QUALITY-OF-LIFE AND CIRCADIAN VARIATION OF HEART-RATE AND HEART-RATE-VARIABILITY IN SHORT-TERM SURVIVORS AND NONSURVIVORS AFTER ACUTE MYOCARDIAL-INFARCTION

The purpose of this study was the simultaneous examination of the qual ity of life and changes in heart rate (HR) variables of patients immed iately following acute myocardial infarction (AMI). Quality of life, e stimated on a rating scale assessing the patients' well-being, as well as the circadian an rhythm of their HR and HR variability, were deter mined within the first 3 days and at approximately 3 weeks after admis sion and die results were related to survival. The quality of life wit hin the first 3 days post AMI was low in both the surviving (n = 42) a nd the nonsurviving (n = 5) patients but only the scores of the surviv ors increased significantly over the following three weeks. The HR of the survivors, initially lower than that of the nonsurvivors, decrease d significantly at 3 weeks and a normal circadian pattern had develope d. The HR variability of the survivors within the first 3 days was sig nificantly higher than that of the nonsurvivors and had developed a cl ear circadian pattern after 3 weeks. It is concluded that in patients with AMI such diverse clinical aspects as quality of life and circadia n patterns of HR and HR variability can be assessed meaningfully immed iately post AMI and may find common expression in changes in sympathov agal balance.