Association between pressure pain sensitivity and autonomic function as assessed by a tilt table test

Area of Science:

• Cardiology
• Autonomic Neuroscience
• Physiology

Background:

• Autonomic nervous system (ANS) dysfunction is prevalent in stable ischemic heart disease.
• Pressure sensitivity of the sternum (PPS) has not been previously linked to ANS function.
• Tilt table testing (TTT) is a standard method for assessing ANS function.

Purpose of the Study:

• To investigate the association between sternum pressure sensitivity (PPS) and autonomic nervous system (ANS) function.
• To evaluate PPS and its relationship with systolic blood pressure (SBP) and heart rate (HR) responses during tilt table testing (TTT).
• To determine if reducing resting PPS improves ANS function and lowers risk factors for autonomic nervous system dysfunction (ANSD).

Main Methods:

• A cross-sectional study involving 361 patients with stable ischemic heart disease.
• Measurements included PPS, SBP, and HR during TTT.
• An intervention study reassessed patients after a stress intervention trial to evaluate changes in PPS and ANS responses.

Main Results:

• Resting PPS and PPS response to TTT were correlated (r = -0.37).
• PPS response to TTT correlated with SBP (r = 0.44), HR (r = 0.49), and ANSD risk factors (r = -0.21).
• Reduced resting PPS was linked to increased PPS response to TTT (r = -0.52) and fewer ANSD risk factors (r = -0.23).

Conclusions:

• Sternum pressure sensitivity (PPS) at rest and during TTT reflects autonomic nervous system (ANS) function.
• PPS may serve as a novel indicator of ANS status in patients with ischemic heart disease.
• Interventions reducing resting PPS may improve ANS function and mitigate ANSD risk.