Cardiac autonomic control in Brugada syndrome patients during sleep: The effects of sleep disordered breathing

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:168

Article

Tobaldini, Eleonora¹  Brugada, Josep²  Benito, Begona²  Molina, Irma²  Montserrat, Josep³  Kara, Tomas^4,5,6  Leinveber, Pavel⁷  Porta, Alberto⁸  Macedo, Paula G.^9,10  Montano, Nicola¹  Somers, Virend K.¹⁰ 

[1] Univ Milan, Dept Biomed & Clin Sci, L Sacco Hosp, I-20122 Milan, Italy

[2] Hosp Clin Barcelona, Dept Cardiol, Barcelona, Spain

[3] CIBERES, IDIBAPS, Hosp Clin, Dept Pneumol, Barcelona, Spain

[4] Mayo Clin & Mayo Fdn, Dept Cardiovasc Dis, Rochester, MN 55905 USA

[5] Mayo Clin & Mayo Fdn, Dept Internal Med, Rochester, MN 55905 USA

[6] St Annes Univ Hosp Brno, ICRC Dept Cardiovasc Dis, St Annes Hosp, Brno, Czech Republic

[7] St Annes Univ Hosp Brno, Ctr Biomed Engn, Int Clin Res Ctr, Brno, Czech Republic

[8] Univ Milan, Galeazzi Orthoped Inst, Dept Biomed Sci Hlth, Milan, Italy

[9] Hosp Base Dist Fed, Dept Cardiol, Brasilia, DF, Brazil

[10] Mayo Clin & Mayo Fdn, Dept Internal Med, Div Cardiovasc Dis, Rochester, MN 55905 USA

关键词: Brugada syndrome;    Sleep disordered breathing;    Heart rate variability;    Non-linear analysis;    Sleep;    Autonomic nervous system;   

DOI  :  10.1016/j.ijcard.2013.04.137

来源: Elsevier

【 摘 要 】

Aims: Brugada syndrome is characterized by typical ECG features, ventricular arrhythmias and sudden cardiac death (SCD), more frequent during nighttime. Autonomic cardiovascular control has been implicated in triggering the ventricular arrhythmias. Sleep-disordered breathing (SDB) elicits marked autonomic changes during sleep and is also associated with an increased risk of nighttime SCD. Brugada patients may have a higher likelihood of SDB compared to controls. However, no data are available on cardiac autonomic control in Brugada patients, particularly with regard to the comorbidity of SDB. Methods: We evaluated autonomic cardiovascular control in Brugada patients with SDB (BRU-SDB, n = 9), without SDB (BRU, n = 9), in controls (CON, n = 8) and in non-Brugada patients with SDB (n = 6), during wakefulness and sleep (N2, N3 and REM). Linear spectral and entropy-derived measures of heart rate variability (HRV) were performed during apnea-free stable breathing epochs. Results: Total HRV was attenuated in BRU-SDB compared to CON and BRU. During N2 and REM, in BRU-SDB patients sympathetic modulation decreased compared to BRU and CON, while during REM, they showed an increased parasympathetic modulation, compared to the other two groups. BRU-SDB and SDB were similar in terms of spectral components. Entropy-derived indices showed preserved dynamic changes in Brugada patients compared to controls through the different sleep stages. Conclusion: Brugada syndrome per se does not appear associated with an altered autonomic cardiovascular control during wakefulness and sleep. The comorbidity with SDB may contribute to disrupted autonomic cardiovascular regulation during sleep, possibly predisposing to the increased likelihood of sleep-related ventricular tachyarrhythmias and SCD. (C) 2013 Elsevier Ireland Ltd. All rights reserved.

【 授权许可】

Free