BACKGROUND: Autonomic markers, such as heart rate variability (HRV), heart rate turbulence (HRT), and baroreflex sensitivity (BRS) provide information on the risk of all-cause mortality after an acute myocardial infarction (AMI), but their value in predicting nonfatal cardiac events is not well known. METHODS: A consecutive series of 675 patients with an AMI were followed up to 30 months. At baseline, the patients underwent a 24-hour Holter recording, and assessment of BRS using phenylephrine test. Several parameters of HRV and HRT were determined. RESULTS: After the follow-up, 98 patients (15%) had a nonfatal acute coronary event. Among the studied variables, the short-term scaling exponent alpha1 (P = 0.002), power-law slope beta (P = 0.008), low-frequency component of HRV power spectrum (P < 0.001), turbulence slope (P < 0.001), and BRS (P < 0.001) had the strongest association with the occurrence of nonfatal acute coronary events in univariate comparisons. After adjustment with relevant clinical variables (such as age, gender, ejection fraction, functional class, medication, diabetes) in the Cox proportional hazards model, alpha1 and beta remained as statistically significant predictors of nonfatal acute coronary events (HR = 2.0 [1.2-3.2, 95% CIs, P = 0.006] for alpha1 < or = 1.025), (HR = 1.9 [1.2-3.1, P = 0.008] for beta < or =-1.507). CONCLUSION: Several autonomic markers provide information on the risk of recurrent nonfatal coronary events after an AMI. Altered fractal heart rate behavior seems to be the strongest independent predictor of such events.
BACKGROUND: Autonomic markers, such as heart rate variability (HRV), heart rate turbulence (HRT), and baroreflex sensitivity (BRS) provide information on the risk of all-cause mortality after an acute myocardial infarction (AMI), but their value in predicting nonfatal cardiac events is not well known. METHODS: A consecutive series of 675 patients with an AMI were followed up to 30 months. At baseline, the patients underwent a 24-hour Holter recording, and assessment of BRS using phenylephrine test. Several parameters of HRV and HRT were determined. RESULTS: After the follow-up, 98 patients (15%) had a nonfatal acute coronary event. Among the studied variables, the short-term scaling exponent alpha1 (P = 0.002), power-law slope beta (P = 0.008), low-frequency component of HRV power spectrum (P < 0.001), turbulence slope (P < 0.001), and BRS (P < 0.001) had the strongest association with the occurrence of nonfatal acute coronary events in univariate comparisons. After adjustment with relevant clinical variables (such as age, gender, ejection fraction, functional class, medication, diabetes) in the Cox proportional hazards model, alpha1 and beta remained as statistically significant predictors of nonfatal acute coronary events (HR = 2.0 [1.2-3.2, 95% CIs, P = 0.006] for alpha1 < or = 1.025), (HR = 1.9 [1.2-3.1, P = 0.008] for beta < or =-1.507). CONCLUSION: Several autonomic markers provide information on the risk of recurrent nonfatal coronary events after an AMI. Altered fractal heart rate behavior seems to be the strongest independent predictor of such events.
Authors: Mikko P Tulppo; Antti M Kiviniemi; Arto J Hautala; Mika Kallio; Tapio Seppänen; Timo H Mäkikallio; Heikki V Huikuri Journal: Circulation Date: 2005-07-11 Impact factor: 29.690
Authors: H V Huikuri; T Mäkikallio; K E Airaksinen; R Mitrani; A Castellanos; R J Myerburg Journal: J Am Coll Cardiol Date: 1999-12 Impact factor: 24.094
Authors: Timo H Mäkikallio; Petra Barthel; Raphael Schneider; Axel Bauer; Jari M Tapanainen; Mikko P Tulppo; Georg Schmidt; Heikki V Huikuri Journal: Eur Heart J Date: 2005-03-18 Impact factor: 29.983
Authors: John B Williamson; Greg Lewis; Angela J Grippo; Damon Lamb; Emily Harden; Mika Handleman; Jocelyn Lebow; C Sue Carter; Stephen W Porges Journal: Auton Neurosci Date: 2010-05-07 Impact factor: 3.145
Authors: Daniel Périard; Bujar Beqiraj; Daniel Hayoz; Bharathi Viswanathan; Katie Evans; Sally W Thurston; Philip W Davidson; Gary J Myers; Pascal Bovet Journal: Int J Environ Res Public Health Date: 2015-03-23 Impact factor: 3.390