Why the study?
Autonomic impairment marks HFrEF, but a systematic review comprehensively examining representative values of heart rate variability metrics in HFrEF was lacking.
What are the representative values of heart rate variability metrics in patients with HFrEF?
What are the representative values of heart rate variability metrics in patients with HFrEF?
This systematic review provides representative reference ranges for HRV metrics in HFrEF patients, confirming that lower values are associated with poor prognosis.
Establishes reference HRV values in HFrEF; leaves open prospective validation for prognostic use in practice and trials.
INTRODUCTION: Autonomic impairment is a hallmark of heart failure with reduced ejection fraction (HFrEF). While there have been studies on general values for each index of heart rate variability (HRV) analysis in HFrEF, a systematic review comprehensively examining representative values in HFrEF is lacking. METHODS: We searched PubMed, Embase, and Cochrane databases to extract studies reporting representative values of HRV metrics in HFrEF. RESULTS: A total of 470 HFrEF patients from 6 studies were included in the review. In general, time and frequency domains were abnormally lower in HFrEF, portending a worse prognosis. In HFrEF, the mean or median value of the standard deviation of NN interval, root mean square successive difference, pNN50, and low-frequency power/high-frequency power were 40 to 121 msec, 19 to 62 msec, 1.3 to 14%, and 1.00 to 1.73, respectively. CONCLUSION: In this systematic review, most HRV metrics were found to be calculated from 24- hour Holter recordings and were lower in HFrEF patients with poor prognosis.
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Nagai et al. (2024) studied this question.
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