Effects of Beta-Blocker on Heart Rate Variability of Heart Failure with Preserved Ejection Fraction

Shiza Saleem, Mohanad Alkhodari, Leontios Hadjileontiadis, Ahsan Khandoker, Herbert Jelinek
Khalifa University


Abstract

Heart failure is characterized by sympathetic activation and parasympathetic withdrawal leading to an abnormal autonomic modulation. Beta-blockers (BB) inhibit overstimulation of the sympathetic system and are indicated in heart failure patients with reduced ejection fraction. However, the effect of beta-blocker therapy on heart failure with preserved ejection fraction (HFpEF) is unclear. This study investigated the effect of BB therapy on heart rate variability (HRV) features as a measure of risk of an abnormal cardiac event. ECGs of seventy-three patients with HFpEF > 55% were recruited. Fifty-six patients in the BB group and 17 patients in the without BB group. HRV analysis was performed for recordings between 6-10 am and 6-10 pm, which are times associated with increased risk of cardiac events. Higher HRV for the BB group were observed. The result shows that RMSSD (p=0.011),HF power (p=0.012),and VLF power (p=0.047) were significantly higher during the 6 – 10 am interval. Sample entropy (p=0.016), PIP (p=0.015), IALS (p=0.015) and PSS (p=0.008) were significantly higher for the 6 – 10 pm. Beta-blocker therapy increases HRV measures in the HFpEF group depending on the feature investigated indicating an overall decreased risk of a cardiac event.