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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
9
pubmed:dateCreated
2002-10-16
pubmed:abstractText
Impaired myocardial performance is known to be associated with electrical and mechanical beat-to-beat alternans phenomena. The alternans in blood pressure and heart rate and their interdependency in idiopathic dilated cardiomyopathy (IDC) were studied. The arterial blood pressure and the electrocardiograph (ECG) were continuously recorded in 22 patients suffering from IDC (age 49 +/- 13 years, ejection fraction 0.33 +/- 0.13, left ventricular diameter of 67 +/- 8 mm) and in 21 healthy controls (age 52 +/- 15 years). The beat-to-beat variations of the interbeat intervals (IBI) and of the blood pressure amplitudes (AMP) were measured. An alternans beat was defined as a beat preceded and followed by beats that had higher or lower values in the respective modality. The percentages of singular and repetitive alternans patterns, and the interdependency of the alternans patterns in AMP and IBI were assessed. The study found significantly more singular and repetitive alternans patterns in the IDC group compared to the control group both in the analysis of AMP and IBI (singular alternans in IBI: 55 +/- 11 vs 47 +/- 7%, P < 0.01; singular alternans in AMP: 61 +/- 15 vs 45 +/- 6%, P < 0.01; triple alternans in IBI: 29 +/- 18 vs 16 +/- 9%, P < 0.01; triple alternans in AMP: 34 +/- 24 vs 12 +/- 7%, P < 0.01). The amplitudes of the AMP alternans patterns were higher in IDC compared to controls (9 +/- 7 vs 4 +/- 2% of AMP, P = 0.01) whereas they did not differ in IBI. The correlation analysis revealed a significant interdependency of the alternans pattern in IBI and AMP in 18 of 22 IDC patients and in 12 of 21 controls (r = 0.50 +/- 0.21 [IDC]; r = 0.26 +/- 0.05 [controls]). The slope of the linear regression (delta AMP vs delta IBI) was steeper in the IDC group compared to the control group (62 +/- 50 vs 20 +/- 22 mmHg/s, P < 0.01). The percentages of alternans patterns appearing in IBI and AMP were positively correlated to the left ventricular diameter (r = 0.70 in the IBI, and r = 0.30 in the AMP). The blood pressure amplitude and the heart rate did not differ between the two groups. Patients suffering from IDC have a higher prevalence, stability, amplitude, and interdependency of alternans patterns in IBI and AMP compared to the control group. The amount of alternans patterns indicates the stage of disease. The alternans analysis may have impact on the functional assessment of patients suffering from heart failure.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
Sep
pubmed:issn
0147-8389
pubmed:author
pubmed:issnType
Print
pubmed:volume
25
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1307-14
pubmed:dateRevised
2004-11-17
pubmed:meshHeading
pubmed:year
2002
pubmed:articleTitle
Alternans of blood pressure and heart rate in dilated cardiomyopathy.
pubmed:affiliation
Klinik für Innere Medizin III, Universität Jena, Germany. uwe.leder@uni-jena.de
pubmed:publicationType
Journal Article