Open AccessSeverity of Arterial and Chronic Thromboembolic Pulmonary Hypertension is Associated with Impairment of Heart Rate Turbulence
Author(s) -
Bienias Piotr,
Kostrubiec Maciej,
Rymarczyk Zuzanna,
Korczak Dariusz,
Ciurzyński Michał,
Kurzyna Marcin,
Torbicki Adam,
Fijałkowska Anna,
Pruszczyk Piotr
Publication year - 2015
Publication title -
annals of noninvasive electrocardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.494
H-Index - 48
eISSN - 1542-474X
pISSN - 1082-720X
DOI - 10.1111/anec.12169
Subject(s) - medicine , heart rate turbulence , cardiology , pulmonary hypertension , natriuretic peptide , chronic thromboembolic pulmonary hypertension , hemodynamics , heart rate , heart failure , heart rate variability , blood pressure
Background Heart rate turbulence (HRT) impairment is a validated and an independent indicator of cardiovascular death. There are limited data on HRT in pulmonary hypertension (PH), so we assessed potential HRT alterations in PH, especially in relation to its severity. Methods Thirty‐three out of 41 patients were enrolled in the study aged 49.7 ± 15.9 years (22 with arterial, 11 with chronic thromboembolic PH). Routine evaluations, right heart catheterization, and 24‑hour Holter monitoring with heart rate variability and HRT assessment were performed. Results HRT was significantly impaired in PH patients, as compared to 25 healthy controls: mean turbulence onset (TO) was −0.27% versus −2.60% (P < 0.0001), and median turbulence slope (TS) was 3.13 versus 13.5 msRR (P < 0.0001). Abnormal HRT (TO ≥ 0.0% and/or TS ≤ 2.5 ms/RR) was found in 63.3% of PH patients. Patients with PH and abnormal HRT presented more compromised functional, biochemical, and hemodynamic status than PH patients with normal TO and TS values. Multivariate stepwise regression analysis showed that TO value was related to oxygen desaturation <90% in 6‑minute walking test (6‑MWT; OR 0.41, P < 0.001) and was related to N‑Terminal pro‐B type Natriuretic Peptide concentration (OR 0.40, P < 0.001); TS was related to 6‑MWT distance (OR 0.53, P < 0.0001). Conclusions Patients with arterial or chronic thromboembolic PH are characterized by significant impairment of HRT which is related to the disease severity. We hypothesize that patients with abnormal HRT could be considered as subjects with an increased risk of cardiovascular death, however, it needs further investigation.