Influence of spontaneous ventricular premature beat coupling interval on the value of heart rate turbulence
Authors:
M. Kozák; L. Křivan; M. Sepši; P. Trčka; J. Vlašínová
Authors‘ workplace:
Interní kardiologická klinika Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Jindřich Špinar, CSc., FESC
Published in:
Vnitř Lék 2008; 54(9): 803-809
Category:
Original Contributions
Overview
The heart rate turbulence is promising marker of a sudden cardiac death.
The aim of the study is to evaluate the influence of the ventricular premature beat (VPB) coupling interval on the values of turbulence onset (TO) and turbulence slope (TS) parameters in the three groups of patients – “healthy” with ventricular premature beats, pts post myocardial infarction (MI) and pts with chronic heart failure with the left ventricle ejection fraction (LVEF) < 0.35.
Patients and methods:
382 pts were examined: healthy – 149, post MI – 123 and LVEF < 0.35 – 110. The distribution of VPB was analyzed and the values of TO and TS were evaluated according to the coupling intervals of VPB – in the intervals 00–50, 51–100 ( % of RR interval) and in the intervals 34–66 and 67–100 ( % of RR interval).
Results:
The coupling interval of spontaneous ventricular premature beats cause the statistically significant variability HRT values in all three groups of pts.
Conclusion:
The values of TO in the groups of post MI pts and pts with chronic heart failure are higher (risky for sudden cardiac death) after VPB with longer coupling intervals (50–100%, event. 67–100% of RR interval). The TS values are lower (risky for sudden cardiac death) after VPB with longer coupling interval, too. For evaluation of HRT we should use the VPBs with long coupling intervals.
Key words:
heart rate turbulence – ventricular premature beat coupling interval
Sources
1. Schmidt G, Malik M, Barthel P et al. Heart-rate turbulence after ventricular premature beats as a predictor of mortality after acute myocardial infarction. Lancet 1999; 353: 1390–1396.
2. La Rovere MT, Bigger JT Jr, Marcus FI et al. Baroreflex sensitivity and heart-rate variability in prediction of total cardiac mortality after myocardial infarction. ATRAMI Investigators. Lancet 1998; 351: 478–484.
3. Davies LC, Francis DP, Ponikowski P et al. Relation of heart rate and blood pressure turbulence following premature ventricular complexes to baroreflex sensitivity in chronic congestive heart failure. Am J Cardiol 2001; 87: 737–742.
4. Marine JE, Watanabe MA, Smith TW et al. Effect of atropine on heart rate turbulence. Am J Cardiol 2002; 89: 767–769.
5. Lin LY, Lai LP, Lin JL et al. Tight mechanism correlation between heart rate turbulence and baroreflex sensitivity: sequential autonomic blockade analysis. J Cardiovasc Electrophysiol 2002; 13: 427–431.
6. Watanabe MA, Marine JE, Sheldon R et al. Effects of ventricular premature stimulus coupling interval on blood pressure and heart rate turbulence. Circulation 2002; 106: 325–330.
7. Lee KT, Lai WT, Chu CS et al. Effect of electrophysiologic character of ventricular premature beat on heart rate. J Electrocardiol 2004; 37: 41–46.
8. Wichterle D, Melenovsky V, Malik M. Mechanisms involved in heart rate turbulence. Card Electrophysiol Rev 2002; 6: 262–266.
9. Mrowka R, Persson PB, Theres H et al. Blunted arterial baroreflex causes “pathological” heart rate turbulence. Am J Physiol Regul Integr Comp Physiol 2000; 279: R1171–R1175.
10. Watanabe MA, Schmidt G. Heart rate turbulence: a 5-year review. Heart Rhythm 2004; 1: 732–738.
11. Mäkikallio TH, Barthel P, Schneider R et al. Prediction of sudden cardiac death after acute myocardial infarction: role of Holter monitoring in the modern treatment era. Eur Heart J 2005; 26: 762–769.
12. Hallstrom AP, Stein PK, Schneider R et al. Structural relationships between measures based on heart beat intervals: potential for improved risk assessment. IEEE Trans Biomed Eng 2004; 20: 1414–1420.
13. Guzik P, Schmidt G. A phenomenon of heart-rate turbulence, its evaluation, and prognostic value. Card Electrophysiol Rev 2002; 6: 256–261.
14. Lindgren KS, Makikallio TH, Seppanen T et al. Heart rate turbulence after ventricular and atrial premature beats in subjects without structural heart disease. J Cardiovasc Electrophysiol 2003; 14: 447–452.
15. Schwab JO, Shlevkov A, Grunwald K et al. Influence of the point of origin on heart rate turbulence after stimulated ventricular and atrial premature beats. Basic Res Cardiol 2004; 99: 56–60.
16. Savelieva I, Wichterle D, Harries M et al. Heart rate turbulence after atrial and ventricular premature beats: relation to left ventricular function and coupling intervals. Pacing Clin Electrophysiol 2003; 26: 401–405.
17. Segerson NM, Wasmund SL, Abedin M et al. Heart rate turbulence parameters correlate with post-premature ventricular contraction changes in muscle sympathetic. Heart Rhythm 2007; 4: 284–289.
18. Flevari P, Georgidaou P, Leftheriotis E et al. Heart rate turbulence after short runs of nonsustained ventricular tachycardia in chronic heart failure. Pacing Clin Electrophysiol 2007; 30: 787–795.
Labels
Diabetology Endocrinology Internal medicineArticle was published in
Internal Medicine
2008 Issue 9
Most read in this issue
- Kidney damage in multiple myeloma and other monoclonal gammopathies
- BK viral infection after renal transplantation
- Hypertension in dialysis patients
- Coronary artery disease with premature manifestation in young patients