Power-Law Relationship of Heart Rate Variability as a Predictor of Mortality in the Elderly

Autor: P. Puukka, L. B. Sourander, K. E. J. Airaksinen, I. J. Raiha, T. H. Makikallio, Heikki V. Huikuri, Tapio Seppänen
Rok vydání: 1998
Předmět:
Zdroj: Circulation. 97:2031-2036
ISSN: 1524-4539
0009-7322
DOI: 10.1161/01.cir.97.20.2031
Popis: Background —The prognostic role of heart rate (HR) variability analyzed from 24-hour ECG recordings in the general population is not well known. We studied whether analysis of 24-hour HR behavior is able to predict mortality in a random population of elderly subjects. Methods and Results —A random sample of 347 subjects of ≥65 years of age (mean, 73±6 years) underwent a comprehensive clinical evaluation, laboratory tests, and 24-hour ECG recordings and were subsequently followed up for 10 years. Various spectral and nonspectral measures of HR variability were analyzed from the baseline 24-hour ECG recordings. Risk factors for all-cause, cardiac, cerebrovascular, cancer, and other causes of death were assessed. By the end of 10-year follow-up, 184 subjects (53%) had died and 163 (47%) were still alive. Seventy-four subjects (21%) had died of cardiac disease, 37 of cancer (11%), 25 of cerebrovascular disease (7%), and 48 (14%) of various other causes. Among all analyzed variables, a steep slope of the power-law regression line of HR variability (P P P =.0002). The slope of HR variability predicted both cardiac (adjusted relative risk, 2.05; P =.0002) and cerebrovascular death (adjusted relative risk, 2.84; P =.0001) but not cancer or other causes of death. Conclusions —Power-law relationship of 24-hour HR variability is a more powerful predictor of death than the traditional risk markers in elderly subjects. Altered long-term behavior of HR implies an increased risk of vascular causes of death rather than being a marker of any disease or frailty leading to death.
Databáze: OpenAIRE
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