| Objective: Sprionolactone therapy can improve the survival in CHF, but the mechanism of its benefit is uncertain. Experimental evidence suggests that aldosterone may have detrimental effects on the autonomic nervous system, especially during the morning hours. The study was designed to explore the circadian rhythm of time domine and frequency domine measures of HRV in heart failure, and to evalulate the circadian effects of aldosterone blockade on autonomic tong in chronic heart failure (CHF).Methods: Fourty-eight-hour HRV in the time domine and frequency domine were analyzed in twenty-four patients with New York Heart Association class Ⅱto IV CHF and ten normal people. All these 34 people were divided into three groups: (1) Normal group; (2) NYHA heart function Ⅱclass group; (3) NYHA heart function≥ Ⅲclass group which was divided into two small groups: (1) Therapy group received spironolactone 40 mg daily; (2) Placebo group for four weeks each. After treatment phase, a full circadian assessment was undertaken of spironolactone,s autonomic effect.Results: 1. The time domine and frequency domine measures ofHRV declined gradually according to the severity of heart failure. Thehigh frequency power spectral component declined sharply in patientswith class Ⅱheart function compared with the controls (p<0.01), butthere was no significant difference between the two heart failuregroups (p>0.05). 2. Disappearance of the circadian rhythm in terms of... |
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