TY - JOUR
T1 - Predictors of impaired heart rate variability and clinical outcome in patients with acute myocardial infarction treated by primary angioplasty
AU - Larosa, Claudio
AU - Sgueglia, Gregory Angelo
AU - Sestito, Alfonso
AU - Infusino, Fabio
AU - Niccoli, Giampaolo
AU - Lamendola, Priscilla
AU - Mariani, Luca
AU - Santangeli, Pasquale
AU - Lombardo, Antonella
AU - Crea, Filippo
AU - Lanza, Gaetano Antonio
PY - 2008/1
Y1 - 2008/1
N2 - OBJECTIVE: To investigate the determinants and prognostic value of heart rate variability (HRV) in acute myocardial infarction (AMI) patients treated by percutaneous coronary intervention (PCI). METHODS: We studied 64 patients with AMI (58.4 ± 10 years, 56 men), treated by PCI within 12 h of symptom onset. Patients underwent 24-h electrocardiographic Holter recording before discharge. HRV was measured in the time- and frequency-domain. Cardiac events were assessed at 6 months. RESULTS: At univariate analysis, Thrombolysis in Myocardial Infarction (TIMI) flow grade <3 was significantly predictive of reduced frequency-domain variables. On multivariate analysis, diabetes and pre-PCI time > 6 h were the strongest predictors of depressed HRV, with peak creatine kinase myocardial-type and lower left ventricular ejection fraction being also variably correlated with impaired HRV. At 6-month follow-up, seven patients (10.1%) had cardiac events (one AMI, six revascularization procedures). A low standard deviation of RR intervals was a significant predictor of events (P = 0.009), although only age was associated with the endpoint (P = 0.05) on multivariate analysis. CONCLUSIONS: Our study shows that, in AMI patients treated by primary PCI, a delay in coronary revascularization and AMI extension are key factors for determining depressed HRV.
AB - OBJECTIVE: To investigate the determinants and prognostic value of heart rate variability (HRV) in acute myocardial infarction (AMI) patients treated by percutaneous coronary intervention (PCI). METHODS: We studied 64 patients with AMI (58.4 ± 10 years, 56 men), treated by PCI within 12 h of symptom onset. Patients underwent 24-h electrocardiographic Holter recording before discharge. HRV was measured in the time- and frequency-domain. Cardiac events were assessed at 6 months. RESULTS: At univariate analysis, Thrombolysis in Myocardial Infarction (TIMI) flow grade <3 was significantly predictive of reduced frequency-domain variables. On multivariate analysis, diabetes and pre-PCI time > 6 h were the strongest predictors of depressed HRV, with peak creatine kinase myocardial-type and lower left ventricular ejection fraction being also variably correlated with impaired HRV. At 6-month follow-up, seven patients (10.1%) had cardiac events (one AMI, six revascularization procedures). A low standard deviation of RR intervals was a significant predictor of events (P = 0.009), although only age was associated with the endpoint (P = 0.05) on multivariate analysis. CONCLUSIONS: Our study shows that, in AMI patients treated by primary PCI, a delay in coronary revascularization and AMI extension are key factors for determining depressed HRV.
KW - Acute myocardial infarction
KW - Clinical outcome
KW - Heart rate variability
KW - Percutaneous coronary intervention
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U2 - 10.2459/JCM.0b013e3280c56d56
DO - 10.2459/JCM.0b013e3280c56d56
M3 - Article
C2 - 18268424
AN - SCOPUS:40349085817
VL - 9
SP - 76
EP - 80
JO - Journal of Cardiovascular Medicine
JF - Journal of Cardiovascular Medicine
SN - 1558-2027
IS - 1
ER -