Impairment of autonomic nervous system activity in patients with pulmonary arterial hypertension: a case control study.
J Card Fail
; 15(10): 882-9, 2009 Dec.
Article
em En
| MEDLINE
| ID: mdl-19944365
ABSTRACT
BACKGROUND:
Chronotropic response to exercise (CR) and heart rate recovery (HRR) immediately after exercise are indirect indices of sympathetic and parasympathetic activity, respectively. The aim of this study was to evaluate CR and HRR in patients with pulmonary arterial hypertension (PAH) in relation to disease severity. METHODS ANDRESULTS:
Ten PAH patients (6 females/4 males, mean age 48+/-12 years) and 10 control subjects matched for age, gender, and body mass index (6 females/4 males, mean age 46+/-6 years) performed a ramp incremental symptom-limited cardiopulmonary exercise test on a cycle ergometer. Main measurements included heart rate at rest (HR), CR=[(peak HR-resting HR/220-age-resting HR)x100, %], HRR(1)=HR difference from peak exercise to 1minute after, ventilatory efficiency during exercise (VE/VCO(2) slope), peak oxygen uptake (VO(2)p), and the first-degree slope of VO(2) for the first minute of the recovery period (VO(2)/t-slope). PAH patients had a significantly decreased CR (58+/-31 vs 92+/-13, %, P < .001) and HRR(1) (10+/-5 vs 29+/-6, beats/min, P < .001) as well as VO(2)p (11.9+/-3.5 vs 26.9+/-6.6, mL.kg.min) and VO(2)/t-slope (0.2+/-0.1 vs. 0.9+/-0.2, mL.kg.min(2)) compared with controls. CR and HRR(1) correlated well with VO(2)p (r=0.7; P < .001 and r=0.85; P < .001, respectively) and VO(2)/t-slope (r=0.66; P < .001 and r=0.85; P < .001, respectively) and had a significant inverse correlation with VE/VCO(2) slope (r=-0.47; P < .01 and r=-0.77; P < .001, respectively).CONCLUSIONS:
PAH patients present a significant impairment of CR and HRR(1) in relation to disease severity, indicating profound autonomic nervous system abnormalities.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doenças do Sistema Nervoso Autônomo
/
Hipertensão Pulmonar
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Card Fail
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2009
Tipo de documento:
Article
País de afiliação:
Grécia