Evolutionary pattern and prognostic importance of heart rate variability during the early phase of acute myocardial infarction
| Autor: | Pavlos Toutouzas, Stephen Campbell, Flavio Studart, Athanassios D. Doulalas, Athanassios Pipilis, Ioannis Rizos, Peter Sleight, Ioannis H. Gialafos, Marcus Flather |
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| Rok vydání: | 2001 |
| Předmět: |
Male
medicine.medical_specialty Myocardial Infarction Risk Assessment Heart Rate Internal medicine Heart rate Humans Medicine Heart rate variability Thrombolytic Therapy Myocardial infarction Aged business.industry Cabg surgery Middle Aged Prognosis medicine.disease Autonomic nervous system Autonomic imbalance Cardiology Female Cardiology and Cardiovascular Medicine Early phase business Risk assessment |
| Zdroj: | International Journal of Cardiology. 77:169-179 |
| ISSN: | 0167-5273 |
| DOI: | 10.1016/s0167-5273(00)00420-4 |
| Popis: | To investigate the evolution of time domain heart rate variability in the early phase of acute myocardial infarction (MI) and assess its prognostic ability.We analysed several measures of heart rate variability (SDNN, SDANN, SDNN index, RMSSD) in 138 patients at days 0, 1 and 5+/-1 after hospital admission for acute MI. Results were correlated with infarct site, clinical variation and clinical outcome (death, MI, PTCA, CABG surgery).Measures of heart rate variability (SDNN, SDANN and SDNN index) declined during the first 24 h after acute MI (P0.01) and increased to admission levels after about 5 days. SDNN values on day 0, 1 and 5 respectively were: 86+/-35, 75+/-28 and 87+/-27 ms. Patients with anterior infarction had lower heart rate variability than patients with inferior infarction on all test days but similar evolution patterns. After 3 years of follow-up there were 12 cardiac deaths (8.7%) and six resuscitated arrests and 33 (24%) new MIs, or revascularisation procedures. The evolutionary pattern of heart rate variability was similar in survivors to those who died although values were generally lower. Mortality was significantly higher in the group with SDNN50 ms at day 1 (P0.01) and 5 (P0.05), but not at day 0.Our findings show that autonomic imbalance, already evident on the day of the acute event, progresses further over the next 24 h and recovers over the next few days. Low heart rate variability as early as 24 h after acute MI may be a useful predictor of cardiac mortality and contribute to the early risk stratification and therapeutic management of patients. |
| Databáze: | OpenAIRE |
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