• citations in SCIndeks: 0
  • citations in CrossRef:0
  • citations in Google Scholar:[]
  • visits in previous 30 days:5
  • full-text downloads in 30 days:4


article: 7 from 18  
Back back to result list
2007, vol. 135, iss. 3-4, pp. 135-142
The influence of respiratory pattern on heart rate variability analysis in heart failure
aClinical Center of Serbia, Clinic for Cardiology, Belgrade, Serbia
bUniversity Children's Hospital, Belgrade, Serbia
cUniversity of Belgrade, Faculty of Medicine, Institute of Medical Statistics and Informatics, Serbia
dUniversity of Belgrade, Faculty of Medicine, Clinical Hospital Center 'Bežanijska kosa', Serbia

Keywords: heart failure; heart rate variability; controlled respiration
Introduction. Autonomic dysfunction is present early in the course of heart failure, and has a direct role on deterioration of cardiac function and prognosis. Heart rate variability (HRV) estimates sympathovagal control of heart frequency. The influence of respiratory pattern on HRV is clinically important. Breathing disorders are common in heart failure and highly affect HRV and autonomic evaluation. It was previously shown that slow and deep breathing increased parasympathetic tone, but effects of this respiratory pattern on HRV were not evaluated. Objective. The aim of the study was to estimate effects of slow and deep breathing (SDB) on HRV in heart failure patients. Method. In 55 patients with heart failure (78% male, mean age 57.18±10.8 yrs, mean EF=34.12±10.01%) and 14 healthy controls (57.1% male, mean age 53.1±8.2 yrs), short term HRV spectral analysis was performed (Cardiovit AT 60, Schiller). VLF, LF, HF and LF/HF were determined during spontaneous and deep and slow breathing at 0.1 Hz (SDB). Results. LF, HF and LF/HF significantly increased during SDB compared with spontaneous breathing both in controls (LF 50.71±61.55 vs. 551.14±698.01 ms2, p<0.001; HF 31.42±29.98 vs.188.78±142.74 ms2, p<0.001 and LF/HF 1.46±0.61 vs. 4.21±3.23, p=0.025) and heart failure patients (LF 27.37±36.04 vs. 94.50±96.13 ms2, p<0.001; HF 12.13±19.75 vs. 41.58±64.02 ms2, p<0.001 and LF/HF 3.77±3.79 vs. 6.38±5.98, p=0.031). Increments of LF and HF induced by SDB were significantly lower in patients than healthy controls. Heart failure patients had lower HRV compared to healthy controls both during spontaneous breathing and SDB. During spontaneous breathing, only HF was significantly lower between healthy controls and patients (p=0.002). During SDB VLF (p=0.022), LF (p<0.001) and HF (p<0.001) were significantly lower in heart failure patients compared to controls. Conclusion. These data suggest that SDB increases HRV both in healthy and heart failure patients; the highest increment is in LF range. Differences in spectral profile of HRV between healthy controls and heart failure patients become more profound during SDB. Controlled respiration during HRV analysis might increase sensitivity and reliability in detection of autonomic dysfunction in heart failure patients.
Bernardi, L., Spadacini, G., Bellwon, J., Hajric, R., Roskamm, H., Frey, A.W. (1998) Effect of breathing rate on oxygen saturation and exercise performance in chronic heart failure. Lancet, 351(9112): 1308-11
Bernardi, L., Porta, C., Spicuzza, L., Bellwon, J., Spadacini, G., Frey, A.W., Yeung, L.Y.C., Sanderson, J.E., Pedretti, R., Tramarin, R. (2002) Slow breathing increases arterial baroreflex sensitivity in patients with chronic heart failure. Circulation, 105(2): 143-5
Bigger, J.T., Fleiss, J.L., Steinman, R.C., Rolnitzky, L.M., Kleiger, R.E., Rottman, J.N. (1992) Frequency domain measures of heart period variability and mortality after myocardial infarction. Circulation, 85(1): 164-71
Cohn, J.N., Levine, T.B., Olivari, M.T., Garberg, V., Lura, D., Francis, G.S., Simon, A.B., Rector, T. (1984) Plasma norepinephrine as a guide to prognosis in patients with chronic congestive heart failure. N Engl J Med, 311(13): 819-23
deBoer R.W., Karemaker, J.M., Strackee, J. (1987) Hemodynamic fluctuations and baroreflex sensitivity in humans: A beat-to-beat model. Am J Physiol, 253(3 Pt 2): H680-9
Diehl, R.R., Linden, D., Berlit, P. (1997) Determinants of heart rate variability during deep breathing: Basic findings and clinical applications. Clin Auton Res, 7(3): 131-5
Esler, M., Kaye, D., Lambert, G., Esler, D., Jennings, G. (1997) Adrenergic nervous system in heart failure. Am J Cardiol, 80(11A): 7L-14L
Francis, G.S., Benedict, C., Johnstone, D.E., Kirlin, P.C., Nicklas, J., Liang, C.S., Kubo, S.H., Rudin-Toretsky, E., Yusuf, S. (1990) Comparison of neuroendocrine activation in patients with left ventricular dysfunction with and without congestive heart failure. A substudy of the Studies of Left Ventricular Dysfunction (SOLVD). Circulation, 82(5): 1724-9
Frenneaux, M.P. (2004) Autonomic changes in patients with heart failure and in post-myocardial infarction patients. Heart, 90(11): 1248-55
Guzzetti, S., Cogliati, C., Turiel, M., Crema, C., Lombardi, F., Malliani, A. (1995) Sympathetic predominance followed by functional denervation in the progression of chronic heart failure. Eur Heart J, 16(8): 1100-7
Hirsch, J.A., Bishop, B. (1981) Respiratory sinus arrhythmia in humans: How breathing pattern modulates heart rate. Am J Physiol, 241(4): H620-9
Katz, A., Liberty, I.F., Porath, A., Ovsyshcher, I., Prystowsky, E.N. (1999) A simple bedside test of 1-minute heart rate variability during deep breathing as a prognostic index after myocardial infarction. Am Heart J, 138(1 Pt 1): 32-8
la Rovere, M.T., Pinna, G.D., Maestri, R., Mortara, A., Capomolla, S., Febo, O., Ferrari, R., Franchini, M., Gnemmi, M., Opasich, C., Riccardi, P.G., Traversi, E., Cobelli, F. (2003) Short-term heart rate variability strongly predicts sudden cardiac death in chronic heart failure patients. Circulation, 107(4): 565-70
Lanfranchi, P.A., Braghiroli, A., Bosimini, E., Mazzuero, G., Colombo, R., Donner, C.F., Giannuzzi, P. (1999) Prognostic value of nocturnal Cheyne-Stokes respiration in chronic heart failure. Circulation, 99(11): 1435-40
Malik, M., Camm, A.J. (1993) Components of heart rate variability: What they really mean and what we really measure. Am J Cardiol, 72(11): 821-2
Malliani, A., Pagani, M., Lombardi, F., Cerutti, S. (1991) Cardiovascular neural regulation explored in the frequency domain. Circulation, 84(2): 482-92
Mortara, A., Sleight, P., Pinna, G.D., Maestri, R., Prpa, A., la Rovere, M.T., Cobelli, F., Tavazzi, L. (1997) Abnormal awake respiratory patterns are common in chronic heart failure and may prevent evaluation of autonomic tone by measures of heart rate variability. Circulation, 96(1): 246-52
Nolan, J., Batin, P.D., Andrews, R., Lindsay, S.J., Brooksby, P., Mullen, M., Baig, W., Flapan, A.D., Cowley, A., Prescott, R.J., Neilson, J.M., Fox, K.A. (1998) Prospective study of heart rate variability and mortality in chronic heart failure: Results of the United Kingdom heart failure evaluation and assessment of risk trial (UK-heart). Circulation, 98(15): 1510-6
Ponikowski, P., Anker, S.D., Chua, T.P., Francis, D., Banasiak, W., Poole-Wilson, P.A., Coats, A.J., Piepoli, M. (1999) Oscillatory breathing patterns during wakefulness in patients with chronic heart failure: Clinical implications and role of augmented peripheral chemosensitivity. Circulation, 100(24): 2418-24
Remme, W.J., Swedberg, K., Task Force for the Diagnosis and Treatment of Chronic Heart Failure, European Society of Cardiology (2001) Guidelines for the diagnosis and treatment of chronic heart failure. Eur Heart J, 22(17): 1527-60
Sanderson, J.E., Yeung, L.Y., Yeung, D.T., Kay, R.L., Tomlinson, B., Critchley, J.A., Woo, K.S., Bernardi, L. (1996) Impact of changes in respiratory frequency and posture on power spectral analysis of heart rate and systolic blood pressure variability in normal subjects and patients with heart failure. Clin Sci (Lond), 91(1): 35-43
Saul, J.P., Berger, R.D., Albrecht, P., Stein, S.P., Chen, M.H., Cohen, R.J. (1991) Transfer function analysis of the circulation: Unique insights into cardiovascular regulation. Am J Physiol, 261(4 Pt 2): H1231-45
Scalvini, S., Volterrani, M., Zanelli, E., Pagani, M., Mazzuero, G., Coats, A.J., Giordano, A. (1998) Is heart rate variability a reliable method to assess autonomic modulation in left ventricular dysfunction and heart failure? Assessment of autonomic modulation with heart rate variability. Int J Cardiol, 67(1): 9-17
Sleight, P., la Rovere, M.T., Mortara, A., Pinna, G., Maestri, R., Leuzzi, S., Bianchini, B., Tavazzi, L., Bernardi, L. (1995) Physiology and pathophysiology of heart rate and blood pressure variability in humans: Is power spectral analysis largely an index of baroreflex gain?. Clin Sci (Lond), 88(1): 103-9
Task Force of the European Society of Cardiology, North American Society of Pacing and Electrophysiology (1996) Heart rate variability: Standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation, 93(5): 1043-65
Zamaklar-Trifunović, D., Seferović, P.M., Živković, M., Jelić, V., Vukomanović, G., Petrović, M., Milić, N., Ristić, A.D., Simeunović, D. (2005) Uticaj težine insuficijencije rada srca na varijabilnost frekvencije rada srca. Srpski arhiv za celokupno lekarstvo, vol. 133, br. 11-12, str. 484-491


article language: Serbian
document type: Paper
DOI: 10.2298/SARH0704135Z
published in SCIndeks: 03/12/2007

Related records

No related records