HEART RATE VARIABILITY IN DILATED CARDIOMYOPATHY
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To evaluate the clinical importance of heart rate variability ( HRV) in patients with dilated cardiomyopathy (DCM), time domain and frequency domain analysis of 24 hour HRV was performed in 40 patients with DCM (group A): [29(72.5%) patients with ischemic cardiomyopathy and11(27.5%)patients with idiopathic cardiomyopathy; 26(65%)males and 14(35%) females with a mean age 44+12 years] and 20 normal healthy controls (group B): [12(60%)males and 8 (40%)females with a mean age 43+11 years]. All measurements of HRV were significantly reduced in patients with DCM compared with the control group (P<0.01) . 29/40 ( 72.5%) patients completed their follow up for 6±2 months ; 11 (38%) developed progressive heart failure (HF) defined by a deterioration in NYHA functional class that was refractory to maximal medical therapy. This group included 4 cardiac deaths during their follow up, while the remaining 18 (62%) remained clinically stable. Measures of HRV were further reduced in patients who developed progressive HF during follow up than in those who remained clinically stable. The SDNNI measure of the time domain HRV was correlated with NYHA functional class, enddiastolic dimension (EDD) and reduced left ventricular ejection fraction (EF). HRV was reduced in patients with DCM and related to disease severity. HRV is clinically useful as an early noninvasive marker of DCM deterioration.