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Related Experiment Videos

Autonomic function in hypertrophic cardiomyopathy

D M Gilligan1, W L Chan, E Sbarouni

  • 1Department of Medicine (Clinical Cardiology), Royal Postgraduate Medical School, Hammersmith Hospital, London.

British Heart Journal
|June 1, 1993
PubMed
Summary
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Patients with hypertrophic cardiomyopathy show impaired cardiac autonomic function, specifically reduced parasympathetic activity. This dysfunction is linked to the severity of left ventricular hypertrophy but not syncope occurrence.

Area of Science:

  • Cardiology
  • Autonomic Nervous System Research
  • Clinical Medicine

Background:

  • Autonomic dysfunction predicts adverse events post-myocardial infarction.
  • Hypertrophic cardiomyopathy (HCM) increases sudden death risk, especially with syncope.

Purpose of the Study:

  • To investigate autonomic dysfunction in HCM patients.
  • To determine if autonomic dysfunction correlates with syncope in HCM.

Main Methods:

  • Assessed autonomic function in 30 HCM patients (15 with syncope, 15 without) and 28 controls.
  • Measured parasympathetic activity via heart rate variation during deep breathing and Valsalva ratio.
  • Evaluated sympathetic activity through blood pressure responses to handgrip and standing.

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Main Results:

  • HCM patients exhibited reduced heart rate variation with deep breathing and lower Valsalva ratios, indicating impaired parasympathetic activity.
  • No significant differences in autonomic function were found between HCM patients with and without syncope.
  • Impaired heart rate variability correlated with increased left ventricular hypertrophy severity (r = 0.39, p = 0.03).

Conclusions:

  • HCM patients demonstrate selective impairment of cardiac parasympathetic activity.
  • The afferent limb of cardiac autonomic reflexes appears impaired in HCM.
  • The severity of this autonomic impairment is associated with the degree of left ventricular hypertrophy.