Heart rate variability in patients with chronic heart failure and chronic obstructive pulmonary disease: clinical parallels

Diseases comorbidity issues are of concern of many researchers, in recent decades, there are attempts to understand the hierarchy of diseases cause-and-effect relationships. Integrative approach to the patient’s condition assessment, whose comorbidity index increases with aging, is of great practical importance, since it allows the practitioner to choose the best drug therapy strategy and to objectively assess the risk of adverse cardiovascular events. Cardiovascular diseases, including those associated with bronchopulmonary system diseases, occupy leading position in mortality rate. One of the most common combinations in clinical practice is a combination of heart failure and chronic obstructive pulmonary disease. Their pathogenetic relationship may be due to common for diseases neurohumoral imbalance. The review presents data on the prevalence and mortality of patients with congestive heart failure and chronic obstructive pulmonary disease, describes the importance of autonomic nervous system dysfunction assessment in cardiovascular and bronchopulmonary diseases combination. Data on the heart rate variability assessment informativeness from the perspective of the clinical characteristics determination relevance and prognosis in patients with congestive heart failure and chronic obstructive pulmonary disease are presented. The main assessed time-domain and spectral parameters are narrated. The results of the heart rate variability parameters study in multicenter clinical trials in patients groups with heart failure and bronchopulmonary obstruction, which define the clinical and prognostic predictors among the heart rate variability parameters, are presented. In general, information on heart rate variability in congestive heart failure in comorbidity with chronic obstructive pulmonary disease is scantily presented in the available literature.