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5Ô¨ÀλÑÖ¿œ»ÔœÒ®¨µÑ¦Ñ»Î±œÀ¶ÑÒѸ¨Ó¨¿ÑÒ¨LF

iHF¨Ó¿ÑÁœÒœ¶Òο§Ñ¸¨ÓÎÔÑÒ¨§µœÃ¨Ò¨®Ñ§Ñ LF

normHF normÎÃÒÎÀLFiHF LF/HF) iTot Power Total Power5¶»¶ÉÒÑÀÒѲÑÀɜ»Ê¿Ñ ¦Ñ¾œ¸Ñ

TABELA 1.ƲǑǢǑǞǗǤǢǚǑǟǑǝǚǙǗǣǡǗǜǤǢǑǓǑǢǚǹǑǒǚǝǟǠǣǤǚǦǢǗǜǓǗǟ ǨǚǹǗǢǑǖǑǣǢǨǑǚǣǡǚǤǚǓǑǟǚǥǠǓǠǞǢǑǖǥ

TABLE 1. Heart rate variability parameters analysed in this study.

ƲǑǢǑǞǗǤǑǢ

Parameter

Ʊǡǚǣ

Description

ƱǡǣǗǔ

Range

VLF (ms2₎ ƤǑǢǚǹǑǟǣǑǥVLFǠǡǣǗǔǥ

Variance in VLF range

LF (ms2₎ ƤǑǢǚǹǑǟǣǑǥLFǠǡǣǗǔǥ

Variance in LF range

LF norm (nu)

LFǥǟǠǢǞǑǝǚǙǠǓǑǟǚǞǹǗǖǚǟǚǨǑǞǑ

LF ǥǜǥǡǟǑǓǑǢǚǹǑǟǣǑVLFv

LF in normalised units = LF/ (total variance - VLF) v 100

HF (ms2₎ ƤǑǢǚǹǑǟǣǑǥHFǠǡǣǗǔǥ

Variance in HF range

HF norm (nu)

HFǥǟǠǢǞǑǝǚǙǠǓǑǟǚǞǹǗǖǚǟǚǨǑǞǑ

=HF ǥǜǥǡǟǑǓǑǢǚǹǑǟǣǑVLFv

HF in normalised units = HF/ (total variance - VLF) v 100

LF/HF LF [ms2_{] / HF [ms}2_]

VLF – ǓǢǝǠǟǚǣǜǑǦǢǗǜǓǗǟǨǚǹǑLF=ǟǚǣǜǑǦǢǗǜǓǗǟǨǚǹǑLF norm –

ǟǚǣǜǑ ǦǢǗǜǓǗǟǨǚǹǑ ǥ ǟǠǢǞǑǝǚǙǠǓǑǟǚǞ ǹǗǖǚǟǚǨǑǞǑHF – visoka

ǦǢǗǜǓǗǟǨǚǹǑHF norm=ǓǚǣǠǜǑǦǢǗǜǓǗǟǨǚǹǑǥǟǠǢǞǑǝǚǙǠǓǑǟǚǞǹǗ

dinicama; LF/HF–ǠǖǟǠǣǟǚǣǜǗǚǓǚǣǠǜǗǦǢǗǜǓǗǟǨǚǹǗ

VLF – very low frequency; LF – low frequency; LF norm – low nor-malised frequency; HF – high frequency; HF norm – high nornor-malised frequency; LF/HF – low/high frequency ratio

TABELA 2.ƧǗǞǠǔǢǑǦǣǜǗǠǣǠǒǚǟǗǚǣǡǚǤǑǟǚǜǑ

TABLE 2. Demographic characteristics of study group.

ƱǖǝǚǜǗ

Characteristics

ƪǖǢǑǓǚǚǣǡǚǤǑǟǚǨǚ

Healthy controls

ƣǠǝǗǣǟǚǨǚ

Patients

ƣǢǠǹ

Number

ƲǠǝ ǞǥǪǜǚǘǗǟǣǜǚ

Gender (male/female)

ƴǤǑǢǠǣǤ ǔǠǖǚǟǗ

Age (years) j j

ƫǟǖǗǜǣǤǗǝǗǣǟǗǞǑǣǗ ƫƵƯkg/m2₎

Body mass index (BMI; kg/m2₎

j j

яѶҁѶнѥѶнёјҁѼџѡҁѪҁѴѼѪҁѶҁјҁ

ŜӶ¸ÊÑʨ À¶ ¨Ó¿ÑÁœÒ¨ »ÑÎ À¿œÃ Ñ Ô¿œÃÒÎÀÊ ¨ ÀÊÑÒÃÑ¿ÃÒÑÜԨµÑ®¨µÑÆçœÊÎÃÑÑÒѸ¨Ê¨´»œÀÊÑʨ Àʨ»œ¶¿ÑöÀ¶»Î¿¨¼¤œÒ¨§œÊÎè¨ÃœÒʨ֨»Ñ®¨ µœœ§É¨¿¨µÀ»¨ª¿ÑÀÉÎܸѨ§œÊÎèÓÑɿޜҶÓÒÑ

´ÑµÒÎÀʨ¿ÑÓ¸¨»œ³Ê¶ÃœÒÊÎÔtʜÀʨµœÃÒÎÖÑ»Êο

À»ÑÒ¶§œ¿¨´»ÑÑÒѸ¨ÓÑÔÑ¿¨µÑÒÀœ ANOVA°ÑÉ¿Î

®œÒ¶ÓÒѴѵÒÎÀʨÉÎԜÓÑÒÎÀʨ»Î¿¨¼¤œÒµœÇ¨¿ÀÎ ÒÎÔ Pearson»ÎœÖ¨®¨µœÒʸ¨ÒœÑ¿Òœ»Î¿œ¸Ñ®¨µœËœ

ÊÎèÉѿѧœÊ¿¨µÀ»œÀÊÑʨÀʨ´»œÑÒѸ¨ÓœÉ¿¨§œ ¨ ÔÑÒ¨À¶¶¨ÀɨʨÔÑ ¶º³Äʜ»ÉÎÀ¸œ¸Î²Ñ¿¨ÊѧÀ»œ Ê¿ÑÒÀÖο§Ñ®¨µœÉÎÃÑÊÑ»Ñ

REZULTATI

ќѕн҅нёјҁѼџЪѕЪѧђҁнѥѴнѶҁ҅нјҁ

ÀɨÊÑÒ¨®¨»ÎÒʿθҜ²¿¶Éœ¨¾Î¸œÀÒ¨®¨À¨Ò À¶Ö¨®¨µœÒ®¨µÎ§ ¿ÑÃÑ À¿®Ñ ¾¨¸¨ À¶ À¸¨´Òœ ÉθҜ ÀÊ¿¶»Ê¶¿œÉ¿¨¾¸¨ÁÒΨÀʨª²ÎèÒѨ¨ÒÜ»ÀÑʜ¸œ

ÀҜ§ÑÀœ BMI ¦Ñ¾œ¸Ñ½¸¨Ò¨´»¨ÉÎÃÑ®¨Î¾Î¸œ

ÆèÀɨʨÔÑÒ¨ª¾Î¸œÀÒ¨»Ñ»Îà µœÃ¨ µÑ²ÒÎÀʨ»ÎÔÑÒÑ Ã¨¸ÑÊÑ®¨ÎÒÑ »Ñ¿Ã¨Î§¨ÎÉÑʨµÑ Ñ »ÎÃÎÀÊѸѾθœÀÒ¨»Ñ ¨Àªœ§¨µÀ»Ñ»Ñ¿Ã¨Î §¨ÎÉÑʨµÑÆèÀɨʨÔÑÒ¨ª¾Î¸œÀÒ¨»Ñ¾Î¸œÀÒ¨» µœÉ¿œ¸œÁÑΨÒÖÑ¿»Ê§¨Î»Ñ¿ÃÑÑοÊλοΠÒÑ¿ÒÎÉ¿œ§Î¼¤œ œ¶¿Ñ±œÒ圻ÎüœÀʾθœÀÒ¨»Ñ ѿʜ¿¨µÀ»Ñª¨Éœ¿ÊœÒÓ¨µÑµœ¶ÊÔ¿±œÒÑ»Îà ¾Î¸œÀÒ¨»Ñ ÑèµÑ¾œÊœÀ§œ¸¨Ê¶ÀʨɻÎà ¾Î¸œÀÒ¨»Ñ Ç¿ÎÀœ´ÒÎÔ¿œ§œÉÎɶ¼ÊÑ Ñ¿Ñ ÃÑÀ¿®Ñ¾¨¸ÎµœÎ»Î´œÊ¨¿¨²ÎèҜ P§œÀœ ®¨£Ê¿œÒ¶Ê»¶»ÑÃѵœ¿Ñ±œÒΨÀɨʨÔÑ œ¾Î¸œÀÒ¨ ®¨À¶¾¨¸¨ÀÊѾ¨¸Òβ»¸¨Ò¨´»Î²ÀÊѠѾθœÀÒ¨

»ÑÉ¿¨ÉÑÃѸ圻¸ÑÀ¨NYHA I»¸ÑÀ¨NYHA II, 14

»¸ÑÀ¨NYHA IIIÑÜԜʻ¸ÑÀ¨NYHA IVÇ¿ÎÀœ´ÒÑ

TABELA 3.ƭǝǚǟǚǩǜǗǠǣǠǒǚǟǗǚǣǡǚǤǚǓǑǟǚǧǒǠǝǗǣǟǚǜǑ

TABLE 3. _{Clinical characteristics of study group.} ƭǝǚǟǚǩǜǗǠǣǠǒǚǟǗ

Clinical characteristics

ƣǠǝǗǣǟǚǨǚ n=63) Patients (n=63)

ƧǚǝǑǤǑǨǚǠǟǑǜǑǢǖǚǠǞǚǠǡǑǤǚǹǑ

Dilated cardiomyopathy

ƫǣǧǗǞǚǹǣǜǑǜǑǢǖǚǠǞǚǠǡǑǤǚǹǑ

Ischaemic cardiomyopathy

ƲǢǗǝǗǘǑǟǚǟǦǑǢǜǤǞǚǠǜǑǢǖǑ

Previous myocardial infarction

ƢǢǤǗǢǚǹǣǜǑǧǚǡǗǢǤǗǟǙǚǹǑ

Arterial hypertension

Ƣƭƣƥ

CABG

DM2

ƵǢǑǹǑǻǗǡǠǡǥǪǤǑǻǑǢǑǖǑǣǢǨǑ ǞǗǣǗǨǚ

Heart failure duration (months) j

NYHA I/II/III/IV

ƨǧǠǜǑǢǖǚǠǔǢǑǦǣǜǑ

studija

Echocardiograph

ƨƷƮƭ

LVEF j

EDD (mm) j

ESD (mm) j

ƵǗǢǑǡǚǹǑ

Therapy

ƧǚǔǠǜǣǚǟ

Digoxin

ƧǚǥǢǗǤǚǜ

Diuretic

ACEǚǟǧǚǒǚǤǠǢ

ACE inhibitor

ƣǗǤǑǒǝǠǜǑǤǠǢ

Beta-blocker

Ƣƭƣƥ=ǑǠǢǤǠǜǠǢǠǟǑǢǟǚǒǑǹǡǑǣǔǢǑǦǤ ǑǠǢǤǠǜǠǢǠǟǑǢǟǠǡǢǗǞǠǪǼǗ ǻǗDM2=ǖǚǹǑǒǗǤǗǣǞǗǝǚǤǥǣǤǚǡNYHA=ǜǝǑǣǚǦǚǜǑǨǚǹǑǡǢǗǞǑ

New York Heart AssociationƨƷƮƭ=ǗǹǗǜǨǚǠǟǑǦǢǑǜǨǚǹǑǝǗǓǗǜǠǞǠǢǗ

EDD=ǖǚǞǗǟǙǚǹǑǝǗǓǗǜǠǞǠǢǗǟǑǜǢǑǹǥǖǚǹǑǣǤǠǝǗESD=ǖǚǞǗǟǙǚǹǑ ǝǗǓǗǜǠǞǠǢǗǟǑǜǢǑǹǥǣǚǣǤǠǝǗ

CABG – coronary artery bypass surgery; DM2 – diabetes mellitus type 2; NYHA – New York Heart Association; LVEF – left ventricle ejection frac-tion; EDD – end-diastolic dimension; ESD – end-systolic dimension

œµœ»®¨ÎÒÑÖ¿Ñ»®¨µÑ¸œÔœ»Î§Î¿œ»ÎèÀɨÊÑÒ¨»Ñ¾¨ ¸ÑµœÍθœÀÒ¨®¨À¶¾¨¸¨¸œ´œÒ¨ÀÊÑÒÃÑ¿ÃÒ¨§ ¸œ»ÎÔ¨§ÑÉ¿ÎʨÔÉÎɶ¼ÊÑ Ñ¿ÑÃÑÀ¿®Ñ¾Î¸œÀÒ¨ »Ñ À¶É¿¨§Ñ¸Ñ貨ÊѸ¨À¾Î¸œÀÒ¨»Ñ

趿œÊ¨» ACE¨Òª¨¾¨ÊÎ¿Ñ ¾¸Î»Ñ

Êο¾œÊÑÑÿœÒœ¿²¨´»¨ª¿œ®œÉÊοÑ

їҁѡнђҁџнѕ҅ѼѥѶґѡЪјҎЪ҅чнђЪѡҁѪҁѥѡчҁјѼѪ ҍѪѡҁҎнснѥѴнѶҁ҅нјҁнџѼѕЪѥ҅нјҁѥ

н҅ѥѓґнчнђЪ҅чнђѼмѡҁѪҁѥѡчҁ

£»¶ÉÒÑÀÒѲÑÀɜ»Ê¿Ñ¨Ô¿œÃÒÎÀʨÀÔÑ»œ¨ÀɨÊÑ Òœ»Î§ÉÎҜÒʜÀɜ»Ê¿ÑÀ¶¾¨¸œÀÊÑʨÀʨ´»¨ÓÒѴѵ ÒΧѠœ»ÎþθœÀÒ¨»ÑÀ¨ÒÀ¶Ö¨®¨µœÒ®¨µÎ§¿ÑÃÑÀ¿

®Ñ¶ÎÃÒÎÀ¶ÒÑÓÿÑԜ¨ÀɨÊÑÒ¨»œVLF pLF,

HFiTot Power pÆÃÒÎÀLF/HFµœ¾¨ÎԜ¤¨Ñ

Ô¿œÃÒÎÀʨLF normiHF normÀ¶¾¨¸œ§Ñ œ¶²¿¶É¨

ξθœ¸¨ª¨ÀɨÊÑÒ¨»Ñ¶ÎÃÒÎÀ¶ÒÑÓÿÑԜѸ¨ÎԜ¿Ñ Ó¸¨»œÒ¨À¶¾¨¸œÀÊÑʨÀʨ´»¨ÓÒѴѵҜ ¦Ñ¾œ¸Ñ

ѯѪ҅ѼѥҎҁѡнђҁџнѕ҅ѼѥѶнґѡЪјҎЪ҅чнђЪѡҁѪҁѥѡчҁн

NYHAґѓ҅јчнѼ҅ҁѕ҅ЪјѕҁѥЪјѼѪџѼѕЪѥ҅нјҁѥ

н҅ѥѓґнчнђЪ҅чнђѼмѡҁѪҁѥѡчҁ

Ó§œ±¶ º³Ä ¨NYHA Ö¶Ò»®¨ÎÒѸҜ »¸ÑÀœ »ÎÃ

¾Î¸œÀÒ¨»ÑÀÉÎɶ¼ÊÑ œ§¿ÑÃÑÀ¿®Ñ¶ÊÔ¿±œÒѵœÓÒÑ

´ÑµÒÑÉÎԜÓÑÒÎÀÊÀÉÎԜ¤Ñ œ§NYHA»¸ÑÀœº³ÄÀœ

À§Ñ ¶µœ³ÊÑʨÀʨ´»¨ÓÒѴѵÒѻοœ¸Ñ®¨µÑÀ¶É¿ÎÊ

ÒβÀ§œ¿Ñ¶ÊÔ¿±œÒѵœ¨Ó§œ±¶NYHA»¸ÑÀœ¨Éѿѧœ

ÊÑ¿ÑVLF,LFiTot Power p½Î¿œ¸Ñ®¨µÑ¨Ó§œ

±¶NYHA»¸ÑÀœ¨LF norm¾¨¸Ñµœ¨ÀÉÎÃÒ¨ÔÎÑÀÊÑʨ

Àʨ´»œÓÒѴѵÒÎÀʨ ¦Ñ¾œ¸Ñ

TABELA 4.ƲǠǢǗdzǗǻǗǓǑǢǚǹǑǒǚǝǟǠǣǤǚǦǢǗǜǓǗǟǨǚǹǗǢǑǖǑǣǢǨǑǙǖǢǑǓǚǧǚǣǡǚǤǑǟǚǜǑǚǒǠǝǗǣǟǚǜǑ

TABLE 4. _{Comparison of heart rate variability between healthy controls and patients.} ƲǑǢǑǞǗǤǑǢ

Parameter

ƪǖǢǑǓǚǚǣǡǚǤǑǟǚǨǚ

Healthy controls

ƣǠǝǗǣǟǚǨǚ

Patients p

ƷǢǗǜǓǗǟǨǚǹǑǢǑǖǑǣǢǨǑ ǠǤǜǥǨǑǹǞǚǟǥǤ

Heart rate (beat/minute) j j

VLF (ms2_{) j j}

LF (ms2_{) j j}

HF (ms2_{) j j}

LF/HF j j

Tot Power (ms2_{) j j}

LF norm (nu) j j

HF norm (nu) j j

Tot Power=ǥǜǥǡǟǑǣǟǑǔǑǣǡǗǜǤǢǑ

Tot Power – total power

TABELA 5.ƭǠǢǗǝǑǨǚǹǑNYHAǦǥǟǜǨǚǠǟǑǝǟǗǜǝǑǣǗǚǓǑǢǚǹǑǒǚǝǟǠ ǣǤǚǦǢǗǜǓǗǟǨǚǹǗǢǑǖǑǣǢǨǑǜǠǖǚǣǡǚǤǚǓǑǟǚǧǒǠǝǗǣǟǚǜǑ

TABLE 5. _{Correlation between NYHA functional class and heart rate}

variability in study group.

ƲǑǢǑǞǗǤǑǢ

Parameter r p

VLF

LF

HF

LF/HF

Tot Power

LF norm

ѱѡѼмЪ҅ҁҎҁѡнђҁџнѕ҅ѼѥѶнґѡЪјҎЪ҅чнђЪѡҁѪҁѥѡчҁѥ ѴѡѼюѡЪѥнђѼмн҅ѥѓґнчнђЪ҅чнђЪѡҁѪҁѥѡчҁ

ŜӶ¸ÊÑʨ Éœ Ñ º³Ä »Îà ÓÿÑÔ¨ª ¨ÀɨÊÑ Ò¨»Ñ ¨ ¾Î¸œÀÒ¨»Ñ ¿ÑÀÉœÒ¨ª ÉÎNYHA Ö¶Ò»

®¨ÎÒѸҨ§»¸ÑÀÑ§Ñ NYHA IÉ¿œ§ÑNYHA IIÉ¿œ§Ñ

NYHA IIIÉ¿œ§ÑNYHA IVÉ¿¨»ÑÓÑÒ¨À¶ÒѲ¿ÑÖ¨

»ÎÒ¨§Ñ¨°ÑÀԜԿœÃÒÎÀʨ¨ÀɨʨÔÑÒ¨ªÉѿѧœ

ÊѿѺ³ÄÎÀ¨§LF/HF¶Î´ÑÔÑÀœÊ¿œÒÃÉÑÃÑÀÒÑÉ¿œ

ÃÎÔÑ œ§ÉÎɶ¼ÊÑ Ñ¿ÑÃÑÀ¿®ÑÃλLF/HFÉλÑÓ¶µœ

Ê¿œÒÃÉοÑÀÊÑÀÉÎԜ¤Ñ œ§NYHA»¸ÑÀœÇœ œ

º³Ä»ÎÃÓÿÑÔ¨ª¨ÀɨÊÑÒ¨»Ñ¨¾Î¸œÀÒ¨»Ñ¿ÑÀÉοœ

±œÒ¨ªÉ¿œ§ÑNYHAÖ¶Ò»®¨ÎÒѸҨ§»¸ÑÀѧÑÑÒѸ¨

ÓΧÔÑ¿¨µÑÒÀœ ANOVAÉλÑÓѸεœÀÊÑʨÀʨ´»¨Ô¨

ÀλÎÓÒѴѵҜ¿ÑÓ¸¨»œ ¦Ñ¾œ¸Ñº¿œÃÒÎÀʨVLFÀœ

ÀÊÑʨÀʨ´»¨ÓÒѴѵÒοÑÓ¸¨»¶µ¶¨Ó§œ±¶ÓÿÑÔ¨ª¨À

ɨÊÑÒ¨»Ñ¨¾Î¸œÀÒ¨»ÑÖ¶Ò»®¨ÎÒѸҨª»¸ÑÀÑNYHA

III p¨NYHA IV p»ÑΨ¨Ó§œ±¶¾Î

¸œÀÒ¨»ÑÖ¶Ò»®¨ÎÒѸҨª»¸ÑÀÑNYHA IiNYHA IV

GRAFIKON 1.ƤǑǢǚǹǑǒǚǝǟǠǣǤǦǢǗǜǓǗǟǨǚǹǗǢǑǖǑǣǢǨǑǜǠǖǙǖǢǑǓǚǧǚǣǡǚǤǑǟǚǜǑǚǒǠǝǗǣǟǚǜǑǢǑǣǡǠǢǗdzǗǟǚǧǡǠNYHAǦǥǟǜǨǚǠǟǑǝǟǚǞǜǝǑǣǑǞǑ

GRAPH 1. Heart rate variability in healthy controls and heart failure patients classified in NYHA functional classes.

VLF=ǓǢǝǠǟǚǣǜǑǦǢǗǜǓǗǟǨǚǹǑLF=ǟǚǣǜǑǦǢǗǜǓǗǟǨǚǹǑHF=ǓǚǣǠǜǑǦǢǗǜǓǗǟǨǚǹǑTot Power=ǥǜǥǡǟǑǣǟǑǔǑǣǡǗǜǤǢǑ

VLF – very low frequency; LF – low frequency; HF – high frequency; Tot Power – total power

GRAFIKON 2.ƱǖǟǠǣǟǚǣǜǗǚǓǚǣǠǜǗǦǢǗǜǓǗǟǨǚǹǗǜǠǖǙǖǢǑǓǚǧǚǣǡǚǤǑǟǚǜǑǚǒǠǝǗǣǟǚǜǑǢǑǣǡǠǢǗdzǗǟǚǧǡǠNYHAǦǥǟǜǨǚǠǟǑǝǟǚǞǜǝǑǣǑǞǑ

GRAPH 2. Low/high frequency ratio in healthy controls and heart failure patients classified in NYHA functional classes.

0 200 400 600 800 1000 1200 1400 1600 1800 2000

NYHA I NYHA II NYHA III NYHA IV

VLF

LF

HF

Tot Power

ms2

Здрави испитаници Healthy subjects

Healthy subjects

NYHA I NYHA II NYHA III NYHA IV

LF/HF

pNYHA IIiNYHA III pNYHA II iNYHA IV p³ÊÑʨÀʨ´»¨ÓÒѴѵÒοÑÓ¸¨

´¨ÊœÔ¿œÃÒÎÀʨLF¶ÊÔ¿±œÒœÀ¶¨Ó§œ±¶ÓÿÑÔ¨ª¨À

ɨÊÑÒ¨»Ñ¨¾Î¸œÀÒ¨»ÑÖ¶Ò»®¨ÎÒѸҜ»¸ÑÀœNYHA

I pNYHA II pNYHA III p¨

NYHA IV p»ÑΨ¨Ó§œ±¶¾Î¸œÀÒ¨»ÑÖ¶Ò»®¨

ÎÒѸҨª»¸ÑÀÑNYHA IiNYHA III pNYHA I

iNYHA IV pNYHA IIiNYHA III p NYHA IIiNYHA IV pº¿œÃÒÎÀʨHFÀ¶Àœ

ÀÊÑʨÀʨ´»¨ÓÒѴѵÒοÑÓ¸¨»ÎÔѸœ¨Ó§œ±¶ÓÿÑÔ¨ª

¨ÀɨÊÑÒ¨»Ñ¨¾Î¸œÀÒ¨»ÑÖ¶Ò»®¨ÎÒѸҜ»¸ÑÀœNYHA

I pNYHA II pNYHA III p¨

NYHA IV p»ÑΨ¨Ó§œ±¶¾Î¸œÀÒ¨»ÑÖ¶Ò»

®¨ÎÒѸҨª»¸ÑÀÑNYHA I iNYHA III pʜ

NYHA IIiNYHA III p³ÊÑʨÀʨ´»¨ÓÒѴѵÒÎ

¿ÑÓ¸¨´¨ÊœÔ¿œÃÒÎÀʨTot Power ms2_{ÓѾœ¸œÁœÒœÀ¶}

¨Ó§œ±¶ÓÿÑÔ¨ª¨ÀɨÊÑÒ¨»Ñ¨¾Î¸œÀÒ¨»ÑÖ¶Ò»®¨Î

ÒѸҜ»¸ÑÀœNYHA II pNYHA III p¨

ÎÒѸҨª»¸ÑÀÑNYHA IiNYHA III pNYHA I iNYHA IV pNYHA IIiNYHA III p NYHA IIiNYHA IV p

Çœ œ ÎÃÒÎÀÑLF/HF ¾Î¸œÀÒ¨»Ñ ¿ÑÓ¸¨´¨Ê¨ª

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ÒѸҨª»¸ÑÀÑNYHA IIiNYHA IV p¨ÀÊÑʨ

Àʨ´»¨ÓÒѴѵҶ¿ÑÓ¸¨»¶¨Ó§œ±¶¾Î¸œÀÒ¨»ÑÖ¶Ò»®¨

ÎÒѸҨª»¸ÑÀÑNYHA IIIiNYHA IV p

їҁѡнђҁџнѕ҅ѼѥѶґѡЪјҎЪ҅чнђЪѡҁѪҁѥѡчҁн ЪсѼјҁѡѪнѼюѡҁґѥјнѴѡѼчЪаЪ҅ҁґѓ҅јчнђҁ

ѕЪҎЪјѼмѼѡЪ

º³Ä µœ ¶ »Î¿œ¸Ñ®¨µ¨ À œªÎ»Ñ¿Ã¨Î²¿ÑÖÀ»¨ É¿Î ®œ œÒΧֶһ®¨µÎ§¸œÔœ»Î§Î¿œ»ÎþθœÀÒ¨»ÑÀÑ ÉÎɶ¼ÊÑ œ§ ¿ÑÃÑ À¿®Ñ £ÊÔ¿±œÒÑ µœ ÀÊÑʨÀʨ´»¨ ÓÒѴѵÒѻοœ¸Ñ®¨µÑ¨Ó§œ±¶œµœ»®¨ÎҜֿѻ®¨µœ¸œ

Ԝ»Î§Î¿œ¨VLF pLF pHF p

iTot Power p ·¿ÑÖ¨»ÎÒ

TABELA 6.ƲǠǢǗdzǗǻǗǓǑǢǚǹǑǒǚǝǟǠǣǤǚǦǢǗǜǓǗǟǨǚǹǗǢǑǖǑǣǢǨǑǜǠǖǙǖǢǑǓǚǧǚǣǡǚǤǑǟǚǜǑǚǒǠǝǗǣǟǚǜǑǢǑǣǡǠǢǗdzǗǟǚǧǡǠNYHAǦǥǟǜǨǚǠǟǑǝ ǟǚǞǜǝǑǣǑǞǑ

TABLE 6. _{Comparison of heart rate variability of healthy controls and heart failure patients categorised in NYHA functional classes.}

ƲǑǢǑǞǗǤǑǢ

Parameter

ƪǖǢǑǓǚǚǣǡǚǤǑǟǚǨǚ

Healthy controls (n=14)

NYHA I (n=11)

NYHA II (n=29)

NYHA III (n=14)

NYHA IV

(n=9) p*

VLF (ms2_{) j j j j j}

LF (ms2_{) j j j j j}

HF (ms2_{) j j j j j}

LF/HF j j j j j

Tot Power (ms2_{) j j j j j}

LF norm (nu) j j j j j

HF norm (nu) j j j j j

*ANOVA=ǑǟǑǝǚǙǑǓǑǢǚǹǑǟǣǗ

*ANOVA – analysis of variance

GRAFIKON 3.ƲǠǓǗǙǑǟǠǣǤǗǹǗǜǨǚǠǟǗǦǢǑǜǨǚǹǗǚǓǗǠǞǑǟǚǣǜǗǦǢǗǜǓǗǟǨǚǹǗ AǟǚǣǜǗǦǢǗǜǓǗǟǨǚǹǗ BǓǚǣǠǜǗǦǢǗǜǓǗǟǨǚǹǗ CǚǥǜǥǡǟǗǣǟǑ ǔǗǣǡǗǜǤǢǑ DǜǠǖǚǣǡǚǤǚǓǑǟǚǧǒǠǝǗǣǟǚǜǑ

GRAPH 3. _{Correlation between ejection fraction and very low frequency (A), low frequency (B), high frequency (C), and total power (D) in study group.}

EF=ǗǹǗǜǨǚǠǟǑǦǢǑǜǨǚǹǑVLF=ǓǢǝǠǟǚǣǜǑǦǢǗǜǓǗǟǨǚǹǑLF=ǟǚǣǜǑǦǢǗǜǓǗǟǨǚǹǑHF=ǓǚǣǠǜǑǦǢǗǜǓǗǟǨǚǹǑTot Power=ǥǜǥǡǟǑǣǟǑǔǑǣǡǗǜǤǢǑ

EF – ejection fraction; VLF – very low frequency; LF – low frequency; HF – high frequency; Tot Power – total power

600 500 400 300 200 100 0 -100 80

70

60

50

40

30

20

10

0

80

70

60

50

40

30

20

10

0

80

70

60

50

40

30

20

10

0

80

70

60

50

40

30

20

10

0

1000 800 600 400 200 0 -200

400 300

200 100

0

-100 -1000 0 1000 2000 3000

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ABSTRACT

INTRODUCTION Autonomic regulation of cardiovascu-lar functions in congestive heart failure is characterised by enhanced sympathetic and diminished parasympathetic activ-ity. The long term predominance of sympathetic tone is a sig-nificant factor in arrhythmogenesis, sudden cardiac death, and progressive pump failure. Heart rate variability (HRV) is a non-invasive method for estimating the sympatho vagal balance in cardiovascular control.

AIM The aim of this study was to analyse the influence of heart failure severity on HRV.

METHOD HRV was estimated through the spectral analysis of short term ECG (Cardiovit AT 60, Schiller, CH) in 63 patients (78% male, mean age 56.9±10.9 years) and 14 healthy volunteers (57.1% male, mean age 53.1±8.2 years). The following spectral components were measured: VLF (very low frequency), LF (low frequency), HF (high frequency), and total power (Tot Power). RESULTS All spectral components were statistically, significant-ly lower in patients with heart failure in comparison to healthy controls (VLF: 159.89±147.02 vs. 285.50±202.77 ms2_{; p=0.023, LF:}

161.48±204.01 vs. 474.57±362.93 ms2_{; p<0.001, HF: 88.58±102.47}

vs. 362.71±318.28 ms2_{; p<0.001), as well as total power (Tot}

Power: 723.39±644.52 vs. 1807.29±1204.74 ms2_{; p<0.001). A}

sig-nificant, negative correlation between HRV parameters and NYHA class was detected in heart failure patients (VLF: r=-0.391; p=0.002, LF: r=-0.401; p=0.001, and Tot Power r=-0.372; p=0.003). Ejection fraction proved to be in significant, positive correlation to VLF (r=0.541; p=0.002), LF (r=0.531; p=0.003), HF (r=0.418; p=0.020), and Tot Power (r=0.457; p=0.013).

CONCLUSION Significant HRV reduction is a precursor to incipient heart failure (NYHA I). In heart failure progression, total power as well as the power of all spectral components is pro-gressively reduced. LF and Tot Power are the most prominent parameters for discriminating between the different stages of heart failure. These results could promote HRV as an important decision-making tool in heart failure treatment as well as in monitoring the results of that treatment.

Key words: heart failure; heart rate variability; spectral analysis

Danijela ZAMAKLAR-TRIFUNOVIĆ Institut za kardiovaskularne bolesti Klinički centar Srbije

Dr Koste Todorovića 8, 11000 Beograd Tel/faks: 011 361 4738

E-mail: hose@eunet.yu

INFLUENCE OF HEART FAILURE SEVERITY ON HEART RATE VARIABILITY

Danijela ZAMAKLAR-TRIFUNOVIĆ1_{, Petar M. SEFEROVIĆ}1_{, Mirjana ŽIVKOVIĆ}1_{, Vera JELIĆ}1_{, Goran VUKOMANOVIĆ}2_, Milan PETROVIĆ1_{, Nataša MILIĆ}3_{, Arsen D. RISTIĆ}1_{, Dejan SIMEUNOVIĆ}1

1_{Institute for Cardiovascular Diseases, Clinical Centre of Serbia, Belgrade;} 2_{University Children’s Hospital, Belgrade;} 3_{Institute for Medical Statistics, School of Medicine, University of Belgrade, Belgrade}