PMID- 10676601
OWN - NLM
STAT- MEDLINE
DCOM- 20000407
LR  - 20200225
IS  - 0160-9289 (Print)
IS  - 1932-8737 (Electronic)
IS  - 0160-9289 (Linking)
VI  - 23
IP  - 2
DP  - 2000 Feb
TI  - Cardiac autonomic tone and its relation to nonsustained ventricular 
      tachyarrhythmias in idiopathic dilated cardiomyopathy.
PG  - 103-8
AB  - BACKGROUND: In contrast to postinfarct patients, little is known about cardiac 
      autonomic tone and its relation to spontaneous ventricular tachyarrhythmias in 
      idiopathic dilated cardiomyopathy (IDC). Both heart rate variability (HRV) and 
      baroreflex sensitivity (BRS) are indices of autonomic innervation of the heart. 
      HYPOTHESIS: The aim of the present study was to determine the relation between 
      cardiac autonomic tone assessed by HRV and BRS and spontaneous nonsustained 
      ventricular tachycardia (NSVT) on Holter in a large patient population with IDC. 
      METHODS: 24-h digital Holter recordings including HRV analysis and BRS testing 
      were prospectively performed in 137 patients with IDC and preserved sinus rhythm. 
      Mean age was 48 +/- 12 years, and mean left ventricular (LV) ejection fraction 
      was 32 +/- 9%. The HRV analysis on Holter included the mean RR interval (RRm), 
      the standard deviation of all normal RR intervals (SDNN), the square root of the 
      mean of the squared differences between adjacent normal RR intervals (rMSSD), and 
      the proportion of adjacent normal RR intervals differing more than 50 ms (pNN50). 
      Testing for BRS was performed noninvasively using the phenylephrine method. 
      RESULTS: Of 137 study patients, 42 (31%) had spontaneous NSVT on 24-h Holter. 
      Compared with patients without NSVT, patients with NSVT on Holter had a higher 
      New York Heart Association (NYHA) functional class (NYHA III: 40 vs. 18%, p < 
      0.01), a lower ejection fraction (29 +/- 9 vs. 34 +/- 9%, p = 0.01), and an 
      increased LV end-diastolic diameter (69 +/- 8 mm vs. 66 +/- 7 mm, p = 0.03). The 
      HRV variables rMSSD, pNN50, RRm, and BRS did not differ significantly between 
      patients with and without spontaneous NSVT. Only SDNN on Holter was slightly 
      lower in patients with versus without NSVT (106 +/- 45 vs. 121 +/- 46 ms, p = 
      0.08). CONCLUSIONS: Patients with IDC and spontaneous NSVT on Holter are 
      characterized by a higher NYHA functional class, a lower LV ejection fraction, an 
      increased LV end-diastolic diameter, and a tendency toward a lower SDNN value 
      compared with patients without NSVT. The remaining measures of HRV including 
      rMSSD and pNN50 reflecting primarily tonic vagal activity, as well as BRS 
      reflecting predominantly reflex vagal activity, were similar in patients with and 
      without NSVT. The prognostic significance of these findings in patients with IDC 
      is currently under investigation in the Marburg Cardiomyopathy Study (MACAS) at 
      our institution.
FAU - Hoffmann, J
AU  - Hoffmann J
AD  - Department of Cardiology, Hospital of the Philipps-University of Marburg, 
      Germany.
FAU - Grimm, W
AU  - Grimm W
FAU - Menz, V
AU  - Menz V
FAU - Maisch, B
AU  - Maisch B
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Clin Cardiol
JT  - Clinical cardiology
JID - 7903272
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Baroreflex
MH  - Cardiomyopathy, Dilated/complications/*physiopathology
MH  - Electrocardiography, Ambulatory
MH  - Female
MH  - Heart/*innervation
MH  - Heart Rate
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Tachycardia, Ventricular/*diagnosis/etiology
MH  - Vagus Nerve/*physiopathology
PMC - PMC6655140
EDAT- 2000/02/17 00:00
MHDA- 2000/02/17 00:01
PMCR- 2009/02/03
CRDT- 2000/02/17 00:00
PHST- 2000/02/17 00:00 [pubmed]
PHST- 2000/02/17 00:01 [medline]
PHST- 2000/02/17 00:00 [entrez]
PHST- 2009/02/03 00:00 [pmc-release]
AID - CLC4960230207 [pii]
AID - 10.1002/clc.4960230207 [doi]
PST - ppublish
SO  - Clin Cardiol. 2000 Feb;23(2):103-8. doi: 10.1002/clc.4960230207.