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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Thoracic Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1463805

A Diagnostic Index for Predicting Heart Rate Variability Decline and Prognostic Value in Newly Diagnosed Non-Small Cell Lung Cancer Patients

Provisionally accepted
Lifang Zhang Lifang Zhang Ying Liu Ying Liu *Di Han Di Han *Yan Wang Yan Wang *Fanqi Geng Fanqi Geng *Wei Ding Wei Ding *Xuejuan Zhang Xuejuan Zhang *
  • The Affiliated Hospital of Qingdao University, Qingdao, China

The final, formatted version of the article will be published soon.

    Background: Heart 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.: This 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. Results: Patients 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).The 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.

    Keywords: Heart rate variability, Non-small cell lung cancer, Diagnostic index, RESTING HEART RATE, Serum sodium, Interleukin-6, overall survival

    Received: 15 Jul 2024; Accepted: 18 Nov 2024.

    Copyright: © 2024 Zhang, Liu, Han, Wang, Geng, Ding and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Ying Liu, The Affiliated Hospital of Qingdao University, Qingdao, China
    Di Han, The Affiliated Hospital of Qingdao University, Qingdao, China
    Yan Wang, The Affiliated Hospital of Qingdao University, Qingdao, China
    Fanqi Geng, The Affiliated Hospital of Qingdao University, Qingdao, China
    Wei Ding, The Affiliated Hospital of Qingdao University, Qingdao, China
    Xuejuan Zhang, The Affiliated Hospital of Qingdao University, Qingdao, China

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