PMID- 15673380
OWN - NLM
STAT- MEDLINE
DCOM- 20050428
LR  - 20220409
IS  - 1045-3873 (Print)
IS  - 1045-3873 (Linking)
VI  - 16
IP  - 1
DP  - 2005 Jan
TI  - Traditional and nonlinear heart rate variability are each independently 
      associated with mortality after myocardial infarction.
PG  - 13-20
AB  - INTRODUCTION: Decreased heart rate variability (HRV) and abnormal nonlinear HRV 
      shortly after myocardial infarction (MI) are risk factors for mortality. 
      Traditional HRV predicts mortality in patients with a range of times post-MI, but 
      the association of nonlinear HRV and outcome in this population is unknown. 
      METHODS AND RESULTS: HRV was determined from 740 tapes recorded before 
      antiarrhythmic therapy in Cardiac Arrhythmia Suppression Trial patients with 
      ventricular premature contractions (VPCs) suppressed on the first randomized 
      treatment. Patients were 70 +/- 121 days post-MI. Follow up was 362 +/- 241 days 
      (70 deaths). The association between traditional time and frequency-domain HRV 
      and mortality and nonlinear HRV and mortality were compared for the entire 
      population (ALL), those without coronary artery bypass graft post-MI (no CABG), 
      and those without CABG or diabetes (no CABG, no DIAB) using univariate and 
      multivariate Cox regression analysis. Strength of association was compared by P 
      values and Wald Chi-square values. Nonlinear HRV included short-term fractal 
      scaling exponent, power law slope, and SD12 (Poincare dimension). For ALL and for 
      no CABG, increased daytime SD12 had the strongest association with mortality 
      (P=0.002 ALL and P <0.001 no CABG). For no CABG, no DIAB increased 24-hour SD12 
      hours had the strongest association (P <0.001) with mortality. Upon multivariate 
      analysis, increased SD12, decreased ln ULF (ultra low frequency), and history of 
      prior MI and history of congestive heart failure each remained in the model. 
      CONCLUSION: Nonlinear HRV is associated with mortality post-MI. However, as with 
      traditional HRV, this is diluted by CABG surgery post-MI and by diabetes. Results 
      suggest that decreased long-term HRV and increased randomness of heart rate are 
      each independent risk factors for mortality post-MI.
FAU - Stein, Phyllis K
AU  - Stein PK
AD  - Washington University School of Medicine, St. Louis, Missouri 63108, USA. 
      pstein@im.wustl.edu
FAU - Domitrovich, Peter P
AU  - Domitrovich PP
FAU - Huikuri, Heikki V
AU  - Huikuri HV
FAU - Kleiger, Robert E
AU  - Kleiger RE
CN  - Cast Investigators
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - J Cardiovasc Electrophysiol
JT  - Journal of cardiovascular electrophysiology
JID - 9010756
SB  - IM
CIN - J Cardiovasc Electrophysiol. 2005 Jan;16(1):21-3. PMID: 15673381
MH  - Algorithms
MH  - Arrhythmias, Cardiac/diagnosis/mortality
MH  - Clinical Trials as Topic
MH  - Comorbidity
MH  - Diagnosis, Computer-Assisted/*methods
MH  - Electrocardiography, Ambulatory/*methods
MH  - Female
MH  - *Heart Rate
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Models, Cardiovascular
MH  - Myocardial Infarction/*diagnosis/*mortality
MH  - Nonlinear Dynamics
MH  - Prognosis
MH  - Reproducibility of Results
MH  - Risk Assessment/*methods
MH  - Risk Factors
MH  - Sensitivity and Specificity
MH  - Survival Analysis
MH  - United States/epidemiology
EDAT- 2005/01/28 09:00
MHDA- 2005/04/29 09:00
CRDT- 2005/01/28 09:00
PHST- 2005/01/28 09:00 [pubmed]
PHST- 2005/04/29 09:00 [medline]
PHST- 2005/01/28 09:00 [entrez]
AID - JCE04358 [pii]
AID - 10.1046/j.1540-8167.2005.04358.x [doi]
PST - ppublish
SO  - J Cardiovasc Electrophysiol. 2005 Jan;16(1):13-20. doi: 
      10.1046/j.1540-8167.2005.04358.x.