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Heart rate variability in left ventricular hypertrophy

M K Mandawat1, D R Wallbridge, S D Pringle

  • 1Department of Medical Cardiology, Royal Infirmary, Glasgow.

British Heart Journal
|February 1, 1995
PubMed
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Left ventricular hypertrophy significantly reduces heart rate variability, indicating impaired cardiac autonomic function. This relationship, particularly with left ventricular mass index, may increase sudden death risk.

Area of Science:

  • Cardiology
  • Autonomic Nervous System Function
  • Cardiac Imaging

Background:

  • Left ventricular hypertrophy (LVH) and strain are linked to increased cardiac morbidity and mortality.
  • Impaired cardiac autonomic function, measured by heart rate variability (HRV), predicts sudden death post-myocardial infarction.

Purpose of the Study:

  • To investigate the impact of left ventricular hypertrophy on heart rate variability.
  • To explore the relationship between left ventricular mass and HRV.

Main Methods:

  • Studied 154 patients with LVH (hypertension or aortic valve disease) and 36 controls.
  • Measured HRV using 24-hour Holter recordings (non-spectral methods).
  • Assessed left ventricular mass index (LVMI) and fractional shortening via echocardiography.

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Main Results:

  • Patients with LVH exhibited higher LVMI and significantly reduced HRV compared to controls (P < 0.001).
  • A strong inverse correlation was found between HRV and LVMI (r = -0.478, P < 0.001).
  • LVMI was identified as the primary determinant of HRV in multivariate analysis.

Conclusions:

  • HRV is markedly reduced in LVH patients due to hypertension or aortic valve disease.
  • A continuous inverse relationship exists between HRV and LVMI.
  • Diminished cardiac autonomic function in LVH may underlie sudden cardiac death mechanisms.