Heartbeat Chronicles: Decoding the Interplay of Echocardiography and Heart Rate Variability in Chronic Heart Failure Patients – Unraveling the Mysteries with Traditional and Advanced 24-Hour Holter ECG Parameters

Duca, Ştefania-Teodora; Tudorancea, Ionuţ; Miftode, Radu-Ştefan; Chetran, Adriana; Costache, Alexandru-Dan; Pavăl, D. Robert; Costache-Enache, Irina-Iuliana

doi:10.2478/rjc-2024-0009

Figures & Tables

Correlation between left ventricular ejection fraction (%) and RMSSD (ms). RMSSD—square root of the mean of the squares of the successive differences between adjacent NN intervals.

Association between the E/A ratio and both acceleration (ms) and deceleration capacity (ms).

Correlation between the E/A ratio and the Triangular Index (ms).

Correlation between the E/E’ ratio and both deceleration capacity (ms) and the Triangular Index (ms).

Association between mitral valve deceleration time (ms) and both acceleration (ms) and deceleration capacity (ms).

Association between the left atrial volume index (mL/m2) and RMSSD (ms) as well as PNN50 (%). RMSSD—square root of the mean of the squares of the successive differences between adjacent NN intervals, PNN50—ratio of NN50 to the total count of NN intervals.

Summary of investigated parameter values

	Minimum	Maximum	Mean	Standard deviation
LVEDD (mm)	40	91	57.804	9.14
LVEF (%)	10	55	32	8.31
LVEDV (ml)	97	586	224.01	88.1
LVESV (ml)	55	513	157.1	76.8
E/A	0.15	3.27	1.32	0.75
E/E’	3.5	28	12.87	5.83
E/E’ lateral	1.5	26	10.93	5.34
E/E’ septal	5.07	34.3	15.01	7.48
S’ lateral (cm/s)	0.03	0.13	0.06	0.02
S’ septal (cm/s)	0.03	0.11	0.06	0.02
MV Dec T (ms)	64	685	197.92	88.16
LAVI (mL/m²)	18.52	72.08	31.63	5.83
ePASP	9	93	32.91	16.69
Cardiac output (L)	1.72	7.77	4.76	1.44
Aortic Vmax (m/sec)	0.8	4.9	1.8	1
Mean AVG (mmHg)	2.58	95	17.71	1
SDNN (ms)	32	165	81.48	29.87
SDANN (ms)	24	140	68.87	27.15
SDNN Index (ms)	17	102	40.59	18.23
RMSSD (ms)	7	93	30.45	18.48
PNN50 (%)	0	43	7.58	10.17
Triangular Index (ms)	5.5	54.2	19.8	8.7
VLF (Hz)	126.8	10314.3	1665.67	1835.99
LF (Hz)	23.8	1775.9	338.88	380.22
HF (Hz)	4.5	2202.4	195	275.96
Deceleration capacity(ms)	-4.96	9.05	3,92	2.33
Acceleration Capacity(ms)	-10.72	-1.23	-4.9	2.20

The relationship between Echocardiographic Parameters and Holter ECG Parameters

		SDNN	SDANN	SDNN Index	RMSSD	PNN50	Triangular Index	VLF	LF	HF	Deceleration capacity	Acceleration Capacity
LVEDD (mm)	Spearman’s rho	0.096	0.064	0.105	0.215	0.201	0.003	-0.01	-0.01	0.221	-0.087	-0.124
	p-value	0.399	0.574	0.355	0.056	0.074	0.978	0.956	0.942	0.049	0.445	0.274
LVEF (%)	Spearman’s rho	0.075	0.030	0.029	-0.294	-0.305	0.195	-0.01	0.039	-0.22	0.201	-0.142
	p-value	0.507	0.793	0.802	0.008	0.006	0.083	0.967	0.731	0.054	0.075	0.210
LVEDV (ml)	Spearman’s rho	0.080	0.053	0.115	0.153	0.169	0.003	0.134	0.009	0.083	-0.089	-0.016
	p-value	0.479	0.638	0.311	0.175	0.134	0.977	0.237	0.935	0.467	0.433	0.886
LVESV (ml)	Spearman’s rho	0.028	0.028	0.045	0.209	0.220	-0.097	0.070	-0.04	0.111	-0.191	0.074
	p-value	0.807	0.805	0.691	0.063	0.050	0.390	0.539	0.750	0.325	0.090	0.513
E/A	Spearman’s rho	-0.19	-0.116	-0.218	0.127	0.139	-0.233	-0.21	-0.15	0.109	-0.381	0.226
	p-value	0.098	0.303	0.052	0.261	0.220	0.037	0.061	0.173	0.337	< .001	0.044
E/E’	Spearman’s rho	-0.11	-0.051	-0.145	0.177	0.225	-0.241	-0.13	-0.18	0.146	-0.239	0.208
	p-value	0.319	0.653	0.199	0.116	0.045	0.031	0.239	0.121	0.196	0.033	0.064
E/E’ lateral	Spearman’s rho	-0.13	-0.065	-0.140	0.123	0.218	-0.250	-0.13	-0.16	0.129	-0.115	0.091
	p-value	0.240	0.565	0.216	0.278	0.053	0.024	0.247	0.152	0.254	0.311	0.424
E/E’ septal	Spearman’s rho	-0.15	-0.099	-0.142	0.211	0.226	-0.243	-0.17	-0.18	0.142	-0.358	0.236
	p-value	0.187	0.383	0.210	0.060	0.044	0.030	0.135	0.111	0.208	0.001	0.035
S’ lateral (cm/s)	Spearman’s rho	0.122	0.074	0.092	-0.206	-0.224	0.282	-0.01	0.048	-0.20	0.163	-0.150
	p-value	0.281	0.513	0.418	0.066	0.046	0.011	0.959	0.674	0.078	0.149	0.183
S’ septal (cm/s)	Spearman’s rho	0.116	0.107	0.102	-0.263	-0.258	0.263	0.064	0.096	-0.22	0.311	-0.285
	p-value	0.306	0.347	0.366	0.018	0.021	0.019	0.571	0.399	0.051	0.005	0.010
MV Dec T (ms)	Spearman’s rho	0.221	0.125	0.222	-0.022	-0.010	0.251	0.290	0.221	0.027	0.309	-0.293
	p-value	0.049	0.270	0.048	0.847	0.931	0.025	0.009	0.049	0.813	0.005	0.008
LAVI (mL/m²)	Spearman’s rho	0.049	0.013	0.118	0.304	0.278	0.001	0.100	0.015	0.261	-0.208	-0.080
	p-value	0.669	0.910	0.296	0.006	0.010	0.990	0.376	0.895	0.019	0.065	0.479
ePASP	Spearman’s rho	-0.01	-0.039	-0.045	0.292	0.278	-0.101	-0.17	-0.07	0.254	-0.316	0.064
	p-value	0.975	0.732	0.694	0.009	0.013	0.373	0.138	0.512	0.023	0.004	0.570
Cardiac output (L)	Spearman’s rho	0.030	0.107	-0.027	-0.237	-0.233	-0.032	0.084	0.053	-0.28	0.003	0.066
	p-value	0.795	0.346	0.814	0.035	0.038	0.779	0.460	0.646	0.014	0.981	0.564
Aortic Vmax (m/sec)	Spearman’s rho	0.004	-0.069	0.019	0.024	-0.011	0.009	0.072	0.103	0.008	0.151	-0.119
	p-value	0.975	0.543	0.864	0.833	0.921	0.934	0.524	0.365	0.943	0.181	0.295
Mean AVG (mmHg)	Spearman’s rho	-0.05	-0.063	0.003	0.012	-0.005	-0.050	0.075	-0.12	-0.03	0.099	-0.073
	p-value	0.638	0.577	0.976	0.918	0.963	0.658	0.506	0.273	0.823	0.384	0.520

Patient characteristics

Characteristics	All sample (n=80)
Sex	M – 59 (73.8 %)F – 21 (26.3 %)
Environment	R – 44 (55.0 %)U – 36 (45.0 %)
Smoker	YES – 39 (48.8 %)NO – 41 (51.2 %)
Alcohol consumption	YES – 18 (22.5%)NO – 62 (77.5%)
Diabetes	YES – 25 (31.3 %)NO – 55 (68.8 %)
CKD	YES – 18 (22.5 %)NO – 62 (77.5 %)
Obesity	YES – 22 (27.5 %)NO – 58 (72.5 %)
NYHA class	I – 6 (7.5 %)II – 37 (46.3 %)III – 34 (42.5 %)IV – 3 (3.8 %)

Heartbeat Chronicles: Decoding the Interplay of Echocardiography and Heart Rate Variability in Chronic Heart Failure Patients – Unraveling the Mysteries with Traditional and Advanced 24-Hour Holter ECG Parameters

Figures & Tables

Figure 1

Figure 2

Figure 3

Figure 4

Figure 5

Figure 6

Summary of investigated parameter values

The relationship between Echocardiographic Parameters and Holter ECG Parameters

Patient characteristics

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