Kim Kyungsuk, Chae Jean, Lee Sanghun
J Palliat Care. 2015;31(2):103-8. doi: 10.1177/082585971503100206.
Several recent studies have suggested that assessing heart rate variability (HRV) is an easy method for obtaining prognostic information on cancer patients; however, these studies had limitations such as uncontrolled confounders and small numbers in a heterogeneous group. The intention of our study was to explore and validate the role of HRV variables in patients with advanced non-small-cell lung cancer (NSCLC).
A total of 167 patients who were eligible for HRV testing were consecutively enrolled from a regional hospital in South Korea. Demographic and clinical variables, including the Eastern Cooperative Oncology Group (ECOG) performance status grade, NSCLC stage, therapeutic intervention, and other data were also recorded. The effects of time-domain and frequency-domain indices of HRV were compared with other clinical factors to determine overall survival.
Among the HRV parameters, standard deviation of all normal-to-normal intervals (SDNN) significantly predicted poor survival by univariate analysis. However, multivariate analysis revealed that it was not an independent prognosticator for survival in NSCLC patients, as the HRV parameters significantly correlated with the ECOG performance status grade.
HRV variables should be used to monitor advanced NSCLC patients' general well-being and ability to perform the activities of daily living rather than to predict their overall survival.
最近的几项研究表明，评估心率变异性（HRV）是获取癌症患者预后信息的一种简便方法；然而，这些研究存在局限性，如混杂因素未得到控制以及异质性群体数量较少。我们研究的目的是探讨并验证HRV变量在晚期非小细胞肺癌（NSCLC）患者中的作用。
从韩国一家地区医院连续招募了167名符合HRV检测条件的患者。还记录了人口统计学和临床变量，包括东部肿瘤协作组（ECOG）体能状态分级、NSCLC分期、治疗干预及其他数据。将HRV的时域和频域指标的影响与其他临床因素进行比较，以确定总生存期。
在HRV参数中，单因素分析显示，所有正常RR间期标准差（SDNN）显著预示着较差的生存期。然而，多因素分析表明，它并非NSCLC患者生存的独立预后因素，因为HRV参数与ECOG体能状态分级显著相关。
HRV变量应用于监测晚期NSCLC患者的总体健康状况和日常生活活动能力，而非预测其总生存期。
