Irregular heart rate patterns during the deep breathing test in patients with familial amyloidotic polyneuropathy

Abstract

Background: The aim was to estimate the relative risk of electrocardiogram (ECG) changes and specific pain symptoms on coronary heart disease (CHD), cardiovascular (CVD), and total mortality (CHDM, CVDM, TM). Methods: The results of the prospective follow-up study of 9393 men and 3334 women aged 25 to 64 years for randomly selected cohorts from Moscow-free living population examined by standard epidemiologic methods in 1975 to 2001 years were investigated. In the middle of 2009 during follow-up, 242 718 person-years was observed with 5765 deaths identified. The mortality data were received from the reliable official city source. The causes of death were coded by International Classification of Diseases, Eighth Edition, and classified into CHD, CVD, and TM groups. Electrocardiogram were coded by Minnesota code (MC). The pain was classified according to World Health Organization (Rose) questionnaire. A relative mortality risk (RR) was estimated using single-factor age-adjusted Cox model. The results were presented as RR and 95% confidence interval. Results: The TM in cohort was 23.8 ± 0.3 TPY. Among men, the maximal RR for CHDM was in the following groups: A, “major QQS codes” (MC 11-1 to 1-1-7 or 1-2-1 to 1-2-7)—RR, 5.6 (4.5-6.8); B, “pain and ischemic ECG abnormalities”—RR, 9.3 (6.8-12.6); C, “pain and minor QQS codes or nonspecific ECG abnormalities” (Rose+, MC 1-2-8, 1-3-1 to 1-3-6, 3-1, 3-3, 4or 5codes)—RR, 3.3 (2.5-4.3); D, “major ST-T abnormalities” (C 4-1, 42, 5-1, 5-2 without 3-1, 3-3)—RR, 3.1 (2.4-4.1); and F, “major arrhythmias/ conduction defects” (C 6-1, 6-8, 7-1, 8-3)—RR, 3.8 (2.5-5.9). A risk for CVDM was lower except D and F groups as compares with CHDM. Total mortality risk was 1.4 to 2.3 times lower than CHDM risk. Among women, maximal RRs for CHDM were in D, F, and B groups: RR: 3.7, 3.1, and 3.1, respectively. For CVDM, maximal RRs remained only in 2 first groups— 2.9 and 3.1, respectively. In group A, minimal RR for CHDM was 0.8, and for TM, it was 1.7. Men had higher RR for TM in A and B groups as compared with women. The ECG and pain groups were combined into the variable “CHD screening symptoms” with 3 states “no CHD/possible CHD/ definite CHD.” For all mortality groups, RRs in “definite CHD” were higher than in “possible CHD” regardless of sex. Conclusion: As provided by the analysis above, this classification may be used as CHD prevalence criteria for both sexes.