Improvement of Risk-stratification by Use of a New Combination of Holter Variables in Survivors of Myocardial Infarction

Vittrup, Axel; Johansen, Allan; Møller, Mogens; Mickley, Hans

doi:10.1080/140174302320774483

Cited by 4 publications

(1 citation statement)

References 16 publications

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“…The addition of other variables such as heart rate variability and the detection of ventricular tachycardia to silent ischemia to create a combined index of abnormal ambulatory ECG responses can improve the sensitivity and predictive value of the test. 37 However, for patients in the convalescent phase of MI, the value of ambulatory ECG as an additional noninvasive method of risk stratification is limited to those who cannot exercise. For the majority of patients who are discharged after infarction and who are able to exercise, silent ischemia on ambulatory monitoring does not add incremental information to that gleaned from clinical assessment and exercise testing concerning the risk of acute events.…”

Section: Patients Who Have Had MImentioning

confidence: 99%

Silent Myocardial Ischemia

2003

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Section: Patients Who Have Had MImentioning

confidence: 99%

Silent Myocardial Ischemia

2003

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Sportmedizinische Aspekte kardialer Risikostratifizierung

Banzer

Lucki

Bürklein

et al. 2006

Herzschr. Elektrophys.

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The present study investigates the association of the predicted CHD-risk (PROCAM) with the individual endurance capacity and heart rate variability (HRV) in a population-based sample of sedentary elderly. After stratification, in 57 men (48.1+/-9.5 yrs.) with an overall PROCAM-risk <10% (28.7+/-10.9 points) and 22 men (54.5+/-7.7 yrs.) with a coronary 10-year risk > or =10% (50.8+/-5.6 points) cycle ergometries and short-term HRV analysis of time (RRMEAN, SDNN, RMSSD) and frequency domain parameters (LF, HF, TP, LF/HF) were conducted. Additionally the autonomic stress index (SI) was calculated. Nonparametric tests were used for statistical correlation analysis (Spearman rho) and group comparisons (Mann-Whitney). For endurance capacity [W/kg] (r=-0.469, p<0.001), SDNN (r=-0.302, p<0.05), RMSSD (r= -0.311, p<0.05), LF (r=-0.325, p<0.05), HF (r= -0.311, p<0.05) and TP (r= -0.307, p<0.05) negative monotone correlations with the coronary score-risk were determined. Significant positive correlations were calculated for SI (r=0.476, p<0.001). Except for RRMEAN and LF/HF significant group differences (p<0.05) were computed for SDNN (30.0+/-20.0 vs 20.0+/-10.0 ms), RMSSD (22.2+/-18.3 vs 18.0+/-8.7 ms), LF (90.9+/-241.5 vs 41.35+/-81.1 ms(2)), HF (43.0+/-105.1 vs 18.0+/-27.0 ms(2)) and TP (189.0+/-457.1 vs 100.0+/-157.6 ms(2)). Significant differences (p<0.01) were evaluated for exercise capacity (2.4+/-0.5 vs 1.8+/-0.3 W/kg) and SI (90+/-183 vs 322+/-291). The results underline the predictive value of HRV analysis in risk stratification and outline the interrelation of a decreased exercise capacity and autonomic function with a raised individual 10-year cardiac risk. As an independent parameter of the vegetative regulatory state the stress index may contribute to an increased practical relevance of short-time HRV analysis.

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