Cardiac and peripheral autonomic control in restrictive cardiomyopathy

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Ana Luiza C Sayegh1, Marcelo R Dos Santos2, Adriana O Sarmento2

  • 1Clinical Unit of Cardiomyopathy, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.

ESC Heart Failure
|August 4, 2017
PubMed

Insights

Restrictive cardiomyopathy (RCM) patients exhibit significant autonomic dysfunction, including increased sympathetic activity and reduced baroreflex sensitivity. These findings suggest a similar cardiovascular risk profile to dilated cardiomyopathy (DCM) patients.

Area of Science:

  • Cardiology
  • Autonomic Neuroscience
  • Cardiovascular Research

Background:

  • Autonomic dysfunction is a known factor in dilated cardiomyopathy (DCM) progression and poor outcomes.
  • Autonomic and neurovascular control alterations in restrictive cardiomyopathy (RCM) remain largely uncharacterized despite similar symptoms to DCM.

Purpose of the Study:

  • To investigate autonomic and neurovascular control in patients with RCM.
  • To compare autonomic function in RCM patients with DCM patients and healthy controls.

Main Methods:

  • Evaluated 15 RCM patients, 10 DCM patients, and 10 healthy subjects.
  • Measured heart rate, blood pressure, muscle sympathetic nerve activity (MSNA), cardiac sympathetic activity (heart rate variability), spontaneous baroreflex sensitivity (BRS), and forearm blood flow.

Main Results:

  • Both RCM and DCM groups showed higher MSNA, increased cardiac sympathovagal imbalance, reduced BRS, and lower forearm blood flow compared to healthy subjects.
  • Found inverse correlations between BRS and both peripheral and cardiac sympathetic activity.
  • RCM patients displayed autonomic dysfunctions and peripheral vasoconstriction.

Conclusions:

  • RCM patients exhibit cardiac and peripheral autonomic dysfunction, similar to DCM patients.
  • Normal ejection fraction in RCM may mask disease severity, complicating treatment.
  • These autonomic alterations may confer a similar cardiovascular risk as seen in DCM.
Abstract

Keywords:
Baroreflex controlDilated cardiomyopathyHeart failureNeurovascular controlRestrictive cardiomyopathySympathetic activity

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