Assessment of the sympatho-vagal interaction in central serous chorioretinopathy measured by power spectral analysis of heart rate variability

Bernasconi, Paolo; Messmer, Elmar P.; Bernasconi, A.; Thölen, Adelheid

doi:10.1007/s004170050123

Cited by 41 publications

(40 citation statements)

References 12 publications

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“…24,25 Moreover, a type A personality and sympathetic hyperactivity frequently characterize these patients, easily leading to changes in systemic hemodynamics and OPP. 26,27 New OCT technologies have substantially improved our capability in qualitatively and quantitatively evaluating the choroidal vasculature and perfusion. 28,29 OCT-Angiography (OCT-A), a recent label-free imaging modality that uses the blood cells motion as contrast, is able to provide information on the blood flow in the chorioretinal microvasculature.…”

Section: Resultsmentioning

confidence: 99%

“…A dysfunction of the autonomic nervous system is widely recognized in people affected by CSCR. 27 Compared to healthy subjects, CSCR patients have a higher sympathetic tone, associated with type A personality, easy emotional stress, and high levels of catecholamines in the blood. 16,26 Psychological stress and increased BP are found strictly linked in people with sympathetic hyperactivity.…”

Section: Discussionmentioning

confidence: 99%

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Choroidal Vascular Reactivity in Central Serous Chorioretinopathy

Piccolino

Lupidi

Cagini

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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METHODS. For this multicenter, observational, case-control study, we enrolled 35 patients with an established diagnose of CSCR and 25 age-matched healthy controls. All subjects underwent a handgrip isometric exercise to obtain elevation of blood pressure (BP). In the resting phase and during the physical effort, macular OCT-angiograms were acquired. Systemic hemodynamic data were recorded at baseline and during stress conditions using an electronic sphygmomanometer. The analysis of vascular density (VD) of the choriocapillaris (CC) was performed on OCT-angiograms. The results obtained in CSCR patients, both at baseline and during the stress test, were compared with those of healthy subjects. RESULTS.Baseline and under stress values of systolic BP, diastolic BP, and mean arterial pressure were significantly higher (P < 0.05) in CSCR patients compared to controls, reaching values in the range of hypertension during the exercise. Baseline VD values of the CC were significantly lower (P < 0.05) in CSCR cases compared to healthy subjects. We noticed a significant increase (P < 0.05) in these values under stress condition in CSCR patients and not in controls.CONCLUSIONS. The present study suggests that choroidal blood flow is dysregulated in CSCR. During physical stress, CSCR patients easily reach critical values of BP that are not dampened by compensatory mechanisms in the choroidal vessels, as it happens in healthy subjects. The CC in CSCR could be particularly vulnerable to variations of systemic hemodynamics.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Choroidal Vascular Reactivity in Central Serous Chorioretinopathy

Piccolino

Lupidi

Cagini

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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“…Previous studies have shown an association between CSC and increased sympathetic activity [6], higher levels of catecholamine [7] and high blood pressure [6]. Since OSAS causes an increase in sympathetic activity and may increase cortisol levels [9,14], it can be speculated that patients with OSAS are at higher risk of developing CSC than the general population.…”

Section: Discussionmentioning

confidence: 99%

“…Risk factors including psychological stress and type-A behaviour [3], corticosteroids [4] and sympathomimetic use [5] have been reported to induce or exacerbate CSC. Patients with CSC demonstrated increased heart-rate variability as a marker of sympathetic activity compared to controls [6]. Additionally, there are several reports of increased corticosteroid and catecholamine levels in these patients [7].…”

Section: Introductionmentioning

confidence: 99%

Obstructive sleep apnea in patients with central serous chorioretinopathy

Kloos

Laube

Thoelen

2008

Graefes Arch Clin Exp Ophthalmol

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Background Patients with central serous chorioretinopathy (CSC) show an increased sympathetic activity compared to controls. Additionally, there are several reports of increased corticosteroid and catecholamine levels in these patients. Obstructive sleep apnea syndrome (OSAS) has been shown to enhance sympathetic activity depending on severity. Respiratory disturbance increases urinary catecholamine secretion and is associated with the occurance of hypertension in a dose dependent manner. Therefore we hypothesize that OSAS may act as a risk factor for the development of CSC. Methods Patients with active CSC or with pigment epithelial disturbances after CSC were contacted to answer a questionnaire about general health, drugs and sleeping habits and to complete the Epworth Sleepiness Scale (ESS) score, a widely used subjective measure of daytime sleepiness. Patients with an ESS score of >10 were referred to our department of pulmonary medicine for evaluating of respiratory disturbance in sleep. ResultsWe identified 56 consecutive patients with angiographic criteria for acute CSC or pigment epithelial defects after CSC, seven (12.5%) of whom were excluded because of a history of systemic or topic corticosteroid use. Thirtysix (73.5%) of the remaining 49 patients returned the questionnaire. Fourteen (38.8%) had an ESS score of >10. They were referred to the Department of Pulmonary Medicine. In eight (22.2%) of these patients, a diagnosis of obstructive sleep apnea syndrome was confirmed. Conclusions We found that 22% of the patients with acute or chronic CSC in this case series also suffered from OSAS, whereas in the general population OSAS is considerably less frequently reported (2-4%). OSAS therefore may act as a risk factor for the development of CSC. However, prospective controlled data is needed to definitely evaluate the possible association between CSC and OSAS. Also the clinical course of CSC during treatment of OSAS would be of particular interest.

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“…The R-R interval data of 20 consecutive 256-beat intervals were then subjected to power spectral analysis using the autoregressive model (ProBeat, Access pro med, Vaduz, Liechtenstein) [17]. This method was chosen instead of fast Fourier transformation because with autoregressive algorithms, shorter segments can be reliably analysed.…”

Section: Power Spectral Analysismentioning

confidence: 99%

Spectral Analysis of Fetal Heart Rate Variability in Fetuses with Supraventricular Extrasystoles

Troeger

Schaub²,

Bernasconi³

et al. 2003

Fetal Diagn Ther

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Objective: Fetal heart rate (FHR) variability is an important indicator of fetal well-being. In fetal tachyarrhythmias, however, visual analysis of FHR variability is limited. We therefore applied power spectral analysis of FHR to evaluate the fetal state. Methods: Fetal R-R intervals were detected by means of an external ECG in 3 fetuses with supraventricular extrasystoles after cardiac malformations had been excluded by fetal echocardiography. Using an autoregressive model, power spectral densities were calculated from 20 consecutive 256-beat segments for the following frequency bands: <0.03 Hz (very low frequency), 0.03–0.069 Hz (low frequency; LF), 0.07–0.129 Hz (mid-frequency) and 0.13–1.0 Hz (high frequency; HF). Results: The FHR variability in fetal supraventricular extrasystoles mainly resulted from the HF component (63.91 ± 6.97%). The sympatho-vagal balance (LF/HF) was decreased in the tracings with extrasystoles (0.13). Conclusion: The analysis of FHR variability in fetal supraventricular extrasystoles revealed an imbalance between sympathetic and parasympathetic regulation.

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Assessment of the sympatho-vagal interaction in central serous chorioretinopathy measured by power spectral analysis of heart rate variability

Abstract: These results support the view that the pathogenesis of CSC is related to an increase in the sympathetic activity of the autonomic nervous system. Furthermore, the LF/HF ratios seem to correlate with the activity of the disease.

Cited by 41 publications

References 12 publications

Choroidal Vascular Reactivity in Central Serous Chorioretinopathy

Choroidal Vascular Reactivity in Central Serous Chorioretinopathy

Obstructive sleep apnea in patients with central serous chorioretinopathy

Spectral Analysis of Fetal Heart Rate Variability in Fetuses with Supraventricular Extrasystoles

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