Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, Korea.
Institute of Gastroenterology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, Korea.
PLoS One. 2018 Mar 2;13(3):e0193753. doi: 10.1371/journal.pone.0193753. eCollection 2018.
High heart rate is an independent predictor of total cancer incidence and all-cause mortality in patients with cancer. We aimed to evaluate the impact of resting heart rate on the recurrence of colorectal polyp, using long-term surveillance follow-up data of colorectal cancer survivors.
Three hundred patients were selected from the colorectal cancer survivor cohort of Severance Hospital, Seoul, Korea. Resting heart rate, physical activity, and body composition analysis at the time of 5-year survival, and clinical data including colonoscopy surveillance results were collected for mean follow-up duration of 8 years.
Patients with a high resting heart rate showed a significantly higher recurrence rate of advanced adenoma than those with a low resting heart rate (quartile 1, 45-66 beats per minute (b.p.m.); quartile 2, 67-73 b.p.m.; quartile 3, 74-80 b.p.m.; quartile 4, 81-120 b.p.m.; 3.8% vs. 7.9% vs. 10.0% vs. 14.7%, p for trend = 0.018). After adjustment for various risk factors, patients in the highest quartile of resting heart rate (≥ 81 b.p.m.) had a significantly higher risk of advanced adenoma recurrence (hazard ratio [HR]: 6.183, 95% confidence interval [CI]: 1.181-32.373, p = 0.031), compared to those in the lowest quartile (≤ 66 b.p.m.). In subgroup analysis, the association of resting heart rate with advanced adenoma recurrence appeared to be stronger among patients who had more than normal body fat mass or sedentary life style.
Elevated resting heart rate was independently associated with a higher rate of advanced adenoma recurrence in colorectal cancer survivors.
高心率是癌症患者总癌症发病率和全因死亡率的独立预测因素。我们旨在使用韩国首尔 Severance 医院的结直肠癌幸存者队列的长期监测随访数据来评估静息心率对结直肠息肉复发的影响。
从韩国首尔 Severance 医院的结直肠癌幸存者队列中选择了 300 名患者。在 5 年生存时收集静息心率、体力活动和身体成分分析以及包括结肠镜监测结果在内的临床数据，平均随访时间为 8 年。
静息心率较高的患者高级腺瘤的复发率明显高于静息心率较低的患者（第 1 四分位数，45-66 次/分钟；第 2 四分位数，67-73 次/分钟；第 3 四分位数，74-80 次/分钟；第 4 四分位数，81-120 次/分钟；3.8%比 7.9%比 10.0%比 14.7%，趋势检验 p=0.018）。在调整了各种危险因素后，静息心率最高四分位数（≥81 次/分钟）的患者高级腺瘤复发的风险显著更高（风险比[HR]：6.183，95%置信区间[CI]：1.181-32.373，p=0.031），与最低四分位数（≤66 次/分钟）相比。在亚组分析中，静息心率与高级腺瘤复发的关联在体脂过多或久坐生活方式的患者中似乎更强。
静息心率升高与结直肠癌幸存者中高级腺瘤复发率升高独立相关。
