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[Compromise of the cardiac autonomic nervous system in patients with Fontan-type circulation: preliminary data].
G Ital Cardiol. 1999 Mar; 29(3):255-60.GI

Abstract

BACKGROUND

Rhythm disturbances are frequent after Fontan operations. Arrhythmias related to reduced heart rate variability (HRV) have been described in various cardiovascular diseases.

METHODS

We attempted to investigate HRV in 12 patients who underwent Fontan operation (age 11.4 +/- 3 years). Results were compared to a control group of 13 children matched for age, sex and heart rate (10.4 +/- 3 years). All patients underwent 24-hour Holter monitoring. The following time domain indexes were calculated: mean duration of RR intervals, standard deviation of all RR intervals (SD), square root of the mean squared differences of successive RR intervals (r-MSSD), percentage of differences between adjacent RR intervals > 50 msec (pNN50). The following frequency domain indexes were calculated: total power (TP), low frequency (LF), high frequency (HF), LF/HF ratio.

RESULTS

The following indexes were significantly reduced in Fontan patients: SD (p < 0.0001), r-MSSD (p < 0.0001), pNN50 (p = 0.0002), TP (p < 0.0001), LF (p < 0.0001), HF (p = 0.0001). LF/HF increased significantly (p = 0.04). No differences were detected according to the type of operation (cavopulmonary connection vs atriopulmonary connection) or clinical status.

CONCLUSIONS

Patients with Fontan circulation had a significantly reduced HRV and particularly abnormal sympatho-vagal balance. Surgery on the caval veins and the atria alters the intracardiac ganglia that are abundant at the cavo-atrial junction and in the myocardium of the right atrium. Abnormalities of HRV in Fontan patients may act as a co-factor in the initiation of arrhythmia in these patients.

Authors+Show Affiliations

Butera G
Service de Cardiologie Pédiatrique, Hôpital Necker Enfants Malades, Paris, France.
Bonnet D
No affiliation info available
Bonhoeffer P
No affiliation info available
Aggoun Y
No affiliation info available
Iserin L
No affiliation info available
Sidi D
No affiliation info available
Kachaner J
No affiliation info available
Villain E
No affiliation info available

MeSH

AdolescentAutonomic Nervous SystemChi-Square DistributionChildElectrocardiography, AmbulatoryFemaleFollow-Up StudiesFontan ProcedureHeartHeart RateHumansMaleStatistics, NonparametricTricuspid Atresia

Pub Type(s)

Comparative Study
English Abstract
Journal Article

Language

ita

PubMed ID

10231670

Citation

Butera, G, et al. "[Compromise of the Cardiac Autonomic Nervous System in Patients With Fontan-type Circulation: Preliminary Data]." Giornale Italiano Di Cardiologia, vol. 29, no. 3, 1999, pp. 255-60.
Butera G, Bonnet D, Bonhoeffer P, et al. [Compromise of the cardiac autonomic nervous system in patients with Fontan-type circulation: preliminary data]. G Ital Cardiol. 1999;29(3):255-60.
Butera, G., Bonnet, D., Bonhoeffer, P., Aggoun, Y., Iserin, L., Sidi, D., Kachaner, J., & Villain, E. (1999). [Compromise of the cardiac autonomic nervous system in patients with Fontan-type circulation: preliminary data]. Giornale Italiano Di Cardiologia, 29(3), 255-60.
Butera G, et al. [Compromise of the Cardiac Autonomic Nervous System in Patients With Fontan-type Circulation: Preliminary Data]. G Ital Cardiol. 1999;29(3):255-60. PubMed PMID: 10231670.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Compromise of the cardiac autonomic nervous system in patients with Fontan-type circulation: preliminary data]. AU - Butera,G, AU - Bonnet,D, AU - Bonhoeffer,P, AU - Aggoun,Y, AU - Iserin,L, AU - Sidi,D, AU - Kachaner,J, AU - Villain,E, PY - 1999/5/8/pubmed PY - 1999/5/8/medline PY - 1999/5/8/entrez SP - 255 EP - 60 JF - Giornale italiano di cardiologia JO - G Ital Cardiol VL - 29 IS - 3 N2 - BACKGROUND: Rhythm disturbances are frequent after Fontan operations. Arrhythmias related to reduced heart rate variability (HRV) have been described in various cardiovascular diseases. METHODS: We attempted to investigate HRV in 12 patients who underwent Fontan operation (age 11.4 +/- 3 years). Results were compared to a control group of 13 children matched for age, sex and heart rate (10.4 +/- 3 years). All patients underwent 24-hour Holter monitoring. The following time domain indexes were calculated: mean duration of RR intervals, standard deviation of all RR intervals (SD), square root of the mean squared differences of successive RR intervals (r-MSSD), percentage of differences between adjacent RR intervals > 50 msec (pNN50). The following frequency domain indexes were calculated: total power (TP), low frequency (LF), high frequency (HF), LF/HF ratio. RESULTS: The following indexes were significantly reduced in Fontan patients: SD (p < 0.0001), r-MSSD (p < 0.0001), pNN50 (p = 0.0002), TP (p < 0.0001), LF (p < 0.0001), HF (p = 0.0001). LF/HF increased significantly (p = 0.04). No differences were detected according to the type of operation (cavopulmonary connection vs atriopulmonary connection) or clinical status. CONCLUSIONS: Patients with Fontan circulation had a significantly reduced HRV and particularly abnormal sympatho-vagal balance. Surgery on the caval veins and the atria alters the intracardiac ganglia that are abundant at the cavo-atrial junction and in the myocardium of the right atrium. Abnormalities of HRV in Fontan patients may act as a co-factor in the initiation of arrhythmia in these patients. SN - 0046-5968 UR - https://www.unboundmedicine.com/medline/citation/10231670/[Compromise_of_the_cardiac_autonomic_nervous_system_in_patients_with_Fontan_type_circulation:_preliminary_data]_ L2 - https://antibodies.cancer.gov/detail/CPTC-GZMA-1 DB - PRIME DP - Unbound Medicine ER -