Advanced search
Start date
Betweenand
Related content
(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Day-night pattern of autonomic nervous system modulation in patients with heart failure with and without sleep apnea

Full text
Author(s):
Ueno, Linda M. [1, 2] ; Drager, Luciano F. [1] ; Rodrigues, Ana C. T. [1] ; Rondon, Maria U. P. B. [1] ; Mathias, Jr., Wilson [1] ; Krieger, Eduardo M. [1] ; Fazan Junior, Rubens [3] ; Negrao, Carlos E. [1, 4] ; Lorenzi-Filho, Geraldo [4]
Total Authors: 9
Affiliation:
[1] Univ Sao Paulo, Heart Inst InCor, BR-03828000 Sao Paulo, Ermelino Matara - Brazil
[2] Univ Sao Paulo, Escola Artes Ciencias & Humanidades, BR-03828000 Sao Paulo, Ermelino Matara - Brazil
[3] Univ Sao Paulo, Sch Med Ribeirao Preto, BR-03828000 Sao Paulo, Ermelino Matara - Brazil
[4] Univ Sao Paulo, Sch Phys Educ & Sport, BR-03828000 Sao Paulo, Ermelino Matara - Brazil
Total Affiliations: 4
Document type: Journal article
Source: INTERNATIONAL JOURNAL OF CARDIOLOGY; v. 148, n. 1, p. 53-58, APR 2011.
Web of Science Citations: 12
Abstract

Introduction: Among patients with congestive heart failure (CHF) both obstructive and central sleep apnea (SA) are associated with increased sympathetic activity. However, the day-night pattern of cardiac autonomic nervous system modulation in CHF patients with and without sleep apnea is unknown. Material and methods: Twenty-five CHF patients underwent polysomnography with simultaneous beat-to-beat blood pressure (Portapres), respiration and electrocardiogram monitoring. Patients were divided according to the presence (SA, n=17) and absence of SA (NoSA, n=8). Power spectral analyses of heart rate variability (HRV) and spontaneous baroreflex sensitivity (BRS) were determined in periods with stable breathing while awake at 6 AM, 10 AM, 10 PM, as well as during stage 2 sleep. In addition, muscle sympathetic nerve activity (MSNA) was evaluated at 10 AM. Results: RR variance, low-frequency (LF), high-frequency (HF) powers of HRV, and BRS were significantly lower in patients with SA compared with NoSA in all periods. HF power, a marker of vagal activity, increased during sleep in patients with NoSA but in contrast did not change across the 24-hour period in patients with SA. MSNA was significantly higher in patients with SA compared with NoSA. RR variance, LF and HF powers correlated inversely with simultaneous MSNA (r=-0.64, -0.61, and -0.61 respectively; P < 0.01). Conclusions: Patients with CHF and SA present a reduced and blunted cardiac autonomic modulation across the 24-hour period. These findings may help to explain the increased cardiovascular risk in patients with CHF and SA. (C) 2009 Elsevier Ireland Ltd. All rights reserved. (AU)