Heart Rate Variability in Acute Myocardial Infarction: Results of the HeaRt-V-AMI Single-Center Cohort Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. HRV Measurement
2.3. Study Outcomes
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | Overall (n = 104) |
---|---|
Age, mean ± SD, years | 60.64 ± 13.36 |
Women, n (%) | 31 (29.8) |
BMI, mean ± SD, kg/m2 | 28.42 ± 5.69 |
BSA, mean ± SD, m2 | 1.91 ± 0.25 |
Smoking, n (%) | 61 (58.65) |
Alcohol consumption, n (%) | 17 (16.35) |
Sedentarism, n (%) | 96 (92.31) |
Time to PCI, median (IQR), hours | 8.0 (6.0–10.25) |
History of IHD, n (%) | 16 (15.4) |
Arterial hypertension, n (%) | 58 (55.8) |
Previous stroke, n (%) | 6 (5.8) |
Diabetes mellitus | 22 (21.15) |
PAD, n (%) | 3 (2.9) |
COPD, n (%) | 3 (2.9) |
Chronic hepatitis, n (%) | 1 (1.0) |
Prior beta-blocker, n (%) | 24 (23.1) |
Killip class | |
Class I, n (%) | 69 (66.3) |
Class II, n (%) | 29 (27.9) |
Class III, n (%) | 6 (5.8) |
STEMI territory | |
Anterior (V3, V4), n (%) | 3 (2.9) |
Anteroseptal (V1–V4), n (%) | 23 (22.1) |
Anterolateral (V3–V6), n (%) | 1 (1.0) |
Extensive anterior (V1–V6), n (%) | 25 (24.0) |
Inferior (II, III, aVF) | 52 (50.0) |
SBP, mean ± SD, mmHg | 145.85 ± 21.85 |
eGFR, mean ± SD, mL/min/1.73 m2 | 82.96 ± 23.56 |
CK-MB, admission, median (IQR), U/L | 48.0 (23.0–89.2) |
CK-MB, peak, median (IQR), U/L | 188 (87.0–288.5) |
AST, median (IQR), U/L | 56 (36.0–102.5) |
ALT, median (IQR), U/L | 34.0 (25.0–51.7) |
CRP, median (IQR), mg/dL | 29.9 (12.5–65.7) |
Fibrinogen, median (IQR), mg/dL | 431.0 (371.7–517.0) |
LDL, mean ± SD, mg/dL | 136.1 ± 53.5 |
Triglycerides, mean ± SD, mg/dL | 165.8 ± 108.9 |
Blood glucose, mean ± SD, mg/dL | 162.8 ± 60.8 |
LVEF, admission, median (IQR), % | 40.0 (34.7–45.0) |
LVEF, discharge, median (IQR), % | 40.0 (35.0–47.0) |
E/A | |
<1, n (%) | 63 (60.6) |
>2, n (%) | 5 (4.8) |
PCI Characteristics | Overall (n = 104) |
---|---|
Coronary lesions | |
Single artery, n (%) | 48 (46.2) |
Two arteries, n (%) | 33 (31.7) |
Three arteries, n (%) | 23 (22.1) |
Culprit artery | |
LAD, n (%) | 50 (48.1) |
LCX, n (%) | 14 (13.5) |
RCA, n (%) | 37 (35.6) |
LM, n (%) | 2 (1.9) |
DG, n (%) | 1 (1.0) |
LM disease, n (%) | 4 (3.8) |
Initial TIMI flow | |
TIMI 0, n (%) | 57 (54.8) |
TIMI 1, n (%) | 10 (9.6) |
TIMI 2, n (%) | 18 (17.3) |
TIMI 3, n (%) | 19 (18.3) |
Final TIMI flow | |
TIMI 0, n (%) | 0 (0) |
TIMI 1, n (%) | 1 (1.0) |
TIMI 2, n (%) | 10 (9.6) |
TIMI 3, n (%) | 92 (88.5) |
Contrast media, mean ± SD, mL | 204.8 ± 51.4 |
HRV Parameters | Overall | First 5 min | Last 5 min |
---|---|---|---|
SDNN, median (IQR), ms | 29.2 (20.87–40.85) | 29.5 (20.7–43.7) | 28.15 (19.1–39.0) |
RMSSD, median (IQR), ms | 32.5 (25.7–46.4) | 36.7 (25.2–52.0) | 29.8 (22.3–45.5) |
NN50, median (IQR), beats | 89.0 (36.0–159.5) | 28.5 (11.0–51.7) | 18.5 (7.7–45.7) |
pNN50, median (IQR), % | 7.5 (3.1–17.7) | 10.3 (3.0–20.7) | 4.5 (2.0–17.9) |
RR triangular index, median (IQR), ms | 6.3 (5.3–8.8) | 6.2 (4.8–8.7) | 6.1 (4.5–8.0) |
VLF, median (IQR), ms2 | 75.8 (35.7–142.4) | 66.0 (19.1–130.5) | 40.2 (22.5–154.6) |
VLF, median (IQR), log | 4.3 (3.5–4.9) | 4.1 (2.9–4.8) | 3.6 (3.0–5.0) |
LF, median (IQR), ms2 | 372.9 (175.3–654.5) | 365.2 (108.2–712.5) | 359.2 (101.0–751.5) |
LF, median (IQR), log | 5.9 (5.1–6.4) | 5.8 (4.6–6.5) | 5.8 (4.5–6.6) |
LF, median (IQR), n.u. | 66.9 (59.8–74.8) | 63.9 (54.9–73.5) | 65.3 (56.0–75.4) |
HF, median (IQR), ms2 | 168.5 (96.1–310.0) | 188.0 (71.4–332.5) | 155.5 (59.4–290.3) |
HF, median (IQR), log | 5.1 (4.5–5.7) | 5.2 (4.2–5.8) | 5.0 (4.0–5.6) |
HF, median (IQR), n.u. | 32.7 (25.0–39.8) | 35.1 (25.8–44.5) | 34.3 (24.4–43.2) |
LF/HF median (IQR) | 2.0 (1.4–2.9) | 1.7 (1.2–2.8) | 1.9 (1.2–3.0) |
SD1, median (IQR), ms | 23.0 (18.2–32.9) | 26.0 (17.8–37.0) | 21.1 (15.8–32.2) |
SD2, median (IQR), ms | 33.3 (22.2–44.5) | 32.7 (22.2–47.8) | 32.2 (21.4–46.3) |
SD2/SD1, median (IQR) | 1.3 (1.0–1.5) | 1.2 (0.9–1.5) | 1.3 (1.0–1.6) |
ApEn, median (IQR) | 1.3 (1.2–1.4) | 1.0 (0.9–1.1) | 1.0 (0.9–1.1) |
HRV Parameters | First vs. Last 5 min of PCI | p-Value |
---|---|---|
SDNN, ms | Z −2.155 | p = 0.031 |
RMSSD, median (IQR), ms | Z −3.436 | p < 0.001 |
NN50, median (IQR), beats | Z −1.807 | p = 0.071 |
pNN50, median (IQR), % | Z −3.043 | p = 0.002 |
RR triangular index, median (IQR), ms | Z −1.786 | p = 0.075 |
VLF, median (IQR), ms2 | Z −0.417 | p = 0.677 |
VLF, median (IQR), log | Z −0.581 | p = 0.580 |
LF, median (IQR), ms2 | Z −0.987 | p = 0.324 |
LF, median (IQR), log | Z −0.737 | p = 0.447 |
LF, median (IQR), n.u. | Z −0.858 | p = 0.395 |
HF, median (IQR), ms2 | Z −2.289 | p = 0.022 |
HF, median (IQR), log | Z −2.116 | p = 0.033 |
HF, median (IQR), n.u. | Z −0.914 | p = 0.358 |
LF/HF median (IQR) | Z −1.199 | p = 0.235 |
SD1, median (IQR), ms | Z −3.446 | p < 0.001 |
SD2, median (IQR), ms | Z −1.850 | p = 0.064 |
SD2/SD1, median (IQR) | Z −3.748 | p < 0.001 |
ApEn, median (IQR) | Z −1.931 | p = 0.055 |
HRV Parameters | Deceased | Survivors | p-Value |
---|---|---|---|
HRV during entire PCI duration | |||
SDNN, median (IQR), ms | 23.9 (20.2–35.6) | 29.2 (21.2–41.1) | p = 0.806 |
RMSSD, median (IQR), ms | 38.9 (29.8–49.5) | 32.3 (25.1–46.1) | p = 0.361 |
NN50, median (IQR), beats | 102.0 (51.0–106.0) | 86.5 (32.2–167.7) | p = 0.981 |
pNN50, median (IQR), % | 14.1 (7.3–22.5) | 7.2 (2.9–17.4) | p = 0.205 |
RR triangular index, median (IQR), ms | 5.7 (4.9–6.3) | 6.3 (5.3–8.8) | p = 0.447 |
VLF, median (IQR), ms2 | 33.3 (29.2–76.2) | 75.8 (37.7–142.6) | p = 0.155 |
VLF, median (IQR), log | 3.5 (3.3–4.3) | 4.3 (3.6–4.9) | p = 0.157 |
LF, median (IQR), ms2 | 178.5 (113.5–194.5) | 391.0 (178.2–681.7) | p = 0.064 |
LF, median (IQR), log | 5.1 (4.7–5.2) | 5.9 (5.1–6.5) | p = 0.052 |
LF, median (IQR), n.u. | 63.8 (58.0–70.4) | 66.9 (59.9–74.8) | p = 0.369 |
HF, median (IQR), ms2 | 100.4 (81.6–106.4) | 178.7 (96.5–323.5) | p = 0.108 |
HF, median (IQR), log | 4.6 (4.4–4.6) | 5.1 (4.5–5.7) | p = 0.106 |
HF, median (IQR), n.u. | 35.9 (29.4–41.7) | 32.7 (25.0–39.7) | p = 0.373 |
LF/HF median (IQR) | 1.7 (1.3–2.3) | 2.0 (1.5–2.9) | p = 0.352 |
SD1, median (IQR), ms | 27.5 (21.1–35.1) | 22.8 (17.7–32.6) | p = 0.349 |
SD2, median (IQR), ms | 19.7 (19.2–36.3) | 33.3 (22.7–45.2) | p = 0.240 |
SD2/SD1, median (IQR) | 0.9 (0.8–1.0) | 1.3 (1.0–1.6) | p = 0.008 |
ApEn, median (IQR) | 1.2 (1.0–1.2) | 1.3 (1.2–1.4) | p = 0.019 |
HRV in the first 5 min of PCI | |||
SDNN, median (IQR), ms | 32.3 (20.5–44.8) | 29.3 (21.0–43.5) | p = 0.841 |
RMSSD, median (IQR), ms | 51.9 (32.0–69.0) | 36.3 (24.3–51.5) | p = 0.240 |
NN50, median (IQR), beats | 23.0 (17.0–33.0) | 28.5 (11.0–50.7) | p = 0.847 |
pNN50, median (IQR), % | 26.1 (7.4–26.6) | 9.1 (2.8–20.5) | p = 0.174 |
RR triangular index, median (IQR), ms | 5.1 (4.8–6.4) | 6.2 (4.8–9.1) | p = 0.256 |
VLF, median (IQR), ms2 | 24.0 (20.5–88.7) | 66.0 (18.9–136.7) | p = 0.357 |
VLF, median (IQR), log | 3.1 (3.0–4.4) | 4.1 (2.9–4.8) | p = 0.365 |
LF, median (IQR), ms2 | 139.7 (22.7–252.3) | 387.5 (110.9–744.7) | p = 0.056 |
LF, median (IQR), log | 4.9 (3.1–5.5) | 5.8 (4.6–6.5) | p = 0.067 |
LF, median (IQR), n.u. | 58.1 (53.1–59.8) | 65.3 (55.0–73.8) | p = 0.252 |
HF, median (IQR), ms2 | 93.3 (37.4–125.8) | 194.7 (73.3–341.1) | p = 0.099 |
HF, median (IQR), log | 4.5 (3.6–4.8) | 5.2 (4.2–5.8) | p = 0.106 |
HF, median (IQR), n.u. | 41.7 (39.9–46.6) | 34.0 (25.8–44.3) | p = 0.216 |
LF/HF median (IQR) | 1.3 (1.1–1.4) | 1.9 (1.2–2.8) | p = 0.199 |
SD1, median (IQR), ms | 36.7 (22.7–49.1) | 25.7 (17.2–36.6) | p = 0.234 |
SD2, median (IQR), ms | 27.2 (18.2–39.5) | 32.7 (22.4–48.0) | p = 0.499 |
SD2/SD1, median (IQR) | 0.8 (0.7–0.8) | 1.2 (1.0–1.5) | p = 0.006 |
ApEn, median (IQR) | 1.0 (0.6–1.0) | 1.0 (0.9–1.1) | p = 0.188 |
HRV in the last 5 min of PCI | |||
SDNN, median (IQR), ms | 24.3 (19.3–44.7) | 28.4 (19.1–38.7) | p = 0.944 |
RMSSD, median (IQR), ms | 34.2 (28.2–45.2) | 29.8 (21.9–45.7) | p = 0.429 |
NN50, median (IQR), beats | 39.0 (18.0–40.0) | 18.0 (7.0–47.2) | p = 0.333 |
pNN50, median (IQR), % | 10.2 (4.0–21.9) | 4.5 (1.8–17.4) | p = 0.246 |
RR triangular index, median (IQR), ms | 4.7 (4.3–7.1) | 6.1 (4.5–8.0) | p = 0.580 |
VLF, median (IQR), ms2 | 35.5 (18.7–77.9) | 40.2 (23.2–155.0) | p = 0.489 |
VLF, median (IQR), log | 3.5 (2.9–4.3) | 3.69 (3.1–5.0) | p = 0.456 |
LF, median (IQR), ms2 | 400.4 (81.8–424.4) | 337.1 (106.5–794.2) | p = 0.377 |
LF, median (IQR), log | 5.9 (4.4–6.0) | 5.7 (4.6–6.6) | p = 0.352 |
LF, median (IQR), n.u. | 72.9 (51.0–74.6) | 65.1 (56.2–75.0) | p = 0.932 |
HF, median (IQR), ms2 | 129.6 (78.3–143.6) | 168.0 (59.3–328.7) | p = 0.279 |
HF, median (IQR), log | 4.8 (4.3–4.9) | 5.1 (4.0–5.6) | p = 0.262 |
HF, median (IQR), n.u. | 26.8 (25.2–48.8) | 34.4 (24.8–43.0) | p = 0.944 |
LF/HF median (IQR) | 2.7 (1.0–2.9) | 1.8 (1.3–2.9) | p = 0.938 |
SD1, median (IQR), ms | 24.2 (19.9–32.0) | 21.1 (15.5–32.4) | p = 0.429 |
SD2, median (IQR), ms | 24.4 (18.8–33.6) | 32.3 (21.4–46.4) | p = 0.329 |
SD2/SD1, median (IQR) | 1.0 (0.9–1.0) | 1.3 (1.0–1.6) | p = 0.018 |
ApEn, median (IQR) | 1.0 (0.8–1.0) | 1.0 (1.0–1.1) | p = 0.165 |
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Brinza, C.; Floria, M.; Scripcariu, D.-V.; Covic, A.M.; Covic, A.; Popa, I.V.; Statescu, C.; Burlacu, A. Heart Rate Variability in Acute Myocardial Infarction: Results of the HeaRt-V-AMI Single-Center Cohort Study. J. Cardiovasc. Dev. Dis. 2024, 11, 254. https://doi.org/10.3390/jcdd11080254
Brinza C, Floria M, Scripcariu D-V, Covic AM, Covic A, Popa IV, Statescu C, Burlacu A. Heart Rate Variability in Acute Myocardial Infarction: Results of the HeaRt-V-AMI Single-Center Cohort Study. Journal of Cardiovascular Development and Disease. 2024; 11(8):254. https://doi.org/10.3390/jcdd11080254
Chicago/Turabian StyleBrinza, Crischentian, Mariana Floria, Dragos-Viorel Scripcariu, Alexandra Maria Covic, Adrian Covic, Iolanda Valentina Popa, Cristian Statescu, and Alexandru Burlacu. 2024. "Heart Rate Variability in Acute Myocardial Infarction: Results of the HeaRt-V-AMI Single-Center Cohort Study" Journal of Cardiovascular Development and Disease 11, no. 8: 254. https://doi.org/10.3390/jcdd11080254