gms | German Medical Science

Reduced heart rate variability (HRV) is associated with increased morbidity and mortality in patients with systolic heart failure (HF). So far available data regarding the prognostic significance of HRV in diastolic heart failure is insufficient. We prospectively analyzed HRV in pts. with diastolic dysfunction (DD) with or without diastolic HF. Pts. aged 50 to 85 years with at least one of the following diagnoses were included: arterial hypertension, diabetes mellitus, manifestation of atherosclerosis, sleep apnoea or a history HF. Grade of DD was determined according to the American Society of Echocardiography. Left ventricular ejection fraction < 45 % was an exclusion criterion. Framingham criteria were used to classify patients with respect to their symptoms. HRV parameters were determined from digital high-resolution 24 hour Holter recordings (CardioDay, getemed, Germany). This study was performed as a substudy of the German Heart Failure Network (KNHI). We studied 140 pts. (49% males, mean age 66±8 years). 120 had DD (grade I, n=91, grade II, n=29). Among those, 25 (21%) had signs of overt HF. Pts. without echocardiographic signs of DD (DD grade 0, n=20) served as controls. Pts. with DD and symptoms of HF had significant lower SDNN and SDANN compared to asymptomatic pts. with DD and controls. There was a trend towards a reduced pNN50 in pts. with DD and symptoms of HF. No difference was found in HRV parameters between asymptomatic pts. with DD and controls. Notably, no correlation was found between the grade of DD and symptoms of HF and the reduction in HRV parameters. Table 1 [Tab. 1] shows HRV parameters in the different groups. Thus, reduced HRV may be a helpful tool to identify pts. with DD prone to develop symptoms of heart failure.