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European Heart Journal 1998 19(11):1719-1724; doi:10.1053/euhj.1998.1148
Copyright © 1998 by the European Society of Cardiology.
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Heart rate variability index in congestive heart failure: relation to clinical variables and prognosis

J.A.M. Wijbengaaf1, A.H.M.M. Balka, S.H. Meija, M.L. Simoonsa and M. Malikb

a Thoraxcenter, University Hospital Rotterdam, Rotterdam, The Netherlands
b Department of Cardiological Sciences, St. George’s Hospital Medical School, London, U.K.

accepted May 27, 1998

Aim

To evaluate the clinical and prognostic value of the heart rate variability index in patients with congestive heart failure.

Methods

Sixty-four patients with chronic congestive heart failure and sinus rhythm underwent clinical assessment, 24-h ambulatory electrocardiography and echocardio-graphy. Patients were followed for 6 to 30 months. Cardiac death or heart transplantation constituted the primary end-point of the study.

Results

The heart rate variability index was related to left ventricular ejection fraction (r=0·29,P=0·02) and New York Heart Association class (P=0·01). Patients with a restrictive left ventricular filling pattern had a lower heart rate variability index compared to patients with a non-restrictive pattern (26±11 vs 33±9 units,P=0·01). Patients who died (n=11) or underwent heart transplantation (n=4) had a lower heart rate variability index compared to survivors (21±10 vs 33±9 units,P<0·0001). In multivariate survival analysis, a reduced heart rate variability index was related to survival independent of parameters of left ventricular function.

Conclusion

The heart rate variability index provides independent information on clinical status and prognosis in patients with chronic congestive heart failure.The European Society of Cardiology

Key Words: Congestive heart failure • heart rate variability index • clinical status • prognosis

f1 Correspondence:Anke Wijbenga, MD, Thoraxcenter Bd 381, University Hospital Rotterdam, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.


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