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Cardiovascular autonomic control in patients undergoing left ventricular assist device (LVAD) support and pharmacologic therapy

Nunan, David and Sandercock, Gavin RH and George, Robert S and Jakovljevic, Djordje G and Donovan, Gay and Bougard, Robert and Yacoub, Magdi H and Brodie, David A and Birks, Emma J (2013) 'Cardiovascular autonomic control in patients undergoing left ventricular assist device (LVAD) support and pharmacologic therapy.' International Journal of Cardiology, 168 (4). pp. 4145-4149. ISSN 0167-5273

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Objectives The objective of the study is to determine cardiac autonomic control in patients undergoing assessment for and/or LVAD therapy. Methods Heart rate variability (HRV) was measured in 17 explanted LVAD, 17 implanted LVAD and 23 NYHA III-IV classified chronic heart failure (CHF) patients and ten healthy matched controls under three conditions: supine free breathing, standing and supine controlled breathing. Five measures of HRV were assessed: mean R-R interval (mR-R), high frequency (HF) and low frequency (LF) spectral power, LF in normalised units (LFnu), and LF to HF (LF:HF) ratio. Results Repeat measures ANOVA showed significant (p < 0.05) differences in HRV between all three conditions within groups. Lower values were observed in CHF for LF(in log natural units) compared with explanted patients (- 1.4 [95% CI - 2.6 to - 0.7], p = 0.04) and controls (- 2.1 [- 3.5 to - 0.7], p = 0.001) and for LF:HF compared with implanted patients under paced breathing conditions (z = - 2.7, p = 0.007) and controls in standing (z = - 2.9, p = 0.004) and paced breathing conditions (z = - 2.3, p = 0.02). However, no significant differences were seen between explanted, implanted and control groups under any condition. Conclusions Patients implanted with an LVAD and explanted from a LVAD following myocardial recovery demonstrate a more normal dynamic response to autonomic stimuli and have a lower HRV risk profile compared to CHF patients. © 2013 Elsevier Ireland Ltd.

Item Type: Article
Uncontrolled Keywords: Bridge-to-recovery; Reverse remodelling; Heart rate variability; Normalisation; Prognosis
Subjects: R Medicine > R Medicine (General)
R Medicine > RD Surgery
Divisions: Faculty of Science and Health
Faculty of Science and Health > Sport, Rehabilitation and Exercise Sciences, School of
SWORD Depositor: Elements
Depositing User: Elements
Date Deposited: 16 Sep 2013 08:35
Last Modified: 15 Jan 2022 00:32

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