PMID- 18675217
OWN - NLM
STAT- MEDLINE
DCOM- 20081215
LR  - 20161222
IS  - 1556-3871 (Electronic)
IS  - 1547-5271 (Linking)
VI  - 5
IP  - 8
DP  - 2008 Aug
TI  - Heart rate turbulence predicts all-cause mortality and sudden death in congestive 
      heart failure patients.
PG  - 1095-1102
LID - 10.1016/j.hrthm.2008.04.017 [doi]
AB  - BACKGROUND: Abnormal heart rate turbulence (HRT) has been documented as a strong 
      predictor of total mortality and sudden death in postinfarction patients, but 
      data in patients with congestive heart failure (CHF) are limited. OBJECTIVE: The 
      aim of this study was to evaluate the prognostic significance of HRT for 
      predicting mortality in CHF patients in New York Heart Association (NYHA) class 
      II-III. METHODS: In 651 CHF patients with sinus rhythm enrolled into the MUSIC 
      (Muerte Subita en Insuficiencia Cardiaca) study, the standard HRT parameters 
      turbulence onset (TO) and slope (TS), as well as HRT categories, were assessed 
      for predicting total mortality and sudden death. RESULTS: HRT was analyzable in 
      607 patients, mean age 63 years (434 male), 50% of ischemic etiology. During a 
      median follow up of 44 months, 129 patients died, 52 from sudden death. Abnormal 
      TS and HRT category 2 (HRT2) were independently associated with increased 
      all-cause mortality (HR: 2.10, CI: 1.41 to 3.12, P <.001 and HR: 2.52, CI: 1.56 
      to 4.05, P <.001; respectively), sudden death (HR: 2.25, CI: 1.13 to 4.46, P = 
      .021 for HRT2), and death due to heart failure progression (HR: 4.11, CI: 1.84 to 
      9.19, P <.001 for HRT2) after adjustment for clinical covariates in multivariate 
      analysis. The prognostic value of TS for predicting total mortality was similar 
      in various groups dichotomized by age, gender, NYHA class, left ventricular 
      ejection fraction, and CHF etiology. TS was found to be predictive for total 
      mortality only in patients with QRS > 120 ms. CONCLUSION: HRT is a potent risk 
      predictor for both heart failure and arrhythmic death in patients with class II 
      and III CHF.
FAU - Cygankiewicz, Iwona
AU  - Cygankiewicz I
AD  - Catalan Institute of Cardiovascular Sciences, Barcelona, Spain; University of 
      Rochester, Rochester, New York 14642, USA. iwona.cygankiewicz@heart.rochester.edu
FAU - Zareba, Wojciech
AU  - Zareba W
FAU - Vazquez, Rafael
AU  - Vazquez R
FAU - Vallverdu, Montserrat
AU  - Vallverdu M
FAU - Gonzalez-Juanatey, Jose R
AU  - Gonzalez-Juanatey JR
FAU - Valdes, Mariano
AU  - Valdes M
FAU - Almendral, Jesus
AU  - Almendral J
FAU - Cinca, Juan
AU  - Cinca J
FAU - Caminal, Pere
AU  - Caminal P
FAU - de Luna, Antoni Bayes
AU  - de Luna AB
CN  - Muerte Subita en Insuficiencia Cardiaca Investigators
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20080502
PL  - United States
TA  - Heart Rhythm
JT  - Heart rhythm
JID - 101200317
SB  - IM
CIN - Heart Rhythm. 2008 Aug;5(8):1103-4. PMID: 18675218
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Algorithms
MH  - Death, Sudden, Cardiac/epidemiology/*etiology
MH  - Disease Progression
MH  - Female
MH  - Heart Failure/*complications/*mortality/physiopathology
MH  - *Heart Rate
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mortality/trends
MH  - Multivariate Analysis
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Prospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - United States/epidemiology
FIR - de Luna, Antonio Bayes
IR  - de Luna AB
FIR - Cinca, Juan
IR  - Cinca J
FIR - Cygankiewicz, Iwona
IR  - Cygankiewicz I
FIR - Genis, Antonio Bayes
IR  - Genis AB
FIR - Domingo, Maite
IR  - Domingo M
FIR - Noquero, Mariana
IR  - Noquero M
FIR - Vazquez, Rafael
IR  - Vazquez R
FIR - Pastor, Luis
IR  - Pastor L
FIR - Cubero, Jose M
IR  - Cubero JM
FIR - Fernandez, Antonio
IR  - Fernandez A
FIR - del Ojo, Juan Leal
IR  - del Ojo JL
FIR - Pavon, Ricardo
IR  - Pavon R
FIR - Garcia-Medina, Dolores
IR  - Garcia-Medina D
FIR - Valdes, Mariano
IR  - Valdes M
FIR - Pascual, Domingo
IR  - Pascual D
FIR - Ansaldo, Pilar
IR  - Ansaldo P
FIR - Juanatey, Jose R Gonzalez
IR  - Juanatey JR
FIR - Mazon, Pilar
IR  - Mazon P
FIR - Grigorian, Lilian
IR  - Grigorian L
FIR - Otero, Fernando
IR  - Otero F
FIR - Fiol, Miguel
IR  - Fiol M
FIR - Fernandez, Carlos
IR  - Fernandez C
FIR - Almendral, Jesus
IR  - Almendral J
FIR - Dominguez, Marta
IR  - Dominguez M
FIR - Munoz, Roberto
IR  - Munoz R
FIR - Bardaji, Alfredo
IR  - Bardaji A
FIR - de Castro, Ramon
IR  - de Castro R
FIR - Valdovinos, Pilar
IR  - Valdovinos P
FIR - Nieto, Vicente
IR  - Nieto V
FIR - Martinez, Efren
IR  - Martinez E
FIR - Medina, Olga
IR  - Medina O
FIR - Huerta, Ricardo
IR  - Huerta R
EDAT- 2008/08/05 09:00
MHDA- 2008/12/17 09:00
CRDT- 2008/08/05 09:00
PHST- 2008/02/22 00:00 [received]
PHST- 2008/04/25 00:00 [accepted]
PHST- 2008/08/05 09:00 [pubmed]
PHST- 2008/12/17 09:00 [medline]
PHST- 2008/08/05 09:00 [entrez]
AID - S1547-5271(08)00480-3 [pii]
AID - 10.1016/j.hrthm.2008.04.017 [doi]
PST - ppublish
SO  - Heart Rhythm. 2008 Aug;5(8):1095-1102. doi: 10.1016/j.hrthm.2008.04.017. Epub 
      2008 May 2.