Heartbeat Chronicles: Decoding the Interplay of Echocardiography and Heart Rate Variability in Chronic Heart Failure Patients – Unraveling the Mysteries with Traditional and Advanced 24-Hour Holter ECG Parameters
Article Category: Original Article
Published Online: May 30, 2024
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DOI: https://doi.org/10.2478/rjc-2024-0009
Keywords
© 2024 Ștefania-Teodora Duca et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
Objective
Chronic heart failure (CHF) is a clinical syndrome that encompasses individuals who either have received a definitive diagnosis of heart failure or display a gradual escalation of symptoms as time elapses. Echocardiography, particularly evaluating left ventricular function, is crucial for diagnosis and prognosis. However, 24-hour Holter monitoring, focusing on heart rate variability (HRV), provides insights into autonomic dynamics and vulnerability. Recent HRV parameters offer nuanced information, enhancing risk stratification and guiding personalized interventions in CHF. The interplay between echocardiography and HRV enables a comprehensive approach, refining the management of CHF by considering both cardiac structure and autonomic regulation.
Methods
This prospective study at “St. Spiridon” County Hospital involved 80 patients with left ventricular ejection fraction (LVEF) < 50%. The diagnosis was according to standard clinical echocardiography, laboratory panel, and Holter ECG monitoring.
Results
Unexpectedly, no statistically significant relationship was found between commonly used HRV parameters and echocardiographic parameters. Further analyses showed statistically significant associations between non-traditional HRV parameters and E/A ratio, E/E’, and S’ lateral and septal. Additionally, modifications in HRV parameters were correlated with mitral valve deceleration time, left atrial volume index, estimated pulmonary artery systolic pressure, and cardiac output.
Conclusions
Less commonly used Holter ECG parameters, such as acceleration capacity, deceleration capacity, and triangular index, demonstrated significant diagnostic efficacy, especially when conventional HRV parameters were normal. This highlights the importance of incorporating non-traditional HRV parameters in CHF patient risk stratification, urging further exploration through comprehensive multicenter studies for long-term prognostic implications.