Negative Predictors of Heart Rate Variability and Quality of Life in Patients with Heart Failure and Mid-Range Ejection Fraction:A Cross-Sectional and Descriptive Study
DOI:
https://doi.org/10.71164/socialmedicine.v18i2.2025.1807Abstract
Introduction. Heart Rate Variability (HRV) is a health indicator and a predictor for sudden cardiac death among patients with Heart Failure with mid-range Ejection fraction (HFmrEF). Many factors have a negative influence on HRV. This study aims to assess the prevalence of known factors associated with low HRV and the correlation between HRV and Quality of life (QoL)among HFmrEF patients. Methods.A cross-sectional descriptive study took place at a tertiary cardiac care center in Kannur district, Kerala, from February to June 2023. The study involved 250 participants with HFmrEF. The researchers collected data using a consecutive sampling technique. They utilized the Minnesota Living with Heart Failure Questionnaire to assess quality of life, and a checklist to identify negative predictors of HRV. They used an HRV finger sensor to assess HRV and performed the analysis using Spearman’s rank correlation coefficient and descriptive statistics. Results.The significant study findings show the prevalence of known negative predictors among HFmrEF patients such as stress (83.6%), male gender (78.8%), poor sleep habits (58.4%), unhealthy eating behavior (55.6%), physical inactivity (53.2%), being overweight (40.8%), age over 60 years(39.2%), smoking (36.8%), diabetes (33.6%), alcoholism (23.6%), and chronic noise exposure (20.4%).The quality of life for patients with HFmrEF was reported as poor in 59% of cases, moderate in 27%, and good in 14%. A moderate negative correlation was identified between the quality of life and HRV score (r = -0.43, p < 0.001).Conclusion. The moderate inverse relationship between HRV and QoL score emphasizes the importance of improving HRV in patients with HF.Stress emerged as the primary adverse predictor, and acknowledging these negative factors can shed light on their management, ultimately contributing to a more favorable prognosis.
References
Harikrishnan S, Jeemon P, Ganapathi S, Agarwal A, Viswanathan S, Sreedharan M, et al. Five-year mortality and readmission rates in patients with heart failure in India: Results from the Trivandrum heart failure registry. Int J Cardiol [Internet]. 2021;326:139–43. Available from: http://dx.doi.org/10.1016/j.ijcard.2020.10.012
Gastelurrutia P, Lupón J, Moliner P, Yang X, Cediel G, de Antonio M, et al. Comorbidities, fragility, and quality of life in heart failure patients with midrange ejection fraction. Mayo Clin Proc Innov Qual Outcomes [Internet]. 2018;2(2):176–85. Available from: http://dx.doi.org/10.1016/j.mayocpiqo.2018.02.004
Chattipakorn N, Incharoen T, Kanlop N, Chattipakorn S. Heart rate variability in myocardial infarction and heart failure. Int J Cardiol [Internet]. 2007;120(3):289–96. Available from: http://dx.doi.org/10.1016/j.ijcard.2006.11.221
Arshi B, Geurts S, Tilly MJ, van den Berg M, Kors JA, Rizopoulos D, et al. Heart rate variability is associated with left ventricular systolic, diastolic function and incident heart failure in the general population. BMC Med [Internet]. 2022;20(1):91. Available from: http://dx.doi.org/10.1186/s12916-022-02273-9
Hassan AR, Abdelsamea MS, Elhelw HKR. Assessment of heart rate variability in heart failure patients. Egypt J Hosp Med [Internet]. 2019;77(4):5338–44. Available from: http://dx.doi.org/10.21608/ejhm.2019.56657
Sammito S, Böckelmann I. Factors influencing heart rate variability. Int Cardiovasc For J [Internet]. 2016;6. Available from: http://dx.doi.org/10.17987/icfj.v6i0.242
Jose R, Kamath N, Gopalakrishnapillai S, Sunil S. Predictors of Heart Rate Variability: A systematic review. J Clin Diagn Res [Internet]. 2023; Available from: http://dx.doi.org/10.7860/jcdr/2023/57454.17270
Wu Y, Gu R, Yang Q, Luo Y-J. How do amusement, anger and fear influence heart rate and heart rate variability? Front Neurosci [Internet]. 2019;13:1131. Available from: http://dx.doi.org/10.3389/fnins.2019.01131
Jackowska M, Dockray S, Endrighi R, Hendrickx H, Steptoe A. Sleep problems and heart rate variability over the working day: Sleep problems and heart rate variability. J Sleep Res [Internet]. 2012;21(4):434–40. Available from: http://dx.doi.org/10.1111/j.1365-2869.2012.00996.x
Rickenbacher P, Kaufmann BA, Maeder MT, Bernheim A, Goetschalckx K, Pfister O, et al. Heart failure with mid-range ejection fraction: a distinct clinical entity? Insights from the Trial of Intensified versus standard Medical therapy in Elderly patients with Congestive Heart Failure (TIME-CHF): Heart failure with mid-range ejection fraction: a distinct clinical entity? Eur J Heart Fail [Internet]. 2017;19(12):1586–96. Available from: http://dx.doi.org/10.1002/ejhf.798
Tegegne BS, Man T, van Roon AM, Riese H, Snieder H. Determinants of heart rate variability in the general population: The Lifelines Cohort Study. Heart Rhythm [Internet]. 2018;15(10):1552–8. Available from: http://dx.doi.org/10.1016/j.hrthm.2018.05.006
Molfino A, Fiorentini A, Tubani L, Martuscelli M, Rossi Fanelli F, Laviano A. Body mass index is related to autonomic nervous system activity as measured by heart rate variability. Eur J Clin Nutr [Internet]. 2009;63(10):1263–5. Available from: http://dx.doi.org/10.1038/ejcn.2009.35
Lindholm H, Sinisalo J, Ahlberg J, Hirvonen A, Hublin C, Partinen M, et al. Attenuation of vagal recovery during sleep and reduction of cortisol/melatonin ratio in late afternoon associate with prolonged daytime sleepiness among media workers with irregular shift work. Am J Ind Med [Internet]. 2012;55(7):643–9. Available from: http://dx.doi.org/10.1002/ajim.22042
Lu W-C, Tzeng N-S, Kao Y-C, Yeh C-B, Kuo TBJ, Chang C-C, et al. Correlation between health-related quality of life in the physical domain and heart rate variability in asymptomatic adults. Health Qual Life Outcomes [Internet]. 2016;14(1). Available from: http://dx.doi.org/10.1186/s12955-016-0555-y
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
