Measurement of heart rate variability:: A clinical tool or a research toy?

被引:181
作者
Huikuri, HV
Mäkikallio, T
Airaksinen, KEJ
Mitrani, R
Castellanos, A
Myerburg, RJ
机构
[1] Univ Oulu, Dept Med, Div Cardiol, SF-90220 Oulu, Finland
[2] Univ Miami, Sch Med, Miami, FL USA
关键词
D O I
10.1016/S0735-1097(99)00468-4
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVES The objectives of this review are to discuss the diversity of mechanisms that may explain the association between heart rate (HR) variability and mortality, to appraise the clinical applicability of traditional and new measures of HR variability and to propose future directions in this field of research. There is a large body of data demonstrating that abnormal HR variability measured over a 24-h period provides information on the risk of subsequent death in subjects with and without structural heart disease. However, the mechanisms responsible for this association are not completely established. Therefore, no specific therapy is currently available to improve the prognosis for patients with abnormal HR variability. Reduced HR variability has been most commonly associated with a risk of arrhythmic death, but recent data suggest that abnormal variability also predicts vascular causes of death, progression of coronary atherosclerosis and death due to heart failure. A consensus is also lacking on the best HR variability measure for clinical purposes. Time and frequency domain measures of HR variability have been most commonly used, but recent studies show that new analysis methods based on nonlinear dynamics may be more powerful in terms of risk stratification. Before the measurement of HR variability can be applied to clinical practice and used to direct therapy, more precise insight into the pathophysiological link between HR variability and mortality are needed. Further studies should also address the issue of which of the HR variability indexes, including the new nonlinear measures, is best for clinical purposes in various patient populations. (C) 1999 by the American College of Cardiology.
引用
收藏
页码:1878 / 1883
页数:6
相关论文
共 66 条
[1]   Gender difference in autonomic and hemodynamic reactions to abrupt coronary occlusion [J].
Airaksinen, KEJ ;
Ikäheimo, MJ ;
Linnaluoto, M ;
Tahvanainen, KUO ;
Huikuri, HV .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1998, 31 (02) :301-306
[2]  
AIRAKSINEN KEJ, 1993, AM J CARDIOL, V72, P1026
[3]  
AIRAKSINEN KEJ, IN PRESS AM J CARDIO
[4]  
AKHTAR M, 1992, CIRCULATION, V85, P1
[5]   HEART-RATE-VARIABILITY FROM 24-HOUR ELECTROCARDIOGRAPHY AND THE 2-YEAR RISK FOR SUDDEN-DEATH [J].
ALGRA, A ;
TIJSSEN, JGP ;
ROELANDT, JRTC ;
POOL, J ;
LUBSEN, J .
CIRCULATION, 1993, 88 (01) :180-185
[6]   Risk stratification following myocardial infarction in the thrombolytic era -: A two-step strategy using noninvasive and invasive methods [J].
Andresen, D ;
Steinbeck, G ;
Brüggemann, T ;
Müller, D ;
Haberl, R ;
Behrens, S ;
Hoffmann, E ;
Wegscheider, K ;
Dissmann, R ;
Ehlers, HC .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1999, 33 (01) :131-138
[7]   Autonomic markers and prediction of cardiac death after myocardial infarction [J].
Barron, HV ;
Viskin, S .
LANCET, 1998, 351 (9101) :461-462
[8]   RETARDING EFFECT OF LOWERED HEART-RATE ON CORONARY ATHEROSCLEROSIS [J].
BEERE, PA ;
GLAGOV, S ;
ZARINS, CK .
SCIENCE, 1984, 226 (4671) :180-182
[9]   Power law behavior of RR-interval variability in healthy middle-aged persons, patients with recent acute myocardial infarction, and patients with heart transplants [J].
Bigger, JT ;
Steinman, RC ;
Rolnitzky, LM ;
Fleiss, JL ;
Albrecht, P ;
Cohen, RJ .
CIRCULATION, 1996, 93 (12) :2142-2151
[10]   FREQUENCY-DOMAIN MEASURES OF HEART PERIOD VARIABILITY AND MORTALITY AFTER MYOCARDIAL-INFARCTION [J].
BIGGER, JT ;
FLEISS, JL ;
STEINMAN, RC ;
ROLNITZKY, LM ;
KLEIGER, RE ;
ROTTMAN, JN .
CIRCULATION, 1992, 85 (01) :164-171