Relationship between heart rate variability combined with cardiac function-related indicators and the condition of patients with chronic heart failure and ventricular arrhythmias

ObjectiveTo investigate the relationship between heart rate variability (HRV) combined with cardiac function-related indicators and the condition of patients with chronic heart failure (CHF) and ventricular arrhythmias (VA).

MethodsThe clinical data of 89 CHF patients were analyzed, and the patients were grouped according to the New York Heart Association (NYHA) cardiac function classification, left ventricular ejection fraction (LVEF) and VA. The HRV time domain indicators (SDNN-24h, SDANN, SDNN index, rMSSD, PNN50), brain natriuretic peptide (BNP), echocardiography-related indicators (LVEF, LVEDD, LVESD), and total number of preventricular contractions were compared among the different groups. A multifactorial binary logistic regression model was used to analyze the factors influencing the development of VA in patients with CHF. The SDNN-24h, LVEF and BNP indicators were analyzed by two-by-two linear correlation.

ResultsThe coronary heart disease accounted for the highest proportion of CHF causes (56.2%). The BNP, LVEDD and LVESD in NYHA cardiac function class Ⅳ group were greater than those in class Ⅰ-Ⅱ group and class Ⅲ group, the LVEF and SDANN in class Ⅳ group were less than those in class Ⅰ-Ⅱ group and class Ⅲ group, the SDNN-24h in class Ⅲ group was greater than that in class Ⅳ group, the rMSSD in class Ⅲ group was greater than that in class Ⅰ~Ⅱ group, and the difference was statistically significant (P < 0.05 to P < 0.01). The BNP, LVEDD and LVESD in HFpEF group were less than those in HFmrEF and HFrEF groups, the LVEF, SDNN-24h, SDANN, SDNN index, rMSSD and PNN50 in HFpEF group were larger than those in HFmrEF and HFrEF groups, and LVEF in HFmrEF group was larger than that in HFrEF group, with statistically significant differences (P < 0.05 to P < 0.01). The percentage of males, BNP, LVEDD, LVESD and SDNN index were greater in the positive VA group than those in the negative group, the LVEF was lower in the positive group than that in the negative group, and the difference was statistically significant (P < 0.05 to P < 0.01). Increased SDNN index (OR: 1.033, 95%CI: 1.012-1.053, P < 0.01) and LVEDD(OR: 1.124, 95%CI: 1.069-1.182, P < 0.01) were risk factors for VA. The LVEF was positively correlated with SDNN-24h, the BNP was negatively correlated with SDNN-24h and LVEF (P < 0.05).

ConclusionsThe combination of HRV and cardiac function-related indicators can more comprehensively evaluate the condition of CHF patients and predict the occurrence of VA.