Abstract
Aims: To assess whether analysis of heart rate variability (HRV) from 24 h Holter recordings provides information about the mode of death (pump failure vs. sudden death) in chronic heart failure (CHF). Methods and results: We analysed 24 h HRV in 330 consecutive CHF patients in sinus rhythm. Indices derived from time domain, spectral domain, and fractal analyses of 24 h automatic HRV were evaluated. Data from clinical assessment, echocardiography, right heart catheterization, exercise test, blood biochemical examination, and arrhythmia pattern were analysed. Patients were followed up for 3 years. Two simple multivariable models, both including 24 h spectral indices, were able to identify patients at higher risk of progressive pump failure and sudden death, respectively. Depressed power of night-time HRV (≤509 ms2) below 0.04 Hz [very low frequency (VLF)], high pulmonary wedge pressure (PWP ≥ 18 mm Hg) and low left ventricular ejection fraction (LVEF ≤ 24%) were independently related to death for progressive pump failure, while the reduction of power between 0.04 and 0.15 Hz at night (LF ≤ 20 ms2) and increased left ventricular end-systolic diameter (LVESD ≥ 61 mm) were linked to sudden mortality. Conclusion: Automatic spectral analysis of 24 h HRV provides independent risk indices related to mode of death in sinus rhythm CHF patients.
| Original language | English |
|---|---|
| Pages (from-to) | 357-362 |
| Number of pages | 6 |
| Journal | European Heart Journal |
| Volume | 26 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Feb 2005 |
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Keywords
- Autonomic nervous system
- Heart failure
- Heart rate variability
- Progressive pump failure
- Sudden death
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Different spectral components of 24 h heart rate variability are related to different modes of death in chronic heart failure. / Guzzetti, Stefano; La Rovere, Maria Teresa; Pinna, Gian Domenico; Maestri, Roberto; Borroni, Ester; Porta, Alberto; Mortara, Andrea; Malliani, Alberto.
In: European Heart Journal, Vol. 26, No. 4, 02.2005, p. 357-362.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Different spectral components of 24 h heart rate variability are related to different modes of death in chronic heart failure
AU - Guzzetti, Stefano
AU - La Rovere, Maria Teresa
AU - Pinna, Gian Domenico
AU - Maestri, Roberto
AU - Borroni, Ester
AU - Porta, Alberto
AU - Mortara, Andrea
AU - Malliani, Alberto
PY - 2005/2
Y1 - 2005/2
N2 - Aims: To assess whether analysis of heart rate variability (HRV) from 24 h Holter recordings provides information about the mode of death (pump failure vs. sudden death) in chronic heart failure (CHF). Methods and results: We analysed 24 h HRV in 330 consecutive CHF patients in sinus rhythm. Indices derived from time domain, spectral domain, and fractal analyses of 24 h automatic HRV were evaluated. Data from clinical assessment, echocardiography, right heart catheterization, exercise test, blood biochemical examination, and arrhythmia pattern were analysed. Patients were followed up for 3 years. Two simple multivariable models, both including 24 h spectral indices, were able to identify patients at higher risk of progressive pump failure and sudden death, respectively. Depressed power of night-time HRV (≤509 ms2) below 0.04 Hz [very low frequency (VLF)], high pulmonary wedge pressure (PWP ≥ 18 mm Hg) and low left ventricular ejection fraction (LVEF ≤ 24%) were independently related to death for progressive pump failure, while the reduction of power between 0.04 and 0.15 Hz at night (LF ≤ 20 ms2) and increased left ventricular end-systolic diameter (LVESD ≥ 61 mm) were linked to sudden mortality. Conclusion: Automatic spectral analysis of 24 h HRV provides independent risk indices related to mode of death in sinus rhythm CHF patients.
AB - Aims: To assess whether analysis of heart rate variability (HRV) from 24 h Holter recordings provides information about the mode of death (pump failure vs. sudden death) in chronic heart failure (CHF). Methods and results: We analysed 24 h HRV in 330 consecutive CHF patients in sinus rhythm. Indices derived from time domain, spectral domain, and fractal analyses of 24 h automatic HRV were evaluated. Data from clinical assessment, echocardiography, right heart catheterization, exercise test, blood biochemical examination, and arrhythmia pattern were analysed. Patients were followed up for 3 years. Two simple multivariable models, both including 24 h spectral indices, were able to identify patients at higher risk of progressive pump failure and sudden death, respectively. Depressed power of night-time HRV (≤509 ms2) below 0.04 Hz [very low frequency (VLF)], high pulmonary wedge pressure (PWP ≥ 18 mm Hg) and low left ventricular ejection fraction (LVEF ≤ 24%) were independently related to death for progressive pump failure, while the reduction of power between 0.04 and 0.15 Hz at night (LF ≤ 20 ms2) and increased left ventricular end-systolic diameter (LVESD ≥ 61 mm) were linked to sudden mortality. Conclusion: Automatic spectral analysis of 24 h HRV provides independent risk indices related to mode of death in sinus rhythm CHF patients.
KW - Autonomic nervous system
KW - Heart failure
KW - Heart rate variability
KW - Progressive pump failure
KW - Sudden death
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U2 - 10.1093/eurheartj/ehi067
DO - 10.1093/eurheartj/ehi067
M3 - Article
VL - 26
SP - 357
EP - 362
JO - European Heart Journal
JF - European Heart Journal
SN - 0195-668X
IS - 4
ER -