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Involvement of Autonomic Nervous System in New-Onset Atrial Fibrillation during Acute Myocardial Infarction
Background: Atrial fibrillation (AF) is common after acute myocardial infarction (AMI) and associated with in-hospital and long-term mortality. However, the pathophysiology of AF in AMI is poorly understood. Heart rate variability (HRV), measured by Holter-ECG, reflects cardiovascular response to th...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7290762/ https://www.ncbi.nlm.nih.gov/pubmed/32423138 http://dx.doi.org/10.3390/jcm9051481 |
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author | Sagnard, Audrey Guenancia, Charles Mouhat, Basile Maza, Maud Fichot, Marie Moreau, Daniel Garnier, Fabien Lorgis, Luc Cottin, Yves Zeller, Marianne |
author_facet | Sagnard, Audrey Guenancia, Charles Mouhat, Basile Maza, Maud Fichot, Marie Moreau, Daniel Garnier, Fabien Lorgis, Luc Cottin, Yves Zeller, Marianne |
author_sort | Sagnard, Audrey |
collection | PubMed |
description | Background: Atrial fibrillation (AF) is common after acute myocardial infarction (AMI) and associated with in-hospital and long-term mortality. However, the pathophysiology of AF in AMI is poorly understood. Heart rate variability (HRV), measured by Holter-ECG, reflects cardiovascular response to the autonomic nervous system and altered (reduced or enhanced) HRV may have a major role in the onset of AF in AMI patients. Objective: We investigated the relationship between autonomic dysregulation and new-onset AF during AMI. Methods: As part of the RICO survey, all consecutive patients hospitalized for AMI at Dijon (France) university hospital between June 2001 and November 2014 were analyzed by Holter-ECG <24 h following admission. HRV was measured using temporal and spectral analysis. Results: Among the 2040 included patients, 168 (8.2%) developed AF during AMI. Compared to the sinus-rhythm (SR) group, AF patients were older, had more frequent hypertension and lower left ventricular ejection fraction LVEF. On the Holter parameters, AF patients had higher pNN50 values (11% vs. 4%, p < 0.001) and median LH/HF ratio, a reflection of sympathovagal balance, was significantly lower in the AF group (0.88 vs 2.75 p < 0.001). The optimal LF/HF cut-off for AF prediction was 1.735. In multivariate analyses, low LF/HF <1.735 (OR(95%CI) = 3.377 (2.047–5.572)) was strongly associated with AF, ahead of age (OR(95%CI) = 1.04(1.01–1.06)), mean sinus-rhythm rate (OR(95%CI) = 1.03(1.02–1.05)) and log NT-proBNP (OR(95%CI) = 1.38(1.01–1.90). Conclusion: Our study strongly suggests that new-onset AF in AMI mainly occurs in a dysregulated autonomic nervous system, as suggested by low LF/HF, and higher PNN50 and RMSSD values. |
format | Online Article Text |
id | pubmed-7290762 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-72907622020-06-17 Involvement of Autonomic Nervous System in New-Onset Atrial Fibrillation during Acute Myocardial Infarction Sagnard, Audrey Guenancia, Charles Mouhat, Basile Maza, Maud Fichot, Marie Moreau, Daniel Garnier, Fabien Lorgis, Luc Cottin, Yves Zeller, Marianne J Clin Med Article Background: Atrial fibrillation (AF) is common after acute myocardial infarction (AMI) and associated with in-hospital and long-term mortality. However, the pathophysiology of AF in AMI is poorly understood. Heart rate variability (HRV), measured by Holter-ECG, reflects cardiovascular response to the autonomic nervous system and altered (reduced or enhanced) HRV may have a major role in the onset of AF in AMI patients. Objective: We investigated the relationship between autonomic dysregulation and new-onset AF during AMI. Methods: As part of the RICO survey, all consecutive patients hospitalized for AMI at Dijon (France) university hospital between June 2001 and November 2014 were analyzed by Holter-ECG <24 h following admission. HRV was measured using temporal and spectral analysis. Results: Among the 2040 included patients, 168 (8.2%) developed AF during AMI. Compared to the sinus-rhythm (SR) group, AF patients were older, had more frequent hypertension and lower left ventricular ejection fraction LVEF. On the Holter parameters, AF patients had higher pNN50 values (11% vs. 4%, p < 0.001) and median LH/HF ratio, a reflection of sympathovagal balance, was significantly lower in the AF group (0.88 vs 2.75 p < 0.001). The optimal LF/HF cut-off for AF prediction was 1.735. In multivariate analyses, low LF/HF <1.735 (OR(95%CI) = 3.377 (2.047–5.572)) was strongly associated with AF, ahead of age (OR(95%CI) = 1.04(1.01–1.06)), mean sinus-rhythm rate (OR(95%CI) = 1.03(1.02–1.05)) and log NT-proBNP (OR(95%CI) = 1.38(1.01–1.90). Conclusion: Our study strongly suggests that new-onset AF in AMI mainly occurs in a dysregulated autonomic nervous system, as suggested by low LF/HF, and higher PNN50 and RMSSD values. MDPI 2020-05-14 /pmc/articles/PMC7290762/ /pubmed/32423138 http://dx.doi.org/10.3390/jcm9051481 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Sagnard, Audrey Guenancia, Charles Mouhat, Basile Maza, Maud Fichot, Marie Moreau, Daniel Garnier, Fabien Lorgis, Luc Cottin, Yves Zeller, Marianne Involvement of Autonomic Nervous System in New-Onset Atrial Fibrillation during Acute Myocardial Infarction |
title | Involvement of Autonomic Nervous System in New-Onset Atrial Fibrillation during Acute Myocardial Infarction |
title_full | Involvement of Autonomic Nervous System in New-Onset Atrial Fibrillation during Acute Myocardial Infarction |
title_fullStr | Involvement of Autonomic Nervous System in New-Onset Atrial Fibrillation during Acute Myocardial Infarction |
title_full_unstemmed | Involvement of Autonomic Nervous System in New-Onset Atrial Fibrillation during Acute Myocardial Infarction |
title_short | Involvement of Autonomic Nervous System in New-Onset Atrial Fibrillation during Acute Myocardial Infarction |
title_sort | involvement of autonomic nervous system in new-onset atrial fibrillation during acute myocardial infarction |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7290762/ https://www.ncbi.nlm.nih.gov/pubmed/32423138 http://dx.doi.org/10.3390/jcm9051481 |
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