Prognostic value of heart rate variability in patients with coronary artery disease in the current treatment era
Coronary artery disease (CAD) mortality has declined substantially over the past decades thanks to advancing medical and interventional/surgical treatments; therefore, the prognostic value of the heart rate variability in CAD in the current treatment era is not well established. We evaluated the pro...
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| description | Coronary artery disease (CAD) mortality has declined substantially over the past decades thanks to advancing medical and interventional/surgical treatments; therefore, the prognostic value of the heart rate variability in CAD in the current treatment era is not well established. We evaluated the prognostic significance of baseline heart rate variability in 1,757 ARTEMIS study patients with angiographically verified CAD. During an average follow-up time of 8.7 ± 2.2 years, a total of 285 (16.2%) patients died. Of the patients, 63 (3.6%) suffered sudden cardiac death or were resuscitated from sudden cardiac arrest (SCD/SCA), 60 (3.4%) experienced non-sudden cardiac death (NSCD), and death attributable to non-cardiac causes (NCD) occurred in 162 (9.2%) patients. For every 10 ms decrease in standard deviation of normal to normal intervals the risk for SCD/SCA, NSCD and NCD increased significantly: HR 1.153 (95% CI 1.075–1.236, p |
| doi_str_mv | 10.1371/journal.pone.0254107 |
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Juhani ; Huikuri, Heikki V ; Kiviniemi, Antti M ; Perkiömäki, Juha S</creator><contributor>Shimosawa, Tatsuo</contributor><creatorcontrib>Vuoti, Antti O ; Tulppo, Mikko P ; Ukkola, Olavi H ; Junttila, M. Juhani ; Huikuri, Heikki V ; Kiviniemi, Antti M ; Perkiömäki, Juha S ; Shimosawa, Tatsuo</creatorcontrib><description><![CDATA[Coronary artery disease (CAD) mortality has declined substantially over the past decades thanks to advancing medical and interventional/surgical treatments; therefore, the prognostic value of the heart rate variability in CAD in the current treatment era is not well established. We evaluated the prognostic significance of baseline heart rate variability in 1,757 ARTEMIS study patients with angiographically verified CAD. During an average follow-up time of 8.7 ± 2.2 years, a total of 285 (16.2%) patients died. Of the patients, 63 (3.6%) suffered sudden cardiac death or were resuscitated from sudden cardiac arrest (SCD/SCA), 60 (3.4%) experienced non-sudden cardiac death (NSCD), and death attributable to non-cardiac causes (NCD) occurred in 162 (9.2%) patients. For every 10 ms decrease in standard deviation of normal to normal intervals the risk for SCD/SCA, NSCD and NCD increased significantly: HR 1.153 (95% CI 1.075–1.236, p<0.001), HR 1.187 (95% CI 1.102–1.278, p<0.001) and HR 1.080 (95% CI 1.037–1.125, p<0.001), respectively. The natural logarithm of the low-frequency component of the power spectrum and the short-term scaling exponent of the detrended fluctuation analysis also had significant association with all modes of death (p<0.001). After relevant adjustment, standard deviation of normal-to-normal intervals retained its association with NSCD and NCD (p<0.01), the natural logarithm of the low-frequency component of the power spectrum with all modes of death (p from <0.05 to <0.01), and the short-term scaling exponent of the detrended fluctuation analysis with SCD/SCA (p<0.05) and NCD (p<0.001). In conclusion, impairment of many measures of heart rate variability predicts mortality but is not associated with any specific mode of death in patients with stable CAD during the current treatment era, limiting the clinical applicability of heart rate variability to targeting therapy.]]></description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0254107</identifier><identifier>PMID: 34214132</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Alcohol use ; Analysis ; Biology and Life Sciences ; Cardiovascular disease ; Coronary artery ; Coronary artery disease ; Coronary heart disease ; Coronary vessels ; Death ; Diabetes ; Electrocardiography ; Evaluation ; Fractals ; Health risks ; Health services ; Heart beat ; Heart diseases ; Heart rate ; Hospitals ; Internal medicine ; Intervals ; Medical prognosis ; Medical research ; Medical treatment ; Medicine ; Medicine and Health Sciences ; Mortality ; Nervous system ; Patients ; Prognosis ; Standard deviation ; Time series ; Variability</subject><ispartof>PloS one, 2021-07, Vol.16 (7), p.e0254107-e0254107</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Vuoti et al. 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Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Vuoti et al 2021 Vuoti et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c669t-b5975089eab6095d51e99c7058ab990d9256f05af40d2f40515cb8ada554feaa3</citedby><cites>FETCH-LOGICAL-c669t-b5975089eab6095d51e99c7058ab990d9256f05af40d2f40515cb8ada554feaa3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8253412/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8253412/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids></links><search><contributor>Shimosawa, Tatsuo</contributor><creatorcontrib>Vuoti, Antti O</creatorcontrib><creatorcontrib>Tulppo, Mikko P</creatorcontrib><creatorcontrib>Ukkola, Olavi H</creatorcontrib><creatorcontrib>Junttila, M. Juhani</creatorcontrib><creatorcontrib>Huikuri, Heikki V</creatorcontrib><creatorcontrib>Kiviniemi, Antti M</creatorcontrib><creatorcontrib>Perkiömäki, Juha S</creatorcontrib><title>Prognostic value of heart rate variability in patients with coronary artery disease in the current treatment era</title><title>PloS one</title><description><![CDATA[Coronary artery disease (CAD) mortality has declined substantially over the past decades thanks to advancing medical and interventional/surgical treatments; therefore, the prognostic value of the heart rate variability in CAD in the current treatment era is not well established. We evaluated the prognostic significance of baseline heart rate variability in 1,757 ARTEMIS study patients with angiographically verified CAD. During an average follow-up time of 8.7 ± 2.2 years, a total of 285 (16.2%) patients died. Of the patients, 63 (3.6%) suffered sudden cardiac death or were resuscitated from sudden cardiac arrest (SCD/SCA), 60 (3.4%) experienced non-sudden cardiac death (NSCD), and death attributable to non-cardiac causes (NCD) occurred in 162 (9.2%) patients. For every 10 ms decrease in standard deviation of normal to normal intervals the risk for SCD/SCA, NSCD and NCD increased significantly: HR 1.153 (95% CI 1.075–1.236, p<0.001), HR 1.187 (95% CI 1.102–1.278, p<0.001) and HR 1.080 (95% CI 1.037–1.125, p<0.001), respectively. The natural logarithm of the low-frequency component of the power spectrum and the short-term scaling exponent of the detrended fluctuation analysis also had significant association with all modes of death (p<0.001). After relevant adjustment, standard deviation of normal-to-normal intervals retained its association with NSCD and NCD (p<0.01), the natural logarithm of the low-frequency component of the power spectrum with all modes of death (p from <0.05 to <0.01), and the short-term scaling exponent of the detrended fluctuation analysis with SCD/SCA (p<0.05) and NCD (p<0.001). In conclusion, impairment of many measures of heart rate variability predicts mortality but is not associated with any specific mode of death in patients with stable CAD during the current treatment era, limiting the clinical applicability of heart rate variability to targeting therapy.]]></description><subject>Alcohol use</subject><subject>Analysis</subject><subject>Biology and Life Sciences</subject><subject>Cardiovascular disease</subject><subject>Coronary artery</subject><subject>Coronary artery disease</subject><subject>Coronary heart disease</subject><subject>Coronary vessels</subject><subject>Death</subject><subject>Diabetes</subject><subject>Electrocardiography</subject><subject>Evaluation</subject><subject>Fractals</subject><subject>Health risks</subject><subject>Health services</subject><subject>Heart beat</subject><subject>Heart diseases</subject><subject>Heart rate</subject><subject>Hospitals</subject><subject>Internal medicine</subject><subject>Intervals</subject><subject>Medical prognosis</subject><subject>Medical research</subject><subject>Medical treatment</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Mortality</subject><subject>Nervous system</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Standard deviation</subject><subject>Time series</subject><subject>Variability</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk9tq3DAQhk1padK0b1CooVDai91KsmRbN4UQelgIpPR0K8byeFfBa20kOW3evrNZt8QlF0VgifE3v_SPNFn2nLMlLyr-9tKPYYB-ufMDLplQkrPqQXbMdSEWpWDFwzvro-xJjJeMqaIuy8fZUSEFl7wQx9nuc_DrwcfkbH4N_Yi57_INQkh5gIQUCw4a17t0k7sh30FyOKSY_3Rpk1sf_ADhJiccaWpdRIi4B9MGczuGQHCeAkLa7lcY4Gn2qIM-4rNpPsm-f3j_7ezT4vzi4-rs9Hxhy1KnRaN0pVitEZqSadUqjlrbiqkaGq1Zq4UqO6agk6wV9FFc2aaGFpSSHQIUJ9mLg-6u99FMxYqG6lTVuuasJmJ1IFoPl2YX3JasGA_O3AZ8WBvy5WyPBgRwZIwrtJLyy1oWilei0l3RdK1uSOvdtNvYbLG1ZDZAPxOd_xncxqz9tamFKiQXJPB6Egj-asSYzNZFi30PA_rx9tw1cVJIQl_-g97vbqLWQAbc0Hna1-5FzWlZVnT_umJELe-haLS4dZZeVucoPkt4M0sgJuGvtIYxRrP6-uX_2Ysfc_bVHZYeYJ820fdjcn6Ic1AeQBt8jAG7v0XmzOwb4081zL4xzNQYxW-RQf9n</recordid><startdate>20210702</startdate><enddate>20210702</enddate><creator>Vuoti, Antti O</creator><creator>Tulppo, Mikko P</creator><creator>Ukkola, Olavi H</creator><creator>Junttila, M. 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Juhani ; Huikuri, Heikki V ; Kiviniemi, Antti M ; Perkiömäki, Juha S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c669t-b5975089eab6095d51e99c7058ab990d9256f05af40d2f40515cb8ada554feaa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Alcohol use</topic><topic>Analysis</topic><topic>Biology and Life Sciences</topic><topic>Cardiovascular disease</topic><topic>Coronary artery</topic><topic>Coronary artery disease</topic><topic>Coronary heart disease</topic><topic>Coronary vessels</topic><topic>Death</topic><topic>Diabetes</topic><topic>Electrocardiography</topic><topic>Evaluation</topic><topic>Fractals</topic><topic>Health risks</topic><topic>Health services</topic><topic>Heart beat</topic><topic>Heart diseases</topic><topic>Heart rate</topic><topic>Hospitals</topic><topic>Internal medicine</topic><topic>Intervals</topic><topic>Medical prognosis</topic><topic>Medical research</topic><topic>Medical treatment</topic><topic>Medicine</topic><topic>Medicine and Health Sciences</topic><topic>Mortality</topic><topic>Nervous system</topic><topic>Patients</topic><topic>Prognosis</topic><topic>Standard deviation</topic><topic>Time series</topic><topic>Variability</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vuoti, Antti O</creatorcontrib><creatorcontrib>Tulppo, Mikko P</creatorcontrib><creatorcontrib>Ukkola, Olavi H</creatorcontrib><creatorcontrib>Junttila, M. 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Juhani</au><au>Huikuri, Heikki V</au><au>Kiviniemi, Antti M</au><au>Perkiömäki, Juha S</au><au>Shimosawa, Tatsuo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic value of heart rate variability in patients with coronary artery disease in the current treatment era</atitle><jtitle>PloS one</jtitle><date>2021-07-02</date><risdate>2021</risdate><volume>16</volume><issue>7</issue><spage>e0254107</spage><epage>e0254107</epage><pages>e0254107-e0254107</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract><![CDATA[Coronary artery disease (CAD) mortality has declined substantially over the past decades thanks to advancing medical and interventional/surgical treatments; therefore, the prognostic value of the heart rate variability in CAD in the current treatment era is not well established. We evaluated the prognostic significance of baseline heart rate variability in 1,757 ARTEMIS study patients with angiographically verified CAD. During an average follow-up time of 8.7 ± 2.2 years, a total of 285 (16.2%) patients died. Of the patients, 63 (3.6%) suffered sudden cardiac death or were resuscitated from sudden cardiac arrest (SCD/SCA), 60 (3.4%) experienced non-sudden cardiac death (NSCD), and death attributable to non-cardiac causes (NCD) occurred in 162 (9.2%) patients. For every 10 ms decrease in standard deviation of normal to normal intervals the risk for SCD/SCA, NSCD and NCD increased significantly: HR 1.153 (95% CI 1.075–1.236, p<0.001), HR 1.187 (95% CI 1.102–1.278, p<0.001) and HR 1.080 (95% CI 1.037–1.125, p<0.001), respectively. The natural logarithm of the low-frequency component of the power spectrum and the short-term scaling exponent of the detrended fluctuation analysis also had significant association with all modes of death (p<0.001). After relevant adjustment, standard deviation of normal-to-normal intervals retained its association with NSCD and NCD (p<0.01), the natural logarithm of the low-frequency component of the power spectrum with all modes of death (p from <0.05 to <0.01), and the short-term scaling exponent of the detrended fluctuation analysis with SCD/SCA (p<0.05) and NCD (p<0.001). In conclusion, impairment of many measures of heart rate variability predicts mortality but is not associated with any specific mode of death in patients with stable CAD during the current treatment era, limiting the clinical applicability of heart rate variability to targeting therapy.]]></abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>34214132</pmid><doi>10.1371/journal.pone.0254107</doi><tpages>e0254107</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Alcohol use Analysis Biology and Life Sciences Cardiovascular disease Coronary artery Coronary artery disease Coronary heart disease Coronary vessels Death Diabetes Electrocardiography Evaluation Fractals Health risks Health services Heart beat Heart diseases Heart rate Hospitals Internal medicine Intervals Medical prognosis Medical research Medical treatment Medicine Medicine and Health Sciences Mortality Nervous system Patients Prognosis Standard deviation Time series Variability |
| title | Prognostic value of heart rate variability in patients with coronary artery disease in the current treatment era |
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