Baroreflex Sensitivity and its Association with Arrhythmic Events in Chagas Disease
Background:Sudden death is the leading cause of death in Chagas disease (CD), even in patients with preserved ejection fraction (EF), suggesting that destabilizing factors of the arrhythmogenic substrate (autonomic modulation) contribute to its occurrence.Objective:To determine baroreflex sensitivity (BRS) in patients with undetermined CD (GI), arrhythmogenic CD with nonsustained ventricular tachycardia (NSVT) (GII) and CD with spontaneous sustained ventricular tachycardia (STV) (GIII), to evaluate its association with the occurrence and complexity of arrhythmias.Method:Forty-two patients with CD underwent ECG and continuous and noninvasive BP monitoring (TASK force monitor). The following were determined: BRS (phenylephrine method); heart rate variability (HRV) on 24-h Holter; and EF (echocardiogram).Results:GIII had lower BRS (6.09 ms/mm Hg) as compared to GII (11.84) and GI (15.23). The difference was significant between GI and GIII (p = 0.01). Correlating BRS with the density of ventricular extrasystoles (VE), low VE density (<10/h) was associated with preserved BRS. Only 59% of the patients with high VE density (> 10/h) had preserved BRS (p = 0.003). Patients with depressed BRS had higher VE density (p = 0.01), regardless of the EF. The BRS was the only variable related to the occurrence of SVT (p = 0.028).Conclusion:The BRS is preserved in undetermined CD. The BRS impairment increases as disease progresses, being more severe in patients with more complex ventricular arrhythmias. The degree of autonomic dysfunction did not correlate with EF, but with the density and complexity of ventricular arrhythmias.
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Sociedade Brasileira de Cardiologia - SBC
2014
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oai:scielo:S0066-782X20140006000082015-11-03Baroreflex Sensitivity and its Association with Arrhythmic Events in Chagas DiseaseSantos,Astrid MeirelesScanavacca,Mauricio IbrahimDarrieux,FranciscoIanni,BárbaraMelo,Sissy Lara dePisani,CristianoSantos Neto,FranciscoSosa,EduardoHachul,Denise Tessariol Chagas Disease Arrhythmias, Cardiac Death, Sudden Baroreflex / physiology Analysis of Variance Background:Sudden death is the leading cause of death in Chagas disease (CD), even in patients with preserved ejection fraction (EF), suggesting that destabilizing factors of the arrhythmogenic substrate (autonomic modulation) contribute to its occurrence.Objective:To determine baroreflex sensitivity (BRS) in patients with undetermined CD (GI), arrhythmogenic CD with nonsustained ventricular tachycardia (NSVT) (GII) and CD with spontaneous sustained ventricular tachycardia (STV) (GIII), to evaluate its association with the occurrence and complexity of arrhythmias.Method:Forty-two patients with CD underwent ECG and continuous and noninvasive BP monitoring (TASK force monitor). The following were determined: BRS (phenylephrine method); heart rate variability (HRV) on 24-h Holter; and EF (echocardiogram).Results:GIII had lower BRS (6.09 ms/mm Hg) as compared to GII (11.84) and GI (15.23). The difference was significant between GI and GIII (p = 0.01). Correlating BRS with the density of ventricular extrasystoles (VE), low VE density (<10/h) was associated with preserved BRS. Only 59% of the patients with high VE density (> 10/h) had preserved BRS (p = 0.003). Patients with depressed BRS had higher VE density (p = 0.01), regardless of the EF. The BRS was the only variable related to the occurrence of SVT (p = 0.028).Conclusion:The BRS is preserved in undetermined CD. The BRS impairment increases as disease progresses, being more severe in patients with more complex ventricular arrhythmias. The degree of autonomic dysfunction did not correlate with EF, but with the density and complexity of ventricular arrhythmias.info:eu-repo/semantics/openAccessSociedade Brasileira de Cardiologia - SBCArquivos Brasileiros de Cardiologia v.102 n.6 20142014-06-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2014000600008en10.5935/abc.20140066 |
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Santos,Astrid Meireles Scanavacca,Mauricio Ibrahim Darrieux,Francisco Ianni,Bárbara Melo,Sissy Lara de Pisani,Cristiano Santos Neto,Francisco Sosa,Eduardo Hachul,Denise Tessariol |
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Santos,Astrid Meireles Scanavacca,Mauricio Ibrahim Darrieux,Francisco Ianni,Bárbara Melo,Sissy Lara de Pisani,Cristiano Santos Neto,Francisco Sosa,Eduardo Hachul,Denise Tessariol Baroreflex Sensitivity and its Association with Arrhythmic Events in Chagas Disease |
author_facet |
Santos,Astrid Meireles Scanavacca,Mauricio Ibrahim Darrieux,Francisco Ianni,Bárbara Melo,Sissy Lara de Pisani,Cristiano Santos Neto,Francisco Sosa,Eduardo Hachul,Denise Tessariol |
author_sort |
Santos,Astrid Meireles |
title |
Baroreflex Sensitivity and its Association with Arrhythmic Events in Chagas Disease |
title_short |
Baroreflex Sensitivity and its Association with Arrhythmic Events in Chagas Disease |
title_full |
Baroreflex Sensitivity and its Association with Arrhythmic Events in Chagas Disease |
title_fullStr |
Baroreflex Sensitivity and its Association with Arrhythmic Events in Chagas Disease |
title_full_unstemmed |
Baroreflex Sensitivity and its Association with Arrhythmic Events in Chagas Disease |
title_sort |
baroreflex sensitivity and its association with arrhythmic events in chagas disease |
description |
Background:Sudden death is the leading cause of death in Chagas disease (CD), even in patients with preserved ejection fraction (EF), suggesting that destabilizing factors of the arrhythmogenic substrate (autonomic modulation) contribute to its occurrence.Objective:To determine baroreflex sensitivity (BRS) in patients with undetermined CD (GI), arrhythmogenic CD with nonsustained ventricular tachycardia (NSVT) (GII) and CD with spontaneous sustained ventricular tachycardia (STV) (GIII), to evaluate its association with the occurrence and complexity of arrhythmias.Method:Forty-two patients with CD underwent ECG and continuous and noninvasive BP monitoring (TASK force monitor). The following were determined: BRS (phenylephrine method); heart rate variability (HRV) on 24-h Holter; and EF (echocardiogram).Results:GIII had lower BRS (6.09 ms/mm Hg) as compared to GII (11.84) and GI (15.23). The difference was significant between GI and GIII (p = 0.01). Correlating BRS with the density of ventricular extrasystoles (VE), low VE density (<10/h) was associated with preserved BRS. Only 59% of the patients with high VE density (> 10/h) had preserved BRS (p = 0.003). Patients with depressed BRS had higher VE density (p = 0.01), regardless of the EF. The BRS was the only variable related to the occurrence of SVT (p = 0.028).Conclusion:The BRS is preserved in undetermined CD. The BRS impairment increases as disease progresses, being more severe in patients with more complex ventricular arrhythmias. The degree of autonomic dysfunction did not correlate with EF, but with the density and complexity of ventricular arrhythmias. |
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Sociedade Brasileira de Cardiologia - SBC |
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2014 |
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http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2014000600008 |
work_keys_str_mv |
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