Continuous long-term heart rate variability and risk assessment in pulmonary hypertension
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Continuous long-term heart rate variability and risk assessment in pulmonary hypertension. / Andersen, Mads Ørbæk; Diederichsen, Soren Zöga; Svendsen, Jesper Hastrup; Carlsen, Jørn.
I: Open Heart, Bind 10, Nr. 1, e002302, 2023.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Continuous long-term heart rate variability and risk assessment in pulmonary hypertension
AU - Andersen, Mads Ørbæk
AU - Diederichsen, Soren Zöga
AU - Svendsen, Jesper Hastrup
AU - Carlsen, Jørn
N1 - Publisher Copyright: © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2023
Y1 - 2023
N2 - Objective Current multimodal risk assessment for pulmonary hypertension (PH) has been redefined with a simplified assessment for follow-up in the new European Society of Cardiology/European Respiratory Society (ESC/ERS) guidelines. Follow-up risk assessment parameters include WHO functional class, 6 min walk test and N-terminal pro-brain natriuretic peptide. Although these parameters have prognostic implications assessment reflect data relating to specific time points. Methods Patients diagnosed with PH received an implantable loop recorder (ILR) to monitor daytime and night-time heart rate (HR), HR variability (HRV) and daily physical activity. Associations between the ILR measurements and established risk parameters were analysed using correlations, linear mixed models as well as logistical mixed models for addressing the ESC/ERS risk-score. Results 41 patients (median age: 56 years, range: 44-61.5 years) were included. Continuous monitoring had a median duration of 755 days (range: 343-1138 days), totalling 96 patient-years. In the linear mixed models, HRV and physical activity indexed by daytime HR (PAiHR) were significantly associated with the ERS/ERC risk parameters. In a logistical mixed model, HRV revealed a significant difference between 1-year mortality (<5% vs >5%) (p=0.027) with an OR of 0.82 for being in the group with 1-year mortality >5% for every increase by one HRV unit. Conclusions Risk assessment in PH can be refined with continuous monitoring of HRV and PAiHR. These markers were associated with the ESC/ERC parameters. Our study with continuous risk stratification in PH demonstrated that a lower HRV predict worse prognosis.
AB - Objective Current multimodal risk assessment for pulmonary hypertension (PH) has been redefined with a simplified assessment for follow-up in the new European Society of Cardiology/European Respiratory Society (ESC/ERS) guidelines. Follow-up risk assessment parameters include WHO functional class, 6 min walk test and N-terminal pro-brain natriuretic peptide. Although these parameters have prognostic implications assessment reflect data relating to specific time points. Methods Patients diagnosed with PH received an implantable loop recorder (ILR) to monitor daytime and night-time heart rate (HR), HR variability (HRV) and daily physical activity. Associations between the ILR measurements and established risk parameters were analysed using correlations, linear mixed models as well as logistical mixed models for addressing the ESC/ERS risk-score. Results 41 patients (median age: 56 years, range: 44-61.5 years) were included. Continuous monitoring had a median duration of 755 days (range: 343-1138 days), totalling 96 patient-years. In the linear mixed models, HRV and physical activity indexed by daytime HR (PAiHR) were significantly associated with the ERS/ERC risk parameters. In a logistical mixed model, HRV revealed a significant difference between 1-year mortality (<5% vs >5%) (p=0.027) with an OR of 0.82 for being in the group with 1-year mortality >5% for every increase by one HRV unit. Conclusions Risk assessment in PH can be refined with continuous monitoring of HRV and PAiHR. These markers were associated with the ESC/ERC parameters. Our study with continuous risk stratification in PH demonstrated that a lower HRV predict worse prognosis.
KW - Hypertension, Pulmonary
KW - Pulmonary Arterial Hypertension
KW - Telemedicine
U2 - 10.1136/openhrt-2023-002302
DO - 10.1136/openhrt-2023-002302
M3 - Journal article
C2 - 37385731
AN - SCOPUS:85165612872
VL - 10
JO - Open Heart
JF - Open Heart
SN - 2398-595X
IS - 1
M1 - e002302
ER -
ID: 367903431