Department of Cardiology, Copenhagen University Hospital Herlev, The Copenhagen City Heart Study, Copenhagen University Hospital , Bispebjerg.
Scand J Clin Lab Invest. 2014 Mar;74(2):163-9. doi: 10.3109/00365513.2013.867531. Epub 2013 Dec 13.
Elevated resting heart rate (RHR) is associated with cardiovascular mortality and morbidity. Assessment of heart rate (HR) from Holter recording may afford a more precise estimate of the effect of RHR on cardiovascular risk, as compared to casual RHR. Comparative analysis was carried out in an age-stratified subsample of 131 subjects in the Copenhagen City Heart Study (CCHS).
Casual RHR was assessed from electrocardiograms recorded during clinical assessment. Hourly daytime HRs were mapped by Holter recording. Holter RHR was defined as the average of the lowest 3 hourly HRs recorded and mean HR calculated from all daytime HRs. Follow-up was recorded from public registers. Outcome measure was hazard rate for the combined endpoint of cardiovascular mortality, non-fatal heart failure and non-fatal acute myocardial infarction. Comparison of casual RHR, Holter RHR and mean HR by Multivariate Cox regression was performed.
A total of 57 composite endpoints occurred during 17.1 years of follow-up. Regression analysis suggests correlation between Casual RHR and Holter RHR. Multivariate Cox regression analysis adjusted for gender and age demonstrated hazard rates of 1.02 (p = 0.079) for casual RHR, 1.04 (p = 0.036*) for Holter RHR, and 1.03 (p = 0.093) for mean HR for each 10 beat increment in HR.
In a comparative analysis on the correlation and significance of differing RHR measurement modalities RHR measured by 24-hour Holter recording was found to be marginally superior as a predictor of cardiovascular morbidity and mortality. The results presented here do not however warrant the abandonment of a tested epidemiological variable.
静息心率（RHR）升高与心血管死亡率和发病率有关。与偶然的 RHR 相比，通过动态心电图记录评估心率（HR）可以更准确地估计 RHR 对心血管风险的影响。在哥本哈根城市心脏研究（CCHS）的一个年龄分层亚组中，对 131 名受试者进行了对比分析。
通过临床评估期间记录的心电图评估偶然的 RHR。通过动态心电图记录映射每小时白天的 HR。动态心电图 RHR 定义为记录的最低 3 小时 HR 的平均值和所有白天 HR 计算的平均 HR。随访记录来自公共登记处。终点是心血管死亡率、非致命性心力衰竭和非致命性急性心肌梗死的综合终点发生率。通过多变量 Cox 回归比较偶然 RHR、动态心电图 RHR 和平均 HR。
在 17.1 年的随访期间，共发生了 57 个复合终点事件。回归分析表明偶然 RHR 与动态心电图 RHR 之间存在相关性。多变量 Cox 回归分析调整了性别和年龄，表明 HR 每增加 10 次/分时，偶然 RHR 的危险比为 1.02（p = 0.079），动态心电图 RHR 的危险比为 1.04（p = 0.036*），平均 HR 的危险比为 1.03（p = 0.093）。
在对不同 RHR 测量方式的相关性和意义进行的对比分析中，发现 24 小时动态心电图记录的 RHR 作为心血管发病率和死亡率的预测指标略优。然而，这里提出的结果并不保证放弃经过测试的流行病学变量。
