title: [Clinical research of heart rate turbulence on predictive value in patients with acute myocardial infarction].
abstract: OBJECTIVE
  To assess the predictive value of heart rate turbulence (HRT) in patients with acute myocardial infarction.
  
  
  METHODS
  One hundred and twenty-five patients with acute myocardial infarction were enrolled in this study. During the period from 6 to 21 days after onset of acute myocardial infarction, they were undergone 24-hour Holter recordings to collect the mean RR interval and heart rate variability (HRV) SDNN. The Holter files were processed with software of "HRT! View V0.60-1" to obtain the value of Turbulence Onset (TO) and Turbulence Slope (TS) and the value of "heart rate variability (HRV) SDNN". LVEF and EDD were measured by Ultrasonic Cardiography. Endpoint of follow-up was cardiac death. According to the results, patients were divided into two groups (the "survivors" and the "nonsurvivors"). The predictive value for high-risk patients with acute myocardial infarction was assessed by variables between the two groups.
  
  
  RESULTS
  In the period of follow-up (mean 225.4 +/- 99.8 days), 14 patients died and 111 patients survived. In the univariate Cox regression analysis, "TS" was a strong univariate predictor of mortality (hazard ratio 11.46, P < 0.01); "TO" was a relatively weak predictor and the hazard ratio was 2.76 (P > 0.05). Combination of abnormal TO and abnormal TS was the strongest mortality predictor (hazard ratio 26.70, P < 0.01); in the multivariate Cox regression analysis, TS < or = 2.5 ms/RR and EDD > or = 5.6 cm were the independent predictors of mortality with hazard ratios 9.49 (P < 0.01) and 3.64 (P < 0.05), respectively.
  
  
  CONCLUSIONS
  The absence of the heart rate turbulence after ventricular premature beats is a very potent post-infarction risk predictor which is independent of and stronger than other known risk predictors.
authors.affiliation: Department of Cardiology, Beijing Friendship Hospital, Capital University of Medical Science, Beijing 100050, China.
authors.forename: De-qiang
authors.initials: DQ
authors.lastname: Zhang
authors.forename: Jie-ying
authors.initials: JY
authors.lastname: Huang
authors.forename: Ye-ming
authors.initials: YM
authors.lastname: Fang
authors.forename: Yong-quan
authors.initials: YQ
authors.lastname: Wu
authors.forename: Jin-rui
authors.initials: JR
authors.lastname: Liang
authors.forename: Wen-ying
authors.initials: WY
authors.lastname: Ma
authors.forename: Ping
authors.initials: P
authors.lastname: Wang
authors.forename: Lian-fen
authors.initials: LF
authors.lastname: Qi
authors.forename: Xiao-jie
authors.initials: XJ
authors.lastname: Liu
authors.forename: Chuan-jie
authors.initials: CJ
authors.lastname: Li
authors.forename: Hong-wei
authors.initials: HW
authors.lastname: Li
authors.forename: San-qing
authors.initials: SQ
authors.lastname: Jia
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000503:physiopathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D018879:Ventricular Premature Complexes / Q000401:mortality* / Q000503:physiopathology*