TY - JOUR
T1 - Decreased heart rate variability and its association with increased mortality after acute myocardial infarction
AU - Kleiger, Robert E.
AU - Miller, J. Philip
AU - Bigger, J. Thomas
AU - Moss, Arthur J.
N1 - Funding Information:
From the Department of Medicine and Division of Biostatistics, Department of Preventive Medicine and Public Health, Washington University of Medicine, St. Louis, Missouri; Division of Cardiology, Department of Medicine, Columbia University, New York, New York; and Department of Preventive Medicine, University of Rochester, New York. This study was supported in part by Grants HL-22982 and HL-70204 from the National Heart, Lung, and Blood Institute, and Grant RR-00645 from the Research Resources Administration, Bethesda, Maryland; funds from the Gebbie Foundation, Jamestown, New York; Merck, Sharp and Dohme Research Laboratories, West Point, Pennsylvania; and the Winthrop and Chernow Foundations, New York, New York. Manuscript received June 9, 1986; revised manuscript received and accepted September 2.1986.
PY - 1987/2/1
Y1 - 1987/2/1
N2 - A high degree of heart rate (HR) variability is found in compensated hearts with good function, whereas HR variability can be decreased with severe coronary artery disease, congestive heart failure, aging and diabetic neuropathy. To test the hypothesis that HR variability is a predictor of long-term survival after acute myocardial infarction (AMI), the Holter tapes of 808 patients who survived AMI were analyzed. Heart rate variability was defined as the standard deviation of all normal RR intervals in a 24-hour continuous electrocardiogram recording made 11 ± 3 days after AMI. In all patients demographic, clinical and laboratory variables were measured at baseline. Mean follow-up time was 31 months. Of all Holter variables measured, HR variability had the strongest univariate correlation with mortality. The relative risk of mortality was 5.3 times higher in the group with HR variability of less than 50 ms than the group with HR variability of more than 100 ms. HR variability remained a significant predictor of mortality after adjusting for clinical, demographic, other Holter features and ejection fraction. A hypothesis to explain this finding is that decreased HR variability correlates with increased sympathetic or decreased vagal tone, which may predispose to ventricular fibrillation.
AB - A high degree of heart rate (HR) variability is found in compensated hearts with good function, whereas HR variability can be decreased with severe coronary artery disease, congestive heart failure, aging and diabetic neuropathy. To test the hypothesis that HR variability is a predictor of long-term survival after acute myocardial infarction (AMI), the Holter tapes of 808 patients who survived AMI were analyzed. Heart rate variability was defined as the standard deviation of all normal RR intervals in a 24-hour continuous electrocardiogram recording made 11 ± 3 days after AMI. In all patients demographic, clinical and laboratory variables were measured at baseline. Mean follow-up time was 31 months. Of all Holter variables measured, HR variability had the strongest univariate correlation with mortality. The relative risk of mortality was 5.3 times higher in the group with HR variability of less than 50 ms than the group with HR variability of more than 100 ms. HR variability remained a significant predictor of mortality after adjusting for clinical, demographic, other Holter features and ejection fraction. A hypothesis to explain this finding is that decreased HR variability correlates with increased sympathetic or decreased vagal tone, which may predispose to ventricular fibrillation.
UR - http://www.scopus.com/inward/record.url?scp=0023100673&partnerID=8YFLogxK
U2 - 10.1016/0002-9149(87)90795-8
DO - 10.1016/0002-9149(87)90795-8
M3 - Article
C2 - 3812275
AN - SCOPUS:0023100673
SN - 0002-9149
VL - 59
SP - 256
EP - 262
JO - The American journal of cardiology
JF - The American journal of cardiology
IS - 4
ER -