Time domain heart rate variability as a predictor of long-term prognosis after acute myocardial infarction

Ping-Yen Liu, Wei-Chuan Tsai, Li Jen Lin, Yi-Heng Li, Ting-Hsing Chao, Liang-Miin Tsai, Jyh Hong Chen

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15 Citations (Scopus)

Abstract

Background and Purpose: Decreased heart rate variability (HRV) has been shown to be a predictor of both sudden cardiac death and cardiovascular death among patients surviving acute myocardial (MI). However, the prognostic significance of time domain HRV in patients with MI is still controversial. In addiction to the mean of all normal-to-normal (NN) intervals, we analyzed the prognostic significance of the 5 most widely used time domain parameters of HRV during long-term follow-up in patients surviving their first MI. Methods: Five time domain measure HRV from 24-hours ECG were obtained after discharge in 260 consecutive patients (207 males; mean age, 60 years) surviving their first MI. These parameters included: standard deviation of all NN intervals, mean of standard deviations of all NN intervals in all-minute segments (SDNNi), standard deviation of the average of all NN intervals in all 5-minute segments, the square root of the mean of the sum of the squares of differences between adjacent NN intervals, and percentage of difference between adjacent NN intervals > 50 ms. Results: The study endpoint was cardiovascular death. After follow-up for 67 months (range, 1 to 114 months), there were 55 cardiovascular deaths (21%) uncluding 39 sudden deaths (15%). Multivariate Cox regression analysis showed that SDNNi <30) ms was a significant predictor of cardiovascular death (hazard ratio, 4.98; 95% confidence interval [CI], 2.03 to 12.21; p < 0.001 as was number of ventricular premature complexes ≥10 beats / hour (hazard ratio, 5.35; 95% CI, 2.26 to 12.62; p < 0.001), age ≥70 years (hazard ratio, 3.65: 95% CI, 1.44 to 9.23: p = 0.006, and left ventricular ejection fraction < 45% (hazard ratio, 3.29%; 95 CI, 1.13 to 9.57; p = 0.03). SDNNi < 30 ms was also an important predictor of sudden cardiac death (hazard ratio, 5.02; 95% CI, 1.49 to 16.85; p = 0.009). Conclusions: These data suggest that SDNNi is a significant time domain parameter of HRV for long prognosis in post-MI patients.

Original languageEnglish
Pages (from-to)474-479
Number of pages6
JournalJournal of the Formosan Medical Association
Volume102
Issue number7
Publication statusPublished - 2003 Jul

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Heart Rate
Myocardial Infarction
Confidence Intervals
Sudden Cardiac Death
Ventricular Premature Complexes
Sudden Death
Stroke Volume
Electrocardiography
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

@article{224530e0778a41ac91f3257afd3377c2,
title = "Time domain heart rate variability as a predictor of long-term prognosis after acute myocardial infarction",
abstract = "Background and Purpose: Decreased heart rate variability (HRV) has been shown to be a predictor of both sudden cardiac death and cardiovascular death among patients surviving acute myocardial (MI). However, the prognostic significance of time domain HRV in patients with MI is still controversial. In addiction to the mean of all normal-to-normal (NN) intervals, we analyzed the prognostic significance of the 5 most widely used time domain parameters of HRV during long-term follow-up in patients surviving their first MI. Methods: Five time domain measure HRV from 24-hours ECG were obtained after discharge in 260 consecutive patients (207 males; mean age, 60 years) surviving their first MI. These parameters included: standard deviation of all NN intervals, mean of standard deviations of all NN intervals in all-minute segments (SDNNi), standard deviation of the average of all NN intervals in all 5-minute segments, the square root of the mean of the sum of the squares of differences between adjacent NN intervals, and percentage of difference between adjacent NN intervals > 50 ms. Results: The study endpoint was cardiovascular death. After follow-up for 67 months (range, 1 to 114 months), there were 55 cardiovascular deaths (21{\%}) uncluding 39 sudden deaths (15{\%}). Multivariate Cox regression analysis showed that SDNNi <30) ms was a significant predictor of cardiovascular death (hazard ratio, 4.98; 95{\%} confidence interval [CI], 2.03 to 12.21; p < 0.001 as was number of ventricular premature complexes ≥10 beats / hour (hazard ratio, 5.35; 95{\%} CI, 2.26 to 12.62; p < 0.001), age ≥70 years (hazard ratio, 3.65: 95{\%} CI, 1.44 to 9.23: p = 0.006, and left ventricular ejection fraction < 45{\%} (hazard ratio, 3.29{\%}; 95 CI, 1.13 to 9.57; p = 0.03). SDNNi < 30 ms was also an important predictor of sudden cardiac death (hazard ratio, 5.02; 95{\%} CI, 1.49 to 16.85; p = 0.009). Conclusions: These data suggest that SDNNi is a significant time domain parameter of HRV for long prognosis in post-MI patients.",
author = "Ping-Yen Liu and Wei-Chuan Tsai and Lin, {Li Jen} and Yi-Heng Li and Ting-Hsing Chao and Liang-Miin Tsai and Chen, {Jyh Hong}",
year = "2003",
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language = "English",
volume = "102",
pages = "474--479",
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issn = "0929-6646",
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}

Time domain heart rate variability as a predictor of long-term prognosis after acute myocardial infarction. / Liu, Ping-Yen; Tsai, Wei-Chuan; Lin, Li Jen; Li, Yi-Heng; Chao, Ting-Hsing; Tsai, Liang-Miin; Chen, Jyh Hong.

In: Journal of the Formosan Medical Association, Vol. 102, No. 7, 07.2003, p. 474-479.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Time domain heart rate variability as a predictor of long-term prognosis after acute myocardial infarction

AU - Liu, Ping-Yen

AU - Tsai, Wei-Chuan

AU - Lin, Li Jen

AU - Li, Yi-Heng

AU - Chao, Ting-Hsing

AU - Tsai, Liang-Miin

AU - Chen, Jyh Hong

PY - 2003/7

Y1 - 2003/7

N2 - Background and Purpose: Decreased heart rate variability (HRV) has been shown to be a predictor of both sudden cardiac death and cardiovascular death among patients surviving acute myocardial (MI). However, the prognostic significance of time domain HRV in patients with MI is still controversial. In addiction to the mean of all normal-to-normal (NN) intervals, we analyzed the prognostic significance of the 5 most widely used time domain parameters of HRV during long-term follow-up in patients surviving their first MI. Methods: Five time domain measure HRV from 24-hours ECG were obtained after discharge in 260 consecutive patients (207 males; mean age, 60 years) surviving their first MI. These parameters included: standard deviation of all NN intervals, mean of standard deviations of all NN intervals in all-minute segments (SDNNi), standard deviation of the average of all NN intervals in all 5-minute segments, the square root of the mean of the sum of the squares of differences between adjacent NN intervals, and percentage of difference between adjacent NN intervals > 50 ms. Results: The study endpoint was cardiovascular death. After follow-up for 67 months (range, 1 to 114 months), there were 55 cardiovascular deaths (21%) uncluding 39 sudden deaths (15%). Multivariate Cox regression analysis showed that SDNNi <30) ms was a significant predictor of cardiovascular death (hazard ratio, 4.98; 95% confidence interval [CI], 2.03 to 12.21; p < 0.001 as was number of ventricular premature complexes ≥10 beats / hour (hazard ratio, 5.35; 95% CI, 2.26 to 12.62; p < 0.001), age ≥70 years (hazard ratio, 3.65: 95% CI, 1.44 to 9.23: p = 0.006, and left ventricular ejection fraction < 45% (hazard ratio, 3.29%; 95 CI, 1.13 to 9.57; p = 0.03). SDNNi < 30 ms was also an important predictor of sudden cardiac death (hazard ratio, 5.02; 95% CI, 1.49 to 16.85; p = 0.009). Conclusions: These data suggest that SDNNi is a significant time domain parameter of HRV for long prognosis in post-MI patients.

AB - Background and Purpose: Decreased heart rate variability (HRV) has been shown to be a predictor of both sudden cardiac death and cardiovascular death among patients surviving acute myocardial (MI). However, the prognostic significance of time domain HRV in patients with MI is still controversial. In addiction to the mean of all normal-to-normal (NN) intervals, we analyzed the prognostic significance of the 5 most widely used time domain parameters of HRV during long-term follow-up in patients surviving their first MI. Methods: Five time domain measure HRV from 24-hours ECG were obtained after discharge in 260 consecutive patients (207 males; mean age, 60 years) surviving their first MI. These parameters included: standard deviation of all NN intervals, mean of standard deviations of all NN intervals in all-minute segments (SDNNi), standard deviation of the average of all NN intervals in all 5-minute segments, the square root of the mean of the sum of the squares of differences between adjacent NN intervals, and percentage of difference between adjacent NN intervals > 50 ms. Results: The study endpoint was cardiovascular death. After follow-up for 67 months (range, 1 to 114 months), there were 55 cardiovascular deaths (21%) uncluding 39 sudden deaths (15%). Multivariate Cox regression analysis showed that SDNNi <30) ms was a significant predictor of cardiovascular death (hazard ratio, 4.98; 95% confidence interval [CI], 2.03 to 12.21; p < 0.001 as was number of ventricular premature complexes ≥10 beats / hour (hazard ratio, 5.35; 95% CI, 2.26 to 12.62; p < 0.001), age ≥70 years (hazard ratio, 3.65: 95% CI, 1.44 to 9.23: p = 0.006, and left ventricular ejection fraction < 45% (hazard ratio, 3.29%; 95 CI, 1.13 to 9.57; p = 0.03). SDNNi < 30 ms was also an important predictor of sudden cardiac death (hazard ratio, 5.02; 95% CI, 1.49 to 16.85; p = 0.009). Conclusions: These data suggest that SDNNi is a significant time domain parameter of HRV for long prognosis in post-MI patients.

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