Relationship between 24-hour Heart Rate Variability and Hypotension in Patients with Chronic Heart Failure during Hospitalization

FU Chunsheng; HU Xiaolong; LI Xuexiang

doi:10.12102/j.issn.1672-1349.2024.10.021

Abstract：Objective:To investigate the relationship of 24-hour heart rate variability and hypotension in patients with chronic heart failure(CHF)during hospitalization.Methods:The patients with CHF admitted to our hospital from May 2019 to July 2022 were prospectively selected as the study objects.The heart rate variability of the patients was measured by 24-hour Holter electrocardiogram on the day of admission,and the patients were divided into the occurrence group and non-occurrence group according to the occurrence of hypotension during hospitalization.The general data,echocardiographic indexes and 24-hour heart rate variability at admission were compared.Pearson method was used to analyze the correlation between 24-hour heart rate variability and blood pressure.Logistic regression analysis was used to examine the relationship of 24-hour heart rate variability and hypotension in CHF patients.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of 24-hour heart rate variability for hypotension during hospitalization in CHF patients.Results:A total of 112 patients with CHF were included,including 61 males and 51 females,the average age was 57 to 79(68.17±2.98)years old,and the incidence of hypotension during hospitalization was 14.29%.Twenty-four hour standard diviation of NN intervals(SDNN),root mean square of normal adjacent sinus R-R interval difference(rMSSD),percentage of normal adjacent R-R interval difference>50 ms(pNN50),low frequency(LF)and LF/high frequency(HF)decreased in the occurrence group than those in the non-occurrence group(P<0.01).The results of Pearson correlation test showed that 24-hour heart rate variability indexes SDNN,rMSSD,pNN50,LF,and LF/HF were positively correlated with systolic blood pressure and diastolic blood pressure(P<0.05).Logistic regression analysis showed that low rMSSD,pNN50 and LF/HF at admission were the influential factors for hypotension in CHF patients during hospitalization(P<0.05).The ROC curve showed that the AUC of SDNN,rMSSD,pNN50,LF and LF/HF in predicting hypotension of CHF patients during hospitalization was more than 0.70,which should certain predictive value.AUC of combined prediction was more than 0.90,which should high predictive value.Conclusion:Twenty-four hour heart rate variability was an influencing factor for hypotension in CHF patients during hospitalization,and could be used as a predictor of hypotension in CHF patients.