Five-minute recording of heart rate variability in severe chronic heart failure: Correlates with right ventricular function and prognostic implications

Lucreziotti, Stefano; Gavazzi, Antonello; Inserra, C.; Klersy, Catherine; Campana, Carlo; Ghio, Stefano; Vanoli, Emilio; Tavazzi, Luigi

doi:10.1067/mhj.2000.106168

Cited by 65 publications

(56 citation statements)

References 38 publications

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“…LF:HF showed great intra-individual variation and while the lower 95% CI in explants was below the cut-point of La Rovere et al [9], this was not the case in implanted patients and the mean values in both cases do not suggest that these patients are at significantly heightened risk of SCD [10]. From these data, we propose that the balance between LF and HF power is likely to be partially restored in CHF patients during LVAD support and that this restoration of balance is maintained post-explantation.…”

Section: Low To High Frequency Ratio: Explants and Implantsmentioning

confidence: 89%

“…Further non-statistical comparisons were made by comparing mean (±SD) levels of significant short-term HRV risk factors reported previously [9,10] with values obtained for explanted, implanted and CHF patients and for comparison, control subjects. This analysis allowed visual evaluation of spectral HRV profiles at different points during 'bridging to recovery' in comparison with heart failure patients and healthy control individuals.…”

Section: Discussionmentioning

confidence: 99%

“…Values for LF predictive of mortality range from 3.3 ln ms 2 from Holter recordings [22] to between b 13 ms 2 [9] and 20 ms 2 [10] when extracted from more-stationary recordings as in the present study. We have previously calculated estimated normal values for the LF frequency component to be around 519 ± 219 ms 2 or 5.0 ± 1.8 ln ms 2 [23].…”

Section: Low Frequency Spectral Power: Explants and Implantsmentioning

confidence: 99%

“…This is because of very low values for LF due to severely attenuated baroreflex sensitivity in these patients [25]. Regardless of its physiological meaning, low LF:HF is a risk factor of mortality and cardiac event in CHF patients [9,10]. The reduced LF component in the HRV profile of CHF patients results in a low LF:HF ratio and the most sensitive values to predict mortality reported by La Rovere et al were b 0.37 and b0.43 [9].…”

Section: Low To High Frequency Ratio: Explants and Implantsmentioning

confidence: 99%

“…Overall R-R interval variation is lower in CHF patients who die compared with survivors [6][7][8]. Spectral analysis of HRV produces a characteristic HRV profile in CHF with attenuated variability both in the low frequency (LF, 0.04-0.15 Hz) and reduced low-to-high frequency ratio (LF:HF) which both predict patient mortality [9,10].…”

Section: Introductionmentioning

confidence: 99%

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Cardiovascular autonomic control in patients undergoing left ventricular assist device (LVAD) support and pharmacologic therapy

Nunan¹,

Sandercock²,

George³

et al. 2013

International Journal of Cardiology

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Objectives: The objective of the study is to determine cardiac autonomic control in patients undergoing assessment for and/or LVAD therapy. Methods: Heart rate variability (HRV) was measured in 17 explanted LVAD, 17 implanted LVAD and 23 NYHA III-IV classified chronic heart failure (CHF) patients and ten healthy matched controls under three conditions: supine free breathing, standing and supine controlled breathing. Five measures of HRV were assessed: mean R-R interval (mR-R), high frequency (HF) and low frequency (LF) spectral power, LF in normalised units (LFnu), and LF to HF (LF:HF) ratio. Results: Repeat measures ANOVA showed significant (p b 0.05) differences in HRV between all three conditions within groups. Lower values were observed in CHF for LF(in log natural units) compared with explanted patients (− 1.4 [95% CI − 2.6 to − 0.7], p = 0.04) and controls (− 2.1 [− 3.5 to −0.7], p = 0.001) and for LF: HF compared with implanted patients under paced breathing conditions (z = − 2.7, p = 0.007) and controls in standing (z = − 2.9, p = 0.004) and paced breathing conditions (z = −2.3, p = 0.02). However, no significant differences were seen between explanted, implanted and control groups under any condition. Conclusions: Patients implanted with an LVAD and explanted from a LVAD following myocardial recovery demonstrate a more normal dynamic response to autonomic stimuli and have a lower HRV risk profile compared to CHF patients.

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Section: Low To High Frequency Ratio: Explants and Implantsmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Low Frequency Spectral Power: Explants and Implantsmentioning

confidence: 99%

Section: Low To High Frequency Ratio: Explants and Implantsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Cardiovascular autonomic control in patients undergoing left ventricular assist device (LVAD) support and pharmacologic therapy

Nunan¹,

Sandercock²,

George³

et al. 2013

International Journal of Cardiology

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Heart Rate Variability in Heart Failure

Moore¹,

Nolan²

2004

Dynamic Electrocardiography

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Heart failure is one of the main causes of death in infants with and without congenital heart disease and has long term consequences in surviving infants, such as impaired linear growth, worse neurodevelopmental outcomes and an enhanced cardiovascular mortality. Current pharmacotherapy is not proven by prospective randomized trials. We use online monitoring of heart rate variability (HRV) to measure the effect of pharmacotherapy on the autonomic nervous system. Methods:The infants are routinely monitored with Dräger Infinity Monitors™ (Dräger; Germany) on our pediatric intensive care unit. For analysis of heart rate variability, we export the monitor data to the Pathfinder™ ECG Software using a network connection. 7 clinical cases are discussed.Results: Infants with a high frequency power in the spectral analysis of heart rate variability below 20ms had a high risk to die from heart failure ± inflammation. Propranolol but not metoprolol improves HRV, NT-Pro BNP and troponin T values. We anticipate a further improvement of HRV in 2 cases with an additional digoxin treatment. Conclusion:Reduced HRV seems to be an important risk factor for life threatening complications in infants with severe heart failure and should be monitored in infants with severe heart failure. Propranolol but not metoprolol improves HRV. Additional digoxin further improves HRV in two cases treated with propranolol.These preliminary results have to be proven by prospective trials using HRV analysis for risk stratification.

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Evaluation of the Autonomic Nervous System: From Algorithms to Clinical Practice

Rovere

2011

Advanced Methods of Biomedical Signal Processing

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Five-minute recording of heart rate variability in severe chronic heart failure: Correlates with right ventricular function and prognostic implications

Cited by 65 publications

References 38 publications

Cardiovascular autonomic control in patients undergoing left ventricular assist device (LVAD) support and pharmacologic therapy

Cardiovascular autonomic control in patients undergoing left ventricular assist device (LVAD) support and pharmacologic therapy

Heart Rate Variability in Heart Failure

Evaluation of the Autonomic Nervous System: From Algorithms to Clinical Practice

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