[Clinical research of heart rate turbulence on predictive value in patients with acute myocardial infarction].
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.
Zhang
De-qiang
DQ
Department of Cardiology, Beijing Friendship Hospital, Capital University of Medical Science, Beijing 100050, China.
Huang
Jie-ying
JY
Fang
Ye-ming
YM
Wu
Yong-quan
YQ
Liang
Jin-rui
JR
Ma
Wen-ying
WY
Wang
Ping
P
Qi
Lian-fen
LF
Liu
Xiao-jie
XJ
Li
Chuan-jie
CJ
Li
Hong-wei
HW
Jia
San-qing
SQ
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*