AUTHOR=Wu Shuang , Guan Weizheng , Zhao Huan , Li Guangqiao , Zhou Yufu , Shi Bo , Zhang Xiaochun 

TITLE=Prognostic role of short-term heart rate variability and deceleration/acceleration capacities of heart rate in extensive-stage small cell lung cancer

JOURNAL=Frontiers in Physiology

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2023.1277383

DOI=10.3389/fphys.2023.1277383

ISSN=1664-042X

ABSTRACT=<p><bold>Background:</bold> Prior research suggests that autonomic modulation investigated by heart rate variability (HRV) might act as a novel predictive biomarker for cancer prognosis, such as in breast cancer and pancreatic cancer. It is not clear whether there is a correlation between autonomic modulation and prognosis in patients with extensive-stage small cell lung cancer (ES-SCLC). Therefore, the purpose of the study was to examine the association between short-term HRV, deceleration capacity (DC) and acceleration capacity (AC) of heart rate and overall survival in patients with ES-SCLC.</p><p><bold>Methods:</bold> We recruited 40 patients with ES-SCLC, and 39 were included in the final analysis. A 5-min resting electrocardiogram of patients with ES-SCLC was collected using a microelectrocardiogram recorder to analyse short-term HRV, DC and AC. The following HRV parameters were used: standard deviation of the normal-normal intervals (SDNN) and root mean square of successive interval differences (RMSSD). Overall survival of patients with ES-SCLC was defined as time from the date of electrocardiogram measurement to the date of death or the last follow-up. Follow-up was last performed on 07 June 2023. There was a median follow-up time of 42.2 months.</p><p><bold>Results:</bold> Univariate analysis revealed that the HRV parameter SDNN, as well as DC significantly predicted the overall survival of ES-SCLC patients (all <italic>p</italic> &lt; 0.05). Multivariate analysis showed that the HRV parameters SDNN (hazard ratio = 5.254, 95% CI: 1.817–15.189, <italic>p</italic> = 0.002), RMSSD (hazard ratio = 3.024, 95% CI: 1.093–8.372, <italic>p</italic> = 0.033), as well as DC (hazard ratio = 3.909, 95% CI: 1.353–11.293, <italic>p</italic> = 0.012) were independent prognostic factors in ES-SCLC patients.</p><p><bold>Conclusion:</bold> Decreased HRV parameters (SDNN, RMSSD) and DC are independently associated with shorter overall survival in ES-SCLC patients. Autonomic nervous system function (assessed based on HRV and DC) may be a new biomarker for evaluating the prognosis of patients with ES-SCLC.</p>