Related Experiment Videos
Prognostic value of heart rate variability in time domain analysis in congestive heart failure
S Boveda1, M Galinier, A Pathak
1Department of Cardiology, Rangueil University Hospital, Toulouse, France. boveda.s@chu-toulouse.fr
Insights
Reduced heart rate variability (HRV) is a significant predictor of mortality in patients with chronic heart failure (CHF). This noninvasive measure offers valuable prognostic information for managing CHF patients.
Area of Science:
- Cardiology
- Autonomic Nervous System Function
- Heart Failure Research
Background:
- Heart rate variability (HRV) analysis is a noninvasive method to assess cardiac autonomic control.
- Disturbances in HRV are frequently observed in patients diagnosed with chronic heart failure (CHF).
Purpose of the Study:
- To evaluate the prognostic significance of time-domain heart rate variability measures in patients with CHF.
- To determine if HRV can predict mortality risk in individuals with chronic heart failure.
Main Methods:
- Prospective study including 190 CHF patients in sinus rhythm.
- Collected 24-hour Holter ECG recordings to measure time-domain HRV parameters.
- Follow-up period of 22 months to track all-cause mortality.
Main Results:
- Independent predictors of all-cause mortality identified: ischemic heart disease, cardiothoracic ratio >= 60%, and standard deviation of normal-to-normal intervals (SDNN) < 67 ms.
- SDNN < 67 ms was associated with a 2.5-fold increased risk of mortality (95% CI 1.5-4.2).
Conclusions:
- Depressed heart rate variability demonstrates independent prognostic value in patients with chronic heart failure.
- HRV parameters, specifically SDNN, can aid in risk stratification for mortality in CHF populations.
Aims:
Analysis of heart rate variability is a noninvasive tool that allows to study autonomic control of the heart. Several studies have shown disturbed heart rate variability in patients with chronic heart failure (CHF). We sought to assess the prognostic value of time domain measures of heart rate variability in CHF.
Methods And Results:
We prospectively enrolled 190 patients with CHF in sinus rhythm, mean age 61+/-12 years, 109 (57.4 %) in NYHA class II and 81 (42.6 %) in class III or IV, mean cardiothoracic ratio 57.6+/-6.4 % and mean left ventricular ejection fraction 28.2+/-8.8 %, 85 (45 %) with ischemic and 105 (55 %) with idiopathic dilated cardiomyopathy. Time domain measures of heart rate variability were obtained from 24 h Holter ECG recordings. During follow-up (22+/-18 months), 55 patients died. In multivariate analysis, independent predictors for all-cause mortality were: ischemic heart disease, cardiothoracic ratio > or =60 % and standard deviation of all normal RR intervals <67 ms (RR=2.5, 95 % CI 1.5--4.2).
Conclusions:
Depressed heart rate variability has independent prognostic value in patients with CHF.