gms | German Medical Science

27. Wissenschaftlicher Kongress der Deutschen Hochdruckliga

Deutsche Liga zur Bekämpfung des hohen Blutdrucks – Deutsche Hypertonie Gesellschaft e. V.

26. bis 29.11.2003, Bonn

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Short-term heart rate turbulence analysis versus variability and baroreceptor sensitivity in patients suffering from dilated cardiomyopathy

Kurzzeitanalyse der Herzfrequenzturbulenz versus Variabilität und Barorezeptorsensitivität in DCM Patienten

Meeting Abstract (Hypertonie 2003)

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  • presenting/speaker N. Wessel
  • R. Bauernschmitt
  • H. Malberg

Hypertonie 2003. 27. Wissenschaftlicher Kongress der Deutschen Hochdruckliga. Bonn, 26.-29.11.2003. Düsseldorf, Köln: German Medical Science; 2004. Doc03hochV47

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hoch2003/03hoch047.shtml

Published: November 11, 2004

© 2004 Wessel et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Introduction

This study investigates the suitability of short-term heart rate turbulence (HRT) in comparison to heart rate and blood pressure variability as well as baroreceptor sensitivity analyses to characterise the regulatory differences in patients suffering from dilated cardiomyopathy (DCM) and healthy controls.

Methods

In this study, 30-minute data of non-invasive continuous blood pressure recordings and ecgs of 37 DCM patients and 167 controls under standard resting conditions were analysed. The heart rate variability (HRV) and the systolic (S-) & diastolic blood pressure variability (DBPV) were investigated by applying time-and-frequency-domain as well as non-linear dynamical methods. The spontaneous baroreceptor sensitivity (BRS) was estimated using the dual sequence method. From the detected premature beats, the turbulence onset (TO) and turbulence slope (TS) were calculated.

Results

Highly significant differences were found between DCM patients and controls in terms of HRV, SBPV, DBPV as well as BRS. Applying a combined heart rate-blood pressure trigger, appropriate ventricular premature beats were detected in 24.3% (9) of the DCM patients and in 11.3% (19) of the controls. This fact demonstrates the restricted applicability of short-term HRT analyses. However, the HRT parameters showed significant differences in this subgroup with ventricular premature beats (TO: DCM: 1.80±2.72, Controls: -4.34±3.10, p<0.001; TS: DCM: 6.75±5.50, Controls: 21.30±17.72, p=0.021). Considering all (including HRT) parameters in the subgroup with ventricular beats, a discrimination rate between DCM patients and controls of 88.0% was obtained (max. 6 parameters). For comparison, for the total group this rate was 86.3% (without HRT parameters).

Conclusion

The comparable classification rates and the high correlations between heart rate turbulence and variability and baroreflex parameters suggest a more universal applicability of the latter methods.