Heart rate variability in pulmonary vascular disease at altitude: a randomised trial

被引：0
作者：
Herzig, Joel J. [1 ,2 ]
Ulrich, Silvia [1 ,2 ]
Schneider, Simon R. [1 ]
Muller, Julian [1 ]
Lichtblau, Mona [1 ,2 ]
Ulrich, Tanja L. [1 ]
Bauer, Meret [1 ]
Furian, Michael [1 ]
Bloch, Konrad E. [1 ,2 ]
Mayer, Laura [1 ]
Schwarz, Esther I. [1 ,2 ]
机构：
[1] Univ Hosp Zurich USZ, Dept Pulmonol, Zurich, Switzerland
[2] Univ Zurich, Zurich, Switzerland
来源：
ERJ OPEN RESEARCH | 2024年 / 10卷 / 05期
基金：
瑞士国家科学基金会;
关键词：
BAROREFLEX SENSITIVITY; BLOOD-PRESSURE; ARTERIAL-PRESSURE; HYPERTENSION; MORTALITY; FAILURE; HYPOXIA; ASCENT;
D O I：
10.1183/23120541.00235-2024
中图分类号：
R56 [呼吸系及胸部疾病];
学科分类号：
摘要：
Background Hypoxia is a trigger for sympathetic activation and autonomic cardiovascular dysfunction. Pulmonary vascular disease (PVD) is associated with hypoxaemia, which increases with altitude. The aim was to investigate how exposure of patients with PVD to hypobaric hypoxia at altitude affects autonomic cardiovascular regulation. Methods In a randomised crossover study, patients with PVD were studied for 1 day and one night at an altitude of 2500 m (hypobaric hypoxia) and low altitude at 470 m in a random order. Outcomes were heart rate variability (HRV) in the time domain and in the frequency domain (low frequency (LF)/high frequency (HF) and LF/HF) and heart rate (HR) during day and night and baroreflex sensitivity (BRS). Results In 25 patients with PVD (72% pulmonary arterial hypertension and 28% distal chronic thromboembolic pulmonary hypertension; mean +/- SD age 60.7 +/- 13.6 years), exposure to altitude resulted in significant increases in awake HR by 9.4 bpm (95% confidence interval (CI) 6.3-12.4, p<0.001) and nocturnal HR by 9.0 bpm (95% CI 6.6-11.4, p<0.001) and significant changes in awake and particularly nocturnal HRV indicating decreasing parasympathetic and increasing sympathetic activity (change in daytime LF/HF 1.7 (95% CI 0.6-2.8), p=0.004; nocturnal LF/HF 1.9 (95% CI 0.3-3.4), p=0.022) and a significant decrease in BRS (-2.4<middle dot>mmHg-1 (95% CI -4.3- -0.4, p=0.024)). Conclusion Exposure of PVD patients to altitude resulted in a significant change in HRV indicating an increase in sympathetic activity and a decrease in BRS. The relative change in HRV at altitude was more pronounced during sleep.
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页码：1 / 11
页数：11
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