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. 2023 Mar 20;43(3):400-404.
doi: 10.12122/j.issn.1673-4254.2023.03.09.

[Resting heart rate correlates with major adverse cardiovascular and cerebrovascular events in patients with post-myocardial infarction ventricular aneurysms: a retrospective cohort study]

[Article in Chinese]
L Lu  1   2   3 , J Zhong  1   2   3 , X Wu  4 , Q Chen  1   2   3 , H Lin  1   2   3 , L Chen  1   2   3 , Y Luo  1   2   3
Affiliations

[Resting heart rate correlates with major adverse cardiovascular and cerebrovascular events in patients with post-myocardial infarction ventricular aneurysms: a retrospective cohort study]

[Article in Chinese]
L Lu et al. Nan Fang Yi Ke Da Xue Xue Bao. .

Abstract
in English, Chinese

Objective: To analyze the association of resting heart rate (RHR) with the prognosis of patients with post-infarction ventricular aneurysms.

Methods: We retrospectively analyzed the clinical data of 227 patients with post-infarction ventricular aneurysms admitted to our hospital during 2017-2019. The endpoint event was the occurrence of any major adverse cardiovascular and cerebrovascular events (MACCEs) during the follow-up for 24 months. According to RHR measurements, the patients were divided into 3 groups with baseline RHR < 10%, 10%-90%, and >90%. The Cox proportional risk model and restricted cubic spline (RCS) model were used to analyze the effect of RHR on MACCEs.

Results: During the 24-month followup, 90 patients (39.6%) experienced MACCEs. The fully adjusted RCS curves showed a nonlinear "U" shaped correlation between RHR and the occurrence of MACCEs. In the fully adjusted model, the risk of MACCEs increased by 3.01-fold (Hazard ratio [HR]=4.01, 95% CI: 2.07-7.76, P < 0.001) in patients with RHR>90%, as compared with patients with RHR of 10%-90%. In patients with RHR in 1-9th percentile, 10th-90th percentile and 91st-100th percentile, the incidences of MACCEs were 39.1%, 36.6% and 66.7% (P=0.027), the incidences of ventricular tachycardia/ventricular fibrillation (VT/VF) were 17.4%, 2.7% and 4.8% (P=0.005), and the incidences of readmission for heart failure were 8.7%, 26.8% and 42.9% (P=0.036), respectively.

Conclusion: Continuous monitoring and management of heart rate range may provide guidance for prognosis prediction in patients with post-infarction ventricular aneurysms.

目的: 分析静息心率（RHR）高低与心肌梗死后室壁瘤患者不良预后的关系。

方法: 回顾性收集2017~2019年入住我院的心梗后室壁瘤患者资料，最终共227例纳入研究，随访24月，随访期间任何主要不良心脑血管事件（MACCEs）的发生都是终点事件。根据基线RHR测量值高低分为RHR < 10%、10%~90%和>90%三组，使用Cox比例风险模型、限制性立方样条（RCS）模型来研究RHR对MACCEs的影响，结果以风险比（HR）的95%置信区间（CI）表示。

结果: 在24月的随访中，90例（39.6%）患者发生MACCEs。RCS曲线显示RHR与MACCEs发生之间存在非线性“U”型相关性。与RHR在10%~90%组的个体相比，RHR>90% 组的MACCEs风险增加了3.01倍（HR=4.01，95% CI：2.07-7.76，P < 0.001）。患者在RHR < 10%组，10%~90%组和91%~100%组的MACCEs发生率分别为39.1%、36.6%、66.7%（P=0.027），其中，室性心动过速/心室颤动（VT/VF）的发生率分别为17.4%、2.7%、4.8%（P=0.005），心衰再入院的发生率为8.7%、26.8%、42.9%（P=0.036）。

结论: 持续监测和管理心率范围可为心梗后室壁瘤患者的预后提供指导。

Keywords: major adverse cardiovascular and cerebrovascular events; post-myocardial infarction ventricular aneurysms; resting heart rate.

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Figures

图 1
图 1
心肌梗死后室壁瘤患者静息心率与MACCEs风险之间的相关性曲线 RCS curve for the correlation between resting heart rate and MACCEs risks in patients with post-myocardial infarction ventricular aneurysms. The solid red line represents the RCS curve of the multivariate adjusted hazard ratios for MACCEs versus RHR, 95%CI of HR was shown with shaded area. The black dotted line represents HR=1, and the blue dotted line represents the RHR value (72 r/min) when HR=1.
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