Novel heart rate turbulence parameters.
نویسندگان
چکیده
Heart rate turbulence (HRT) is the return of heart rate to equilibrium after a premature ventricular contraction (PVC). It consists of a brief speed up period in heart rate, followed by a slow decrease back to the baseline rate. The concept of HRT was introduced to the medical community by Schmidt et al in 1999. While studying PVC characteristics researchers had noticed that heart rate seemed to speed up after a PVC. Since, then, HRT has been investigated in a variety of clinical conditions. In their well written manuscript Song et al investigated HRT in patients with masked hypertension (MH), essential hypertension (EH) and white-coat hypertension (WCH). Compared to normotensive patients they found statistically significant lower HRT parameters in all hypertensive patients1. Heart rate turbulence is a recently defined index of heart rate variability. Classically there are two major HRT parameters. Turbulence onset (TO) measures whether or not there is a brief tachycardia in the average of two normal heart beat intervals after, compared with before the PVC. Second parameter is Turbulence slope (TS) which measures the degree to which there is a slower oscillation in heart rate after the PVC. Clinical trials such as the EMIAT and the MIPP showed that decreased TO and TS had strong predictive value for mortality2. Besides these there are other adjunctive parameters of HRT validated in various clinical studies3. Turbulence dynamicity quantifies the relationship between turbulence slope and underlying heart rate. Turbulence frequency decrease measures HRT in the frequency domain. Turbulence timing is the first beat number of the 5-beat RR sequence giving the maximum regression slope. Turbulence jump is a parameter which quantifies the maximum difference between adjacent RR intervals4. Incorporating novel HRT parameters in this study would render the results more accurate and precise.
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ورودعنوان ژورنال:
- European review for medical and pharmacological sciences
دوره 19 20 شماره
صفحات -
تاریخ انتشار 2015