Comparison of four methods of heart rate variability analysis in patients with advanced heart failure

2.50
Hdl Handle:
http://hdl.handle.net/10755/151761
Type:
Presentation
Title:
Comparison of four methods of heart rate variability analysis in patients with advanced heart failure
Abstract:
Comparison of four methods of heart rate variability analysis in patients with advanced heart failure
Conference Sponsor:Sigma Theta Tau International
Conference Year:1992
Conference Date:August 6 - 8, 1992
Author:Woo, Mary, DNS/DNSc/DSN
P.I. Institution Name:UCLA Medical Center, Division of Cardiology
Title:Clinical Research Nurse
Heart rate variability (HRV) is the successive change in R-R

intervals, and reflects autonomic nervous system tone. Decreased

parasympathetic and increased sympathetic tone is associated with

decreased HRV and increased mortality in survivors of myocardial

infarction. While a variety of methods have been used to analyze

HRV, these techniques are not necessarily equivalent.



Objectives: The purpose of this study was to compare 4 different

methods of HRV analysis in two disparate groups: patients with

advanced heart failure, who characteristically have high

sympathetic tone, and healthy controls.



Methods: Twenty-four hour Holter recordings were obtained in 50

patients with advanced heart failure and 50 age- and sex-matched

healthy controls. From these 24-hour electrocardiogram recordings,

HRV was assessed by R-R interval histograms, standard deviation of

the R-R interval means of all 5 minute epochs (SDANN), and Poincare

plots. Spectral HRV analysis was performed on 256 beat epochs,

free of ectopy, from 6 standardized times.



Results: For R-R interval histograms, SDANN, and Poincare plots,

diminished HRV was identified in 65 to 100 percent of advanced

heart failure patients versus 0 to 8 percent of controls.

Agreement among these tests ranged from 69 to 92 percent. Spectral

analysis low frequency to high frequency ratios varied greatly over

the 24-hour recording period, even in the same subject, possibly

due to variations in activity. The low to high frequency ratio was

reduced in heart failure patients as compared to controls,

suggesting higher sympathetic tone only in the 3AM recording period

but not at 1AM, 7AM, 9PM, 3PM, or 5PM. Only 16 percent of heart

failure patients had low to high frequency spectral ratios greater

than 2 standard deviations above control values at the 3AM time

period. Agreement between spectral analysis at 3AM and the other

methods which analyzed 24 hours of data ranged between 58 to 67

percent.



Conclusions: HRV assessed from sinus R-R intervals over a 24-hour

period with different techniques yield similar but not identical

results. HRV assessed from spectral analysis of short time periods

of data varies markedly during a 24-hour period, even in sedentary

patients with advanced heart failure, and should not be compared to

measures obtained from the 24-hour methods. Standardization of

subject activity and recording time is necessary for comparison of

spectral analysis of brief periods of data. Further research is

required to determine if differences among methods assessing

24-hour HRV yield complimentary information.



Repository Posting Date:
26-Oct-2011
Date of Publication:
6-Aug-1992
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleComparison of four methods of heart rate variability analysis in patients with advanced heart failureen_GB
dc.identifier.urihttp://hdl.handle.net/10755/151761-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Comparison of four methods of heart rate variability analysis in patients with advanced heart failure</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">1992</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">August 6 - 8, 1992</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Woo, Mary, DNS/DNSc/DSN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">UCLA Medical Center, Division of Cardiology</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Clinical Research Nurse</td></tr><tr><td colspan="2" class="item-abstract">Heart rate variability (HRV) is the successive change in R-R<br/><br/>intervals, and reflects autonomic nervous system tone. Decreased<br/><br/>parasympathetic and increased sympathetic tone is associated with<br/><br/>decreased HRV and increased mortality in survivors of myocardial<br/><br/>infarction. While a variety of methods have been used to analyze<br/><br/>HRV, these techniques are not necessarily equivalent.<br/><br/><br/><br/>Objectives: The purpose of this study was to compare 4 different<br/><br/>methods of HRV analysis in two disparate groups: patients with<br/><br/>advanced heart failure, who characteristically have high<br/><br/>sympathetic tone, and healthy controls.<br/><br/><br/><br/>Methods: Twenty-four hour Holter recordings were obtained in 50<br/><br/>patients with advanced heart failure and 50 age- and sex-matched<br/><br/>healthy controls. From these 24-hour electrocardiogram recordings,<br/><br/>HRV was assessed by R-R interval histograms, standard deviation of<br/><br/>the R-R interval means of all 5 minute epochs (SDANN), and Poincare<br/><br/>plots. Spectral HRV analysis was performed on 256 beat epochs,<br/><br/>free of ectopy, from 6 standardized times.<br/><br/><br/><br/>Results: For R-R interval histograms, SDANN, and Poincare plots,<br/><br/>diminished HRV was identified in 65 to 100 percent of advanced<br/><br/>heart failure patients versus 0 to 8 percent of controls.<br/><br/>Agreement among these tests ranged from 69 to 92 percent. Spectral<br/><br/>analysis low frequency to high frequency ratios varied greatly over<br/><br/>the 24-hour recording period, even in the same subject, possibly<br/><br/>due to variations in activity. The low to high frequency ratio was<br/><br/>reduced in heart failure patients as compared to controls,<br/><br/>suggesting higher sympathetic tone only in the 3AM recording period<br/><br/>but not at 1AM, 7AM, 9PM, 3PM, or 5PM. Only 16 percent of heart<br/><br/>failure patients had low to high frequency spectral ratios greater<br/><br/>than 2 standard deviations above control values at the 3AM time<br/><br/>period. Agreement between spectral analysis at 3AM and the other<br/><br/>methods which analyzed 24 hours of data ranged between 58 to 67<br/><br/>percent.<br/><br/><br/><br/>Conclusions: HRV assessed from sinus R-R intervals over a 24-hour<br/><br/>period with different techniques yield similar but not identical<br/><br/>results. HRV assessed from spectral analysis of short time periods<br/><br/>of data varies markedly during a 24-hour period, even in sedentary<br/><br/>patients with advanced heart failure, and should not be compared to<br/><br/>measures obtained from the 24-hour methods. Standardization of<br/><br/>subject activity and recording time is necessary for comparison of<br/><br/>spectral analysis of brief periods of data. Further research is<br/><br/>required to determine if differences among methods assessing<br/><br/>24-hour HRV yield complimentary information.<br/><br/><br/><br/></td></tr></table>en_GB
dc.date.available2011-10-26T11:12:51Z-
dc.date.issued1992-08-06en_GB
dc.date.accessioned2011-10-26T11:12:51Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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