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Heart rate variability: its association with hemodynamic function of the left ventricle in patients with coronary
K Szydlo1, M Trusz-Gluza, A Filipecki
1I Clinic of Cardiology, Silesian School of Medicine, Katowice, Poland.
Insights
Heart failure patients with coronary heart disease show suppressed heart rate variability (HRV), linked to impaired left ventricular function. Reduced HRV and loss of diurnal rhythm occur with lower ejection fraction and ventricular wall motion abnormalities.
Area of Science:
- Cardiology
- Autonomic Nervous System Research
- Medical Diagnostics
Background:
- Patients with heart failure secondary to coronary heart disease (CHD) exhibit autonomic nervous system imbalance, measurable via heart rate variability (HRV).
- The relationship between HRV suppression, hemodynamic function, and left ventricular contractile disturbances in CHD patients remains unclear.
Purpose of the Study:
- To investigate the prevalence of HRV suppression in CHD patients.
- To determine if HRV suppression correlates with hemodynamic function and left ventricular contractile disturbances.
Main Methods:
- Analysis of 24-hour ambulatory ECG recordings for HRV parameters (time and frequency domains) in 105 CHD patients and 17 healthy controls.
- Assessment of ventriculographic and hemodynamic measurements, including left ventricular ejection fraction (LVEF) and segmental wall motion.
- Correlation analysis between HRV parameters and cardiac function indicators.
Main Results:
- Significant correlations were observed between all HRV parameters and LVEF and left ventricular end-diastolic pressure (P < 0.001).
- Patients with LVEF < 40% demonstrated significantly lower HRV values and impaired diurnal variation in frequency-domain HRV.
- Segmental akinesis or dyskinesis was associated with lower HRV, and dyskinesis specifically showed reduced diurnal rhythms of LF and HF, irrespective of LVEF.
Conclusions:
- HRV suppression is prevalent in CHD patients and is significantly associated with impaired left ventricular function.
- Reduced LVEF and ventricular wall motion abnormalities are linked to diminished HRV and loss of diurnal HRV patterns.
- HRV analysis provides valuable insights into autonomic dysfunction and cardiac impairment in patients with coronary heart disease.
Abstract:
Patients with heart failure secondary to coronary heart disease (CHD) are characterized by an imbalance of the autonomic nervous system, which can be assessed by analysis of the heart rate variability (HRV). However it is still unclear whether all patients with CHD reveal suppression of HRV and if it is related to hemodynamic function and contractile disturbances of the left ventricle. To answer these questions data from 105 consecutive patients were analyzed and compared with 17 healthy subjects. All study participants underwent 24-hour ambulatory ECG recordings with calculation of HRV parameters and angiographic examination after collection of clinical data and other noninvasive evaluations. Time- (SDRR, SDANN, SD, pNN50) and frequency- (LF, HF) domain parameters of HRV were assessed. All ventriculographic and hemodynamic measurements were used in the analysis. Highly significant correlations were found between all HRV parameters, and left ventricular ejection fraction (LVEF) and left ventricular end-diastolic pressure (P < 0.001). Patients with LVEF < 40% were characterized by significantly lower values of HRV and impairment or lack (LVEF < 20%) of diurnal variation of frequency-domain measurements of HRV. Patients with segmental akinesis or dyskinesis also had lower values of HRV. The group with dyskinesis was characterized by significantly lower diurnal rhythms of LF and HF, independent of LVEF.