Wensel, R. and Jilek, C. and Doerr, M. and Francis, D. P. and Stadler, H. and Lange, T. and Blumberg, F. and Opitz, C. and Pfeifer, M. and Ewert, R. (2009) Impaired cardiac autonomic control relates to disease severity in pulmonary hypertension. EUROPEAN RESPIRATORY JOURNAL, 34 (4). pp. 895-901. ISSN 0903-1936, 1399-3003
Full text not available from this repository. (Request a copy)Abstract
Pulmonary arterial hypertension (PAH) results in chronic right heart failure, which is associated with an increase in sympathetic tone. This may adversely affect cardiac autonomic control. We investigated the changes in cardiac autonomic nervous activity in relation to disease severity in patients with PAH. In 48 patients with PAH (median World Health Organization class III, pulmonary artery pressure 52 +/- 14 mmHg, pulmonary vascular resistance 1,202 +/- 718 dyn.s.cm(-5), cardiac index 2.0 +/- 0.8 L.min(-1).m(-2)) and 41 controls, cardiac autonomic nervous activity was evaluated by measurement of heart rate variability (HRV) and baroreflex sensitivity. All patients underwent cardiopulmonary exercise testing (peak oxygen uptake 13.2 +/- 5.1 mL.kg(-1).min(-1), minute ventilation/carbon dioxide production slope 47 +/- 16). In patients with PAH, spectral power of HRV was reduced in the high-frequency (239 +/- 64 versus 563 +/- 167 ms(2)), low-frequency (245 +/- 58 versus 599 +/- 219 ms(2)) and very low-frequency bands (510 +/- 149 versus 1106 +/- 598 ms(2); all p < 0.05). Baroreflex sensitivity was also blunted (5.8 +/- 0.6 versus 13.9 +/- 1.2 ms.mmHg(-1); p < 0.01). The reduction in high-frequency (r=0.3, p=0.04) and low-frequency (r=0.33, p=0.02) spectral power and baroreflex sensitivity (r=0.46, p < 0.01) was related to the reduction in peak oxygen uptake. Patients with PAH have a marked alteration in cardiac autonomic control that is related to exercise capacity and may, therefore, serve as an additional marker of disease severity.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CHRONIC HEART-FAILURE; SYMPATHETIC-NERVE ACTIVITY; ARTERIAL-HYPERTENSION; RATE-VARIABILITY; SPECTRAL-ANALYSIS; GAS-EXCHANGE; EXERCISE; MORTALITY; PATHOPHYSIOLOGY; ASSOCIATION; Exercise capacity; heart autonomic system; heart rate variability; pulmonary hypertension |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 04 Sep 2020 04:57 |
| Last Modified: | 04 Sep 2020 04:57 |
| URI: | https://pred.uni-regensburg.de/id/eprint/28327 |
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