title: Heart rate variability and heart rate turbulence in patients with hematologic malignancies subjected to high-dose chemotherapy in the course of hematopoietic stem cell transplantation.
abstract: BACKGROUND
  In hematological malignancies, remissions and cures may be achieved by hematopoietic stem cell transplantation (HSCT) following high-dose chemotherapy (HDC). Cardiotoxicity of such therapy has not yet been fully elucidated. Noninvasive approaches allowing to evaluate an autonomic control of the heart function include analyses of both heart rate variability (HRV) and heart rate turbulence (HRT).
  
  
  METHODS
  In 38 patients with hematological malignancies, 24-hour electrocardiography Holter monitoring , with HRV and HRT analysis before HSCT (A test) and after HSCT (B test), was performed.
  
  
  RESULTS
  The 24-hour analysis of HRV demonstrated that SDNN, SDNNi, rMSSD, and pNN50 parameters were significantly lower after HSCT as compared to the results obtained before the transplantation (P < 0.05). For period of diurnal activity and for night hours, SDANN, SDNNi, rMSSD, and pNN50 were significantly lower in B test, as compared to the results of A test (P < 0.05). The analysis of HRT demonstrated that turbulence onset parameter was significantly higher, and turbulence slope parameter was significantly lower in B test, as compared to A test (P < 0.05). The multifactorial stepwise backward regression analysis indicated that administration of cyclophosphamide and carmustine and higher concentrations of blood cholesterol represented risk factors for decreased HRV. Cyclophosphamide and higher triglyceride levels represented independent risk factors for decreased HRT.
  
  
  CONCLUSIONS
  In patients with hematopoietic malignancies treated with HSCT, decreased HRV and HRT were observed after chemotherapy and stem cells administration.
authors.affiliation: Department of Pathophysiology, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Poręba
authors.forename: Rafał
authors.initials: R
authors.lastname: Poręba
authors.forename: Paweł
authors.initials: P
authors.lastname: Gać
authors.forename: Lidia
authors.initials: L
authors.lastname: Usnarska-Zubkiewicz
authors.forename: Witold
authors.initials: W
authors.lastname: Pilecki
authors.forename: Ewa
authors.initials: E
authors.lastname: Piotrowicz
authors.forename: Ryszard
authors.initials: R
authors.lastname: Piotrowicz
authors.forename: Leszek
authors.initials: L
authors.lastname: Rusiecki
authors.forename: Kazimierz
authors.initials: K
authors.lastname: Kuliczkowski
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Mazur
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Sobieszczańska
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002784:Cholesterol / Q000097:blood; D003131:Combined Modality Therapy; D015716:Electrocardiography, Ambulatory / Q000379:methods; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D019337:Hematologic Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000601:surgery*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007938:Leukemia / Q000097:blood / Q000188:drug therapy / Q000601:surgery; D008223:Lymphoma / Q000097:blood / Q000188:drug therapy / Q000601:surgery; D008297:Male; D009101:Multiple Myeloma / Q000097:blood / Q000188:drug therapy / Q000601:surgery; D012307:Risk Factors
chemical_list: D000970:Antineoplastic Agents; D002784:Cholesterol
keywords: cardiotoxicity; heart rate turbulence; heart rate variability; hematopoietic stem cell transplantation; high-dose chemotherapy