram samples collected from 08:00 to 18:00, 18:00 to 08:00, and all day to understand the impact of time on the findings. To address the research objectives, we used Cox regression analysis, stratified curve fitting, threshold effect analysis, subgroup analysis, and the assessment of interaction effects.
Results
During an average follow-up of 1.88 years, 3611 (7.5%) participants developed AF. UsHRV time domain metrics were unstable in a day, and the HR was more significant in those ≥55 years of age, with a statistically significant interaction. In contrast, the usHRV frequency metrics are more clinically significant and stable. The hazard ratios for the 08:00 to 18:00 samples were 0.79 (95% confidence interval [CI] 0.74–0.84) for log(ratio of low frequency and high frequency), 0.74 (95% CI 0.67–0.80) for log(low-frequency normalized units), and 2.26 (95% CI 1.80–2.84) for log(high-frequency normalized units), respectively.
Conclusion
The frequency domain metrics of usHRV exhibit strong stability, surpassing those derived from time domain metrics, and offer improved convenience compared with HRV. This makes them particularly notable for their clinical significance.