ISSN ONLINE: 2558-815X
ISSN PRINT: 1584-9244
ISSN-L: 1584-9244

Differences in autonomic nervous imbalance across the spectrum of heart failure through ECG Holter power spectral analysis


Introduction. Heart failure is a complex syndrome that causes increased cardiac pressure and alters cardiac output, its prevalence being on the rise in developed countries. The autonomic nervous system suffers a significant imbalance in heart failure patients, with decreased parasympathetic response and increased sympathetic influence.
The objective of the study was to assess the neurohormonal response in heart failure by evaluating 24-hour ECG Holter recordings from 59 patients using power spectral analysis.
Material and methods. The research aimed to compare sympathetic hyperactivation and vagal imbalance between three groups that were established based on the type of heart failure, with reduced, mildly reduced, or preserved ejection fraction. A specific emphasis was placed on symptoms, risk factors, and comorbidities and on their association with power spectral indices in the three groups.
Results. The study revealed a significant correlation between low-frequency (LF) and high-frequency (HF) parameters and the categories of heart failure, showing a decrease in values in heart failure with reduced ejection fraction (HFrEF) and an increase in heart failure with preserved ejection fraction (HFpEF). Also, a noteworthy negative correlation has been described between the LF/HF ratio and chronic kidney disease, as well as a positive link between obesity and this parameter of autonomic balance.
Conclusions. The findings of the study enhance the comprehension of the pathophysiology of heart failure and emphasize the significance of recognizing this condition as a syndrome characterized by systemic alterations and interactions with other systems, such as the autonomic nervous system.
Keywords: heart failure, heart rate variability, frequency-domain parameters.

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Address for correspondence:
Giovanni-Paul PORTELLI
Department of Cardio-Thoracic Pathology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050471, Bucharest, Romania


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Portellli GP, Stanica IC, Hodorogea A, Uscoiu G, Ghita N, Zaharia O, Nanea IT. Differences in autonomic nervous imbalance across the spectrum of heart failure through ECG Holter power spectral analysis. Arch Balk Med Union. 2024;59(2):142-151.