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Analysis of Heart-Rate Variability during Angioedema Attacks in Patients with Hereditary C1-Inhibitor Deficiency

C1-inhibitor hereditary angioedema (C1-INH-HAE) is a rare disease characterized by self-limiting edema associated with localized vasodilation due to increased levels of circulating bradykinin. C1-INH-HAE directly influences patients’ everyday lives, as attacks are unpredictable in frequency, severit...

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Autores principales: Perego, Francesca, De Maria, Beatrice, Bova, Maria, Petraroli, Angelica, Marcelli Cesoni, Azzurra, De Grazia, Valeria, Zingale, Lorenza Chiara, Porta, Alberto, Spadaro, Giuseppe, Dalla Vecchia, Laura Adelaide
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8002127/
https://www.ncbi.nlm.nih.gov/pubmed/33809031
http://dx.doi.org/10.3390/ijerph18062900
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author Perego, Francesca
De Maria, Beatrice
Bova, Maria
Petraroli, Angelica
Marcelli Cesoni, Azzurra
De Grazia, Valeria
Zingale, Lorenza Chiara
Porta, Alberto
Spadaro, Giuseppe
Dalla Vecchia, Laura Adelaide
author_facet Perego, Francesca
De Maria, Beatrice
Bova, Maria
Petraroli, Angelica
Marcelli Cesoni, Azzurra
De Grazia, Valeria
Zingale, Lorenza Chiara
Porta, Alberto
Spadaro, Giuseppe
Dalla Vecchia, Laura Adelaide
author_sort Perego, Francesca
collection PubMed
description C1-inhibitor hereditary angioedema (C1-INH-HAE) is a rare disease characterized by self-limiting edema associated with localized vasodilation due to increased levels of circulating bradykinin. C1-INH-HAE directly influences patients’ everyday lives, as attacks are unpredictable in frequency, severity, and the involved anatomical site. The autonomic nervous system could be involved in remission. The cardiac autonomic profile has not yet been evaluated during the attack or prodromal phases. In this study, a multiday continuous electrocardiogram was obtained in four C1-INH-HAE patients until attack occurrence. Power spectral heart rate variability (HRV) indices were computed over the 4 h preceding the attack and during the first 4 h of the attack in three patients. Increased vagal modulation of the sinus node was detected in the prodromal phase. This finding may reflect localized vasodilation mediated by the release of bradykinin. HRV analysis may furnish early markers of an impending angioedema attack, thereby helping to identify patients at higher risk of attack recurrence. In this perspective, it could assist in the timing, titration, and optimization of prophylactic therapy, and thus improve patients’ quality of life.
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spelling pubmed-80021272021-03-28 Analysis of Heart-Rate Variability during Angioedema Attacks in Patients with Hereditary C1-Inhibitor Deficiency Perego, Francesca De Maria, Beatrice Bova, Maria Petraroli, Angelica Marcelli Cesoni, Azzurra De Grazia, Valeria Zingale, Lorenza Chiara Porta, Alberto Spadaro, Giuseppe Dalla Vecchia, Laura Adelaide Int J Environ Res Public Health Article C1-inhibitor hereditary angioedema (C1-INH-HAE) is a rare disease characterized by self-limiting edema associated with localized vasodilation due to increased levels of circulating bradykinin. C1-INH-HAE directly influences patients’ everyday lives, as attacks are unpredictable in frequency, severity, and the involved anatomical site. The autonomic nervous system could be involved in remission. The cardiac autonomic profile has not yet been evaluated during the attack or prodromal phases. In this study, a multiday continuous electrocardiogram was obtained in four C1-INH-HAE patients until attack occurrence. Power spectral heart rate variability (HRV) indices were computed over the 4 h preceding the attack and during the first 4 h of the attack in three patients. Increased vagal modulation of the sinus node was detected in the prodromal phase. This finding may reflect localized vasodilation mediated by the release of bradykinin. HRV analysis may furnish early markers of an impending angioedema attack, thereby helping to identify patients at higher risk of attack recurrence. In this perspective, it could assist in the timing, titration, and optimization of prophylactic therapy, and thus improve patients’ quality of life. MDPI 2021-03-12 /pmc/articles/PMC8002127/ /pubmed/33809031 http://dx.doi.org/10.3390/ijerph18062900 Text en © 2021 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
Perego, Francesca
De Maria, Beatrice
Bova, Maria
Petraroli, Angelica
Marcelli Cesoni, Azzurra
De Grazia, Valeria
Zingale, Lorenza Chiara
Porta, Alberto
Spadaro, Giuseppe
Dalla Vecchia, Laura Adelaide
Analysis of Heart-Rate Variability during Angioedema Attacks in Patients with Hereditary C1-Inhibitor Deficiency
title Analysis of Heart-Rate Variability during Angioedema Attacks in Patients with Hereditary C1-Inhibitor Deficiency
title_full Analysis of Heart-Rate Variability during Angioedema Attacks in Patients with Hereditary C1-Inhibitor Deficiency
title_fullStr Analysis of Heart-Rate Variability during Angioedema Attacks in Patients with Hereditary C1-Inhibitor Deficiency
title_full_unstemmed Analysis of Heart-Rate Variability during Angioedema Attacks in Patients with Hereditary C1-Inhibitor Deficiency
title_short Analysis of Heart-Rate Variability during Angioedema Attacks in Patients with Hereditary C1-Inhibitor Deficiency
title_sort analysis of heart-rate variability during angioedema attacks in patients with hereditary c1-inhibitor deficiency
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8002127/
https://www.ncbi.nlm.nih.gov/pubmed/33809031
http://dx.doi.org/10.3390/ijerph18062900
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