PMID- 30403436
OWN - NLM
STAT- MEDLINE
DCOM- 20200519
LR  - 20210109
IS  - 1542-474X (Electronic)
IS  - 1082-720X (Print)
IS  - 1082-720X (Linking)
VI  - 24
IP  - 3
DP  - 2019 May
TI  - Diurnal variation of frequency domain T-wave alternans on 24-hour ambulatory 
      electrocardiogram in subjects without heart disease: Significant effect of 
      autonomic nervous activity of the heart.
PG  - e12620
LID - 10.1111/anec.12620 [doi]
LID - e12620
AB  - BACKGROUND: T-wave alternans (TWA) is a risk stratification predictor for sudden 
      cardiac death. However, little is known about the diurnal variation of TWA. 
      Whether TWA are affected by heart rate (HR) or cardiac autonomic nervous activity 
      in the subjects without significant structural heart disease in daily life is not 
      fully understood. Thus, this study was aimed to clarify these issues. METHODS: 
      Frequency domain (FD)-TWA analysis was conducted in 47 subjects without 
      significant structural heart disease using 24-hr ambulatory electrocardiogram 
      (AECG). Measurement of heart rate variability (HRV) was performed in order to 
      evaluate the autonomic activity of the heart. The maximum FD-TWA value in each 
      period was measured four times per day (A, 00:00-6:00 hr; B, 06:00-12:00 hr; C, 
      12:00-18:00 hr; D, 18:00-24:00 hr). Correlations between FD-TWA and either HR or 
      HRV parameters (LF/HF, LFnu, HFnu, SDNN, CVNN, pNN50) were analyzed in each 
      period (A-D). RESULTS: There was diurnal variation of FD-TWA (median, 
      inter-quartile range [IQR]: A, 8.2 [6.5, 10.6] muV; B, 10.1 [8.4, 15.0] muV; C, 
      17.6 [12.3, 25.0] muV: D, 11.9 [9.1, 19.9] muV; p < 0.0001). Maximum FD-TWA had 
      positive correlations with HR and LF/HF (HR, r = 0.496, p < 0.0001; LF/HF, 
      r = 0.414, p = 0.004), while FD-TWA had a negative correlation with HFnu 
      (r = -0.291, p = 0.048). On multiple linear regression analysis, HR had an 
      independent effect on log FD-TWA amplitude (beta = 0.461, p = 0.001). CONCLUSIONS: 
      FD-TWA has marked diurnal variation in the daily life of the subjects without 
      significant structural heart disease. This variation could be more strongly 
      affected by HR than the HRV indices.
CI  - (c) 2018 Wiley Periodicals, Inc.
FAU - Hashimoto, Kenichi
AU  - Hashimoto K
AUID- ORCID: 0000-0001-6838-1215
AD  - Department of Intensive Care Medicine, National Defense Medical College, Saitama, 
      Japan.
FAU - Kasamaki, Yuji
AU  - Kasamaki Y
AD  - Department of General Medicine, Kanazawa Medical University Himi Municipal 
      Hospital, Kanazawa, Japan.
FAU - Soma, Masayoshi
AU  - Soma M
AD  - Division of General Medicine, Department of Medicine, Nihon University School of 
      Medicine, Tokyo, Japan.
FAU - Takase, Bonpei
AU  - Takase B
AD  - Department of Intensive Care Medicine, National Defense Medical College, Saitama, 
      Japan.
LA  - eng
PT  - Journal Article
DEP - 20181107
PL  - United States
TA  - Ann Noninvasive Electrocardiol
JT  - Annals of noninvasive electrocardiology : the official journal of the 
      International Society for Holter and Noninvasive Electrocardiology, Inc
JID - 9607443
SB  - IM
MH  - Autonomic Nervous System/*physiopathology
MH  - Cohort Studies
MH  - Death, Sudden, Cardiac/*prevention & control
MH  - Echocardiography, Doppler/*methods
MH  - Electrocardiography/*methods
MH  - Electrocardiography, Ambulatory/*methods
MH  - Female
MH  - Healthy Volunteers
MH  - Heart Rate/physiology
MH  - Humans
MH  - Linear Models
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Retrospective Studies
PMC - PMC6931700
OTO - NOTNLM
OT  - Holter monitoring
OT  - circadian rhythm
OT  - heart rate
OT  - heart rate variability
COIS- The authors declare that they have no conflict of interest.
EDAT- 2018/11/08 06:00
MHDA- 2020/05/20 06:00
PMCR- 2018/11/07
CRDT- 2018/11/08 06:00
PHST- 2018/05/08 00:00 [received]
PHST- 2018/09/09 00:00 [revised]
PHST- 2018/09/18 00:00 [accepted]
PHST- 2018/11/08 06:00 [pubmed]
PHST- 2020/05/20 06:00 [medline]
PHST- 2018/11/08 06:00 [entrez]
PHST- 2018/11/07 00:00 [pmc-release]
AID - ANEC12620 [pii]
AID - 10.1111/anec.12620 [doi]
PST - ppublish
SO  - Ann Noninvasive Electrocardiol. 2019 May;24(3):e12620. doi: 10.1111/anec.12620. 
      Epub 2018 Nov 7.