期刊
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
卷 19, 期 11, 页码 1169-1174出版社
WILEY
DOI: 10.1111/j.1540-8167.2008.01232.x
关键词
risk factor; heart rate variability; elderly; heart rate turbulence; ventricular ectopy
资金
- National Heart, Lung, and Blood Institute [R0-1 HL62181]
- [N01-HC-85079]
- [N01-HC-85086]
- [N01-HC-35129]
- [N01 HC-15103]
- [N01 HC-55222]
- [U01 HL080295]
Novel HRV Predicts CV Mortality in the Elderly. Background: It is unknown whether abnormal heart rate turbulence (HRT) and abnormal fractal properties of heart rate variability identify older adults at increased risk of cardiovascular death (CVdth). Methods: Data from 1,172 community-dwelling adults, ages 72 +/- 5 (65-93) years, who participated in the Cardiovascular Health Study (CHS), a study of risk factors for CV disease in people >= 65 years. HRT and the short-term fractal scaling exponent (DFA1) derived from 24-hour Holter recordings. HRT categorized as: normal (turbulence slope [TS] and turbulence onset [TO] normal) or abnormal (TS and/or TO abnormal). DFA1 categorized as low (<= 1) or high (> 1). Cox regression analyses stratified by Framingham Risk Score (FRS) strata (low = < 10, mid = 10-20, and high > 20) and adjusted for prevalent clinical cardiovascular disease (CVD), diabetes, and quartiles of ventricular premature beat counts (VPCs). Results: CVdths (N = 172) occurred over a median follow-up of 12.3 years. Within each FRS stratum, low DFA1 + abnormal HRT predicted risk of CVdth (RR = 7.7 for low FRS; 3.6, mid FRS; 2.8, high FRS). Among high FRS stratum participants, low DFA1 alone also predicted CVdth (RR = 2.0). VPCs in the highest quartile predicted CVdth, but only in the high FRS group. Clinical CV disease predicted CVdth at each FRS stratum (RR = 2.9, low; 2.6, mid; and 1.9, high). Diabetes predicted CVdth in the highest FRS group only (RR = 2.2). Conclusions: The combination of low DFA1 + abnormal HRT is a strong risk factor for CVdth among older adults even after adjustment for conventional CVD risk measures and the presence of CVD. (J Cardiovasc Electrophysiol, Vol. 19, pp. 1169-1174, November 2008).
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