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BioMed Research International
Volume 2013 (2013), Article ID 503421, 6 pages
Clinical Study

Heart Rate Variability Is Associated with Survival in Patients with Brain Metastasis: A Preliminary Report

1Institute of Physiology, National Yang-Ming University, Beitou, Taipei 11221, Taiwan
2Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Niao-Sung, Kaohsiung 83306, Taiwan
3Department of Mathematics, Stanford University, Stanford, CA 94305, USA
4School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Kwei-Shan, Taoyuan 33302, Taiwan
5Department of Anesthesiology, Taipei Veterans General Hospital, Beitou, Taipei 11217, Taiwan

Received 30 June 2013; Accepted 12 August 2013

Academic Editor: Tsair-Fwu Lee

Copyright © 2013 Yu-Ming Wang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Impaired heart rate variability (HRV) has been demonstrated as a negative survival prognosticator in various diseases. We conducted this prospective study to evaluate how HRV affects brain metastasis (BM) patients. Fifty-one BM patients who had not undergone previous brain operation or radiotherapy (RT) were recruited from January 2010 to July 2012, and 40 patients were included in the final analysis. A 5-minute electrocardiogram was obtained before whole brain radiotherapy. Time domain indices of HRV were compared with other clinical factors on overall survival (OS). In the univariate analysis, Karnofsky performance status (KPS) <70 ( ) and standard deviation of the normal-to-normal interval (SDNN) <10 ms ( ) significantly predict poor survival. The multivariate analysis revealed that KPS <70 and SDNN <10 ms were independent negative prognosticators for survival in BM patients with hazard ratios of 2.657 and 2.204, respectively. In conclusion, HRV is associated with survival and may be a novel prognostic factor for BM patients.