Turbulence dynamics: An independent predictor of late mortality after acute myocardial infarction

Axel Bauer, Marek Malik, Petra Barthel, Raphael Schneider, Mari A. Watanabe, A. John Camm, Albert Schömig, Georg Schmidt

Research output: Contribution to journalArticlepeer-review

36 Scopus citations

Abstract

Introduction: The prognostic value of heart rate turbulence for predicting mortality after acute myocardial infarction is well established. This study investigates a new measure of heart rate turbulence, termed turbulence dynamics, which quantifies the relationship between turbulence slope and underlying heart rate (HRVPC). Methods: Six hundred eight patients participating in the European Myocardial Infarction Amiodarone Trial had ≥ 25 ventricular premature complexes/24 h. During a follow-up period of 21 months (median), 120 patients died. Turbulence dynamics was assessed as the slope of the regression line between turbulence slope and HRVPC. Survival analyses included age, history of previous myocardial infarction, presence of diabetes mellitus, mean normal-to-normal interval, heart rate variability index, presence of non-sustained ventricular tachycardia, left ventricular ejection fraction, turbulence onset and turbulence slope. All risk predictors were dichotomized at pre-defined cut-off points, turbulence dynamics was dichotomized at the median. Primary endpoint of the study was death of any cause. Results: In most patients, turbulence slope was inversely correlated to HRVPC. Univariately, turbulence dynamics was the second strongest risk predictor of mortality (relative risk 2.4 (95% confidence interval 1.6-3.6), p < 0.001). Multivariately, turbulence dynamics was the third strongest risk predictor (1.7 (1.1-2.7, p < 0.01)). Conclusion: In the patient population studied, turbulence dynamics was an independent predictor of mortality. The results indicate that in addition to the overall level of autonomic function the loss of autonomic adaptability contributes to prognosis.

Original languageEnglish
Pages (from-to)42-47
Number of pages6
JournalInternational Journal of Cardiology
Volume107
Issue number1
DOIs
StatePublished - 8 Feb 2006

Keywords

  • Autonomic nervous system
  • Myocardial infarction
  • Sudden death

Fingerprint

Dive into the research topics of 'Turbulence dynamics: An independent predictor of late mortality after acute myocardial infarction'. Together they form a unique fingerprint.

Cite this