Heart rate variability in chronic heart failure

The analysis of heart rate variability (HRV) provides information about autonomic cardiovascular control in healthy subjects. In the past 15 years, several articles have been published regarding HRV and chronic heart failure (CHF). The results of these papers substantially demonstrated that HRV is significantly different in CHF patients compared to controls. Moreover, some variables derived from HRV analysis showed significant independent prognostic capacity. In particular, the reduction of variance (expressed as SDNN) and low-frequency spectral component of HRV (ranging from 0.03 to 0.15 Hz) seem related to an increased mortality in CHF. Nevertheless, these variables are not yet considered in clinical practice. A better understanding of the physiopathological basis of the reported alterations of HRV in CHF patients is required in order to permit its use as a clinical tool for prognosis and tailored therapy in individual CHF patients.

[1]  J. Miller,et al.  Decreased heart rate variability and its association with increased mortality after acute myocardial infarction. , 1987, The American journal of cardiology.

[2]  M. Stampfer,et al.  Impairment of Autonomically Mediated Heart Rate Control in Patients with Cardiac Dysfunction , 1975, Circulation research.

[3]  M. Packer The neurohormonal hypothesis: a theory to explain the mechanism of disease progression in heart failure. , 1992, Journal of the American College of Cardiology.

[4]  A. Malliani,et al.  Cardiovascular Neural Regulation Explored in the Frequency Domain , 1991, Circulation.

[5]  G D Pinna,et al.  Abnormal awake respiratory patterns are common in chronic heart failure and may prevent evaluation of autonomic tone by measures of heart rate variability. , 1997, Circulation.

[6]  T. Nishioka,et al.  Heart rate variability in patients with diabetes mellitus, ischemic heart disease, and congestive heart failure. , 1992, Journal of electrocardiology.

[7]  G. C. Butler,et al.  Fractal component of variability of heart rate and systolic blood pressure in congestive heart failure. , 1997, Clinical science.

[8]  A. Goldberger Fractal mechanisms in the electrophysiology of the heart , 1992, IEEE Engineering in Medicine and Biology Magazine.

[9]  J. Cohn,et al.  Plasma norepinephrine as a guide to prognosis in patients with chronic congestive heart failure. , 1984, The New England journal of medicine.

[10]  P. Reddy,et al.  Respiratory sinus arrhythmia in the denervated human heart. , 1989, Journal of applied physiology.

[11]  A Malliani,et al.  The role of the sympathetic nervous system in congestive heart failure. , 1983, European heart journal.

[12]  J. Bigger,et al.  Baroreflex sensitivity and heart-rate variability in prediction of total cardiac mortality after myocardial infarction , 1998, The Lancet.

[13]  P. Binkley,et al.  Parasympathetic withdrawal is an integral component of autonomic imbalance in congestive heart failure: demonstration in human subjects and verification in a paced canine model of ventricular failure. , 1991, Journal of the American College of Cardiology.

[14]  A. Malliani,et al.  Heart rate variability. Standards of measurement, physiological interpretation, and clinical use , 1996 .

[15]  W. Stevenson,et al.  Patterns of beat-to-beat heart rate variability in advanced heart failure. , 1992, American heart journal.

[16]  R. Prescott,et al.  Prospective study of heart rate variability and mortality in chronic heart failure: results of the United Kingdom heart failure evaluation and assessment of risk trial (UK-heart). , 1998, Circulation.

[17]  M Pagani,et al.  Absence of low-frequency variability of sympathetic nerve activity in severe heart failure. , 1997, Circulation.

[18]  A. Mark,et al.  Direct evidence from intraneural recordings for increased central sympathetic outflow in patients with heart failure. , 1986, Circulation.

[19]  P. Ponikowski,et al.  Oscillatory breathing patterns during wakefulness in patients with chronic heart failure: clinical implications and role of augmented peripheral chemosensitivity. , 1999, Circulation.

[20]  S. Boveda,et al.  Depressed low frequency power of heart rate variability as an independent predictor of sudden death in chronic heart failure. , 2000, European heart journal.

[21]  M. Turiel,et al.  Sympathetic predominance followed by functional denervation in the progression of chronic heart failure. , 1995, European heart journal.

[22]  D C Harrison,et al.  Decreased catecholamine sensitivity and beta-adrenergic-receptor density in failing human hearts. , 1982, The New England journal of medicine.

[23]  M. Turiel,et al.  Power Spectral Analysis of Heart Rate and Arterial Pressure Variabilities as a Marker of Sympatho‐Vagal Interaction in Man and Conscious Dog , 1986, Circulation research.

[24]  A. Camm,et al.  Decreased heart rate variability in survivors of sudden cardiac death not associated with coronary artery disease. , 1994, British heart journal.

[25]  G. Breithardt,et al.  Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. , 1996 .

[26]  K. Swedberg,et al.  Hormones regulating cardiovascular function in patients with severe congestive heart failure and their relation to mortality. CONSENSUS Trial Study Group. , 1990, Circulation.

[27]  D. Levy,et al.  Predicting survival in heart failure case and control subjects by use of fully automated methods for deriving nonlinear and conventional indices of heart rate dynamics. , 1997, Circulation.

[28]  A. Porta,et al.  Linear and non-linear 24 h heart rate variability in chronic heart failure , 2000, Autonomic Neuroscience.

[29]  P. Ponikowski,et al.  Detection and significance of a discrete very low frequency rhythm in RR interval variability in chronic congestive heart failure. , 1996, The American journal of cardiology.

[30]  CIBIS-II Investigators and Committees The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): a randomised trial , 1999, The Lancet.

[31]  G. Casolo,et al.  Decreased spontaneous heart rate variability in congestive heart failure. , 1989, The American journal of cardiology.

[32]  M. Lab,et al.  Contribution to heart rate variability by mechanoelectric feedback. Stretch of the sinoatrial node reduces heart rate variability. , 1996, Circulation.