Heart Rate Variability on Holter Monitor Linked To CHF

MedicalResearch.com Interview with
Phyllis K. Stein, PhD
Division of Hospital Medicine
Washington University School of Medicine
St. Louis, Missouri

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This study was based on results from the Cardiovascular Health Study (CHS) which was designed to be a prospective study of risk factors for cardiovascular disease and stroke in community-dwelling older adults. Of this cohort, about ΒΌ volunteered to have Holter recordings. They form the basis of our study. All participants were carefully followed and all outcomes fully adjudicated.

Thus, we were able to add the Holter findings to the existing Health ABC study and determine whether they added to a validated risk score.

MedicalResearch.com: What should readers take away from your report?

Response: Readers should take away the idea that there is some kind of subtle autonomic dysfunction that precedes incident stroke in older adults. However, in general, standard clinical Holter recordings, which are scanned to identify abnormal events and generally not scanned to research standards, are not sufficient to capture most of the measures that added to prediction of incident stroke, the exception being VPC counts.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Future research might focus on re-analysis of existing, stored clinical Holter recordings to validate findings. It is unclear which interventions might positively affect these risk markers, but if Holter recordings were collected in addition to the known lifestyle interventions, it would be possible to determine if improvement in other, modifiable risk factors, e.g., glycemic control or even stress management which was not considered here, would also affect the HRV parameters. It is known from the CAST trial, that artificially reducing the number of VPCs is not likely to be helpful.

MedicalResearch.com: Is there anything else you would like to add?

Response: No disclosures. However, the Washington University School of Medicine HRV Lab is eager to provide research quality HRV scanning and analysis for existing recordings and to collaborate with other investigators in both analysis and interpretation of HRV parameters.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.


Association of Holter-Derived Heart Rate Variability Parameters with the Development of Congestive Heart Failure in the Cardiovascular Health Study
JACC Heart Fail. 2017 Mar 30. pii: S2213-1779(17)30052-5. doi: 10.1016/j.jchf.2016.12.015. [Epub ahead of print]
Patel VN1, Pierce BR1, Bodapati RK2, Brown DL2, Ives DG3, Stein PK4.

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on April 25, 2017 by Marie Benz MD FAAD