Cardiac autonomic dysfunction in elderly women with myocardial infarction

Pinheiro, Andreia de Oliveira; Pereira, Valter Luis; Baltatu, Ovidiu Constantin; Campos, Luciana Aparecida

doi:10.1185/03007995.2015.1074065

Cited by 16 publications

(17 citation statements)

References 33 publications

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“…Our HRV findings indicate that women have poorer autonomic functioning at 1 and 12 months following ACS, compared to men. These findings are consistent with those of De Oliveira Pinheiro and colleagues who reported that compared to men, women had lower HRV (triangular index, SDNN, HF, HF/LF, RMSSD and SD1) in the immediate 5-10 days following MI [11]. Indeed, our findings indicate that such differences persist after the acute period.…”

Section: Discussionsupporting

confidence: 93%

“…To date, only one study has investigated sex differences in HRV following ACS. De Oliveira Pinheiro et al found that women over 50 years of age had significantly reduced HRV compared to agematched men, 5-10 days post-infarction [11]. No study has yet examined whether this sex-specific differential exists beyond the initial weeks following ACS.…”

Section: Introductionmentioning

confidence: 99%

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Resting Heart Rate and Heart Rate Variability in the Year Following Acute Coronary Syndrome: How Do Women Fare?

Scovelle

Oldenburg

Taylor

et al. 2021

Heart, Lung and Circulation

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Background Women experience poorer health outcomes following acute coronary syndrome (ACS). Heart rate (HR) and heart rate variability (HRV) have emerged as sensitive and cost-effective markers of autonomic function and prognostic risk factors of poor cardiac outcomes. The aim of the current study was to investigate whether sex-specific differences existed across HR and five parameters of HRV, at 1 and 12 months following ACS diagnosis. Methods Between January 2013 and June 2014, a sample of 416 ACS patients was enrolled in the Anxiety Depression & Heart Rate Variability in cardiac patients: Evaluating the impact of Negative emotions on functioning after Twenty four months (ADVENT) longitudinal cohort study. At 1 and 12 months following discharge, patient HR and HRV (root mean square of successive differences [RMSDD], standard deviation of RR intervals [SDRR], high frequency power [HF], low frequency power [LF], very low frequency power [VLF]) was measured via three-lead electrocardiogram. Results At 1 month post-ACS, sex was a significant predictor of HR and VLF power in fully-adjusted models. At 12 months post-ACS, sex was a predictor of HR, SDRR and VLF power in fully-adjusted models. Conclusion Sex-specific differences in resting HR and HRV were observed in the year following ACS, whereby women had higher HR and lower HRV, suggestive of poorer autonomic function. Further large-scale cohort studies examining autonomic function as a driver of sex-specific outcomes following ACS are required.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Resting Heart Rate and Heart Rate Variability in the Year Following Acute Coronary Syndrome: How Do Women Fare?

Scovelle

Oldenburg

Taylor

et al. 2021

Heart, Lung and Circulation

View full text Add to dashboard Cite

show abstract

“…In women, estrogen can protect women against heart disease by reducing circulatory levels of harmful cholesterol [58], whereas testosterone increased the concentrations of low-density lipoprotein and inflammatory markers that can drive the progression of atherosclerosis and stroke [59][60][61] in men. Further, there is evidence that women have stronger immune systems, in part because testosterone caused immunosuppression and more frequently infection [60,62]. From a psychological perspective, women who provide more social support to others and are more engaged in their social networks are shown to be buffered or at least better equipped to deal with stress.…”

Section: Discussionmentioning

confidence: 99%

Sex differences in the association between marital status and the risk of cardiovascular, cancer, and all-cause mortality: a systematic review and meta-analysis of 7,881,040 individuals

Wang

Jiao

Nie

et al. 2020

glob health res policy

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Purpose: To ascertain whether sex differences exist in the relationship between marital status and cardiovascular diseases (CVD), coronary heart disease (CHD), cancer and all-cause mortality in the general population and to explore the potential effect of age, location, the duration of follow-up and publication years on these outcomes. Methods: A systematic search was performed in PubMed and EMBASE from inception through to April 2018 and review of references to obtain sex-specific relative risks and their 95% confidence intervals. These were used to derive the women-to-men ratio of RRs (RRR) and 95% CI for each study. RRs and RRRs for each outcome were then pooled using random effects inverse-variance weighted meta-analysis. Results: Twenty-one studies with 7,891,623 individuals and 1,888,752 deaths were included in the meta-analysis. Compared with married individuals, being unmarried was significantly associated with all-cause, cancer, CVD and coronary heart disease mortalities for both sexes. However, the association with CVD and all-cause mortality was stronger in men. Being divorced/separated was associated with a higher risk of all-cause mortality in men and a stronger risk of cancer and CVD mortality. The pooled ratio for women versus men showed 31 and 9% greater risk of stroke mortality and all-cause mortality associated with never married in men than in women. Conclusions: Being unmarried conferred higher risk of stroke and all-cause mortality for men than women. Moreover, divorced/separated men had higher risk of cancer mortality and CVD mortality. Further studies are warranted to clarify the biological, behavioral, and/or social mechanisms involved in sex differences by these associations.

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“…Myocardial ischemia induces changes in the neurohumoral control systems, including sympathoexcitation, that contribute to autonomic nervous system (ANS) imbalance and myocardial remodeling[1, 2] [3]. Cardiac ANS is comprised of the intrinsic and extrinsic networks of the cardiac neural circuits that closely control cardiac function [4–6].…”

Section: Introductionmentioning

confidence: 99%

“…In the diseased heart, there is evidence that abnormal autonomic function can lead to and exacerbate congestive heart failure, ventricular arrhythmias, and sudden cardiac death [1, 2] [3]. Clinically, inhibition of the sympathetic ANS through neural modulation techniques such as thoracic epidural anesthesia, spinal cord stimulation, and stellate ganglion sympathectomy, has been shown to be beneficial in treating ventricular arrhythmias[17–21].…”

Section: Introductionmentioning

confidence: 99%

Inflammatory and apoptotic remodeling in autonomic nervous system following myocardial infarction

et al. 2017

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BackgroundChronic myocardial infarction (MI) triggers pathological remodeling in the heart and cardiac nervous system. Abnormal function of the autonomic nervous system (ANS), including stellate ganglia (SG) and dorsal root ganglia (DRG) contribute to increased sympathoexcitation, cardiac dysfunction and arrythmogenesis. ANS modulation is a therapeutic target for arrhythmia associated with cardiac injury. However, the molecular mechanism involved in the pathological remodeling in ANS following cardiac injury remains to be established.Methods and resultsIn this study, we performed transcriptome analysis by RNA-sequencing in thoracic SG and (T1-T4) DRG obtained from Yorkshire pigs following either acute (3 to 5 hours) or chronic (8 weeks) myocardial infarction. By differential expression and weighted gene co-expression network analysis (WGCNA), we identified significant transcriptome changes and specific gene modules in the ANS tissues in response to myocardial infarction at either acute or chronic phases. Both differential expressed genes and the member genes of the WGCNA gene module associated with post-infarct condition were significantly enriched for inflammatory signaling and apoptotic cell death. Targeted validation analysis supported a significant induction of inflammatory and apoptotic signal in both SG and DRG following myocardial infarction, along with cellular evidence of apoptosis induction based on TUNEL analysis. Importantly, these molecular changes were observed specifically in the thoracic segments but not in their counterparts obtained from lumbar sections.ConclusionMyocardial injury leads to time-dependent global changes in gene expression in the innervating ANS. Induction of inflammatory gene expression and loss of neuron cell viability in SG and DRG are potential novel mechanisms contributing to abnormal ANS function which can promote cardiac arrhythmia and pathological remodeling in myocardium.

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Cardiac autonomic dysfunction in elderly women with myocardial infarction

Abstract: This study suggests that elderly women with MI may have a worse prognosis than men, indicated by cardiac autonomic dysfunction. Since our study is cross-sectional and cannot infer causality, causation should be confirmed in further longitudinal studies.

Cited by 16 publications

References 33 publications

Resting Heart Rate and Heart Rate Variability in the Year Following Acute Coronary Syndrome: How Do Women Fare?

Resting Heart Rate and Heart Rate Variability in the Year Following Acute Coronary Syndrome: How Do Women Fare?

Sex differences in the association between marital status and the risk of cardiovascular, cancer, and all-cause mortality: a systematic review and meta-analysis of 7,881,040 individuals

Inflammatory and apoptotic remodeling in autonomic nervous system following myocardial infarction

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