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Alterações da Actividade Autonómica Durante o Teste de Inclinação em Doentes com Fibrilhação Auricular Paroxística: Análise com Wavelets

dc.contributor.authorOliveira, MM
dc.contributor.authorNogueira da Silva, M
dc.contributor.authorTimóteo, AT
dc.contributor.authorFeliciano, J
dc.contributor.authorSilva, S
dc.contributor.authorXavier, R
dc.contributor.authorRocha, I
dc.contributor.authorSilva-Carvalho, L
dc.contributor.authorCruz Ferreira, R
dc.date.accessioned2011-07-22T14:40:19Z
dc.date.available2011-07-22T14:40:19Z
dc.date.issued2009
dc.description.abstractThe autonomic nervous system (ANS) is known to be an important modulator in the pathogenesis of paroxysmal atrial fibrillation (PAF). Changes in ANS control of heart rate variability (HRV) occur during orthostatism to maintain cardiovascular homeostasis. Wavelet transform has emerged as a useful tool that provides time-frequency decomposition of the signal under investigation, enabling intermittent components of transient phenomena to be analyzed. AIM: To study HRV during head-up tilt (HUT) with wavelet transform analysis in PAF patients and healthy individuals (normals). METHODS: Twenty-one patients with PAF (8 men; age 58 +/- 14 yrs) were examined and compared with 21 normals (7 men, age 48 +/- 12 yrs). After a supine resting period, all subjects underwent passive HUT (60 degrees) while in sinus rhythm. Continuous monitoring of ECG and blood pressure was carried out (Task Force Monitor, CNSystems). Acute changes in RR-intervals were assessed by wavelet analysis and low-frequency power (LF: 0.04-0.15 Hz), high-frequency power (HF: 0.15-0.60 Hz) and LF/HF (sympathovagal) were calculated for 1) the last 2 min of the supine period; 2) the 15 sec of tilting movement (TM); and 3) the 1st (TT1) and 2nd (TT2) min of HUT. Data are expressed as means +/- SEM. RESULTS: Baseline and HUT RR-intervals were similar for the two groups. Supine basal blood pressure was also similar for the two groups, with a sustained increase in PAF patients, and a decrease followed by an increase and then recovery in normals. Basal LF, HF and LF/ HF values in PAF patients were 632 +/- 162 ms2, 534 +/- 231 ms2 and 1.95 +/- 0.39 respectively, and 1058 +/- 223 ms2, 789 +/- 244 ms2 and 2.4 +/- 0.36 respectively in normals (p = NS). During TM, LF, HF and LF/HF values for PAF patients were 747 +/- 277 ms2, 387 +/- 94 ms2 and 2.9 +/- 0.6 respectively, and 1316 +/- 315 ms2, 698 +/- 148 ms2 and 2.8 +/- 0.6 respectively in normals (p < 0.05 for LF and HF). During TF1, LF, HF and LF/ HF values for PAF patients were 1243 +/- 432 ms2, 302 +/- 88 ms2 and 7.7 +/- 2.4 respectively, and 1992 +/- 398 ms2, 333 +/- 76 ms2 and 7.8 +/- 0.98 respectively for normals (p < 0.05 for LF). During TF2, LF, HF and LF/HF values for PAF patients were 871 +/- 256 ms2, 242 +/- 51 ms2 and 4.7 +/- 0.9 respectively, and 1263 +/- 335 ms2, 317 +/- 108 ms2 and 8.6 +/- 0.68 respectively for normals (p < 0.05 for LF/HF). The dynamic profile of HRV showed that LF and HF values in PAF patients did not change significantly during TM or TT2, and LF/HF did not change during TM but increased in TT1 and TT2. CONCLUSION: Patients with PAF present alterations in HRV during orthostatism, with decreased LF and HF power during TM, without significant variations during the first minutes of HUT. These findings suggest that wavelet transform analysis may provide new insights when assessing autonomic heart regulation and highlight the presence of ANS disturbances in PAF.por
dc.identifier.citationRev Port Cardiol. 2009 Mar;28(3):243-57por
dc.identifier.urihttp://hdl.handle.net/10400.17/321
dc.language.isoporpor
dc.peerreviewedyespor
dc.publisherSociedade Portuguesa de Cardiologiapor
dc.subjectFibrilhação Auricularpor
dc.subjectSistema Nervoso Autónomopor
dc.subjectProcessos Biofísicospor
dc.subjectTeste de Inclinaçãopor
dc.subjectHSM CAR
dc.titleAlterações da Actividade Autonómica Durante o Teste de Inclinação em Doentes com Fibrilhação Auricular Paroxística: Análise com Waveletspor
dc.title.alternativeAlterations in Autonomic Response Head-Up Tilt Testing in Paroxysmal Atrial Fibrillation Patients: a Wavelet Analysispor
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage257por
oaire.citation.startPage243por
oaire.citation.titleRevista Portuguesa de Cardiologiapor
rcaap.rightsopenAccesspor
rcaap.typearticlepor

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