Journal
HEART
Volume 88, Issue 4, Pages 378-380Publisher
BMJ PUBLISHING GROUP
DOI: 10.1136/heart.88.4.378
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Funding
- NCRR NIH HHS [P41 RR13622, P41 RR013622] Funding Source: Medline
- NIA NIH HHS [P60 AG008812, AG08812] Funding Source: Medline
- NIDDK NIH HHS [DK 30583] Funding Source: Medline
- ODCDC CDC HHS [H75/CCH119124] Funding Source: Medline
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Objective: To re-examine the standard pNN50 heart rate variability (HRV) statistic by determining how other thresholds compare with the commonly adopted 50 ms threshold in distinguishing physiological and pathological groups. Design: Retrospective analysis of Halter monitor databases. Subjects: Comparison of HRV data between 72 healthy subjects and 43 with congestive heart failure (CHF); between sleeping and waking states in the 72 healthy subjects; and between 20 young and 20 healthy elderly subjects. Main outcome measures: Probability values for discriminating between groups using a family of. pNN values ranging from pNN4 to pNN100. Results: For all three comparisons, pNN values substantially less than 50 ms consistently provided better separation between groups. For the normal versus CHF groups, p < 10(-13) for pNN12 versus p < 10(-4) for pNN50; for the sleeping versus awake groups, p < 10(-21) for pNN 12 versus p < 10(-10) for pNN50; and for the young versus elderly groups, p < 10(-6) for pNN28 versus p < 10(-4) for pNN50. In addition, for the subgroups of elderly healthy subjects versus younger patients with CHF, p < 0.007 for pNN20 versus p < 0.17 for pNN50; and for the subgroup of New York Heart Association functional class I-II CHF versus class III-IV, p < 0.04 for pNN10 versus p < 0.13 for pNN50. Conclusions: pNN50 is only one member of a general pNNx family of HRV statistics. Enhanced discrimination between a variety of normal and pathological conditions is obtained by using pNN thresholds as low as 20 ms or less rather than the standard 50 ms threshold.
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