Short- and long-term assessment of heart rate variability for risk stratification after acute myocardial infarction

Lü, Fei; Copie, Xavier; Malik, Marek; Camm, A. John

doi:10.1016/s0002-9149(97)89199-0

Cited by 152 publications

(95 citation statements)

References 13 publications

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“…26,27 Moreover, HRV markers of vagal-heart rate modulation (HF power and RMSSD) and total R-R variability (SDNN) derived from our sample were within a range that was similar to patients post-myocardial infarction. 28,29 The major finding in the present study is that within the context of impaired HRV there are significant sex-based differences in the association between duration of diabetes and vagal-heart rate modulation and total R-R variability. Among male participants, HF power, RMSSD and SDNN decreased significantly with greater duration of diabetes.…”

Section: Discussionmentioning

confidence: 52%

Sex-based differences in the association between duration of type 2 diabetes and heart rate variability

Nolan

Barry-Bianchi

Mechetiuc

et al. 2009

Diabetes and Vascular Disease Research

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We examined the association between heart rate variability (HRV) and duration of type 2 diabetes among 155 female and 106 male subjects: mean±SD for duration=49.6±65.6 and 57.3±77.1 months, respectively, p=0.38. Among males, duration of diabetes was independently and inversely associated with vagal-heart rate modulation (high frequency (HF) power, 0.15-0.40 Hz, standardised ß = -0.32, p=0.001; root mean square of successive differences between R-R intervals, ß = -0.26, p=0.006) and total R-R variability (standard deviation of normal R-R intervals, ß = -0.36, p=0.001); but not among females (p≥0.80 for each HRV index). In contrast, HF was inversely associated with age of diabetes diagnosis (ß = -0.16, p=0.04) and 10-year absolute risk for coronary heart disease (ß = -0.16, p=0.04) among female subjects. Longitudinal research is needed to establish whether risk factors for early cardiac autonomic impairment differ among men and women with type 2 diabetes. domain measures are obtained by spectral analysis of recurrent cycles of R-R variation within established frequency bandwidths that correspond to sympathetic, vagal and non-neural modulation of the sinus node cycle length. Among individuals with diabetes, decreased HRV is independently associated with impaired lipid and glucose metabolism, as well as incident coronary heart disease (CHD), myocardial infarction and mortality. 2,9,10 With the exception of one investigation, 11 there is consistent evidence that the duration of type 1 and 2 diabetes is inversely associated with HRV measures of total R-R variability and vagal-heart rate modulation. 4,10,[12][13][14][15][16][17][18] Few studies have investigated sex-based differences in factors that potentially influence HRV impairment among patients with Keywords

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Section: Discussionmentioning

confidence: 52%

Sex-based differences in the association between duration of type 2 diabetes and heart rate variability

Nolan

Barry-Bianchi

Mechetiuc

et al. 2009

Diabetes and Vascular Disease Research

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“…Our results also show that PWV, a marker of subclinical atherosclerosis, did not impact on the ethnic difference in cardiac autonomic function. The use of 5 min as opposed to 24 h recordings may also be a limitation, although shortand long-term measures of HRV have been reported to show reasonable agreement [43] and both are predictive of mortality following myocardial infarction [44].…”

Section: Discussionmentioning

confidence: 99%

Indian Asians have poorer cardiovascular autonomic function than Europeans: this is due to greater hyperglycaemia and may contribute to their greater risk of heart disease

Bathula¹,

Hughes²,

Panerai

et al. 2010

Diabetologia

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“…2 Isolated short-term (5-minute) recordings may be of use, but data for their predictive value are scarce and have been derived largely through the post hoc selection of suitable fragments of 24-hour recordings. 3 The aim of this study was to determine the prognostic significance of shortterm recordings of HRV soon after AMI.• • • Subjects were recruited from among patients admitted to coronary care units at 3 hospitals in the United Kingdom between 1998 and 2000. This was a substudy of a double-blind, placebo-controlled comparison of the effect of early (Յ48 hours) and late (at 5 days) angiotensin-converting enzyme (ACE) inhibition with ramipril on short-term HRV.…”

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confidence: 99%

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confidence: 99%

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Prognostic significance of early short-term measurements of heart rate variability following acute myocardial infarction

Steeds

Fletcher

Smith

et al. 2004

The American Journal of Cardiology

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C ardiac autonomic control is profoundly deranged after acute myocardial infarction (AMI), with evidence of impaired vagal control and high levels of sympathetic activity. The extent of this derangement, in particular subnormal vagal activity, can be assessed by the measurement of baroreflex sensitivity and heart rate variability (HRV). There is considerable evidence to show that low levels of these markers of cardiac autonomic control are strongly and independently associated with an adverse prognosis. 1 It is currently widely believed that abnormal cardiac autonomic control after AMI is not merely a consequence of the infarct but actively and deleteriously influences the clinical course of the disease. The predictive value of HRV has been exclusively derived from a 24-hour Holter electrocardiogram, which is slow and expensive to record and analyze. 2 Isolated short-term (5-minute) recordings may be of use, but data for their predictive value are scarce and have been derived largely through the post hoc selection of suitable fragments of 24-hour recordings. 3 The aim of this study was to determine the prognostic significance of shortterm recordings of HRV soon after AMI.• • • Subjects were recruited from among patients admitted to coronary care units at 3 hospitals in the United Kingdom between 1998 and 2000. This was a substudy of a double-blind, placebo-controlled comparison of the effect of early (Յ48 hours) and late (at 5 days) angiotensin-converting enzyme (ACE) inhibition with ramipril on short-term HRV. Data presented in this report are derived from HRV recordings taken before the study drug was administered. Patients were eligible if they presented Յ48 hours of AMI in sinus rhythm. AMI was diagnosed according to criteria of the World Health Organization. 4 Patients were excluded if they had established autonomic dysfunction, had a noncardiac disease likely to influence mortality rate, had a permanent pacemaker, were already treated with ACE inhibitors, or treatment with ACE inhibitors was contraindicated. Patients who were being treated with ␤-adrenoceptor antagonists before admission were eligible for inclusion provided that there was no change to drug dose after admission but before HRV was examined. No patients began taking ␤-adrenoceptor antagonists after admission but before HRV could be examined. All patients were discharged on an ACE inhibitor. All patients gave their written informed consent before entry into the ramipril study, which was approved by the local clinical research ethics committees. The substudy, which did not involve further patient contact, received separate approval.Studies were performed Յ48 hours of admission, with subjects in the semi-supine position after a 2-hour fast and Ն30 minutes of rest in bed. Studies were performed on the admitting ward at the bedside.

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Short- and long-term assessment of heart rate variability for risk stratification after acute myocardial infarction

Cited by 152 publications

References 13 publications

Sex-based differences in the association between duration of type 2 diabetes and heart rate variability

Sex-based differences in the association between duration of type 2 diabetes and heart rate variability

Indian Asians have poorer cardiovascular autonomic function than Europeans: this is due to greater hyperglycaemia and may contribute to their greater risk of heart disease

Prognostic significance of early short-term measurements of heart rate variability following acute myocardial infarction

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