Original Investigation 11Autonomic control in CVS can be assessed by HRV analysis.Various time domain and frequency domain indices are usually used for this purpose (2). The physiological explanation of these indices is known (2,19,20). These indices can assess cardiac autonomic regulation but not peripheral blood flow. In our previous papers, we have proposed an original method for the assessment of cardiovascular autonomic control based on synchronization between the 0.1-Hz rhythms in heart rate (HR) and photoplethysmogram (PPG) (21). The quality of 0.1-Hz rhythms synchronization was found to be higher in healthy subjects than in patients with cardiovascular disease (22). From a physiological viewpoint, the synchronization of 0.1-Hz rhythms is the result of adequate functional interaction of CVS parts (heart and peripheral vessels). The clinical importance of this diagnostic method is shown for patients with prior myocardial infarction, patients with acute coronary syndrome, and hypertensive patients (3,23). The physiological explanation of 0.1-Hz rhythms in PPG is a debatable point. An opto-physiological model of a finger in conjunction with a near-infrared reflectance PPG device has been proposed (24). It was shown that both oscillations in the microcirculatory bed and blood filling of digital arteries make a substantial contribution to the PPG signal. Therefore, 0.1-Hz oscillations in PPG may be associated directly with baroreceptor regulation of blood pressure (BP). At the same time, a number of authors assume that 0.1-Hz oscillations in blood microcirculation are not associated with autonomic regulation (25)(26)(27)(28). To avoid confusion, we do not interpret the origin of 0.1-Hz oscillations in PPG in the present paper. Thus, the features of cardiovascular autonomic control in women before and after menopause are not fully understood. Controversial results concerning this problem have been reported. The aim of the present study cross-sectional study is to assess the features of autonomic control of CVS in pre-and postmenopausal women.
Material and Methods
PatientsThe study was approved by the ethics committee of the Saratov Research Institute of Cardiology in Saratov, Russia (no. 24, Sept. 12, 2013) and informed consent was obtained from all participants. Our cross-sectional study included 185 postmenopausal women aged 59.3±8.5 years (mean±SD) and 104 premenopausal women aged 45.1±5.8 years. Both groups were investigated and treated, if necessary, in the clinic of Saratov State Medical University (Saratov, Russia). Clinical characteristics (cardiovascular, gynecological, etc.) were assessed in all women. We assessed the level of the following sex hormones: estradiol, follicle-stimulating hormone (FSH), dehydroepiandrosterone sulfate (DHEAS), and testosterone. Only patients aged between 35 and 70 years were enrolled in our study. Women with CVD were not on beta-blockers or calcium channel blockers during the 7 days before the start of the study.Patients were not included in our study if they ...