(Circulation. 1997;95:1449-1454.)
© 1997 American Heart Association, Inc.
Articles |
Absence of Low-Frequency Variability of Sympathetic Nerve Activity in Severe Heart Failure
From the Cardiovascular Division, Department of Internal Medicine, University of Iowa, Iowa City (P. van de B., R.O., V.K.S.), and Centro Ricerche Cardiovascolari, CNR, Medecina Interna II, Ospedale "L. Sacco," Università di Milano, Italy (N.M., M.P.).
Correspondence to Virend Somers, MD, PhD, Cardiovascular Division, Department of Internal Medicine, University of Iowa, 200 Hawkins Dr, Iowa City, IA 52242. E-mail virend-somers{at}uiowa.edu.
Background In normal humans, variability of blood pressure, RR interval, and sympathetic activity occurs predominantly at a low frequency (LF; 0.04 to 0.14 Hz) and a high frequency (HF; ±0.25 Hz). In conditions that increase sympathetic activation in normal humans, the LF component is increased relative to the HF component. Patients with heart failure have high levels of sympathetic activity. We tested the hypothesis that the LF component of sympathetic nerve activity variability is increased in heart failure.
Methods and Results. We performed spectral analysis of simultaneous recordings of resting muscle sympathetic nerve activity (MSNA) and RR interval in 21 patients with chronic heart failure and 12 age-matched control subjects. MSNA was higher in patients with heart failure (62±4 bursts per minute) than in the normal subjects (39±4 bursts per minute; P<.01). LF components of RR interval and MSNA variability were lower in the heart failure patients versus the control subjects (P<.01). HF variability of RR interval and MSNA was preserved, at least in part, in heart failure. There was close coherence between variability patterns of RR interval and MSNA. Furthermore, in 14 heart failure patients who had no LF variability in MSNA compared with 7 heart failure patients who did manifest LF variability in MSNA, RR interval was shorter, the variance of RR interval was lower, MSNA was higher, respiratory rate was faster, and left ventricular ejection fraction was lower (all P<.05). At a median follow-up of 12 months, 4 heart failure patients had died, all of whom had had absent LF oscillations in MSNA and RR interval.
Conclusions The LF variability of sympathetic nerve activity is absent in patients with severe heart failure. This disturbed pattern of variability is closely coherent with the abnormal variability of RR interval. These disturbances of rhythmic oscillations of autonomic outflow, evident in both RR interval and MSNA, suggest a central autonomic regulatory impairment in heart failure and may have important prognostic implications.
Key Words: heart failure • heart rate • autonomic nervous system • respiration
This article has been cited by other articles:
 |
|
 |
|
  M. Henze, D. Hart, A. Samarel, J. Barakat, L. Eckert, and K. Scrogin Persistent alterations in heart rate variability, baroreflex sensitivity, and anxiety-like behaviors during development of heart failure in the rat Am J Physiol Heart Circ Physiol, July 1, 2008; 295(1): H29 - H38. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Laitio, J. Jalonen, T. Kuusela, and H. Scheinin The Role of Heart Rate Variability in Risk Stratification for Adverse Postoperative Cardiac Events Anesth. Analg., December 1, 2007; 105(6): 1548 - 1560. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. M. D. Watson, S. G. Hood, R. Ramchandra, R. M. McAllen, and C. N. May Increased cardiac sympathetic nerve activity in heart failure is not due to desensitization of the arterial baroreflex Am J Physiol Heart Circ Physiol, July 1, 2007; 293(1): H798 - H804. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Radaelli, M. Cazzaniga, A. Viola, G. Balestri, M. B. Janetti, M. G. Signorini, P. Castiglioni, A. Azzellino, G. Mancia, and A. U. Ferrari Enhanced Baroreceptor Control of the Cardiovascular System by Polyunsaturated Fatty Acids in Heart Failure Patients J. Am. Coll. Cardiol., October 17, 2006; 48(8): 1600 - 1606. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G A Lanza, D Cianflone, A G Rebuzzi, G Angeloni, A Sestito, G Ciriello, G La Torre, F Crea, A Maseri, and for the Stratificazione Prognostica dell'Angina In Prognostic value of ventricular arrhythmias and heart rate variability in patients with unstable angina Heart, August 1, 2006; 92(8): 1055 - 1063. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Julien The enigma of Mayer waves: Facts and models Cardiovasc Res, April 1, 2006; 70(1): 12 - 21. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Waki, K. Katahira, J. W Polson, S. Kasparov, D. Murphy, and J. F. R Paton Automation of analysis of cardiovascular autonomic function from chronic measurements of arterial pressure in conscious rats Exp Physiol, January 1, 2006; 91(1): 201 - 213. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Valipour, F. Schneider, W. Kossler, S. Saliba, and O. C. Burghuber Heart rate variability and spontaneous baroreflex sequences in supine healthy volunteers subjected to nasal positive airway pressure J Appl Physiol, December 1, 2005; 99(6): 2137 - 2143. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. A. Lanfranchi, R. Colombo, G. Cremona, P. Baderna, L. Spagnolatti, G. Mazzuero, P. Wagner, L. Perini, H. Wagner, C. Cavallaro, et al. Autonomic cardiovascular regulation in subjects with acute mountain sickness Am J Physiol Heart Circ Physiol, December 1, 2005; 289(6): H2364 - H2372. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Bertram, V. Orea, B. Chapuis, C. Barres, and C. Julien Differential responses of frequency components of renal sympathetic nerve activity to arterial pressure changes in conscious rats Am J Physiol Regulatory Integrative Comp Physiol, October 1, 2005; 289(4): R1074 - R1082. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Motte, M. Mathieu, S. Brimioulle, A. Pensis, L. Ray, J.-M. Ketelslegers, N. Montano, R. Naeije, P. van de Borne, and K. M. Entee Respiratory-related heart rate variability in progressive experimental heart failure Am J Physiol Heart Circ Physiol, October 1, 2005; 289(4): H1729 - H1735. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. P. Tulppo, A. M. Kiviniemi, A. J. Hautala, M. Kallio, T. Seppanen, T. H. Makikallio, and H. V. Huikuri Physiological Background of the Loss of Fractal Heart Rate Dynamics Circulation, July 19, 2005; 112(3): 314 - 319. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Guzzetti, M. T. L. Rovere, G. D. Pinna, R. Maestri, E. Borroni, A. Porta, A. Mortara, and A. Malliani Different spectral components of 24 h heart rate variability are related to different modes of death in chronic heart failure Eur. Heart J., February 2, 2005; 26(4): 357 - 362. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. P. Tulppo, H. V. Huikuri, E. Tutungi, D. S. Kimmerly, A. W. Gelb, R. L. Hughson, T. H. Makikallio, and J. Kevin Shoemaker Feedback effects of circulating norepinephrine on sympathetic outflow in healthy subjects Am J Physiol Heart Circ Physiol, February 1, 2005; 288(2): H710 - H715. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Cogliati, S. Colombo, T. G. Ruscone, D. Gruosso, A. Porta, N. Montano, A. Malliani, and R. Furlan Acute {beta}-Blockade Increases Muscle Sympathetic Activity and Modifies Its Frequency Distribution Circulation, November 2, 2004; 110(18): 2786 - 2791. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Kurata, A. Uehara, and A. Ishikawa Improvement of Cardiac Sympathetic Innervation by Renal Transplantation J. Nucl. Med., July 1, 2004; 45(7): 1114 - 1120. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Tulppo and H. V. Huikuri Origin and significance of heart rate variability J. Am. Coll. Cardiol., June 16, 2004; 43(12): 2278 - 2280. [Full Text] [PDF]
|
|
|
|
|
|
J. Cui, R. Zhang, T. E. Wilson, and C. G. Crandall Spectral analysis of muscle sympathetic nerve activity in heat-stressed humans Am J Physiol Heart Circ Physiol, March 1, 2004; 286(3): H1101 - H1106. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Filipovic, R. Jeger, C. Probst, T. Girard, M. Pfisterer, L. Gurke, K. Skarvan, and M. D. Seeberger Heart rate variability and cardiac troponin I are incremental and independent predictors of one-year all-cause mortality after major noncardiac surgery in patients at risk of coronary artery disease J. Am. Coll. Cardiol., November 19, 2003; 42(10): 1767 - 1776. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Velez-Roa, M. Renard, J.-P. Degaute, and P. van de Borne Peripheral sympathetic control during dobutamine infusion: effects of aging and heart failure J. Am. Coll. Cardiol., November 5, 2003; 42(9): 1605 - 1610. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. U. Pliquett, K. G. Cornish, and I. H. Zucker Statin therapy restores sympathovagal balance in experimental heart failure J Appl Physiol, August 1, 2003; 95(2): 700 - 704. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. A. Malave, A. A. Taylor, J. Nattama, A. Deswal, and D. L. Mann Circulating Levels of Tumor Necrosis Factor Correlate With Indexes of Depressed Heart Rate Variability: A Study in Patients With Mild-to-Moderate Heart Failure Chest, March 1, 2003; 123(3): 716 - 724. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. T. La Rovere, G. D. Pinna, R. Maestri, A. Mortara, S. Capomolla, O. Febo, R. Ferrari, M. Franchini, M. Gnemmi, C. Opasich, et al. Short-Term Heart Rate Variability Strongly Predicts Sudden Cardiac Death in Chronic Heart Failure Patients Circulation, February 4, 2003; 107(4): 565 - 570. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. A. Lanfranchi and V. K Somers Arterial baroreflex function and cardiovascular variability: interactions and implications Am J Physiol Regulatory Integrative Comp Physiol, October 1, 2002; 283(4): R815 - R826. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.-i. Hayano, S. Mukai, H. Fukuta, S. Sakata, N. Ohte, and G. Kimura Postural Response of Low-Frequency Component of Heart Rate Variability Is an Increased Risk for Mortality in Patients With Coronary Artery Disease Chest, December 1, 2001; 120(6): 1942 - 1952. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. van de Borne, J. Neubauer, M. Rahnama, J.-L. Jansens, N. Montano, A. Porta, V. K. Somers, and J. P. Degaute Differential Characteristics of Neural Circulatory Control: Early Versus Late After Cardiac Transplantation Circulation, October 9, 2001; 104(15): 1809 - 1813. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. van de Borne, M. Rahnama, S. Mezzetti, N. Montano, A. Porta, J. P. Degaute, and V. K. Somers Contrasting effects of phentolamine and nitroprusside on neural and cardiovascular variability Am J Physiol Heart Circ Physiol, August 1, 2001; 281(2): H559 - H565. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J. Kenney, T. I. Musch, and M. L. Weiss Renal sympathetic nerve regulation to heating is altered in rats with heart failure Am J Physiol Heart Circ Physiol, June 1, 2001; 280(6): H2868 - H2875. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Ponikowski, D. P. Francis, M. F. Piepoli, L. C. Davies, T. P. Chua, C. H. Davos, V. Florea, W. Banasiak, P. A. Poole-Wilson, A. J. S. Coats, et al. Enhanced Ventilatory Response to Exercise in Patients With Chronic Heart Failure and Preserved Exercise Tolerance : Marker of Abnormal Cardiorespiratory Reflex Control and Predictor of Poor Prognosis Circulation, February 20, 2001; 103(7): 967 - 972. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Van De Borne, N. Montano, K. Narkiewicz, J. P. Degaute, A. Malliani, M. Pagani, and V. K. Somers Importance of ventilation in modulating interaction between sympathetic drive and cardiovascular variability Am J Physiol Heart Circ Physiol, February 1, 2001; 280(2): H722 - H729. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. C. D. Souza, G. Ballejo, M. C. O. Salgado, V. J. Dias Da Silva, and H. C. Salgado Cardiac sympathetic overactivity and decreased baroreflex sensitivity in L-NAME hypertensive rats Am J Physiol Heart Circ Physiol, February 1, 2001; 280(2): H844 - H850. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. F. Notarius and J. S. Floras Limitations of the use of spectral analysis of heart rate variability for the estimation of cardiac sympathetic activity in heart failure Europace, January 1, 2001; 3(1): 29 - 38. [Abstract] [PDF]
|
|
|
|
|
|
A. Mortara, M. T. La Rovere, G. D. Pinna, R. Maestri, S. Capomolla, and F. Cobelli Nonselective beta-adrenergic blocking agent, carvedilol, improves arterial baroflex gain and heart rate variability in patients with stable chronic heart failure J. Am. Coll. Cardiol., November 1, 2000; 36(5): 1612 - 1618. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Yasuma and J.-I. Hayano Impact of acute hypoxia on heart rate and blood pressure variability in conscious dogs Am J Physiol Heart Circ Physiol, November 1, 2000; 279(5): H2344 - H2349. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Gehrmann, P. E. Hammer, C. T. Maguire, H. Wakimoto, J. K. Triedman, and C. I. Berul Phenotypic screening for heart rate variability in the mouse Am J Physiol Heart Circ Physiol, August 1, 2000; 279(2): H733 - H740. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Petretta, L. Spinelli, F. Marciano, C. Apicella, M. L. E. Vicario, G. Testa, M. Volpe, and D. Bonaduce Effects of losartan treatment on cardiac autonomic control during volume loading in patients with DCM Am J Physiol Heart Circ Physiol, July 1, 2000; 279(1): H86 - H92. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Pruvot, G. Thonet, J.-M. Vesin, G. van-Melle, K. Seidl, H. Schmidinger, J. Brachmann, W. Jung, E. Hoffmann, R. Tavernier, et al. Heart Rate Dynamics at the Onset of Ventricular Tachyarrhythmias as Retrieved From Implantable Cardioverter-Defibrillators in Patients With Coronary Artery Disease Circulation, May 23, 2000; 101(20): 2398 - 2404. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.M. Karemaker and K.I. Lie Heart rate variability: a telltale of health or disease Eur. Heart J., March 2, 2000; 21(6): 435 - 437. [PDF]
|
|
|
|
|
|
M Galinier, A Pathak, J Fourcade, C Androdias, D Curnier, S Varnous, S Boveda, P Massabuau, M Fauvel, J.M Senard, et al. Depressed low frequency power of heart rate variability as an independent predictor of sudden death in chronic heart failure Eur. Heart J., March 2, 2000; 21(6): 475 - 482. [Abstract] [PDF]
|
|
|
|
|
|
B. Nafz, J. Stegemann, M. H. Bestle, N. Richter, E. Seeliger, I. Schimke, H. W. Reinhardt, and P. B. Persson Antihypertensive Effect of 0.1-Hz Blood Pressure Oscillations to the Kidney Circulation, February 8, 2000; 101(5): 553 - 557. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. S. Leong, P. Mann, M. Wallymahmed, I. A. MacFarlane, and J. P. H. Wilding Abnormal Heart Rate Variability in Adults with Growth Hormone Deficiency J. Clin. Endocrinol. Metab., February 1, 2000; 85(2): 628 - 633. [Abstract] [Full Text]
|
|
|
|
|
|
P. Ponikowski, S. D. Anker, T. P. Chua, D. Francis, W. Banasiak, P. A. Poole-Wilson, A. J. S. Coats, and M. Piepoli Oscillatory Breathing Patterns During Wakefulness in Patients With Chronic Heart Failure : Clinical Implications and Role of Augmented Peripheral Chemosensitivity Circulation, December 14, 1999; 100(24): 2418 - 2424. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Ponikowski, M. Piepoli, T.P. Chua, W. Banasiak, D. Francis, S.D. Anker, and A.J.S. Coats The impact of cachexia on cardiorespiratory reflex control in chronic heart failure Eur. Heart J., November 2, 1999; 20(22): 1667 - 1675. [Abstract] [PDF]
|
|
|
|
|
|
J. A. Taylor, C. W. Myers, N. Montano, C. Cogliati, A. Porta, M. Pagani, A. Malliani, K. Narkiewicz, F. M. Abboud, and V. K. Somers Mathematical Treatment of Autonomic Oscillations - 2 • Response Circulation, October 12, 1999; 100 (15): e64 - e64. [Full Text] [PDF]
|
|
|
|
|
|
L. Spinelli, M. Petretta, F. Marciano, G. Testa, M. A. E. Rao, M. Volpe, and D. Bonaduce Cardiac autonomic responses to volume overload in normal subjects and in patients with dilated cardiomyopathy Am J Physiol Heart Circ Physiol, October 1, 1999; 277(4): H1361 - H1368. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. ANNANE, F. TRABOLD, T. SHARSHAR, I. JARRIN, A. S. BLANC, J. C. RAPHAEL, and P. GAJDOS Inappropriate Sympathetic Activation at Onset of Septic Shock . A Spectral Analysis Approach Am. J. Respir. Crit. Care Med., August 1, 1999; 160(2): 458 - 465. [Abstract] [Full Text]
|
|
|
|
 |
|
 Y. Murasato, Y. Harada, M. Ikeda, Y. Nakashima, and Y. Hayashida Effect of Magnesium Deficiency on Autonomic Circulatory Regulation in Conscious Rats Hypertension, August 1, 1999; 34(2): 247 - 252. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. van de Borne, N. Montano, K. Narkiewicz, J. P. Degaute, R. Oren, M. Pagani, and V. K. Somers Sympathetic Rhythmicity in Cardiac Transplant Recipients Circulation, March 30, 1999; 99(12): 1606 - 1610. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Malik and D. L Eckberg Sympathovagal Balance: A Critical Appraisal • Response Circulation, December 8, 1998; 98(23): 2643 - 2644. [Full Text] [PDF]
|
|
|
|
|
|
A. Malliani, M. Pagani, N. Montano, and G. S. Mela Sympathovagal Balance: A Reappraisal Circulation, December 8, 1998; 98 (23): 2640 - 2643. [Full Text] [PDF]
|
|
|
|
|
|
V. Shusterman, B. Aysin, V. Gottipaty, R. Weiss, S. Brode, D. Schwartzman, K. P. Anderson, and for the ESVEM Investigators Autonomic nervous system activity and the spontaneous initiation of ventricular tachycardia J. Am. Coll. Cardiol., December 1, 1998; 32(7): 1891 - 1899. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Narkiewicz, N. Montano, C. Cogliati, P. J. H. van de Borne, M. E. Dyken, and V. K. Somers Altered Cardiovascular Variability in Obstructive Sleep Apnea Circulation, September 15, 1998; 98(11): 1071 - 1077. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. L. Cooley, N. Montano, C. Cogliati, P. van de Borne, W. Richenbacher, R. Oren, and V. K. Somers Evidence for a Central Origin of the Low-Frequency Oscillation in RR-Interval Variability Circulation, August 11, 1998; 98(6): 556 - 561. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Ishise, H. Asanoi, S. Ishizaka, S. Joho, T. Kameyama, K. Umeno, and H. Inoue Time course of sympathovagal imbalance and left ventricular dysfunction in conscious dogs with heart failure J Appl Physiol, April 1, 1998; 84(4): 1234 - 1241. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Nakata, S. Takata, T. Yuasa, A. Shimakura, M. Maruyama, H. Nagai, S. Sakagami, and K.-I. Kobayashi Spectral analysis of heart rate, arterial pressure, and muscle sympathetic nerve activity in normal humans Am J Physiol Heart Circ Physiol, April 1, 1998; 274(4): H1211 - H1217. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Uechi, K. Asai, M. Osaka, A. Smith, N. Sato, T. E. Wagner, Y. Ishikawa, H. Hayakawa, D. E. Vatner, R. P. Shannon, et al. Depressed Heart Rate Variability and Arterial Baroreflex in Conscious Transgenic Mice With Overexpression of Cardiac Gs{alpha} Circ. Res., March 9, 1998; 82(4): 416 - 423. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Dalla Vecchia, A. Mangini, P. Di Biasi, C. Santoli, and A. Malliani Improvement of left ventricular function and cardiovascular neural control after endoventriculoplasty and myocardial revascularization Cardiovasc Res, January 1, 1998; 37(1): 101 - 107. [Abstract] |