Correlation between heart rate variables and the inci-dence of cardiovascular adverse events in patients with heart failure

FU Lan-lan; LI Mei-ling; PAN Zhi-qiong; ZHOU Jia

摘要：Background Chronic heart failure(CHF)is the end-stage manifestation and main cause of death of cardiovas-cular system diseases.Ventricular arrhythmia is a common complication,which can increase myocardial oxygen consumption,aggravate the disease,and even cause sudden death due to malignant arrhythmia.As a quantitative method to evaluate cardiac autonomic nervous function,heart rate variability is non-invasive and reproducible,and can quantify the risk associated with various cardiac and non-cardiac diseases.The purpose of this study was to ana-lyze the correlation between heart rate variability and the incidence of cardiovascular adverse events in patients with heart failure.Methods 80 patients with heart failure who were treated in our hospital from May 2020 to May 2022 were selected as the study objects.After 3 months of follow-up,patients were divided into occurrence group(n=44)and nonoccurrence group(n=36)according to the occurrence of adverse cardiovascular events(angina pec-toris,myocardial infarction,arrhythmia).The index of heart rate variability and the indicators of cardiac function in patients with heart failure was analyzed by one-way analysis of variance(ANOVA).The Key indicators of heart rate variability include standard deviation of normal RR interval(SDNN),mean standard deviation of consecutive 5-minute heartbeat interval(SDANN),square root of mean square of difference between adjacent heartbeat intervals(RMSSD),and percentage of RR intervals differing more than 50 ms from the preceding one(PNN50).The indica-tors of cardiac function include the New York Heart Association(NYHA)functional classification,left ventricular ejection fraction(LVEF),brain natriuretic peptide(BNP)and cardiac troponin I(cTnI).Multivariate logistic regres-sion was used to analyze the incidence of cardiovascular adverse events in patients with heart failure.Receiver oper-ating characteristic(ROC)curve was used to analyze the predictive value of heart rate variability in patient out-comes.The correlation between heart rate variability and the incidence of cardiovascular adverse events was ana-lyzed by Kendall's tau-b analysis.Results There were significant differences in SDNN,SDANN,RMSSD,PNN50,cardiac function grade,LVEF and BNP level between the two groups(P＜0.05).Through logistic regres-sion analysis,SDNN,SDANN,RMSSD and PNN50 were independent predictors for the incidence of cardiovascu-lar adverse events(P＜0.05).The areas under curve for SDNN,SDANN,RMSSD,and PNN50 predicting of the inci-dence of cardiovascular adverse events were 0.732,0.732,0.758,and 0.819 respectively,and the sensitivity was 77.27％,81.81％,75.00％and 65.91％,respectively.The specificity was 61.11％,61.11％,80.56％,83.33％(P＜0.05),respectively.Through Kendall's tau-b analysis,the index of heart rate variability was negatively correlated with the incidence of adverse cardiovascular events in patients with prognosis(P＜0.05).Conclusions Heart rate variability has predictive value for the incidence of adverse cardiovascular events in patients with heart failure.The lower the heart rate variability,the higher incidence of cardiovascular adverse events.[S Chin J Cardiol 2024;25(3):135-141]