Correlation between heart rate variability and left ventricular stiffness in patients with heart failure with preserved ejection fraction
Objective To screen out sensitive heart rate variability(HRV)index reflecting left ventricular(LV)stiffness in patients with heart failure with preserved ejection fraction(HFpEF),and to assess its prognostic evaluation value for HFpEF patients.Methods We selected 150 patients with normal LVEF who had undergone 24-hour ambulatory electrocardiography and routine echocardiography examinations.The enrolled patients were divided into normal control group(68 cases)and HFpEF group(82 cases).The receiver operating characteristic curve analysis was used to screen out the sensitive HRV index associated with LV stiffness in HFpEF patients.The primary endpoint events were followed up.Results Among HRV indexes,the area under curve(AUC)of SDANN was the largest in the prediction of HFpEF(AUC=0.68,P＜0.01);the cut-off value was 90 ms.SDANN was negatively associated with LV diastolic wall strain.The higher the SDANN was,the higher the LV stiffness was.According to the cut-off value of SDANN,the patients with HFpEF were divided into high-SDANN group(cut-off value≥90 ms,44 cases)and low-SDANN group(cut-off value＜90 ms,38 cases).In the low-SDANN group,the LV stiffness was lower.The survival curve analysis revealed that in the high-SDANN group the incidence of major adverse cardiac events and total mortality were significantly higher than those in the low-SDANN group(P＜0.05).Conclusion SDANN could be served as a sensitive indicator for making clinical diagnosis and prognostic evaluation among patients with HFpEF.
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