Integrated Evaluation of Heart Rate Variability and Clinical Outcomes in Chronic Heart Failure: Insights into Cardiac Autonomic Dysfunction
Cardiac Autonomic Dysfunction in Chronic Heart Failure
DOI:
https://doi.org/10.69750/dmls.03.04.0201Keywords:
Heart rate variability, chronic heart failure, autonomic dysfunction, ventricular arrhythmias, cardiac outcomes, cardiovascular riskAbstract
Background: Chronic heart failure carries a significant cardiovascular morbidity and mortality burden globally. An imbalance in cardiac autonomic function with sympathetic predominance and parasympathetic recession is a prominent part of the disease process and its poor clinical outcome. HRV is a non-invasive indicator of ANS function in cardiovascular diseases.
Objective: To assess the relationship of heart rate variability (HRV) parameters with clinical outcomes in CHF patients and the prognostic value of cardiac autonomic dysfunction.
Methods: The cross-sectional study was an observational study conducted at Erie County Medical center, Buffalo from February 2023 to April 2025 under the reference number IRB/2023/CHF-117. A total of 300 patients with chronic heart failure were enrolled using consecutive non-probability sampling. Holter monitoring was done for 24 hours to calculate heart rate variability parameters such as SDNN, RMSSD, pNN50 and LF/HF ratio. New York Heart Association classification, echocardiographic findings, frequency of hospitalizations, arrhythmic complications and cardiovascular outcomes were assessed clinically. The SPSS 26.0 software was used for statistical analysis.
Results: Patients with severe autonomic dysfunction demonstrated significantly reduced SDNN, RMSSD, and pNN50 values together with elevated LF/HF ratio (p<0.001). Recurrent hospitalization, ventricular arrhythmias, worsening NYHA functional class, length of hospital stay and decreased LVEF were all significantly associated with severe HRV impairment. Multivariate logistic regression analysis revealed that reduced SDNN, elevated LF/HF ratio, diabetes mellitus, atrial fibrillation and reduced EF were independent factors in predicting adverse cardiovascular outcomes.
Conclusion: Reduced HRV is also a strong predictor of adverse clinical events in CHF. HRV assessment could be a valuable prognostic tool for the early stratification of cardiovascular risk and for individual patient management.
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