Key result
High sleep cyclic variation of heart rate index is linked to LVDD in nonischemic patients.
Why the study?
Cyclic variation of heart rate (CVHR) reflects autonomic responses to apneic or hypoxic stress, but its association with cardiac function remains unclear.
Is a high cyclic variation of heart rate index associated with left ventricular diastolic dysfunction in patients without ischemia?
Observational (n=181)
Is a high cyclic variation of heart rate index associated with left ventricular diastolic dysfunction in patients without ischemia?
A high frequency of cyclic variation of heart rate during sleep is independently associated with left ventricular diastolic dysfunction in nonischemic patients.
May flag diastolic dysfunction via sleep HR variation in nonischemic patients; leaves open prospective validation before clinical adoption.
Background Cyclic variation of heart rate (CVHR) associated with sleep‐disordered breathing reflects cardiac autonomic responses to apneic/hypoxic stress. However, the association of CVHR with cardiac function is unclear. Methods We investigated a total of 181 patients who underwent both 24‐hour Holter electrocardiography (ECG) and quantitative gated single‐photon emission computed tomography (SPECT) myocardial functional imaging, excluding patients with atrial fibrillation, myocardial infarction, structural heart disease, and implantable devices, from January 2017 to July 2018. The number of CVHR per hour (CVHR index) in sleeping‐time Holter ECG was compared with the parameters of left ventricular (LV) systolic and diastolic functions assessed by cardiac SPECT functional imaging, peak filling rate (PFR), first‐third mean filling rate (1/3 MFR), and time to peak filling rate (TTPF). Results In all patients, the CVHR index was not associated with any parameters of cardiac functions. However, in a propensity score–matched subgroup of patients without ischemia (N = 39), the CVHR index was negatively correlated with PFR (r = −0.35, P < .05) and 1/3 MFR (r = −0.37, P < .05) but positively correlated with TTPF (r = 0.43, P < .01) and was not correlated with LV ejection fraction. Multivariate linear regression analysis revealed that high CVHR index was independently associated with LV diastolic dysfunction, even after adjusting for the relative wall thickness and LV mass index assessed by echocardiography. Conclusion These results indicate that the high frequency of CVHR in sleeping time is associated with LV diastolic dysfunction in nonischemic patients, irrespective of LV geometry.
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Yaegashi et al. (2021) conducted an observational in Patients undergoing Holter ECG and SPECT imaging (n=181). Cyclic variation of heart rate (CVHR) was evaluated on Left ventricular diastolic function parameters (PFR, 1/3 MFR, and TTPF) (r = 0.43 (for TTPF), p=<.01). A high cyclic variation of heart rate index during sleep was independently associated with left ventricular diastolic dysfunction in nonischemic patients (r=0.43, P<0.01 for time to peak filling rate).
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