Altered Heart Rate Turbulence and Variability Parameters Predict 1-Year Mortality in Heart Failure with Preserved...

Area of Science:

• Cardiology
• Autonomic Nervous System Research
• Medical Prognostics

Background:

• Heart failure with preserved ejection fraction (HFpEF) presents a complex clinical challenge with limited effective treatments.
• Identifying robust predictors of adverse outcomes is crucial for managing HFpEF patients.
• Autonomic dysfunction is increasingly recognized as a factor in cardiovascular diseases.

Purpose of the Study:

• To investigate the prognostic value of heart rate turbulence (HRT) and heart rate variability (HRV) parameters in predicting mortality among ambulatory HFpEF patients.
• To assess whether HRT and HRV can differentiate between HFpEF survivors and non-survivors.

Main Methods:

• A case-control study utilizing data from the RESPOND Heart Failure Registry.
• Analysis of 24-hour Holter ECG monitoring to derive HRT parameters (turbulence onset (TO), turbulence slope (TS)) and HRV parameters (standard deviation of NN intervals (SDNN)).
• Comparison of these parameters between HFpEF patients who died within 12 months and matched survivors.

Main Results:

• The study included 22 HFpEF patients (mean age 80 years, 18% female, LVEF 57%).
• Deceased patients exhibited significantly higher TO values compared to survivors.
• Survivors demonstrated significantly higher TS and SDNN values than non-survivors.

Conclusions:

• HRT and HRV parameters effectively distinguish HFpEF individuals at higher risk of adverse outcomes.
• These autonomic markers can aid in the prognostic assessment and risk stratification of HFpEF patients.
• Quantifying autonomic disbalance through HRT and HRV offers potential for improved clinical decision-making in HFpEF care.