P. Bienias, M. Ciurzyński, O. Dzikowska-Diduch, Z. Rymarczyk , M. Roik , M. Kostrubiec , M. Kurzyna , A. Torbicki , A. Fijałkowska, P. Pruszczyk

16th Congress of International Society of Holter and Noninvasive Electrocardiography, Lyon, Francja, 04-06.06.2015; Scientific Program and Abstract Book ISHNE 2015, s12 Introduction: Heart rate variability (HRV) and turbulence (HRT) are validated methods of cardiac autonomic nervous system (ANS) function evaluation. Cardiac ANS dysfunction is associated with poor prognosis and sudden cardiac death. We assessed HRV and especially HRT alterations according to the type and functional severity of pulmonary hypertension (PH). Materials & Methods: Out of consecutive 60 PH patients, 22 with arterial PH (PAH) and 21 with chronic thromboembolic PH (CTEPH) were enrolled in the study (aged 54.7±18 years, mean disease duration 4.2 years, 28F). Control group consisted of 30 healthy persons. Routine assessment, echocardiography, right heart catheterization (RHC) and 24 h Holter monitoring with time-domain HRV and HRT assessment were performed. Abnormal HRT was diagnosed when turbulence onset (TO) was ≥0.0% and/or turbulence slope (TS) was ≤2.5 ms/RR. Results: Most of HRV indices (SDNN, SDANN, SDNNI) and both of HRT parameters were significantly impaired in PH, as compared to controls. Patients in WHO FC III IV or with CTEPH presented more compromised HRV and HRT when compared to WHO FC I II or with PAH, respectively (table). Echocardiographic and RHC measurements did not differ significantly in PH groups. Abnormal HRT was found in 12 (54%) PAH and in 17 (81%) CTEPH pts (p=0.10), while in 9 (50%) WHO FC Class I II and in 20 (80%) Class III IV pts (p=0.05). Multivariate regression analysis showed that abnormal HRT in all PH pts was related to higher WHO FC (OR 5.3, 95%CI 1.4 19.9, p=0.01) Conclusions: Higher WHO FC and CTEPH increases cardiac ANS dysfunction assessed by heart rate variability and turbulence. However, clinical implications of our findings need further investigations.