Different spectral components of 24 h heart rate variability are related to different modes of death in chronic heart failure

Stefano Guzzetti, Maria Teresa La Rovere, Gian Domenico Pinna, Roberto Maestri, Ester Borroni, Alberto Porta, Andrea Mortara, Alberto Malliani

Research output: Contribution to journalArticlepeer-review


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 languageEnglish
Pages (from-to)357-362
Number of pages6
JournalEuropean Heart Journal
Issue number4
Publication statusPublished - Feb 2005


  • Autonomic nervous system
  • Heart failure
  • Heart rate variability
  • Progressive pump failure
  • Sudden death

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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