Tohoku University Graduate School of Engineering, Sendai, Japan.
Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Ann Noninvasive Electrocardiol. 2021 Jan;26(1):e12790. doi: 10.1111/anec.12790. Epub 2020 Aug 17.
Many indices of heart rate variability (HRV) and heart rate dynamics have been proposed as cardiovascular mortality risk predictors, but the redundancy between their predictive powers is unknown.
From the Allostatic State Mapping by Ambulatory ECG Repository project database, 24-hr ECG data showing continuous sinus rhythm were extracted and SD of normal-to-normal R-R interval (SDNN), very-low-frequency power (VLF), scaling exponent α , deceleration capacity (DC), and non-Gaussianity λ were calculated. The values were dichotomized into high-risk and low-risk values using the cutoffs reported in previous studies to predict mortality after acute myocardial infarction. The rate of multiple high-risk predictors accumulating in the same person was examined and was compared with the rate expected under the assumption that these predictors are independent of each other.
Among 265,291 ECG data from the ALLSTAR database, the rates of subjects with high-risk SDNN, DC, VLF, α , and λ values were 2.95, 2.75, 5.89, 15.75, and 18.82%, respectively. The observed rate of subjects without any high-risk value was 66.68%, which was 1.10 times the expected rate (60.74%). The ratios of observed rate to the expected rate at which one, two, three, four, and five high-risk values accumulate in the same person were 0.73 times (24.10 and 32.82%), 1.10 times (6.56 and 5.99%), 4.26 times (1.87 and 0.44%), 47.66 times (0.63 and 0.013%), and 1,140.66 times (0.16 and 0.00014%), respectively.
High-risk predictors of HRV and heart rate dynamics tend to cluster in the same person, indicating a high degree of redundancy between them.
许多心率变异性（HRV）和心率动力学指标已被提出作为心血管死亡率的风险预测因子，但它们的预测能力之间的冗余性尚不清楚。
从动态心电图储备项目数据库的全身适应状态映射中，提取出显示连续窦性节律的 24 小时心电图数据，并计算正常-正常 R-R 间期的标准差（SDNN）、极低频功率（VLF）、标度指数α、减速能力（DC）和非高斯性λ。使用以前研究报告的截止值将这些值分为高风险值和低风险值，以预测急性心肌梗死后的死亡率。检查同一人同时存在多个高风险预测因子的概率，并将其与假设这些预测因子彼此独立的情况下的预期概率进行比较。
在 ALLSTAR 数据库的 265291 份心电图数据中，SDNN、DC、VLF、α和λ值高风险的受试者比例分别为 2.95%、2.75%、5.89%、15.75%和 18.82%。没有任何高风险值的受试者的观察率为 66.68%，是预期率（60.74%）的 1.10 倍。在同一人同时存在一个、两个、三个、四个和五个高风险值的情况下，观察率与预期率的比值分别为 0.73 倍（24.10%和 32.82%）、1.10 倍（6.56%和 5.99%）、4.26 倍（1.87%和 0.44%）、47.66 倍（0.63%和 0.013%）和 1140.66 倍（0.16%和 0.00014%）。
HRV 和心率动力学的高风险预测因子往往在同一人身上聚集，表明它们之间存在高度的冗余。
