Evaluation of heart-rate turbulence as a new prognostic marker in patients with chronic heart failure

Jiro Koyama, Jun Watanabe, Aki Yamada, Yoshito Koseki, Yuji Konno, Sunao Toda, Tsuyoshi Shinozaki, Masahito Miura, Mitsumasa Fukuchi, Mototsugu Ninomiya, Yutaka Kagaya, Kunio Shirato

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94 Citations (Scopus)


The significance of heart-rate turbulence (HRT) in patients with chronic heart failure (CHF) was evaluated to examine whether it is sensitive to the risk of ventricular tachycardia (VT). HRT is reported to predict the prognosis after myocardial infarction (MI), but its prognostic value in patients with CHF remains unknown. HRT was measured in 50 CHF patients (left ventricular ejection fraction <50% and/or left ventricular end-diastolic diameter >55mm, 34 cardiomyopathy, 16 post-MI) and 21 patients without obvious heart diseases (control). HRT slope and HRT onset were measured by the original definitions using digitized Holter ECG recordings. Cardiac pump function was assessed by echocardiography. The value of the HRT slope was significantly lower in CHF than in control (3.7±1.7 vs 16.4±5.3, mean±SD, p<0.01). The value of the HRT onset in patients with CHF was significantly higher than that in control patients (-1.1±1.9 vs -3.6±1.7, mean±SD, p<0.05). The HRT slope and onset in CHF patients with VT were nearly identical to those without VT. The HRT slope appears to be a powerful prognostic marker that shows significant differences between CHF subgroups when divided by clinical events; that is, CHF death and CHF hospitalization. However, it has limited value for predicting fatal ventricular arrhythmias.

Original languageEnglish
Pages (from-to)902-907
Number of pages6
JournalCirculation Journal
Issue number10
Publication statusPublished - 2002 Oct 1


  • Heart rate variability
  • Late potential
  • SDNN
  • Sudden cardiac death
  • T wave alternans

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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