title: Evaluation of heart-rate turbulence as a new prognostic marker in patients with chronic heart failure.
abstract: The significance of heart-rate turbulence (HRT) in patients with chronic heart failure (CHF) was evaluated to examine whether it is sensitive to the risk of ventricular tachycardia (VT). HRT is reported to predict the prognosis after myocardial infarction (MI), but its prognostic value in patients with CHF remains unknown. HRT was measured in 50 CHF patients (left ventricular ejection fraction <50% and/or left ventricular end-diastolic diameter >55 mm, 34 cardiomyopathy, 16 post-MI) and 21 patients without obvious heart diseases (control). HRT slope and HRT onset were measured by the original definitions using digitized Holter ECG recordings. Cardiac pump function was assessed by echocardiography. The value of the HRT slope was significantly lower in CHF than in control (3.7 +/- 1.7 vs 16.4 +/- 5.3, mean +/- SD, p < 0.01). The value of the HRT onset in patients with CHF was significantly higher than that in control patients (-1.1 +/- 1.9 vs -3.6 +/- 1.7, mean +/- SD, p < 0.05). The HRT slope and onset in CHF patients with VT were nearly identical to those without VT. The HRT slope appears to be a powerful prognostic marker that shows significant differences between CHF subgroups when divided by clinical events; that is, CHF death and CHF hospitalization. However, it has limited value for predicting fatal ventricular arrhythmias.
authors.affiliation: Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Jiro
authors.initials: J
authors.lastname: Koyama
authors.forename: Jun
authors.initials: J
authors.lastname: Watanabe
authors.forename: Aki
authors.initials: A
authors.lastname: Yamada
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Koseki
authors.forename: Yuji
authors.initials: Y
authors.lastname: Konno
authors.forename: Sunao
authors.initials: S
authors.lastname: Toda
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Shinozaki
authors.forename: Masahito
authors.initials: M
authors.lastname: Miura
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Fukuchi
authors.forename: Mototsugu
authors.initials: M
authors.lastname: Ninomiya
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kagaya
authors.forename: Kunio
authors.initials: K
authors.lastname: Shirato
mesh_terms: D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000503:physiopathology*; D016022:Case-Control Studies; D015716:Electrocardiography, Ambulatory; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016019:Survival Analysis; D017180:Tachycardia, Ventricular / Q000175:diagnosis; D018879:Ventricular Premature Complexes / Q000175:diagnosis