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. 2000 May;83(5):531–538. doi: 10.1136/heart.83.5.531

Heart rate variability and baroreflex sensitivity in idiopathic dilated cardiomyopathy

J Hoffmann 1, W Grimm 1, V Menz 1, H Muller 1, B Maisch 1
PMCID: PMC1760828  PMID: 10768902

Abstract

OBJECTIVE—To examine the relation between cardiac autonomic tone, assessed by baroreflex sensitivity and heart rate variability, and left ventricular function, arrhythmias on Holter monitoring, and clinical variables in patients with idiopathic dilated cardiomyopathy.
DESIGN—A prospective observational study.
PATIENTS—160 patients with idiopathic dilated cardiomyopathy and preserved sinus rhythm in the absence of antiarrhythmic drug treatment. Measures of heart rate variability obtained by digital 24 hour Holter recordings included the mean of all coupling intervals between normal beats (RRm), the standard deviation of the mean of normal RR intervals (SDNN), and the square root of the mean of the squared differences between adjacent normal RR intervals (rMSSD). Baroreflex sensitivity testing was performed using the phenylephrine method.
RESULTS—Mean SDNN (SEM) was 112 (46) ms, and baroreflex sensitivity was 7.5 (5.0) ms/mm Hg. SDNN showed a weak correlation with baroreflex sensitivity (r = 0.19, p < 0.05) and with left ventricular ejection fraction (r = 0.29, p < 0.05). SDNN showed no significant correlation with age (r = −0.07), the presence of non-sustained ventricular tachycardia (r = −0.13), or left ventricular end diastolic diameter (r = −0.07). In addition, baroreflex sensitivity showed no significant correlation with age (r = −0.13), non-sustained ventricular tachycardia (r = −0.08), left ventricular end diastolic diameter (r = 0.09), or ejection fraction (r = 0.14).
CONCLUSIONS—The weak correlation between baroreflex sensitivity and heart rate variability suggests that these two indices explore different aspects of cardiac autonomic control in patients with idiopathic dilated cardiomyopathy. The weak or absent correlation between baroreflex sensitivity, heart rate variability, and other potential non-invasive risk predictors, including left ventricular ejection fraction, left ventricular end diastolic diameter, and non-sustained ventricular tachycardia on Holter monitoring, indicate that these variables may have independent prognostic value in idiopathic dilated cardiomyopathy.


Keywords: cardiomyopathy; baroreflex sensitivity; heart rate variability

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Figure 1  .

Figure 1  

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Plot of the mean and SD of baroreflex sensitivity for SDNN bins. The correlation coefficient between these variables was only 0.19 (p < 0.05).

Figure 2  .

Figure 2  

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Plot of the mean and SD of SDNN for left ventricular ejection fraction bins showing only a moderate correlation between these variables (r = 0.29, p < 0.05).

Figure 3  .

Figure 3  

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Plot of the mean and SD of baroreflex sensitivity for left ventricular ejection fraction bins showing no significant correlation between these variables (r = 0.14).

Figure 4  .

Figure 4  

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(A) SDNN and (B) baroreflex sensitivity according to the presence or absence of non-sustained ventricular tachycardia (NSVT) on Holter monitoring. There was no significant difference in heart rate variability and baroreceptor sensitivity between patients with and without NSVT.

Selected References

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