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Association of patient-reported outcomes and heart rate trends in heart failure: a report from the Chiron project.
Scientific Reports ( IF 3.8 ) Pub Date : 2020-01-17 , DOI: 10.1038/s41598-019-57239-4 Luca Monzo 1 , Michele Schiariti 1 , Pietro Fedele Calvisi 1 , Silvio Bonfiglio 2 , Mitja Luštrek 3 , Paolo E Puddu 1, 4, 5
Scientific Reports ( IF 3.8 ) Pub Date : 2020-01-17 , DOI: 10.1038/s41598-019-57239-4 Luca Monzo 1 , Michele Schiariti 1 , Pietro Fedele Calvisi 1 , Silvio Bonfiglio 2 , Mitja Luštrek 3 , Paolo E Puddu 1, 4, 5
Affiliation
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Patient-reported outcomes (PROs) have been previously considered "soft" end-points because of the lack of association of the reported outcome to measurable biological parameters. The present study aimed to assess whether electrocardiographic measures are associated to PROs changes. We evaluated the association between heart rate (HR), QRS and QT/QTc durations and PROs, classified as "good" or "bad" according to the patients' overall feeling of health, in patients from the Chiron project. Twenty-four chronic heart failure (HF) patients were enrolled in the study (71% male, mean age 62.9 ± 9.4 years, 42% ischemic etiology, 15 NYHA class II and 9 class III) providing 1086 days of usable physiological recordings (4 hours/day). The mean HR was significantly higher in the "bad" than in the "good" PROs class (74.0 ± 6.4 bpm vs 68.0 ± 7.2 bpm; p < 0.001). Conversely, the ratio between movement and rest activities showed significantly higher values in "good" compared to "bad" PROs. We also found significantly longer QTc and QRS durations in patients with "bad" PROs compared to patients with "good" PROs. That in patients with mild to moderate HF, higher HR, wider QRS and longer QTc, as well as a reduced HR ratio between movement and rest, were associated with "bad" PROs is clinically noteworthy because the association of worse PROs with measurable variations of biological parameters may help physicians in evaluating PROs reliability itself and in their clinical decisions. Whether a timely intervention on these biological parameters may prevent adverse outcomes is important and deserves to be investigated in further studies.
中文翻译：
患者报告的结局与心力衰竭心率趋势的关联：Chiron项目的报告。
患者报告的结局（PRO）以前被认为是“软性”终点，因为缺乏报告的结局与可测量的生物学参数的关联。本研究旨在评估心电图测量是否与PRO改变有关。我们评估了Chiron项目患者的心率（HR），QRS和QT / QTc持续时间与PROs之间的关联，根据患者的总体健康感觉将其分为“好”或“不好”。该研究纳入了24名慢性心力衰竭（HF）患者（男性71％，平均年龄62.9±9.4岁，缺血性病因42％，NYHA II类15次和III类9次），提供了1086天的可用生理记录（4小时/天）。“差”的平均HR显着高于“好”的HR PRO类（74.0±6.4 bpm与68.0±7.2 bpm; p <0.001）。相反，运动和休息活动之间的比率在“好” PRO中显示出比“坏” PRO高得多的值。我们还发现，“不良” PRO患者的QTc和QRS持续时间明显长于“良好” PRO患者。在轻度至中度HF，较高的HR，较快的QRS和较长的QTc以及运动与休息之间的HR比降低的患者中，“不良” PROs相关联在临床上值得注意，因为较差的PROs与可测量的变异性相关生物学参数可以帮助医生评估PRO本身的可靠性以及他们的临床决策。
更新日期：2020-01-17
中文翻译：
患者报告的结局与心力衰竭心率趋势的关联：Chiron项目的报告。
患者报告的结局（PRO）以前被认为是“软性”终点，因为缺乏报告的结局与可测量的生物学参数的关联。本研究旨在评估心电图测量是否与PRO改变有关。我们评估了Chiron项目患者的心率（HR），QRS和QT / QTc持续时间与PROs之间的关联，根据患者的总体健康感觉将其分为“好”或“不好”。该研究纳入了24名慢性心力衰竭（HF）患者（男性71％，平均年龄62.9±9.4岁，缺血性病因42％，NYHA II类15次和III类9次），提供了1086天的可用生理记录（4小时/天）。“差”的平均HR显着高于“好”的HR PRO类（74.0±6.4 bpm与68.0±7.2 bpm; p <0.001）。相反，运动和休息活动之间的比率在“好” PRO中显示出比“坏” PRO高得多的值。我们还发现，“不良” PRO患者的QTc和QRS持续时间明显长于“良好” PRO患者。在轻度至中度HF，较高的HR，较快的QRS和较长的QTc以及运动与休息之间的HR比降低的患者中，“不良” PROs相关联在临床上值得注意，因为较差的PROs与可测量的变异性相关生物学参数可以帮助医生评估PRO本身的可靠性以及他们的临床决策。
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