Email this article Heart rate variability in patients with neurocardiogenic syncopes
- Authors: Abdrakhmanov AS1, Abdrakhmanov AS1
-
Affiliations:
- Issue: Vol 81, No 5 (2009)
- Pages: 75-77
- Section: Editorial
- URL: https://ter-arkhiv.ru/0040-3660/article/view/30374
- ID: 30374
Cite item
Full Text
Abstract
Aim. To investigate chronotropic heart regulation and prognostic significance of heart rate variability (HRV) in patients with neurocardiogenic syncopes (NCS).
Material and methods. A total of 90 patients (25 healthy controls and 65 patients with documented HRV, mean age 33.9 ± 17.4 years) were divided into 3 groups depending on an NCS type (cardioinhibitory, n = 18; vasodepressive, n = 25; mixed, n = 22). All the examinees have undergone a long-term passive head-up tilt table test with registration and analysis of HRV.
Results. A cardioinhibitory NCS variant was characterized by slow heart rate (both at rest and test), increased mode amplitude - Amo (by 28, 1, 21, 6 and 46.8% at rest, tilt test, in rehabilitation, respectively), range of deviation (RD) (by 47, 1, 62, 5 and 52.9%, respectively). A simultaneous rise of indices characterizing activity of the sympathic and parasympathic parts of the autonomic nervous system led to the absence of significant differences of the integral parameters (Amo/RD; index of regulatory system tension) vs control. Still more marked changes in the indices of cardiovascular vegetative regulation were registered in a vasodepressive NCS, but the differences with the control were moderate. Vegetative tonicity and reactivity in mixed NCS represent an intermediate variant between cardioinhibitory and vasodepressory types.
Conclusion. In NCS patients circadian HRV was less than in the controls. The parasympathic tonicity prevails in all NCS types. Moreover, NCS is affected by episodes of activation of sympathico-adrenal system. Typical HRV in different NCS variants allows using this method for their diagnosis, prognosis and follow-up of the patients.
Material and methods. A total of 90 patients (25 healthy controls and 65 patients with documented HRV, mean age 33.9 ± 17.4 years) were divided into 3 groups depending on an NCS type (cardioinhibitory, n = 18; vasodepressive, n = 25; mixed, n = 22). All the examinees have undergone a long-term passive head-up tilt table test with registration and analysis of HRV.
Results. A cardioinhibitory NCS variant was characterized by slow heart rate (both at rest and test), increased mode amplitude - Amo (by 28, 1, 21, 6 and 46.8% at rest, tilt test, in rehabilitation, respectively), range of deviation (RD) (by 47, 1, 62, 5 and 52.9%, respectively). A simultaneous rise of indices characterizing activity of the sympathic and parasympathic parts of the autonomic nervous system led to the absence of significant differences of the integral parameters (Amo/RD; index of regulatory system tension) vs control. Still more marked changes in the indices of cardiovascular vegetative regulation were registered in a vasodepressive NCS, but the differences with the control were moderate. Vegetative tonicity and reactivity in mixed NCS represent an intermediate variant between cardioinhibitory and vasodepressory types.
Conclusion. In NCS patients circadian HRV was less than in the controls. The parasympathic tonicity prevails in all NCS types. Moreover, NCS is affected by episodes of activation of sympathico-adrenal system. Typical HRV in different NCS variants allows using this method for their diagnosis, prognosis and follow-up of the patients.
References
- Джанашия П. Х., Шевченко Н. М. Синкопальные состояния. М.; 2004.
- Баевский Р. М., Кириллов О. И., Клецкин С. З. Математический анализ изменений сердечного ритма при стрессе. М.: Наука; 1984. 39-93.
- Task forse of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Heart rate variability. Standards of measurment, physiological interpretation and clinical use. Circulation 1996; 9: 1043-1056.
- Зорин А. В. и др. Нарушения вегетативной регуляции при ишемии миокарда. Тер. арх. 1999; 9: 57-61.
- van Boven A. J., Jukema J. W., Haariksma J. et al. Depressed heart rate variability is associated with events in patients with stable coronary artery disease and preserved left ventricular function. Am Heart J. 1998; 135(4): 571-576.
- Lombardi F., Mortara A. Heart rate variability and cardiac failure. Heart 1998; 80: 214-231.
- Явелов И. С., Грацианский Н. А., Зуйков Ю. А. Вариабельность ритма сердца при острых коронарных синдромах: значение для оценки прогноза заболевания. Часть 1 и 2. Кардиология. 1997; 2: 61-68.
Supplementary files
