David M MacDonald, Takudzwa Mkorombindo, Sharon X Ling, Selcuk Adabag, Richard Casaburi, John E Connett, Erika S Helgeson, Janos Porszasz, Harry B Rossiter, William W Stringer, Helen Voelker, Dongxing Zhao, Mark T Dransfield, Ken M Kunisaki
{"title":"10秒心电图的心率变异性与慢性阻塞性肺病急性加重的风险：BLOCK慢性阻塞性肺病试验的二次分析。","authors":"David M MacDonald, Takudzwa Mkorombindo, Sharon X Ling, Selcuk Adabag, Richard Casaburi, John E Connett, Erika S Helgeson, Janos Porszasz, Harry B Rossiter, William W Stringer, Helen Voelker, Dongxing Zhao, Mark T Dransfield, Ken M Kunisaki","doi":"10.15326/jcopdf.2021.0264","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Autonomic dysfunction is common in chronic obstructive pulmonary disease (COPD), and worse autonomic function may be a marker of risk for acute exacerbations of COPD (AECOPD). Heart rate variability (HRV) is a measure of autonomic function. Our objective was to test whether lower (worse) HRV is a risk factor for AECOPD.</p><p><strong>Methods: </strong>We measured standard deviation of normal RR intervals (SDNN) and root mean square of successive RR interval differences (RMSSD) on 10-second electrocardiograms (ECGs) performed at screening and day 42 in participants in the Beta Blockers for the Prevention of Acute Exacerbations of COPD trial ( BLOCK-COPD), a placebo-controlled trial of metoprolol for prevention of AECOPD. We used Cox-proportional hazards models to test if these HRV measures were associated with risk of any AECOPD, and separately, hospitalized AECOPD. We tested associations using baseline HRV measures and incorporating HRV measures from day 42 as a time-varying covariate. We also tested for interactions with metoprolol assignment.</p><p><strong>Results: </strong>Of 532 trial participants, 529 (forced expiratory volume in 1 second [FEV<sub>1</sub> ]41 ± 16.3 % predicted) were included in this analysis. We did not find a significant association between HRV measures and risk of AECOPD when all participants were analyzed together. There was a significant interaction between RMSSD and assignment to metoprolol on time to first hospitalized AECOPD; in the placebo group greater RMSSD was associated with a lower risk of hospitalized AECOPD (adjusted hazard ratio0.71, 95% confidence interval: 0.52 to 0.96, per 10 ms increase) but there was no association in the metoprolol group.</p><p><strong>Conclusions: </strong>Autonomic dysfunction as measured by HRV may be a risk factor for AECOPD. Future studies should analyze longer HRV recordings and their performance in broader samples of people with COPD, including those on beta-blockers.</p>","PeriodicalId":13385,"journal":{"name":"Indogermanische Forschungen","volume":"5 1","pages":"226-236"},"PeriodicalIF":0.1000,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9166329/pdf/","citationCount":"0","resultStr":"{\"title\":\"Heart Rate Variability on 10-Second Electrocardiogram and Risk of Acute Exacerbation of COPD: A Secondary Analysis of the BLOCK COPD Trial.\",\"authors\":\"David M MacDonald, Takudzwa Mkorombindo, Sharon X Ling, Selcuk Adabag, Richard Casaburi, John E Connett, Erika S Helgeson, Janos Porszasz, Harry B Rossiter, William W Stringer, Helen Voelker, Dongxing Zhao, Mark T Dransfield, Ken M Kunisaki\",\"doi\":\"10.15326/jcopdf.2021.0264\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Autonomic dysfunction is common in chronic obstructive pulmonary disease (COPD), and worse autonomic function may be a marker of risk for acute exacerbations of COPD (AECOPD). Heart rate variability (HRV) is a measure of autonomic function. Our objective was to test whether lower (worse) HRV is a risk factor for AECOPD.</p><p><strong>Methods: </strong>We measured standard deviation of normal RR intervals (SDNN) and root mean square of successive RR interval differences (RMSSD) on 10-second electrocardiograms (ECGs) performed at screening and day 42 in participants in the Beta Blockers for the Prevention of Acute Exacerbations of COPD trial ( BLOCK-COPD), a placebo-controlled trial of metoprolol for prevention of AECOPD. We used Cox-proportional hazards models to test if these HRV measures were associated with risk of any AECOPD, and separately, hospitalized AECOPD. We tested associations using baseline HRV measures and incorporating HRV measures from day 42 as a time-varying covariate. We also tested for interactions with metoprolol assignment.</p><p><strong>Results: </strong>Of 532 trial participants, 529 (forced expiratory volume in 1 second [FEV<sub>1</sub> ]41 ± 16.3 % predicted) were included in this analysis. We did not find a significant association between HRV measures and risk of AECOPD when all participants were analyzed together. There was a significant interaction between RMSSD and assignment to metoprolol on time to first hospitalized AECOPD; in the placebo group greater RMSSD was associated with a lower risk of hospitalized AECOPD (adjusted hazard ratio0.71, 95% confidence interval: 0.52 to 0.96, per 10 ms increase) but there was no association in the metoprolol group.</p><p><strong>Conclusions: </strong>Autonomic dysfunction as measured by HRV may be a risk factor for AECOPD. Future studies should analyze longer HRV recordings and their performance in broader samples of people with COPD, including those on beta-blockers.</p>\",\"PeriodicalId\":13385,\"journal\":{\"name\":\"Indogermanische Forschungen\",\"volume\":\"5 1\",\"pages\":\"226-236\"},\"PeriodicalIF\":0.1000,\"publicationDate\":\"2022-04-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9166329/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Indogermanische Forschungen\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.15326/jcopdf.2021.0264\",\"RegionNum\":3,\"RegionCategory\":\"文学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"0\",\"JCRName\":\"LANGUAGE & LINGUISTICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indogermanische Forschungen","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.15326/jcopdf.2021.0264","RegionNum":3,"RegionCategory":"文学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"0","JCRName":"LANGUAGE & LINGUISTICS","Score":null,"Total":0}
Heart Rate Variability on 10-Second Electrocardiogram and Risk of Acute Exacerbation of COPD: A Secondary Analysis of the BLOCK COPD Trial.
Introduction: Autonomic dysfunction is common in chronic obstructive pulmonary disease (COPD), and worse autonomic function may be a marker of risk for acute exacerbations of COPD (AECOPD). Heart rate variability (HRV) is a measure of autonomic function. Our objective was to test whether lower (worse) HRV is a risk factor for AECOPD.
Methods: We measured standard deviation of normal RR intervals (SDNN) and root mean square of successive RR interval differences (RMSSD) on 10-second electrocardiograms (ECGs) performed at screening and day 42 in participants in the Beta Blockers for the Prevention of Acute Exacerbations of COPD trial ( BLOCK-COPD), a placebo-controlled trial of metoprolol for prevention of AECOPD. We used Cox-proportional hazards models to test if these HRV measures were associated with risk of any AECOPD, and separately, hospitalized AECOPD. We tested associations using baseline HRV measures and incorporating HRV measures from day 42 as a time-varying covariate. We also tested for interactions with metoprolol assignment.
Results: Of 532 trial participants, 529 (forced expiratory volume in 1 second [FEV1 ]41 ± 16.3 % predicted) were included in this analysis. We did not find a significant association between HRV measures and risk of AECOPD when all participants were analyzed together. There was a significant interaction between RMSSD and assignment to metoprolol on time to first hospitalized AECOPD; in the placebo group greater RMSSD was associated with a lower risk of hospitalized AECOPD (adjusted hazard ratio0.71, 95% confidence interval: 0.52 to 0.96, per 10 ms increase) but there was no association in the metoprolol group.
Conclusions: Autonomic dysfunction as measured by HRV may be a risk factor for AECOPD. Future studies should analyze longer HRV recordings and their performance in broader samples of people with COPD, including those on beta-blockers.
期刊介绍：
Indogermanische Forschungen publishes contributions (essays and reviews) mainly in the areas of historical-comparative linguistics, historical linguistics, typology and characteristics of the languages of the Indogermanic language family. Essays on general linguistics and non-Indogermanic languages are also featured, provided that they coincide with the main focus of the journal with respect to methods and language history.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
