Depressed low frequency power of heart rate variability as an independent predictor of sudden death in chronic heart failure

被引:230
作者
Galinier, M
Pathak, A
Fourcade, J
Androdias, C
Curnier, D
Varnous, S
Boveda, S
Massabuau, P
Fauvel, M
Senard, JM
Bounhoure, JP
机构
[1] Rangueil Univ Hosp, Dept Cardiol, F-31403 Toulouse 4, France
[2] Pharmacol Lab, Toulouse, France
关键词
heart rate variability; sudden death; heart failure;
D O I
10.1053/euhj.1999.1875
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims Identification of patients with chronic heart failure at risk for sudden death remains difficult. We sought to assess the prognostic value for all-cause and sudden death of time and frequency domain measures of heart rate variability in chronic heart failure. Methods and Results We prospectively enrolled 190 patients with chronic heart failure in sinus rhythm, mean age 61 +/- 12 years, 109 (57.4%) in NYHA class II and 81 (42.6%) in classes III or IV, mean cardiothoracic ratio 57.6 +/- 6.4% and mean left ventricular ejection fraction 28.2 +/- 8.8%, 85 (45%) with ischaemic and 105 (55%) with idiopathic dilated cardiomyopathy. Time and frequency domain measures of heart rate variability were obtained from 24h Holter ECG recordings, spectral measures were averaged for calculation of daytime (1000h-1900h) and night-time (2300h-0600h) values. During follow-up (22 +/- 18 months), 55 patients died, 21 of them suddenly and two presented with a syncopal spontaneous sustained ventricular tachycardia. In multivariate analysis, independent predictors for all-cause mortality were: ischaemic heart disease, cardiothoracic ratio greater than or equal to 60% and standard deviation of all normal RR intervals <67 ms (RR=2.5, 95% CI 1.5-4.2). Independent predictors of sudden death were: ischaemic heart disease and daytime low frequency power <3.3 In (ms(2)) (RR=2.8, 95% CI 1.2-8.6). Conclusion Depressed heart rate variability has independent prognostic value in patients with chronic heart failure; spectral analysis identifies an increased risk for sudden death in these patients. (C) 2000 The European Society of Cardiology.
引用
收藏
页码:475 / 482
页数:8
相关论文
共 38 条
  • [1] CIRCADIAN PATTERN OF HEART-RATE-VARIABILITY IN CHRONIC HEART-FAILURE PATIENTS - EFFECTS OF PHYSICAL-TRAINING
    ADAMOPOULOS, S
    PONIKOWSKI, P
    CERQUETANI, E
    PIEPOLI, M
    ROSANO, G
    SLEIGHT, P
    COATS, AJS
    [J]. EUROPEAN HEART JOURNAL, 1995, 16 (10) : 1380 - 1386
  • [2] Physical activity influences heart rate variability and very-low-frequency components in Holter electrocardiograms
    Bernardi, L
    Valle, F
    Coco, M
    Calciati, A
    Sleight, P
    [J]. CARDIOVASCULAR RESEARCH, 1996, 32 (02) : 234 - 237
  • [3] FREQUENCY-DOMAIN MEASURES OF HEART PERIOD VARIABILITY AND MORTALITY AFTER MYOCARDIAL-INFARCTION
    BIGGER, JT
    FLEISS, JL
    STEINMAN, RC
    ROLNITZKY, LM
    KLEIGER, RE
    ROTTMAN, JN
    [J]. CIRCULATION, 1992, 85 (01) : 164 - 171
  • [4] PROGNOSTIC VALUE OF HEART-RATE-VARIABILITY IN PATIENTS AWAITING CARDIAC TRANSPLANTATION
    BINDER, T
    FREY, B
    PORENTA, G
    HEINZ, G
    WUTTE, M
    KREINER, G
    GOSSINGER, H
    SCHMIDINGER, H
    PACHER, R
    WEBER, H
    [J]. PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, 1992, 15 (11): : 2215 - 2220
  • [5] 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
    BINKLEY, PF
    NUNZIATA, E
    HAAS, GJ
    NELSON, SD
    CODY, RJ
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1991, 18 (02) : 464 - 472
  • [6] Prognostic value of heart rate variability during long-term follow-up in patients with mild to moderate heart failure
    Brouwer, J
    vanVeldhuisen, DJ
    Veld, AJMI
    Haaksma, J
    Dijk, A
    Visser, KR
    Boomsma, F
    Dunselman, PHJM
    Lie, KI
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1996, 28 (05) : 1183 - 1189
  • [7] Camm AJ, 1996, CIRCULATION, V93, P1043
  • [8] DECREASED SPONTANEOUS HEART-RATE VARIABILITY IN CONGESTIVE HEART-FAILURE
    CASOLO, G
    BALLI, E
    TADDEI, T
    AMUHASI, J
    GORI, C
    [J]. AMERICAN JOURNAL OF CARDIOLOGY, 1989, 64 (18) : 1162 - 1167
  • [9] Connolly SJ, 1997, LANCET, V350, P1417
  • [10] Evidence for a central origin of the low-frequency oscillation in RR-interval variability
    Cooley, RL
    Montano, N
    Cogliati, C
    van de Borne, P
    Richenbacher, W
    Oren, R
    Somers, VK
    [J]. CIRCULATION, 1998, 98 (06) : 556 - 561