Analysis Of Heart Rate Variability In Patients With Non-EF Reduced Heart Failure

Objective To analyze the characteristics of heart rate variability(HRV)in Patients with Non-EF reduced heart failure(include HFpEF and HFmrEF),and the relationship between LVEF and HRV,and to explore the significance of HRV in early diagnosis,disease assessment and prognosis of patients with chronic heart failure.Methods85 patients with heart failure who were admitted to the department of cardiology,The Second Affiliated Hospital of Xi 'an Medical College from January to June 2017,underwent heart rate variability test and met the inclusion criteria were selected as the experimental group,Divided into two groups according to the 2016 European heart failure guidelines:(1)Non-EF reduced group(LVEF ? 40 %)52 cases,24 males and 28 females,with an average age of 70.65±11.55 years.(2)EF reduced group(LVEF <40 %)33 cases,17 males and 16 females,with an average age of 69.45 ±12.19 years.In addition,20 normal persons from our hospital were selected as control group,11 males and 9 females,with an average age of 71.64 ± 10.18 years,collected 24-hour dynamic echocardiography and echocardiography,Recorded HRV(SDNN?SDANN?SDNNindex?rMSSD? pNN50?24-hour Frequency Domain power?LF?HF?LF/HF)and LVEF,Compared that HRV values between the three group,Analyzed the correlation between LVEF and HRV.SPSS 19.0.statistical was used to carry out statistical an analyzed by varance,and the nonparametric test was alysis.The measurement data were expressed by x ± s,the counting datase were expressed by cases and percentages,the comparison between multiple samples in accordance with the normal distribution data was analyzed by variance,and the nonparametric test was used for multiple samples in accordance with the normal distribution data.Spearman correlation analysis was used for the correlation between LVEF and HRV,with P<0.05 as the difference having statistical significance.Result1.General data comparison Non-EF reduced heart failure group,EF reduced heart failure group and control group in the age composition,body mass index,fasting blood glucose,TC,TG,LDL-C,alanine aminotransferase and other basic clinical data were compared without statistical difference(P>0.05).2.Comparison of HRV among various basic diseases in experimental group The basic diseases of the experimental group were divided into coronary heart disease group,hypertension group,cardiomyopathy group and coronary heart disease complicated with hypertension group.SDNN,SDANN,SDNNindex,24 h frequency domain power,LF,HF were not statistically significant difference among the four groups(P>0.05).3.Comparison of HRV between experimental group and control group,SDNN,SDANN,SDNNindex,and 24 h frequency domain power were all decreased,and the difference between the two groups was statistically significant(P<0.05).4.Comparison of the HRV in the non-EF reduced group and the EF reduced group in the experimental group,SDNN,SDANN,SDNNindex indicators are higher,the difference between the two groups was statistically significant(P<0.05).5.Spearman correlation analysis showed that the correlation between LVEF and HRV in the experimental group showed that as the LVEF decreased,the SDNN and SDANN of heart rate variability also decreased,showing significant correlation(P <0.05);The analysis of the correlation between LVEF and HRV in the EF reduced group showed that with the decrease of LVEF,the heart rate variability of SDANN and SDNNindex also decreased,showing significant correlation(P <0.05);The analysis of the correlation between LVEF and HRV in non-EF reduced heart failure group showed no correlation between LVEF and SDNN,SDANN,SDNNindex,24 h frequency domain,and LF(P >0.05).Conclusion1.The time domain indicators SDNN,SDANN,SDNNindex,frequency domain power values of 24 h frequency domain,of patients with heart failure were significantly lower than the normal population,suggesting that there is autonomic dysfunction in patients with heart failure.2.The time domain indicators SDNN and SDANN in patients with non-EF reduced heart failure were significantly lower than those in normal healthy people,suggesting that patients with non-EF reduced heart failure have autonomic dysfunction,and the degree of damage is lighter than EF reduced heart failure.3.There was no significant difference in the HRV decline among heart failure patients with different underlying diseases.4.There is a significant linear positive correlation between SDNN,SDANN,and LVEF in patients with heart failure.There is also a significant linear positive correlation between SDANN,SDNNN,and LVEF in patients with EF reduced heart failure,indicating that as the LVEF decreases,HRV decreases,Autonomic dysfunction is more severe;however,HRV values in patients with non-EF reduced heart failure are not significantly correlated with LVEF.5.The reduced of heart rate variability can be an important clue for early identification of HFpEF/HFmrEF.6.Heart rate variability can be used as an important test to assess the condition and prognosis of patients with heart failure.