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...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-07-01
|
| Series: | Journal of Cardiovascular Development and Disease |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2308-3425/9/7/213 |
| _version_ | 1797433462687268864 |
|---|---|
| author | Jus Ksela Lea Rupert Anze Djordjevic Miha Antonic Viktor Avbelj Borut Jug |
| author_facet | Jus Ksela Lea Rupert Anze Djordjevic Miha Antonic Viktor Avbelj Borut Jug |
| author_sort | Jus Ksela |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-03-09T10:17:22Z |
| format | Article |
| id | doaj.art-78e7f78ddafe42819e40a6921affab90 |
| institution | Directory Open Access Journal |
| issn | 2308-3425 |
| language | English |
| last_indexed | 2024-03-09T10:17:22Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj.art-78e7f78ddafe42819e40a6921affab902023-12-01T22:17:38ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252022-07-019721310.3390/jcdd9070213Altered Heart Rate Turbulence and Variability Parameters Predict 1-Year Mortality in Heart Failure with Preserved Ejection FractionJus Ksela0Lea Rupert1Anze Djordjevic2Miha Antonic3Viktor Avbelj4Borut Jug5Department of Cardiovascular Surgery, University Medical Centre Ljubljana, 1000 Ljubljana, SloveniaDepartment of Anaesthesiology and Perioperative Intensive Therapy, University Medical Centre Ljubljana, 1000 Ljubljana, SloveniaDepartment of Cardiac Surgery, University Medical Centre Maribor, 2000 Maribor, SloveniaDepartment of Cardiac Surgery, University Medical Centre Maribor, 2000 Maribor, SloveniaDepartment of Communication Systems, Jozef Stefan Institute, 1000 Ljubljana, SloveniaFaculty of Medicine, University of Ljubljana, 1000 Ljubljana, SloveniaBackground: 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.https://www.mdpi.com/2308-3425/9/7/213heart failure with preserved ejection fractionheart rate turbulenceheart rate variabilitypremature ventricular complexmortality predictor |
| spellingShingle | Jus Ksela Lea Rupert Anze Djordjevic Miha Antonic Viktor Avbelj Borut Jug Altered Heart Rate Turbulence and Variability Parameters Predict 1-Year Mortality in Heart Failure with Preserved Ejection Fraction Journal of Cardiovascular Development and Disease heart failure with preserved ejection fraction heart rate turbulence heart rate variability premature ventricular complex mortality predictor |
| 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 | heart failure with preserved ejection fraction heart rate turbulence heart rate variability premature ventricular complex mortality predictor |
| url | https://www.mdpi.com/2308-3425/9/7/213 |
| work_keys_str_mv | AT jusksela alteredheartrateturbulenceandvariabilityparameterspredict1yearmortalityinheartfailurewithpreservedejectionfraction AT learupert alteredheartrateturbulenceandvariabilityparameterspredict1yearmortalityinheartfailurewithpreservedejectionfraction AT anzedjordjevic alteredheartrateturbulenceandvariabilityparameterspredict1yearmortalityinheartfailurewithpreservedejectionfraction AT mihaantonic alteredheartrateturbulenceandvariabilityparameterspredict1yearmortalityinheartfailurewithpreservedejectionfraction AT viktoravbelj alteredheartrateturbulenceandvariabilityparameterspredict1yearmortalityinheartfailurewithpreservedejectionfraction AT borutjug alteredheartrateturbulenceandvariabilityparameterspredict1yearmortalityinheartfailurewithpreservedejectionfraction |