Abstract:
BACKGROUND:In clinical cardiology, heart rate variability is a putative index of autonomic cardiovascular function. Signs of reduced vagal activity are not only associated with an enhanced risk of sudden cardiac death, but such impaired heart rate variability became a new predictor of sudden cardiac death and other mortality in patients with a variety of diseased states. HYPOTHESIS:It is postulated (1) that the time structure (chronome) of heart rate variability in clinical health includes a circadian rhythm and deterministic chaos, the latter gauged by the correlation dimensions of RR intervals; and (2) that this chronome is altered in patients with coronary artery disease (CAD). METHODS:From 24-h Holter records of 11 healthy controls and 10 patients with CAD, 500-s sections around 02:00, 06:00, 10:00, 14:00, 18:00 and 22:00 hours were analyzed for smoothed RR intervals sampled at 4 Hz. Correlation integrals were estimated for embedding dimensions from 1 to 20 with a 1.0-s time lag, using an algorithm modified from Grassberger and Procaccia. The Wilcoxon signed-rank test compares circadian end points assessed by cosinor between the CAD patients and age-matched controls. RESULTS:A circadian rhythm characterizes the correlation dimension of healthy subjects peaking during the night (p < 0.005). Patients with CAD have a lowered correlation dimension (p < 0.05) and an altered circadian variation which requires the consideration of an approximately 12-h (circasemidian) component. CONCLUSION:The results demonstrate the sensitivity of circadian rhythms for the detection of disease. A partial 24- to 12-h (circadian-to-circasemidian) frequency multiplication (or partial variance transposition) in CAD of the correlation dimension, apart from being a potential clue to the etiology of the disease, adds a new feature to a chronocardiology combining, with the fractal scaling, an assessment of circadian and circasemidian components as measures of predictable variability to be tested for use in diagnosis, prognosis, and as putative guides to treatment timing.
journal_name
Clin Cardioljournal_title
Clinical cardiologyauthors
Otsuka K,Cornélissen G,Halberg Fdoi
10.1002/clc.4960200710subject
Has Abstractpub_date
1997-07-01 00:00:00pages
631-8issue
7eissn
0160-9289issn
1932-8737journal_volume
20pub_type
临床试验,杂志文章abstract::Type II heparin-induced thrombocytopenia (HIT) is a potentially severe adverse effect of heparin treatment triggered by an immune response. Although most cases occur in patients receiving unfractioned heparin, HIT can also arise after low-molecular-weight heparin (LMWH). We report a case of HIT in a postoperative orth...
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journal_title:Clinical cardiology
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pub_type: 杂志文章,评审
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更新日期:1984-12-01 00:00:00
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1996-11-01 00:00:00
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更新日期:1999-08-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
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更新日期:2004-07-01 00:00:00
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