Document Detail


Cardiac autonomic and ventricular mechanical functions in asymptomatic chronic chagasic cardiomyopathy.
MedLine Citation:
PMID:  22218415     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The association of variably altered cardiac autonomic and ventricular systolic and diastolic functions is still controversial and little explored in chronic Chagas' disease.
OBJECTIVE: To evaluate the extent to which cardiac autonomic and mechanical ventricular functions are altered and whether they are associated in asymptomatic chagasic cardiomyopathy.
METHODS: A total of 13 patients with asymptomatic chagasic cardiomyopathy and 15 normal subjects (control group) were evaluated and the autonomic modulation of heart rate variability for five minutes, in the temporal and spectral domains, in the supine and orthostatic positions, as well as ventricular function based on morphological-functional variables obtained by Doppler echocardiography were correlated. Statistical analysis used the Mann-Whitney test and Spearman's correlation.
RESULTS: In both positions, the temporal index (p = 0.0004 to 0.01) and total (p = 0.0007-0.005) and absolute spectral areas, of low and high frequencies (p = 0.0001 to 0.002), were lower in the chagasic group. The vagal-sympathetic balance was similar in both positions (p = 0.43 to 0.89). The echocardiographic variables did not differ between groups (p = 0.13 to 0.82), except the left ventricular end-systolic diameter, which was larger (p = 0.04) and correlated directly with reduced rates of global (p = 0.01 to 0.04) and parasympathetic (p = 0.002 to 0.01) autonomic modulation in patients with Chagas disease in the orthostatic position.
CONCLUSION: The sympathetic and parasympathetic depressions with preserved balance were associated with only one ventricular dysfunction indicator. This suggests that cardiac autonomic dysfunction may precede and be independently more severe than ventricular dysfunction, with no causal association between both disorders in chronic chagasic cardiomyopathy.
Authors:
Daniel França Vasconcelos; Luiz Fernando Junqueira
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Publication Detail:
Type:  Journal Article     Date:  2012-01-06
Journal Detail:
Title:  Arquivos brasileiros de cardiologia     Volume:  98     ISSN:  1678-4170     ISO Abbreviation:  Arq. Bras. Cardiol.     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-03-01     Completed Date:  2012-10-18     Revised Date:  2012-11-23    
Medline Journal Info:
Nlm Unique ID:  0421031     Medline TA:  Arq Bras Cardiol     Country:  Brazil    
Other Details:
Languages:  eng; por     Pagination:  111-9     Citation Subset:  IM    
Affiliation:
Laboratório Cardiovascular, Faculdade de Medicina, Universidade de Brasília, DF, Brasil. dfrancav@cardiol.br
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MeSH Terms
Descriptor/Qualifier:
Adult
Autonomic Nervous System Diseases / classification,  physiopathology*
Case-Control Studies
Chagas Cardiomyopathy / physiopathology*,  ultrasonography
Chronic Disease
Female
Heart Rate / physiology*
Humans
Male
Middle Aged
Posture / physiology*
Statistics, Nonparametric
Systole
Time Factors
Ventricular Dysfunction, Left / physiopathology*,  ultrasonography
Comments/Corrections
Comment In:
Arq Bras Cardiol. 2012 Sep;99(3):867; author reply 868-9   [PMID:  23011195 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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