Document Detail


Heart rate variability: a sensitive parameter for detecting abnormal cardiocirculatory changes during a stressful dental procedure.
MedLine Citation:
PMID:  15646606     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The authors conducted a study to evaluate the sensitivity of heart rate variability, or HRV, in quantifying the cardiocirculatory reaction to dental stress compared with other clinical parameters more frequently used in clinical practice. METHODS: Twenty-five healthy subjects (15 men and 10 women aged 19 through 73 years) who underwent dental extractions were enrolled in the study. The authors measured systolic blood pressure, or SBP; diastolic blood pressure, or DBP; heart rate, or HR; and HRV at baseline, immediately after local anesthetic was administered, during the dental extraction and five minutes after the dental extraction. Time domain measures of HRV were based on interbeat intervals and were obtained by using standard deviations of the R-R intervals, which were calculated during a five-minute period in a continuous electrocardiographic record. RESULTS: Analysis of variance for repeated measures showed no time-related difference between the four study periods with regard to SBP and DBP. However, HR values were significantly different in three of the four periods, and HRV values were significantly different in all four testing periods. Furthermore, HRV values exhibited greater variability in the maximum changes recorded during dental extractions compared with HR values (0 to 80 milliseconds versus 0 to 31 beats/minute, respectively). CONCLUSIONS: HRV is a highly sensitive parameter for quantifying the sympathetic drive to the heart during a cardiovascular reaction to a dental operation. CLINICAL IMPLICATIONS: Clinicians may find that HRV evaluation is useful in monitoring patients with heart disease to detect early signs of cardiac impairment related to local, high sympathetic activity and to prevent cardiovascular emergencies.
Authors:
Lucio Montebugnoli; Dora Servidio; Romina Andrea Miaton; Carlo Prati
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of the American Dental Association (1939)     Volume:  135     ISSN:  0002-8177     ISO Abbreviation:  J Am Dent Assoc     Publication Date:  2004 Dec 
Date Detail:
Created Date:  2005-01-13     Completed Date:  2005-02-10     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  7503060     Medline TA:  J Am Dent Assoc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1718-23     Citation Subset:  D; IM    
Affiliation:
Department of Oral Science, University of Bologna, Italy. montebu@alma.unibo.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anesthetics, Local / administration & dosage
Blood Pressure / physiology
Diastole
Electrocardiography
Female
Heart Rate / physiology*
Humans
Linear Models
Male
Mepivacaine / administration & dosage
Middle Aged
Stress, Physiological / physiopathology
Sympathetic Nervous System / physiopathology
Systole
Time Factors
Tooth Extraction*
Chemical
Reg. No./Substance:
0/Anesthetics, Local; 96-88-8/Mepivacaine
Comments/Corrections
Comment In:
J Am Dent Assoc. 2005 Mar;136(3):276, 278; author reply 278   [PMID:  15819338 ]

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


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