超短心率波动与心血管事件的长期关联
Michele Orini1,2, Stefan van Duijvenboden3,4,5, William J Young6,4
1Institute of Cardiovascular Science, University College London, 1-19 Torrington Pl, London, WC1E 7HB, UK. m.orini@ucl.ac.uk.
Scientific reports
|November 4, 2023
概括
从简短的心电图中,超短心率变化 (usHRV) 预测了一般人群中心血管事件的发生. 这种可访问的心脏自主标志物,使用≤15秒的记录进行测量,显示出显著的预测价值.
科学领域:
- 心脏病学 心脏病学
- 自主神经系统的自主神经系统
- 公共卫生 公共卫生
背景情况:
- 心率变化 (HRV) 是心脏自主功能的关键指标,在心脏病患者中具有既定的预后价值.
- 超短HRV (usHRV) 提供了一种可扩展的方法,用于使用标准和可穿戴心电图设备评估心脏自主状态.
- 在一般人群中,usHRV对心血管事件的预测能力在很大程度上仍未得到研究.
研究的目的:
- 为了验证usHRV,从≤15秒的心电图记录 (RMSSD,SDSD,PHF指数) 来得出的,与标准HRV测量相对应.
- 确定USHRV与心房的发生率,主要心脏不良事件,中风和在没有先前心血管疾病的个体中死亡率之间的关联.
主要方法:
- 15秒的usHRV与6分钟的HRV在国家健康与发展调查中使用相关性分析和Bland-Altman图表的验证 (n=1337).
- 在英国生物库 (n=51,628) 进行前性队列研究,平均随访时间为11.5年,以评估USHRV与心血管结果之间的关联.
- 使用非线性考克斯回归分析来评估降低usHRV (5s,10s,15s ECG) 和事件发生率之间的关系.
主要成果:
- 在RMSSD和SDSD的15秒和6分钟HRV之间观察到很好的协议,PHF的良好协议.
- 从5秒,10秒或15秒的心电图测量下降的usHRV显著与心房动,主要心脏不良事件,中风和死亡率的风险增加有关.
- 与基准组相比,在最低的usHRV百分位数 (<第20位) 中的个体对研究结果表现出1.16至1.29 (p<0.05) 之间的危险比率.
结论:
- 来自≤15秒ECG记录的超短HRV显示与标准的短期HRV测量有很强的相关性.
- usHRV是未来心血管事件的验证和强有力的预测器,包括心房动,主要心脏不良事件,中风和一般人群的死亡率.
- 这些发现支持使用usHRV作为一种可访问和可扩展的工具,用于大规模人口研究中的心血管风险评估.
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