- 作者：Robert M. Carney ; PhD<sup>asup><sup> ; sup><sup>bsup><sup> ; sup><sup>carneyr@bmc.wustl.edu" class="auth_mailsup> ; Brian Steinmeyer ; MS<sup>asup><sup> ; sup><sup>bsup> ; Kenneth E. Freedland ; PhD<sup>asup><sup> ; sup><sup>bsup> ; Phyllis K. Stein ; PhD<sup>bsup><sup> ; sup><sup>csup> ; Junichiro Hayano ; MD<sup>csup><sup> ; sup><sup>dsup> ; James A. Blumenthal ; PhD<sup>asup><sup> ; sup><sup>esup> ; Allan S. Jaffe ; MD<sup>csup><sup> ; sup><sup>fsup>
- 刊名：American Heart Journal
- 出版年：July 2014
- 年：2014
- 卷：168
- 期：1
- 页码：117-125
- 全文大小：638 K
sSec_2">Methods
sp0010">Functional data analysis and model-based clustering methods were used to identify nocturnal HR patterns in 245 depressed and 247 nondepressed patients with a recent MI. All-cause mortality and recurrent infarctions were ascertained over a median follow-up of 24 months.
sSec_3">Results
sp0015">Three HR activity patterns were identified. In the first, HR gradually declined during the nighttime and increased the next morning. The second pattern was similar, but with a higher overall HR during the recording interval. The third showed almost no decrease in HR at night (ie, “nondipping”). All-cause mortality was higher among patients with pattern 3 than pattern 1 (P = .007), and the combined end point of recurrent MI or all-cause mortality was higher in pattern 3 than pattern 2 (P = .05). Patterns 2 and 3 were more common in the depressed than in the nondepressed patients.
sSec_4">Conclusions
sp0020">The nondipping nocturnal HR independently predicts all-cause mortality and recurrent MI. Future studies should examine the underlying causes of nondipping nocturnal HR and its association with depression and investigate the effects of treatment on survival.