Heart rate variability in heart failure.

Abstract

by Yeung Yuk-Ching.Thesis (M.Phil.)--Chinese University of Hong Kong, 2002.Includes bibliographical references (leaves 119-129).Abstracts in English and Chinese.Abstract in English --- p.iiAbstract in Chinese --- p.vGlossary --- p.viiiAcknowledgements --- p.xPublications Arising From this Thesis --- p.xiiList of Tables --- p.xviiiList of Figures --- p.xixChapter 1 --- INTRODUCTION --- p.1Chapter 1.1 --- Definition of Heart Rate Variability --- p.1Chapter 1.2 --- Physiology --- p.1Chapter 1.2.1 --- Review of Autonomic Nervous System and Influence of Heart Rate --- p.1Chapter 1.2.2 --- The Role of Baroreceptors in the Control of Circulation --- p.4Chapter 1.2.3 --- The Control and Physiological Importance of Heart Rate --- p.7Chapter 1.2.3.1 --- Normal Heart Rate --- p.7Chapter 1.2.3.2 --- Autonomic Control of Heart Rate --- p.8Chapter 1.2.3.2.1 --- Sympathetic Effects --- p.8Chapter 1.2.3.2.2 --- Vagal Effects --- p.8Chapter 1.2.3.3 --- Reflexes Influencing Heart Rate --- p.9Chapter 1.2.3.3.1 --- Baroreceptors --- p.10Chapter 1.2.3.3.2 --- Chemoreceptors --- p.10Chapter 1.2.3.3.3 --- Atrial Receptors --- p.11Chapter 1.2.3.3.4 --- Coronary Chemoreflex --- p.11Chapter 1.2.3.3.5 --- Other Reflexes --- p.12Chapter 1.2.3.4 --- Influence of Complex Events on Heart Rate --- p.12Chapter 1.2.3.4.1 --- Respiratory Influence --- p.12Chapter 1.2.3.4.2 --- Effects of Decreases in Venous Return --- p.13Chapter 1.2.3.4.3 --- Exercise --- p.13Chapter 1.2.3.5 --- Physiological Importance of Heart Rate --- p.14Chapter 1.3 --- Spectral Analysis of Blood Pressure and Heart Rate Variability in Evaluating Cardiovascular Regulation --- p.14Chapter 1.4 --- Clinical Relevance --- p.15Chapter 1.4.1 --- Increased Sympathetic Activity --- p.15Chapter 1.4.2 --- Reduced Parasympathetic Activity --- p.15Chapter 1.4.3 --- Low Heart Rate Variability --- p.16Chapter 1.4.4 --- Depressed Baroreflex Sensitivity --- p.17Chapter 1.4.5 --- Prognostic Value of Heart Rate Variability in Disease States --- p.17Chapter 1.4.6 --- Abnormality of Autonomic Nervous System in Heart Failure --- p.17Chapter 2 --- METHODS FOR ASSESSING HEART RATE VARIABILITY --- p.20Chapter 2.1 --- Time Domain Analysis of Heart Rate Variability --- p.20Chapter 2.1.1 --- Statistical Methods --- p.21Chapter 2.1.2 --- Geometric Methods --- p.22Chapter 2.2 --- Spectral Analysis of Heart Rate Variability --- p.23Chapter 2.3 --- "Nonlinear Indices (fractal, entropy, chaos theory)" --- p.27Chapter 3 --- HEART FAILURE --- p.28Chapter 3.1 --- Heart Rate Variability in Heart Failure --- p.28Chapter 3.2 --- Effect of Changes in Respiratory Frequency and Posture on Heart Rate Variability Analysis in Heart Failure --- p.34Chapter 3.3 --- Effect of Respiratory Rates on Baroreceptor Function in Heart Failure --- p.34Chapter 3.4 --- Effect of Treatment on Heart Rate Variability in Heart Failure Patients --- p.35Chapter 4 --- AIMS --- p.39Chapter 4.1 --- Effect of Changes in Respiratory Frequency and Posture on Heart Rate Variability --- p.39Chapter 4.2 --- Effect of Slow Breathing --- p.39Chapter 4.3 --- Effect of Therapeutic Interventions in Chronic Heart Failure --- p.39Chapter 4.3.1 --- A Comparison of Celiprolol with Metoprolol --- p.39Chapter 4.3.2 --- A Comparison of Carvedilol with Metoprolol --- p.40Chapter 5 --- STUDIES --- p.41Chapter 5.1 --- 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 --- p.41Chapter 5.1.1 --- Subjects --- p.41Chapter 5.1.2 --- Recording Technique and Protocol --- p.42Chapter 5.1.3 --- Signal Acquisition --- p.42Chapter 5.1.4 --- Power Spectral Analysis --- p.43Chapter 5.1.5 --- Statistical Analysis --- p.46Chapter 5.1.6 --- Results --- p.46Chapter 5.1.7 --- Discussion --- p.52Chapter 5.1.8 --- Summary --- p.56Chapter 5.2 --- Slow Breathing Increases Arterial Baroreflex Sensitivityin Patients with Chronic Heart Failure --- p.57Chapter 5.2.1 --- Subjects --- p.57Chapter 5.2.2 --- Assessment of Baroreflex Sensitivity --- p.57Chapter 5.2.3 --- Statistical Analysis --- p.58Chapter 5.2.4 --- Results --- p.59Chapter 5.2.5 --- Discussion --- p.62Chapter 5.2.6 --- Summary --- p.63Chapter 5.3 --- β-Blockers in Heart Failure: a Comparison of a Vasodilating β- Blocker with Metoprolol on Heart Rate Variability by 24 Hour ECG Recordings (Time-Domain & Spectral Analysis) --- p.65Chapter 5.3.1 --- Trial Design --- p.65Chapter 5.3.2 --- Study Patients --- p.65Chapter 5.3.3 --- Study Measurements --- p.66Chapter 5.3.4 --- Statistical Analysis --- p.67Chapter 5.3.5 --- Results --- p.67Chapter 5.3.6 --- Discussion --- p.80Chapter 5.3.7 --- Summary --- p.81Chapter 5.4 --- Effect of β-Blockade on Baroreceptor and Autonomic Function in Heart Failure-Assessment by Short Term Spectral Analysis --- p.83Chapter 5.4.1 --- Trial Design and Study Patients --- p.83Chapter 5.4.2 --- Recording Technique and Protocol --- p.83Chapter 5.4.3 --- "Signal Acquisition, Power Spectral Analysis and Cross Spectral Analysis" --- p.83Chapter 5.4.4 --- Reproducibility --- p.84Chapter 5.4.5 --- Statistical Analysis --- p.84Chapter 5.4.6 --- Results --- p.84Chapter 5.4.7 --- Discussion --- p.93Chapter 5.4.8 --- Summary --- p.97Chapter 5.5 --- β-Blockade in Heart Failure: A Comparison of Carvedilol with Metoprolol on HRV by 24 hour ECG Recordings (Time-Domain & Spectral Analysis) --- p.98Chapter 5.5.1 --- Trial Design and Patient Demographics --- p.98Chapter 5.5.2 --- Study Measurements --- p.98Chapter 5.5.3 --- Statistical Analysis --- p.99Chapter 5.5.4 --- Results --- p.99Chapter 5.5.5 --- Discussion --- p.105Chapter 5.5.6 --- Conclusions --- p.107Chapter 5.6 --- Comparison of Carvedilol and Metoprolol on Baroreceptor Gain in Heart Failure by Short Term Spectral Analysis --- p.108Chapter 5.6.1 --- Study Design --- p.108Chapter 5.6.2 --- Study Patients --- p.108Chapter 5.6.3 --- Recording Technique and Protocol --- p.108Chapter 5.6.4 --- "Signal Acquisition, Power Spectral Analysis and Cross Spectral Analysis" --- p.108Chapter 5.6.5 --- Statistical Analysis --- p.109Chapter 5.6.6 --- Results --- p.109Chapter 5.6.7 --- Discussion --- p.112Chapter 5.6.8 --- Summary --- p.112Chapter 6 --- "GENERAL DISCUSSION, LIMITATIONS & CONCLUSIONS" --- p.113Chapter 6.1 --- Discussion --- p.113Chapter 6.2 --- Conclusions --- p.117Chapter 7 --- REFERENCES --- p.11