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Neurohumoral activations in congestive heart failure: correlations with cardiac function, heart rate variability, and
T Yoshikawa1, A Baba, M Akaishi
1Cardiopulmonary Division, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
Insights
Heart rate variability and baroreceptor sensitivity in heart failure patients may indicate autonomic regulation independent of cardiac function. These autonomic markers show distinct correlations with neurohumoral factors.
Area of Science:
- Cardiology
- Autonomic Nervous System Research
- Heart Failure Studies
Background:
- The clinical significance of heart rate variability (HRV) and baroreceptor sensitivity (BRS) in relation to cardiac function and neurohumoral factors in heart failure is not fully established.
- Autonomic dysfunction is a key feature of heart failure, impacting cardiac function and prognosis.
Purpose of the Study:
- To investigate the relationship between HRV, BRS, cardiac function, and neurohumoral factors in patients with heart failure.
- To determine if HRV and BRS are independent indicators of autonomic regulation in heart failure.
Main Methods:
- Frequency domain analysis of HRV and BRS were assessed in 146 heart failure patients.
- Correlations were examined between HRV, BRS, conventional clinical variables, and plasma levels of norepinephrine and atrial natriuretic peptide.
- Cardiac function parameters including left ventricular ejection fraction, dimensions, and left atrial size were evaluated.
Main Results:
- Plasma atrial natriuretic peptide levels correlated with cardiac function, while norepinephrine levels did not.
- Total power and low-frequency power of HRV correlated with plasma norepinephrine.
- Baroreceptor sensitivity correlated with plasma atrial natriuretic peptide.
- No significant correlation was found between HRV, BRS, and cardiac function parameters.
- A positive correlation was observed between low-frequency power of HRV and baroreceptor sensitivity.
Conclusions:
- Heart rate variability and baroreceptor sensitivity reflect autonomic regulation in heart failure.
- These autonomic measures may serve as indicators independent of direct cardiac function in heart failure patients.
- Further research is warranted to elucidate the prognostic implications of HRV and BRS in heart failure.
Background:
The clinical significance of the determination of heart rate variability and baroreceptor sensitivity relating to cardiac function and neurohumoral factors remains to be established.
Methods And Results:
We investigated the relation between conventional clinical variables and frequency domain analysis of heart rate variability and baroreceptor sensitivity in 146 patients with heart failure. Cardiac function including left ventricular ejection fraction, left ventricular dimensions, and left atrial size was different by the plasma atrial natriuretic peptide level but not by the norepinephrine level. The total power and low-frequency power were correlated with plasma norepinephrine, whereas baroreceptor sensitivity was correlated with plasma atrial natriuretic peptide. None of the frequency domain variables and baroreceptor sensitivity was correlated with cardiac function. There was a positive correlation between the low-frequency power and baroreceptor sensitivity.
Conclusions:
Heart rate variability and baroreceptor sensitivity, which reflect autonomic regulation, may be an indicator independent from cardiac function in patients with heart failure.