CoChat
Sign Up
Cited by 133Heart Rate Variability and Autonomic ControlCardiac Health and Mental HealthAcute Myocardial Infarction Research

Prognostic role of heart rate variability in patients with a recent acute myocardial infarction

Lanza, Gaetano Antonio, Guido, Vincenzo, Galeazzi, M.Marco, Mustilli, Marina, Natali, Rosaria, Ierardi, Carolina, Milici, Caterina, Burzotta, Francesco +4 more·1998·The American Journal of Cardiology
DOI 10.1016/s0002-9149(98)00635-3
Open this paper in CoChat — free account

Abstract

A low heart rate variability (HRV) has been shown to be a powerful predictor of cardiac events in patients surviving an acute myocardial infarction (MI), but it is not clear yet which among the HRV parameters has the best predictive value. Time domain and frequency domain HRV was assessed on 24-hour predischarge Holter recording of 239 patients with a recent MI. Patients were followed up for 6 to 54 months (median 28), during which 26 deaths (11%) occurred, 19 of which were cardiac in origin and 12 were sudden. Most HRVs did not show any difference between patients with or without mortality end points, but the average low-frequency and low-frequency/high-frequency ratio was lower in patients with events. However, when dichotomized according to cut points that maximized the risk of sudden death, several HRVs were significantly predictive of clinical end points. Overall, the mean of the standard deviations of all RR intervals for all 5-minute segments and the standard deviation of the mean RR intervals for all 5-minute segments were the time domain variables most significantly associated with mortality end points, whereas very low frequency was the most predictive frequency domain variable. Compared with the best time domain variables, very low frequency showed a better sensitivity (0.27 to 0.42 vs 0.19 to 0.33) for end points with only a small loss in specificity (0.92 vs 0.96). On multivariate Cox proportional analysis, a left ventricular ejection fraction <40% and a number of ventricular premature beats > or = 10/hour were the most powerful independent predictors for all end points, whereas no HRV was independently associated with the events. A low frequency/high frequency ratio < 1.05 only had a borderline association with sudden death (RR = 2.86, p = 0.076). Our data show a strong association between HRV and mortality in patients surviving a recent MI, with a slight better sensitivity of frequency domain analysis. In our study, however, HRV did not add independent prognostic information to more classic prognostic variables (e.g., left ventricular function and ventricular arrhythmias).

Integrity signals

Registry

Crossref · 10.1016/s0002-9149(98)00635-3

Cites

21 of 21 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Sudden death, increased morbidity and mortality following cardiac surgery in hostile or depressed patients, and increased death rates in patients with sepsis or organ failure are linked clinically to decreased vagus nerve activity.

    “Sudden death, increased morbidity and mortality following cardiac surgery in hostile or depressed patients, and increased death rates in patients with sepsis or organ failure are linked clinically to decreased vagus nerve activity (50)(51)(52)(53)(54).”

    From Physiology and immunology of the cholinergic antiinflammatory pathway (2007) · cites this paper as [50]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Lanza, G. A., Guido, V., Galeazzi, M. M., Mustilli, M., Natali, R., Ierardi, C., Milici, C., Burzotta, F., Pasceri, V., Tomassini, F., Lupi, A., & Maseri, A.
Affiliations
Università Cattolica del Sacro Cuore (IT)
Corresponding author
Lanza, Gaetano Antonio
ORCID
Venue
The American Journal of Cardiology
Publisher
Elsevier BV
Published
1998-12
Volume
82
Issue
11
Pages
1323-1328
ISSN
0002-9149 (ISSN-L)
DOI
10.1016/s0002-9149(98)00635-3
OpenAlex
W2122255720
Cited by
133
References
21
Citations by year
2026: 1 · 2025: 1 · 2024: 3 · 2023: 1 · 2022: 1 · 2021: 4 · 2020: 4 · 2019: 2 · 2017: 2 · 2016: 2 · 2015: 2 · 2014: 4 · 2013: 5 · 2012: 10
FWCI
3.53
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The American Journal of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
Keywords
heart rate variability, acute myocardial infarction, prognosis, sudden cardiac death, mortality prediction, very low frequency band, LF/HF ratio, time-domain HRV, frequency-domain HRV, left ventricular ejection fraction, premature ventricular contractions, left ventricular function
MeSH terms
Aged, Analysis of Variance, Female, Follow-Up Studies, Heart Rate, Humans, Male, Middle Aged, Myocardial Infarction, Predictive Value of Tests, Prognosis, Stroke Volume, Electrocardiography, Ambulatory, Death, Sudden, Cardiac

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review