Related Experiment Video
Updated: Jul 12, 2025
Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Cardiac autonomic dysfunction in adult congenital heart disease
Carmen Pizarro1, Franziska Luise Bosse2, Charlotte Begrich2
1University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany. carmen.pizarro@ukbonn.de.
Insights
Adults with congenital heart disease (ACHD) show impaired heart rate variability (HRV), which predicts mortality and sudden cardiac death (SCD). These HRV alterations are crucial for risk stratification in ACHD patients.
Area of Science:
- Cardiology
- Medical Science
- Clinical Research
Background:
- Advances in diagnosis and treatment have increased the adult population with congenital heart disease (ACHD).
- Rhythm disorders remain a significant challenge in managing ACHD patients.
- Heart rate variability (HRV) is a key indicator of autonomic nervous system function and cardiac health.
Purpose of the Study:
- To investigate alterations in heart rate variability (HRV) in adults with congenital heart disease (ACHD).
- To determine the prognostic value of HRV in predicting outcomes such as mortality and sudden cardiac death (SCD) in ACHD patients.
Main Methods:
- Ninety-seven ACHD patients and 19 controls underwent 24-hour Holter monitoring.
- Analysis included assessment of premature ventricular contractions and various HRV indices (time and frequency domains).
- Patients were followed for a mean of 3.9 years to track mortality and SCD events.
Main Results:
- ACHD patients exhibited a higher burden of premature ventricular contractions and significantly decreased HRV indices compared to controls.
- NT-proBNP levels showed significant correlations with multiple time and frequency domain HRV parameters.
- Reduced HRV parameters were associated with increased risk of mortality and survived SCD in ACHD patients.
Conclusions:
- Adult congenital heart disease (ACHD) is associated with significant impairments in heart rate variability (HRV).
- These HRV alterations have important prognostic implications for ACHD mortality and the risk of sudden cardiac death (SCD).
- HRV assessment can aid in risk stratification and management of ACHD patients.
Purpose:
Due to recent advances in diagnosis and treatment, the number of adults with congenital heart disease (ACHD) has substantially increased. This achievement is mitigated by rhythm disorders. Here, we sought to determine alterations in heart rate variability (HRV) and their prognostic value in ACHD.
Methods:
Ninety seven ACHD patients (39.2 ± 14.1 years, 51.5% female) and 19 controls (39.7 ± 15.0 years, 47.4% female) underwent 24-h Holter monitoring.
Results:
As compared to controls, ACHD patients offered a significantly higher burden of premature ventricular contractions (p = 0.02) and decreased HRV indices (natural logarithmic transformation of very low frequency (lnVLF): 7.46 ± 0.76 ms2 vs. 7.91 ± 0.92ms2, p = 0.03; natural logarithmic transformation of low frequency (lnLF): 6.39 ± 0.95ms2 vs. 7.01 ± 1.07ms2, p = 0.01; natural logarithmic transformation of the ratio of low to high frequency spectra (lnLF/HF): 0.81 ± 0.74 vs. 1.17 ± 0.51, p = 0.04). No differences in HRV measures were observed across ACHD lesion groups. NT-proBNP levels were significantly related to both time and frequency domain indices (natural logarithmic transformation of the standard deviation of NN intervals (lnSDNN): Spearman´s rho = -0.32, p = 0.001; natural logarithmic transformation of the standard deviation of the average NN intervals for each 5-min segment of a 24-h Holter monitoring (lnSDANN): Spearman´s rho: -0.33, p = 0.001; natural logarithmic transformation of the total power (lnTP): Spearman´s rho: -0.25, p = 0.01; lnVLF: Spearman´s rho: -0.33, p = 0.001; lnLF: Spearman´s rho: -0.35, p < 0.001; lnLF/HF: Spearman´s rho: -0.34, p = 0.001). After a mean follow-up of 3.9 ± 0.7 years, 8 patients died and 3 patients survived sudden cardiac death (SCD). Several HRV parameters were significantly higher in event-free ACHD patients than in those who died or survived SCD (natural logarithmic transformation of the average of the standard deviations of NN intervals for each 5-min segment of a 24-h Holter monitoring (lnASDNN): p = 0.04; lnPNN30: p = 0.04; lnVFL: p = 0.03; lnLF: p < 0.01). On univariate Cox regression analysis, the time domain indices lnSDNN, lnASDNN and lnPNN30, as well as the frequency domain parameters lnTP, lnVLF and lnLF were associated with death and survived cardiac arrest.
Conclusion:
ACHD is accompanied by HRV impairment that carries prognostic implications on ACHD mortality and survived SCD.
More Related Videos
09:40Induction of Right Ventricular Failure by Pulmonary Artery Constriction and Evaluation of Right Ventricular Function in Mice
Published on: May 13, 2019
08:22Measuring Cardiac Autonomic Nervous System ANS Activity in Toddlers - Resting and Developmental Challenges
Published on: February 25, 2016
Related Concept Videos
01:30Cardiomyopathy II: Dilated Cardiomyopathy
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
01:17Pathophysiology of Heart Failure
01:26Imbalances in Cardiac Output
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
01:25Cardiomyopathy I: Introduction and Classification
01:29Cardiomyopathy V: Interprofessional Care