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Heart rate behaviour at different stages of congestive heart failure
T Stefenelli1, J Bergler-Klein, S Globits
1Department of Cardiology, University of Vienna, Austria.
European Heart Journal
|July 1, 1992
Summary
Reduced heart rate variability in congestive heart failure patients correlates with disease severity. Changes in R-R interval histograms reflect New York Heart Association (NYHA) functional class, but improvement doesn't always alter heart rate behavior.
Area of Science:
- Cardiology
- Heart Failure Research
- Autonomic Nervous System Function
Background:
- Depressed heart rate variation is a known predictor of mortality in severe congestive heart failure (CHF).
- The relationship between heart rate variability and the clinical status of CHF patients requires further elucidation.
Purpose of the Study:
- To investigate the correlation between the degree of altered heart rate and the clinical state in patients with congestive heart failure.
- To assess if heart rate variability changes reflect clinical improvement or deterioration over time.
Main Methods:
- 24-hour Holter monitoring was conducted on 21 CHF patients (ejection fraction: 18 +/- 11%) at baseline and after 6 months of oral therapy.
- Analysis included R-R interval histograms and heart rate variability metrics, stratified by NYHA functional class.
Main Results:
- Baseline heart rate variation and night/day ratio were reduced, correlating with higher NYHA functional class.
- R-R interval histogram morphology was sensitive to clinical state; higher NYHA class showed smaller R-R variability and standard deviation.
- Clinical deterioration (n=8) showed a trend towards further reduced R-R variability, while stable or improved patients (n=13) had no significant changes.
Conclusions:
- Variations in R-R interval histogram shapes correspond to different NYHA functional classes in CHF patients.
- Severe CHF progression may be linked to further reductions in heart rate variability.
- Clinical improvement in CHF does not necessarily lead to significant changes in heart rate variability patterns.
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