A diagnostic index for predicting heart rate variability decline and prognostic value in newly diagnosed non-small cell lung cancer patients

BackgroundHeart rate variability (HRV) is an important marker of autonomic nervous system function and cardiovascular health. Holter monitoring is a crucial method for evaluating HRV, but the procedure and result analysis are relatively complex. This study aims to develop a simplified diagnostic ind...

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Main Authors: Lifang Zhang, Ying Liu, Di Han, Yan Wang, Fanqi Geng, Wei Ding, Xuejuan Zhang
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-12-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2024.1463805/full
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author Lifang Zhang
Ying Liu
Di Han
Yan Wang
Fanqi Geng
Wei Ding
Xuejuan Zhang
author_facet Lifang Zhang
Ying Liu
Di Han
Yan Wang
Fanqi Geng
Wei Ding
Xuejuan Zhang
author_sort Lifang Zhang
collection DOAJ
description BackgroundHeart rate variability (HRV) is an important marker of autonomic nervous system function and cardiovascular health. Holter monitoring is a crucial method for evaluating HRV, but the procedure and result analysis are relatively complex. This study aims to develop a simplified diagnostic index for predicting HRV decline in newly diagnosed non-small cell lung cancer (NSCLC) patients and evaluate its prognostic value.MethodsThis retrospective cross-sectional study included 131 newly diagnosed NSCLC patients. Baseline characteristics were compared between normal HRV group and declined HRV group. Univariate and multivariate logistic regression analyses identified significant predictors of HRV decline. A diagnostic index was developed based on resting heart rate (RHR), serum sodium, and interleukin-6 (IL-6) and externally validated. Kaplan-Meier survival analysis assessed the prognostic value of the index.ResultsPatients with declined HRV had higher median RHR (84 b.p.m. vs. 70 b.p.m., p < 0.001), lower serum sodium (136.3 mmol/L vs. 138.7 mmol/L, p < 0.001), lower serum albumin (39 g/L vs. 41 g/L, p = 0.031), higher lactate dehydrogenase (LDH) (202 U/L vs. 182 U/L, p = 0.010), and higher IL-6 (11.42 pg/ml vs. 5.67 pg/ml, p < 0.001). Multivariate analysis identified RHR (OR = 3.143, p = 0.034), serum sodium (OR = 6.806, p < 0.001), and IL-6 (OR = 3.203, p = 0.033) as independent predictors of HRV decline. The diagnostic index, with an area under the curve (AUC) of 0.849, effectively predicted HRV decline. ROC analysis of the external validation data demonstrated an AUC of 0.788. Survival analysis showed that patients with a diagnostic index > 2 had significantly worse overall survival (log-rank p < 0.001).ConclusionsThe study identified key clinical parameters that predict HRV decline in newly diagnosed NSCLC patients. The developed diagnostic index, based on RHR, serum sodium, and IL-6, effectively stratifies patients by HRV status and has significant prognostic value, aiding in early identification and management of high-risk patients.
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publisher Frontiers Media S.A.
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spelling doaj-art-6bd9d5bf8ea244f3b73b15422c2dc3352025-08-20T02:12:50ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2024-12-011410.3389/fonc.2024.14638051463805A diagnostic index for predicting heart rate variability decline and prognostic value in newly diagnosed non-small cell lung cancer patientsLifang Zhang0Ying Liu1Di Han2Yan Wang3Fanqi Geng4Wei Ding5Xuejuan Zhang6Department of General Medicine, The Affiliated Hospital of Qingdao University, Qingdao, ChinaDepartment of Infectious Disease, The Affiliated Hospital of Qingdao University, Qingdao, ChinaDepartment of General Medicine, The Affiliated Hospital of Qingdao University, Qingdao, ChinaDepartment of General Medicine, The Affiliated Hospital of Qingdao University, Qingdao, ChinaDepartment of General Medicine, The Affiliated Hospital of Qingdao University, Qingdao, ChinaDepartment of General Medicine, The Affiliated Hospital of Qingdao University, Qingdao, ChinaDepartment of General Medicine, The Affiliated Hospital of Qingdao University, Qingdao, ChinaBackgroundHeart rate variability (HRV) is an important marker of autonomic nervous system function and cardiovascular health. Holter monitoring is a crucial method for evaluating HRV, but the procedure and result analysis are relatively complex. This study aims to develop a simplified diagnostic index for predicting HRV decline in newly diagnosed non-small cell lung cancer (NSCLC) patients and evaluate its prognostic value.MethodsThis retrospective cross-sectional study included 131 newly diagnosed NSCLC patients. Baseline characteristics were compared between normal HRV group and declined HRV group. Univariate and multivariate logistic regression analyses identified significant predictors of HRV decline. A diagnostic index was developed based on resting heart rate (RHR), serum sodium, and interleukin-6 (IL-6) and externally validated. Kaplan-Meier survival analysis assessed the prognostic value of the index.ResultsPatients with declined HRV had higher median RHR (84 b.p.m. vs. 70 b.p.m., p < 0.001), lower serum sodium (136.3 mmol/L vs. 138.7 mmol/L, p < 0.001), lower serum albumin (39 g/L vs. 41 g/L, p = 0.031), higher lactate dehydrogenase (LDH) (202 U/L vs. 182 U/L, p = 0.010), and higher IL-6 (11.42 pg/ml vs. 5.67 pg/ml, p < 0.001). Multivariate analysis identified RHR (OR = 3.143, p = 0.034), serum sodium (OR = 6.806, p < 0.001), and IL-6 (OR = 3.203, p = 0.033) as independent predictors of HRV decline. The diagnostic index, with an area under the curve (AUC) of 0.849, effectively predicted HRV decline. ROC analysis of the external validation data demonstrated an AUC of 0.788. Survival analysis showed that patients with a diagnostic index > 2 had significantly worse overall survival (log-rank p < 0.001).ConclusionsThe study identified key clinical parameters that predict HRV decline in newly diagnosed NSCLC patients. The developed diagnostic index, based on RHR, serum sodium, and IL-6, effectively stratifies patients by HRV status and has significant prognostic value, aiding in early identification and management of high-risk patients.https://www.frontiersin.org/articles/10.3389/fonc.2024.1463805/fullheart rate variabilitynon-small cell lung cancerdiagnostic indexresting heart rateserum sodiuminterleukin-6
spellingShingle Lifang Zhang
Ying Liu
Di Han
Yan Wang
Fanqi Geng
Wei Ding
Xuejuan Zhang
A diagnostic index for predicting heart rate variability decline and prognostic value in newly diagnosed non-small cell lung cancer patients
Frontiers in Oncology
heart rate variability
non-small cell lung cancer
diagnostic index
resting heart rate
serum sodium
interleukin-6
title A diagnostic index for predicting heart rate variability decline and prognostic value in newly diagnosed non-small cell lung cancer patients
title_full A diagnostic index for predicting heart rate variability decline and prognostic value in newly diagnosed non-small cell lung cancer patients
title_fullStr A diagnostic index for predicting heart rate variability decline and prognostic value in newly diagnosed non-small cell lung cancer patients
title_full_unstemmed A diagnostic index for predicting heart rate variability decline and prognostic value in newly diagnosed non-small cell lung cancer patients
title_short A diagnostic index for predicting heart rate variability decline and prognostic value in newly diagnosed non-small cell lung cancer patients
title_sort diagnostic index for predicting heart rate variability decline and prognostic value in newly diagnosed non small cell lung cancer patients
topic heart rate variability
non-small cell lung cancer
diagnostic index
resting heart rate
serum sodium
interleukin-6
url https://www.frontiersin.org/articles/10.3389/fonc.2024.1463805/full
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