Heart rate variability in patients with systemic sarcoidosis.
OBJECTIVE
The identification of subjects with systemic sarcoidosis at higher risk for sudden death is an unresolved issue. An influence of the autonomic activity on the genesis of ventricular arrhythmias was postulated. Heart rate variability (HRV) analysis provides a useful method to measure autonomic activity, and is a predictor of increased risk of death in various conditions. Therefore, the aim of the study was to evaluate HRV in patients with systemic sarcoidosis.


METHODS
The study included 35 patients with biopsy proven systemic sarcoidosis who were not taking antiarrhythmic medications. Thallium scintigraphy was performed to all patients with systemic sarcoidosis. The cardiac sarcoidosis was accepted in 16 patients as abnormal thallium scintigraphy and normal coronary arteriography. The time-domain analysis of HRV was expressed as the standard deviation of all normal to normal NN intervals (SDNN) detected during 24-hour Holter monitoring. Twenty-four healthy subjects represented a control group for HRV analysis.


RESULTS
There were no differences in age (44 +/- 13 years for cardiac sarcoidosis, 42 +/- 15 years for noncardiac sarcoidosis, and 40 +/- 10 years for control group; P = NS), sex (the ratio of female; 63%, 68%, and 55%, respectively; P = NS), and echocardiographic ejection fraction (63 +/- 10%, 67 +/- 8%, and 69 +/- 6%, respectively; P = NS) among study groups. The mean SDNN value of the group with cardiac sarcoidosis was significantly lower than both the group with noncardiac sarcoidosis and the control group (72 +/- 32 ms vs 110 +/- 46 ms and 152 +/- 36 ms; P < 0.05, respectively).


CONCLUSIONS
HRV is decreased in patients with systemic sarcoidosis compared to the control group. This decreasing is more obvious in patients with cardiac sarcoidosis.
Siyami Ersek Thoracic and Cardiovascular Surgery Center, Cardiology Department, Istanbul, Turkey. drnuslu@yahoo.com
Nevzat
N
Uslu
Ahmet
A
Akyol
Sevket
S
Gorgulu
Mehmet
M
Eren
Birsen
B
Ocakli
Seden
S
Celik
Aydin
A
Yildirim
Huseyin
H
Aksu
Zekeriya
Z
Nurkalem
D000328:Adult; D000704:Analysis of Variance; D009202:Cardiomyopathies / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016022:Case-Control Studies; D004452:Echocardiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D011877:Radionuclide Imaging; D012507:Sarcoidosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013794:Thallium Radioisotopes
D013794:Thallium Radioisotopes