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Minerva Cardioangiologica 2020 Jul 08

DOI: 10.23736/S0026-4725.20.05094-X


language: English

Autonomic dysfunction in a group of lower extremities arterial disease outpatients

Carmelo BUTTÀ 1 , Antonino TUTTOLOMONDO 2, Alessandra CASUCCIO 3, Domenico DI RAIMONDO 2, Giuseppe MICELI 2, Francesco CUTTITTA 2, Valentina ZAPPULLA 2, Francesca CORPORA 2, Antonio PINTO 2

1 U.O.C. Cardiologia, Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Messina, Messina, Italy; 2 UOC Medicina Interna e con Stroke Care, Dipartimento di Promozione della Salute, Materno-infantile, di Medicina Interna e Specialistica di Eccellenza, Università degli Studi di Palermo, Palermo, Italy; 3 Dipartimento di Scienze per la Promozione della Salute, Materno Infantile, di Medicina Interna e Specialistica di Eccellenza, Università degli Studi di Palermo, Palermo, Italy


BACKGROUND: The understanding of the specific role of sympathetic neural control and dysregulation in lower extremities arterial disease (LEAD) is still very limited. Aim of our study was to investigate the autonomic profile in LEAD patients and to evaluate if the eventual autonomic alterations were more severe in patients with advanced disease.
METHODS: We enrolled all consecutive outpatients with LEAD referred to our Departments between July 2012 and September 2014. They were compared to a group of matched outpatients without LEAD. All patients underwent Holter ECG monitoring. Time-domain analysis of heart rate variability (HRV) was evaluated.
RESULTS: Compared to controls, patients with LEAD had a lower SDNN (p=0.007) and SDANN (p=0.003). Patients with clinically advanced LEAD had a lower SDNN (p=0.006) and SDANN (p=0.004) compared to LEAD patients with less severe disease and to those without disease.
CONCLUSIONS: LEAD patients had a reduced SDNN and SDANN than patients without LEAD. Autonomic dysfunction was more significant in clinically advanced stages of disease. This association did not relate to ABI value but to clinical stage of disease.

KEY WORDS: Ankle brachial index; Peripheral arterial disease; Claudication; Heart rate variability; Autonomic nervous system

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