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- Janszky, I., et al.
(författare)
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Heart rate variability in long-term risk assessment in middle-aged women with coronary heart disease : The Stockholm Female Coronary Risk Study
- 2004
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Ingår i: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 255:1, s. 13-21
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. Low heart rate variability (HRV) is associated with poor prognosis after acute coronary events in men. In women, the prognostic impact is not well documented. The objective of this study was to assess the long-term predictive power of HRV on mortality amongst middle-aged women with coronary heart disease (CHD). Design, Settings and Subjects. Consecutive women below 65 years hospitalized for an acute coronary syndrome during a 3-year period in Stockholm were examined for cardiovascular prognostic factors including HRV, and followed for a median of 9 years. An ambulatory 24-h electrocardiograph was recorded during normal activities, 3-6 months after hospitalization. SDNN index (mean of the standard deviations of all normal to normal intervals for all 5-min segments of the entire recording) and the following frequency domain parameters were assessed: total power, high-frequency (HF) power, low-frequency (LF) power, very-low frequency (VLF) power and LF/HF ratio. Using Cox proportional hazards regression, the hazard ratios (HR) for each 25% decrease of the HRV parameters were assessed. Results. After controlling for the independent, significant predictors of mortality amongst the clinical variables, the following HRV parameters were found to be significant predictors of all-cause mortality: SDNN index [HR 1.56, 95% confidence intervals (CI) 1.19-2.05], total power (HR 1.21, 95% CI 1.08-1.35), VLF power (HR 1.22, 95% CI 1.09-1.36), LF power (HR 1.18 95%, CI 1.07-1.30) and HF power (HR 1.18, 95% CI 1.05-1.33). The results were essentially the same when cardiovascular mortality was used as end-points. The HRV parameters were stronger predictors of mortality in the first 5 years following the index event. Conclusion. Low HRV is a predictor of long-term mortality amongst middle-aged women with CHD when measured 3-6 months after hospitalization for an acute coronary syndrome, even after controlling for established clinical prognostic markers.
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- Koertge, J., et al.
(författare)
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Vital exhaustion and recurrence of CHD in women with acute myocardial infarction
- 2002
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Ingår i: Psychology, Health & Medicine. - : Informa UK Limited. - 1354-8506 .- 1465-3966. ; 7:2, s. 117-126
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to investigate the prospective impact of vital exhaustion on recurrence after acute myocardial infarction (AMI) in women. Women ≤ 65 years, mean age = 55.30, SD = 7. 63, N = 110, consecutively admitted to a coronary care unit with AMI were examined after three-six months, and followed for five years. Vital exhaustion was assessed using an early version of the Maastricht Questionnaire. A recurrent event was defined as cardiac death, AMI or a revascularization procedure. Forty-five recurrent events were found (in 41% of the study group). One standard deviation (8.4 points) increase of vital exhaustion scores was associated with a 53 % increased risk of a new event and a score above the median was associated with a hazard ratio of 2.24 (95% CI 1.21-4.14). These results remained after adjusting severity of chest pain and significant coronary stenosis. In conclusion, it was found that vital exhaustion is a marker of poor prognosis in women with AMI. The relationship appears to be independent of signs of underlying disease, including severity of chest pain and significant coronary stenosis.
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