Document Detail


Heart rate turbulence predicts all-cause mortality and sudden death in congestive heart failure patients.
MedLine Citation:
PMID:  18675217     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Abnormal heart rate turbulence (HRT) has been documented as a strong predictor of total mortality and sudden death in postinfarction patients, but data in patients with congestive heart failure (CHF) are limited. OBJECTIVE: The aim of this study was to evaluate the prognostic significance of HRT for predicting mortality in CHF patients in New York Heart Association (NYHA) class II-III. METHODS: In 651 CHF patients with sinus rhythm enrolled into the MUSIC (Muerte Subita en Insuficiencia Cardiaca) study, the standard HRT parameters turbulence onset (TO) and slope (TS), as well as HRT categories, were assessed for predicting total mortality and sudden death. RESULTS: HRT was analyzable in 607 patients, mean age 63 years (434 male), 50% of ischemic etiology. During a median follow up of 44 months, 129 patients died, 52 from sudden death. Abnormal TS and HRT category 2 (HRT2) were independently associated with increased all-cause mortality (HR: 2.10, CI: 1.41 to 3.12, P <.001 and HR: 2.52, CI: 1.56 to 4.05, P <.001; respectively), sudden death (HR: 2.25, CI: 1.13 to 4.46, P = .021 for HRT2), and death due to heart failure progression (HR: 4.11, CI: 1.84 to 9.19, P <.001 for HRT2) after adjustment for clinical covariates in multivariate analysis. The prognostic value of TS for predicting total mortality was similar in various groups dichotomized by age, gender, NYHA class, left ventricular ejection fraction, and CHF etiology. TS was found to be predictive for total mortality only in patients with QRS > 120 ms. CONCLUSION: HRT is a potent risk predictor for both heart failure and arrhythmic death in patients with class II and III CHF.
Authors:
Iwona Cygankiewicz; Wojciech Zareba; Rafael Vazquez; Montserrat Vallverdu; Jose R Gonzalez-Juanatey; Mariano Valdes; Jesus Almendral; Juan Cinca; Pere Caminal; Antoni Bayes de Luna;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2008-05-02
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  5     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-08-04     Completed Date:  2008-12-15     Revised Date:  2009-10-27    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1095-1102     Citation Subset:  IM    
Affiliation:
Catalan Institute of Cardiovascular Sciences, Barcelona, Spain; University of Rochester, Rochester, New York 14642, USA. iwona.cygankiewicz@heart.rochester.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Algorithms
Death, Sudden, Cardiac / epidemiology,  etiology*
Disease Progression
Female
Heart Failure / complications*,  mortality*,  physiopathology
Heart Rate*
Humans
Male
Middle Aged
Mortality / trends
Multivariate Analysis
Predictive Value of Tests
Prognosis
Prospective Studies
Risk Assessment
Risk Factors
United States / epidemiology
Investigator
Investigator/Affiliation:
Antonio Bayes de Luna / ; Juan Cinca / ; Iwona Cygankiewicz / ; Antonio Bayes Genis / ; Maite Domingo / ; Mariana Noquero / ; Rafael Vázquez / ; Luis Pastor / ; Jose M Cubero / ; Antonio Fernández / ; Juan Leal del Ojo / ; Ricardo Pavón / ; Dolores García-Medina / ; Mariano Valdés / ; Domingo Pascual / ; Pilar Ansaldo / ; José R González Juanatey / ; Pilar Mazón / ; Lilian Grigorian / ; Fernando Otero / ; Miguel Fiol / ; Carlos Fernández / ; Jesús Almendral / ; Marta Domínguez / ; Roberto Muñoz / ; Alfredo Bardají / ; Ramón de Castro / ; Pilar Valdovinos / ; Vicente Nieto / ; Efren Martínez / ; Olga Medina / ; Ricardo Huerta /
Comments/Corrections
Comment In:
Heart Rhythm. 2008 Aug;5(8):1103-4   [PMID:  18675218 ]

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