Heart Rate Variability and Arrhythmic Burden in Pulmonary Hypertension
| Autor: | Georg Nickenig, C. Witte, Dirk Skowasch, Carmen Pizarro, J W Schrickel, J. O. Schwab, Christoph Hammerstingl, J. U. Meyer zur Heide genannt Meyer-Arend, René Andrié |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
COPD Premature atrial contraction business.industry Atrial fibrillation Disease 030204 cardiovascular system & hematology medicine.disease Pulmonary hypertension Sudden cardiac death 03 medical and health sciences 0302 clinical medicine Internal medicine Heart rate cardiovascular system medicine Cardiology Heart rate variability 030212 general & internal medicine business |
| Zdroj: | Pulmonary Dysfunction and Disease ISBN: 9783319420097 |
| DOI: | 10.1007/5584_2016_18 |
| Popis: | A growing body of evidence indicates that sudden cardiac death constitutes a major cause of mortality in pulmonary hypertension (PH). As validated method to evaluate cardiac autonomic system dysfunction, alterations in heart rate variability (HRV) are predictive of arrhythmic events, particularly in left ventricular disease. Here, we sought to determine the clinical value of HRV assessment in PH. Sixty-four patients were allocated to different PH-subgroups in this prospectively conducted trial: 25 patients with pulmonary arterial hypertension (PAH), 11 patients with chronic thromboembolic PH (CTEPH), and 28 patients with COPD-induced PH. All patients underwent 24-h Holter electrocardiogram for HRV assessment by time- and frequency-domain analysis. Arrhythmic burden was evaluated by manual analysis and complementary automatic measurement of premature atrial and ventricular contractions. The results were compared to 31 healthy controls. The PAH patients offered a significantly higher mean heart rate (78.6 ± 10.4 bpm vs. 70.1 ± 10.3 bpm, p = 0.04), a higher burden of premature ventricular contractions (p < 0.01), and decreases in HRV (SDNN: p < 0.01; SDANN: p < 0.01; very low frequency: p < 0.01; low frequency/high frequency ratio: p < 0.01; total power: p = 0.02). In CTEPH patients, only the amount of premature ventricular contractions differed from controls (p < 0.01), whereas in COPD both premature atrial contraction count and frequency-domain-based HRV manifested significant differences. In conclusion, PAH appears to be primarily affected by HRV alterations and ventricular arrhythmic burden, indicating a high risk for malignant arrhythmic events. |
| Databáze: | OpenAIRE |
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