American Journal of Cardiology
Volume 103, Issue 8 , Pages 1066-1072 , 15 April 2009

Prognostic Value of Heart Rate Turbulence and Its Relation to Inflammation in Patients With Unstable Angina Pectoris

  • Gaetano A. Lanza, MD

      Affiliations

    • Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Roma, Italy
    • Corresponding Author InformationCorresponding author: Tel: +3906-06-3015-4187; fax: +39-06-305-5535
    • ,
  • Gregory A. Sgueglia, MD

      Affiliations

    • Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Roma, Italy
    • ,
  • Giulia Angeloni, MD

      Affiliations

    • Dipartimento Cardiovascolare, Università Cattolica del Sacro Cuore, Campobasso, Italy
    • ,
  • Sergio Valsecchi

      Affiliations

    • Medtronic Italia S.p.A., Roma, Italy
    • ,
  • Alfonso Sestito, MD

      Affiliations

    • Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Roma, Italy
    • ,
  • Antonio G. Rebuzzi, MD

      Affiliations

    • Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Roma, Italy
    • ,
  • Filippo Crea, MD

      Affiliations

    • Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Roma, Italy
    • ,
  • Attilio Maseri, MD

      Affiliations

    • Dipartimento Cardiovascolare, Università Vita e Salute, Ospedale San Raffaele, Milano, Italy
    • ,
  • Domenico Cianflone, MD

      Affiliations

    • Dipartimento Cardiovascolare, Università Vita e Salute, Ospedale San Raffaele, Milano, Italy
    • ,
  • Stratificazione Prognostica dell'Angina Instabile Study Investigators

Received 9 October 2008 ,Revised 5 January 2009 ,Accepted 5 January 2009.

References 

  1. Lanza GA, Cianflone D, Rebuzzi AG, Angeloni G, Sestito A, Ciriello G, et al. Prognostic value of ventricular arrhythmias and heart rate variability in patients with unstable angina. Heart. 2006;92:1055–1063
  2. Francis J, Watanabe MA, Schmidt G. Heart rate turbulence: a new predictor for risk of sudden cardiac death. Ann Noninvasive Electrocardiol. 2005;10:102–109
  3. Davies LC, Francis DP, Ponikowski P, Piepoli MF, Coats AJ. Relation of heart rate and blood pressure turbulence following premature ventricular complexes to baroreflex sensitivity in chronic congestive heart failure. Am J Cardiol. 2001;87:737–742
  4. Schmidt G, Malik M, Barthel P, Schneider R, Ulm K, Rolnitzky L, et al. Heart-rate turbulence after ventricular premature beats as a predictor of mortality after acute myocardial infarction. Lancet. 1999;353:1390–1396
  5. Barthel P, Schneider R, Bauer A, Ulm K, Schmitt C, Schömig A, et al. Risk stratification after acute myocardial infarction by heart rate turbulence. Circulation. 2003;108:1221–1226
  6. Makikallio TH, Barthel P, Schneider R, Vuolteenaho O, Tapanainen JM, Ylitalo K, et al. Prediction of sudden cardiac death after acute myocardial infarction: role of Holter monitoring in the modern treatment era. Eur Heart J. 2005;26:762–769
  7. Sade E, Aytemir K, Oto A, Ozmen F, Ozkutlu H, Tokgözoglu L, et al. Assessment of heart rate turbulence in the acute phase of myocardial infarction for long-term prognosis. Pacing Clin Electrophysiol. 2003;26:544–550
  8. Ghuran A, Reid F, La Rovere MT, Schmidt G, Bigger JT, Camm AJ, et al. Heart rate turbulence-based predictors of fatal and nonfatal cardiac arrest (the Autonomic Tone and Reflexes After Myocardial Infarction substudy). Am J Cardiol. 2002;89:184–190
  9. Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation. 2002;105:1135–1143
  10. Corti R, Fuster V, Badimon JJ. Pathogenetic concepts of acute coronary syndromes. J Am Coll Cardiol. 2003;41(suppl S):7S–14S
  11. Borovikova LV, Ivanova S, Zhang M, Yang H, Botchkina GI, Watkins LR, et al. Vagus nerve stimulation attenuates the systemic inflammatory response to endotoxin. Nature. 2000;405:458–462
  12. Jensen-Urstad M, Jensen-Urstad K, Ericson M, Johansson J. Heart rate variability is related to leucocyte count in men and to blood lipoproteins in women in a healthy population of 35-year-old subjects. J Intern Med. 1998;243:33–40
  13. Sajadieh A, Nielsen OW, Rasmussen V, Hein HO, Abedini S, Hansen JF. Increased heart rate and reduced heart-rate variability are associated with subclinical inflammation in middle-aged and elderly subjects with no apparent heart disease. Eur Heart J. 2004;25:363–370
  14. Janszky I, Ericson M, Lekander M, Blom M, Buhlin K, Georgiades A, et al. Inflammatory markers and heart rate variability in women with coronary heart disease. J Intern Med. 2004;256:421–428
  15. Aronson D, Mittleman MA, Burger AJ. Interleukin-6 levels are inversely correlated with heart rate variability in patients with decompensated heart failure. J Cardiovasc Electrophysiol. 2001;12:294–300
  16. Malave HA, Taylor AA, Nattama J, Deswal A, Mann DL. Circulating levels of tumor necrosis factor correlate with indexes of depressed heart rate variability: a study in patients with mild-to-moderate heart failure. Chest. 2003;123:716–724
  17. Lanza GA, Sgueglia GA, Cianflone D, Rebuzzi AG, Angeloni G, Sestito A, et al. Relation of heart rate variability to serum levels of C-reactive protein in patients with unstable angina pectoris. Am J Cardiol. 2006;97:1702–1706
  18. Lanza GA, Pitocco D, Navarese EP, Sestito A, Sgueglia GA, Manto A, et al. Association between cardiac autonomic dysfunction and inflammation in type 1 diabetic patients: effect of beta-blockade. Eur Heart J. 2007;28:814–820
  19. Sestito A, Valsecchi S, Infusino F, Sgueglia GA, Bellocci F, Zecchi P, et al. Differences in heart rate turbulence between patients with coronary artery disease and patients with ventricular arrhythmias but structurally normal hearts. Am J Cardiol. 2004;93:1114–1118
  20. Berkowitsch A, Zareba W, Neumann T, Erdogan A, Nitt SM, Moss AJ, et al. Risk stratification using heart rate turbulence and ventricular arrhythmias in MADIT II: usefulness and limitations of a 10-minute Holter recording. Ann Noninvasive Electrocardiol. 2004;9:270–279
  21. La Rovere MT, Bigger JT, Marcus FI, Mortara A, Schwartz PJ. Baroreflex sensitivity and heart rate variability in prediction of total cardiac mortality after myocardial infarction (ATRAMI (Autonomic Tone and Reflexes After Myocardial Infarction) Investigators). Lancet. 1998;351:478–484
  22. Exner DV, Kavanagh KM, Slawnych MP, Mitchell LB, Ramadan D, Aggarwal SG, et al Noninvasive risk assessment early after a myocardial infarction: the REFINE Study. J Am Coll Cardiol. 2007;50:2275–2284
  23. Liuzzo G, Biasucci LM, Gallimore JR, Grillo RL, Rebuzzi AG, Pepys MB, et al. The prognostic value of C-reactive protein and serum amyloid A protein in severe unstable angina. N Engl J Med. 1994;331:417–424
  24. Toss H, Lindahl B, Siegbahn A, Wallentin L. Prognostic influence of increased fibrinogen and C-reactive protein levels in unstable coronary artery disease. Circulation. 1997;96:4204–4210
  25. Wang H, Yu M, Ochani M, Amella CA, Tanovic M, Susarla S, et al Nicotinic acetylcholine receptor alpha7 subunit is an essential regulator of inflammation. Nature. 2003;421:384–388
  26. Tracey KJ. The inflammatory reflex. Nature. 2002;420:853–859
  27. Banks WA, Kastin AJ. Blood to brain transport of interleukin links the immune and central nervous systems. Life Sci. 1991;48:PL117–PL121

PII: S0002-9149(09)00044-7

doi: 10.1016/j.amjcard.2009.01.006

American Journal of Cardiology
Volume 103, Issue 8 , Pages 1066-1072 , 15 April 2009

Article Tools

* Image Usage & Resolution