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Published on: May 12, 2019
Spectral analysis, death and coronary anatomy following cardiac catheterisation
Roger K G Moore1, Nick Newall, David G Groves
1The Cardiothoracic Center Liverpool, Thomas Drive, Liverpool, L14 3PE, United Kingdom. moore@roger.go-legend.net
Insights
Reduced low frequency (LF) power in heart rate variability (HRV) independently predicts mortality and is associated with significant coronary artery stenosis in patients after cardiac catheterisation.
Area of Science:
- Cardiology
- Medical Diagnostics
- Prognostic Biomarkers
Background:
- Heart rate variability (HRV) analysis offers insights into autonomic nervous system function.
- Diagnostic cardiac catheterisation (CC) is a key procedure for evaluating coronary artery disease.
Purpose of the Study:
- To investigate the associations and prognostic value of angiographic, clinical, and HRV parameters.
- To evaluate HRV as a potential predictor of outcomes in patients undergoing CC.
Main Methods:
- Prospective enrollment of 841 patients undergoing elective CC.
- Collection of clinical data, serum biochemistry, and ECG recordings for HRV analysis (LF, HF power).
- Statistical analysis using logistic regression and Cox proportional hazard models.
Main Results:
- Decreased low frequency (LF) spectral power was linked to proximal right coronary stenosis (OR=1.65) and all-cause mortality (OR=5.01).
- Increased LF power was associated with normal coronary angiograms in patients without prior ischemic events (OR=2.16).
Conclusions:
- Reduced LF power is an independent predictor of all-cause mortality post-elective CC.
- LF power demonstrates significant associations with both coronary stenosis and mortality risk.
Objective:
To establish the associations and prognostic utility of angiographic, clinical and HRV parameters in a large cohort of patients undergoing diagnostic cardiac catheterisation (CC).
Methods:
Patients undergoing CC as elective day cases were enrolled at a single tertiary center from September 2001 to January 2003. Patient data, serum biochemistry, current drug therapy, catheter reports and five minute high resolution electrocardiograph (ECG) recordings were prospectively recorded and validated in an electronic archive. ECG recordings were used to generate time domain (SDNN (standard deviation of NN intervals)) and spectral HRV parameters (low frequency (LF) and high frequency (HF) power). Significant associations between dichotomized HRV variables and covariates were investigated using binary logistic regression. The independent prognostic ability of clinical markers was evaluated using the Cox proportional hazard model.
Results:
841 consecutive consenting patients of mean age 61+/-10 years were recruited into the study with a mean follow-up period of 690+/-436 days. In multivariate analysis decreasing LF spectral power was independently associated with proximal right coronary stenosis OR (odds ratio)=1.65 (95% CI=1.16-2.36), P=0.006 and to all cause mortality OR=5.01 (95% CI=1.47-17.01), P=0.010. Increasing LF power was also independently associated with normal coronary angiograms in patients investigated suspected coronary disease without a confirmed prior history of a coronary ischaemic event OR=2.16 (95% CI=1.26-3.73), P=0.002.
Conclusions:
Reduced LF power independently predicts all cause mortality in a large cohort of patients receiving medical therapy after elective CC. LF power was also independently associated with >75% proximal RCA stenosis.
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