Autonomic balance and cardiovascular hemodynamic function in men with prolactinoma

Area of Science:

• Cardiology
• Endocrinology
• Autonomic Neuroscience

Background:

• Prolactinoma (PR) in men can disrupt cardiovascular and autonomic nervous system (ANS) interactions.
• Understanding the interplay between cardiovascular hemodynamics and ANS balance is crucial for managing PR-associated endocrine disorders.

Purpose of the Study:

• To investigate the association between sympathetic-parasympathetic balance, assessed via heart rate variability (HRV), and cardiovascular hemodynamic function in men with newly diagnosed PR.
• To evaluate cardiac pumping efficiency using impedance cardiography (ICG) and arterial stiffness using applanation tonometry (AT) in relation to HRV.

Main Methods:

• An observational cohort study involving 20 men with newly diagnosed PR.
• Correlation analysis between ICG (ACI, VI, HI) and AT (AP, AI) parameters with 24-hour HRV indices (time-domain and frequency-domain).
• Echocardiographic assessment was also performed.

Main Results:

• Significant correlations were observed between ICG parameters (ACI, HI, VI) and HRV indices.
• Elevated aortic augmentation pressure (AP) correlated with reduced parasympathetic activity (lower pNN50, RMSSD, TP).
• Increased augmentation index (AI) was associated with decreased parasympathetic markers (lower RMSSD, SDSD, pNN50, TP).

Conclusions:

• Newly diagnosed prolactinoma in men is associated with reduced heart pumping efficiency and increased arterial stiffness.
• These cardiovascular changes correlate with a diminished parasympathetic influence, indicating an altered sympathetic-parasympathetic balance.