心筋梗塞後の心周期の変動性と死亡率の周波数領域測定値
J T Bigger1, J L Fleiss, R C Steinman
1Department of Medicine, School of Public Health, Columbia University, New York, N.Y. 10032.
Circulation
|January 11, 1992
まとめ
心臓周期の変動量,特に超低周波 (ULF) と非常に低周波 (VLF) の電力は,心筋梗塞後の死亡率の強力な予測指標です. これらの対策は,伝統的なリスク要因と組み合わせると,リスク予測を改善します.
科学分野:
- 心臓病学 心臓病学
- バイオメディカルエンジニアリング
- クリニック・リサーチ 臨床研究
背景:
- 心臓の周期変数 (HPV) 周波数領域の測定値と,心筋梗塞後の715人の患者の死亡率との関連を調べた.
- 4年間のフォローアップ期間で,死亡率の結果を評価する.
研究 の 目的:
- 心臓周期変数 (HPV) と死亡率の6つの周波数領域測定値の間の関連性を確立する.
- 心筋梗塞後の死亡率に関するHPV測定値の独立した予測値を決定する.
主な方法:
- 心筋梗塞の2週間後の715人の患者を研究した.
- ハート・ペリオド・ヴァイアビリティ (HPV) の6つの周波数領域測定値を分析した.
- 多変数コックス回帰モデルを使用し,既知のリスク予測要因に調整した.
主要な成果:
- すべてのHPV測定では,全原因,心臓,不律性による死亡と有意な単変数関連が示されました.
- 低周波帯 (ULF,VLF) は,高周波帯 (LF,HF) よりも強い関連性を示した.
- ULFの力は,多変量分析で死亡率の最も強い独立した予測因子でした.
結論:
- トータル,ULF,およびVLFのパワーは,従来の危険因子を調整した後も,死亡率の有意な予測因子であり続けました.
- HPVの測定は,既存の予測値に追加すると,約50%の2.5年死亡率を持つ高リスクサブグループを特定します.
- VLF電源は,不律性死と特定の関連性を示しました.
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