AUTHOR=Wu Shuang , Li Guangqiao , Guan Weizheng , Zhao Huan , Wang Jingfeng , Zhou Yongchun , Zhou Yufu , Shi Bo 

TITLE=Low Heart Rate Variability Predicts Poor Overall Survival of Lung Cancer Patients With Brain Metastases

JOURNAL=Frontiers in Neuroscience

VOLUME=16

YEAR=2022

URL=https://www.frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2022.839874

DOI=10.3389/fnins.2022.839874

ISSN=1662-453X

ABSTRACT=<sec><title>Background</title><p>The aim of this prospective study was to evaluate the association between heart rate variability (HRV) and overall survival of lung cancer patients with brain metastases (LCBM).</p></sec><sec><title>Methods</title><p>Fifty-six LCBM patients were enrolled in this study. Five-minute electrocardiograms were collected before the time to first brain radiotherapy. HRV was analyzed quantitatively by using the time domain parameters, i.e., the standard deviation of all normal-normal intervals (SDNN) and the root mean square of successive differences (RMSSD). Survival time for LCBM patients was defined as from the date of HRV testing to the date of death or the last follow-up.</p></sec><sec><title>Results</title><p>In the univariate analysis, SDNN ≤ 13 ms (<italic>P</italic> = 0.003) and RMSSD ≤ 4.8 ms (<italic>P</italic> = 0.014) significantly predicted poor survival. Multivariate analysis confirmed that RMSSD ≤ 4.8 ms (<italic>P</italic> = 0.013, hazard ratio = 3.457, 95% confidence interval = 1.303–9.171) was also an independent negative prognostic factor after adjusting for mean heart rate, Karnofsky performance status, and number of brain metastases in LCBM patients.</p></sec><sec><title>Conclusion</title><p>Decreased RMSSD is independently associated with shorter survival time in LCBM patients. HRV might be a novel predictive biomarker for LCBM prognosis.</p></sec>