Cardiac Autonomic Response to Active Standing in Calcific Aortic Valve Stenosis
Aortic stenosis is a progressive heart valve disorder characterized by calcification of the leaflets. Heart rate variability (HRV) analysis has been proposed for assessing the heart response to autonomic activity, which is documented to be altered in different cardiac diseases. The objective of the...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-05-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/9/2004 |
| _version_ | 1797535020841172992 |
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| author | José M. Torres-Arellano Juan C. Echeverría Nydia Ávila-Vanzzini Rashidi Springall Andrea Toledo Oscar Infante Rafael Bojalil Jorge E. Cossío-Aranda Erika Fajardo Claudia Lerma |
| author_facet | José M. Torres-Arellano Juan C. Echeverría Nydia Ávila-Vanzzini Rashidi Springall Andrea Toledo Oscar Infante Rafael Bojalil Jorge E. Cossío-Aranda Erika Fajardo Claudia Lerma |
| author_sort | José M. Torres-Arellano |
| collection | DOAJ |
| description | Aortic stenosis is a progressive heart valve disorder characterized by calcification of the leaflets. Heart rate variability (HRV) analysis has been proposed for assessing the heart response to autonomic activity, which is documented to be altered in different cardiac diseases. The objective of the study was to evaluate changes of HRV in patients with aortic stenosis by an active standing challenge. Twenty-two volunteers without alterations in the aortic valve (NAV) and twenty-five patients diagnosed with moderate and severe calcific aortic valve stenosis (AVS) participated in this cross-sectional study. Ten minute electrocardiograms were performed in a supine position and in active standing positions afterwards, to obtain temporal, spectral, and scaling HRV indices: mean value of all NN intervals (meanNN), low-frequency (LF) and high-frequency (HF) bands spectral power, and the short-term scaling indices (α<sub>1</sub> and α<sub>sign1</sub>). The AVS group showed higher values of LF, LF/HF and α<sub>sign1</sub> compared with the NAV group at supine position. These patients also expressed smaller changes in meanNN, LF, HF, LF/HF, α<sub>1,</sub> and α<sub>sign1</sub> between positions. In conclusion, we confirmed from short-term recordings that patients with moderate and severe calcific AVS have a decreased cardiac parasympathetic supine response and that the dynamic of heart rate fluctuations is modified compared to NAV subjects, but we also evidenced that they manifest reduced autonomic adjustments caused by the active standing challenge. |
| first_indexed | 2024-03-10T11:38:41Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T11:38:41Z |
| publishDate | 2021-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-830514488e9c457c8d644315dd9158b52023-11-21T18:39:59ZengMDPI AGJournal of Clinical Medicine2077-03832021-05-01109200410.3390/jcm10092004Cardiac Autonomic Response to Active Standing in Calcific Aortic Valve StenosisJosé M. Torres-Arellano0Juan C. Echeverría1Nydia Ávila-Vanzzini2Rashidi Springall3Andrea Toledo4Oscar Infante5Rafael Bojalil6Jorge E. Cossío-Aranda7Erika Fajardo8Claudia Lerma9Department of Electromechanical Instrumentation, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, MexicoDepartment of Electrical Engineering, Universidad Autónoma Metropolitana, Unidad Iztapalapa, Mexico City 09340, MexicoDepartment of Outpatients Clinic, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, MexicoDepartment of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, MexicoDepartment of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, MexicoDepartment of Electromechanical Instrumentation, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, MexicoDepartment of Health Care, Universidad Autónoma Metropolitana, Unidad Xochimilco, Mexico City 04960, MexicoDepartment of Outpatients Clinic, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, MexicoDepartment of Outpatients Clinic, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, MexicoDepartment of Electromechanical Instrumentation, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, MexicoAortic stenosis is a progressive heart valve disorder characterized by calcification of the leaflets. Heart rate variability (HRV) analysis has been proposed for assessing the heart response to autonomic activity, which is documented to be altered in different cardiac diseases. The objective of the study was to evaluate changes of HRV in patients with aortic stenosis by an active standing challenge. Twenty-two volunteers without alterations in the aortic valve (NAV) and twenty-five patients diagnosed with moderate and severe calcific aortic valve stenosis (AVS) participated in this cross-sectional study. Ten minute electrocardiograms were performed in a supine position and in active standing positions afterwards, to obtain temporal, spectral, and scaling HRV indices: mean value of all NN intervals (meanNN), low-frequency (LF) and high-frequency (HF) bands spectral power, and the short-term scaling indices (α<sub>1</sub> and α<sub>sign1</sub>). The AVS group showed higher values of LF, LF/HF and α<sub>sign1</sub> compared with the NAV group at supine position. These patients also expressed smaller changes in meanNN, LF, HF, LF/HF, α<sub>1,</sub> and α<sub>sign1</sub> between positions. In conclusion, we confirmed from short-term recordings that patients with moderate and severe calcific AVS have a decreased cardiac parasympathetic supine response and that the dynamic of heart rate fluctuations is modified compared to NAV subjects, but we also evidenced that they manifest reduced autonomic adjustments caused by the active standing challenge.https://www.mdpi.com/2077-0383/10/9/2004aortic valve diseasecardiac autonomic modulationactive standing |
| spellingShingle | José M. Torres-Arellano Juan C. Echeverría Nydia Ávila-Vanzzini Rashidi Springall Andrea Toledo Oscar Infante Rafael Bojalil Jorge E. Cossío-Aranda Erika Fajardo Claudia Lerma Cardiac Autonomic Response to Active Standing in Calcific Aortic Valve Stenosis Journal of Clinical Medicine aortic valve disease cardiac autonomic modulation active standing |
| title | Cardiac Autonomic Response to Active Standing in Calcific Aortic Valve Stenosis |
| title_full | Cardiac Autonomic Response to Active Standing in Calcific Aortic Valve Stenosis |
| title_fullStr | Cardiac Autonomic Response to Active Standing in Calcific Aortic Valve Stenosis |
| title_full_unstemmed | Cardiac Autonomic Response to Active Standing in Calcific Aortic Valve Stenosis |
| title_short | Cardiac Autonomic Response to Active Standing in Calcific Aortic Valve Stenosis |
| title_sort | cardiac autonomic response to active standing in calcific aortic valve stenosis |
| topic | aortic valve disease cardiac autonomic modulation active standing |
| url | https://www.mdpi.com/2077-0383/10/9/2004 |
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