The Prognostic Correlation of Heart Rate Variability at Diagnosis with Survival of Patients with Hepatocellular Carcinoma

Ciurea, Ana-Maria; Gheonea, Dan Ionuţ; Schenker, Michael; Mehedințeanu, Alina Maria; Târtea, Georgică Costinel; Vere, Cristin Constantin

doi:10.3390/diagnostics11050890

Cited by 7 publications

(6 citation statements)

References 34 publications

(42 reference statements)

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“…Some studies showed an association between a high HRV value and better survival rate in several cancers (e.g. breast, pancreas, prostate) ( 18 – 24 ). However, these studies were heterogeneous, and several had small sample sizes.…”

Section: Introductionmentioning

confidence: 99%

The promising prognostic value of vagal nerve activity at the initial management of ovarian cancer

et al. 2022

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ObjectiveIdentifying new modifiable prognostic markers is important for ovarian cancer (OC). Low parasympathic activity is associated with inflammation, oxidative stress and sympathetic nervous system activation. Previous studies reported that low vagal nerve activity, measured by low heart rate variability (HRV), may predict poor cancer prognosis. We aimed to examine the prognostic value of HRV in OC.MethodsThis bicentric retrospective study included patients diagnosed with serous OC FIGO stage ≥IIB, between January 2015 and August 2019, with electrocardiograms (ECG) available around diagnosis. HRV was measured from ECG using the time domain parameter of standard deviation of all normal-to-normal heartbeat intervals (SDNN). Optimal SDNN cut-off was determined using the Youden index criteria of time-dependent ROC curves. We used multivariate cox proportional hazard models to investigate the association between HRV and overall survival (OS), while adjusting for well-known OC prognostic factors.ResultsThe 202 patients included were 65.7 years-old on average, 93% had stage FIGO IIIC/IV, 56% had complete surgical resection. Median OS was 38.6 months [95%CI:34.4-47.4]. The median SDNN was 11.1ms, with an optimal cut-off of 10ms to predict OS. OS was shorter for patients with low HRV compared to high HRV (26.4 vs 45.1 months; p<0.001). In multivariate analysis, HRV remained an independent prognostic factor with a two-fold higher risk of death among patients with low SDNN compared to those with high SDNN (HR=2.03, 95%CI=1.35-3.06, p<0.001).ConclusionLow HRV, was associated with worse OS in OC patients, supporting previous studies on the prognostic role of HRV in cancer. If replicated in prospective studies, vagal nerve activity may be a new therapeutic target in OC.

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Section: Introductionmentioning

confidence: 99%

The promising prognostic value of vagal nerve activity at the initial management of ovarian cancer

et al. 2022

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“…The SDNN reflects the overall activity of the ANS (Vanderlei et al, 2009;Lombardi and Stein, 2011). Clinical studies have found significant associations between decreased SDNN and elevated levels of inflammatory markers, cancer progression, and reduced survival Frontiers in Physiology frontiersin.org in patients with malignant tumours (Hu et al, 2018;Ciurea et al, 2021;Wang et al, 2021;Wu et al, 2021). This study revealed that SDNN was independently associated with overall survival in ES-SCLC patients, suggesting that SDNN has the potential to serve as a prognostic factor in ES-SCLC patients.…”

Section: Discussionmentioning

confidence: 68%

“…HRV is the variation in duration of successive R-R intervals, and it reflects ANS regulation (Camm et al, 1996;Lombardi and Stein, 2011). Most previous studies have shown that HRV has predictive value in the overall survival of cancer patients; that is, ANS dysfunction (characterized by decreased HRV parameters) may predict shorter survival of cancer patients (Ciurea et al, 2021;Wang et al, 2021;Wu et al, 2022). For example, the HRV parameter "standard deviation of the normal-normal intervals" (SDNN) is independently correlated with overall survival in patients with hepatocellular carcinoma (Ciurea et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

“…Most previous studies have shown that HRV has predictive value in the overall survival of cancer patients; that is, ANS dysfunction (characterized by decreased HRV parameters) may predict shorter survival of cancer patients (Ciurea et al, 2021;Wang et al, 2021;Wu et al, 2022). For example, the HRV parameter "standard deviation of the normal-normal intervals" (SDNN) is independently correlated with overall survival in patients with hepatocellular carcinoma (Ciurea et al, 2021). The HRV indicator "root mean square of successive interval differences" (RMSSD) is an independent prognostic factor in lung cancer patients with brain metastases (Wu et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

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Prognostic role of short-term heart rate variability and deceleration/acceleration capacities of heart rate in extensive-stage small cell lung cancer

Wu,

Guan,

Zhao

et al. 2023

Front. Physiol.

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Background: Prior research suggests that autonomic modulation investigated by heart rate variability (HRV) might act as a novel predictive biomarker for cancer prognosis, such as in breast cancer and pancreatic cancer. It is not clear whether there is a correlation between autonomic modulation and prognosis in patients with extensive-stage small cell lung cancer (ES-SCLC). Therefore, the purpose of the study was to examine the association between short-term HRV, deceleration capacity (DC) and acceleration capacity (AC) of heart rate and overall survival in patients with ES-SCLC.Methods: We recruited 40 patients with ES-SCLC, and 39 were included in the final analysis. A 5-min resting electrocardiogram of patients with ES-SCLC was collected using a microelectrocardiogram recorder to analyse short-term HRV, DC and AC. The following HRV parameters were used: standard deviation of the normal-normal intervals (SDNN) and root mean square of successive interval differences (RMSSD). Overall survival of patients with ES-SCLC was defined as time from the date of electrocardiogram measurement to the date of death or the last follow-up. Follow-up was last performed on 07 June 2023. There was a median follow-up time of 42.2 months.Results: Univariate analysis revealed that the HRV parameter SDNN, as well as DC significantly predicted the overall survival of ES-SCLC patients (all p < 0.05). Multivariate analysis showed that the HRV parameters SDNN (hazard ratio = 5.254, 95% CI: 1.817–15.189, p = 0.002), RMSSD (hazard ratio = 3.024, 95% CI: 1.093–8.372, p = 0.033), as well as DC (hazard ratio = 3.909, 95% CI: 1.353–11.293, p = 0.012) were independent prognostic factors in ES-SCLC patients.Conclusion: Decreased HRV parameters (SDNN, RMSSD) and DC are independently associated with shorter overall survival in ES-SCLC patients. Autonomic nervous system function (assessed based on HRV and DC) may be a new biomarker for evaluating the prognosis of patients with ES-SCLC.

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“…Recent studies have shown that the sympathetic nervous system is involved in many types of cancer [ 21 , 36 , 37 , 38 , 39 ]. This subdivision of the nervous system acts through noradrenaline, which is released by the local sympathetic fibers in the vicinity of or even inside the gastric tumors and through epinephrine released from the adrenal gland [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Sympathetic Nervous Influences Are Negative Prognostic Factors in Stomach Cancer

Petrescu,

Târtea,

Udriștoiu

et al. 2024

Life

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(1) Background: The aim of our study was to assess the involvement of the sympathetic nervous system in the progression of patients with gastric carcinoma by analyzing the sympathetic neuronal fibers and beta 2 adrenoreceptors. (2) Methods: We performed a retrospective study in which we analyzed the clinical, biological, and histological data from a total of 104 patients diagnosed with stomach cancer. (3) Results: After analyzing the immunoreactivity of beta 2 adrenoreceptors, we observed increased values in patients with tumors larger than 5 cm in diameter (p = 0.0371), with a deeper degree of tumor invasion T3–4 (p = 0.0159), invasion in more than two lymph nodes (p = 0.0462), or a TNM stage III–IV. Regarding the survival analysis, better survival rates (65%) were observed for patients with a low value of beta 2 adrenoreceptors (B2A−), compared to B2A (+) patients, in which survival at 3 years of follow-up was only 43%. In addition, the analysis of intra-tumoral sympathetic fibers showed a better survival rate (83%) for patients with a low value of density compared to patients with increased density, in whom the survival rate was only 24%. (4) Conclusions: The findings of this study indicate that patients with stomach cancer have a more unfavorable prognosis when they have a higher density of sympathetic nerve fibers and an increased expression of beta 2 adrenergic receptors inside the tumor.

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The Prognostic Correlation of Heart Rate Variability at Diagnosis with Survival of Patients with Hepatocellular Carcinoma

Cited by 7 publications

References 34 publications

The promising prognostic value of vagal nerve activity at the initial management of ovarian cancer

The promising prognostic value of vagal nerve activity at the initial management of ovarian cancer

Prognostic role of short-term heart rate variability and deceleration/acceleration capacities of heart rate in extensive-stage small cell lung cancer

Sympathetic Nervous Influences Are Negative Prognostic Factors in Stomach Cancer

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