Copyright © 1991 by the European Society of Cardiology.
© 1991 The European Society of Cardiology
Heart rate variability in left ventricular hypertrophy and heart failure, and the effects of beta-blockade
A non-spectral analysis of heart rate variability in the frequency domain and in the time domain
Department of Cardiology, Lariboisiere Hospital Paris, France
Received 7 September 1989; revised 12 March 1990; .
Correspondence: Philippe Coumel, Hòpital Lariboisière, 2, rue Ambroise Paré, 75015-Paris, France.
Abstract
An analysis of heart rate (HR) variability (HRV) was based on quantifying the number and amplitude of HR fluctuations over long (8–30 cycles) and short (2–4 cycles) sequences of acceleration and deceleration-forming oscillations. The ‘product’ (number times amplitude) is an equivalent of the power spectrum in the frequency domain. In the time domain, positive correlations with HR were found for the number of long (L) sympathetic-mediated oscillations, whereas they were negative for short (S) vagally-mediated oscillations. The L/S ratio, an index of the autonomic nervous system (ANS) balance, closely paralleled the circadian HR values.
HRV was studied in the ambulatory ECG of three groups of 15 normal adults (group I), 13 patients with left ventricular hypertrophy (LVH, group II) and 13 patients-with heart failure (HF, group III). In basic conditions the mean HR was 77.1 ±l.9 beats min–1 (mean±SEM) in group 1, 76.8±3.3 in II, 79.5±3.5 in III (P = NS). The different types of oscillations had smaller 24-h average values of the product in groups II and III than in group I, but the trends did not reach significance. However, the pooled 24 hourly values of the L/S ratio in group I (1.17 ± 0.09) were lower than in group II (1.33 ±0.06, P<0.05 at Ancova) and higher than in group III (1.06 ±0.09, P<0.001). A 3-day treatment with acebutolol non-uniformly slowed the mean HR: -9.5% in group I, -18.1% in II and -19.1% in III (P<0.001), and uniformly diminished the L/S ratio by 17% to 20% (P<0.01).
In conclusion, the sympathetic predominance of the ANS balance in LVH and HF is reflected by the beta-blockade induced HR decrease that is twice as marked in patients as in controls. In basic conditions HRV tends to be depressed in LVH and even more in HF. The ANS imbalance, however, has different modalities depending on the presence of HF, probably because of the different status of beta-adrenergic receptors in this condition.
Key Words: Heart rate variability • autonomic nervous system • left ventricular hypertrophy • heart failure • beta-blockers
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  F. Holmqvist, M. Stridh, J. E. P. Waktare, J. Brandt, L. Sornmo, A. Roijer, and C. J. Meurling Rapid fluctuations in atrial fibrillatory electrophysiology detected during controlled respiration Am J Physiol Heart Circ Physiol, August 1, 2005; 289(2): H754 - H760. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. B. Altunkeser, K. Ozdemir, H. Gok, A. Temizhan, M. Tokac, and T. Karabag Can P Wave Parameters Obtained from 12-Lead Surface Electrocardiogram be a Predictor for Atrial Fibrillation in Patients Who Have Structural Heart Disease? Angiology, July 1, 2003; 54(4): 475 - 479. [Abstract] [PDF]
|
|
|
|
|
|
B. B. Altunkeser, K. Ozdemir, H. Gok, M. Yazici, and A. Icli The Effect of Valsalva Maneuver on P Wave in 12-Lead Surface Electrocardiography in Patients with Paroxysmal Atrial Fibrillation Angiology, July 1, 2002; 53(4): 443 - 449. [Abstract] [PDF]
|
|
|
|
 |
|
 P. Coumel Sotalol: a fool's deal? Eur. Heart J., August 2, 2001; 22(16): 1370 - 1373. [PDF]
|
|
|
|
 |
|
 M P Ingemansson, M Holm, and S B Olsson Autonomic modulation of the atrial cycle length by the head up tilt test: non-invasive evaluation in patients with chronic atrial fibrillation Heart, July 1, 1998; 80(1): 71 - 76. [Abstract] [Full Text]
|
|
|
|
 |
|
 U. C. Hoppe, E. Jansen, M. Sudkamp, and D. J. Beuckelmann Hyperpolarization-Activated Inward Current in Ventricular Myocytes From Normal and Failing Human Hearts Circulation, January 13, 1998; 97(1): 55 - 65. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S.M. Horner, C.F. Murphy, B. Coen, D.J. Dick, F.G. Harrison, Z. Vespalcova, and M.J. Lab Contribution to Heart Rate Variability by Mechanoelectric Feedback: Stretch of the Sinoatrial Node Reduces Heart Rate Variability Circulation, October 1, 1996; 94(7): 1762 - 1767. [Abstract] [Full Text]
|
|
|
|
|
|
T. F. o. t. E. S. o. C. t. N. A. S. o. P. Electrophysiology Heart Rate Variability : Standards of Measurement, Physiological Interpretation, and Clinical Use Circulation, March 1, 1996; 93(5): 1043 - 1065. [Full Text]
|
|
|
|
 |
|
 M. Petretta, D. Bonaduce, F. Marciano, V. Bianchi, G. Valva, C. Apicella, N. de Luca, and P. Gisonni Effect of 1 Year of Lisinopril Treatment on Cardiac Autonomic Control in Hypertensive Patients With Left Ventricular Hypertrophy Hypertension, March 1, 1996; 27(3): 330 - 338. [Abstract] [Full Text]
|
|