Produção Nacional
Revisado por pares
Effects of Cardiac Resynchronization Therapy on Muscle Sympathetic Nerve Activity
2013; Wiley; Volume: 37; Issue: 1 Linguagem: Inglês
10.1111/pace.12254
ISSN1540-8159
AutoresRicardo Kuniyoshi, Martino Martinelli Filho, Carlos Eduardo Negrão, Sérgio Siqueira, Maria Urbana Pinto Brandão Rondon, Ivani C. Trombetta, Fatima H. Sert Kuniyoshi, Mateus Camaroti Laterza, SILVANA A. D’ÓRIO NISHIOKA, Roberto Costa, Wagner Tetsuji Tamaki, Elizabeth Crevelari, Giselle de Lima Peixoto, José Antônio Franchini Ramires, Roberto Kalil Filho,
Tópico(s)Heart Rate Variability and Autonomic Control
ResumoIntroduction Muscle sympathetic nerve activity (MSNA) is an independent prognostic marker in patients with heart failure (HF). Therefore, its relevance to the treatment of HF patients is unquestionable. Objectives In this study, we investigated the effects of cardiac resynchronization therapy (CRT) on MSNA response at rest and during exercise in patients with advanced HF . Methods We assessed 11 HF patients (51 ± 3.4 years; New York Heart Association class III–IV; left ventricular ejection fraction 27.8 ± 2.2%; optimal medical therapy) submitted to CRT. Evaluations were made prior to and 3 months after CRT. MSNA was performed at rest and during moderate static exercise (handgrip). Peak oxygen consumption (VO 2 ) was evaluated by means of cardiopulmonary exercise test. HF patients with advanced NYHA class without CRT and healthy individuals were also studied . Results CRT reduced MSNA at rest (48.9 ± 11.1 bursts/min vs 33.7 ± 15.3 bursts/min, P < 0.05) and during handgrip exercise (MSNA 62.3 ± 13.1 bursts/min vs 46.9 ± 14.3 bursts/min, P < 0.05). Among HF patients submitted to CRT, the peak VO 2 increased (12.9 ± 2.8 mL/kg/min vs 16.5 ± 3.9 mL/kg/min, P < 0.05) and an inverse correlation between peak VO 2 and resting MSNA (r = –0.74, P = 0.01) was observed . Conclusions In patients with advanced HF and severe systolic dysfunction: (1) a significant reduction of MSNA (at rest and during handgrip) occurred after CRT, and this behavior was significantly superior to HF patients receiving only medical therapy; (2) MSNA reduction after CRT had an inverse correlation with O 2 consumption outcomes .
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