Cargando…

Altered Heart Rate Turbulence and Variability Parameters Predict 1-Year Mortality in Heart Failure with Preserved Ejection Fraction

Background: Heart failure with preserved ejection fraction (HFpEF) is a complex and heterogeneous clinical syndrome. In the absence of effective and potent treatment strategies, the main challenge in HFpEF management remains the availability of strong predictors of unfavourable outcomes. In our stud...

Descripción completa

Detalles Bibliográficos
Autores principales: Ksela, Jus, Rupert, Lea, Djordjevic, Anze, Antonic, Miha, Avbelj, Viktor, Jug, Borut
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9321795/
https://www.ncbi.nlm.nih.gov/pubmed/35877575
http://dx.doi.org/10.3390/jcdd9070213
_version_ 1784756135897595904
author Ksela, Jus
Rupert, Lea
Djordjevic, Anze
Antonic, Miha
Avbelj, Viktor
Jug, Borut
author_facet Ksela, Jus
Rupert, Lea
Djordjevic, Anze
Antonic, Miha
Avbelj, Viktor
Jug, Borut
author_sort Ksela, Jus
collection PubMed
description Background: Heart failure with preserved ejection fraction (HFpEF) is a complex and heterogeneous clinical syndrome. In the absence of effective and potent treatment strategies, the main challenge in HFpEF management remains the availability of strong predictors of unfavourable outcomes. In our study, we sought to evaluate the potential prognostic value of heart rate turbulence (HRT) and variability (HRV) parameters on mortality in ambulatory HFpEF patients. Methods: This was a case–control study comparing HRT and HRV parameters in HFpEF survivors vs. non-survivors. Patients from the RESPOND Heart Failure Registry with HFpEF who underwent 24 h ECG monitoring (Holter) were included; HRT parameters (i.e., turbulence onset (TO) and turbulence slope (TS)) and HRV parameters (i.e., standard deviation of NN intervals (SDNN)) derived from 24 h Holter ECGs were calculated in patients who died within 12 months, and compared to their age-, gender-, LVEF-, ECHO-, aetiology-, and therapy-matched alive controls. Results: A total of 22 patients (mean age 80 ± 7 years, 18% female, mean LVEF 57 ± 9%) were included in the final analysis. In deceased patients, values of TO were significantly higher, and values of TS and SDNN were significantly lower as compared to survivors. Conclusions: HRT and HRV parameters have the ability to differentiate individuals with HFpEF who are at the greatest risk of unfavourable outcomes. The extent of autonomic disbalance as determined by HRT and HRV could potentially assist in the prognostic assessment and risk stratification of HFpEF patients.
format Online
Article
Text
id pubmed-9321795
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-93217952022-07-27 Altered Heart Rate Turbulence and Variability Parameters Predict 1-Year Mortality in Heart Failure with Preserved Ejection Fraction Ksela, Jus Rupert, Lea Djordjevic, Anze Antonic, Miha Avbelj, Viktor Jug, Borut J Cardiovasc Dev Dis Article Background: Heart failure with preserved ejection fraction (HFpEF) is a complex and heterogeneous clinical syndrome. In the absence of effective and potent treatment strategies, the main challenge in HFpEF management remains the availability of strong predictors of unfavourable outcomes. In our study, we sought to evaluate the potential prognostic value of heart rate turbulence (HRT) and variability (HRV) parameters on mortality in ambulatory HFpEF patients. Methods: This was a case–control study comparing HRT and HRV parameters in HFpEF survivors vs. non-survivors. Patients from the RESPOND Heart Failure Registry with HFpEF who underwent 24 h ECG monitoring (Holter) were included; HRT parameters (i.e., turbulence onset (TO) and turbulence slope (TS)) and HRV parameters (i.e., standard deviation of NN intervals (SDNN)) derived from 24 h Holter ECGs were calculated in patients who died within 12 months, and compared to their age-, gender-, LVEF-, ECHO-, aetiology-, and therapy-matched alive controls. Results: A total of 22 patients (mean age 80 ± 7 years, 18% female, mean LVEF 57 ± 9%) were included in the final analysis. In deceased patients, values of TO were significantly higher, and values of TS and SDNN were significantly lower as compared to survivors. Conclusions: HRT and HRV parameters have the ability to differentiate individuals with HFpEF who are at the greatest risk of unfavourable outcomes. The extent of autonomic disbalance as determined by HRT and HRV could potentially assist in the prognostic assessment and risk stratification of HFpEF patients. MDPI 2022-07-02 /pmc/articles/PMC9321795/ /pubmed/35877575 http://dx.doi.org/10.3390/jcdd9070213 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ksela, Jus
Rupert, Lea
Djordjevic, Anze
Antonic, Miha
Avbelj, Viktor
Jug, Borut
Altered Heart Rate Turbulence and Variability Parameters Predict 1-Year Mortality in Heart Failure with Preserved Ejection Fraction
title Altered Heart Rate Turbulence and Variability Parameters Predict 1-Year Mortality in Heart Failure with Preserved Ejection Fraction
title_full Altered Heart Rate Turbulence and Variability Parameters Predict 1-Year Mortality in Heart Failure with Preserved Ejection Fraction
title_fullStr Altered Heart Rate Turbulence and Variability Parameters Predict 1-Year Mortality in Heart Failure with Preserved Ejection Fraction
title_full_unstemmed Altered Heart Rate Turbulence and Variability Parameters Predict 1-Year Mortality in Heart Failure with Preserved Ejection Fraction
title_short Altered Heart Rate Turbulence and Variability Parameters Predict 1-Year Mortality in Heart Failure with Preserved Ejection Fraction
title_sort altered heart rate turbulence and variability parameters predict 1-year mortality in heart failure with preserved ejection fraction
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9321795/
https://www.ncbi.nlm.nih.gov/pubmed/35877575
http://dx.doi.org/10.3390/jcdd9070213
work_keys_str_mv AT kselajus alteredheartrateturbulenceandvariabilityparameterspredict1yearmortalityinheartfailurewithpreservedejectionfraction
AT rupertlea alteredheartrateturbulenceandvariabilityparameterspredict1yearmortalityinheartfailurewithpreservedejectionfraction
AT djordjevicanze alteredheartrateturbulenceandvariabilityparameterspredict1yearmortalityinheartfailurewithpreservedejectionfraction
AT antonicmiha alteredheartrateturbulenceandvariabilityparameterspredict1yearmortalityinheartfailurewithpreservedejectionfraction
AT avbeljviktor alteredheartrateturbulenceandvariabilityparameterspredict1yearmortalityinheartfailurewithpreservedejectionfraction
AT jugborut alteredheartrateturbulenceandvariabilityparameterspredict1yearmortalityinheartfailurewithpreservedejectionfraction