Artikel
Long-term heart rate turbulence analysis versus variability in patients with dilated cardiomyopathy
Langzeit Herzfrequenz Turbulenz versus Variabilitätsanalyse bei Patienten mit dilatativer Kardiomyopathie
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Veröffentlicht: | 10. August 2005 |
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Gliederung
Text
This study investigates the interrelation of ventricular premature beats (VPB) based heart rate turbulence (HRT) and VBP excluding heart rate variability (HRV) analyses. Holter-ECGs from 53 DCM patients and 53 sex- and age matched healthy volunteers were investigated to characterize the regulatory differences between patients with dilated cardiomyopathy (DCM) (29.1±9.0%, NYHA classes II-III) and healthy controls.
HRV was calculated applying methods of time and frequency domain as well as non-linear dynamics. The HRT analysis was performed by the classical parameters Turbulence Onset (TO) and Slope (TS) as well as by the normalized prematureness. To compare the results of HRT and HRV analyses, we applied the Mann-Whitney-U test, the discriminant function and Pearson correlation analysis.
Various HRT and HRV parameters show a significant alteration in autonomic cardiovascular control. Compared to HRV parameters, HRT parameters 'TO' and 'TS' did not succeeded in improving the rate for discriminating DCM patients and healthy controls. However, the normalized prematureness seems to have a large importance for discriminating the groups as well as for the baroreflex mediated interactions after VPB (i.e. 'TS'). The degree of prematureness was determined as the most correlated parameter to HRT. The high correlations between the HRT and HRV parameters suggest that similar dynamic phenomena of cardiovascular regulation are recorded, which, however, HRV analysis is independent of the occurrence of VPB. Furthermore, the high correlations of HRT und HRV analysis point to high degree of dependency, particularly in DCM patients. In view of the high correlations and information content of HRV parameters with HRT and the good discrimination rate for the entire group examined, future clinical studies should be aimed at verifying the prognostic value of the HRT and HRV parameters.
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