Related Experiment Video

Updated: Oct 15, 2026

A Pacing-Controlled Procedure for the Assessment of Heart Rate-Dependent Diastolic Functions in Murine Heart Failure Models
07:49

A Pacing-Controlled Procedure for the Assessment of Heart Rate-Dependent Diastolic Functions in Murine Heart Failure Models

Published on: July 21, 2023

Prognostic role of heart rate variability in patients with idiopathic dilated cardiomyopathy

G A Lanza1, M G Bendini, A Intini

  • 1Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.

Italian Heart Journal : Official Journal of the Italian Federation of Cardiology
|June 27, 2000
PubMed

Insights

A low heart rate variability (HRV) LF/HF ratio predicts cardiac events in idiopathic dilated cardiomyopathy patients. This finding aids in assessing prognosis for these individuals.

Area of Science:

  • Cardiology
  • Heart Failure Research
  • Biomedical Engineering

Background:

  • Idiopathic dilated cardiomyopathy (IDCM) is a significant cause of heart failure.
  • Predicting outcomes in IDCM patients remains a clinical challenge.
  • Heart rate variability (HRV) analysis is a non-invasive tool to assess autonomic function.

Purpose of the Study:

  • To determine if HRV parameters can predict clinical outcomes in patients with IDCM.
  • To investigate the prognostic value of time-domain and frequency-domain HRV measures.

Main Methods:

  • Analysis of 24-hour Holter recordings from 56 IDCM patients (mean age 49 years, LVEF 28%).
  • Assessment of time-domain and frequency-domain HRV parameters.
  • Correlation of HRV metrics with cardiac death, arrhythmic events, and overall cardiac events.

Main Results:

  • A low frequency to high frequency (LF/HF) ratio (< 1.2) was significantly associated with increased risk of cardiac death (RR 6.8), arrhythmic events (RR 11.0), and total cardiac events (RR 4.8).
  • The LF/HF ratio was the only independent predictor of arrhythmic events (RR 8.2) and the most powerful predictor of total cardiac events (RR 3.8) in multivariate analysis.
  • Standard time-domain and most frequency-domain HRV parameters did not show significant prognostic value.

Conclusions:

  • A low LF/HF ratio derived from 24-hour Holter monitoring is a potent predictor of adverse cardiac events in IDCM patients.
  • This HRV metric can aid clinicians in risk stratification and management strategies for IDCM.
  • Further research may explore integrating HRV into routine IDCM patient assessment.
Abstract

Related Concept Videos

Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
Heart Failure IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...