Prognostic significance of heart rate turbulence parameters in patients with chronic heart failure

BMC Cardiovascular Disorders

Xiu-Fen Qu¹  Wei Qiu²  Wei Feng²  Lin Sun²  Hong-Yu Xie²  Shuai Guo²  Zhao-Jun Wang²  De-Chun Yin² 

[1] Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Dazhi Street No.199, Nangang District, Harbin 150001, P.R. China;Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, P.R. China

关键词: Prognosis;    Chronic heart failure;    Heart rate turbulence;   

Others  :  855151
DOI  :  10.1186/1471-2261-14-50

 received in 2013-12-19, accepted in 2014-04-03,  发布年份 2014

【 摘 要 】

Background

This study is aimed to evaluate the clinical significance of heart rate turbulence (HRT) parameters in predicting the prognosis in patients with chronic heart failure (CHF).

Methods

From June 2011 to December 2012, a total of 104 CHF patients and 30 healthy controls were enrolled in this study. We obtained a 24-hour Holter ECG recording to assess the HRT parameters, included turbulence onset (TO), turbulence slope (TS), standard deviation of N-N intervals (SDNN), and resting heart rate (RHR). The relationships between HRT parameters and the prognosis of CHF patients were determined.

Results

The assessment follow-up period lasted until January 31, 2013. The overall mortality of CHF patients was 9.6% (10/104). Our results revealed that CHF patients had higher levels of TO than those of healthy subjects, but the TS levels of CHF patients were lower than that of the control group. CHF patients with NYHA grade IV had higher HRT_1/2 rate than those with NYHA grade II/III. There were statistical differences in TS, LVEF, SDNN and RHR between the non-deteriorating group and the non-survivor group. Significant differences in TS among the three groups were also found. Furthermore, CHF patients in the non-survivor group had lower levels of TS than those in the deteriorating group. Correlation analyses indicated that TO negatively correlate with SDNN, while TS positively correlated with SDNN and left ventricular ejection fraction (LVEF). We also observed negative correlations between TS and left ventricular end-diastolic cavity dimension (LVEDD), RHR, homocysteine (Hcy) and C-reactive protein (CRP). Multivariate Cox regression analysis further confirmed that LVEF (≤30%), HRT₂, SDNN and RHR were independent risk factors which can indicate poor prognosis in CHF patients.

Conclusions

Our findings indicate that HRT may have good clinical predictive value in patients with CHF. Thus, quantifying HRT parameters could be a useful tool for predicting mortality in CHF patients.

【 授权许可】

   
2014 Yin et al.; licensee BioMed Central Ltd.

【 图 表 】

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