title: Assessment of cardiac autonomic functions by heart rate recovery, heart rate variability and QT dynamicity parameters in patients with acromegaly.
abstract: Cardiovascular complications are the most common causes of morbidity and mortality in acromegaly. However, there is little data regarding cardiac autonomic functions in these patients. Herein, we aimed to investigate several parameters of cardiac autonomic functions in patients with acromegaly compared to healthy subjects. We enrolled 20 newly diagnosed acromegalic patients (55% female, age:45.7 ± 12.6 years) and 32 age- and gender-matched healthy subjects. All participants underwent 24 h Holter recording. Heart rate recovery (HRR) indices were calculated by subtracting 1st, 2nd and 3rd minute heart rates from maximal heart rate. All patients underwent heart rate variability (HRV) and QT dynamicity analysis. Baseline characteristics were similar except diabetes mellitus and hypertension among groups. Mean HRR1 (29.2 ± 12.3 vs 42.6 ± 6.5, p = 0.001), HRR2 (43.5 ± 15.6 vs 61.1 ± 10.8, p = 0.001) and HRR3 (46.4 ± 16.2 vs 65.8 ± 9.8, p = 0.001) values were significantly higher in control group. HRV parameters as, SDNN [standard deviation of all NN intervals] (p = 0.001), SDANN [SD of the 5 min mean RR intervals] (p = 0.001), RMSSD [root square of successive differences in RR interval] (p = 0.001), PNN50 [proportion of differences in successive NN intervals >50 ms] (p = 0.001) and high-frequency [HF] (p = 0.001) were significantly decreased in patients with acromegaly; but low frequency [LF] (p = 0.046) and LF/HF (p = 0.001) were significantly higher in acromegaly patients. QTec (p = 0.009), QTac/RR slope (p = 0.017) and QTec/RR slope (p = 0.01) were significantly higher in patients with acromegaly. Additionally, there were significant negative correlation of disease duration with HRR2, HRR3, SDNN, PNN50, RMSSD, variability index. Our study results suggest that cardiac autonomic functions are impaired in patients with acromegaly. Further large scale studies are needed to exhibit the prognostic significance of impaired autonomic functions in patients with acromegaly.
authors.affiliation: Department of Cardiology, Faculty of Medicine, Hacettepe University, 06100, Sihhiye, Ankara, Turkey, muhammet_dural@hotmail.com.
authors.forename: Muhammet
authors.initials: M
authors.lastname: Dural
authors.forename: Giray
authors.initials: G
authors.lastname: Kabakcı
authors.forename: Neşe
authors.initials: N
authors.lastname: Cınar
authors.forename: Tomris
authors.initials: T
authors.lastname: Erbaş
authors.forename: Uğur
authors.initials: U
authors.lastname: Canpolat
authors.forename: Kadri Murat
authors.initials: KM
authors.lastname: Gürses
authors.forename: Lale
authors.initials: L
authors.lastname: Tokgözoğlu
authors.forename: Ali
authors.initials: A
authors.lastname: Oto
authors.forename: Ergün Barış
authors.initials: EB
authors.lastname: Kaya
authors.forename: Hikmet
authors.initials: H
authors.lastname: Yorgun
authors.forename: Levent
authors.initials: L
authors.lastname: Sahiner
authors.forename: Selçuk
authors.initials: S
authors.lastname: Dağdelen
authors.forename: Kudret
authors.initials: K
authors.lastname: Aytemir
mesh_terms: D000172:Acromegaly / Q000175:diagnosis / Q000503:physiopathology*; D000328:Adult; D001341:Autonomic Nervous System / Q000502:physiology*; D016022:Case-Control Studies; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D005080:Exercise Test; D005260:Female; D006321:Heart / Q000294:innervation* / Q000503:physiopathology; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013997:Time Factors
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