Homocysteine and P wave dispersion in patients with heart transplantation

Acampa, Maurizio; Lazzerini, Pietro Enea; Guideri, Francesca; Rechichi, Serena; Capecchi, Pier Leopoldo; Maccherini, Massimo; Laghi-Pasini, Franco

doi:10.1111/j.1399-0012.2009.01126.x

Cited by 20 publications

(19 citation statements)

References 35 publications

(36 reference statements)

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“…In the presence of normal catecholamine concentration, the reduced HRV after prolonged high altitude exposure for 18 months could be attributed to the increased concentration of serum coronary risk factors and elevated homocysteine. This hypothesis finds support from findings by Acampa et al, 2011 showing that hyperhomocytenemia is associated with an alteration in the electrical atrial conduction, possibly contributing, at least in part, to the increased risk of cardiac arrhythmias in the denervated hearts of orthotopic heart transplantation (OHT) patients [118]. However, in light of previous findings on negligible role of homocysteine in influencing sympathetic activity [119], further research is required to understand the factors that mediate sympathetic dominance on prolonged stay for >18 months at high altitude.…”

Section: Discussionsupporting

confidence: 62%

Autonomic Cardiovascular Responses in Acclimatized Lowlanders on Prolonged Stay at High Altitude: A Longitudinal Follow Up Study

et al. 2014

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Acute exposure to hypobaric hypoxia at high altitude is reported to cause sympathetic dominance that may contribute to the pathophysiology of high altitude illnesses. The effect of prolonged stay at high altitude on autonomic functions, however, remains to be explored. Thus, the present study aimed at investigating the effect of high altitude on autonomic neural control of cardiovascular responses by monitoring heart rate variability (HRV) during chronic hypobaric hypoxia. Baseline electrocardiography (ECG) data was acquired from the volunteers at mean sea level (MSL) (<250 m) in Rajasthan. Following induction of the study population to high altitude (4500–4800 m) in Ladakh region, ECG data was acquired from the volunteers after 6 months (ALL 6) and 18 months of induction (ALL 18). Out of 159 volunteers who underwent complete investigation during acquisition of baseline data, we have only included the data of 104 volunteers who constantly stayed at high altitude for 18 months to complete the final follow up after 18 months. HRV parameters, physiological indices and biochemical changes in serum were investigated. Our results show sympathetic hyperactivation along with compromise in parasympathetic activity in ALL 6 and ALL 18 when compared to baseline data. Reduction of sympathetic activity and increased parasympathetic response was however observed in ALL 18 when compared to ALL 6. Our findings suggest that autonomic response is regulated by two distinct mechanisms in the ALL 6 and ALL 18. While the autonomic alterations in the ALL 6 group could be attributed to increased sympathetic activity resulting from increased plasma catecholamine concentration, the sympathetic activity in ALL 18 group is associated with increased concentration of serum coronary risk factors and elevated homocysteine. These findings have important clinical implications in assessment of susceptibility to cardio-vascular risks in acclimatized lowlanders staying for prolonged duration at high altitude.

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Section: Discussionsupporting

confidence: 62%

Autonomic Cardiovascular Responses in Acclimatized Lowlanders on Prolonged Stay at High Altitude: A Longitudinal Follow Up Study

et al. 2014

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“…Weighted mean was 99.3 ± 11.5 ms; the weighted median was 99.4 ms. Pmin was reported in 62 studies. The highest reported Pmin values were 104 ± 9.2 ms 10 . The lowest reported Pmin values were 31.1 ± 5.4 ms 82 .…”

Section: Resultsmentioning

confidence: 88%

“…1). 3 , 7–85 Fourteen of these articles utilized only a computer‐assisted technique for P‐wave evaluation.…”

Section: Resultsmentioning

confidence: 99%

Meta‐Analysis of P‐Wave Dispersion Values in Healthy Individuals: The Influence of Clinical Characteristics

Nussinovitch¹

2012

Noninvasive Electrocardiol

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Pd, Pmax, and Pmin span a wide range of values in healthy individuals. Seemingly, abnormal values were often reported in healthy adults. The high variability of P-wave parameters in healthy individuals, and overlapping of the results with those reported for patients with increased risk for atrial fibrillation, might suggest that this technique has limited sensitivity and specificity. The variability between studies may stem from methodological issues and, therefore, there is a definite need for methodological standardization of Pd measurements.

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“…Sample size calculation: Our primary endpoint was the P wave dispersion duration changes after intubation. Sample size estimation was based on the study performed by Acampa et al 22 . In order to detect a 20% change in Pwd duration (34 ± 6.1 msec control values in Acampa's study 22 ), with an α error of 0.05 and a power of 90%, we calculated that sample size should be at least 17 patients per group.…”

Section: Analysis Of P-wave Dispersionmentioning

confidence: 99%

Efeitos de esmolol, lidocaína e fentanil nos intervalos dispersão da onda P, QT, QTc e respostas hemodinâmicas à intubação endotraqueal durante indução com propofol: um estudo comparativo

Hancı¹,

Yurtlu²,

Karabağ³

et al. 2013

Rev. Bras. Anestesiol.

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Background and objectives: In our study we aimed to investigate the effect of esmolol, lidocaine and fentanyl on P-wave dispersion (Pwd), QT and corrected QT (QTc) durations and hemodynamic responses to endotracheal intubation during propofol induction. Methods: A total of eighty adult patients, American Society of Anesthesiologists (ASA) Physical Status I or II aged 18 to 60 years were included in this prospective, randomised, double-blind study. All patients had control electrocardiograms (ECGs) done before anesthesia induction. The patients were randomised into four equal groups. The control group (Group C) received saline 5 mL, the esmolol group (Group E) received esmolol 0.5 mg.kg -1 , the fentanyl group (Group F) received fentanyl 2 µg.kg -1 and the lidocaine group (Group L) received lidocaine 1.5 mg.kg -1 before

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Homocysteine and P wave dispersion in patients with heart transplantation

Abstract: HHcy seems associated with an alteration in the electrical atrial conduction, possibly contributing, at least in part, to the increased risk of cardiac arrhythmias in the denervated hearts of OHT patients.

Cited by 20 publications

References 35 publications

Autonomic Cardiovascular Responses in Acclimatized Lowlanders on Prolonged Stay at High Altitude: A Longitudinal Follow Up Study

Autonomic Cardiovascular Responses in Acclimatized Lowlanders on Prolonged Stay at High Altitude: A Longitudinal Follow Up Study

Meta‐Analysis of P‐Wave Dispersion Values in Healthy Individuals: The Influence of Clinical Characteristics

Efeitos de esmolol, lidocaína e fentanil nos intervalos dispersão da onda P, QT, QTc e respostas hemodinâmicas à intubação endotraqueal durante indução com propofol: um estudo comparativo

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