Heart rate variability during sleep in patients with vasovagal syncope

dc.contributor.authorCintra, Fátima Dumas [UNIFESP]
dc.contributor.authorPoyares, Dalva [UNIFESP]
dc.contributor.authorAmaral, Alessandro do [UNIFESP]
dc.contributor.authorMarchi, Guilherme de [UNIFESP]
dc.contributor.authorBarreto, Simone [UNIFESP]
dc.contributor.authorTufik, Sergio [UNIFESP]
dc.contributor.authorDe Paola, Angelo Amato Vincenzo [UNIFESP]
dc.contributor.authorGuilleminault, Christian
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionSleep Disorders Ctr
dc.date.accessioned2016-01-24T12:38:13Z
dc.date.available2016-01-24T12:38:13Z
dc.date.issued2005-12-01
dc.description.abstractBackground: There are a few studies showing no significant heart rate variability (HRV) over a 24-hour period in vasovagal syncope (VVS) patients, but no research has examined HRV and its sympathetic and parasympathetic components during rapid eye movement (REM) and non-REM sleep. the authors hypothesized that REM sleep might be a critical state in which VVS patients would show abnormal responses.Objectives: To analyze the sympathetic and parasympathetic components of HRV during REM and SWS in patients with VVS compared to normal subjects, and in patients with positive HUTT compared to negative ones. Methods: Thirty-seven VVS patients and 20 normal age-matched controls were submitted to polysomnography with 24-hour Holter monitoring to assess HRV Time and frequency domain techniques were carefully performed for 24 hours and during Stages 3 and 4 of REM and non-REM sleep. Variation of sympathetic activity index (VSAI) was defined as the difference in the low frequency (LF) component of HRV between REM and Stages 3 and 4 of non-REM sleep. An analysis of variance was performed to compare patients and controls; patients with positive and negative head-up tilt testing.Results: the LF component was lower in syncope compared to normal patients (1,769.54 +/- 1,738.17, 3,225.37 +/- 2,585.05, respectively, P = 0.03). There was a significant decrease in VSAI in the syncope group compared to the control group (-539.39 +/- 1,930.78, 1,268.10 +/- 2,420.20, respectively, P = 0.01). the other sleep variables analyzed including very LF, high frequency, low frequency/high frequency and time domain parameters did not reach statistical significance. Syncope patients also showed an increase in slow wave sleep (28.2 +/- 10.5, 19.7 +/- 7.8, P = 0.01).Conclusions: VVS patients exhibited sympathetic suppression during REM sleep. Possible mechanisms are discussed in this article.en
dc.description.affiliationUniversidade Federal de São Paulo, Dept Psicol, Div Clin Electrophysiol & Sleep Med, BR-04024002 São Paulo, Brazil
dc.description.affiliationUniversidade Federal de São Paulo, Div Biol, BR-04024002 São Paulo, Brazil
dc.description.affiliationSleep Disorders Ctr, Stanford, CA USA
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Dept Psicol, Div Clin Electrophysiol & Sleep Med, BR-04024002 São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Div Biol, BR-04024002 São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent1310-1316
dc.identifierhttps://dx.doi.org/10.1111/j.1540-8159.2005.00272.x
dc.identifier.citationPace-pacing and Clinical Electrophysiology. Oxford: Blackwell Publishing, v. 28, n. 12, p. 1310-1316, 2005.
dc.identifier.doi10.1111/j.1540-8159.2005.00272.x
dc.identifier.issn0147-8389
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/28592
dc.identifier.wosWOS:000234255300008
dc.language.isoeng
dc.publisherBlackwell Publishing
dc.relation.ispartofPace-pacing and Clinical Electrophysiology
dc.rightsAcesso restrito
dc.subjectSyncopeen
dc.subjectREM sleepen
dc.subjectHeart rate variabilityen
dc.subjectSympathetic activationen
dc.titleHeart rate variability during sleep in patients with vasovagal syncopeen
dc.typeArtigo
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