title: Prognostic Value of Heart Rate Variability in Patients With Cancer.
abstract: Previous studies have shown that autonomic dysfunction is associated with shorter survival in patients with advanced cancer. We examined the association between heart rate variability, a measure of autonomic function, and survival in a large cohort of patients with cancer.
  
  
  
  We retrospectively examined the records of 651 patients with cancer who had undergone ambulatory electrocardiogram monitoring for 20 to 24 hours. Time domain heart rate variability (SD of normal-to-normal beat interval [SDNN]) was calculated using power spectral analysis. Survival data were compared between patients with SDNN ≥ 70 milliseconds (Group 1, n = 520) and SDNN < 70 milliseconds (Group 2, n = 131).
  
  
  
  Two groups were similar in most variables, except that patients in group 2 had a significantly higher percentage of male patients (P = 0.03), hematological malignancies (P = 0.04), and use of non-selective serotonin reuptake inhibitor antidepressants (P = 0.04). Patients in group 2 had a significantly shorter survival rate (25% of patients in group 2 died by 18.7 weeks vs. 78.9 weeks in group 1 patients; P < 0.0001). Multivariate analysis showed that SDNN < 70 milliseconds remained significant for survival (hazard ratio 1.9 [95% confidence interval: 1.4-2.5]) independent of age, cancer stage, and performance status.
  
  
  
  The presence of cancer in combination with decreased heart rate variability (SDNN < 70 milliseconds) is associated with shorter survival time.
authors.affiliation: *Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A.; †Corrona Research Foundation, Albany, New York, U.S.A.; ‡Department of Physical Medicine and Rehabilitation, Dicle University Faculty of Medicine, Diyarbakir, Turkey; and §Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, U.S.A.
authors.forename: Ying
authors.initials: Y
authors.lastname: Guo
authors.forename: Shalini
authors.initials: S
authors.lastname: Koshy
authors.forename: David
authors.initials: D
authors.lastname: Hui
authors.forename: J Lynn
authors.initials: JL
authors.lastname: Palmer
authors.forename: Ki
authors.initials: K
authors.lastname: Shin
authors.forename: Mehtap
authors.initials: M
authors.lastname: Bozkurt
authors.forename: Syed Wamique
authors.initials: SW
authors.lastname: Yusuf
mesh_terms: D000328:Adult; D000368:Aged; D001341:Autonomic Nervous System / Q000503:physiopathology*; D015331:Cohort Studies; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000503:physiopathology*; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult