ORIGINAL ARTICLE   

Minerva Cardiology and Angiology 2021 February;69(1):28-35

DOI: 10.23736/S2724-5683.20.05094-X

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

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 Unit of Cardiology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy; ² Unit of Internal Medicine and Stroke, Department of Health Promotion, Maternal and Child, Internal and Specialized Medicine, University of Palermo, Palermo, Italy; ³ Department of Health Promotion, Maternal and Child, Internal and Specialized Medicine, University of 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; Intermittent claudication; Autonomic nervous system