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Heart rate variability and left ventricular diastolic function in patients with borderline hypertension with and
G Martini1, F Rabbia, L Gastaldi
1Department of Medicine and Experimental Oncology, University of Turin, Torino, Italy. centroiperten.torino@livio.it
Insights
Borderline hypertensive patients with left ventricular hypertrophy show reduced heart rate variability (HRV) and impaired diastolic function. These changes correlate with increased left ventricular mass, impacting cardiac health.
Area of Science:
- Cardiology
- Hypertension Research
- Cardiac Electrophysiology
Background:
- Borderline hypertensive patients (BHT) represent an intermediate risk group for cardiovascular disease.
- Left ventricular hypertrophy (LVH) is a known complication of hypertension, affecting cardiac function.
- Heart rate variability (HRV) reflects autonomic nervous system activity and is linked to cardiovascular health.
Purpose of the Study:
- To investigate the relationship between HRV, left ventricular mass, and diastolic function in BHT.
- To compare these parameters in BHT with and without LVH against normotensive controls.
Main Methods:
- Utilized 24-hour Holter ECG and blood pressure monitoring in 42 BHT and 20 controls.
- Performed M-mode and 2D echocardiography with Doppler analysis to assess left ventricular parameters.
- Calculated time-domain HRV indices, including Standard Deviation of all Cycles (SDNN) and Standard Deviation of the means of heart periods over five-minute intervals (SDANN).
Main Results:
- SDNN and SDANN were significantly reduced in BHT with LVH compared to controls and BHT without LVH.
- Diastolic left ventricular compliance, assessed by the E/A ratio, significantly declined in BHT with LVH.
- A positive correlation was observed between HRV indices (SDNN, SDANN) and diastolic function (E/A ratio) across all groups.
Conclusions:
- BHT with LVH exhibit significantly reduced HRV, indicating impaired autonomic regulation.
- The observed reduction in HRV is associated with increased left ventricular mass and abnormal diastolic function.
- These findings suggest that HRV assessment may provide insights into cardiac remodeling and diastolic dysfunction in BHT.
Abstract:
The relationships between heart rate variability (HRV), left ventricular mass and diastolic function in borderline hypertensive patients (BHT) were evaluated. 24 h Holter electrocardiogram (ECG) and blood pressure (BP) monitoring, M and 2 D echocardiogram and Doppler analysis in 42 BHT with and without left ventricular hypertrophy (LVH) and in 20 normotensive controls were assessed. From 24-h ECG, time domain indexes of HRV were calculated. Standard Deviation of all Cycles (SDNN) and Standard Deviation of the means of heart periods over five-minute intervals (SDANN) were significantly reduced in BHT with LVH but not in BHT without LVH. No significant differences of short-term variability measures were detectable, although a progressive decrease among control subjects and BHT with and without LVH was observed. Diastolic left ventricular compliance evaluated by early to late transmitral flow velocity ratio (E/A ratio) significantly declined from normotensive subjects to BHT with LVH. There was a significant positive correlation between E/A and SDNN and SDANN throughout all studied groups. This indicates that BHT with LVH has a reduced HRV compared to other groups. This impairment is probably related to left ventricular mass and left ventricular filling abnormalities.