Author/Editor     Novaković, Marko; Prokšelj, Katja; Starc, Vito; Jug, Borut
Title     Cardiovascular autonomic dysfunction and carotid stiffness in adults with repaired tetralogy of Fallot
Type     članek
Publication year     2017
Volume     str. 53-61
ISSN     0959-9851 - Clinical autonomic research : official journal of the Clinical Autonomic Research Society
Language     eng
Abstract     Purpose Adults after surgical repair of tetralogy of Fallot (ToF) may have impaired vascular and cardiac autonomic function. Thus, we wanted to assess interrelations between heart rate variability (HRV) and heart rate recovery (HRR), as parameters of cardiac autonomic function, and arterial stiffness, as a parameter of vascular function, in adults with repaired ToF as compared to healthy controls. Methods In a case-control study of adults with repaired ToF and healthy age-matched controls we measured: 5-min HRV variability (with time and frequency domain data collected), carotid artery stiffness (through pulse-wave analysis using echo-tracking ultrasound) and post-exercise HRR (cycle ergometer exercise testing). Results Twenty-five patients with repaired ToF (mean age 38 +- 10 years) and 10 healthy controls (mean age 39 +- 8 years) were included. Selected HRR and HRV (time-domain) parameters, but not arterial stiffness were significantly reduced in adults after ToF repair. Moreover, a strong association between late/slow HRR (after 2, 3 and 4 min) and carotid artery stiffness was detected in ToF patients (r = -0.404, p = 0.045; r = -0.545, p = 0.005 and r = -0.545, p = 0.005, respectively), with statistical significance retained even after adjusting for age, gender, resting heart rate and [beta]-blockers use (r = -0.393, p = 0.024 for HRR after 3 min). Conclusion Autonomic cardiac function is impaired in patients with repaired ToF, and independently associated with vascular function in adults after ToF repair, but not in age-matched healthy controls. These results might help in introducing new predictors of cardiovascular morbidity in a growing population of adults after surgical repair of ToF.
Keywords     autonomic nervous system
vascular stiffness
cardiovascular autonomic dysfunction
avtonomni živčni sistem
žilna togost
kardiovaskularna avtonomna disfunkcija