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Heart rate variability and haemodynamic function in individuals with hypertrophic cardiomyopathy
Alaa I Alyahya1,2,3, Sarah J Charman1,2, Nduka C Okwose1,2,4
1Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
Insights
Heart rate variability (HRV) in hypertrophic cardiomyopathy (HCM) shows increased vagal activity and is linked to peripheral resistance. This study highlights HRV as a feasible method for assessing autonomic function in HCM patients.
Area of Science:
- Cardiology
- Autonomic Nervous System Function
- Cardiovascular Physiology
Background:
- Heart rate variability (HRV) quantifies cardiac autonomic function.
- Hypertrophic cardiomyopathy (HCM) is a condition affecting cardiac structure and function.
- Understanding autonomic dysfunction is crucial in managing HCM.
Purpose of the Study:
- To compare HRV and hemodynamic function between individuals with HCM and healthy controls.
- To investigate the relationship between HRV parameters and hemodynamic variables in HCM patients.
Main Methods:
- Twenty-eight individuals with HCM and 28 matched healthy controls underwent 5-minute HRV and hemodynamic assessments.
- Measurements were performed using bioimpedance technology under resting supine conditions.
- Frequency domain HRV indices (LF, HF, LF/HF ratio) and RR interval were analyzed.
Main Results:
- Individuals with HCM exhibited higher high-frequency (HF) power (indicating increased vagal activity) and a lower RR interval compared to controls.
- HCM patients showed reduced stroke volume (SV) index and cardiac index, alongside elevated total peripheral resistance (TPR).
- HF power was significantly correlated with SV (r=-0.46) and TPR (r=0.28) in the HCM group.
Conclusions:
- Short-term frequency domain HRV indices offer a practical method for evaluating autonomic function in individuals with HCM.
- Increased vagal activity, reflected by HF power, is observed in HCM and is associated with altered peripheral resistance.
Objectives:
Heart rate variability (HRV) is a measure of cardiac autonomic function. This study: (1) evaluated the differences in HRV and haemodynamic function between individuals with hypertrophic cardiomyopathy (HCM) and healthy controls, and (2) determined the relationship between HRV and haemodynamic variables in individuals with HCM.
Methods:
Twenty-eight individuals with HCM (n = 7, females; age 54 ± 15 years; body mass index: 29 ± 5 kg/m2 ) and 28 matched healthy individuals (n = 7 females; age 54 ± 16 years; body mass index: 29 ± 5 kg/m2 ) completed 5-min HRV and haemodynamic measurements under resting (supine) conditions using bioimpedance technology. Frequency domain HRV measures (absolute and normalized low-frequency power (LF), high-frequency power (HF) and LF/HF ratio) and RR interval were recorded.
Results:
Individuals with HCM demonstrated higher vagal activity (i.e., absolute unit of HF power (7.40 ± 2.50 vs. 6.03 ± 1.35 ms2 , p = 0.01) but lower RR interval (914 ± 178 vs. 1014 ± 168 ms, p = 0.03) compared to controls. Stroke volume (SV) index and cardiac index were lower in HCM compared with healthy individuals (SV, 33 ± 9 vs. 43 ± 7 ml/beat/m², p < 0.01; cardiac index,2.33 ± 0.42 vs. 3.57 ± 0.82 L/min/m2 , p < 0.01), but total peripheral resistance (TPR) was higher in HCM (3468 ± 1027 vs. 2953 ± 1050 dyn·s·m2 cm-5 , p = 0.03). HF power was significantly related to SV (r = -0.46, p < 0.01) and TPR (r = 0.28, p < 0.05) in HCM.
Conclusions:
Short-term frequency domain indices of HRV provide a feasible approach to assess autonomic function in individuals with HCM. Vagal activity, represented by HF power, is increased, and associated with peripheral resistance in individuals with HCM.
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