Power-law behavior of heart rate variability in Chagas’ disease

Ribeiro, Antônio Luiz Pinho; Lombardi, Federico; Sousa, Marcos Roberto de; Barros, Márcio Vinícius Lins; Porta, Alberto; Barros, Vladimir Costa Val; Gomes, M.; Machado, Fernando Santana; Rocha, Manoel Otávio Costa

doi:10.1016/s0002-9149(01)02263-9

Cited by 55 publications

(70 citation statements)

References 20 publications

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“…In addition, observations of impaired cardiac autonomic modulation on the sinus node as detected by conventional linear or nonlinear heart rate variability analysis in subjects with Chagas heart disease have also stressed the possibility of a link between autonomic dysfunction and arrhythmias 46,68 . Moreover, several studies based on heart rate variability analysis in patients with coronary disease have showed that altered autonomic influence on the heart has a key role in the vulnerability, development and maintenance of life-threatening arrhythmias, which may result in sudden death 49,50,69 .…”

Section: Dysautonomic Arrhythmogenesis -A Working Hypothesismentioning

confidence: 99%

Insights into the clinical and functional significance of cardiac autonomic dysfunction in Chagas disease

Junqueira Junior

2012

Rev. Soc. Bras. Med. Trop.

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INTRODUCTION: Exclusive or associated lesions in various structures of the autonomic nervous system occur in the chronic forms of Chagas disease. In the indeterminate form, the lesions are absent or mild, whereas in the exclusive or combined heart and digestive disease forms, they are often more pronounced. Depending on their severity these lesions can result mainly in cardiac parasympathetic dysfunction but also in sympathetic dysfunction of variable degrees. Despite the key autonomic effect on cardiovascular functioning, the pathophysiological and clinical significance of the cardiac autonomic dysfunction in Chagas disease remains unknown. METHODS: Review of data on the cardiac autonomic dysfunction in Chagas disease and their potential consequences, and considerations supporting the possible relationship between this disturbance and general or cardiovascular clinical and functional adverse outcomes. RESULTS: We hypothesise that possible consequences that cardiac dysautonomia might variably occasion or predispose in Chagas disease include: transient or sustained arrhythmias, sudden cardiac death, adverse overall and cardiovascular prognosis with enhanced morbidity and mortality, an inability of the cardiovascular system to adjust to functional demands and/or respond to internal or external stimuli by adjusting heart rate and other hemodynamic variables, and immunomodulatory and cognitive disturbances. CONCLUSIONS: Impaired cardiac autonomic modulation in Chagas disease might not be a mere epiphenomenon without significance. Indirect evidences point for a likely important role of this alteration as a primary predisposing or triggering cause or mediator favouring the development of subtle or evident secondary cardiovascular functional disturbances and clinical consequences, and influencing adverse outcomes.

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Section: Dysautonomic Arrhythmogenesis -A Working Hypothesismentioning

confidence: 99%

Insights into the clinical and functional significance of cardiac autonomic dysfunction in Chagas disease

Junqueira Junior

2012

Rev. Soc. Bras. Med. Trop.

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“…Twenty-four-hour Holter monitoring was performed using a portable three-channel cassette tape recorder (Dynamis, Cardios, São Paulo, Brazil) (Ribeiro et al 2002a). Patients were encouraged to continue with their normal everyday activities during the recordings, with the avoidance of physical exercise or drugs that could interfere with autonomic function.…”

Section: Methodsmentioning

confidence: 99%

“…This cutoff point was chosen since it has been previously used in other clinical trials performed in patients with LV dysfunction (Ribeiro et al 2002a). …”

Section: Methodsmentioning

confidence: 99%

Brain natriuretic peptide and left ventricular dysfunction in chagasic cardiomyopathy

Talvani

Rocha

Cogan³

et al. 2004

Mem. Inst. Oswaldo Cruz

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“…Previous studies on this subject have produced contradictory results. Ribeiro et al 6 and Villar et al 7 reported that the intensity of vagal dysfunction is not related to the presence of cardiomyopathy, whereas Davila et al 5, Tundo et al 8 , and Vasconcelos and Junqueira Junior 9 reported an association between autonomic indexes and LV function. The reasons for the absence of a signifi cant correlation in some of the previous studies are most likely related to a small sample size and lack of patients with severe LV dysfunction.…”

mentioning

confidence: 98%

“…In ChD, parasympathetic dysfunction precedes left ventricular (LV) dysfunction 2 , and autonomic and myocardial dysfunction may be independent phenomena. Previous studies have yielded controversial results regarding the relationship between vagal dysfunction and LV function [5][6][7][8][9] .…”

mentioning

confidence: 99%

Is autonomic function associated with left ventricular systolic function in Chagas heart disease patients undergoing treatment for heart failure?

Raadschilders

Rocha

Sousa

et al. 2014

Rev. Soc. Bras. Med. Trop.

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Introduction:The association between cardiac autonomic and left ventricular (LV) dysfunction in Chagas disease (ChD) is controversial. Methods: A standardized protocol that includes the Valsalva maneuver, a respiratory sinus arrhythmia (RSA) test, and an echocardiographic examination was used. Spearman correlation coeffi cients (rho) were used to investigate associations. Results: The study population consisted of 118 ChD patients undergoing current medical treatment, with an average LV ejection fraction of 51.4±2.6%. The LV ejection fraction and diastolic dimension were correlated with the Valsalva index (rho=0.358, p<0.001 and rho=-0.266, p=0.004, respectively) and the RSA (rho=0.391, p<0.001 and rho=-0.311, p<0.001, respectively). Conclusions:The impairment of LV function is directly associated with a reduction of cardiac autonomic modulation in ChD.

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Power-law behavior of heart rate variability in Chagas’ disease

Cited by 55 publications

References 20 publications

Insights into the clinical and functional significance of cardiac autonomic dysfunction in Chagas disease

Insights into the clinical and functional significance of cardiac autonomic dysfunction in Chagas disease

Brain natriuretic peptide and left ventricular dysfunction in chagasic cardiomyopathy

Is autonomic function associated with left ventricular systolic function in Chagas heart disease patients undergoing treatment for heart failure?

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