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Cardiovascular variability is similarly altered in coronary patients with normal left ventricular function and in

Alberto Radaelli1, Giuseppe Mancia, Giulia Balestri

  • 1aDivision of Cardiac Rehabilitation, Ospedale San Gerardo, Monza bDepartment of Clinical Medicine and Prevention, University of Milano-Bicocca, Milan cCardiology Department, Ospedale Desio, Desio dCardiology Department, Ospedale San Gerardo, Monza eUniversity of Milano-Bicocca fIRCCS Fondazione Don Carlo Gnocchi gDivision of Cardiac Surgery, Ospedale San Gerardo, Monza, Italy.

Journal of Hypertension
|August 2, 2014
PubMed

Insights

Coronary artery disease (CAD) patients without myocardial infarction (MI) exhibit significantly reduced heart rate (HR) and blood pressure (BP) variability. This indicates impaired autonomic modulation, similar to patients with congestive heart failure (CHF).

Area of Science:

  • Cardiology
  • Autonomic Nervous System Function
  • Cardiovascular Physiology

Background:

  • Myocardial infarction (MI) impairs baroreflex function and reduces heart rate (HR) variability.
  • Coronary artery disease (CAD) patients without prior MI may also have altered baroreflex sensitivity.
  • Investigating cardiovascular variability in CAD patients without MI is crucial for understanding autonomic dysfunction.

Purpose of the Study:

  • To assess cardiovascular variability in coronary artery disease (CAD) patients without a history of myocardial infarction (MI).
  • To compare HR and blood pressure (BP) variability between CAD patients, congestive heart failure (CHF) patients, and healthy controls.
  • To investigate baroreflex function and pulse-wave velocity in these groups.

Main Methods:

  • Studied 32 individuals: 11 with CAD (no MI), 11 with CHF (reduced ejection fraction), and 10 age-matched controls (CNT).
  • Measured HR variability (time and frequency domains) and BP variability.
  • Assessed baroreflex function and pulse-wave velocity.

Main Results:

  • Both CAD and CHF groups showed significantly reduced overall HR variability compared to controls.
  • Low and high frequency spectral components of HR variability were also diminished in CAD and CHF patients.
  • CAD and CHF patients exhibited reduced baroreflex function, increased pulse-wave velocity, and less pronounced low-frequency BP oscillations than controls.

Conclusions:

  • Coronary artery disease patients without MI or left ventricular dysfunction display profound alterations in HR and BP variability.
  • These alterations are comparable to those observed in congestive heart failure patients.
  • Impaired autonomic modulation of the heart and blood vessels is likely responsible for these findings.
Abstract

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