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Heart rate variability in normal tension glaucoma: A case-control study.

Abstract Primary vascular dysregulation (PVD) is believed to be a main cause of local vasospasm and impaired autoregulation as a possible contributing factor in the pathogenesis of normal tension glaucoma (NTG). Subjects with PVD respond stronger to psychological stress. Autonomic dysfunction is another reason of instable ocular blood flow and may be studied by means of assessment of heart rate variability (HRV) especially during a hand-cold provocation test (CPT).To compare the shift of HRV parameters in NTG and healthy subjects after a cold provocation test and to assess the relation between structural damage, circulatory parameters and autonomic dysfunction in NTG.HRV was studied using CPT in 78 NTG patients and 60 health control matches. The ocular blood flow was measured using color Doppler imaging (CDI). The 24 hours blood pressure (BP) monitoring was carried out. The cardiovascular fitness assessment was made to all patients before and after CPT. Mean group difference of HRV parameters was compared between NTG and healthy subjects using the Euclidean metric. The mean ocular perfusion pressure (MOPP) was measured. Optic nerve head and retinal nerve fiber layer (RNFL) were evaluated using spectral-domain optic coherence tomography (SD-OCT). The relation between HRV, CDI, and SD-OCT-parameters was assessed.In contrast to healthy subjects, a predominance of the sympathetic activity after the CPT was revealed in the NTG group. The end diastolic velocity (EDV) in central retinal artery (CRA) and short posterior ciliary artery (SPCA) was significantly reduced in NTG compared to healthy eyes. In NTG, the main HRV parameter characterizing the total effect of autonomic blood circulation regulation (SDNN) correlated with MOPP (0.75, P = .035), SPCA EDV (0.93, P < .001), and CRA EDV (0.9, P < .001). The average daily diastolic BP correlated with RNFL (0.67, P = .009).The NTG patients have the disturbance of the autonomic nervous system, which increases in response to stress provocation and is related to ocular blood flow and structural damage.
PMID
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Authors

Mayor MeshTerms

Heart Rate

Keywords
Journal Title medicine
Publication Year Start




PMID- 29384857
OWN - NLM
STAT- MEDLINE
DCOM- 20180213
LR  - 20180213
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 5
DP  - 2018 Feb
TI  - Heart rate variability in normal tension glaucoma: A case-control study.
PG  - e9744
LID - 10.1097/MD.0000000000009744 [doi]
AB  - Primary vascular dysregulation (PVD) is believed to be a main cause of local
      vasospasm and impaired autoregulation as a possible contributing factor in the
      pathogenesis of normal tension glaucoma (NTG). Subjects with PVD respond stronger
      to psychological stress. Autonomic dysfunction is another reason of instable
      ocular blood flow and may be studied by means of assessment of heart rate
      variability (HRV) especially during a hand-cold provocation test (CPT).To compare
      the shift of HRV parameters in NTG and healthy subjects after a cold provocation 
      test and to assess the relation between structural damage, circulatory parameters
      and autonomic dysfunction in NTG.HRV was studied using CPT in 78 NTG patients and
      60 health control matches. The ocular blood flow was measured using color Doppler
      imaging (CDI). The 24 hours blood pressure (BP) monitoring was carried out. The
      cardiovascular fitness assessment was made to all patients before and after CPT. 
      Mean group difference of HRV parameters was compared between NTG and healthy
      subjects using the Euclidean metric. The mean ocular perfusion pressure (MOPP)
      was measured. Optic nerve head and retinal nerve fiber layer (RNFL) were
      evaluated using spectral-domain optic coherence tomography (SD-OCT). The relation
      between HRV, CDI, and SD-OCT-parameters was assessed.In contrast to healthy
      subjects, a predominance of the sympathetic activity after the CPT was revealed
      in the NTG group. The end diastolic velocity (EDV) in central retinal artery
      (CRA) and short posterior ciliary artery (SPCA) was significantly reduced in NTG 
      compared to healthy eyes. In NTG, the main HRV parameter characterizing the total
      effect of autonomic blood circulation regulation (SDNN) correlated with MOPP
      (0.75, P = .035), SPCA EDV (0.93, P &lt; .001), and CRA EDV (0.9, P &lt; .001). The
      average daily diastolic BP correlated with RNFL (0.67, P = .009).The NTG patients
      have the disturbance of the autonomic nervous system, which increases in response
      to stress provocation and is related to ocular blood flow and structural damage.
FAU - Kurysheva, Natalia Ivanovna
AU  - Kurysheva NI
AD  - Ophthalmological Department of the Federal Medical and Biological Agency of the
      Russian Federation.
FAU - Shlapak, Vitaliy Nikiforovich
AU  - Shlapak VN
AD  - Science Center of Radiation and Chemical Safety and Hygiene of the Federal
      Medical and Biological Agency of the Russian Federation.
FAU - Ryabova, Tamara Yakovlevna
AU  - Ryabova TY
AD  - Science Center of Radiation and Chemical Safety and Hygiene of the Federal
      Medical and Biological Agency of the Russian Federation.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Aged
MH  - Blood Pressure Determination
MH  - Case-Control Studies
MH  - Cold Temperature
MH  - Eye/diagnostic imaging/physiopathology
MH  - *Heart Rate
MH  - Heart Rate Determination
MH  - Humans
MH  - Low Tension Glaucoma/diagnostic imaging/*physiopathology
MH  - Middle Aged
MH  - Optic Nerve/diagnostic imaging
MH  - Regional Blood Flow
MH  - Tomography, Optical Coherence
MH  - Ultrasonography, Doppler, Color
EDAT- 2018/02/01 06:00
MHDA- 2018/02/14 06:00
CRDT- 2018/02/01 06:00
PHST- 2018/02/01 06:00 [entrez]
PHST- 2018/02/01 06:00 [pubmed]
PHST- 2018/02/14 06:00 [medline]
AID - 10.1097/MD.0000000000009744 [doi]
AID - 00005792-201802020-00019 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Feb;97(5):e9744. doi: 10.1097/MD.0000000000009744.