Orthostatic Stress and Baroreflex Sensitivity: A Window into Autonomic Dysfunction in Lone Paroxysmal Atrial Fibrillation
The abnormal neural control of atria has been considered one of the mechanisms of paroxysmal atrial fibrillation (PAF) pathogenesis. The baroreceptor reflex has an important role in cardiovascular regulation and may serve as an index of autonomic function. This study aimed to analyze the barorecepto...
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| Format: | Article |
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MDPI AG
2023-09-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/18/5857 |
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| author | Mónica Ferreira Sérgio Laranjo Pedro Cunha Vera Geraldes Mário Oliveira Isabel Rocha |
| author_facet | Mónica Ferreira Sérgio Laranjo Pedro Cunha Vera Geraldes Mário Oliveira Isabel Rocha |
| author_sort | Mónica Ferreira |
| collection | DOAJ |
| description | The abnormal neural control of atria has been considered one of the mechanisms of paroxysmal atrial fibrillation (PAF) pathogenesis. The baroreceptor reflex has an important role in cardiovascular regulation and may serve as an index of autonomic function. This study aimed to analyze the baroreceptor reflex’s role in heart rate regulation during upright tilt (HUT) in patients with lone PAF. The study included 68 patients with lone PAF and 34 healthy individuals who underwent baroreflex assessment. Parameters such as baroreflex sensitivity (BRS), number of systolic blood pressure (BP) ramps, and the baroreflex effectiveness index (BEI) were evaluated. The study found that PAF patients had comparable resting BPs and heart rates (HRs) to healthy individuals. However, unlike healthy individuals, PAF patients showed a sustained increase in BP with an upright posture followed by the delayed activation of the baroreceptor function with a blunted HR response and lower BEI values. This indicates a pronounced baroreflex impairment in PAF patients, even at rest. Our data suggest that together with BRS, BEI could be used as a marker of autonomic dysfunction in PAF patients, making it important to further investigate its relationship with AF recurrence after ablation and its involvement in cardiovascular autonomic remodeling. |
| first_indexed | 2024-03-10T22:37:24Z |
| format | Article |
| id | doaj.art-a2d27367223243fe821cdecd3d764a17 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T22:37:24Z |
| publishDate | 2023-09-01 |
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| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-a2d27367223243fe821cdecd3d764a172023-11-19T11:18:21ZengMDPI AGJournal of Clinical Medicine2077-03832023-09-011218585710.3390/jcm12185857Orthostatic Stress and Baroreflex Sensitivity: A Window into Autonomic Dysfunction in Lone Paroxysmal Atrial FibrillationMónica Ferreira0Sérgio Laranjo1Pedro Cunha2Vera Geraldes3Mário Oliveira4Isabel Rocha5Faculdade de Medicina and Centro Cardiovascular da Universidade de Lisboa—CCUL, Universidade de Lisboa, 1649-004 Lisbon, PortugalArrhythmology, Pacing and Electrophysiology Unit, Serviço de Cardiologia, Hospital de Santa Marta, Centro Hospitalar Universitário de Lisboa Central—CHULC, 1150-199 Lisbon, PortugalArrhythmology, Pacing and Electrophysiology Unit, Serviço de Cardiologia, Hospital de Santa Marta, Centro Hospitalar Universitário de Lisboa Central—CHULC, 1150-199 Lisbon, PortugalFaculdade de Medicina and Centro Cardiovascular da Universidade de Lisboa—CCUL, Universidade de Lisboa, 1649-004 Lisbon, PortugalArrhythmology, Pacing and Electrophysiology Unit, Serviço de Cardiologia, Hospital de Santa Marta, Centro Hospitalar Universitário de Lisboa Central—CHULC, 1150-199 Lisbon, PortugalFaculdade de Medicina and Centro Cardiovascular da Universidade de Lisboa—CCUL, Universidade de Lisboa, 1649-004 Lisbon, PortugalThe abnormal neural control of atria has been considered one of the mechanisms of paroxysmal atrial fibrillation (PAF) pathogenesis. The baroreceptor reflex has an important role in cardiovascular regulation and may serve as an index of autonomic function. This study aimed to analyze the baroreceptor reflex’s role in heart rate regulation during upright tilt (HUT) in patients with lone PAF. The study included 68 patients with lone PAF and 34 healthy individuals who underwent baroreflex assessment. Parameters such as baroreflex sensitivity (BRS), number of systolic blood pressure (BP) ramps, and the baroreflex effectiveness index (BEI) were evaluated. The study found that PAF patients had comparable resting BPs and heart rates (HRs) to healthy individuals. However, unlike healthy individuals, PAF patients showed a sustained increase in BP with an upright posture followed by the delayed activation of the baroreceptor function with a blunted HR response and lower BEI values. This indicates a pronounced baroreflex impairment in PAF patients, even at rest. Our data suggest that together with BRS, BEI could be used as a marker of autonomic dysfunction in PAF patients, making it important to further investigate its relationship with AF recurrence after ablation and its involvement in cardiovascular autonomic remodeling.https://www.mdpi.com/2077-0383/12/18/5857atrial fibrillationbaroreceptor reflexautonomic functionbaroreflex gainbaroreflex effectiveness index |
| spellingShingle | Mónica Ferreira Sérgio Laranjo Pedro Cunha Vera Geraldes Mário Oliveira Isabel Rocha Orthostatic Stress and Baroreflex Sensitivity: A Window into Autonomic Dysfunction in Lone Paroxysmal Atrial Fibrillation Journal of Clinical Medicine atrial fibrillation baroreceptor reflex autonomic function baroreflex gain baroreflex effectiveness index |
| title | Orthostatic Stress and Baroreflex Sensitivity: A Window into Autonomic Dysfunction in Lone Paroxysmal Atrial Fibrillation |
| title_full | Orthostatic Stress and Baroreflex Sensitivity: A Window into Autonomic Dysfunction in Lone Paroxysmal Atrial Fibrillation |
| title_fullStr | Orthostatic Stress and Baroreflex Sensitivity: A Window into Autonomic Dysfunction in Lone Paroxysmal Atrial Fibrillation |
| title_full_unstemmed | Orthostatic Stress and Baroreflex Sensitivity: A Window into Autonomic Dysfunction in Lone Paroxysmal Atrial Fibrillation |
| title_short | Orthostatic Stress and Baroreflex Sensitivity: A Window into Autonomic Dysfunction in Lone Paroxysmal Atrial Fibrillation |
| title_sort | orthostatic stress and baroreflex sensitivity a window into autonomic dysfunction in lone paroxysmal atrial fibrillation |
| topic | atrial fibrillation baroreceptor reflex autonomic function baroreflex gain baroreflex effectiveness index |
| url | https://www.mdpi.com/2077-0383/12/18/5857 |
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