Restoration of heart rate turbulence by titrated beta-blocker therapy in patients with advanced congestive heart failure

Positive correlation with enhanced vagal modulation of heart rate

Lian Yu Lin, Juey Jen Hwang, Ling Ping Lai, Hsiao Lung Chan, Chao Cheng Du, Yung Zu Tseng, Jiunn Lee Lin

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Introduction: Heart rate turbulence (HRT) is a powerful novel predictor for cardiovascular mortality. Chronic congestive heart failure is associated with abnormal HRT. Whether antiadrenergic beta-blocker therapy can restore control of HRT in patients with chronic congestive heart failure is unknown. Methods and Results: A 24-hour Holter ECG recording was obtained before and 1 and 3 months after titrated addition of atenolol therapy in 10 consecutive patients with advanced congestive heart failure. Two parameters derived from HRT, turbulence slope (TS) and turbulence onset (TO), and time- and frequency-domain heart rate variability (HRV) parameters (SDNN, RMSSD, VLF, LF, HF) from 24-hour ECG were compared before and after beta-blocker therapy, together with the same parameters in age-matched normal control. Results showed that TS (3.1 ± 2.2 vs 6.2 ± 3.0; P = 0.001) and all HRV parameters were increased after 3 months of atenolol treatment. No changes in TO were evident (0.6 ± 0.5 vs -0.2 ± 1.3; P = 0.13). The improvement of TS and the vagally mediated parameters of mean R-R interval, RMSSD, and the HF component of HRV were positively correlated. Conclusion: Abnormal HRT caused by chronic congestive heart failure can be restored by beta-blocker therapy. The evolution of TS was positively correlated with measures of vagal modulation of heart rate.

Original languageEnglish
Pages (from-to)752-756
Number of pages5
JournalJournal of Cardiovascular Electrophysiology
Volume15
Issue number7
DOIs
Publication statusPublished - Jul 1 2004
Externally publishedYes

Fingerprint

Heart Failure
Heart Rate
Atenolol
Therapeutics
Electrocardiography
Adrenergic Antagonists
Mortality

Keywords

  • Beta-blocker
  • Congestive heart failure
  • Heart rate turbulence
  • Heart rate variability

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Restoration of heart rate turbulence by titrated beta-blocker therapy in patients with advanced congestive heart failure : Positive correlation with enhanced vagal modulation of heart rate. / Lin, Lian Yu; Hwang, Juey Jen; Lai, Ling Ping; Chan, Hsiao Lung; Du, Chao Cheng; Tseng, Yung Zu; Lin, Jiunn Lee.

In: Journal of Cardiovascular Electrophysiology, Vol. 15, No. 7, 01.07.2004, p. 752-756.

Research output: Contribution to journalArticle

@article{95abb1174ba645cda25f63a1718f0fa8,
title = "Restoration of heart rate turbulence by titrated beta-blocker therapy in patients with advanced congestive heart failure: Positive correlation with enhanced vagal modulation of heart rate",
abstract = "Introduction: Heart rate turbulence (HRT) is a powerful novel predictor for cardiovascular mortality. Chronic congestive heart failure is associated with abnormal HRT. Whether antiadrenergic beta-blocker therapy can restore control of HRT in patients with chronic congestive heart failure is unknown. Methods and Results: A 24-hour Holter ECG recording was obtained before and 1 and 3 months after titrated addition of atenolol therapy in 10 consecutive patients with advanced congestive heart failure. Two parameters derived from HRT, turbulence slope (TS) and turbulence onset (TO), and time- and frequency-domain heart rate variability (HRV) parameters (SDNN, RMSSD, VLF, LF, HF) from 24-hour ECG were compared before and after beta-blocker therapy, together with the same parameters in age-matched normal control. Results showed that TS (3.1 ± 2.2 vs 6.2 ± 3.0; P = 0.001) and all HRV parameters were increased after 3 months of atenolol treatment. No changes in TO were evident (0.6 ± 0.5 vs -0.2 ± 1.3; P = 0.13). The improvement of TS and the vagally mediated parameters of mean R-R interval, RMSSD, and the HF component of HRV were positively correlated. Conclusion: Abnormal HRT caused by chronic congestive heart failure can be restored by beta-blocker therapy. The evolution of TS was positively correlated with measures of vagal modulation of heart rate.",
keywords = "Beta-blocker, Congestive heart failure, Heart rate turbulence, Heart rate variability",
author = "Lin, {Lian Yu} and Hwang, {Juey Jen} and Lai, {Ling Ping} and Chan, {Hsiao Lung} and Du, {Chao Cheng} and Tseng, {Yung Zu} and Lin, {Jiunn Lee}",
year = "2004",
month = "7",
day = "1",
doi = "10.1046/j.1540-8167.2004.03289.x",
language = "English",
volume = "15",
pages = "752--756",
journal = "Journal of Cardiovascular Electrophysiology",
issn = "1045-3873",
publisher = "Wiley-Blackwell",
number = "7",

}

TY - JOUR

T1 - Restoration of heart rate turbulence by titrated beta-blocker therapy in patients with advanced congestive heart failure

T2 - Positive correlation with enhanced vagal modulation of heart rate

AU - Lin, Lian Yu

AU - Hwang, Juey Jen

AU - Lai, Ling Ping

AU - Chan, Hsiao Lung

AU - Du, Chao Cheng

AU - Tseng, Yung Zu

AU - Lin, Jiunn Lee

PY - 2004/7/1

Y1 - 2004/7/1

N2 - Introduction: Heart rate turbulence (HRT) is a powerful novel predictor for cardiovascular mortality. Chronic congestive heart failure is associated with abnormal HRT. Whether antiadrenergic beta-blocker therapy can restore control of HRT in patients with chronic congestive heart failure is unknown. Methods and Results: A 24-hour Holter ECG recording was obtained before and 1 and 3 months after titrated addition of atenolol therapy in 10 consecutive patients with advanced congestive heart failure. Two parameters derived from HRT, turbulence slope (TS) and turbulence onset (TO), and time- and frequency-domain heart rate variability (HRV) parameters (SDNN, RMSSD, VLF, LF, HF) from 24-hour ECG were compared before and after beta-blocker therapy, together with the same parameters in age-matched normal control. Results showed that TS (3.1 ± 2.2 vs 6.2 ± 3.0; P = 0.001) and all HRV parameters were increased after 3 months of atenolol treatment. No changes in TO were evident (0.6 ± 0.5 vs -0.2 ± 1.3; P = 0.13). The improvement of TS and the vagally mediated parameters of mean R-R interval, RMSSD, and the HF component of HRV were positively correlated. Conclusion: Abnormal HRT caused by chronic congestive heart failure can be restored by beta-blocker therapy. The evolution of TS was positively correlated with measures of vagal modulation of heart rate.

AB - Introduction: Heart rate turbulence (HRT) is a powerful novel predictor for cardiovascular mortality. Chronic congestive heart failure is associated with abnormal HRT. Whether antiadrenergic beta-blocker therapy can restore control of HRT in patients with chronic congestive heart failure is unknown. Methods and Results: A 24-hour Holter ECG recording was obtained before and 1 and 3 months after titrated addition of atenolol therapy in 10 consecutive patients with advanced congestive heart failure. Two parameters derived from HRT, turbulence slope (TS) and turbulence onset (TO), and time- and frequency-domain heart rate variability (HRV) parameters (SDNN, RMSSD, VLF, LF, HF) from 24-hour ECG were compared before and after beta-blocker therapy, together with the same parameters in age-matched normal control. Results showed that TS (3.1 ± 2.2 vs 6.2 ± 3.0; P = 0.001) and all HRV parameters were increased after 3 months of atenolol treatment. No changes in TO were evident (0.6 ± 0.5 vs -0.2 ± 1.3; P = 0.13). The improvement of TS and the vagally mediated parameters of mean R-R interval, RMSSD, and the HF component of HRV were positively correlated. Conclusion: Abnormal HRT caused by chronic congestive heart failure can be restored by beta-blocker therapy. The evolution of TS was positively correlated with measures of vagal modulation of heart rate.

KW - Beta-blocker

KW - Congestive heart failure

KW - Heart rate turbulence

KW - Heart rate variability

UR - http://www.scopus.com/inward/record.url?scp=3242667725&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=3242667725&partnerID=8YFLogxK

U2 - 10.1046/j.1540-8167.2004.03289.x

DO - 10.1046/j.1540-8167.2004.03289.x

M3 - Article

VL - 15

SP - 752

EP - 756

JO - Journal of Cardiovascular Electrophysiology

JF - Journal of Cardiovascular Electrophysiology

SN - 1045-3873

IS - 7

ER -