Clinical Autonomic Research

, Volume 6, Issue 1, pp 41–44 | Cite as

Heart rate variability in a case of pheochromocytoma

  • P. K. Stein
  • J. N. Rottman
  • A. F. Hall
  • R. E. Kleiger
Research Paper

Abstract

Indices of heart rate variability (HRV) reflect cardiac autonomic tone and may be markedly affected by pheochromocytoma. The effect of pheochromocytoma on HRV was determined by Holter monitoring before diagnosis, under pre-operative α-blockade and 5 and 19 months after surgery in a 40 year-old female. Mean heart rates, although higher under α-blockade, were unchanged by surgery but indices of HRV reflecting both short term (vagally mediated) and longer term (mediated by vagal, sympathetic and other influences) rhythms were diminished under α-blockade and post-surgery. High frequency power (0.15–0.40 Hz), an index of vagal tone, declined from 512 ms2 pre-diagnosis to 220 ms2 under α-blockade to just over 100 ms2 post-surgery. Low frequency power (0.04–0.15 Hz), a measure reflecting both vagal and sympathetic tone, declined from 409 ms2 pre-diagnosis to 186 ms2 under α-blockade and was just over 200 ms2 post-surgery. SDNN, the standard deviation of normal-to-normal interbeat intervals over 24 hours, declined from 118 ms pre-diagnosis to just over 70 ms both under α-blockade and post-surgery. The ratio of low frequency to high frequency power (LF/HF ratio) increased to 0.84 under α-blockade, and doubled after surgery (0.79; before, 2.05; after). These changes in HRV may provide insights into the effects of endogenous catecholamines and intrinsic counter-regulatory autonomic mechanisms on HRV.

Keywords

pheochromocytoma heart rate variability autonomic nervous system 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Akselrod S, Gordon D, Ubel FA, Shannon DC, Barger AC, Cohen RJ. Power spectrum analysis of heart rate fluctuations: a quantitative probe of beat-to-beat cardiovascular control.Science 1981;213: 220–222.Google Scholar
  2. 2.
    Kamath MV, Ghista DN, Fallen EL. Heart rate variability power spectrogram as a potential noninvasive signature of cardiac regulatory system response, mechanisms, and disorders.Heart Vessels 1987;3: 33–41.Google Scholar
  3. 3.
    Fallen EL, Kamath MV, Ghista DN. Power spectrum of heart rate variability: a non-invasive test of integrated neurocardiac function.Clin Invest Med 1988;11: 331–340.Google Scholar
  4. 4.
    Rottman JN, Steinman RC, Albrecht P, Bigger JT, Rolnitzky LM, Fleiss J. Efficient estimation of the heart period power spectrum suitable for physiologic or pharmacologic studies.Am J Cardiol 1990;66: 1522–1524.Google Scholar
  5. 5.
    Malik M, Cripps T, Farrell T, Camm AJ. Prognostic value of heart rate variability after myocardial infarction: a comparison of different data-processing methods.Med Biol Eng Comput 1989;29: 603–611.Google Scholar
  6. 6.
    Bigger JT, LaRovere MT, Steinman RC et al. Comparison of baroreflex sensitivity and heart period variability after myocardial infarction.J Am Coll Cardiol 1989;14: 1511–1518.Google Scholar
  7. 7.
    Malliani A, Pagani M, Lombardi F, Cerutti S. Cardiovascular neural regulation explored in the frequency domain.Circulation 1991;84: 482–492.Google Scholar

Copyright information

© Rapid Science Publishers 1996

Authors and Affiliations

  • P. K. Stein
    • 1
    • 2
  • J. N. Rottman
    • 1
    • 2
  • A. F. Hall
    • 1
    • 2
  • R. E. Kleiger
    • 1
    • 2
  1. 1.Division of Cardiology, Department of MedicineWashington University School of MedicineSt LouisUSA
  2. 2.The Jewish Hospital at Washington University Medical CenterSt LouisUSA

Personalised recommendations