Related Experiment Videos
Depressed heart rate variability is associated with events in patients with stable coronary artery disease and
A J van Boven1, J W Jukema, J Haaksma
1Department of Cardiology, Thoraxcenter, University Hospital Groningen, The Netherlands.
Insights
Decreased heart rate variability in patients with coronary artery disease and normal heart function may predict adverse clinical events. This finding suggests heart rate variability is a valuable tool for risk assessment.
Area of Science:
- Cardiology
- Clinical Research
- Predictive Analytics
Background:
- Limited data exists on heart rate variability (HRV) in symptomatic coronary artery disease (CAD) patients with preserved left ventricular function.
- HRV may serve as an adjunct to conventional parameters for predicting clinical events in this population.
Purpose of the Study:
- To investigate the predictive value of HRV for clinical events in male patients with stable angina pectoris and preserved left ventricular ejection fraction.
Main Methods:
- Prospective 2-year follow-up study.
- Ambulatory electrocardiographic recordings in 263 male patients (mean age 56 years).
- Left ventricular ejection fraction averaged 71%.
Main Results:
- Patients experiencing events (coronary events, angioplasty, bypass graft) had lower HRV measures (SDNN, 5-min SDNN, spectral components).
- Reduced SDNN remained significant after adjusting for angina severity, prior myocardial infarction, and beta-blocker use.
- Healthy volunteers exhibited the highest HRV measures.
Conclusions:
- In patients with ischemic heart disease and normal ventricular function, decreased heart rate variability is linked to adverse clinical outcomes.
- HRV assessment can aid in identifying patients at higher risk for adverse events.
Background:
Little is known about the value of heart rate variability in patients with symptomatic coronary artery disease with a preserved left ventricular function. We hypothesized that in these patients heart rate variability might be a helpful adjunct to conventional parameters to predict clinical events.
Methods:
In a prospective 2-year follow-up study ambulatory electrocardiographic recordings were performed in 263 consecutive male patients (mean age 56+/-8 years) with stable angina pectoris and a mean left ventricular ejection fraction of 71%+/-12%. Clinical events consisted mainly of coronary events such as percutaneous transluminal angioplasty or coronary artery bypass graft operation.
Results:
Low measures of standard deviation of normal R-R intervals, standard deviation of the mean R-R intervals of 5 minutes, and two spectral components of heart rate variability were found in patients who had had an event compared with patients with no event. Adjusted for severity of angina, the presence of a previous myocardial infarction, and the use of beta-blockers in a logistic regression model this relation remained statistically significant for SDNN. Healthy volunteers appeared to have the highest measures of heart rate variability.
Conclusion:
In patients with ischemic heart disease and normal or near normal ventricular function decreased heart rate variability is associated with adverse clinical events.