The preserved autonomic functions may provide the asymptomatic clinical status in heart failure despite advanced left ventricular systolic dysfunction

Kocaman, Sinan Altan; Taçoy, Gülten; Özdemir, Murat; Açi̇kgöz, Sadık Kadri; Çengel, Atiye

doi:10.5152/akd.2010.159

Cited by 7 publications

(5 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Thus, it might be said that the sympathetic activation of both CRT and ICD groups were alike and this might be a consequence of the same functional status in both groups. We postulated this relationship in concordance with the previous studies (11,12) and in our study; we also disclosed that those parameters related to sympathetic nervous system activation were significantly different between groups when patients were categorized according to their NYHA functional class. However, a prospective study in which the effects of CRT on both functional capacity and HRV and HRT parameters would be more valuable to prove this relationship.…”

Section: Discussionsupporting

confidence: 80%

“…The functional status of the patients is one of the most important determinants of HRV and HRT parameters in severe HF (10)(11)(12). In studies, which investigated HRV and HRT parameters in CRT patients, improvement of functional capacity was accompanied with the improvement of HRV and HRT parameters in good responders to CRT (13)(14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The effects of cardiac resynchronization treatment on autonomic functions aside from functional status in heart failure

Arslan¹,

Balcı²,

Kocaoğlu³

et al. 2013

Anadolu Kardiyol Derg

View full text Add to dashboard Cite

Objective: Cardiac resynchronization therapy (CRT) improves heart rate variability (HRV) and heart rate turbulence (HRT) parameters. Herein, our aim was to compare these parameters with intracardiac-cardioverter defibrillator (ICD) patients with similar functional status to detect possible additional benefits of CRT on autonomic functions. Methods: Patients who had systolic HF (NYHA class II and III) with an ejection fraction <35% were enrolled in this observational, cross-sectional study. These patients were implanted either an ICD or a CRT device. A 24-hour Holter recording was obtained to assess HRV and HRT parameters in 2 groups. Unpaired t-test and Chi-square test were used for comparisons between 2 groups. Logistic regression analysis was performed to determine the variables affecting functional status. Results: Of 105 patients included in the study; 55 had CRT and 50 had ICD device. The baseline characteristics of the patients were similar in both groups. SDNN, SDANN, SDNN index, and LFnu were similar in both groups; however, RMSSD, pNN50, HFnu, LF/HF ratio, turbulence slope and albeit to a non-significant value turbulence onset were better in CRT group. When the HRV and HRT parameters were compared according to functional status, patients in functional class II had significantly better HRV and HRT parameters when compared to the ones in class III (p<0.05 for all). Regression analysis showed that only SDNN was associated with functional class [OR: 0.89 (95% CI: 0.80-0.98), p=0.03]. After the covariance analysis to eliminate the effects of functional status on HRV and HRT parameters; the parameters mostly related with the parasympathetic system activity, namely RMSSD, pNN50, HFnu, LF/HF ratio, turbulence onset and turbulence slope were still better in CRT group. Conclusion: The most striking finding in our study is that HRV and HRT values related with parasympathetic activation are better in CRT patients when compared to ICD patients with similar functional status. Therefore, upgrading to CRT may have additional benefits on autonomic functions, which needs further investigation. (Anadolu Kardiyol Derg 2013; 13: 439-45) Key words: Heart failure, heart rate variability, heart rate turbulence, cardiac resynchronization therapy, functional status, regression analysis Original Investigation Özgün Araşt›rma 439ÖZET Amaç: Kardiyak resenkronizasyon tedavisinin (KRT) kalp yetersizliği (KY) hastalarında kalp hızı değişkenliği (KHD) ve kalp hızı türbülansını (KHT) düzeltti-ği bilinmektedir. Bu çalışmada amacımız KRT'nin fonksiyonel kapasiteyi düzelterek oluşturduğu KHD ve KHT düzelmesinin üzerine olası ek faydasını incelemektir. Bu amaçla intrakardiyak kardioverter defibrilatörü (İKD) olan KY hastalarındaki KHD ve KHT parametrelerini KRT'li hastalarla karşılaştırdık.Yöntemler: Ejeksiyon fraksiyonu <%35 olan sistolik kalp yetmezlikli (NYHA sınıf 2-3) hastalar bu gözlemsel ve kesitsel çalışmaya dahil edildi. Bu hastalara İKD veya KRT cihazı implante edilmişti. Yirmi dört saatlik Holter EKG kayıtlarından KHD ve ...

show abstract

Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

The effects of cardiac resynchronization treatment on autonomic functions aside from functional status in heart failure

Arslan¹,

Balcı²,

Kocaoğlu³

et al. 2013

Anadolu Kardiyol Derg

View full text Add to dashboard Cite

show abstract

“…Several studies of HRV have led to significant prognostic information in chronic heart failure of both ischemic and nonischemic etiology. Most of the studies have found that especially low standart deviations of all analyzed RR intervals (SDNN) predicts mortality in heart failure patients (7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

The effects of Ramadan fasting on heart rate variability in healthy individuals: A prospective study

Cansel

Taşolar

Yağmur³

et al. 2014

Anadolu Kardiyol Derg

View full text Add to dashboard Cite

Objective: Ramadan fasting is one of the five fundamental rituals of Islam. Heart rate variability (HRV) is an independent predictor of increased mortality of patients with myocardial infarction and congestive heart failure. Although many patients in this region fast once a year, the effects of fasting on the HRV, which has a prognostic significance for patients with myocardial infarction and congestive heart failure, are not known. Therefore, the study on the effects of one month fast of HRV in healthy volunteers seems to be reasonable to address. Methods: Our study is a prospective cohort study that includes a total of 40 healthy volunteers with sinus rhythm between 19 and 40 years of age (16 female and 24 male). HRV was determined twice by ambulatory 24-hour Holter recordings at fasting in the middle of Ramadan and first week after Ramadan month. Mean values of continuous variables were compared by using the Student t-test or Mann-Whitney U test. Paired t-test or Wilcoxon test were used for comparison of variables between groups. Results: When two groups compared, statistically significant differences were found in terms of RR (p=0.049), SDNNI (p=0.010), rMSSD (p=0.009), pNN50 (p=0.015), T power (p=0.009), LF (p=0.008), Lfnu (p=0.002), HF (p=0.022) and Hfnu (p=0.013) values. Conclusion: In our study, HRV parameters were found to be increased in Ramadan month, so we think that Ramadan fasting enhances the activity of the parasympathetic system. (Anadolu Kardiyol Derg 2014; 14: 413-6)

show abstract

“…The absence of congestive HF symptoms like dyspnea and peripheral edema has been reported [9] in a series of patients despite severe depression of systolic function; the asymptomatic status was associated with a preserved autonomic function that was considered having a protective effect against the development of congestive HF symptoms despite increased levels of BNP. Given the physiopathological mechanism of NOMI that is related to a severe functional intestinal ischemia as a consequence of low perfusion state, NOMI is more imputed to forward HF rather than backward HF.…”

Section: Discussionmentioning

confidence: 99%

A Wolf in Sheep's Clothing: A Case of Dilated Cardiomyopathy Presenting with Nonspecific Digestive Symptoms: Insights into Nonocclusive Mesenteric Ischemia

Kossaify

2011

Case Reports in Medicine

View full text Add to dashboard Cite

We report on a 32-year-old male patient who presented to the emergency room for abdominal pain associated with nausea and vomiting. The patient experienced these symptoms for the last 3 months and was taken in charge on an outpatient basis. Assessment in the emergency room showed hemodynamic collapse, there were no signs of acute surgical abdomen. Emergent cardiac echogram showed severely dilated hypokinetic cardiomyopathy. The diagnosis of acute heart failure associated with nonocclusive mesenteric ischemia was retained. A review of the pertinent literature is presented.

show abstract

The preserved autonomic functions may provide the asymptomatic clinical status in heart failure despite advanced left ventricular systolic dysfunction

Cited by 7 publications

References 38 publications

The effects of cardiac resynchronization treatment on autonomic functions aside from functional status in heart failure

The effects of cardiac resynchronization treatment on autonomic functions aside from functional status in heart failure

The effects of Ramadan fasting on heart rate variability in healthy individuals: A prospective study

A Wolf in Sheep's Clothing: A Case of Dilated Cardiomyopathy Presenting with Nonspecific Digestive Symptoms: Insights into Nonocclusive Mesenteric Ischemia

Contact Info

Product

Resources

About