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Autonomic function in elderly patients with chronic heart failure.

M Zi1, N Wisniacki, J Delaney

  • 1Department of Geriatric Medicine, University of Liverpool, The Duncan Building, Daulby Street, Liverpool L69 3GA, UK. m.zi@liv.ac.uk

European Journal of Heart Failure
|November 5, 2002
PubMed
Summary
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Autonomic function (AF) declines with age and heart failure (HF). Elderly patients with diastolic heart failure (DHF) show less severe autonomic dysfunction than those with systolic heart failure (SHF).

Area of Science:

  • Cardiology
  • Autonomic Nervous System Research
  • Geriatric Medicine

Background:

  • Autonomic function (AF) is known to be impaired in heart failure (HF).
  • Previous studies focused on young patients with systolic heart failure (SHF).
  • Heart failure predominantly affects older individuals, often presenting as diastolic heart failure (DHF).

Purpose of the Study:

  • To investigate the impact of age on autonomic function in elderly heart failure patients.
  • To determine if the hemodynamic type of heart failure (systolic vs. diastolic) influences autonomic function.

Main Methods:

  • Thirty-six elderly HF patients (11 SHF, 25 DHF) and 21 healthy controls underwent bedside autonomic function tests.
  • Tests included E:I ratios, 30:15 ratios (standing and tilt), and Valsalva ratios.

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Main Results:

  • Elderly HF patients showed impaired autonomic function compared to healthy adults, particularly in Valsalva ratios.
  • No significant differences in E:I ratio, 30:15 tilt, or 30:15 standing were found between HF subtypes and controls.
  • Mean Valsalva ratios were significantly lower in SHF patients than in DHF patients, and lower in DHF patients than in healthy subjects.

Conclusions:

  • Autonomic function is impaired with aging and further diminished in heart failure patients.
  • Diastolic heart failure patients exhibit less severe autonomic dysfunction compared to systolic heart failure patients.