What Is the Clinical and Prognostic Significance of High-Resting Sinus Rate?
The interest in alterations in the autonomic nervous system as useful markers for risk stratification in patients with acute myocardial infarction (MI) has grown steadily in the last few years . The prognostic significance of non-invasive indexes of autonomic nervous system dysfunction, such as heart rate (HR) variability and baroreflex sensitivity, has been evaluated; however, the application of these techniques in clinical practice has been hindered by methodological and practical limitations so that their use is still mostly limited to a few centers. At the same time, it has become clear that simple and crude indexes of sympatheticparasympathetic balance as well as left ventricular function, such as HR or blood pressure, may play a major role in the risk stratification during the acute phase and at discharge [2–4].
KeywordsHeart Rate Variability Acute Myocardial Infarction High Heart Rate Baroreflex Sensitivity Killip Class
Unable to display preview. Download preview PDF.
- 4.Copie X, Hnatkova K, Staunton A et al (1996) Predictive power of increased heart rate versus depressedleft ventricular ejection fraction and heart rate variability for riskstratification after myocardial infarction. Results of a two-year follow-upstudy. J Am Coll Cardiol 27:270–276PubMedCrossRefGoogle Scholar
- 5.Kjekshus J (1990) Heart rate reduction: a mechanism of benefit? Eur Heart J8:115–122Google Scholar
- GruppoItaliano per lo Studio della Soprawivenza nelPlnfarto Miocardico (1990)GISSI-2: a factorial randomised trial of alteplase versus streptokinase andheparin versus no heparin among 12490 patients with acute myocardialinfarction. Lancet 336:65-71Google Scholar
- 10.GruppoItaliano per lo Studio della Soprawivenza nelPlnfarto Miocardico (1994)GISSI-3: effects of lisinopril and transdermal glyceryltrinitrate singly and together on 6-week mortality and ventricular functionafter acute myocardial infarction. Lancet 343:1115–1122Google Scholar