Circadian heart rate and blood pressure variability in autonomic failure [Variabilidade da frequência cardíaca e da pressão arterial na disfunção autonómica]

• Type: Article in International Scientific Journal
• Date: 2005

Authors

Freitas, J (Author) FMUP; Teixeira, E (Author) Other; Santos, R (Author) Other; Elsa Azevedo (Author) FMUP; Carvalho, M (Author) Other; Rocha Goncalves, F (Author) Other

Journal

Title: Revista Portuguesa de Cardiologia

Vol. 24 No. 11

Pages: 241-249

ISSN: 0870-2551

Publisher: Sociedade Portuguesa De Cardiologia

Indexing

Scopus - 6 Citations

Other information

Authenticus ID: P-007-CXA

Abstract (EN): Autonomic failure (AF) induces disabling orthostatic symptoms. Short-term heart rate (HR) and blood pressure (BP) orthostatic patterns are well characterized in these patients but data on long-term blood pressure and heart rate monitoring is lacking. The aim of this study was to assess circadian HR and BP variation in AF patients. We studied 8 patients with severe AF (7 with TTRmet30+ familial amyloidotic polyneuropathy and 1 with pure autonomic failure) - Group A, and 2 control groups (8 asymptomatic TTRmet30 + patients - Group B, and 16 normal aged-matched controls - Group C). All groups underwent 24h HR and BP monitoring. Twenty-four-hour systolic (SBP) and diastolic BP (DBP) were similar in all groups (114.5 ± 10.6 and 73.2 ± 6.7; 123.0 ± 6.2 and 79.0 ± 9.5; 118.6 ± 10.1 and 71.4 ± 9.4 mmHg for groups A, B and C respectively). BP dipping was attenuated or even inverted (p < 0.01) in AF patients (SBP and DBP differences between day and night: -1.6 ± 11.6 and 3.3 ± 6.3; 10.0 ± 1.0 and 11.7 ± 1.5; 15.6 ± 7.9 and 16.2 ± 5.8 mmHg for groups A, B and C respectively; p < 0.01). Although mean 24h HR was similar between patients and controls (80.9 ± 14.0, 87.0 ± 14.6 and 80.7 ± 5.2 bpm for groups A, B and C respectively), there were striking differences in heart rate variability between groups (max-min 24h HR difference: 46 ± 16, 89 ± 11 and 91 ± 9 bpm; pNN50: 0 ±0, 6 ± 2 and 12 ± 6%; SDRR. 68 ± 24, 128 ± 10 and 148 ± 32 ms for groups A, BB and C; p < 0.01). There were significant differences between normal controls and asymptomatic TTRmet30 4 controls in mean HR, diastolic blood pressure dipping and pNN50; p < 0.05. Autonomic failure can be suspected by simple 24h blood pressure evaluation and heart rate monitoring. Asymptomatic TTRmet30+ patients may already show some degree of autonomic impairment, particularly early vagal dysfunction.

Language: English

Type (Professor's evaluation): Scientific