Prognostic value of heart rate variability during long-term follow-up in patients with mild to moderate heart failure

Brouwer, Jan; Veldhuisen, Dirk J. van; Veld, A. J. Man In 'T; Haaksma, J.; Dijk, W.A.; Visser, Klaas; Boomsma, Frans; Dunselman, Peter H.J.M.; Lie, Ki

doi:10.1016/s0735-1097(96)00279-3

Cited by 160 publications

(107 citation statements)

References 28 publications

(34 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Seven of nine patients in the "complex" group died suddenly within 6 months of the recording. Brouwer et al examined the association between Poincaré plot patterns and outcome in patients with mild to moderate heart failure (16). Abnormal 24-hour Poincaré plots were the only HRV index that identified an increased risk of mortality.…”

Section: Discussionmentioning

confidence: 99%

Development of more erratic heart rate patterns is associated with mortality post–myocardial infarction

Stein

Domitrovich

2008

Journal of Electrocardiology

View full text Add to dashboard Cite

Cardiac patients often have sinus arrhythmia of non-respiratory origin [erratic sinus rhythm" (ESR)]. ESR was quantified using hourly Poincaré and power spectral HRV plots from normal-to-normal interbeat intervals (N-Ns) and hourly values of the short-term fractal scaling exponent and correlations of N-Ns in N=60 non-survivors and N=66 randomly-selected survivors in the Cardiac Arrhythmia Suppression Trial. Hours were coded (ABN) as normal (0), borderline (0.5) or ESR (1). T-tests compared ABN for N=2413 paired hours at baseline and on therapy. ABN was higher in nonsurvivors (0.38 ± 0.44 vs. 0.28 ± 0.40, baseline and 0.51 ± 0.45 vs. 0.34 ± 0.43, on therapy, p<0.001). Increased ABN with treatment was greater in non-survivors. Normal hours at baseline (RR=0.77, 095% CI=0.62−0.96, p=0.018) and on treatment (RR=0.47, 95%CI=0.39−0.58) were significantly associated with decreased mortality compared to ESR. Quantification of ESR may identify more vulnerable patients or help monitor the effects of pharmacological treatment. Keywordsheart rate; risk factor; mortality; post-MI; anti-arrhythmic The analysis of heart rate variability (HRV) provides information about cardiac autonomic function. However, we have found that many older subjects and patients with cardiovascular disease have an increased beat-to-beat variability that is irregular and does not reflect underlying respiratory sinus arrhythmia (1). We have called this erratic rhythm. The presence of erratic rhythm, which is frequently episodic, increases values for short-term HRV indices such as rMSSD [root mean square of successive differences of normal-to-normal (N-N) interbeat intervals in ms], pNN50 [the % of N-N intervals >50 ms different from the previous interval) and high frequency power (the amount of variance in N-N intervals at respiratory frequencies, i.e., 0.15−0.4 Hz) that quantify beat-to-beat variability. Thus, in the presence of erratic rhythm, increased short-term HRV does not, as it does for younger people, necessarily reflect greater parasympathetic control of heart rate. A high prevalence of erratic rhythm may also explain why HRV measures that are believed to reflect parasympathetic function have relatively little predictive value for outcomes. At the same time, some "non-linear" HRV measures like the short-term fractal scaling exponent, (DFA1), and (SD12), the ratio of the axes of an ellipse fitted to the Poincaré plot do capture the presence of erratic rhythm (2,3).

show abstract

Section: Discussionmentioning

confidence: 99%

Development of more erratic heart rate patterns is associated with mortality post–myocardial infarction

Stein

Domitrovich

2008

Journal of Electrocardiology

View full text Add to dashboard Cite

show abstract

“…Previous studies have shown that autonomic nervous system abnormalities are associated with the severity of chronic heart failure and with poor outcome. [3][4][5][6] Little is known regarding autonomic nervous system functionality and PAH.…”

mentioning

confidence: 99%

Impairment of Autonomic Nervous System Activity in Patients With Pulmonary Arterial Hypertension: A Case Control Study

Dimopoulos¹,

Anastasiou-Nana²,

Katsaros³

et al. 2009

Journal of Cardiac Failure

View full text Add to dashboard Cite

“…In children with congenital heart disease, HRV is reduced compared to normal controls and is predictive of sudden cardiac death (23,24). Following cardiac surgery for congenital heart disease, HRV is further reduced and may remain reduced years after operation (23,25,26).…”

Section: Resultsmentioning

confidence: 99%

Mid-term assessment of cardiac autonomic functions in children with transposition of the great arteries after arterial switch operation

Doksöz

Öner²,

Güven³

et al. 2014

Anadolu Kardiyol Derg

View full text Add to dashboard Cite

Objective: It has been documented that impaired heart rate variability (HRV) is related to life threatening arrhythmias in children with surgically repaired congenital heart disease. We aimed to analyze the balance of the cardiac autonomic functions by assessing HRV in children with arterial switch operation (ASO). Methods: In this observational cohort study, HRV analysis using 24-h Holter electrocardiography recordings was examined in 22 patients (mean age: 59.5±38.7 months, 18 male, 4 female) who had undergone ASO during the newborn period and 22 healthy children (mean age: 65.1±39.4 months, 18 male, 4 female). After Kolmogorov-Smirnov testing for normality, Student t-test and Mann-Whitney U test were used when appropriate. Chi-square was used for categorical data. Results: In 24-h HRV analysis showed that SDANN and VLF were significantly higher in patient group. Awake SDNN, rMSSD, pNN50, TP and VLF levels of patient group were significantly higher than those of control subjects. Awake LF/HF ratio in patient group was significantly higher than their counterpart in asleep group. In the patient group, awake rMSSD, pNN50, TP, LF and HF were significantly lower than their counterpart in the asleep group. Conclusion: Children with transposition of the great arteries (TGA) following ASO have not decreased levels of time and frequency HRV parameters in the mid-term follow-up period. All HRV parameters reflecting vagal tone were increased in the patient group. It is suggested that vagal tone is more predominant than sympathetic tone for children with ASO. (Anadolu Kardiyol Derg 2014; 14: 735-40)

show abstract

Prognostic value of heart rate variability during long-term follow-up in patients with mild to moderate heart failure

Abstract: Heart rate variability analysis, as assessed by Poincaré plots, has independent prognostic value in patients with mild to moderate chronic heart failure and identifies an increased risk for all-cause and sudden cardiac death in these patients.

Cited by 160 publications

References 28 publications

Development of more erratic heart rate patterns is associated with mortality post–myocardial infarction

Development of more erratic heart rate patterns is associated with mortality post–myocardial infarction

Impairment of Autonomic Nervous System Activity in Patients With Pulmonary Arterial Hypertension: A Case Control Study

Mid-term assessment of cardiac autonomic functions in children with transposition of the great arteries after arterial switch operation

Contact Info

Product

Resources

About