A Novel Heart Rate Variability Algorithm for the Detection of Myocardial Ischemia: Pilot Data from a Prospective Clinical Trial

作者：Oieru Dan; Shlomo Nir; Moalem Israel; Rozen Eli; Naimushin Alexey; Klempfner Robert; Goldenberg Ilan; Goldkorn Ronen^*

来源：Israel Medical Association Journal, 2015, 17(3): 161-165.

• heart rate variability (HRV)
• myocardial ischemia
• coronary artery disease (CAD)

Background: Heart rate variability (HR-V) analysis has been shown to be a predictor of sudden cardiac death and all-cause mortality in patients with cardiac disease.
Objectives: To examine whether newer HRV analysis algorithms; as used by the HeartTrends device, are superior to exercise stress testing (EST) for the detection of myocardial ischemia in patients without known coronary artery disease (CAD).
Methods: We present pilot data of the first 100 subjects enrolled in a clinical trial designed to evaluate the yield of short-term (1 hour) HRV testing for the detection of Myocardial ischemia. The study population comprised subjects without known CAD referred to a tertiary medical center tot EST with single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). All patients underwent a 1 hour electrocardiographic acquisition for HRV analysis with a HeartTrerids device-prior to EST with MPI. Sensitivity, Specificity, and positive and negative predictive values (PPV and NPV, respectively) were calculated for EST and HRV analysis, using MPI as the gold standard for the non-invasive detection of myocardial ischemia.
Results: In this cohort 15% had a pathologic MPI result. HRV analysis showed superior sensitivity (85%), PPV (50%) and, NPV (97%) as compared to standard EST (53%, 42%, 90%; respectively), while the specificity of the two tests was similar (86% and 85%, respectively), The close agreement between HRV and MPI was even mote pronounced among patients >65 years of age.
Conclusions: Our pilot data Suggest that the diagnostic yield Of the novel Heart-trends HRV algorithm is superior to conventional EST for the non-invasive detection of Myocardial ischemia.

• 出版日期2015-3