Effects of posture on cardiac autonomic nervous activity in patients with congestive heart failure

Citation
S. Miyamoto et al., Effects of posture on cardiac autonomic nervous activity in patients with congestive heart failure, J AM COL C, 37(7), 2001, pp. 1788-1793
Citations number
20
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Journal title
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
ISSN journal
0735-1097 → ACNP
Volume
37
Issue
7
Year of publication
2001
Pages
1788 - 1793
Database
ISI
SICI code
0735-1097(20010601)37:7<1788:EOPOCA>2.0.ZU;2-I
Abstract
OBJECTIVES We aimed to clarify which recumbent position is preferred by pat ients with congestive heart failure (CHF) and to evaluate whether cardiac a utonomic nervous activity is different among three recumbent positions (sup ine, left lateral decubitus, right lateral decubitus) in patients with CHF. BACKGROUND It remains unclear whether cardiac autonomic nervous activity is different among three recumbent positions in patients with CHF. METHODS We studied 17 male CHF patients (66 +/- 7 years) and 17 age- and ge nder-matched healthy subjects (66 +/- 7 years). Each subject underwent 24-h ambulatory electrocardiographic monitoring. A channel was used to record t he CM, lead, and another to record the signal of the patient's posture with use of a newly developed small-sized detector (3.2 cm x 3.2 cm). By using spectral analysis of heart rate variability, frequency-domain measures were calculated and compared among the three recumbent positions. Normalized hi gh-frequency (HF: 0.15 to 0.40 Hz) power was used as an index of vagal acti vity and the low frequency (0.04 to 0.15 Hz)/HF power ratio was used as an index of sympathovagal balance. RESULTS In patients with CHF, the time for the right lateral decubitus posi tion was two-fold longer than that for the supine and left lateral decubitu s positions. The increased cardiac sympathetic activity and decreased vagal tone in CHF patients were normalized in the right lateral decubitus positi on. CONCLUSIONS The right lateral decubitus position in patients with CHF may b e a self-protecting mechanism of attenuating the imbalance of cardiac auton omic nervous activity. (J Am Coll Cardiol 2001;37:1788-93) (C) 2001 by the American College of Cardiology.