The ability of several short-term measures of RR variability to predict mortality after myocardial infarction.

Bigger, J. Thomas; Fleiss, Joseph L.; Rolnitzky, Linda; Steinman, Richard C.

doi:10.1161/01.cir.88.3.927

Cited by 449 publications

(254 citation statements)

References 17 publications

Supporting

Mentioning

234

Contrasting

Unclassified

Order By: Relevance

“…Besides their application in the assessment of cardiovascular autonomic function in diabetic patients, these new measures have been introduced in cardiology for risk stratification after myocardial infarction. Low HRV is associated with mortality risk in post-myocardial infarction patients [6,7] and also in the general population [8,9].…”

mentioning

confidence: 99%

Glucose tolerance and other determinants of cardiovascular autonomic function: the Hoorn Study

et al. 2000

View full text Add to dashboard Cite

Aims/hypothesis. Currently, three categories of measures are used to assess cardiovascular autonomic dysfunction: measures of the Ewing-test, measures of heart-rate variability, and measures of baroreflex sensitivity. We studied the determinants of these measures obtained from cardiovascular autonomic function tests in the Hoorn Study. Methods. The study group (n = 631) consisted of a glucose-tolerance-stratified sample from a 50-to 75-year-old group of people. Cardiac cycle duration (RR interval) and continuous finger arterial pressure were measured under three conditions: during (a) spontaneous breathing, (b) six deep breaths over one minute, and (c) an active change in position from lying to standing. From these readings, ten measures of autonomic function were assessed (three Ewing, six heart-rate variability and one baroreflex sensitivity). As possible determinants we considered age, sex, glucose tolerance, cardiovascular disease, use of anti-hypertensive drugs, anthropometric factors, metabolic factors and lifestyle factors.Results. Multivariate analysis showed that eight of ten cardiovascular autonomic function measures were most strongly associated with glucose tolerance. Furthermore, measures were moderately associated with age, sex, waist-to-hip ratio, use of anti-hypertensive drugs, and insulin. The measures were weakly associated with coronary artery disease but not with lipids. The strongest determinants seemed to differ between subjects with and without diabetes: in the non-diabetic subjects the most strongly associated were age and use of anti-hypertensive drugs and in subjects with diabetes, insulin. No consistent differences in association between the three categories of measures were observed. Conclusion/interpretation. The strongest determinants of autonomic function were age, presence of diabetes and use of anti-hypertensive drugs. [Diabetologia (2000) 43: 561±570]Keywords Aging, baroreflex, Type II diabetes mellitus, cardiovascular disease, glucose intolerance, heart-rate variability, hypertension, lifestyle, autonomic nervous system, obesity. Abbreviations: BRS, Baroreflex sensitivity (ms/mmHg); DM, diabetes mellitus; EI difference, expiration-inspiration difference in RR intervals during breathing at 6/min (ms); HRV, heart-rate variability; HF power, high frequency power in the RR-interval spectrum between 0.12±0.40 Hz (ms 2 ); KDM, known diabetes mellitus; LF power, low frequency power in the RR-interval spectrum between 0.04±0.12 Hz (ms 2 ); LF/ (LF + HF), ratio of low frequency power to the sum of low and high frequency power in the RR-interval spectrum; Mean NN, mean of all sinus rhythm (normal-to-normal) RR intervals (ms); NDM, newly-diagnosed diabetes mellitus; RRmax, maximal change in RR interval after standing up (ms); RRmax/min, maximal RR interval between 15 s and 30 s after standing up divided by the minimal RR interval within 15 s after standing up; SBP difference, systolic blood pressure 1.5±2 min after standing up minus systolic blood pressure in supine position (mm...

show abstract

mentioning

confidence: 99%

Glucose tolerance and other determinants of cardiovascular autonomic function: the Hoorn Study

et al. 2000

View full text Add to dashboard Cite

show abstract

“…Correlation between spectral analysis of 24 h and short-term recordings is good (for most indicators there are given coefficients r > 0.75) (ref. 72 ).…”

Section: Reproducibility Of Hrv Measurementsmentioning

confidence: 99%

“…[72][73][74] ). The sensitivity of combination HRV with other risk factors is in the range of 29-58%, specificity up to 99% (ref.…”

Section: Reproducibility Of Hrv Measurementsmentioning

confidence: 99%

See 1 more Smart Citation

Heart rate variability - current diagnosis of the cardiac autonomic neuropathy. A review

Metelka

2014

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

View full text Add to dashboard Cite

Backround. The autonomic nervous system is one of the major homeostatic regulatory systems of the body. Detection of cardiac autonomic neuropathy (CAN), reflected by reduced heart rate variability (HRV), is an independent adverse prognostic factor: sympathovagal balance failure with a sympathetic dominance is the main trigger for lethal arrhythmias and sudden death. Methods and Results. PubMed database based on original articles from 1983 to 2013 and the author´s clinical experience. This review covers the current status of the methodology and the clinical uses of HRV, especially in the field of internal medicine. Conclusion. Heart rate variability is making a valuable contribution to the diagnosis of cardiovascular autonomic dysfunction and CAN. It can be assessed from short-term and long-term ECG recordings. It is one of the few methods that allow outpatient CAN diagnosis, monitoring the progress, therapeutic effect and evaluation of patient prognosis. It is used as an independent prognostic factor in combination with other recognized risk factors in risk stratifying after myocardial infarction. It is a unique method of CAN diagnosis particularly in diabetology. Its diagnostic and prognostic potential in other medical fields is being intensively explored.

show abstract

“…Mental stress-induced myocardial ischaemia during daily life activities is preceded by a decrease in HF-HRV suggesting parasympathetic withdrawal [13]. In addition, HRV-based indices of autonomic dysregulation are associated with the long-term risk of various cardiovascular disorders, including myocardial infarction and arrhythmias [14,15], although some negative studies have been reported as well (e.g., [16]). A reverse pathway is also well documented, such that myocardial ischaemia results in autonomic dysregulation [17].…”

Section: Introductionmentioning

confidence: 99%

Central nervous system involvement in the autonomic responses to psychological distress

et al. 2012

View full text Add to dashboard Cite

Psychological distress can trigger acute coronary syndromes and sudden cardiac death in vulnerable patients. The primary pathophysiological mechanism that plays a role in stress-induced cardiac events involves the autonomic nervous system, particularly disproportional sympathetic activation and parasympathetic withdrawal. This article describes the relation between psychological distress and autonomic nervous system function, with a focus on subsequent adverse cardiovascular outcomes. The role of the central nervous system in these associations is addressed, and a systematic review is presented of studies examining the association between stress-induced central nervous system responses measured by neuroimaging techniques and autonomic nervous system activation. Results of the systematic review indicate that the primary brain areas involved in the autonomic component of the brain-heart association are the insula, medial prefrontal cortex, and cerebellum (based on 121 participants across three studies that fitted the inclusion criteria). Other areas involved in stress-induced autonomic modulation are the (anterior) cingulate cortex, parietal cortex, somatomotor cortex/precentral gyrus, and temporal cortex. The interaction between central and autonomic nervous system responses may have implications for further investigations of the brain-heart associations and mechanisms by which acute and chronic psychological distress increase the risk of myocardial infarction, cardiac arrhythmias, and sudden cardiac death.

show abstract

The ability of several short-term measures of RR variability to predict mortality after myocardial infarction.

Cited by 449 publications

References 17 publications

Glucose tolerance and other determinants of cardiovascular autonomic function: the Hoorn Study

Glucose tolerance and other determinants of cardiovascular autonomic function: the Hoorn Study

Heart rate variability - current diagnosis of the cardiac autonomic neuropathy. A review

Central nervous system involvement in the autonomic responses to psychological distress

Contact Info

Product

Resources

About