HEART RATE VARIABILITY IN CHRONIC HEART FAILURE WITH PRESERVED EJECTION FRACTION
DOI:
https://doi.org/10.11603/1811-2471.2018.v0.i1.8593Keywords:
heart failure, heart rate, fraction of release, nervous system.Abstract
Heart failure remains the main cause of premature death and poor quality of life in patients with different cardiovascular diseases.
The aim of the study – to investigate changes in the heart rate variability in patients with heart failure with a preserved ejection fraction.
Material and Methods. 98 patients (53 men and 45 women) aged 19 to 66 years with HFpEF of I-IIA stages and I-II functional classes according to the classification of NYHA were examined. All participants of the study had a general clinical examination with obligatory measurements of the circumference of the waist and hips, weight, and height, echocardiography, daily monitoring of the ECG.
Results. Changes in HRV and rigid circadian rhythm of heart rate during day and overnight in all patients with HFpEF were recorded. There was a pathological increase in the spectral indices of VLF, LF, LFN both in the daytime and at night. There was no significant decrease in VLF, LF, LFN spectrum at night at the main group. There was no significant increase in HF and HFN at night, as opposed to the control group. The LF/HF ratio was significantly increased in patients with HFpEF. Correlation analysis revealed a negative correlation between age and SDNN (r=-0.336, p<0.05), RMSSD (r=-0.312, p<0.05), pNN50 (r=-0.377, p<0, 05), HF (r=-0.418, p<0.05) and a positive correlation with the ratio of LF/HF (r=0.384, p<0.05). SDNN correlated with the time of IVRT (r=-0.418, p<0.05) and DT (r=-0.436, p<0.05).
Conclusions. The development of chronic heart failure with a preserved ejection fraction is accompanied by a decrease in the overall heart rate variability. There is a decrease in the tone of the parasympathetic autonomic nervous system and an increase in the sympathetic autonomic nervous system in patients with heart failure with a preserved ejection fraction compared to healthy individuals. According to the results of invariant regression analysis, the relationship of the spectral index SDNN with the DT was established.
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