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AUTONOMIC NERVOUS SYSTEM IN PATIENTS WITH CONGESTIVE HEART FAILURE TREATED WITH BETA-BLOCKERS: A HOLTER STUDY.
T.Mandecki, L.Kulejewski, A.Wilczek-Banc.
2-nd Clinic of Cardiology Silesian Medical Academy,Katowice.
Smali doses of beta-blockers (BB) added to the conventional therapy for the congestive heart failure (CHF) seem to be beneficial according to many randomised studies.The improvement in prognosis after BB in these pts m partially reflected in the quality of cardiac arrhythmias. In order to prove if it may be due to the changes in the activation of autonomic nervous system we analysed the frequency parameters of the heart rate variability (HRV) in two groups of pts: A-treated conventionally with small doses of BB added and B-those who did not tolerate the BB. The results:



 

start

group A stat.sign.

n=31 end

start

group B stat.sign.

n=27 end


HRmean

73+/-16

p.<0,01

65+/-13

75+/-17

n.s.

72+/ 15


Lown

15

p.<0,05

8

14

n.s.

13


III,IV

(31,9%)

 

(17%)

(38,9%)

 

(36,1%)


LF/HF mean

4,6

n.s.

4.4

6,2

n.s.

6,3





CONCLUSIONS:
1.The improvement of the cardiac arrhythmias as well as the slowing of the mean heart rate is not reflected in the values of frequency parameters of HRV which could be the sign of the full adrenergic blockade.
2.Paradoxically most pts who did not tolerate the BB had the values of HRV
frequency parameters indicating the high adrenergic drive, probably due to the very
poor left ventricle performance.




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