AI Article Synopsis
- Recent advances in diagnosis and treatment have led to an increase in adults living with congenital heart disease (ACHD), but this population faces challenges, particularly with rhythm disorders, which we aimed to study in relation to heart rate variability (HRV) and its impact on prognosis.
- A study involving 97 ACHD patients and 19 controls revealed that ACHD patients exhibited higher instances of premature ventricular contractions and lower HRV measurements compared to controls, with significant statistical differences indicating potential health risks.
- The findings also showed that specific HRV metrics correlated with NT-proBNP levels, and during a follow-up period, there were notable differences in HRV parameters between patients who experienced cardiac events and those who remained event-free, highlighting the prognostic value of
Article Abstract
Purpose: Due to recent advances in diagnosis and treatment, the number of adults with congenital heart disease (ACHD) has substantially increased. This achievement is mitigated by rhythm disorders. Here, we sought to determine alterations in heart rate variability (HRV) and their prognostic value in ACHD.
Methods: Ninety seven ACHD patients (39.2 ± 14.1 years, 51.5% female) and 19 controls (39.7 ± 15.0 years, 47.4% female) underwent 24-h Holter monitoring.
Results: As compared to controls, ACHD patients offered a significantly higher burden of premature ventricular contractions (p = 0.02) and decreased HRV indices (natural logarithmic transformation of very low frequency (lnVLF): 7.46 ± 0.76 ms vs. 7.91 ± 0.92ms, p = 0.03; natural logarithmic transformation of low frequency (lnLF): 6.39 ± 0.95ms vs. 7.01 ± 1.07ms, p = 0.01; natural logarithmic transformation of the ratio of low to high frequency spectra (lnLF/HF): 0.81 ± 0.74 vs. 1.17 ± 0.51, p = 0.04). No differences in HRV measures were observed across ACHD lesion groups. NT-proBNP levels were significantly related to both time and frequency domain indices (natural logarithmic transformation of the standard deviation of NN intervals (lnSDNN): Spearman´s rho = -0.32, p = 0.001; natural logarithmic transformation of the standard deviation of the average NN intervals for each 5-min segment of a 24-h Holter monitoring (lnSDANN): Spearman´s rho: -0.33, p = 0.001; natural logarithmic transformation of the total power (lnTP): Spearman´s rho: -0.25, p = 0.01; lnVLF: Spearman´s rho: -0.33, p = 0.001; lnLF: Spearman´s rho: -0.35, p < 0.001; lnLF/HF: Spearman´s rho: -0.34, p = 0.001). After a mean follow-up of 3.9 ± 0.7 years, 8 patients died and 3 patients survived sudden cardiac death (SCD). Several HRV parameters were significantly higher in event-free ACHD patients than in those who died or survived SCD (natural logarithmic transformation of the average of the standard deviations of NN intervals for each 5-min segment of a 24-h Holter monitoring (lnASDNN): p = 0.04; lnPNN30: p = 0.04; lnVFL: p = 0.03; lnLF: p < 0.01). On univariate Cox regression analysis, the time domain indices lnSDNN, lnASDNN and lnPNN30, as well as the frequency domain parameters lnTP, lnVLF and lnLF were associated with death and survived cardiac arrest.
Conclusion: ACHD is accompanied by HRV impairment that carries prognostic implications on ACHD mortality and survived SCD.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10589992 | PMC |
| http://dx.doi.org/10.1186/s12872-023-03558-4 | DOI Listing |
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