Key result
The short-term scaling component of heart rate variability was significantly reduced in asymptomatic relatives with left ventricular enlargement (1.15) compared with controls (1.32) (P=0.01).
Why the study?
Does the short-term scaling component of heart rate variability differ between asymptomatic relatives of DCM patients with left ventricular enlargement, DCM patients, and normal controls?
Observational (n=60)
Does the short-term scaling component of heart rate variability differ between asymptomatic relatives of DCM patients with left ventricular enlargement, DCM patients, and normal controls?
Absolute Event Rate: 1.15% vs 1.32%
p-value: p=0.01
The short-term scaling component of heart rate variability is reduced in asymptomatic relatives of dilated cardiomyopathy patients with left ventricular enlargement, suggesting it may serve as an early marker of autonomic dysfunction or disease progression.
May flag early autonomic changes in DCM relatives; hypothesis-generating and should not yet change practice.
BACKGROUND AND AIM: asymptomatic relatives of patients with familial dilated cardiomyopathy who have left ventricular enlargement [LVE] are at risk for progression to dilated cardiomyopathy. A novel index of the fractal correlation properties of heart rate variability (HRV), the short-term scaling component (proportional, variant(1)) in detrended fluctuation analysis, is a promising prognostic tool in left ventricular dysfunction. The aim of this study was to compare values of proportional, variant(1) and conventional HRV indices in LVE relatives with dilated cardiomyopathy patients and normal controls. METHODS: time-domain and spectral HRV measures, and the short-term scaling component ( proportional, variant(1)) were assessed from 24-h Holter recordings from 22 LVE relatives (left ventricular end-diastolic dimension >112% predicted, normal fractional shortening), 24 dilated cardiomyopathy patients and 14 controls. RESULTS: the time domain index SDNN was lower in dilated cardiomyopathy patients [101.8(+/-44.0)] than in LVE relatives [161.7(+/-53.9)] or controls [152.9(+/-51.4)], P=0.01. Similarly, triangular index and spectral measures were reduced in dilated cardiomyopathy patients but not in LVE relatives or controls. In contrast, the short term scaling component ( proportional, variant(1)) in detrended fluctuation analysis was reduced in both dilated cardiomyopathy patients [1.06(+/-0.33)] and in LVE relatives [1.15 (+/-0.20)], compared with controls [1.32(+/-0.16)], P=0.01. Among DCM patients the short-term scaling component ( proportional, variant(1)) was significantly associated with echocardiographic deterioration during follow-up (3.7+/-2.1 year) (P=0.004). CONCLUSION: the short-term scaling component ( proportional, variant(1)) is reduced in asymptomatic relatives of dilated cardiomyopathy patients who have LVE.
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Mahon et al. (2002) conducted an observational in Dilated cardiomyopathy and left ventricular enlargement (n=60). Left ventricular enlargement in asymptomatic relatives of DCM patients vs. Normal controls was evaluated on Short-term scaling component (proportional, variant(1)) in detrended fluctuation analysis (p=0.01). The short-term scaling component of heart rate variability was significantly reduced in asymptomatic relatives with left ventricular enlargement (1.15) compared with controls (1.32) (P=0.01).
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