Risk prediction in post-infarction patients with moderately reduced left ventricular ejection fraction by combined assessment of the sympathetic and vagal cardiac autonomic nervous system

Hamm, Wolfgang; Stülpnagel, Lukas von; Vdovin, Nikolay; Schmidt, Georg; Rizas, Konstantinos D.; Bauer, Axel

doi:10.1016/j.ijcard.2017.06.091

Cited by 22 publications

(17 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Cardiac autonomic modulation dysfunction is involved in triggering of sudden cardiac death (La Rovere et al., 1998). The autonomic dysfunction in post‐MI patients usually exhibited sympathetic overactivity and loss of vagal tone (Hamm et al., 2017), in line with what we found in the present study. The loss of physiological function can be assessed by easily attainable holter‐related parameters such as diversified HR variability data, deceleration capacity, heart rate turbulence (turbulence onset and turbulence slope), and DRs.…”

Section: Discussionsupporting

confidence: 92%

“…Also, the development of percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass grafting (CABG) can diminish the associations between the HRV indices and mortality as reported before (Brateanu, 2015). Besides, the median age of SCA (79 years old) was higher than most previous studies (Bauer, Barthel, & Schneider, 2009;Bauer et al, 2006;Hamm et al, 2017).…”

Section: Discussionmentioning

confidence: 94%

“…For the past decades, numerous studies investigated the prognostic values of combined electrophysiological parameters, which were equally worse than that of patients with LVEF ≤ 35% (Bauer, 2017). From ISAR‐Risk study, DC and HRT identifies high‐risk post‐MI patients with LVEF > 30% for sudden cardiac death (SCD) (Bauer, Barthel, & Schneider, 2009), and combined periodic repolarization dynamics (PRD) and deceleration capacity helped identifies high‐risk postinfarction patients which might benefit from prophylactic strategies (Hamm et al., 2017). Severe autonomic failure (SAF), defined as abnormal heart rate turbulence with the presence of abnormal deceleration capacity (DC), was also proved to be associated with mortality risk (Bauer, Barthel, & Muller, 2009).…”

Section: Discussionmentioning

confidence: 99%

“…At present, different proposals based on electrocardiography and combined autonomic markers, such as HR variability, heart rate turbulence, and deceleration capacity are made to identify special subjects at high risks. The combination of severely impaired baroreflex function with abnormal autonomic tone would improve risk prediction (Bauer, Barthel, & Schneider, 2009; Hamm, Stulpnagel, & Vdovin, 2017; Quintana, Storck, & Lindblad, 1997). In the present study, we investigated changes of autonomic parameters and their values as risk predictors for sudden cardiac death in postinfarction patients with LVEF ≥ 35%.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

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

Liu

Guangming

2020

Noninvasive Electrocardiol

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Liu

Guangming

2020

Noninvasive Electrocardiol

View full text Add to dashboard Cite

show abstract

“…For instance, the deceleration capacity (DC) and acceleration capacity (AC) of the heart rate, which were proposed a decade ago, are promising for assessing the ANS activity [10]. ey aim to separately characterize deceleration and acceleration components in HRV, outperforming conventional HRV indices in prediction of mortality and risk stratification of postmyocardial infarction patients [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Preprocessing Unevenly Sampled RR Interval Signals to Enhance Estimation of Heart Rate Deceleration and Acceleration Capacities in Discriminating Chronic Heart Failure Patients from Healthy Controls

Cao

Yang

et al. 2020

Computational and Mathematical Methods in Medicine

View full text Add to dashboard Cite

Objective. The deceleration capacity (DC) and acceleration capacity (AC) of heart rate, which are recently proposed variants to the heart rate variability, are calculated from unevenly sampled RR interval signals using phase-rectified signal averaging. Although uneven sampling of these signals compromises heart rate variability analyses, its effect on DC and AC analyses remains to be addressed. Approach. We assess preprocessing (i.e., interpolation and resampling) of RR interval signals on the diagnostic effect of DC and AC from simulation and clinical data. The simulation analysis synthesizes unevenly sampled RR interval signals with known frequency components to evaluate the preprocessing performance for frequency extraction. The clinical analysis compares the conventional DC and AC calculation with the calculation using preprocessed RR interval signals on 24-hour data acquired from normal subjects and chronic heart failure patients. Main Results. The assessment of frequency components in the RR intervals using wavelet analysis becomes more robust with preprocessing. Moreover, preprocessing improves the diagnostic ability based on DC and AC for chronic heart failure patients, with area under the receiver operating characteristic curve increasing from 0.920 to 0.942 for DC and from 0.818 to 0.923 for AC. Significance. Both the simulation and clinical analyses demonstrate that interpolation and resampling of unevenly sampled RR interval signals improve the performance of DC and AC, enabling the discrimination of CHF patients from healthy controls.

show abstract

Cardiac deceleration capacity is associated with severity of inflammation in COVID-19

Hoppe,

Strüven,

Brunner

et al. 2023

Infection

View full text Add to dashboard Cite

Purpose In this pilot study, we investigated the cardiac autonomic activity of coronavirus disease 2019 (COVID-19)-infected hospitalized patients. COVID-19 is characterized by cough, fever, and dyspnea, which in some severe cases can lead to hypoxia, respiratory failure, and shock. Since breathing disorders and pulmonary diseases are tightly linked to autonomic dysfunction, we analyzed the cardiac autonomic activity by measuring the deceleration capacity (DC) in COVID-19 patients. Methods In 14 adults (4 men and 10 women) with a median age of 63.5 years and positive for SARS-CoV-2 by polymerase chain reaction (PCR) with severe symptoms requiring hospital treatment, a high-resolution digital 30 min electrocardiogram (ECG) in Frank leads configuration was performed in a resting supine position within the first 48 h after hospital admission. DC was assessed using validated software and associated with several markers of inflammation and clinical course. Results The study revealed a significant association between reduced DC (≤ 2.5 ms) and older age (74 years) in COVID-19 patients, compared to those with a higher DC > 2.5 ms (56.5 years). However, the duration of hospitalization was similar for both groups. There was a nonsignificant trend towards a higher maximum viral load in patients with reduced DC. Further, patients with a DC ≤ 2.5 ms showed higher levels of inflammatory markers such as C-reactive protein (CRP) and procalcitonin (PCT), as well as leukocytosis, compared to patients with a DC > 2.5 ms. Also, the COVID-19-severity marker ferritin was significantly elevated in patients with lower DC. Other markers associated with COVID-19, such as lactate dehydrogenase (LDH) and creatine kinase (CK), exhibited comparable levels in both groups. Conclusions Reduced DC (≤ 2.5 ms) was significantly associated with older age, increased inflammatory markers, and elevated ferritin in patients with COVID-19. These findings suggest that DC might serve as a valuable indicator for predicting the risk of severe inflammation in COVID-19 and possibly complications associated with this disease, such as heart failure. Further studies are needed to confirm these observations and clarify the clinical significance of DC in COVID-19 and other infectious diseases.

show abstract

Risk prediction in post-infarction patients with moderately reduced left ventricular ejection fraction by combined assessment of the sympathetic and vagal cardiac autonomic nervous system

Cited by 22 publications

References 25 publications

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

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

Preprocessing Unevenly Sampled RR Interval Signals to Enhance Estimation of Heart Rate Deceleration and Acceleration Capacities in Discriminating Chronic Heart Failure Patients from Healthy Controls

Cardiac deceleration capacity is associated with severity of inflammation in COVID-19

Contact Info

Product

Resources

About