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Titolo:
PROSPECTIVE-STUDY OF HEART-RATE-VARIABILITY AND MORTALITY IN CHRONIC HEART-FAILURE - RESULTS OF THE UNITED-KINGDOM HEART-FAILURE EVALUATIONAND ASSESSMENT OF RISK TRIAL (UK-HEART)
Autore:
NOLAN J; BATIN PD; ANDREWS R; LINDSAY SJ; BROOKSBY P; MULLEN H; BAIG W; FLAPAN AD; COWLEY A; PRESCOTT RJ; NEILSON JMM; FOX KAA;
Indirizzi:
N STAFFORDSHIRE HOSP,CTR CARDIOTHORAC STOKE ON TRENT ST4 6QG STAFFS ENGLAND GEN INFIRM LEEDS LS1 3EX W YORKSHIRE ENGLAND ST JAMESS UNIV HOSP LEEDS W YORKSHIRE ENGLAND QUEENS MED CTR NOTTINGHAM NG7 2UH ENGLAND DONCASTER ROYAL INFIRM DONCASTER DN2 5LT ENGLAND UNIV EDINBURGH EDINBURGH EH8 9YL MIDLOTHIAN SCOTLAND
Titolo Testata:
Circulation
fascicolo: 15, volume: 98, anno: 1998,
pagine: 1510 - 1516
SICI:
0009-7322(1998)98:15<1510:POHAMI>2.0.ZU;2-V
Fonte:
ISI
Lingua:
ENG
Soggetto:
CARDIAC PARASYMPATHETIC ACTIVITY; ACUTE MYOCARDIAL-INFARCTION; PROGNOSTIC VALUE; DILATED CARDIOMYOPATHY; EJECTION FRACTION; V-HEFT; THERAPY; ELECTROCARDIOGRAMS; DYSFUNCTION; VASODILATOR;
Keywords:
HEART RATE; HEART FAILURE; MORTALITY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
44
Recensione:
Indirizzi per estratti:
Citazione:
J. Nolan et al., "PROSPECTIVE-STUDY OF HEART-RATE-VARIABILITY AND MORTALITY IN CHRONIC HEART-FAILURE - RESULTS OF THE UNITED-KINGDOM HEART-FAILURE EVALUATIONAND ASSESSMENT OF RISK TRIAL (UK-HEART)", Circulation, 98(15), 1998, pp. 1510-1516

Abstract

Background - Patients with chronic heart failure (CHF) have a continuing high mortality. Autonomic dysfunction may play an important role in the pathophysiology of cardiac death in CHF. UK-HEART examined the value of heart rate variability (HRV) measures as independent predictors of death in CHF. Methods and Results - In a prospective study powered for mortality, we recruited 433 outpatients 62 +/- 9.6 years old with CHF (NYHA functional class I to III; mean ejection fraction, 0.41 +/- 0.17). Time-domain HRV indices and conventional prognostic indicators were related to death by multivariate analysis. During 482 +/- 161 days of follow-up, cardiothoracic ratio, SDNN, left ventricular end-systolic diameter, and serum sodium were significant predictors of all-cause mortality. The risk ratio for a 41.2-ms decrease in SDNN was 1.62 (95% CI, 1.16 to 2.44). The annual mortality rate for the study population in SDNN subgroups was 5.5% for >100 ms, 12.7% for 50 to 100 ms, and 51.4% for <50 ms. SDNN, creatinine, and serum sodium were related to progressive heart failure death. Cardiothoracic ratio, left ventricular end-diastolic diameter, the presence of nonsustained ventricular tachycardia, and serum potassium were related to sudden cardiac death. A reduction in SDNN was the most powerful predictor of the risk of death due to progressive heart failure. Conclusions - CHF is associated with autonomic dysfunction, which can be quantified by measuring HRV. Areduction in SDNN identifies patients at high risk of death and is a better predictor of death due to progressive heart failure than other conventional clinical measurements. High-risk subgroups identified by this measurement are candidates for additional therapy after prescription of an ACE inhibitor.

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Documento generato il 15/07/20 alle ore 14:14:36