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Circadian periodicity of heart rate variability in hospitalized angor patients

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Abstract

The relationship between unstable angor (angina) and circadian periodicity of heart rate variability (HRV) was explored in a group of patients hospitalized in a coronary care unit (CCU). Patients were classified as normal (whose symptoms had non-cardiovascular origin, n=8), moderate angor (n=13) and severe angor (n=11). A fourth group of ambulatory healthy volunteers (n=12) was included. Individual 24 h Holter records were analyzed, mean RR and standard deviation of RR (SDNN) being obtained from 1 h-length windows. For frequency domain analysis, 5 min-length windows were employed. The spectral components analyzed were total power (spectral power between 0.01 and 0.5 Hz), low frequency power (LF: power between 0.04 and 0.15 Hz), and high frequency power (HF: power between 0.15 and 0.4 Hz). In addition, LF to HF areas ratio (L/H) was computed. Mesor, amplitude and acrophase for every 24 h rhythm were calculated by cosinor analysis.As compared to ambulatory controls, admission to the CCU diminished amplitude and phase-delayed the circadian oscillation of most HRV parameters, except for SDNN. Moderate angor patients showed decreased amplitude of RR and L/H and augmented amplitude of SDNN when compared to normal hospitalized subjects. A phase delay of about 1.5 h for RR intervals and a phase advance of 3.5–6 h for LFA and SDNN were found in the moderate angor group when compared to normal. Amplitude of 24 h variation of total power decreased in severely angor patients and the circadian oscillation of HF (an indicator of vagal control on the heart) became free running. A phase delay of 2.5 h in SDNN acrophase was found in severely affected patients when compared to moderate. The results indicate that severity of unstable angor correlates with desynchronization of parasympathetic control of heart rate.

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Authors and Affiliations

  1. Instituto de Investigaciones, Médicas Alfredo Lanari, Laboratorio de Neumonología, Combatientes de Malvinas 3150, 1427, Buenos Aires, Argentina

    Carlos E. D’Negri

  2. División de Cardiología, Hospital Ramos Mejía, Buenos Aires, Argentina

    Liliana Marelich, Rafael S. Acunzo, Luis A. Girotti & Leonardo Nicola Siri

  3. Depto. de Fisiología, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina

    Daniel Vigo & Daniel P. Cardinali

  4. Laboratorio de Bioelectricidad, Escuela de Ingeniería—Bioingeniería, Universidad Nacional de Entre Ríos, Paraná, Argentina

    Leonardo Nicola Siri

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  1. Carlos E. D’Negri
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Correspondence to Carlos E. D’Negri.

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D’Negri, C.E., Marelich, L., Vigo, D. et al. Circadian periodicity of heart rate variability in hospitalized angor patients. Clin Auton Res 15, 223–232 (2005). https://doi.org/10.1007/s10286-005-0280-9

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  • DOI: https://doi.org/10.1007/s10286-005-0280-9

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