Cardiovascular autonomic control in patients undergoing left ventricular assist device (LVAD) support and pharmacologic therapy.
OBJECTIVES: The objective of the study is to determine cardiac autonomic control in patients undergoing assessment for and/or LVAD therapy. METHODS: Heart rate variability (HRV) was measured in 17 explanted LVAD, 17 implanted LVAD and 23 NYHA III-IV classified chronic heart failure (CHF) patients an...
| Main Authors: | , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
2013
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| _version_ | 1797068985569640448 |
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| author | Nunan, D Sandercock, G George, R Jakovljevic, D Donovan, G Bougard, R Yacoub, M Brodie, D Birks, E |
| author_facet | Nunan, D Sandercock, G George, R Jakovljevic, D Donovan, G Bougard, R Yacoub, M Brodie, D Birks, E |
| author_sort | Nunan, D |
| collection | OXFORD |
| description | OBJECTIVES: The objective of the study is to determine cardiac autonomic control in patients undergoing assessment for and/or LVAD therapy. METHODS: Heart rate variability (HRV) was measured in 17 explanted LVAD, 17 implanted LVAD and 23 NYHA III-IV classified chronic heart failure (CHF) patients and ten healthy matched controls under three conditions: supine free breathing, standing and supine controlled breathing. Five measures of HRV were assessed: mean R-R interval (mR-R), high frequency (HF) and low frequency (LF) spectral power, LF in normalised units (LFnu), and LF to HF (LF:HF) ratio. RESULTS: Repeat measures ANOVA showed significant (p < 0.05) differences in HRV between all three conditions within groups. Lower values were observed in CHF for LF(in log natural units) compared with explanted patients (-1.4 [95% CI -2.6 to -0.7], p = 0.04) and controls (-2.1 [-3.5 to -0.7], p = 0.001) and for LF:HF compared with implanted patients under paced breathing conditions (z = -2.7, p = 0.007) and controls in standing (z = -2.9, p = 0.004) and paced breathing conditions (z = -2.3, p = 0.02). However, no significant differences were seen between explanted, implanted and control groups under any condition. CONCLUSIONS: Patients implanted with an LVAD and explanted from a LVAD following myocardial recovery demonstrate a more normal dynamic response to autonomic stimuli and have a lower HRV risk profile compared to CHF patients. |
| first_indexed | 2024-03-06T22:17:54Z |
| format | Journal article |
| id | oxford-uuid:5408b1ee-508e-402c-8955-adadc46a7f19 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T22:17:54Z |
| publishDate | 2013 |
| record_format | dspace |
| spelling | oxford-uuid:5408b1ee-508e-402c-8955-adadc46a7f192022-03-26T16:35:19ZCardiovascular autonomic control in patients undergoing left ventricular assist device (LVAD) support and pharmacologic therapy.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:5408b1ee-508e-402c-8955-adadc46a7f19EnglishSymplectic Elements at Oxford2013Nunan, DSandercock, GGeorge, RJakovljevic, DDonovan, GBougard, RYacoub, MBrodie, DBirks, EOBJECTIVES: The objective of the study is to determine cardiac autonomic control in patients undergoing assessment for and/or LVAD therapy. METHODS: Heart rate variability (HRV) was measured in 17 explanted LVAD, 17 implanted LVAD and 23 NYHA III-IV classified chronic heart failure (CHF) patients and ten healthy matched controls under three conditions: supine free breathing, standing and supine controlled breathing. Five measures of HRV were assessed: mean R-R interval (mR-R), high frequency (HF) and low frequency (LF) spectral power, LF in normalised units (LFnu), and LF to HF (LF:HF) ratio. RESULTS: Repeat measures ANOVA showed significant (p < 0.05) differences in HRV between all three conditions within groups. Lower values were observed in CHF for LF(in log natural units) compared with explanted patients (-1.4 [95% CI -2.6 to -0.7], p = 0.04) and controls (-2.1 [-3.5 to -0.7], p = 0.001) and for LF:HF compared with implanted patients under paced breathing conditions (z = -2.7, p = 0.007) and controls in standing (z = -2.9, p = 0.004) and paced breathing conditions (z = -2.3, p = 0.02). However, no significant differences were seen between explanted, implanted and control groups under any condition. CONCLUSIONS: Patients implanted with an LVAD and explanted from a LVAD following myocardial recovery demonstrate a more normal dynamic response to autonomic stimuli and have a lower HRV risk profile compared to CHF patients. |
| spellingShingle | Nunan, D Sandercock, G George, R Jakovljevic, D Donovan, G Bougard, R Yacoub, M Brodie, D Birks, E Cardiovascular autonomic control in patients undergoing left ventricular assist device (LVAD) support and pharmacologic therapy. |
| title | Cardiovascular autonomic control in patients undergoing left ventricular assist device (LVAD) support and pharmacologic therapy. |
| title_full | Cardiovascular autonomic control in patients undergoing left ventricular assist device (LVAD) support and pharmacologic therapy. |
| title_fullStr | Cardiovascular autonomic control in patients undergoing left ventricular assist device (LVAD) support and pharmacologic therapy. |
| title_full_unstemmed | Cardiovascular autonomic control in patients undergoing left ventricular assist device (LVAD) support and pharmacologic therapy. |
| title_short | Cardiovascular autonomic control in patients undergoing left ventricular assist device (LVAD) support and pharmacologic therapy. |
| title_sort | cardiovascular autonomic control in patients undergoing left ventricular assist device lvad support and pharmacologic therapy |
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