Key result
Increased multifractality and time irreversibility of heart rate variability measured prior to aortic valve replacement surgery were significantly associated with 30-day postoperative mortality.
Why the study?
Do pre-operative heart rate variability parameters predict 30-day postoperative mortality in patients undergoing arterial valve replacement surgery?
Case-Control (n=385)
Do pre-operative heart rate variability parameters predict 30-day postoperative mortality in patients undergoing arterial valve replacement surgery?
Answers are grounded in this paper and cite their sources.
Pre-operative nonlinear heart rate variability parameters, specifically increased multifractality and time irreversibility, may help predict 30-day mortality risk in patients undergoing arterial valve replacement.
In recent years the number of arterial stenosis (AS) patients has grown rapidly and valvular disease is expected to be the next great epidemic. We studied a group of 385 arterial valve replacement (AVR) surgery patients, of whom 16 had died in the postoperational period (up to 30 d after the operation). Each patient had a heart rate variability (HRV) recording made prior to the operation in addition to a full set of medical diagnostics including echocardiography. We formed 16 age, sex, New York Heart Association (NYHA) class, and BMI adjusted control pairs for each person who died in the perioperative period. Our aim was to find indications of the risk from AVR surgery based on the medical data and HRV properties. Besides standard, linear HRV methods, we used indexes of time irreversibility introduced by Guzik (G%), Porta (P%), Ehlers (index E) and Hou (index D). In addition, we analyzed the multiscale multifractal properties of HRV calculating the Hurst surface. The nonlinear analysis methods show statistically significant indications of the risk of AVR surgery in an increase of multifractality and an increase of time irreversibility of the HRV measured prior to the operation.
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Żebrowski et al. (2014) conducted a case-control in Aortic stenosis requiring aortic valve replacement (n=385). Preoperative heart rate variability (HRV) parameters vs. Matched controls who survived the perioperative period was evaluated on Perioperative mortality (up to 30 days after operation). Increased multifractality and time irreversibility of heart rate variability measured prior to aortic valve replacement surgery were significantly associated with 30-day postoperative mortality.
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