Кардиоваскулярная терапия и профилактика (Aug 2006)
Prognostic value of high-resolution electrocardiography parameters, heart rate variability, and QT interval dynamics in patients with chronic heart failure
Abstract
Aim. To study prognostic value of high-resolution electrocardiography (HR-ECG), heart rate variability (HRV), QT interval dispersion and duration parameters, for assessing the risk of chronic heart failure (CHF) decompensation, atrial fibrillation (AF), and sudden cardiac death (SCD) in coronary heart disease (CHD) patients. Material and methods. In total, 70 patients with various CHD forms, Functional Class II-III CHF (NYHA), and documented AF paroxysms in anamnesis, were examined. Instrumental examination included 24-hour ECG monitoring, echocardiography, ECG, HR-ECG, HRV assessment. Results. During prognostic follow-up, the participants were divided into groups, according to disease course and clinical outcome. End-points included: CHF decompensation, resulted in hospitalization; arrhythmic complications - prolonged AF paroxysms; SCD. Assessing prognostic value of HR-ECG, HRV and QT interval duration in predicting CHF decompensation, ECG predictors with maximal positive prognostic value were filtered QRS complex duration and corrected maximal QT interval. In predicting AF paroxysms, HR-ECG parameter, filtered P wave duration, had maximal prognostic value. Conclusion. Non-invasive ECG-diagnostics methods: HR-ECG, HRV and QT interval duration assessment, could be used in predicting arrhythmic complication and decompensation risk among CHD patients with CHF.