Baroreflex sensitivity assessed with the sequence method is associated with ventricular arrhythmias in patients implanted with a defibrillator for the primary prevention of sudden cardiac death

Autor: Véronique Le Marcis, Samy Hadjadj, Rodrigue Garcia, Pierre-Jean Saulnier, Bruno Degand, Nicolas Bidegain, François Le Gal, Stéphanie Ragot, Marine Tavernier, Dominique Laude, Mathilde Fraty
Přispěvatelé: Centre hospitalier universitaire de Poitiers (CHU Poitiers), Université de Poitiers - Faculté de Médecine et de Pharmacie, Université de Poitiers, Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), CIC - Poitiers, Université de Poitiers-Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Rok vydání: 2019
Předmět:
Male
Time Factors
Supine position
[SDV]Life Sciences [q-bio]
medicine.medical_treatment
Myocardial Infarction
Pilot Projects
030204 cardiovascular system & hematology
Ventricular Function
Left
Sudden cardiac death
Death
Sudden
Electrocardiography
0302 clinical medicine
Risk Factors
Natriuretic Peptide
Brain
Natriuretic peptide
Medicine
030212 general & internal medicine
Myocardial infarction
Prospective cohort study
Ejection fraction
General Medicine
Middle Aged
Implantable cardioverter-defibrillator
Defibrillators
Implantable
Plethysmography
Primary Prevention
Treatment Outcome
cardiovascular system
Cardiology
Female
Cardiology and Cardiovascular Medicine
medicine.medical_specialty
medicine.drug_class
Clinical Decision-Making
Electric Countershock
Baroreflex
Risk Assessment
03 medical and health sciences
Predictive Value of Tests
Internal medicine
Humans
cardiovascular diseases
Aged
Retrospective Studies
business.industry
Patient Selection
Arrhythmias
Cardiac
Stroke Volume
medicine.disease
Peptide Fragments
Cross-Sectional Studies
business
Biomarkers
Zdroj: Archives of cardiovascular diseases
Archives of cardiovascular diseases, Elsevier/French Society of Cardiology, 2019, 112, pp.270-277. ⟨10.1016/j.acvd.2018.11.009⟩
ISSN: 1875-2136
DOI: 10.1016/j.acvd.2018.11.009
Popis: Summary Background Left ventricular ejection fraction lacks accuracy in predicting sudden cardiac death, resulting in unnecessary implantation of cardioverter defibrillators for the primary prevention of sudden cardiac death. Baroreflex sensitivity could help to stratify patients at risk of ventricular arrhythmia. Aim To assess the association between cardiac baroreflex sensitivity and ventricular arrhythmias in patients implanted with an implantable cardioverter defibrillator for the primary prevention of sudden cardiac death after myocardial infarction. Methods This case-control single-centre study took place between 2015 and 2016. Cases (n = 10) had experienced ventricular arrhythmias treated by the implantable cardioverter defibrillator in the previous 3 years; controls (n = 22) had no arrhythmia during the same period. Baroreflex sensitivity was assessed using the temporal sequence method (mean slope) and cross-spectral analysis (low-frequency gain and high-frequency gain). Results The mean age was 65 years; 94% of the patients were men. 24-hour Holter electrocardiogram autonomous nervous system variables, left ventricular ejection fraction and N-terminal prohormone of B-type natriuretic peptide (NT-proBNP) concentration did not differ between cases and controls. The mean slope was lower in cases than in controls (8 vs. 15 ms/mmHg [P = 0.009] in the supine position; 7 vs. 12 ms/mmHg [P = 0.038] in the standing position). The mean slope in the supine position was still significantly different between groups after adjustment for age, left ventricular ejection fraction and NT-proBNP (P = 0.03). By comparison, low-frequency gain and high-frequency gain did not differ between groups in either the supine or the standing position. Conclusion Patients with ventricular arrhythmias had a lower mean slope compared with those who were free of arrhythmia. A prospective study is needed to confirm this association.
Databáze: OpenAIRE
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