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Objective To study the change regulation of heart rate variability (HRV) and its clinical significance in patients with cardiac amyloidosis (CA). Methods Thirty CA inpatients (CA group) and 33 healthy adult volunteers ( control group) were selected for comparative analysis of HRV indexes recorded by 24-hour ambulatory electrocardiograph. Results Compared with the control group, the HRV indexes of SDNN, SDNN Index, triangle index, SDANN, rMSSD, pNN50, HF, LF, and LF / HF ratio of the CA group are all reduced. Among them, SDNN, SDNN Index, triangle index, SDANN, LF and LF / HF ratio of the CA group are significantly lower than those of the control group ( P < 0. 05). Conclusion The decline of HRV indexes in CA patients indicates cardiac autonomic dysfunction. Vagus nerve and sympathetic nerve activities are both weakened, and the latter is dominant. [ABSTRACT FROM AUTHOR]