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Liu H, Wang X, Wang X. The correlation between heart rate variability index and vulnerability prognosis in patients with acute decompensated heart failure. PeerJ 2023; 11:e16377. [PMID: 38025754 PMCID: PMC10652843 DOI: 10.7717/peerj.16377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 10/08/2023] [Indexed: 12/01/2023] Open
Abstract
Objective To explore the correlation between Heart Rate Variability Index (HRV) and poor prognosis in patients with acute decompensated heart failure (ADHF). Methods A retrospective compilation of clinical data encompassed 128 cases of patients afflicted with acute decompensated heart failure (ADHF) who were admitted to and discharged from our hospital between April 2019 and July 2022. Subsequent to assessing their follow-up progress during the tracking period, the subjects were categorized into two cohorts: the poor prognosis group (n = 31) and the good prognosis group (n = 97). Comparative analysis of clinical data and Heart Rate Variability (HRV) parameters was executed between these two groups. Moreover, a multiple linear regression analysis was employed to identify the contributing factors associated with adverse prognoses in ADHF patients. Furthermore, the receiver operating characteristic (ROC) curve was employed to evaluate the prognostic predictive capability of HRV parameters among ADHF patients. Results The levels of SDNN (t = 3.924, P < 0.001), SDANN (t = 4.520, P < 0.001) and LF (t = 2.676, P = 0.018) in the poor prognosis group were significantly higher than those in the good prognosis group, and the differences were statistically significant (P < 0.05). The levels of PNN50 (t = 2.132, P = 0.035), HF (t = 11.781, P < 0.001) and LF/HF (t = 11.056, P < 0.001) in the poor prognosis group were significantly lower than those in the good prognosis group (P < 0.05). The results of multiple linear regression analysis indicated that SDNN, SDANN, LF, PNN50, and HF were factors influencing poor prognosis in ADHF patients (P < 0.05). The results of the ROC curve analysis indicate that the area under the curve (AUC) for predicting poor prognosis in ADHF patients using HRV parameters were as follows: SDNN (AUC = 0.818, 95% CI [0.722-0.914]), SDANN (AUC = 0.684, 95% CI [0.551-0.816]), PNN50 (AUC = 0.754, 95% CI [0.611-0.841]), LF/HF (AUC = 0.787, 95% CI [0.679-0.896]), and combined diagnosis (AUC = 0.901, 95% CI [0.832-0.970]). Among these, the combined diagnosis exhibited the highest AUC, sensitivity, and specificity for predicting poor prognosis in ADHF patients (P < 0.001). Conclusion The HRV parameters of SDNN, SDANN, PNN50 and LF/HF are closely related to the prognosis of ADHF patients. The combined detection of the above HRV parameters can improve the efficacy of predicting the poor prognosis of ADHF patients. This suggests that clinical staff can identify ADHF patients at risk of poor prognosis by long-term monitoring of HRV in the future.
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Affiliation(s)
- Hongbo Liu
- Department of Cadre Health, Qingdao Municipal Hospital (West district), Qingdao, China
| | - Xiaotong Wang
- Department of Cardiology, Liaocheng Third People’s Hospital, Liaocheng, China
| | - Xiaowei Wang
- Department of Traditional Chinese Medicine, Qingdao Municipal Hospital (West district), Qingdao, China
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Qiu Q, Song W, Zhou X, Yu Z, Wang M, Hao H, Pan D, Luo X. Heart rate variability is associated with cerebral small vessel disease in patients with diabetes. Front Neurol 2022; 13:989064. [PMID: 36438976 PMCID: PMC9685533 DOI: 10.3389/fneur.2022.989064] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 10/27/2022] [Indexed: 12/02/2023] Open
Abstract
OBJECTIVE Low heart rate variability (HRV), an indicator of autonomic nervous system dysfunction, has been associated with increased all-cause and cardiovascular mortality and incident stroke. However, the relationship between HRV and cerebral small vessel disease (CSVD) showed contradictory results. We aimed to examine the relationship of HRV and total burden of CSVD and each of the magnetic resonance imaging (MRI) markers of CSVD. METHODS We recruited 435 patients who attended our hospital for physical examination between June 2020 and August 2021. All underwent 24-h Holter monitoring and MRI scan. The standard deviation of normal-to-normal intervals (SDNN) was selected as the method for HRV assessment. The presence of severe white matter hyperintensity, lacunes, and >10 enlarged basal ganglia perivascular spaces, and cerebral microbleeds were added for estimating the CSVD score (0-4). Multivariate logistic analyses was performed to assess whether HRV was independently associated with the burden of CSVD and each of the MRI markers of CSVD, with and without stratification by prevalent diabetes. RESULTS This study included 435 subjects with a mean age of 64.0 (57.0-70.0) years; 49.4% of the patients were male, and 122 (28.0%) had a history of diabetes. In multivariate analyses, lower SDNN was independently associated with total burden of CSVD and the presence of enlarged perivascular spaces in all subjects. According to diabetes stratification, lower SDNN was independently associated with total burden of CSVD and each MRI markers of CSVD separately only in the diabetic group. CONCLUSIONS Lower HRV was associated with total burden of CSVD and each MRI markers of CSVD separately among diabetic patients, but not among non-diabetic patients.
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Affiliation(s)
- Qianwen Qiu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Neurology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenhui Song
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xirui Zhou
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhiyuan Yu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Minghuan Wang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huang Hao
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dengji Pan
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiang Luo
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Chen YK, Liang WC, Yuan SL, Ni ZX, Li W, Liu YL, Qu JF. Circadian rhythms of blood pressure in hypertensive patients with cerebral microbleeds. Brain Behav 2022; 12:e2530. [PMID: 35234352 PMCID: PMC9014997 DOI: 10.1002/brb3.2530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 12/27/2021] [Accepted: 01/20/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Whether the circadian rhythms of blood pressure (BP) contribute to the presence of cerebral microbleeds (CMBs) remains unknown. This study aimed to assess the relationship between nocturnal BP and CMBs in hypertensive patients. METHODS This prospective case-control study recruited 51 hypertensive patients with CMBs and 51 hypertensive patients without CMBs, matched with age and gender, serving as controls. A 24-h ambulatory BP monitoring was conducted in all subjects. Differences in ambulatory BP parameters between the two groups were compared. Logistic regression analyzes were conducted to investigate the relationship between the ambulatory BP parameters and presence of CMBs. RESULTS Patients with CMBs had a significant higher nocturnal mean SBP and lower relative nocturnal SBP dipping rate. Two logistic models were constructed to explore the association between ABPM indices and the presence of CMBs, adjusted with history of ischemic stroke and smoking. In model 1, higher nocturnal mean SBP positively correlated with presence of CMBs [standardized β = 0.254, odds ratio (OR) = 1.029, p = .041]. In model 2, the relative nocturnal SBP dipping rate was negatively correlated with CMBs (standardized β = -.363, OR = 0.918, p = .007). Only patients with deep CMBs had significant higher nocturnal mean SBP and lower relative nocturnal SBP dipping rate in comparison with those without CMBs. CONCLUSIONS Higher nocturnal SBP and lower relative nocturnal SBP dipping rate may be associated with CMBs in hypertensive patients.
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Affiliation(s)
- Yang-Kun Chen
- Department of Neurology, Dongguan People's Hospital (Affiliated Dongguan Hospital, Southern Medical University), Dongguan, Guangdong Province, China
| | - Wen-Cong Liang
- Department of Neurology, Dongguan People's Hospital (Affiliated Dongguan Hospital, Southern Medical University), Dongguan, Guangdong Province, China.,Department of Neurology, Graduate School of Guangdong Medical University, Zhanjiang, Guangdong Province, China
| | - Shu-Lan Yuan
- Department of Neurology, Dongguan People's Hospital (Affiliated Dongguan Hospital, Southern Medical University), Dongguan, Guangdong Province, China.,Department of Neurology, Graduate School of Guangdong Medical University, Zhanjiang, Guangdong Province, China
| | - Zhuo-Xin Ni
- Department of Neurology, Dongguan People's Hospital (Affiliated Dongguan Hospital, Southern Medical University), Dongguan, Guangdong Province, China
| | - Wei Li
- Department of Neurology, Dongguan People's Hospital (Affiliated Dongguan Hospital, Southern Medical University), Dongguan, Guangdong Province, China
| | - Yong-Lin Liu
- Department of Neurology, Dongguan People's Hospital (Affiliated Dongguan Hospital, Southern Medical University), Dongguan, Guangdong Province, China
| | - Jian-Feng Qu
- Department of Neurology, Dongguan People's Hospital (Affiliated Dongguan Hospital, Southern Medical University), Dongguan, Guangdong Province, China
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Application Effect of Doctor-Nurse-Patient Integration Model Based on Heart Rate Management Strategies in Middle-Aged and Young Outpatients with Hypertension. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:7459518. [PMID: 35341008 PMCID: PMC8942681 DOI: 10.1155/2022/7459518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/09/2022] [Accepted: 02/16/2022] [Indexed: 11/26/2022]
Abstract
Objective In this study, a doctor-nurse-patient integration management scheme based on heart rate (HR) management strategies was constructed to explore its application effect in the health management of young and middle-aged outpatients with hypertension. Methods A total of 75 young and middle-aged patients with essential hypertension admitted to the Outpatient Department of Cardiology of Heji Hospital Affiliated to Changzhi Medical College, Shanxi Province, from October 2019 to July 2020 were selected and divided into an observation group (n = 37) and a control group (n = 38) according to different treatment methods. The control group was treated with routine health education, basis on which, the observation group was additionally intervened by the doctor-nurse-patient integration model established upon HR management strategies. The resting heart rate (RHR) awareness, medication compliance, RHR, systolic/diastolic blood pressure (SBP/DBP), and self-management ability were compared between the two groups before and 3 months after intervention. The diet control rate, hypertension awareness rate, and regular review rate were also compared. Results The RHR awareness and medication compliance were significantly higher in the observation group compared with the control group after intervention (P < 0.05). There were 29 patients with high compliance in the observation group and 19 in the control group, with a significant difference between the two groups (P < 0.05). The mean RHR, as well as the mean SBP and DBP in the observation group, were significantly lower than those in the control group (P < 0.05). In terms of health behavior assessment, the observation group outperformed the control group in the score of each dimension of self-actualization, health responsibility, stress management, interpersonal support, exercise, and nutrition (P < 0.05). In addition, the self-management ability of diet, exercise, medication, blood pressure (BP) monitoring, and disease awareness was significantly higher in the observation group compared with the control group. Conclusions For middle-aged and young outpatients with hypertension, the doctor-nurse-patient integration model based on HR management strategies can improve the RHR awareness of patients and improve their medication compliance and self-management ability, thus better controlling the levels of RHR and BP.
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Tian D, Zhang L, Zhuang Z, Huang T, Fan D. A two-sample Mendelian randomization analysis of heart rate variability and cerebral small vessel disease. J Clin Hypertens (Greenwich) 2021; 23:1608-1614. [PMID: 34196464 PMCID: PMC8678680 DOI: 10.1111/jch.14316] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 04/14/2021] [Accepted: 05/03/2021] [Indexed: 11/26/2022]
Abstract
Cerebral small vessel disease (cSVD) is correlated with a high risk of stroke and cognitive impairment. Previous studies between heart rate variability (HRV) and cSVD revealed paradoxical results. The authors aimed to investigate the relationship between HRV and cSVD using Mendelian randomization analysis. Genetic instruments for HRV were obtained from previous genome‐wide association studies. They applied inverse variance‐weighted analysis, weighted median analysis, simple median analysis, and Mendelian randomization–Egger regression to evaluate the associations of HRV with white matter hyperintensity (WMH) and small vessel stroke (SVS) in the UK Biobank neuroimaging dataset and the MEGASTROKE genome‐wide association study dataset. Two genetically predicted traits of HRV (the root mean square of the successive differences of inter beat intervals [RMSSD] and the peak‐valley respiratory sinus arrhythmia or high frequency power [pvRSA/HF]) were suggestively associated with WMH (β 0.26, 95% confidence interval [CI] 0.04–0.49, p = .02; β 0.14, 95% CI 0.02–0.27, p = .03, respectively). Genetically predicted traits of HRV were not significantly associated with SVS. This study provides genetic support for a suggestive causal effect of HRV (RMSSD, pvRSA/HF) on WMH but not SVS.
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Affiliation(s)
- Danyang Tian
- Department of Neurology, Peking University Third Hospital, Beijing, China
| | - Linjing Zhang
- Department of Neurology, Peking University Third Hospital, Beijing, China
| | - Zhenhuang Zhuang
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Tao Huang
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Dongsheng Fan
- Department of Neurology, Peking University Third Hospital, Beijing, China
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