Skip to main content
Article thumbnail
Location of Repository

Short-term Heart Rate Turbulence Analysis Versus Variability and Baroreceptor Sensitivity in Patients With Dilated Cardiomyopathy

By Hagen Malberg, Robert Bauernschmitt, Udo Meyerfeldt, Alexander Schirdewan and Niels Wessel


New methods for the analysis of arrhythmias and their hemodynamic consequences have been applied in risk stratification, in particular to patients after myocardial infarction. This study investigates the suitability of short-term heart rate turbulence (HRT) analysis in comparison to heart rate and blood pressure variability as well as baroreceptor sensitivity analyses to characterise the regulatory differences between patients with dilated cardiomyopathy (DCM) and healthy controls. In this study, 30 minutes data of non-invasive continuous blood pressure and ECGs of 37 DCM patients and 167 controls measured under standard resting conditions were analysed. The results show highly significant differences between DCM patients and controls in heart rate and blood pressure variability as well as in baroreceptor sensitivity parameters. Applying a combined heart rate-blood pressure trigger, ventricular premature beats were detected in 24.3% (9) of the DCM patients and 11.3% (19) of the controls. This fact demonstrates the limited applicability of short-term HRT analyses. However, the HRT parameters showed significant differences in this subgroup with ventricular premature beats (turbulence onset: DCM: 1.80±2.72, controls: - 4.34±3.10, p<0.001; turbulence slope: DCM: 6.75±5.50, controls: 21.30±17.72, p=0.021). Considering all (including HRT) parameters in the subgroup with ventricular beats, a discrimination rate between DCM patients and controls of 88.0% was obtained (max. 6 parameters). The corresponding value obtained for the total group was 86.3% (without HRT parameters). Comparable classification rates and high correlations between heart rate turbulence and variability and baroreflex parameters point to a more universal applicability of the latter methods

Topics: Indian Pacing and Electrophysiology Journal
Publisher: Indian Pacing and Electrophysiology Group
Year: 2004
OAI identifier:
Download PDF:
Sorry, we are unable to provide the full text but you may find it at the following location(s):
  • (external link)
  • (external link)
  • Suggested articles


    1. (1995). A new non invasive statistical method to assess the spontaneous cardiac baroreflex in humans. Clin Sci
    2. (2002). Advanced analysis of spontaneous baroreflex sensitivity, blood pressure and heart rate variability in patients with dilated cardiomyopathy. Clin Sci
    3. (1997). Augmented peripheral chemosensitivity as a potential input to baroreflex impairment and autonomic imbalance in chronic heart failure. Circulation
    4. (1996). Autonomic Nervous System and Sudden Cardiac Death.
    5. (1998). Baroreflex sensitivity and heart rate variability in coronary disease compared to dilated cardiomyopathy. Pacing Clin Electrophysiol
    6. (1998). Baroreflex sensitivity and heart rate variability in prediction of total cardiac mortality after myocardial infarction. ATRAMI (Autonomic Tone and Reflexes After Myocardial Infarction). Lancet
    7. (2001). Baroreflex Sensitivity and Heart Rate Variability in the Identification of Patients at Risk for Life-Threatening Arrhythmias: Implications for Clinical Trials. Circulation
    8. (1997). Baroreflex sensitivity assessed by complex demodulation of cardiovascular variability. Hypertension
    9. (2000). Blunted arterial baroreflex causes &quot;pathological&quot; heart rate turbulence.
    10. (2000). Depressed low frequency power of heart rate variability as an independent predictor of sudden death in chronic heart failure. Eur Heart J
    11. (1992). Dissociation of sympathetic responses to baroreceptor loading and unloading in compensated congestive heart failure secondary to ischemic or nonischemic dilated cardiomyopathy.
    12. (2002). Effects of ventricular premature stimulus coupling interval on blood pressure and heart rate turbulence. Circulation
    13. (1999). Evaluation of electrocardiograms in the field of extrasystoles. German Patent and Trade Mark Office
    14. (2002). Heart rate and blood pressure turbulence-marker of the baroreflex sensitivity or consequence of postextrasystolic potentiation and pulsus alternans?
    15. (1999). Heart rate turbulence after ventricular premature beats as a predictor of mortality after acute myocardial infarction. Lancet
    16. (2000). Heart rate variability: a telltale of health or disease. Eur Heart J
    17. (1983). Interactions between baroreceptor and sympathic pathways.
    18. (2002). Introduction of heart rate and blood pressure turbulence in the electrophysiologic laboratory.
    19. (2002). Mechanisms involved in heart rate turbulence. Card Electrophysiol Rev
    20. (2000). Nonlinear analysis of complex phenomena in cardiological data. Herzschr Elektrophys
    21. (2002). Phenomenon of heart rate turbulence, its evaluation, and prognostic value. Card Electrophysiol Rev
    22. (2002). Postextrasystolic regulation patterns of blood pressure and heart rate in patients with idiopathic dilated cardiomyopathy.
    23. (2000). Prognostic significance of blood pressure and heart rate variabilities: the Ohasama study. Hypertension
    24. (2002). Prognostic significance of heart rate turbulence in patients with idiopathic dilated cardiomyopathy. Europace
    25. (1995). Quantitative analysis of heart rate variability. Chaos
    26. (2004). Relation of heart rate and Indian Pacing and Electrophysiology
    27. (2000). Short-term forecasting of life-threatening cardiac arrhythmias based on symbolic dynamics and finite-time growth rates. Phys Rev E
    28. (2003). Shortterm heart variability predicts sudden cardiac death in chronic heart failure patients. Circulation
    29. (1996). Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Heart rate variability: standards of measurement, physiological interpretation and clinical use. Circulation
    30. (1996). The application of methods of non linear dynamics for the improved and predictive recognition of patients threatened by sudden cardiac death. Cardiovasc Res,

    To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.