Evidence of parasympathetic impairment in some patients with cardiac syndrome X

Gulli, Giosuè; Cemin, Roberto; Pancera, P; Menegatti, G.; Vassanelli, Corrado; Cevese, Antonio

doi:10.1016/s0008-6363(01)00369-8

Cited by 42 publications

(28 citation statements)

References 40 publications

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“…Autonomic nervous system imbalance with increased adrenergic activity and impaired parasympathetic tone could explain both increased pain sensitivity and endothelial dysfunction. 34,35 More recently, Valeriani et al 36 investigated abnormalities in electric cerebral signals to pain stimuli and found decreased habituation to repetitive noxious stimuli in patients with cardiac syndrome X. In the present study, the majority of patients with syndrome X reported chest pain of moderate extent during adenosine stress.…”

Section: Karamitsos Et Alsupporting

confidence: 53%

Patients With Syndrome X Have Normal Transmural Myocardial Perfusion and Oxygenation

Karamitsos

Arnold

Pegg

et al. 2012

Circ: Cardiovascular Imaging

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Background-The pathophysiology of chest pain in patients with cardiac syndrome X remains controversial. Advances in perfusion imaging with cardiovascular magnetic resonance (CMR) now enable absolute quantification of regional myocardial blood flow (MBF). Furthermore, blood oxygen level-dependent (BOLD) or oxygenation-sensitive CMR provides the unprecedented capability to assess regional myocardial oxygenation. We hypothesized that the combined assessment of regional perfusion and oxygenation with CMR could clarify whether patients with syndrome X show evidence of myocardial ischemia (reduced perfusion and oxygenation) during vasodilator stress compared with normal volunteers. Methods and Results-Eighteen patients with syndrome X (chest pain, abnormal exercise treadmill test, normal coronary angiogram without other causes of microvascular dysfunction) and 14 controls underwent CMR scanning at 3 T. Myocardial function, scar, perfusion (2-3 short-axis slices), and oxygenation were assessed. Absolute MBF was measured during adenosine stress (140 g/kg per minute) and at rest by model-independent deconvolution. For oxygenation, using a T2-prepared BOLD sequence, signal intensity was measured at adenosine stress and rest in the slice matched to the midventricular slice of the perfusion scan. There were no significant differences in MBF at stress (

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Section: Karamitsos Et Alsupporting

confidence: 53%

Patients With Syndrome X Have Normal Transmural Myocardial Perfusion and Oxygenation

Karamitsos

Arnold

Pegg

et al. 2012

Circ: Cardiovascular Imaging

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“…Our data also do not exclude the formal possibility that a parasympathetic rather than a sympathetic dysfunction could be the cause of the autonomic imbalance. Gulli et al (29) observed reduced parasympathetic tone in two thirds of the patients with AL pain and normal coronary arteries, suggesting also an abnormal adrenergic balance. Taken together, these findings further corroborate the hypothesis that abnormal adrenergic function and response to beta-adrenergic stimulation contribute to AL pain in patients with normal coronary arteries.…”

Section: Discussionmentioning

confidence: 98%

Hyperdynamic Myocardial Response to Beta-Adrenergic Stimulation in Patients With Chest Pain and Normal Coronary Arteries

Maďarič

Bartúnek

Verhamme

et al. 2005

Journal of the American College of Cardiology

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“…It is said that the decrease in heart rate variability shows mainly in the inhibition of parasympathetic nerve function, although the impairment of the sympathetic nerve also associated with its decline. [3] And, it is known that a decline of heart rate variability shows in aging, too. [4], [5] If we can evaluate the heart rate variability properly, we can gain much information, for example, about circadian rhythm, [6], [7] cardiac disorders, [3], [6], [8] neurological disorders, [9], [10] diabetic disorders, [11]- [13]or aging.…”

Section: Discussionmentioning

confidence: 99%

An Evaluation Method for Heart Rate Variability, by Using Acceleration Plethysmography

Takada

Okino²,

Niwa

2004

HEP

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Objects We have recently developed a new type of acceleration plethysmography (APG) machine and software. This APG system functions to indicate heart rate variability, by using the coefficient of the variation of the a-a intervals (CVaa%). We tried to evaluate the validity of the APG system to estimate heart rate variability, instead of using ECG. Methods We simultaneously recorded an ECG and an APG by using a 2-channel APG system. We examined the difference between the a-a intervals (Taa) of an APG and the R-R interval of an ECG. Next, APG waveforms of 121 healthy people and 26 diabetics were recorded, and the mean CVaa% in each age category for healthy people and diabetics were calculated. Results 1) All differences between the Taa and the R-R interval were within 10 msec., and the multiple correlation coefficient was 0.999175. 2) The mean CVaa% was 0.2 to 1.5% bigger than the mean coefficient of the variation of the R-R intervals (CVRR%) in all age categories. 3) The mean CVaa% decreased by age. 4) In ages 40-60, mean CVaa% of diabetics was significantly lower than that of healthy people. Conclusion The APG system is suitable to estimate heart rate variability. And, when we want to evaluate heart rate variability by CVaa% of an APG in stead of CVRR% of an ECG, a standard value of CVaa% in each age is necessary. The APG system has some possibilities for explanation of a mechanism of autonomic-nerve-related diseases.

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Evidence of parasympathetic impairment in some patients with cardiac syndrome X

Abstract: In about two thirds of the patients with SX, the pathophysiological mechanism causing the symptoms could be related to the reduced parasympathetic tone, rather than to an augmented sympathetic activity.

Cited by 42 publications

References 40 publications

Patients With Syndrome X Have Normal Transmural Myocardial Perfusion and Oxygenation

Patients With Syndrome X Have Normal Transmural Myocardial Perfusion and Oxygenation

Hyperdynamic Myocardial Response to Beta-Adrenergic Stimulation in Patients With Chest Pain and Normal Coronary Arteries

An Evaluation Method for Heart Rate Variability, by Using Acceleration Plethysmography

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