早野順一郎先生によるセミナー「今だからこそ心拍変動解析」応用編Ⅱ　心拍変動と生命予後：心拍変動による健康リスクの予測　でご紹介の主な予後予測指標です。

心拍変動解析予後予測指標の特徴・文献一覧

予測指標

特徴

文献

SDNN

最も基本的な時間領域の心拍変動指標

急性心筋梗塞後の全死亡1

Deceleration capacity (DC)

急性心筋梗塞後生命リスクの最強の予測因子の一つ

急性心筋梗塞後のLVEF≦30%および>30%例の全死亡2

Very-low frequency power (VLF)

周波数領域の心拍変動で最も予後予測力が高い

急性心筋梗塞後の全死亡3、急性心筋梗塞後のLVEF≦35%例の全死亡、不整脈死4

Detrended fluctuation analysis (DFA) α1

DFA解析による短期間のscaling exponent

末期腎不全透析例の生命予後と特異的に関連

急性心筋梗塞後のLVEF≦35%例の全死亡、不整脈死4、末期腎不全透析例の全死亡5

Non-Gaussianity index λ

心不全の生命予後、交感神経機能との関連が示唆される唯一の心拍変動指標、急性心筋梗塞後では心臓死と特異的に関連

洞調律慢性心不全の生命予後6、急性心筋梗塞後の心臓死7

Heart rate turbulence (HRT)

偶発する孤立性心室性期外収縮に続く心拍応答から圧受容器反射機能を評価する。適用可能な心室性期外収縮が得られる例が少ないのが課題。

急性心筋梗塞後の全死亡8

心拍数周期性変動の振幅 (Acv)

偶発する睡眠呼吸障害に伴う心拍数周期性変動の振幅、臨床的な睡眠呼吸障害がない例でも評価可能

急性心筋梗塞後、末期腎不全透析例、洞調律慢性心不全の全死亡9

 

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  2. Bauer A, Kantelhardt JW, Barthel P, Schneider R, Makikallio T, Ulm K, Hnatkova K, Schomig A, Huikuri H, Bunde A, Malik M, Schmidt G. Deceleration capacity of heart rate as a predictor of mortality after myocardial infarction: cohort study. Lancet. 2006;367:1674-1681.
  3. Bigger JT, Jr., Fleiss JL, Steinman RC, Rolnitzky LM, Kleiger RE, Rottman JN. Frequency domain measures of heart period variability and mortality after myocardial infarction. Circulation. 1992;85:164-171.
  4. Huikuri HV, Makikallio TH, Peng CK, Goldberger AL, Hintze U, Moller M. Fractal correlation properties of R-R interval dynamics and mortality in patients with depressed left ventricular function after an acute myocardial infarction. Circulation. 2000;101:47-53.
  5. Suzuki M, Hiroshi T, Aoyama T, Tanaka M, Ishii H, Kisohara M, Iizuka N, Murohara T, Hayano J. Nonlinear Measures of Heart Rate Variability and Mortality Risk in Hemodialysis Patients. Clin J Am Soc Nephrol. 2012;7:1454-1460.
  6. Kiyono K, Hayano J, Watanabe E, Struzik ZR, Yamamoto Y. Non-Gaussian heart rate as an independent predictor of mortality in patients with chronic heart failure. Heart Rhythm. 2008;5:261-268.
  7. Hayano J, Kiyono K, Struzik ZR, Yamamoto Y, Watanabe E, Stein PK, Watkins LL, Blumenthal JA, Carney RM. Increased non-gaussianity of heart rate variability predicts cardiac mortality after an acute myocardial infarction. Front Physiol. 2011;2:65.
  8. Schmidt G, Malik M, Barthel P, Schneider R, Ulm K, Rolnitzky L, Camm AJ, Bigger JT, Jr., Schomig A. Heart-rate turbulence after ventricular premature beats as a predictor of mortality after acute myocardial infarction. Lancet. 1999;353:1390-1396.
  9. Hayano J, Yasuma F, Watanabe E, Carney RM, Stein PK, Blumenthal JA, Arsenos P, Gatzoulis KA, Takahashi H, Ishii H, Kiyono K, Yamamoto Y, Yoshida Y, Yuda E, Kodama I. Blunted cyclic variation of heart rate predicts mortality risk in post-myocardial infarction, end-stage renal disease, and chronic heart failure patients. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. 2017;19:1392-1400.

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