Patients with moderate and severe calcific aortic valve stenosis exhibited reduced autonomic adjustments during an active standing challenge compared to controls without aortic valve alterations.
Cross-Sectional (n=47)
Does moderate and severe calcific aortic valve stenosis alter heart rate variability and autonomic response during an active standing challenge compared to healthy controls?
Patients with moderate to severe calcific aortic valve stenosis exhibit reduced autonomic adjustments and decreased cardiac parasympathetic response during an active standing challenge.
Aortic stenosis is a progressive heart valve disorder characterized by calcification of the leaflets. Heart rate variability (HRV) analysis has been proposed for assessing the heart response to autonomic activity, which is documented to be altered in different cardiac diseases. The objective of the study was to evaluate changes of HRV in patients with aortic stenosis by an active standing challenge. Twenty-two volunteers without alterations in the aortic valve (NAV) and twenty-five patients diagnosed with moderate and severe calcific aortic valve stenosis (AVS) participated in this cross-sectional study. Ten minute electrocardiograms were performed in a supine position and in active standing positions afterwards, to obtain temporal, spectral, and scaling HRV indices: mean value of all NN intervals (meanNN), low-frequency (LF) and high-frequency (HF) bands spectral power, and the short-term scaling indices (α1 and αsign1). The AVS group showed higher values of LF, LF/HF and αsign1 compared with the NAV group at supine position. These patients also expressed smaller changes in meanNN, LF, HF, LF/HF, α1, and αsign1 between positions. In conclusion, we confirmed from short-term recordings that patients with moderate and severe calcific AVS have a decreased cardiac parasympathetic supine response and that the dynamic of heart rate fluctuations is modified compared to NAV subjects, but we also evidenced that they manifest reduced autonomic adjustments caused by the active standing challenge.
Torres-Arellano et al. (Fri,) conducted a cross-sectional in Moderate and severe calcific aortic valve stenosis (n=47). Active standing challenge vs. Volunteers without alterations in the aortic valve (NAV) was evaluated on Changes in heart rate variability (HRV) indices between supine and active standing positions. Patients with moderate and severe calcific aortic valve stenosis exhibited reduced autonomic adjustments during an active standing challenge compared to controls without aortic valve alterations.
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