Influence of Basic Heart Rate and Sex on Heart Rate Turbulence in Healthy Subjects

Acceleration and deceleration of the heart rate after the occurrence of a ventricular premature complex is characterized as heart rate turbulence (HRT). Two parameters quantify heart rate turbulence: onset and slope. The physiological properties have not been clarified in a large cohort of persons yet. This study evaluated properties of HRT, and focused on the influence of basic heart rate and sex on HRT. Using a special protocol, 95 persons were studied prospectively. HRT and its physiological properties were determined in 95 persons using Holter ECGs. The authors found 24% with a turbulence onset 0% and 5% with a turbulence slope <2.5 ms/RRI. Mean heart rate during Holter differed significantly between women and men (745 vs 817 ms, P < 0.0001). A linear, weighted regression model revealed that an increased heart rate before a ventricular premature complex is associated with a decreased turbulence onset (P < 0.0001). Turbulence slope was attenuated by basic heart rate only in men (P = 0.0022). On the contrary, the study detected no influence of the basic heart rate on turbulence slope in women (P = 0.0015 for the comparison between women and men). Basic heart rate and sex show an influence on HRT and should be considered when using HRT for noninvasive risk stratification.