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Normal scores of deep breathing tests: beware of dysrhythmia in transthyretin amyloidosis
Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper.ORCID-id: 0000-0002-1313-0934
Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper.
Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper.
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för medicin.
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2018 (engelsk)Inngår i: Amyloid: Journal of Protein Folding Disorders, ISSN 1350-6129, E-ISSN 1744-2818, Vol. 25, nr 1, s. 54-61Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background: The heart rate (HR) response to paced deep breathing (DB) is a common test of cardiac autonomic function, where high heart rate variability (HRV) is considered to reflect normal autonomic function. We evaluated the DB test in patients with hereditary transthyretin amyloid (ATTRm) amyloidosis, where autonomic dysregulation and atrial arrhythmias are common.Methods: Paced DB was performed during one minute (six breaths/min) in 165 recordings in adult ATTRm amyloidosis patients with the TTR Val30Met mutation, 42 hypertrophic cardiomyopathy (HCM) patients and 211 healthy subjects. HRV was scored by traditional DB indices and by a novel regularity index, estimating the fraction of the HRV that was coherent with the breathing pattern.Results: Twenty per cent of ATTRm amyloidosis patients presented with age-adjusted HRV scores within normal limits but poor regularity due to subtle atrial arrhythmias and cardiac conduction disturbances. Forty-seven per cent of ATTRm amyloidosis patients presented with HRV scores below normal limits, whereas HCM patients presented with higher HRV than ATTRm amyloidosis patients.Conclusions: Reduced HRV is common in ATTRm amyloidosis patients during DB, however, autonomic function cannot be evaluated in patients presenting with the combination of normal scores and low regularity, since their HR responses often reflects dysrhythmias.

sted, utgiver, år, opplag, sider
Taylor & Francis Group, 2018. Vol. 25, nr 1, s. 54-61
Emneord [en]
HRV, heart rate variability, amyloidosis hereditary, transthyretin, autonomic function
HSV kategori
Identifikatorer
URN: urn:nbn:se:umu:diva-146594DOI: 10.1080/13506129.2018.1434140ISI: 000428570300008PubMedID: 29394116OAI: oai:DiVA.org:umu-146594DiVA, id: diva2:1204638
Tilgjengelig fra: 2018-05-08 Laget: 2018-05-08 Sist oppdatert: 2019-05-22bibliografisk kontrollert

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Wiklund, UrbanAndersson, KennetSuhr, Ole B.Hörnsten, Rolf

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