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

Autor(es)

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]

Afiliação do(s) autor(es)

^[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

• Tipo de documento: Artigo Científico
• Fonte: INTERNATIONAL JOURNAL OF CARDIOLOGY; v. 148, n. 1, p. 53-58, APR 2011.
• Citações Web of Science: 12

Resumo

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)

• Processo FAPESP: 03/10881-2 - Efeitos do treinamento fisico sobre o controle neurovascular em pacientes portadores de insuficiencia cardiaca cronica, com e sem apneia do sono associada a respiracao de cheyne-stokes.
• Beneficiário: Linda Massako Ueno Pardi
• Modalidade de apoio: Bolsas no Brasil - Pós-Doutorado