Evaluation of Heart-Rate Turbulence as a New Prognostic Marker in Patients With Chronic Heart Failure.

Abstract

The significance of heart-rate turbulence (HRT) in patients with chronic heart failure (CHF) was evaluated to examine whether it is sensitive to the risk of ventricular tachycardia (VT). HRT is reported to predict the prognosis after myocardial infarction (MI), but its prognostic value in patients with CHF remains unknown. HRT was measured in 50 CHF patients (left ventricular ejection fraction <50% and/or left ventricular end-diastolic diameter >55 mm, 34 cardiomyopathy, 16 post-MI) and 21 patients without obvious heart diseases (control). HRT slope and HRT onset were measured by the original definitions using digitized Holter ECG recordings. Cardiac pump function was assessed by echocardiography. The value of the HRT slope was significantly lower in CHF than in control (3.7 +/- 1.7 vs 16.4 +/- 5.3, mean +/- SD, p < 0.01). The value of the HRT onset in patients with CHF was significantly higher than that in control patients (-1.1 +/- 1.9 vs -3.6 +/- 1.7, mean +/- SD, p < 0.05). The HRT slope and onset in CHF patients with VT were nearly identical to those without VT. The HRT slope appears to be a powerful prognostic marker that shows significant differences between CHF subgroups when divided by clinical events; that is, CHF death and CHF hospitalization. However, it has limited value for predicting fatal ventricular arrhythmias.

Cardiac autonomic function in patients with rheumatoid arthritis: heart rate turbulence analysis

“…HRT is highly correlated with spontaneous baroreflex sensitivity and it may be used instead of baroreflex sensitivity as a new diagnostic method (21). It is proven that HRT also predicts mortality and sudden cardiac death in various cardiac abnormalities like postmyocardial infarction period (13), after coronary artery bypass grafting surgery (22) and in chronic heart failure (23). In addition, HRT predicts alterations of cardiac autonomic function in diabetes mellitus (24) and hyperthyroidism (25).…”

Effects of Repeated Sauna Treatment on Ventricular Arrhythmias in Patients With Chronic Heart Failure

“…23 Several studies have shown that reduced heart rate variability (HRV), determined from 24-h ambulatory electrocardiographic (ECG) recordings, is associated with a greater risk for ventricular fibrillation and poor prognosis in patients with CHF. [24][25][26][27] Therefore, we prospectively investigated the effects of thermal therapy on cardiac arrhythmias and HRV in patients with CHF.…”

The effect of sleep apnea severity on cardiac autonomic activity during night time in obstructive sleep apnea patients

“…15 HRT is defined as the sinus rhythm cycle-length fluctuation after isolated premature ventricular beats. 16 HRT evaluation has been deemed appropriate for risk estimation after acute myocardial infarction 17 and as a prognostic evaluator for heart failure 18 and other pathological conditions. 16 Autonomic cardiac functions in OSA patients have been the focus of attention for researchers.…”