scholarly journals Predicting efficacy of combined assessment with fragmented QRS and severely depressed heart rate variability on outcome of patients with acute myocardial infarction

2021 ◽  
Author(s):  
Yanling Xu ◽  
Yijun Yu ◽  
Li He ◽  
Yuting Wang ◽  
Ye Gu
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Cox Regression ◽  
Holter Monitoring ◽  
Major Adverse Cardiovascular Events ◽  
Cox Regression Analysis ◽  
Autonomic Nervous ◽  
Fragmented Qrs

AbstractThe association between fragmented QRS (fQRS) and autonomic nervous dysfunction, and major adverse cardiovascular events (MACE) is not fully clear in patients with acute myocardial infarction (AMI). This study aimed to observe whether combined assessment with fQRS and cardiac autonomic nervous function could enhance the predicting efficacy on outcome in AMI patients. A total of 153 consecutive hospitalized AMI patients were included in this retrospective study. Patients were divided into non-fQRS (nfQRS) group and fQRS group according to 12-lead electrocardiogram, into sHRV [severely depressed heart rate variability (HRV): standard deviation of NN intervals (SDNN) < 100 ms and very low frequency (VLF) < 26.7 ms] group and nsHRV (non-severely depressed HRV) group according to 24 h Holter monitoring, and into non-MACE (nMACE) group and MACE group according to 12 months’ follow-up results. The incidence of sHRV was significantly higher in the fQRS group than in the nfQRS group (71.9 vs. 39.3%, p < 0.05). The incidences of MACE were 7.4, 22.2, 25.7 and 56.5%, respectively, in nsHRV + nfQRS group, nsHRV + fQRS group, sHRV + nfQRS group and sHRV + fQRS group (p < 0.05). Multivariable Cox regression analysis showed that patients in the sHRV + fQRS group had a sixfold higher risk of MACE compared to patients in the nsHRV + nfQRS group (HR = 6.228, 95% CI 1.849–20.984, p = 0.003). The predicting sensitivity and specificity on MACE were 81.4 and 58.2% by sHRV, 69.8 and 69.1% by fQRS in these AMI patients. The specificity (81.8%) was the highest with the combination of sHRV and fQRS. Adding sHRV and fQRS to clinical data offered incremental prognostic value. Present results indicate that fQRS is closely related to sHRV, suggesting significant impairment of sympathetic nerve function in AMI patients with fQRS. Combined assessment with fQRS and sHRV enhances the predicting efficacy on outcome in AMI patients.

scholarly journals Impedance Cardiography and Heart Rate Variability for Long-Term Cardiovascular Outcome Prediction After Myocardial Infarction

Medicina ◽  
2012 ◽  
Vol 48 (7) ◽  
pp. 52 ◽  
Author(s):  
Rūta Ablonskytė-Dūdonienė ◽  
Giedrė Bakšytė ◽  
Indrė Čeponienė ◽  
Algimantas Kriščiukaitis ◽  
Kęstutis Drėgūnas ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Standard Deviation ◽  
Impedance Cardiography ◽  
Cox Regression ◽  
Secondary Outcome ◽  
Integrated Analysis ◽  
Cardiac Mortality ◽  
Cox Regression Analysis

Background and Objective. The objective of our study was to evaluate the predictive power of a combined assessment of heart rate variability (HRV) and impedance cardiography (ICG) measures in order to better identify the patients at risk of serious adverse events after ST-segment elevation myocardial infarction (STEMI): all-cause or cardiac mortality (primary outcomes) and in-hospital recurrent ischemia, recurrent nonfatal MI, and need for revascularization (secondary outcomes). Material and Methods. A total of 213 study patients underwent 24-hour electrocardiogram (used for HRV analysis) and thoracic bioimpedance monitoring (used for calculation of hemodynamic measures) immediately after admission. The patients were examined on discharge and contacted after 1 and 5 years. Cox regression analysis was used to determine the predictors of selected outcomes. Results. The standard deviation of all normal-to-normal intervals (SDNN) and cardiac power output (CPO) were found to be the significant determinants of 5-year all-cause mortality (SDNN ≤100.42 ms and CPO ≤1.43 W vs. others: hazard ratio [HR], 11.1; 95% CI, 4.48–27.51; P<0.001). The standard deviation of the averages of NN intervals (SDANN) and CPO were the significant predictors of 5-year cardiac mortality (SDANN ≤85.41 ms and CPO ≤1.43 W vs. others: HR, 11.05; 95% CI, 3.75–32.56; P<0.001). None of the ICG measures was significant in predicting any secondary outcome. Conclusions. The patients with both impaired autonomic heart regulation and systolic function demonstrated by decreased heart rate variability and impedance hemodynamic measures were found to be at greater risk of all-cause and cardiac death within a 5-year period after STEMI. An integrated analysis of electrocardiogram and impedance cardiogram helps estimate patient’s risk of adverse outcomes after STEMI.

Heart Rate Variability Assessment Early After Acute Myocardial Infarction

Circulation ◽  
1996 ◽  
Vol 93 (7) ◽  
pp. 1388-1395 ◽  
Author(s):  
Narendra Singh ◽  
Dmitry Mironov ◽  
Paul W. Armstrong ◽  
Allan M. Ross ◽  
Anatoly Langer
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Heart Rate ◽  
Heart Rate Variability

Predicting long-term cardiovascular outcomes of patients with acute myocardial infarction using soluble ST2

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Mustafa Umut Somuncu ◽  
Belma Kalayci ◽  
Ahmet Avci ◽  
Tunahan Akgun ◽  
Huseyin Karakurt ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Cox Regression ◽  
High Serum ◽  
Major Adverse Cardiovascular Events ◽  
Lower Systolic Blood Pressure ◽  
Cox Regression Analysis ◽  
Killip Class ◽  
Target Vessel Revascularization

AbstractBackgroundThe increase in soluble suppression of tumorigenicity 2 (sST2) both in the diagnosis and prognosis of heart failure is well established; however, existing data regarding sST2 values as the prognostic marker after myocardial infarction (MI) are limited and have been conflicting. This study aimed to assess the clinical significance of sST2 in predicting 1-year adverse cardiovascular (CV) events in MI patients.Materials and methodsIn this prospective study, 380 MI patients were included. Participants were grouped into low sST2 (n = 264, mean age: 60.0 ± 12.1 years) and high sST2 groups (n = 116, mean age: 60.5 ± 11.6 years), and all study populations were followed up for major adverse cardiovascular events (MACE) which are composed of CV mortality, target vessel revascularization (TVR), non-fatal reinfarction, stroke and heart failure.ResultsDuring a 12-month follow-up, 68 (17.8%) patients had MACE. CV mortality and heart failure were significantly higher in the high sST2 group compared to the low sST2 group (15.5% vs. 4.9%, p = 0.001 and 8.6% vs. 3.4% p = 0.032, respectively). Multivariate Cox regression analysis concluded that high serum sST2 independently predicted 1-year CV mortality [hazard ratio (HR) 2.263, 95% confidence interval (CI) 1.124–4.557, p = 0.022)]. Besides, older age, Killip class >1, left anterior descending (LAD) as the culprit artery and lower systolic blood pressure were the other independent risk factors for 1-year CV mortality.ConclusionsHigh sST2 levels are an important predictor of MACE, including CV mortality and heart failure in a 1-year follow-up period in MI patients.

Effect of Infarct-Related Artery Patency on Heart Rate Variability in Acute Myocardial infarction

1995 ◽  
Vol 25 (5) ◽  
pp. 949
Author(s):  
Joon Han Shin ◽  
Han Soo Kim ◽  
Seung Jae Tahk ◽  
Byung-il William Choi ◽  
Hyuck Moon Kwon ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Infarct Related Artery

scholarly journals RISK FACTORS ASSOCIATED WITH THE OCCURRENCE OF EARLY COMPLICATIONS OF ACUTE MYOCARDIAL INFARCTION AFTER CARDIO-INTERVENTION TREATMENT

2020 ◽  
Vol 73 (6) ◽  
pp. 1245-1251
Author(s):  
Iryna A. Holovanova ◽  
Grygori A. Oksak ◽  
Iryna M. Tkachenko ◽  
Maxim V. Khorosh ◽  
Mariia M. Tovstiak ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cox Regression ◽  
Risk Indicators ◽  
Interventional Treatment ◽  
Early Complications ◽  
Cox Regression Analysis ◽  
Intervention Treatment

The aim of our study was to identify the main risk factors for the occurrence of early complications of acute myocardial infarction after cardio-interventional treatment and to evaluate prognostic risk indicators. Materials and methods: Risk factors of myocardial infarction were determined by copying the case history data and calculating on their basis of the odds ratio and ±95% confidence interval. After it, we made a prediction of the risk of early complications of AMI with cardiovascular intervention by using a Cox regression that took into account the patient’s transportation time by ambulance. Results: Thus, the factors that increase the chances of their occurrence were: summer time of year; recurrent myocardial infarction of another specified localization (I122.8); the relevance of the established STEMI diagnosis; diabetes mellitus; renal pathology; smoking; high rate of BMI. Factors that reduce the chances of their occurrence: men gender – in 35%; the age over of 70 – by 50%; the timely arrival of an emergency medical team – by 55%. The factors that increase the chances of their occurrence were: age over 70 years; subsequent myocardial infarction of unspecified site; diabetes mellitus. Using of a Cox regression analysis, it was proved that the cumulative risk of early complications of AMI with cardio-intervention treatment increased from the 10th minute of ambulance arrival at place, when ECG diagnosis (STEMI), presence of diabetes mellitus, smoking and high BMI. Conclusions: As a result of the conducted research, the risk factors for early complications of AIM with cardio-interventional treatment were identified.

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