scholarly journals Prognostic value of heart rate variability in post-infarction patients

2014 ◽  
Vol 71 (10) ◽  
pp. 925-930 ◽  
Author(s):  
Aneta Boskovic ◽  
Natasa Belada ◽  
Bozidarka Knezevic
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Risk Stratification ◽  
Independent Predictor ◽  
Clinical Signs ◽  
Left Ventricular Ejection ◽  
Ectopic Activity ◽  
Ventricular Ectopic Activity ◽  
Rr Interval

Background/Aim. Depressed heart rate variability (HRV) indicating autonomic disequilibrium and propensity to ventricular ectopy can be useful for risk stratification in patients following acute myocardial infarction (AIM). The aim of the study was to assess heart rate variability as a predictor of allcause mortality in post-infarction patients. Methods. We analyzed the 24-hour electrocardiographic (ECG) recordings of 100 patients (80 males) during hospitalization for AIM. The mean age of patients was 56.99 + 11.03 years. Time domain heart rate variability analysis was obtained from 8 to 13 days after index infarction by mean of a 24- hour ECG recording, and the calculated parameters were: standard deviation of all normal to normal RR intervals (SDNN), RRmax-RRmin (difference between the longest RR interval and the shortest RR interval), mean RR interval. We also analyzed ventricular premature complexes from the ECG data. The patients underwent clinical evaluation, laboratory tests and echocardiography. Results. Within a oneyear follow-up period 11 patients experienced death, 10 of them because of cardiac reason and one because of stroke. There were significantly lower values of SDNN (60.55 ? 12.84 ms vs 98.38 ? 28.21 ms), RRmax-RRmin (454.36 ? 111.00 ms vs 600.99 ? 168.72 ms) and mean RR interval (695.82 ? 65.87 ms vs 840.07 ? 93.97 ms) in deceased patients than in the survivors, respectively (p < 0.01). The deceased patients were of higher mean age, with lower left ventricular ejection fraction (0.46 ? 0.05 vs 0.56 ? 0.06 in survivors), and more frequent clinical signs of heart failure and ventricular ectopic activity (> 10VPCs/h; p < 0.01). Multivariate Cox analysis showed that SDNN was a significant, independent predictor of all-cause mortality in postinfarction patients. The other independent predictors were clinical signs of heart failure - Killip class II and III and ventricular ectopic activity. Conclusion. Depressed HRV is an independent predictor of mortality in post-infarction patients and may provide useful additional prognostic information in non-invasive risk stratification of these patients.

scholarly journals Respiratory-related heart rate variability in progressive experimental heart failure

2005 ◽  
Vol 289 (4) ◽  
pp. H1729-H1735 ◽  
Author(s):  
Sophie Motte ◽  
Myrielle Mathieu ◽  
Serge Brimioulle ◽  
Anne Pensis ◽  
Lynn Ray ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Spectral Analysis ◽  
Left Ventricular ◽  
Right Atrial ◽  
Left Ventricular Ejection ◽  
Total Power ◽  
Progressive Heart Failure ◽  
Atrial Natriuretic

Heart failure is associated with autonomic imbalance, and this can be evaluated by a spectral analysis of heart rate variability. However, the time course of low-frequency (LF) and high-frequency (HF) heart rate variability changes, and their functional correlates during progression of the disease are not exactly known. Progressive heart failure was induced in 16 beagle dogs over a 7-wk period by rapid ventricular pacing. Spectral analysis of heart rate variability and respiration, echocardiography, hemodynamic measurements, plasma atrial natriuretic factor, and norepinephrine was obtained at baseline and every week, 30 min after pacing interruption. Progressive heart failure increased heart rate (from 91 ± 4 to 136 ± 5 beats/min; P < 0.001) and decreased absolute and normalized (percentage of total power) HF variability from week 1 and 2, respectively ( P < 0.01). Absolute LF variability did not change during the study until it disappeared in two dogs at week 7 ( P < 0.05). Normalized LF variability increased in moderate heart failure ( P < 0.01), leading to an increased LF-to-HF ratio ( P < 0.05), but decreased in severe heart failure ( P < 0.044; week 7 vs. week 5). Stepwise regression analysis revealed that among heart rate variables, absolute HF variability was closely associated with wedge pressure, right atrial and pulmonary arterial pressure, left ventricular ejection fraction and volume, ratio of maximal velocity of early (E) and atrial (A) mitral flow waves, left atrial diameter, plasma norepinephrine, and atrial natriuretic peptide (0.45 < r < 0.65, all P < 0.001). In tachycardia-induced heart failure, absolute HF heart rate variability is a more reliable indicator of cardiac dysfunction and neurohumoral activation than LF heart rate variability.

scholarly journals Preprocessing Unevenly Sampled RR Interval Signals to Enhance Estimation of Heart Rate Deceleration and Acceleration Capacities in Discriminating Chronic Heart Failure Patients from Healthy Controls

2020 ◽  
Vol 2020 ◽  
pp. 1-10 ◽  
Author(s):  
Ping Cao ◽  
Bailu Ye ◽  
Linghui Yang ◽  
Fei Lu ◽  
Luping Fang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Chronic Heart Failure ◽  
Characteristic Curve ◽  
Clinical Analysis ◽  
Healthy Controls ◽  
Heart Failure Patients ◽  
Rr Interval ◽  
Frequency Components

Objective. The deceleration capacity (DC) and acceleration capacity (AC) of heart rate, which are recently proposed variants to the heart rate variability, are calculated from unevenly sampled RR interval signals using phase-rectified signal averaging. Although uneven sampling of these signals compromises heart rate variability analyses, its effect on DC and AC analyses remains to be addressed. Approach. We assess preprocessing (i.e., interpolation and resampling) of RR interval signals on the diagnostic effect of DC and AC from simulation and clinical data. The simulation analysis synthesizes unevenly sampled RR interval signals with known frequency components to evaluate the preprocessing performance for frequency extraction. The clinical analysis compares the conventional DC and AC calculation with the calculation using preprocessed RR interval signals on 24-hour data acquired from normal subjects and chronic heart failure patients. Main Results. The assessment of frequency components in the RR intervals using wavelet analysis becomes more robust with preprocessing. Moreover, preprocessing improves the diagnostic ability based on DC and AC for chronic heart failure patients, with area under the receiver operating characteristic curve increasing from 0.920 to 0.942 for DC and from 0.818 to 0.923 for AC. Significance. Both the simulation and clinical analyses demonstrate that interpolation and resampling of unevenly sampled RR interval signals improve the performance of DC and AC, enabling the discrimination of CHF patients from healthy controls.

Effects of angiotensin II (AT1) receptor blockade on cardiac vagal control in heart failure

2001 ◽  
Vol 101 (6) ◽  
pp. 559-566 ◽  
Author(s):  
J. C. VAILE ◽  
S. CHOWDHARY ◽  
F. OSMAN ◽  
H. F. ROSS ◽  
J. FLETCHER ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Angiotensin Ii ◽  
Baroreflex Sensitivity ◽  
At1 Receptor ◽  
Receptor Blockade ◽  
Double Blind ◽  
Rr Interval

The objective of the present study was to determine the autonomic effects of angiotensin II (AT1) receptor blocker therapy in heart failure. In a randomized double-blind cross-over study, we compared the effects of candesartan and placebo on baroreflex sensitivity and on heart rate variability at rest, during stress and during 24h monitoring. Acute effects were assessed 4h after oral candesartan (8mg) and chronic effects after 4 weeks of treatment (dose titrated to 16mg daily). The study group comprised 21 patients with heart failure [mean (S.E.M.) ejection fraction 33% (1%)], in the absence of angiotensin-converting enzyme (ACE) inhibitor therapy. We found that acute candesartan was not different from placebo in its effects on blood pressure or mean RR interval. Chronic candesartan significantly reduced blood pressure [placebo, 137 (3)/82 (3)mmHg; candesartan, 121 (4)/75 (2)mmHg; P<0.001; values are mean (S.E.M.)], but had no effect on mean RR interval [placebo, 857 (25)ms; candesartan, 857 (21)ms]. Compared with placebo there were no significant effects of acute or chronic candesartan on heart rate variability in the time domain and no consistent effects in the frequency domain. Baroreflex sensitivity assessed by the phenylephrine bolus method was significantly increased after chronic candesartan [placebo, 3.5 (0.5)ms/mmHg; candesartan, 4.8 (0.7)ms/mmHg; P<0.05], although there were no changes in cross-spectral baroreflex sensitivity. Thus, in contrast with previous results with ACE inhibitors, angiotensin II receptor blockade in heart failure did not increase heart rate variability, and there was no consistent effect on baroreflex sensitivity.

Heart rate variability and ventricular ectopic activity in hypertensive patients

1989 ◽  
Vol 7 ◽  
pp. S34-35 ◽  
Author(s):  
Carmine Cardillo ◽  
Vincenzo Musumeci ◽  
Nadia Mores ◽  
Giuseppe Guerrera ◽  
Domenico Melina ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Ectopic Activity ◽  
Hypertensive Patients ◽  
Ventricular Ectopic Activity

scholarly journals Influencing Cardiovascular Outcomes through Heart Rate Variability Modulation: A Systematic Review

Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2198
Author(s):  
Alexandru Burlacu ◽  
Crischentian Brinza ◽  
Iolanda Valentina Popa ◽  
Adrian Covic ◽  
Mariana Floria
Keyword(s):  
Heart Failure ◽  
Coronary Artery Disease ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Coronary Artery ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Inverse Association ◽  
Artery Disease ◽  
The Impact

Psychological stress is a well-established risk factor for cardiovascular disease (CVD). Heart rate variability (HRV)-biofeedback could significantly reduce stress levels and improve autonomic nervous system function and cardiovascular endpoints. We aimed to systematically review the literature to investigate the impact of HRV modulation through HRV-biofeedback on clinical outcomes in patients with CVD. A literature search was performed in the following databases: MEDLINE (PubMed), Embase, and Cochrane from the inception until 1 October 2021. Patients in the HRV-biofeedback group had significantly lower rates of all-cause readmissions than patients who received psychological education (respectively, p = 0.028 and p = 0.001). Heart failure following HRV-biofeedback displayed an inverse association with stress and depression (respectively, p = 0.022 and p = 0.033). When stratified according to left ventricular ejection fraction (LVEF), patients with LVEF ≥ 31% showed improved values of the 6 min walk test after HRV-biofeedback interventions (p = 0.05). A reduction in systolic and diastolic blood pressure associated with HRV-biofeedback was observed (p < 0.01) in pre-hypertensive patients. HRV-biofeedback had beneficial effects on different cardiovascular diseases documented in clinical trials, such as arterial hypertension, heart failure, and coronary artery disease. A standard breathing protocol should be applied in future studies to obtain equivalent results and outcomes. However, data regarding mortality in patients with coronary artery disease are scarce and need further research.

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