Abstract 13369: Sympathovagal Imbalance Decades After Atrial Septal Defect Repair
| Autor: | Vibeke E. Hjortdal, Mathias Alstrup, Zarmiga Karunanithi |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
genetic structures Atrial septal defect repair business.industry behavioral disciplines and activities Atrial septal defects Autonomic nervous system Physiology (medical) Internal medicine medicine Cardiology Heart rate variability Cardiology and Cardiovascular Medicine business |
| Zdroj: | Circulation. 142 |
| ISSN: | 1524-4539 0009-7322 |
| DOI: | 10.1161/circ.142.suppl_3.13369 |
| Popis: | Introduction: Heart rate variability (HRV), a measure of the autonomic nervous system activity, is a morbidity and mortality predictor. HRV is decreased in children with atrial septal defects (ASD) indicating parasympathetic withdrawal and sympathetic predominance, and increased right atrial end-diastolic pressure is believed to influence the sympathovagal balance. Despite the belief of a benign long-term outcome after closure, ASD patients have increased mortality rates after the age of 30 yrs. This may correlate to HRV, why we study HRV in adults after closure. Hypothesis: ASD patients have impaired HRV after closure when compared with controls. Methods: Surgically closed ASD patients (n=17, mean age 32±9 yrs., mean time since closure 19±8 yrs.), percutaneously closed ASD patients (n=18, mean age 28±7 yrs., mean time since closure 15±5 yrs.) and age- and gender-matched controls (n=15, mean age 30±9 yrs.) underwent a 48-hr Holter monitoring. Inclusion criteria were an age of minimum 2 yrs. at the time of diagnosis and minimum 3 yrs. must have passed since ASD closure. The following time-domain HRV measures were analyzed: SD of NN intervals (SDNN), SD of the average NN interval for each 5-minute segment, mean of the SDs of all NN intervals for each 5-minute (SDNNi), root mean square of successive RR interval differences (RMSSD), percentage of successive RR intervals that differ by >50 ms (pNN50), and triangular index. Results: Surgically closed ASD patients have an impairment of all time-domain parameters, while transcatheter closed patients have an impairment of half the parameters. Conclusion: These novel findings demonstrate a cardiac sympathovagal imbalance in adult patients several yrs. after ASD closure and may potentially explain why we observe a long-term morbidity and mortality increase in ASD patients. |
| Databáze: | OpenAIRE |
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