Autonomic nervous system dysfunction in the course of active pulmonary tuberculosis.
BACKGROUND
Functional alterations of the autonomic nervous system have been described in relation to chronic hypoxemia in chronic obstructive pulmonary diseases. Aim of the present study was to investigate the occurrence of neuro-vegetative dysfunction during active tuberculosis in the absence of hypoxemia.


METHODS
Fifteen patients affected by pulmonary tuberculosis under standard therapy and 17 matched controls were enrolled. Activation of the sympathetic system was induced by the tilt-up test. Systolic and diastolic arterial pressures and the R-R interval were monitored for 15 min by Finapres and ECG. The baroreflex sensitivity was evaluated by the spontaneous sequences method.


RESULTS
Systolic and diastolic pressures were significantly higher at basal conditions and showed a less increase during the tilt test in tuberculosis patients compared to healthy controls. The basal R-R interval was shorter and its reduction during the tilt test was less evident in patients. The baroreflex sensitivity was decreased in patients at basal conditions and its reduction during the tilt test was less evident than in controls.


CONCLUSIONS
Our preliminary results suggest the presence in tuberculosis patients of an altered autonomic cardiovascular regulation, which is a reduced function of the baroreflex control of the sinus node.
Raimondi
Gianfranco
G
Postgraduate School of Respiratory Medicine, University of Rome Tor Vergata, Rome, Italy.
Contini
Silvia
S
Maria Legramante
Jacopo
J
Bocchino
Marialuisa
M
Sacco
Sergio
S
Pallante
Marco
M
Cazzola
Mario
M
Saltini
Cesare
C
D000328:Adult; D001341:Autonomic Nervous System / Q000503:physiopathology*; D017704:Baroreflex / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology; D016022:Case-Control Studies; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D014397:Tuberculosis, Pulmonary / Q000150:complications*