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. 2022 Dec 28;24(1):493.
doi: 10.3390/ijms24010493.

Acute Severe Heart Failure Reduces Heart Rate Variability: An Experimental Study in a Porcine Model

Jan Naar  1 , Mikulas Mlcek  2 , Andreas Kruger  1 , Dagmar Vondrakova  1 , Marek Janotka  1 , Michaela Popkova  2 , Otomar Kittnar  2 , Petr Neuzil  1 , Petr Ostadal  1
Affiliations

Acute Severe Heart Failure Reduces Heart Rate Variability: An Experimental Study in a Porcine Model

Jan Naar et al. Int J Mol Sci. .

Abstract

There are substantial differences in autonomic nervous system activation among heart (cardiac) failure (CF) patients. The effect of acute CF on autonomic function has not been well explored. The aim of our study was to assess the effect of experimental acute CF on heart rate variability (HRV). Twenty-four female pigs with a mean body weight of 45 kg were used. Acute severe CF was induced by global myocardial hypoxia. In each subject, two 5-min electrocardiogram segments were analyzed and compared: before the induction of myocardial hypoxia and >60 min after the development of severe CF. HRV was assessed by time-domain, frequency-domain and nonlinear analytic methods. The induction of acute CF led to a significant decrease in cardiac output, left ventricular ejection fraction and an increase in heart rate. The development of acute CF was associated with a significant reduction in the standard deviation of intervals between normal beats (50.8 [20.5−88.1] ms versus 5.9 [2.4−11.7] ms, p < 0.001). Uniform HRV reduction was also observed in other time-domain and major nonlinear analytic methods. Similarly, frequency-domain HRV parameters were significantly changed. Acute severe CF induced by global myocardial hypoxia is associated with a significant reduction in HRV.

Keywords: acute heart failure; experimental model; heart rate variability; pig.

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Conflict of interest statement

The authors J.N., A.K. and D.V. received a speaker honorarium from Edwards Lifescience. P.O. received a speaker honorarium from Getinge, Edwards Lifescience and Xenios AG. The authors M.M., M.J., M.P., O.K. and P.N. declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Effect of acute heart failure on time-domain parameters of heart rate variability displayed as an individual graph (A) and as median with interquartile range, minimum and maximum value (B). AHF = acute heart failure; pNN50 = number of pairs of adjacent NN intervals differing by more than 50 ms divided by the total number of all NN intervals; RMSSD = square root of the mean of the sum of the squares of differences between adjacent NN intervals; SDNN = standard deviation of intervals between normal beats.
Figure 2
Figure 2
Representative example of HRV analysis comparing time-domain HRV parameters before (A) and after (B) acute CF induction in one study subject. BPM = beats per minute; pNN50 = number of pairs of adjacent NN intervals differing by more than 50 ms divided by the total number of all NN intervals; RMSSD = square root of the mean of the sum of the squares of differences between adjacent NN intervals; RR = interval between adjacent R waves; SDNN = standard deviation of intervals between normal beats.
Figure 3
Figure 3
Effect of acute heart failure on frequency-domain parameters of heart rate variability. Data are expressed as median with interquartile range, minimum and maximum value. AHF = acute heart failure; HF = high frequency; LF = low frequency; n.u. = normalized units; VLF = very low frequency.
Figure 4
Figure 4
Effect of acute heart failure on nonlinear analysis of heart rate variability displayed as individual graph (A) and as median with interquartile range, minimum and maximum value (B). AHF = acute heart failure; SD1 = standard deviation of the points along short semi-axis of an ellipse fitted to Poincaré plot; SD2 = standard deviation of the points along long semi-axis of an ellipse fitted to Poincaré plot.
See this image and copyright information in PMC

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