TY - JOUR
T1 - Cardiac autonomic control in Brugada syndrome patients during sleep
T2 - The effects of sleep disordered breathing
AU - Tobaldini, Eleonora
AU - Brugada, Josep
AU - Benito, Begona
AU - Molina, Irma
AU - Montserrat, Josep
AU - Kara, Tomas
AU - Leinveber, Pavel
AU - Porta, Alberto
AU - Macedo, Paula G.
AU - Montano, Nicola
AU - Somers, Virend K.
N1 - Funding Information:
This work was supported by an unrestricted grant of the University of Milan, Italy to ET; a National Institute of Health [ 2R01 HL65176-05 ] to VKS; Czech Ministry of Health [No. NS 10098-4/2008 ] and by European Regional Development Fund — Project FNUSA-ICRC [No. CZ.1.05/1.1.00/02.0123 ] to VKS, TK and PL.
Funding Information:
Conflicts of interest: Dr. Somers has served as a Consultant for ResMed, Respicardia, Apnex Medical, Deshum, NeuPro, Johnson and Johnson, and Medtronic Corporation and has been a co-investigator on research grants funded by the ResMed Foundation. Mayo Foundation has received a gift from the Phillips-Respironics Foundation for the study of sleep apnea and cardiovascular disease. For all the other authors, no conflict of interest is declared.
PY - 2013/10/9
Y1 - 2013/10/9
N2 - Aims Brugada syndrome is characterized by typical ECG features, ventricular arrhythmias and sudden cardiac death (SCD), more frequent during nighttime. Autonomic cardiovascular control has been implicated in triggering the ventricular arrhythmias. Sleep-disordered breathing (SDB) elicits marked autonomic changes during sleep and is also associated with an increased risk of nighttime SCD. Brugada patients may have a higher likelihood of SDB compared to controls. However, no data are available on cardiac autonomic control in Brugada patients, particularly with regard to the comorbidity of SDB. Methods We evaluated autonomic cardiovascular control in Brugada patients with SDB (BRU-SDB, n = 9), without SDB (BRU, n = 9), in controls (CON, n = 8) and in non-Brugada patients with SDB (n = 6), during wakefulness and sleep (N2, N3 and REM). Linear spectral and entropy-derived measures of heart rate variability (HRV) were performed during apnea-free stable breathing epochs. Results Total HRV was attenuated in BRU-SDB compared to CON and BRU. During N2 and REM, in BRU-SDB patients sympathetic modulation decreased compared to BRU and CON, while during REM, they showed an increased parasympathetic modulation, compared to the other two groups. BRU-SDB and SDB were similar in terms of spectral components. Entropy-derived indices showed preserved dynamic changes in Brugada patients compared to controls through the different sleep stages. Conclusion Brugada syndrome per se does not appear associated with an altered autonomic cardiovascular control during wakefulness and sleep. The comorbidity with SDB may contribute to disrupted autonomic cardiovascular regulation during sleep, possibly predisposing to the increased likelihood of sleep-related ventricular tachyarrhythmias and SCD.
AB - Aims Brugada syndrome is characterized by typical ECG features, ventricular arrhythmias and sudden cardiac death (SCD), more frequent during nighttime. Autonomic cardiovascular control has been implicated in triggering the ventricular arrhythmias. Sleep-disordered breathing (SDB) elicits marked autonomic changes during sleep and is also associated with an increased risk of nighttime SCD. Brugada patients may have a higher likelihood of SDB compared to controls. However, no data are available on cardiac autonomic control in Brugada patients, particularly with regard to the comorbidity of SDB. Methods We evaluated autonomic cardiovascular control in Brugada patients with SDB (BRU-SDB, n = 9), without SDB (BRU, n = 9), in controls (CON, n = 8) and in non-Brugada patients with SDB (n = 6), during wakefulness and sleep (N2, N3 and REM). Linear spectral and entropy-derived measures of heart rate variability (HRV) were performed during apnea-free stable breathing epochs. Results Total HRV was attenuated in BRU-SDB compared to CON and BRU. During N2 and REM, in BRU-SDB patients sympathetic modulation decreased compared to BRU and CON, while during REM, they showed an increased parasympathetic modulation, compared to the other two groups. BRU-SDB and SDB were similar in terms of spectral components. Entropy-derived indices showed preserved dynamic changes in Brugada patients compared to controls through the different sleep stages. Conclusion Brugada syndrome per se does not appear associated with an altered autonomic cardiovascular control during wakefulness and sleep. The comorbidity with SDB may contribute to disrupted autonomic cardiovascular regulation during sleep, possibly predisposing to the increased likelihood of sleep-related ventricular tachyarrhythmias and SCD.
KW - Autonomic nervous system
KW - Brugada syndrome
KW - Heart rate variability
KW - Non-linear analysis
KW - Sleep
KW - Sleep disordered breathing
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U2 - 10.1016/j.ijcard.2013.04.137
DO - 10.1016/j.ijcard.2013.04.137
M3 - Article
C2 - 23669108
AN - SCOPUS:84886302266
SN - 0167-5273
VL - 168
SP - 3267
EP - 3272
JO - International Journal of Cardiology
JF - International Journal of Cardiology
IS - 4
ER -