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[Prognostic significance of cardiac rhythm variability in patients with chronic heart failure]

N A Kosheleva, A P Rebrov

    Klinicheskaia Meditsina
    |September 22, 2012
    PubMed

    Insights

    Heart rhythm variability (HRV) can predict chronic heart failure (CCF) outcomes. Low heart rhythm variability (LF) is linked to higher risks of CCF decompensation, repeated heart attacks, and death in CCF patients.

    Area of Science:

    • Cardiology
    • Medical Prognostics
    • Heart Failure Research

    Background:

    • Prognosis for chronic heart failure (CCF) presents significant clinical challenges.
    • The role of heart rhythm variability (HRV) in the pathogenesis of CCF remains poorly understood.

    Purpose of the Study:

    • To evaluate the potential of using HRV for predicting the prognosis of CCF.
    • To investigate the association between HRV parameters and adverse cardiovascular events in CCF patients.

    Main Methods:

    • HRV analysis was performed using 5-minute recordings in 110 patients with CCF post-myocardial infarction.
    • Patients were stratified into two groups based on the median low-frequency (LF) component of the HRV spectrum (5.2 ln ms²).
    • Kaplan-Meier survival analysis was used to compare outcomes between the groups.

    Main Results:

    • A low-frequency (LF) component below 5.2 ln ms² was associated with increased risks of CCF decompensation (p=0.03), secondary myocardial infarction (p=0.007), and mortality (p=0.03).
    • The LF component showed an inverse relationship with age, heart rate, NT-proBNP, CRP, and left ventricular ejection fraction.
    • LF < 5.2 ln ms² was identified as an independent risk factor for adverse outcomes in CCF.

    Conclusions:

    • Low heart rhythm variability, specifically a low-frequency component below 5.2 ln ms², is a significant independent risk factor for poor prognosis in chronic heart failure patients.
    • HRV analysis, particularly the LF component, offers a valuable tool for risk stratification and prognosis in patients with chronic heart failure.
    • Further research into HRV mechanisms in CCF pathogenesis is warranted.

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