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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
PubMed

Insights

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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