Deterioration of the circadian variation of heart rate variability in Brugada syndrome may contribute to the pathogenesis of ventricular fibrillation

Abstract Aims Abnormal sympathetic innervation triggers ventricular fibrillation (VF). We examined the circadian variation of autonomic nervous system and its relevance to risk stratification of VF in patients with Brugada syndrome (Brs). Methods We enrolled 12 male Brs patients with documented VF (...

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Published in:Journal of cardiology 2014-08, Vol.64 (2), p.133-138
Main Authors: Tokuyama, Takehito, MD, Nakano, Yukiko, MD, PhD, FJCC, Awazu, Akinori, PhD, Uchimura-Makita, Yuko, MD, Fujiwra, Mai, MD, Watanabe, Yoshikazu, MD, Sairaku, Akinori, MD, Kajihara, Kenta, MD, Motoda, Chikaaki, MD, Oda, Noboru, MD, PhD, Kihara, Yasuki, MD, PhD, FJCC
Format: Article
Language:English
Subjects:
Adult
Autonomic nervous system
Autonomic Nervous System - physiopathology
Brugada Syndrome - complications
Brugada Syndrome - diagnosis
Brugada Syndrome - physiopathology
Cardiovascular
Circadian rhythm
Circadian Rhythm - physiology
Electrocardiography - methods
Heart Rate - physiology
Humans
Male
Middle Aged
Sensitivity and Specificity
Ventricular fibrillation
Ventricular Fibrillation - diagnosis
Ventricular Fibrillation - etiology
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cited_by cdi_FETCH-LOGICAL-c615t-db4032d2af96d68e4a5834942210fb60bf350f5bf1dd369d9f2d0aca056354203
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creator Tokuyama, Takehito, MD
Nakano, Yukiko, MD, PhD, FJCC
Awazu, Akinori, PhD
Uchimura-Makita, Yuko, MD
Fujiwra, Mai, MD
Watanabe, Yoshikazu, MD
Sairaku, Akinori, MD
Kajihara, Kenta, MD
Motoda, Chikaaki, MD
Oda, Noboru, MD, PhD
Kihara, Yasuki, MD, PhD, FJCC
description Abstract Aims Abnormal sympathetic innervation triggers ventricular fibrillation (VF). We examined the circadian variation of autonomic nervous system and its relevance to risk stratification of VF in patients with Brugada syndrome (Brs). Methods We enrolled 12 male Brs patients with documented VF (Brs-S; mean age, 42 ± 4 years), 17 without documented VF (Brs-N; mean age 48 ± 4 years), and 16 age- and gender-matched controls. The clinical data, 12-lead electrocardiography (ECG), signal-averaged ECG, electrophysiological study (EPS), and heart rate variability from 24 h Holter ECG were compared between the groups. Results The low frequency components (LF) in Brs-S and Brs-N and high frequency components (HF) in Brs-S patients were significantly lower than in the controls (409.8 ± 128.6 ms2 , 329.5 ± 108 ms2 vs. 945.3 ± 111.3 ms2 ; 135.1 ± 73.8 ms2 vs. 391.8 ± 63.9 ms2 , respectively). The circadian variation of the LF and LF/HF decreased in the Brs patients, the standard deviation (SD) of LF/HF (
doi_str_mv 10.1016/j.jjcc.2013.12.001
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We examined the circadian variation of autonomic nervous system and its relevance to risk stratification of VF in patients with Brugada syndrome (Brs). Methods We enrolled 12 male Brs patients with documented VF (Brs-S; mean age, 42 ± 4 years), 17 without documented VF (Brs-N; mean age 48 ± 4 years), and 16 age- and gender-matched controls. The clinical data, 12-lead electrocardiography (ECG), signal-averaged ECG, electrophysiological study (EPS), and heart rate variability from 24 h Holter ECG were compared between the groups. Results The low frequency components (LF) in Brs-S and Brs-N and high frequency components (HF) in Brs-S patients were significantly lower than in the controls (409.8 ± 128.6 ms2 , 329.5 ± 108 ms2 vs. 945.3 ± 111.3 ms2 ; 135.1 ± 73.8 ms2 vs. 391.8 ± 63.9 ms2 , respectively). The circadian variation of the LF and LF/HF decreased in the Brs patients, the standard deviation (SD) of LF/HF (&lt;2.5) and SD of LF (&lt;400 ms2 ) had sufficiently high sensitivity (96.6%) and specificity (92.9%) for the diagnosis of Brs. Most of the Brs-S patients (83.3%) were located under the line formed by the SD/mean of HF = SD/mean of LF in the scatter plots. Conclusion Lack of the circadian variation of autonomic function occurs in Brs, and this may contribute to the pathogenesis of VF.</description><identifier>ISSN: 0914-5087</identifier><identifier>EISSN: 1876-4738</identifier><identifier>DOI: 10.1016/j.jjcc.2013.12.001</identifier><identifier>PMID: 24495503</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Adult ; Autonomic nervous system ; Autonomic Nervous System - physiopathology ; Brugada Syndrome - complications ; Brugada Syndrome - diagnosis ; Brugada Syndrome - physiopathology ; Cardiovascular ; Circadian rhythm ; Circadian Rhythm - physiology ; Electrocardiography - methods ; Heart Rate - physiology ; Humans ; Male ; Middle Aged ; Sensitivity and Specificity ; Ventricular fibrillation ; Ventricular Fibrillation - diagnosis ; Ventricular Fibrillation - etiology</subject><ispartof>Journal of cardiology, 2014-08, Vol.64 (2), p.133-138</ispartof><rights>Japanese College of Cardiology</rights><rights>2013 Japanese College of Cardiology</rights><rights>Copyright © 2013 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c615t-db4032d2af96d68e4a5834942210fb60bf350f5bf1dd369d9f2d0aca056354203</citedby><cites>FETCH-LOGICAL-c615t-db4032d2af96d68e4a5834942210fb60bf350f5bf1dd369d9f2d0aca056354203</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24495503$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tokuyama, Takehito, MD</creatorcontrib><creatorcontrib>Nakano, Yukiko, MD, PhD, FJCC</creatorcontrib><creatorcontrib>Awazu, Akinori, PhD</creatorcontrib><creatorcontrib>Uchimura-Makita, Yuko, MD</creatorcontrib><creatorcontrib>Fujiwra, Mai, MD</creatorcontrib><creatorcontrib>Watanabe, Yoshikazu, MD</creatorcontrib><creatorcontrib>Sairaku, Akinori, MD</creatorcontrib><creatorcontrib>Kajihara, Kenta, MD</creatorcontrib><creatorcontrib>Motoda, Chikaaki, MD</creatorcontrib><creatorcontrib>Oda, Noboru, MD, PhD</creatorcontrib><creatorcontrib>Kihara, Yasuki, MD, PhD, FJCC</creatorcontrib><title>Deterioration of the circadian variation of heart rate variability in Brugada syndrome may contribute to the pathogenesis of ventricular fibrillation</title><title>Journal of cardiology</title><addtitle>J Cardiol</addtitle><description>Abstract Aims Abnormal sympathetic innervation triggers ventricular fibrillation (VF). We examined the circadian variation of autonomic nervous system and its relevance to risk stratification of VF in patients with Brugada syndrome (Brs). Methods We enrolled 12 male Brs patients with documented VF (Brs-S; mean age, 42 ± 4 years), 17 without documented VF (Brs-N; mean age 48 ± 4 years), and 16 age- and gender-matched controls. The clinical data, 12-lead electrocardiography (ECG), signal-averaged ECG, electrophysiological study (EPS), and heart rate variability from 24 h Holter ECG were compared between the groups. Results The low frequency components (LF) in Brs-S and Brs-N and high frequency components (HF) in Brs-S patients were significantly lower than in the controls (409.8 ± 128.6 ms2 , 329.5 ± 108 ms2 vs. 945.3 ± 111.3 ms2 ; 135.1 ± 73.8 ms2 vs. 391.8 ± 63.9 ms2 , respectively). The circadian variation of the LF and LF/HF decreased in the Brs patients, the standard deviation (SD) of LF/HF (&lt;2.5) and SD of LF (&lt;400 ms2 ) had sufficiently high sensitivity (96.6%) and specificity (92.9%) for the diagnosis of Brs. Most of the Brs-S patients (83.3%) were located under the line formed by the SD/mean of HF = SD/mean of LF in the scatter plots. Conclusion Lack of the circadian variation of autonomic function occurs in Brs, and this may contribute to the pathogenesis of VF.</description><subject>Adult</subject><subject>Autonomic nervous system</subject><subject>Autonomic Nervous System - physiopathology</subject><subject>Brugada Syndrome - complications</subject><subject>Brugada Syndrome - diagnosis</subject><subject>Brugada Syndrome - physiopathology</subject><subject>Cardiovascular</subject><subject>Circadian rhythm</subject><subject>Circadian Rhythm - physiology</subject><subject>Electrocardiography - methods</subject><subject>Heart Rate - physiology</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Sensitivity and Specificity</subject><subject>Ventricular fibrillation</subject><subject>Ventricular Fibrillation - diagnosis</subject><subject>Ventricular Fibrillation - etiology</subject><issn>0914-5087</issn><issn>1876-4738</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><recordid>eNp9kk2O1DAQhSMEYpqBC7BAXrJJKNuxk0gICYZfaSQWwNpy7Mq0QzpubKelHIT74kwPs2DBylL5e6_selUUzylUFKh8NVbjaEzFgPKKsgqAPih2tG1kWTe8fVjsoKN1KaBtLoonMY4AErpWPi4uWF13QgDfFb_fY8LgfNDJ-Zn4gaQ9EuOC0dbpmZx0cPdXe9QhkYziud67yaWVuJm8C8uNtprEdbbBH5Ac9EqMn1Nw_ZLx5G99jzrt_Q3OGF3cDE-4EWaZdCCD64ObpttmT4tHg54iPrs7L4sfHz98v_pcXn_99OXq7XVpJBWptH0NnFmmh05a2WKtRcvrrmaMwtBL6AcuYBD9QK3lsrPdwCxoo0FILmoG_LJ4efY9Bv9rwZjUwUWD-RUz-iUqKgRroRaNzCg7oyb4GAMO6hjcQYdVUVBbHGpUWxxqi0NRpnIcWfTizn_pD2jvJX_nn4HXZwDzL08Og4rG4WzQuoAmKevd__3f_CM3k5ud0dNPXDGOfglznp-iKmaB-rYtxLYPlAPwVjT8D3V_s9I</recordid><startdate>20140801</startdate><enddate>20140801</enddate><creator>Tokuyama, Takehito, MD</creator><creator>Nakano, Yukiko, MD, PhD, FJCC</creator><creator>Awazu, Akinori, PhD</creator><creator>Uchimura-Makita, Yuko, MD</creator><creator>Fujiwra, Mai, MD</creator><creator>Watanabe, Yoshikazu, MD</creator><creator>Sairaku, Akinori, MD</creator><creator>Kajihara, Kenta, MD</creator><creator>Motoda, Chikaaki, MD</creator><creator>Oda, Noboru, MD, PhD</creator><creator>Kihara, Yasuki, MD, PhD, FJCC</creator><general>Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140801</creationdate><title>Deterioration of the circadian variation of heart rate variability in Brugada syndrome may contribute to the pathogenesis of ventricular fibrillation</title><author>Tokuyama, Takehito, MD ; Nakano, Yukiko, MD, PhD, FJCC ; Awazu, Akinori, PhD ; Uchimura-Makita, Yuko, MD ; Fujiwra, Mai, MD ; Watanabe, Yoshikazu, MD ; Sairaku, Akinori, MD ; Kajihara, Kenta, MD ; Motoda, Chikaaki, MD ; Oda, Noboru, MD, PhD ; Kihara, Yasuki, MD, PhD, FJCC</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c615t-db4032d2af96d68e4a5834942210fb60bf350f5bf1dd369d9f2d0aca056354203</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Autonomic nervous system</topic><topic>Autonomic Nervous System - physiopathology</topic><topic>Brugada Syndrome - complications</topic><topic>Brugada Syndrome - diagnosis</topic><topic>Brugada Syndrome - physiopathology</topic><topic>Cardiovascular</topic><topic>Circadian rhythm</topic><topic>Circadian Rhythm - physiology</topic><topic>Electrocardiography - methods</topic><topic>Heart Rate - physiology</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Sensitivity and Specificity</topic><topic>Ventricular fibrillation</topic><topic>Ventricular Fibrillation - diagnosis</topic><topic>Ventricular Fibrillation - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tokuyama, Takehito, MD</creatorcontrib><creatorcontrib>Nakano, Yukiko, MD, PhD, FJCC</creatorcontrib><creatorcontrib>Awazu, Akinori, PhD</creatorcontrib><creatorcontrib>Uchimura-Makita, Yuko, MD</creatorcontrib><creatorcontrib>Fujiwra, Mai, MD</creatorcontrib><creatorcontrib>Watanabe, Yoshikazu, MD</creatorcontrib><creatorcontrib>Sairaku, Akinori, MD</creatorcontrib><creatorcontrib>Kajihara, Kenta, MD</creatorcontrib><creatorcontrib>Motoda, Chikaaki, MD</creatorcontrib><creatorcontrib>Oda, Noboru, MD, PhD</creatorcontrib><creatorcontrib>Kihara, Yasuki, MD, PhD, FJCC</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tokuyama, Takehito, MD</au><au>Nakano, Yukiko, MD, PhD, FJCC</au><au>Awazu, Akinori, PhD</au><au>Uchimura-Makita, Yuko, MD</au><au>Fujiwra, Mai, MD</au><au>Watanabe, Yoshikazu, MD</au><au>Sairaku, Akinori, MD</au><au>Kajihara, Kenta, MD</au><au>Motoda, Chikaaki, MD</au><au>Oda, Noboru, MD, PhD</au><au>Kihara, Yasuki, MD, PhD, FJCC</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Deterioration of the circadian variation of heart rate variability in Brugada syndrome may contribute to the pathogenesis of ventricular fibrillation</atitle><jtitle>Journal of cardiology</jtitle><addtitle>J Cardiol</addtitle><date>2014-08-01</date><risdate>2014</risdate><volume>64</volume><issue>2</issue><spage>133</spage><epage>138</epage><pages>133-138</pages><issn>0914-5087</issn><eissn>1876-4738</eissn><abstract>Abstract Aims Abnormal sympathetic innervation triggers ventricular fibrillation (VF). We examined the circadian variation of autonomic nervous system and its relevance to risk stratification of VF in patients with Brugada syndrome (Brs). Methods We enrolled 12 male Brs patients with documented VF (Brs-S; mean age, 42 ± 4 years), 17 without documented VF (Brs-N; mean age 48 ± 4 years), and 16 age- and gender-matched controls. The clinical data, 12-lead electrocardiography (ECG), signal-averaged ECG, electrophysiological study (EPS), and heart rate variability from 24 h Holter ECG were compared between the groups. Results The low frequency components (LF) in Brs-S and Brs-N and high frequency components (HF) in Brs-S patients were significantly lower than in the controls (409.8 ± 128.6 ms2 , 329.5 ± 108 ms2 vs. 945.3 ± 111.3 ms2 ; 135.1 ± 73.8 ms2 vs. 391.8 ± 63.9 ms2 , respectively). The circadian variation of the LF and LF/HF decreased in the Brs patients, the standard deviation (SD) of LF/HF (&lt;2.5) and SD of LF (&lt;400 ms2 ) had sufficiently high sensitivity (96.6%) and specificity (92.9%) for the diagnosis of Brs. Most of the Brs-S patients (83.3%) were located under the line formed by the SD/mean of HF = SD/mean of LF in the scatter plots. Conclusion Lack of the circadian variation of autonomic function occurs in Brs, and this may contribute to the pathogenesis of VF.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>24495503</pmid><doi>10.1016/j.jjcc.2013.12.001</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record>
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subjects Adult
Autonomic nervous system
Autonomic Nervous System - physiopathology
Brugada Syndrome - complications
Brugada Syndrome - diagnosis
Brugada Syndrome - physiopathology
Cardiovascular
Circadian rhythm
Circadian Rhythm - physiology
Electrocardiography - methods
Heart Rate - physiology
Humans
Male
Middle Aged
Sensitivity and Specificity
Ventricular fibrillation
Ventricular Fibrillation - diagnosis
Ventricular Fibrillation - etiology
title Deterioration of the circadian variation of heart rate variability in Brugada syndrome may contribute to the pathogenesis of ventricular fibrillation
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