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Sympatho–Vagal Dysfunction in Patients with End-Stage Lung Disease Awaiting Lung Transplantation

Although the literature demonstrates that cardiac autonomic control (CAC) might be impaired in patients with chronic pulmonary diseases, the interplay between CAC and disease severity in end-stage lung disease has not been studied yet. We investigated the effects of end-stage lung disease on CAC thr...

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Autores principales: Tobaldini, Eleonora, Rodrigues, Gabriel D., Mantoan, Giorgio, Monti, Alice, Coti Zelati, Giulia, Cirelli, Camilla, Tarsia, Paolo, Morlacchi, Letizia Corinna, Rossetti, Valeria, Righi, Ilaria, Nosotti, Mario, da S. Soares, Pedro Paulo, Montano, Nicola, Aliberti, Stefano, Blasi, Francesco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230240/
https://www.ncbi.nlm.nih.gov/pubmed/32316428
http://dx.doi.org/10.3390/jcm9041146
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author Tobaldini, Eleonora
Rodrigues, Gabriel D.
Mantoan, Giorgio
Monti, Alice
Coti Zelati, Giulia
Cirelli, Camilla
Tarsia, Paolo
Morlacchi, Letizia Corinna
Rossetti, Valeria
Righi, Ilaria
Nosotti, Mario
da S. Soares, Pedro Paulo
Montano, Nicola
Aliberti, Stefano
Blasi, Francesco
author_facet Tobaldini, Eleonora
Rodrigues, Gabriel D.
Mantoan, Giorgio
Monti, Alice
Coti Zelati, Giulia
Cirelli, Camilla
Tarsia, Paolo
Morlacchi, Letizia Corinna
Rossetti, Valeria
Righi, Ilaria
Nosotti, Mario
da S. Soares, Pedro Paulo
Montano, Nicola
Aliberti, Stefano
Blasi, Francesco
author_sort Tobaldini, Eleonora
collection PubMed
description Although the literature demonstrates that cardiac autonomic control (CAC) might be impaired in patients with chronic pulmonary diseases, the interplay between CAC and disease severity in end-stage lung disease has not been studied yet. We investigated the effects of end-stage lung disease on CAC through the analysis of heart rate variability (HRV) among patients awaiting lung transplantation. Forty-nine patients on the waiting list for lung transplantation (LTx; 19 men, age 38 ± 15 years) and 49 healthy non-smoking controls (HC; 22 men, age 40 ± 16 years) were enrolled in a case–control study at Policlinico Hospital in Milan, Italy. LTx patients were divided into two groups, according to disease severity evaluated by the Lung Allocation Score (LAS). To assess CAC, electrocardiogram (ECG) and respiration were recorded at rest for 10 min in supine position and for 10 min during active standing. Spectral analysis identified low and high frequencies (LF, sympathetic, and HF, vagal). Symbolic analysis identified three patterns, i.e., 0V% (sympathetic) and 2UV% and 2LV% (vagal). Compared to HCs, LTx patients showed higher markers of sympathetic modulation and lower markers of vagal modulation. However, more severely affected LTx patients, compared to less severely affected ones, showed an autonomic profile characterized by loss of sympathetic modulation and predominant vagal modulation. This pattern can be due to a loss of sympathetic rhythmic oscillation and a subsequent prevalent respiratory modulation of heart rate in severely affected patients.
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spelling pubmed-72302402020-05-28 Sympatho–Vagal Dysfunction in Patients with End-Stage Lung Disease Awaiting Lung Transplantation Tobaldini, Eleonora Rodrigues, Gabriel D. Mantoan, Giorgio Monti, Alice Coti Zelati, Giulia Cirelli, Camilla Tarsia, Paolo Morlacchi, Letizia Corinna Rossetti, Valeria Righi, Ilaria Nosotti, Mario da S. Soares, Pedro Paulo Montano, Nicola Aliberti, Stefano Blasi, Francesco J Clin Med Article Although the literature demonstrates that cardiac autonomic control (CAC) might be impaired in patients with chronic pulmonary diseases, the interplay between CAC and disease severity in end-stage lung disease has not been studied yet. We investigated the effects of end-stage lung disease on CAC through the analysis of heart rate variability (HRV) among patients awaiting lung transplantation. Forty-nine patients on the waiting list for lung transplantation (LTx; 19 men, age 38 ± 15 years) and 49 healthy non-smoking controls (HC; 22 men, age 40 ± 16 years) were enrolled in a case–control study at Policlinico Hospital in Milan, Italy. LTx patients were divided into two groups, according to disease severity evaluated by the Lung Allocation Score (LAS). To assess CAC, electrocardiogram (ECG) and respiration were recorded at rest for 10 min in supine position and for 10 min during active standing. Spectral analysis identified low and high frequencies (LF, sympathetic, and HF, vagal). Symbolic analysis identified three patterns, i.e., 0V% (sympathetic) and 2UV% and 2LV% (vagal). Compared to HCs, LTx patients showed higher markers of sympathetic modulation and lower markers of vagal modulation. However, more severely affected LTx patients, compared to less severely affected ones, showed an autonomic profile characterized by loss of sympathetic modulation and predominant vagal modulation. This pattern can be due to a loss of sympathetic rhythmic oscillation and a subsequent prevalent respiratory modulation of heart rate in severely affected patients. MDPI 2020-04-17 /pmc/articles/PMC7230240/ /pubmed/32316428 http://dx.doi.org/10.3390/jcm9041146 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Tobaldini, Eleonora
Rodrigues, Gabriel D.
Mantoan, Giorgio
Monti, Alice
Coti Zelati, Giulia
Cirelli, Camilla
Tarsia, Paolo
Morlacchi, Letizia Corinna
Rossetti, Valeria
Righi, Ilaria
Nosotti, Mario
da S. Soares, Pedro Paulo
Montano, Nicola
Aliberti, Stefano
Blasi, Francesco
Sympatho–Vagal Dysfunction in Patients with End-Stage Lung Disease Awaiting Lung Transplantation
title Sympatho–Vagal Dysfunction in Patients with End-Stage Lung Disease Awaiting Lung Transplantation
title_full Sympatho–Vagal Dysfunction in Patients with End-Stage Lung Disease Awaiting Lung Transplantation
title_fullStr Sympatho–Vagal Dysfunction in Patients with End-Stage Lung Disease Awaiting Lung Transplantation
title_full_unstemmed Sympatho–Vagal Dysfunction in Patients with End-Stage Lung Disease Awaiting Lung Transplantation
title_short Sympatho–Vagal Dysfunction in Patients with End-Stage Lung Disease Awaiting Lung Transplantation
title_sort sympatho–vagal dysfunction in patients with end-stage lung disease awaiting lung transplantation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230240/
https://www.ncbi.nlm.nih.gov/pubmed/32316428
http://dx.doi.org/10.3390/jcm9041146
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