Changes of Heart Rate Variability Parameters in Elderly Patients with Heart Failure and Its Effects on the Occurrence of Major Adverse Cardiac Events

LIU Yingying; SHEN Xin; LYU Na; GUO Zhencheng; LI Jiehua

doi:10.12102/j.issn.1672-1349.2025.08.014

Abstract：Objective: To analyze the changes in heart rate variability parameters in elderly patients with heart failure and their impact on the occurrence of major adverse cardiac events. Methods: A total of 152 elderly patients with heart failure admitted to the First Affiliated Hospital of Anhui Medical University and Hefei Cancer Hospital, Chinese Academy of Sciences from August 2019 to August 2021 were enrolled in this study. Follow-up was conducted for 6 months. According to whether major adverse cardiac events occurred during follow-up, the patients were divided into the major adverse cardiac events group (26 cases) and the non-major adverse cardiac events group (126 cases). Clinical data of the study subjects were retrospectively collected. The heart rate variability parameters of the two groups were analyzed, and the influencing factors of major adverse cardiac events in elderly patients with heart failure were analyzed by univariate analysis and multivariate logistic regression analysis. Results: Compared with the non-major adverse cardiac events group, the major adverse cardiac events group had lower values of SDANN (standard deviation of the average R-R interval over 5-minute segments), RMSSD (root mean square of successive differences), PNN50 (proportion of NN intervals with differences greater than 50 ms in total heartbeats), and triangular index (ratio of total NN intervals to the height of the NN interval histogram) (P < 0.05). Multivariate logistic regression analysis showed that increased age, NYHA functional class III or IV, heart failure type of non-preserved ejection fraction, atrial fibrillation, and elevated serum brain natriuretic peptide (BNP) levels were risk factors for major adverse cardiac events in elderly patients with heart failure (OR values were 1.874, 1.908, 1.885, 1.895, and 2.018, respectively; all P < 0.05). Increased triangular index and LVEF level were protective factors for major adverse cardiac events in elderly patients with heart failure (OR values were 0.480 and 0.463, respectively; all P < 0.05). Conclusion: Heart rate variability parameters are reduced in elderly patients with heart failure. Increased age, NYHA functional class III or IV, non-preserved ejection fraction heart failure type, atrial fibrillation, and elevated serum BNP levels are risk factors for major adverse cardiac events in elderly patients with heart failure, while increased heart rate variability parameters and LVEF are protective factors. Clinically, corresponding intervention strategies can be applied to high-risk elderly patients with heart failure.