Heart rate turbulence predicts all-cause mortality and sudden death in congestive heart failure patients
Open accessAbstract
Background Abnormal heart rate turbulence (HRT) has been documented as a strong predictor of total mortality and sudden death in postinfarction patients, but data in patients with congestive heart failure (CHF) are limited.Objective The aim of this study was to evaluate the prognostic significance of HRT for predicting mortality in CHF patients in New York Heart Association (NYHA) class II-III.Methods In 651 CHF patients with sinus rhythm enrolled into the MUSIC (Muerte Subita en Insuficiencia Cardiaca) study, the standard HRT parameters turbulence onset (TO) and slope (TS), as well as HRT categories, were assessed for predicting total mortality and sudden death.Results HRT was analyzable in 607 patients, mean age 63 years (434 male), 50% of ischemic etiology. During a median follow up of 44 months, 129 patients died, 52 from sudden death. Abnormal TS and HRT category 2 (HRT2) were independently associated with increased all-cause mortality (HR: 2.10, CI: 1.41 to 3.12, P <.001 and HR: 2.52, CI: 1.56 to 4.05, P <.001; respectively), sudden death (HR: 2.25, CI: 1.13 to 4.46, P = .021 for HRT2), and death due to heart failure progression (HR: 4.11, CI: 1.84 to 9.19, P <.001 for HRT2) after adjustment for clinical covariates in multivariate analysis. The prognostic value of TS for predicting total mortality was similar in various groups dichotomized by age, gender, NYHA class, left ventricular ejection fraction, and CHF etiology. TS was found to be predictive for total mortality only in patients with QRS > 120 ms.Conclusion HRT is a potent risk predictor for both heart failure and arrhythmic death in patients with class II and III CHF.
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Abnormal heart rate turbulence is a strong predictor of total mortality and sudden death in congestive heart failure.
“Abnormal heart rate turbulence was documented as a strong predictor of total mortality and sudden death in congestive heart failure.51”
From The Year of 2008 in Electrocardiology (2010) · cites this paper as [51]
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Heart Rate Turbulence: Standards of Measurement, Physiological Interpretation, and Clinical Use
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- Authors
- Cygankiewicz, I., Zareba, W., Vazquez, R., Vallverdu, M., Gonzalez-Juanatey, J. R., Valdes, M., Almendral, J., Cinca, J., Caminal, P., & de Luna, A. B.
- Affiliations
- University of Rochester Medicine (US)
- Hospital General Universitario Gregorio Marañón (ES)
- Universitat Politècnica de Catalunya (ES)
- Corresponding author
- Cygankiewicz, Iwona
- Venue
- Heart Rhythm
- Publisher
- Elsevier BV
- Published
- 2008-08
- Volume
- 5
- Issue
- 8
- Pages
- 1095-1102
- ISSN
- 1547-5271 (ISSN-L)
- OpenAlex
- W2117550616
- Cited by
- 113
- References
- 35
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 4 · 2023: 2 · 2022: 4 · 2021: 4 · 2020: 3 · 2019: 3 · 2018: 5 · 2017: 10 · 2016: 8 · 2015: 7 · 2014: 8 · 2013: 10 · 2012: 11
- FWCI
- 7.22
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Heart Rhythm (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Instituto de Salud Carlos III (G03/078)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Keywords
- heart rate turbulence, congestive heart failure, all-cause mortality, sudden death, heart failure progression, turbulence slope, turbulence onset, arrhythmic death, prognostic factors, music studies, QRS duration
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Algorithms, Female, Heart Failure, Heart Rate, Humans, Male, Middle Aged, Mortality, Predictive Value of Tests, Prognosis, Prospective Studies, Risk Factors, United States, Multivariate Analysis, Death, Sudden, Cardiac, Disease Progression, Risk Assessment
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