The Anatolian Journal of Cardiology
Original Investigation

The efficacy and prognostic value of heart rate variability in 24-hour and short time recordings for determining cardiac autonomic dysfunction in congestive heart failure


Uludağ Üniversitesi Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Bursa, İstanbul Memorial Hastanesi, Kardiyoloji Kliniği, İstanbul Türkiye


Gülhane Askeri Tıp Akademisi, Kalp Damar Cerrahisi Anabilim Dalı, Ankara Türkiye


Department of Cardiovascular Surgery, Faculty of Medicine, Pamukkale University, Denizli, Turkey


Göztepe Eğitim ve Araştırma Hastanesi İstanbul, İç Hastalıkları Kliniği, İstanbul, Türkiye

Anatol J Cardiol 2007; 7: 118-123
Read: 196 Downloads: 155 Published: 01 July 2021

Objective: The heart rate variability (HRV) has been used in patients with heart failure as a non-invasive method and provided neuro-cardiovascular evaluation. This study was planned to determine the efficacy and prognostic value of 24-hour and short time HRV in autonomic dysfunction in patients with congestive heart failure. Methods: Forty-six patients with symptomatic or asymptomatic left ventricular dysfunction (ejection fraction <40%) were included to the study. In the study group, 16 patients were in NYHA class I (35%), 19 - were in NYHA class II (41%) and 11 - were in NYHA class III (24%). In the first day, HRV was evaluated from the 24-hour Holter recordings. Following day; we assessed the HRV during: (1) 10 min of supine resting, (2) 10 min of regular breathing at a frequency of 20 acts/min, and (3) 10 min of passive orthostatism after tilting 80o with tilt table. Results: Twenty-four hour and short time recordings of HRV showed significant decrease in long-term LF/HF24 (LF- low frequency, HF- high frequency), and short-term LF/HFsupine, LF/HFbreathing and LF/HFtilt ratios in patients with NYHA class III when compared with the patients in NYHA class I-II (p=0.0001, p=0.01, p=0.03, p=0.0001, respectively). During 446±186 days of follow-up, cardiovascular end-points occurred in 20 patients. In Cox multivariate analysis, significant predictors of cardiac mortality and morbidity were, reduced LF/HF ratio (HR=0.4, 95%CI 0.31-0.73, p=0.001) in the 24-hour recordings and low left ventricular ejection fraction (HR=0.9, 95% CI 0.83-0.99, p=0.03). Conclusion: Our study demonstrated that both of the methods were useful for assessment of cardiac autonomic dysfunction and only 24-hour recordings of HRV had a prognostic value.

ISSN 2149-2263 EISSN 2149-2271