title: Quality of life and circadian variation of heart rate and heart rate variability in short-term survivors and nonsurvivors after acute myocardial infarction.
abstract: The purpose of this study was the simultaneous examination of the quality of life and changes in heart rate (HR) variables of patients immediately following acute myocardial infarction (AMI). Quality of life, estimated on a rating scale assessing the patients' well-being, as well as the circadian rhythm of their HR and HR variability, were determined within the first 3 days and at approximately 3 weeks after admission and the results were related to survival. The quality of life within the first 3 days post AMI was low in both the surviving (n = 42) and the nonsurviving (n = 5) patients but only the scores of the survivors increased significantly over the following three weeks. The HR of the survivors, initially lower than that of the nonsurvivors, decreased significantly at 3 weeks and a normal circadian pattern had developed. The HR variability of the survivors within the first 3 days was significantly higher than that of the nonsurvivors and had developed a clear circadian pattern after 3 weeks. It is concluded that in patients with AMI such diverse clinical aspects as quality of life and circadian patterns of HR and HR variability can be assessed meaningfully immediately post AMI and may find common expression in changes in sympathovagal balance.
authors.affiliation: Department of Internal Medicine, Gemeinschaftskrankenhaus Herdecke, University of Witten/Herdecke, Germany.
authors.forename: H C
authors.initials: HC
authors.lastname: Kümmell
authors.forename: P
authors.initials: P
authors.lastname: Van Leeuwen
authors.forename: C
authors.initials: C
authors.lastname: Heckmann
authors.forename: P
authors.initials: P
authors.lastname: Engelke
authors.forename: G
authors.initials: G
authors.lastname: Kesting
authors.forename: H
authors.initials: H
authors.lastname: Kremer
authors.forename: A
authors.initials: A
authors.lastname: Becher
mesh_terms: D000368:Aged; D002940:Circadian Rhythm / Q000502:physiology*; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000503:physiopathology*; D011446:Prospective Studies; D011788:Quality of Life; D017741:Survivors; D013997:Time Factors