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European Heart Journal 1999 20(1):38-50; doi:10.1053/euhj.1998.1272
Copyright © 1999 by the European Society of Cardiology.
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Heart rate variability and ischaemia in patients with coronary heart disease and stable angina pectoris

Influence of drug therapy and prognostic value

F. Webera,f1, H. Schneidera, T. von Arnimb and W. Urbaszeka

a Clinic for Internal Medicine, Cardiology Department, University of Rostock, Rostock, Germany
b Ludwig Maximilian University, Munich Red Cross Hospital, Munich, Germany

accepted July 29, 1998

Abstract

Aims

Determination of the influence of therapy with bisoprolol and nifedipine on the heart rate variability of patients from the Total Ischemic Burden Bisoprolol Study and examination of the prognostic value.

Methods and Results

Four hundred and twenty-two patients with stable angina were included. The heart rate variability was determined over a period of 24h. Parameters determined: standard deviation of the mean of all corrected RR intervals, standard deviation of all 5min mean cycle lengths, square root of the mean of the squared differences of successive corrected RR intervals. Nifedipine reduced the mean values of all heart rate variability parameters tested. Square root of the mean of the square differences of successive corrected RR intervals increased under bisoprolol. Standard deviation of the mean of all corrected RR intervals and standard deviation of all 5min mean cycle lengths increased from low baseline values and declined from higher baseline values. The increase in heart rate variability under therapy was accompanied by a tendency towards a better prognosis. Patients with an increase in heart rate variability and simultaneous complete suppression of ischaemia under therapy displayed no serious events in the course of one year.

Conclusions

The increase in the heart rate variability, which can be regarded as prognostically favourable, was predominantly observed under bisoprolol. The parameter constellation of an increase in heart rate variability and complete ischaemia suppression on the 48-h Holter ECG was associated with the greatest benefit.

Key Words: Heart rate variability • beta-blockers • calcium antagonists • coronary heart disease

f1 Correspondence: Dr Frank Weber, Universität Rostock, Klinik für Innere Medizin, Abteilung Kardiologie, Postfach 10 08 88, D-18055 Rostock, Germany.

Malik, MCamm, AJ


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