From the Departments of Internal Medicine and Cardiothoracic Surgery,
College of Medicine, University of Iowa (R.L.C., P.v.d.B., W.R., R.O.,
V.K.S.), Iowa City; and Centro LITA di Vialba, Centro Ricerche Cardiovascolari
CNR, Medicina Interna II, Ospedale "L Sacco", Universitá di
Milano (N.M., C.C.), Milano, Italy.
Correspondence to Virend Somers, MD, PhD, Cardiovascular Division, Department of Internal Medicine, E314–2 GH, University of Iowa, 200 Hawkins Dr, Iowa City, IA 52242. E-mail virend-somers{at}uiowa.edu
Background—Short-term variability of
RR interval and blood pressure occurs predominantly at low frequency
(LF;
Methods and Results—We performed spectral analysis of RR,
blood pressure, and respiration in 2 patients with CHF before and after
LVAD implantation. LF components of the RR-interval and blood pressure
variability were absent in both CHF patients before LVAD implantation.
After LVAD implantation, spectral analysis of the RR interval
showed restoration of a clear and predominant LF
oscillation in the native hearts of both patients, with no
such oscillation evident in the blood pressure profile.
Conclusions—During total circulatory support with the LVAD, the
LF oscillation in RR interval of the native heart, absent
in CHF, is restored. This LF oscillation in RR interval
occurs in the absence of LF oscillations in blood pressure
and thus is unlikely to be explained by baroreflex mechanisms. Hence,
the absence of LF oscillation in the RR interval in CHF is
functional and is reversible by LVAD circulation. The presence of a
predominant LF oscillation in RR interval independent of
any oscillation in blood pressure suggests that the LF
oscillation is a fundamental property of central autonomic
outflow.
© 1998 American Heart Association, Inc.
Clinical Investigation and Reports
Evidence for a Central Origin of the Low-Frequency Oscillation in RR-Interval Variability
0.1 Hz) and high frequency (0.25 Hz). The
arterial baroreflex is thought to be the predominant
determinant of the LF component of RR variability. Patients with severe
congestive heart failure (CHF) have an attenuated or absent LF
oscillation in RR variability. The left
ventricular assist device (LVAD) offers a unique
possibility for analysis of spectral oscillations
in RR interval independent of any effects of blood pressure that
influence these oscillations via the baroreflex.
Key Words: heart failure • nervous system, autonomic • baroreceptors • heart-assist device • reflex
This article has been cited by other articles:
 |
|
 |
|
  R. Zhang, J. A. H. R. Claassen, S. Shibata, S. Kilic, K. Martin-Cook, R. Diaz-Arrastia, and B. D. Levine Arterial-cardiac baroreflex function: insights from repeated squat-stand maneuvers Am J Physiol Regulatory Integrative Comp Physiol, July 1, 2009; 297(1): R116 - R123. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Julien, M. J. Parkes, S. Y. C. Tzeng, P. Y. W. Sin, P. N. Ainslie, P. van de Borne, J.-O. Fortrat, M.-A. Custaud, C. Gharib, A. Porta, et al. Comments on Point:Counterpoint: Respiratory sinus arrhythmia is due to a central mechanism vs. respiratory sinus arrhythmia is due to the baroreflex mechanism J Appl Physiol, May 1, 2009; 106(5): 1745 - 1749. [Full Text] [PDF]
|
|
|
|
|
|
H. Mongue-Din, A. Salmon, M. Y. Fiszman, and Y. Fromes Periodic variation in R-R intervals and cardiovascular autonomic regulation in young adult Syrian hamsters Am J Physiol Regulatory Integrative Comp Physiol, March 1, 2009; 296(3): R610 - R617. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Henze, D. Hart, A. Samarel, J. Barakat, L. Eckert, and K. Scrogin Persistent alterations in heart rate variability, baroreflex sensitivity, and anxiety-like behaviors during development of heart failure in the rat Am J Physiol Heart Circ Physiol, July 1, 2008; 295(1): H29 - H38. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Nollo, L. Faes, A. Porta, R. Antolini, and F. Ravelli Exploring directionality in spontaneous heart period and systolic pressure variability interactions in humans: implications in the evaluation of baroreflex gain Am J Physiol Heart Circ Physiol, April 1, 2005; 288(4): H1777 - H1785. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. F. Joaquim, V. M. Farah, I. Bernatova, R. Fazan Jr., R. Grubbs, and M. Morris Enhanced heart rate variability and baroreflex index after stress and cholinesterase inhibition in mice Am J Physiol Heart Circ Physiol, July 1, 2004; 287(1): H251 - H257. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Ohuchi, H. Ohashi, J. Park, J. Hayashi, A. Miyazaki, and S. Echigo Abnormal Postexercise Cardiovascular Recovery and Its Determinants in Patients After Right Ventricular Outflow Tract Reconstruction Circulation, November 26, 2002; 106(22): 2819 - 2826. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Mangin, A. Monti, and C. Medigue Cardiorespiratory system dynamics in chronic heart failure Eur J Heart Fail, October 1, 2002; 4(5): 617 - 625. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. A. Lanfranchi and V. K Somers Arterial baroreflex function and cardiovascular variability: interactions and implications Am J Physiol Regulatory Integrative Comp Physiol, October 1, 2002; 283(4): R815 - R826. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Zhang, K. Iwasaki, J. H Zuckerman, K. Behbehani, C. G Crandall, and B. D Levine Mechanism of blood pressure and R-R variability: insights from ganglion blockade in humans J. Physiol., August 15, 2002; 543(1): 337 - 348. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H.-K. Liu, S.-J. Guild, J. V. Ringwood, C. J. Barrett, B. L. Leonard, S.-K. Nguang, M. A. Navakatikyan, and S. C. Malpas Dynamic baroreflex control of blood pressure: influence of the heart vs. peripheral resistance Am J Physiol Regulatory Integrative Comp Physiol, August 1, 2002; 283(2): R533 - R542. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Malfatto, G. Branzi, B. Riva, L. Sala, G. Leonetti, and M. Facchini Recovery of cardiac autonomic responsiveness with low-intensity physical training in patients with chronic heart failure Eur J Heart Fail, March 1, 2002; 4(2): 159 - 166. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. A. Allers, D. N. Ruskin, D. A. Bergstrom, L. E. Freeman, L. J. Ghazi, P. L. Tierney, and J. R. Walters Multisecond Periodicities in Basal Ganglia Firing Rates Correlate With Theta Bursts in Transcortical and Hippocampal EEG J Neurophysiol, February 1, 2002; 87(2): 1118 - 1122. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Wichmann, M. A. Kliem, and J. Soares Slow Oscillatory Discharge in the Primate Basal Ganglia J Neurophysiol, February 1, 2002; 87(2): 1145 - 1148. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. C. Malpas Neural influences on cardiovascular variability: possibilities and pitfalls Am J Physiol Heart Circ Physiol, January 1, 2002; 282(1): H6 - H20. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. van de Borne, M. Rahnama, S. Mezzetti, N. Montano, A. Porta, J. P. Degaute, and V. K. Somers Contrasting effects of phentolamine and nitroprusside on neural and cardiovascular variability Am J Physiol Heart Circ Physiol, August 1, 2001; 281(2): H559 - H565. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Franchi, C. Lazzeri, G. Barletta, L. Ianni, and M. Mannelli Centrally Mediated Effects of Bromocriptine on Cardiac Sympathovagal Balance Hypertension, July 1, 2001; 38(1): 123 - 129. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Mangin, A. Monti, C. Medigue, I. Macquin-Mavier, M.-E. Lopes, P. Gueret, A. Castaigne, B. Swynghedauw, and P. Mansier Altered baroreflex gain during voluntary breathing in chronic heart failure Eur J Heart Fail, March 1, 2001; 3(2): 189 - 195. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Malfatto, G. Branzi, S. Gritti, L. Sala, R. Bragato, G. B. Perego, G. Leonetti, and M. Facchini Different baseline sympathovagal balance and cardiac autonomic responsiveness in ischemic and non-ischemic congestive heart failure Eur J Heart Fail, March 1, 2001; 3(2): 197 - 202. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Cevese, G. Gulli, E. Polati, L. Gottin, and R. Grasso Baroreflex and oscillation of heart period at 0.1 Hz studied by {alpha}-blockade and cross-spectral analysis in healthy humans J. Physiol., February 15, 2001; 531(1): 235 - 244. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Yasuma and J.-I. Hayano Impact of acute hypoxia on heart rate and blood pressure variability in conscious dogs Am J Physiol Heart Circ Physiol, November 1, 2000; 279(5): H2344 - H2349. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Cogliati, R. Magatelli, N. Montano, K. Narkiewicz, and V. K. Somers Detection of low- and high-frequency rhythms in the variability of skin sympathetic nerve activity Am J Physiol Heart Circ Physiol, April 1, 2000; 278(4): H1256 - H1260. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M Galinier, A Pathak, J Fourcade, C Androdias, D Curnier, S Varnous, S Boveda, P Massabuau, M Fauvel, J.M Senard, et al. Depressed low frequency power of heart rate variability as an independent predictor of sudden death in chronic heart failure Eur. Heart J., March 2, 2000; 21(6): 475 - 482. [Abstract] [PDF]
|
|
|
|
|
|
R. Furlan, A. Porta, F. Costa, J. Tank, L. Baker, R. Schiavi, D. Robertson, A. Malliani, and R. Mosqueda-Garcia Oscillatory Patterns in Sympathetic Neural Discharge and Cardiovascular Variables During Orthostatic Stimulus Circulation, February 29, 2000; 101(8): 886 - 892. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Taylor, C. W. Myers, N. Montano, C. Cogliati, A. Porta, M. Pagani, A. Malliani, K. Narkiewicz, F. M. Abboud, and V. K. Somers Mathematical Treatment of Autonomic Oscillations - 2 • Response Circulation, October 12, 1999; 100 (15): e64 - e64. [Full Text] [PDF]
|
|
|
|
|
|
F. Iellamo, P. Pizzinelli, M. Massaro, G. Raimondi, G. Peruzzi, and J. M. Legramante Muscle Metaboreflex Contribution to Sinus Node Regulation During Static Exercise : Insights From Spectral Analysis of Heart Rate Variability Circulation, July 6, 1999; 100(1): 27 - 32. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. van de Borne, N. Montano, K. Narkiewicz, J. P. Degaute, R. Oren, M. Pagani, and V. K. Somers Sympathetic Rhythmicity in Cardiac Transplant Recipients Circulation, March 30, 1999; 99(12): 1606 - 1610. [Abstract] [Full Text] [PDF]
|
|