| Parasympathetic effects on cardiac electrophysiology during exercise and recovery in patients with left ventricular dysfunction. | |
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MedLine Citation:
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PMID: 19525382 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Depressed parasympathetic activity has been proposed to be associated with an increased risk of sudden death. Parasympathetic effects (PE) on cardiac electrophysiology during exercise and recovery have not been studied in patients with left ventricular dysfunction. We performed noninvasive electrophysiological studies (NI-EPS) and characterized the electrophysiological properties of the sinus node, atrioventricular (AV) node, and ventricle in subjects with depressed left ventricular ejection fraction and dual-chamber defibrillators. NI-EPS were performed during rest, exercise, and recovery at baseline and after parasympathetic blockade with atropine to assess PE (the difference between parameter values in the 2 conditions). Ten subjects (9 men: age, 60 +/- 9 yr; and left ventricular ejection fraction, 29 +/- 8%) completed the study. All NI-EPS parameters decreased during exercise and trended toward rest values during recovery. PE at rest, during exercise, and during recovery, respectively, were on sinus cycle length, 320 +/- 71 (P = 0.0001), 105 +/- 60 (P = 0.0003), and 155 +/- 82 ms (P = 0.0002); on AV block cycle length, 137 +/- 136 (P = 0.09), 37 +/- 19 (P = 0.002), and 61 +/- 39 ms (P = 0.006); on AV interval, 58 +/- 32 (P = 0.035), 22 +/- 13 (P = 0.002), and 36 +/- 20 ms (P = 0.001); on ventricular effective refractory period, 15.8 +/- 11.3 (P = 0.02), 4.7 +/- 15.2 (P = 0.38), and 6.8 +/- 15.5 ms (P = 0.20); and on QT interval, 13 +/- 12 (P = 0.13), 3 +/- 17 (P = 0.6), and 20 +/- 23 (P = 0.04). In conclusion, we describe for the first time the changes in cardiac electrophysiology and PE during rest, exercise, and recovery in subjects with left ventricular dysfunction. PEs are preserved in these patients. Thus the role of autonomic changes in the pathophysiology of sudden death requires further exploration. |
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Authors:
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Alexandru B Chicos; Prince J Kannankeril; Alan H Kadish; Jeffrey J Goldberger |
Publication Detail:
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Type: Clinical Trial; Journal Article; Research Support, N.I.H., Extramural Date: 2009-06-12 |
Journal Detail:
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Title: American journal of physiology. Heart and circulatory physiology Volume: 297 ISSN: 1522-1539 ISO Abbreviation: Am. J. Physiol. Heart Circ. Physiol. Publication Date: 2009 Aug |
Date Detail:
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Created Date: 2009-07-28 Completed Date: 2009-09-01 Revised Date: 2010-09-27 |
Medline Journal Info:
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Nlm Unique ID: 100901228 Medline TA: Am J Physiol Heart Circ Physiol Country: United States |
Other Details:
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Languages: eng Pagination: H743-9 Citation Subset: IM |
Affiliation:
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Division of Cardiology, Bluhm Cardiovascular Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Atrioventricular Block / diagnosis, drug therapy, physiopathology Atrioventricular Node / drug effects, innervation, physiology Atropine / administration & dosage* Blood Pressure / physiology Defibrillators, Implantable Electrocardiography Exercise / physiology* Female Heart Failure / physiopathology Heart Rate / physiology Heart Ventricles / innervation Humans Male Middle Aged Parasympathetic Nervous System / drug effects*, physiology* Parasympatholytics / administration & dosage* Rest / physiology Sinoatrial Node / drug effects, innervation, physiology Stroke Volume / physiology Ventricular Dysfunction, Left / physiopathology* |
| Grant Support | |
ID/Acronym/Agency:
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1-RO1-HL-70179-01A2/HL/NHLBI NIH HHS; M01-RR-00048/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Parasympatholytics; 51-55-8/Atropine |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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