Predictive values of heart rate variability, deceleration and acceleration capacity of heart rate in post‐infarction patients with LVEF ≥35%

Liu, Xiang; Li, Xiang; Guangming, Tong

doi:10.1111/anec.12771

Cited by 12 publications

(9 citation statements)

References 27 publications

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“…In another study that enrolled 122 elderly patients with AMI, the group with atrial fibrillation (AF) had a shorter SDNN (110.80 ± 21.38 ms vs. 136.49 ± 27.67 ms, P = 0.001) than the group without AF [ 33 ]. However, in another clinical study, it involves 138 patients with AMI and postoperative LVEF of less than 35%, SDNN ( P = 0.018), and HF increased in the nonsudden cardiac arrhythmias (non-SCA) group after AMI compared to those in the SCA group [ 34 ]. These findings are consistent with our trial results relating to cardiac electrical stability.…”

Section: Discussionmentioning

confidence: 99%

Impact of Short-Term Heart Rate Variability in Patients with STEMI Treated by Delayed versus Immediate Stent in Primary Percutaneous Coronary Intervention: A Prospective Cohort Study

Lin

Yang

Guo

et al. 2022

Computational and Mathematical Methods in Medicine

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Objective. Patients with ST-segment elevated myocardial infarction (STEMI) have been treated with the delayed stent strategy to reduce the occurrence of postoperative no-reflow and improve the recovery of postoperative cardiac function. However, the effects of electrocardiac activity and autonomic nerve function after primary percutaneous coronary intervention (pPCI) have been rarely reported. The purpose of this study was to investigate the effects of short-term heart rate variability (HRV) in patients with STEMI treated by immediate stent (IS) and delayed stent (DS) strategy. Methods. A total of 178 patients with STEMI were divided into 124 cases (69.66%) in the IS group and 54 cases (30.34%) in the DS group from July 2019 to September 2021. The mean heart rate, premature ventricular contraction (PVC), left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVED), and HRV indexes were compared between the two groups. Results. In terms of cardiac electrical stability, the number of PVCs, the percentage of PVCs, and the number of paired PVCs in the DS group were lower than those in the IS group. In terms of HRV, high frequency (HF) and standard deviation of all NN (SDNN) intervals were higher in the patients with DS strategy than IS strategy. There were no significant differences in the LVED and LVEF between the two groups. Conclusion. Compared to the IS strategy, the DS strategy in pPCI in patients with STEMI has advantages in postoperative cardiac electrical stability and short-term cardiac autonomic nerve function, with no difference in postoperative short-term cardiac function.

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Section: Discussionmentioning

confidence: 99%

Impact of Short-Term Heart Rate Variability in Patients with STEMI Treated by Delayed versus Immediate Stent in Primary Percutaneous Coronary Intervention: A Prospective Cohort Study

Lin

Yang

Guo

et al. 2022

Computational and Mathematical Methods in Medicine

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“… Bauer et al (2006) demonstrated that a decrease in DC had greater predictive power than SDNN and LVEF and reported that the risk stratification by DC was more useful in patients with LVEF >30% than in those with LVEF ≤30%. Liu et al (2020) recently reported that decreased SDNN, VLF, and DC were independently associated with increased risk of sudden arrhythmic death in post-AMI patients with LVEF ≤35% and that combination of SDNN, VLF, and DC may help identify a high-risk patient group. Lombardi et al (1996) compared HRV and HR dynamics indices between post-AMI patients with and without low LVEF and they observed reduced HRV power in the entire frequency range in patients with low LVEF, suggesting diminished responsiveness of sinus node to autonomic modulatory inputs in these patients.…”

Section: Discussionmentioning

confidence: 99%

Survival Predictors of Heart Rate Variability After Myocardial Infarction With and Without Low Left Ventricular Ejection Fraction

et al. 2021

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BackgroundHeart 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).ObjectiveWe investigated whether the survival predictors of HRV and HR dynamics depend on LVEF after AMI.MethodsWe 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 (α1), non-Gaussianity index (λ25s), and the amplitude of cyclic variation of HR (Acv) were calculated.ResultsThe predictors were categorized into three clusters; DC, SDNN, α1, ULF, VLF, LF, and Acv as Cluster 1, λ25s independently as Cluster 2, and rMSSD, pNN50, and HF as Cluster 3. In univariate analyses, mortality was best predicted by indices belonging to Cluster 1 regardless of LVEF. In multivariate analyses, however, mortality in patients with low LVEF was best predicted by the combinations of Cluster 1 predictors or Cluster 1 and 3 predictors, whereas in patients without low LVEF, it was best predicted by the combinations of Cluster 1 and 2 predictors.ConclusionThe 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.

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“…Consequently, it was estimated that 7‐day ECG monitoring could detect about twice as many abnormal as 24‐h ECG, as indicated by R 7‐day . In a recent study of predictive value of HRV in 138 post‐AMI patients with preserved (≥35%) left ventricular ejection fraction (LVEF), Liu et al (Liu et al, 2020 ) reported that decreased SDNN, VLF, and DC were independently associated with increased risk of sudden arrhythmic death and that combination of SDNN, VLF, and DC may help identify a high‐risk patient group. In an earlier study in 687 post‐AMI patients of ENRICHD cohort (Berkman et al, 2003 ), we also examined the predictive value of combinations of abnormal HRV and HR dynamics indices and found that the combinations of best predictive power of mortality risk differs between patients with reduced (≤35%) and preserved (>35%) LVEF (Hayano et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Enhanced detection of abnormalities in heart rate variability and dynamics by 7‐day continuous ECG monitoring

Hayano

Yuda

2021

Noninvasive Electrocardiol

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Background The analysis of heart rate variability (HRV) and heart rate (HR) dynamics by Holter ECG has been standardized to 24 hs, but longer‐term continuous ECG monitoring has become available in clinical practice. We investigated the effects of long‐term ECG on the assessment of HRV and HR dynamics. Methods Intraweek variations in HRV and HR dynamics were analyzed in 107 outpatients with sinus rhythm. ECG was recorded continuously for 7 days with a flexible, codeless, waterproof sensor attached on the upper chest wall. Data were divided into seven 24‐h segments, and standard time‐ and frequency‐domain HRV and nonlinear HR dynamics indices were computed for each segment. Results The intraweek coefficients of variance of HRV and HR dynamics indices ranged from 2.9% to 26.0% and were smaller for frequency‐domain than for time‐domain indices, and for indices reflecting slower HR fluctuations than faster fluctuations. The indices with large variance often showed transient abnormalities from day to day over 7 days, reducing the positive predictive accuracy of the 24‐h ECG for detecting persistent abnormalities over 7 days. Conversely, 7‐day ECG provided 2.3‐ to 6.5‐fold increase in sensitivity to detect persistent plus transient abnormalities compared with 24‐h ECG. It detected an average of 1.74 to 2.91 times as many abnormal indices as 24‐h ECG. Conclusions Long‐term ECG monitoring increases the accuracy and sensitivity of detecting persistent and transient abnormalities in HRV and HR dynamics and allows discrimination between the two types of abnormalities. Whether this discrimination improves risk stratification deserves further studies.

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Predictive values of heart rate variability, deceleration and acceleration capacity of heart rate in post‐infarction patients with LVEF ≥35%

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 12 publications

References 27 publications

Impact of Short-Term Heart Rate Variability in Patients with STEMI Treated by Delayed versus Immediate Stent in Primary Percutaneous Coronary Intervention: A Prospective Cohort Study

Impact of Short-Term Heart Rate Variability in Patients with STEMI Treated by Delayed versus Immediate Stent in Primary Percutaneous Coronary Intervention: A Prospective Cohort Study

Survival Predictors of Heart Rate Variability After Myocardial Infarction With and Without Low Left Ventricular Ejection Fraction

Enhanced detection of abnormalities in heart rate variability and dynamics by 7‐day continuous ECG monitoring

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