scholarly journals Assessing the impact of isosorbide mononitrate on sinoatrial node pacemaker activity in patients with III and IV functional class of stable angina

2013 ◽  
Vol 94 (2) ◽  
pp. 163-168
Author(s):  
E A Safronova ◽  
I M Shadrina
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Arterial Hypertension ◽  
Stable Angina ◽  
Sinoatrial Node ◽  
Wave Structure ◽  
Isosorbide Mononitrate ◽  
Pacemaker Activity ◽  
Functional Classes ◽  
The Impact

Aim. To evaluate the peripheral autonomic effects of isosorbide mononitrate on sinoatrial node pacemaker activity using wave structure analysis by rhythmocardiography. Methods. The study included 162 patients with III and IV functional classes of stable angina, among them 122 - with hypertension. The control group consisted of 42 healthy volunteers. In addition to standard techniques (electrocardiography, echocardiography, bicycle ergometry, electrocardiogram daily monitoring), high-resolution rhythmocardiography using a KAP-RK-01-«Mikor» diagnostic complex with time and spectral analysis of the sinus rhythm wave structure was performed. The method is based on the evaluation of peripheral autonomic regulation in the sinoatrial pacemaker and influence of humoral and metabolic environment on it. Results. In all patients with III and IV functional classes of stable angina regardless of the concomitant arterial hypertension heart rate variability, as well as Valsalva maneuver response increased in a number of patients taking isosorbide mononitrate. Negative events related to isosorbide mononitrate intake were reduced parasympathetic fluctuations in a number of cases, humoral-metabolic regulation growth, and increase of sympathetic regulation role in patients with concomitant arterial hypertension. Rhythmocardiography allowed to access the influence of isosorbide mononitrate on heart rate variability in patients with ischemic heart disease. Conclusion. Both positive (increased heart rate variability) and negative (spectral features redistribution with humoral, metabolic and sympathetic components increase and parasympathetic component decrease) effects were associated with isosorbide mononitrate intake with lesser sinoatrial node dysregulation in patients with concomitant arterial hypertension.

scholarly journals Effect of isosorbide dinitrate on sinoatrial node pacemaker activity in patients with stable angina pectoris of III and IV functional classes associated with hypertension

2013 ◽  
Vol 94 (6) ◽  
pp. 793-798
Author(s):  
E A Safronova ◽  
T F Mironova
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Essential Hypertension ◽  
Isosorbide Dinitrate ◽  
Stable Angina ◽  
Metabolic Regulation ◽  
Pacemaker Activity ◽  
Converting Enzyme Inhibitors ◽  
Functional Classes ◽  
Valsalva’S Maneuver

Aim. To study the effect of isosorbide dinitrate on heart rate variability in patients with III and IV functional classes of stable angina and concomitant essential hypertension. Methods. The study involved 122 patients with III and IV functional classes of stable angina and concomitant essential hypertension, mean age 58.4±5.8 years. All patients underwent electrocardiography, Doppler echocardiography, 24-hour ECG monitoring. Rhythmocardiography was performed in the morning before the drug intake (acetylsalycilic acid, beta-blockers, statins, angiotensin-converting enzyme inhibitors) and 1.5 hours after 10 mg isosorbide dinitrate intake. Results. There was a statistically significant increase in overall heart rate variability at Valsalva’s maneuver and active postural test in patients with III and IV functional classes of stable angina and concomitant essential hypertension, which was most likely due to the amplitude of humoral-metabolic waves. The amplitude of the sympathetic pacing fluctuations increased in all samples, while the parasympathetic pacing fluctuation amplitude decreased at Valsalva’s maneuver, Ashner’s test and while lying flat. There was a vegetative spectrum shift towards the humoral-metabolic effect in sympathetic active postural test, sympathetic shift in all tests except for sympathetic active postural test, and significant decrease in parasympathetic effect at Ashner’s test, sympathetic active postural test and while lying flat. Conclusion. In patients with III and IV functional classes of stable angina and concomitant essential hypertension there was an increase in the overall heart rate variability mainly due to the humoral-metabolic and sympathetic waves amplitude increase and parasympathetic amplitude decrease. Isosorbide dinitrate intake resulted in vegetative spectrum redistribution towards humoral and sympathetic metabolic regulation patterns and decrease of parasympathetic regulation pattern, which normally prevails.

The association between heart rate variability and biatrial phasic function in arterial hypertension

2014 ◽  
Vol 8 (10) ◽  
pp. 699-708 ◽  
Author(s):  
Marijana Tadic ◽  
Cesare Cuspidi ◽  
Biljana Pencic ◽  
Tamara Marjanovic ◽  
Vera Celic
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Arterial Hypertension

THE IMPACT OF STRESS ON HEART RATE VARIABILITY OF ON-CALL PHYSICIANS

CHEST Journal ◽  
2005 ◽  
Vol 128 (4) ◽  
pp. 277S
Author(s):  
Stavros E. Mountantonakis ◽  
Dimitrios A. Moutzouris ◽  
Craig McPherson
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
The Impact

Leptinemia, parameters of heart rate variability, and prognosis in patients with essential arterial hypertension with obesity

2014 ◽  
Vol 18 (4 (72)) ◽  
Author(s):  
O. Radchenko ◽  
N. Bek ◽  
V. Potapov
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Essential Hypertension ◽  
Arterial Hypertension ◽  
Cardiovascular Events ◽  
Serum Leptin ◽  
Ventricular Systole ◽  
Essential Arterial Hypertension

An examination of 103 patients with essential hypertension and obesity showed the dependence of autonomic cardioregulation, electrical ventricular systole, and prediction of adverse cardiovascular events on the serum leptin concentration (hyper-, normo – or hypoleptinemia).

Abstract P315: Increase in Stress May Contribute to Lower Heart Rate Variability in Healthy Young Subjects

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Amanda C Costa ◽  
Ana Gabriela C Silva ◽  
Cibele T Ribeiro ◽  
Guilherme A Fregonezi ◽  
Fernando A Dias
Keyword(s):  
Cardiovascular Disease ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Healthy Volunteers ◽  
Perceived Stress ◽  
Low Frequency ◽  
Statistical Correlation ◽  
Total Power ◽  
The Impact ◽  
Nonparametric Correlation

Background: Stress is one of the risk factors for cardiovascular disease and decreased heart rate variability is associated to increased mortality in some cardiac diseases. The aim of the study was to assess the impact of perceived stress on cardiac autonomic regulation in young healthy volunteers. Methods: 35 young healthy volunteers (19 to 29 years old, 6 men) from a Brazilian population were assessed for perceived stress by the translated and validated Perceived Stress Scale (PSS, 14 questions) and had the R-R intervals recorded at rest on supine position (POLAR RS800CX) and analyzed (5 minutes, Kubius HRV software) by Fast-Fourier Transform for quantification of Heart Rate Variability (HRV). Results: Average data (±SD) for age, heart rate, BMI, waist circumference and percentage of body fat (%BF) were: 21.3±2.7 years; 65.5±7.9 bpm; 22.3±1.9 Kg/m 2 ; 76.0±6.1 cm and 32.1±6.6%; respectively. The mean score for the PSS-14 was 23.5±7.2 and for the HRV parameter as follow: SSDN=54.8±21.2ms; rMSSD=55.9±32.2ms; low-frequency (LF)= 794.8±579.7ms 2 ; High-frequency (HF)= 1508.0±1783.0 ms 2 ; LF(n.u.)= 41.1±16.2; HF(n.u.)= 58.9±16.2; LF/HF=0.89±0.80 and Total power (TP)= 3151±2570ms 2 . Spearman nonparametric correlation was calculated and there was a significant correlation of PSS-14 scores and LF (ms 2 ) (r=−0.343; p= 0.044). Other HRV variables did not shown significant correlation but also had negative values for Spearman r (TP r=−0.265, p=0.124; HF r=−0.158; SSDN r=−0.207; rMSSD r=−0.243, p=0.160). LF/HF and LF(n.u.) did not correlate to PSS-14 having Spearman r very close to zero (LF/HF r=−0.007, p=0.969; LF(n.u.) r=−0.005, p=0.976). No correlation was found for HRV parameters and BMI and there was a trend for statistical correlation of %BF and LF (ms 2 ) (r=−0.309, p=0.071). Conclusions: These data demonstrate a possible association of perceived stress level and HRV at rest. Changes in LF can be a consequence of both sympathetic and parasympathetic activity, however, analyzing the other variables HF, TP, SSDN and rMSSD (all negative Spearman r) and due to the lack of changes in LF/HF ratio and LF(n.u.) we interpret that increased stress may be associated to decrease in overall heart rate variability. These changes were seen in healthy individuals and may point out an important mechanism in cardiovascular disease development.

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