Chattipakorn Nipon, Incharoen Tanat, Kanlop Natnicha, Chattipakorn Siriporn
Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Int J Cardiol. 2007 Sep 3;120(3):289-96. doi: 10.1016/j.ijcard.2006.11.221. Epub 2007 Mar 8.
The need to refine the identification of patients who might benefit from implantation of an implantable cardioverter defibrillator has been risen by the results of many clinical trials on ICD therapy. Traditional parameters such as left ventricular ejection fraction and the presence of non-sustained ventricular tachycardia were not strong enough to achieve this goal with reasonable cost-effectiveness. Heart rate variability (HRV) is one of the most popular parameters used to assess the autonomic tone. HRV has been reported as a strong predictor of cardiovascular mortality. Currently, three different categories of methods in HRV analysis are being used; the time domain, frequency domain, and non-linear dynamic analysis. Both time domain and frequency domain analyses of HRV have been investigated extensively regarding their use as a prognostic marker for cardiovascular mortality. The non-linear dynamic analysis is the latest tool that has shown to have an even higher predictive value than any of the traditional parameters. However, standardized and supporting evidence on this new technique is still lacking. In this article, the current role of HRV in the prediction of cardiovascular mortality in myocardial infarction and heart failure patients has been reviewed.
许多关于植入式心脏复律除颤器（ICD）治疗的临床试验结果，使得精准识别可能从ICD植入中获益的患者的需求日益凸显。诸如左心室射血分数和非持续性室性心动过速等传统参数，在以合理的成本效益实现这一目标方面力度不够。心率变异性（HRV）是用于评估自主神经张力的最常用参数之一。据报道，HRV是心血管死亡率的有力预测指标。目前，HRV分析使用三种不同类别的方法：时域、频域和非线性动力学分析。HRV的时域和频域分析作为心血管死亡率的预后标志物的应用已得到广泛研究。非线性动力学分析是最新工具，已显示出比任何传统参数都更高的预测价值。然而，关于这项新技术的标准化和支持性证据仍然缺乏。在本文中，我们综述了HRV在预测心肌梗死和心力衰竭患者心血管死亡率方面的当前作用。
