Bradycardia: changes in intrinsic rate rather than cardiac autonomic modulation

Leicht, Anthony S.

doi:10.1007/s10286-013-0208-8

Cited by 5 publications

(2 citation statements)

References 8 publications

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“… 18 , 19 Consequently, the theory of increased vagal tone or decreased sympathetic tone as a cause of starvation‐ or exercise‐induced bradycardia has been questioned by some researchers. 16 , 17 , 18 , 19 , 20 , 21 Likewise, HRV metrics as an index of autonomic regulation have been challenged. 16 , 22 …”

Section: Introductionmentioning

confidence: 99%

Pathophysiological mechanisms of bradycardia in patients with anorexia nervosa

Buchhorn

Baumann

Willaschek

2021

Health Science Reports

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Background The purpose of this investigation was to examine heart rate variability (HRV), interbeat interval (IBI), and their interrelationship in healthy controls, bradycardic hyperpolarization‐activated cyclic nucleotide‐gated channel 4 ( HCN4 ) mutation carriers, and patients with anorexia nervosa (AN). We tested the hypothesis that neural mechanisms cause bradycardia in patients with AN. Therefore, we assumed that saturation of the HRV/IBI relationship as a consequence of sustained parasympathetic control of the sinus node is exclusively detectable in patients with AN. Methods Patients with AN between the ages of 12 and 16 years admitted to our hospital due to malnutrition were grouped and included in the present investigation (N = 20). A matched‐pair group with healthy children and adolescents was created. Groups were matched for age and sex. A 24‐hour Holter electrocardiography (ECG) was performed in controls and patients. More specifically, all patients underwent two 24‐hour Holter ECG examinations (admission; refeeding treatment). Additionally, the IBI was recorded during the night in HCN4 mutation carriers (N = 4). HRV parameters were analyzed in 5‐minute sequences during the night and plotted against mean corresponding IBI length. HRV, IBI, and their interrelationship were examined using Spearman's rank correlation analyses, Mann‐Whitney U tests, and Wilcoxon signed‐rank tests. Results The relationship between IBI and HRV showed signs of saturation in patients with AN. Furthermore, signs of HRV saturation were present in two HCN4 mutation carriers. In contrast, signs of HRV saturation were not present in controls. Conclusions The existence of HRV saturation does not support the existence of parasympathetically mediated bradycardia. Nonneural mechanisms, such as HCN4 downregulation, may be responsible for bradycardia and HRV saturation in patients with AN.

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Section: Introductionmentioning

confidence: 99%

Pathophysiological mechanisms of bradycardia in patients with anorexia nervosa

Buchhorn

Baumann

Willaschek

2021

Health Science Reports

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“…D'Souza et al, 2014;Alicia D'Souza et al, 2017). Consequently, the theory of an increased vagal tone or a decreased sympathetic tone as a cause of starvation-or exercise-induced bradycardia has been questioned by some researchers (M. R. Boyett et al, 2013;Heathers, Nagata, & Murray, 2018;Leicht, 2013). Likewise, HRV metrics as an index of autonomic regulation have been challenged (M. Boyett et al, 2019;M.…”

Section: Introductionmentioning

confidence: 99%

Heart rate regulation in patients with anorexia nervosa

Baumann¹,

Willaschek²,

Buchhorn³

2019

Preprint

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Objective: The purpose of this investigation was to examine heart rate variability (HRV), interbeat interval (IBI), and their interrelationship in healthy subjects, bradycardic HCN4 mutation carriers, and patients with anorexia nervosa (AN). We hypothesized that bradycardia in patients with AN is caused by neural mechanisms. Therefore, we assumed that a saturation effect of the HRV/IBI relationship in consequence of sustained parasympathetic control of the sinus node is exclusively detectable in patients with AN. Method: Patients with AN between the ages of 12 and 16 years admitted to our hospital due to malnutrition were grouped (N = 20). A matched-pair group with healthy children and adolescents was created. Groups were matched for age and gender. We performed 24-hour Holter electrocardiography (ECG) in controls and patients. Specifically, all patients underwent two 24-hour Holter ECGs (admission; refeeding treatment). Additionally, IBI's were recorded during night-time in HCN4 mutation carriers (N = 4). HRV parameters were analyzed in 5-minute sequences during night-time and plotted against mean corresponding IBI length. HRV, IBI, and their interrelationship were examined by calculating saturation indices, Spearman's rank correlation analyses, Mann-Whitney U-and Wilcoxon signed-rank tests. Results:The relationship between IBI and HRV showed signs of saturation in patients with AN. Signs of HRV saturation were also present in two HCN4 mutation carriers. In contrast, signs of HRV saturation were barely present in controls. Discussion:We believe that non-neural mechanisms such as HCN4 down-regulation are possible explanations for HRV saturation and the associated bradycardia in patients with AN.

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