Heart Rate Variability and Hypercapnia in Duchenne Muscular Dystrophy

Mochizuki, Hitoshi; Okahashi, Satomi; Ugawa, Yoshikazu; Tamura, Takuhisa; Suzuki, Mikiya; Miyatake, Satoko; Shigeyama, Toshiki; Ogata, Katsuhisa; Kawai, Mitsuru

doi:10.2169/internalmedicine.47.1118

Cited by 12 publications

(15 citation statements)

References 18 publications

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“…Further analysis screened out five works that did not include any analysis of HRV indices. The remained 8 studies were of an empirical nature designed as a cross-sectional case control [4,11,19,20], cross-sectional [5,21], prospective case control cohort [19], and a prospective cohort [7] (Table 1). Together, the dataset comprises 549 DMD and 142 healthy participants, and covers distinct ethnic groups: Japanese [5,7,19,22], German [21], Indian [4], Italian [11], and American [20].…”

Section: Study Selectionmentioning

confidence: 99%

“…The relationship between HRV and respiratory function was examined by Lanza et al [11] and Mochizuki et al [5]. The study made by lanza et al [11] showed weak correlations between forced vital capacity and HRV indices, while Mochizuki et al [5] found that HRV index [CVrr coefficient of variation of the RR interval (%)] was negatively correlated with P a CO 2 . Based on the results, the authors proposed that low HRV may indicate respiratory insufficiency in patients with DMD, since 73% of those with CVrr < 3% had hypercapnia, and 47% of them had severe hypercapnia.…”

Section: Study Selectionmentioning

confidence: 99%

“…In this context, the main cause of death in DMD patients was respiratory failure, but the development of personal devices for respiratory support have significantly increased life expectancy of patients with DMD. More recently, progressive cardiac disorders are the main cause of DMD patient loss and morbity [4,5]. Degeneration and necrosis of cardiomyocytes are among the main traits of the Duchenne syndrome.…”

Section: Introductionmentioning

confidence: 99%

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Heart Rate Variability and Cardiopulmonary Dysfunction in Patients with Duchenne Muscular Dystrophy: A Systematic Review

et al. 2018

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Duchenne muscular dystrophy (DMD) is a genetic recessive disorder with progressive muscle weakness. Despite the general muscle wasting, degeneration and necrosis of cardiomyocytes have been the main causes of morbidity and death in individuals with DMD. Cardiac failure is generally preceded by disturbances in heart rate variability (HRV), and non-invasive measurement of the autonomic nervous system has been an important tool to predict adverse cardiovascular events. Hence, the application of HRV to study autonomic modulation in DMD individuals, and the establishment of correlations between HRV and heart/lung diseases, age, and mortality will have the potential to improve quality of life and life expectancy of individuals with DMD. In order to evaluate the state of the art in this field, we conducted a systematic search in Medline/PubMed and BVS (virtual library in health) databases. We selected 8 studies using pre-defined criteria and meta-analysis revealed decreased parasympathetic activity and increased sympathetic predominance in individuals with DMD as major observations. Moreover, there is a strong association between diminished HRV and myocardial fibrosis with DMD. These patterns are evident in patients at early-stage DMD and become more prominent as disease severity and age increase. Thus, data minning clearly indicates that HRV assessment can be used as a predictor for sudden death in individuals with DMD. The use of the HRV, which is inexpensive, ubiquitously available in clinics and hospitals, and a non-invasive analysis tool, can save lives and decrease the morbity in DMD by alerting care givers to consider autonomic nervous system intervention.

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Section: Study Selectionmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Heart Rate Variability and Cardiopulmonary Dysfunction in Patients with Duchenne Muscular Dystrophy: A Systematic Review

et al. 2018

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“…The recent literature has found reduced HRV in DMD [21,22], and it is well known that HRV in DMD is reduced, possibly leading to cardiac [34–36] or respiratory [36–44] failure. As the computational task induces sympathetic primacy it may be applied as a tool for improvement of heart rate autonomic modulation.…”

Section: Discussionmentioning

confidence: 99%

Autonomic Modulation in Duchenne Muscular Dystrophy during a Computer Task: A Prospective Control Trial

et al. 2017

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IntroductionDuchenne Muscular Dystrophy (DMD) is characterized by progressive muscle weakness that can lead to disability. Owing to functional difficulties faced by individuals with DMD, the use of assistive technology is essential to provide or facilitate functional abilities. In DMD, cardiac autonomic dysfunction has been reported in addition to musculoskeletal impairment. Consequently, the objective was to investigate acute cardiac autonomic responses, by Heart Rate Variability (HRV), during computer tasks in subjects with DMD.MethodHRV was assessed by linear and nonlinear methods, using the heart rate monitor Polar RS800CX chest strap Electrocardiographic measuring device. Then, 45 subjects were included in the group with DMD and 45 in the healthy Typical Development (TD) control group. They were assessed for twenty minutes at rest sitting, and five minutes after undergoing a task on the computer.ResultsIndividuals with DMD had a statistically significant lower parasympathetic cardiac modulation at rest when compared to the control group, which further declined when undergoing the tasks on the computer.ConclusionDMD patients presented decreased HRV and exhibited greater intensity of cardiac autonomic responses during computer tasks characterized by vagal withdrawal when compared to the healthy TD control subjects.

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“…Uma alta VFC é sinal de boa adaptação, caracterizando um indivíduo saudável, com mecanismos autonômicos eficientes, enquanto que, uma baixa VFC é frequentemente um indicador de adaptação anormal e insuficiente do SNA, implicando a presença de alterações fisiológicas no indivíduo (Khaled et al, 2006). Diante da importância da utilização da VFC como um marcador que reflete a atividade do SNA e como uma ferramenta clínica para avaliar e identificar comprometimentos na saúde, Katlioriene e Zabiela (2002), Mochizuki et al (2008) e Inoue et al (2009) verificaram o comportamento da VFC em pessoas com DMD assim como outros trabalhos científicos verificaram a influência de estímulos externos na VFC, como estímulo auditivo, apresentado por Valenti et al (2013), bem como estímulo visual (Chang & Huang, 2012), ambiente líquido (Kiviniemi et al, 2012;Christoforidi et al, 2012), ambiente de estresse (Baevskiĭ et al, 2012), mudança de temperatura (Zaproudina et al, 2011). No entanto, apesar de sua importância estabelecida, não foram encontrados trabalhos que verifiquem o comportamento da VFC de pessoas com DMD durante tarefas cotidianas, como em utilização de computador.…”

Section: Introductionunclassified

Modulação autonômica cardíaca na distrofia muscular de Duchenne durante tarefa no computador

Alvarez¹

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Agradeço a Deus pela minha vida, minha saúde, minha família, meus estudos e meu trabalho. Aos meus amados pais Milton Alvarez e Maria Aparecida Boscolo Alvarez (Mara), por me apoiarem e se dedicarem à minha formação pessoal e profissional. Meus exemplos de vida, que sempre me incentivam e vibram com todas as conquistas. À minha amada irmã Marcia Patricia Boscolo Alvarez, sempre companheira, amiga e carinhosa. Ao meu amado marido Gustavo Franchin de Souza, pelo apoio, amor, dedicação, compreensão e paciência. Ao meu orientador Prof. Dr. Carlos Bandeira de Mello Monteiro, a quem admiro como mestre e orientador. Agradeço pela oportunidade, empenho, dedicação e por tornar esta etapa da minha vida possível. Ao Prof. Dr. Vitor Engrácia Valenti, de quem tenho muito orgulho pelo profissionalismo e competência. A quem conheci como "Vitinho", na minha matrícula da graduação, o veterano da faculdade, que se tornou uma referência profissional, sempre disponível a me auxiliar nesta jornada. À extinta ABDIM, a todos os profissionais incríveis com quem trabalhei e trabalho, e aos pacientes e seus familiares, que sempre me motivaram, acolheram e me ensinaram muito. A todos os meus amigos que me acompanharam e me apoiaram nesta jornada e àqueles que auxiliaram em algum momento durante esta jornada, em especial à Profa. Dra. Francis Meire Fávero, pelo apoio, incentivo e confiança, e à colega de pós-graduação Talita Dias da Silva, por todo auxílio, dedicação, paciência e competência. A todos os voluntários que se disponibilizaram e participaram deste estudo. Normalização adotada Esta dissertação está de acordo com as seguintes normas, em vigor no momento desta publicação: Referências: adaptado de International Committee of Medical Journals Editors (Vancouver).

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Heart Rate Variability and Hypercapnia in Duchenne Muscular Dystrophy

Abstract: Objective To investigate the relationship between heart rate variability and hypercapnia. Patients and Methods

Cited by 12 publications

References 18 publications

Heart Rate Variability and Cardiopulmonary Dysfunction in Patients with Duchenne Muscular Dystrophy: A Systematic Review

Heart Rate Variability and Cardiopulmonary Dysfunction in Patients with Duchenne Muscular Dystrophy: A Systematic Review

Autonomic Modulation in Duchenne Muscular Dystrophy during a Computer Task: A Prospective Control Trial

Modulação autonômica cardíaca na distrofia muscular de Duchenne durante tarefa no computador

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