Which heart rate variability index is an independent predictor of mortality in cirrhosis?
| Autor: | Ilias El-Azizi, Ali R. Mani, Sadia Rowshan, Michele De Rui, Piero Amodio, Sara Montagnese, Amar S. Bhogal, Donatella Pavanello |
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| Rok vydání: | 2018 |
| Předmět: |
Liver Cirrhosis
Male medicine.medical_specialty Cirrhosis Survival medicine.medical_treatment Liver transplantation Independent predictor Risk Assessment 03 medical and health sciences Liver disease 0302 clinical medicine Heart Rate Internal medicine Heart rate medicine Heart rate variability Humans MELD Hepatology Gastroenterology business.industry Regression analysis Middle Aged medicine.disease Prognosis Survival Analysis Italy 030220 oncology & carcinogenesis Cardiology Etiology Electrocardiography Ambulatory 030211 gastroenterology & hepatology Female business Liver Failure circulatory and respiratory physiology |
| Zdroj: | Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver. 51(5) |
| ISSN: | 1878-3562 |
| Popis: | Background Liver cirrhosis is associated with reduced heart rate variability (HRV), which indicates impaired integrity of cardiovascular control in this patient population. There are several different indices for HRV quantification. The present study was designed to: 1) determine which of the HRV indices is best at predicting mortality in patients with cirrhosis; 2) verify if such ability to predict mortality is independent of the severity of hepatic failure. Methods Ten minutes electrocardiogram was recorded in 74 patients with cirrhosis. Heart rate fluctuations were quantified using statistical, geometrical and non-linear analysis. The patients were followed-up for 18 months and information was collected on the occurrence of death/liver transplantation. Results During the follow-up period, 24 patients (32%) died or were transplanted for hepatic decompensation. Cox’s regression analysis showed that SDNN (total HRV), cSDNN (corrected SDNN), SD1 (short-term HRV), SD2 (long-terms HRV) and spectral indices could predict survival in these patients. However, only SD2 and cSDNN were shown to be independent of MELD in predicting survival. The prognostic value of HRV indices was independent of age, gender, use of beta blockers, and the aetiology of liver disease. Conclusion Two HRV indices were identified that could predict mortality in patients with cirrhosis, independently of MELD. These indices are potentially useful tools for survival prediction. |
| Databáze: | OpenAIRE |
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