Multivariate and multidimensional analysis of cardiovascular oscillations in patients with heart failure

Within 5 years of first diagnosis, nearly 60% of patients with heart failure (HF) suffer from cardiac death. Early diagnosis of HF and reliable risk prediction are still required. Therefore, the objective of this study was to develop a parameter set for enhanced risk stratification in HF patients. In 43 patients suffering from HF (NYHA class > or =II, ejection fraction <45%) and 10 healthy subjects (REF), heart rate and blood pressure variability (HRV and BPV), interactions between heart rate and blood pressure (joint symbolic dynamics, JSD) and blood pressure morphology (BPM) were analysed. BPV, BPM and JSD measures revealed high significance (p<0.0001) in discriminating REF and HF. A set of three parameters from BPV, JSD and BPM was developed for risk stratification (sensitivity 76.5%, specificity 84.2%, area under the receiver operating characteristic curve 81.4%) in patients with HF.