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01-11-2009 | Original Paper

Fractal scaling properties of heart rate dynamics and myocardial efficiency in dilated cardiomyopathy

Authors: Tiina Marjatta Salo, Jan Sundell, Juhani Knuuti, Jukka Kemppainen, Kira Stolen, Pirjo Nuutila, Timo H. Mäkikallio, Heikki V. Huikuri, K. E. Juhani Airaksinen

Published in: Clinical Research in Cardiology | Issue 11/2009

Abstract

Introduction

Since altered heart rate (HR) fluctuations provide prognostic information in heart failure, we examined the associations between HR dynamics, myocardial efficiency and perfusion, among patients with dilated cardiomyopathy.

Methods

Sixteen patients with dilated cardiomyopathy were enrolled. Patients received supervised strength and aerobic training for 5 months (n = 9) or standard care (n = 7). The short-term scaling exponent (α₁) and frequency domain measures of HR behavior were assessed at baseline and after 5 months of intervention. The left ventricular (LV) function measured using echocardiography and oxidative metabolism measured using positron emission tomography (PET) and [¹¹C]-acetate were used to estimate the myocardial efficiency.

Results

Short-term fractal exponent α₁ correlated significantly with LV myocardial efficiency (r = 0.77, p = 0.002) at baseline. After the intervention period, the majority of patients showed improved myocardial efficiency and small or marked change in HR dynamics toward the natural fractal-like organization (α₁ value close 1). Parallel change in fractal properties of HR and myocardial efficiency after intervention was observed in 78% of the patients. Intervention had no significant effect on any other HR fluctuation indices.

Conclusions

The present study suggests that short-term fractal scaling exponent α₁, an important prognostic marker in heart failure, is related to LV myocardial efficiency.

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Title: Fractal scaling properties of heart rate dynamics and myocardial efficiency in dilated cardiomyopathy
Authors: Tiina Marjatta Salo
Jan Sundell
Juhani Knuuti
Jukka Kemppainen
Kira Stolen
Pirjo Nuutila
Timo H. Mäkikallio
Heikki V. Huikuri
K. E. Juhani Airaksinen
Publication date: 01-11-2009
Publisher: D. Steinkopff-Verlag
Published in: Clinical Research in Cardiology / Issue 11/2009
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-009-0060-y

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