Session PC1.3

Relation of Heart Rate Variability to Serum Levels of C-Reactive Protein in Patients with Severe Sepsis

V Papaioannou*, C Dragoumanis, I Pneumatikos

Democritus University
Alexandroupolis, Greece

In this study, we tried to quantify the instantaneous and longitudinal correlations between different HRV indices and daily measured C-reactive protein (CRP) serum levels in a cohort of patients with severe sepsis and septic shock.
We daily assessed HRV in the time domain [standard deviation of RR intervals (SDNN)] and in the frequency domain (LF, HF, LF/HF), the two values of standard deviation (SD1, SD2), as indicators of the dispersion of RR points obtained from the Poincaré plot and measured CRP levels, in twenty patients admitted to our Intensive Care Unit with a primary diagnosis of severe sepsis. Patients with a previous history of atrial flutter or fibrillation, trauma brain injury and acquired immunodeficiency were excluded from the study. The ECG signal was recorded for 10 minutes and sampled at 250 Hz under sedation and mechanical ventilation. Linear regression and correlation analysis with Pearson’s test was performed on log-transformed HRV data and CRP levels to assess whether HRV variables were independent predictors of CRP and for evaluation of trends over time. Differences between survivors and non-survivors were evaluated by analysis of variance.
CRP blood levels exhibited significant negative correlations with LF (r=-0.78, p<0.01), HF (r=-0.80, p<0.01, LF/HF (r=-0.61, p<0.05) and SDNN (r=-0.79, p<0.01) and a positive correlation with SD1/SD2 (r=0.66, p<0.05. SDNN, LF and HF power values were the most significant predictors of increasing CRP levels (p<0.01 for the 3 comparisons) and proved to be significantly different between survivors and non-survivors (p<0.01 for the 2 comparisons).
Our data support the hypothesis that reduction in HRV indices is associated with high levels of CRP, suggesting a possible pathophysiologic link between autonomic dysfunction and inflammatory response in septic patients.

(Abstract Control Number: 181)