Reshef Maya, Perek Shay, Odeh Tamer, Hamati Khalil, Raz-Pasteur Ayelet
Internal Medicine "A" Department, Rambam Medical Health Care Campus, Haifa 3109601, Israel.
Emergency Medicine Department, Rambam Medical Health Care Campus, Haifa 3109601, Israel.
J Clin Med. 2024 Nov 28;13(23):7255. doi: 10.3390/jcm13237255.
Myocardial infarction (MI) is a common emergency with high rates of morbidity and mortality. Current risk stratification scores for non-ST-elevation MI (NSTEMI) use subjective or delayed information. Heart rate variability was shown to correlate with prognosis following MI. This study aimed to evaluate ultra-short heart rate variability (usHRV) as a prognostic factor in NSTEMI patients. : A retrospective analysis was performed on 183 NSTEMI patients admitted to Rambam Health Care Campus in 2014. usHRV measures, including the standard deviation of normal-to-normal intervals (SDNN) and root mean square of successive differences (RMSSD), were calculated. Logistic regression assessed whether clinical, laboratory, or usHRV parameters predicted severe in-hospital complications like heart failure (HF), atrial flutter/fibrillation (AFL/AF), ventricular tachycardia/fibrillation (VT/VF), and atrioventricular block (AVB). Both Cox and logistic regression were used for survival analysis. : Of 183 patients (71.6% male, mean age 67.1), 35 (19%) died within 2 years. In-hospital complications included 39 cases (21.3%) of HF, 3 cases (1.6%) of VT/VF, and 9 cases (4.9%) of AVB. Lower usHRV was significantly associated with higher mortality at 2 years and showed marginal significance at 90 days and 1 year. Increased usHRV was linked to a higher risk of in-hospital ventricular arrhythmia (VT/VF). : Overall, this study is in agreement with previous research, showing a correlation between low usHRV and a higher mortality risk. However, the association between usHRV and the risk of VT/VF demands further investigation. More expansive prospective studies are needed to strengthen the observed associations.
心肌梗死（MI）是一种常见的急症，发病率和死亡率很高。目前用于非ST段抬高型心肌梗死（NSTEMI）的风险分层评分采用主观或延迟信息。心率变异性被证明与心肌梗死后的预后相关。本研究旨在评估超短心率变异性（usHRV）作为NSTEMI患者的预后因素。：对2014年入住兰巴姆医疗保健校园的183例NSTEMI患者进行了回顾性分析。计算了usHRV指标，包括正常到正常间期的标准差（SDNN）和逐次差值的均方根（RMSSD）。逻辑回归评估临床、实验室或usHRV参数是否能预测严重的院内并发症，如心力衰竭（HF）、心房扑动/颤动（AFL/AF）、室性心动过速/颤动（VT/VF）和房室传导阻滞（AVB）。Cox回归和逻辑回归均用于生存分析。：183例患者（男性占71.6%，平均年龄67.1岁）中，35例（19%）在2年内死亡。院内并发症包括39例（21.3%）HF、3例（1.6%）VT/VF和9例（4.9%）AVB。较低的usHRV与2年时较高的死亡率显著相关，在90天和1年时显示出边缘显著性。usHRV增加与院内室性心律失常（VT/VF）风险较高相关。：总体而言，本研究与先前的研究一致，表明低usHRV与较高的死亡风险之间存在相关性。然而，usHRV与VT/VF风险之间的关联需要进一步研究。需要更广泛的前瞻性研究来加强观察到的关联。
