Skip to main content
British Heart Journal logoLink to British Heart Journal
. 1987 Dec;58(6):592–597. doi: 10.1136/hrt.58.6.592

Impaired vagal heart rate control in coronary artery disease.

K E Airaksinen 1, M J Ikäheimo 1, M K Linnaluoto 1, M Niemelä 1, J T Takkunen 1
PMCID: PMC1277310  PMID: 3426895

Abstract

Heart rate variation in deep breathing, a sensitive non-invasive measure of cardiac parasympathetic activity, was measured in 63 patients with coronary artery disease, in 22 patients with atypical chest pain, and in 20 healthy symptom free volunteers. There was significantly less heart rate variation in deep breathing in the patients with coronary artery disease than in the healthy subjects. Twenty patients (32%) with coronary artery disease had lower than normal variation in heart rate. The patients with chest pain showed an intermediate heart rate response to deep breathing. Sinus arrhythmia in the patients with coronary artery disease was not related to the functional class, medication, number or location of narrowed vessels, or to the left ventricular ejection fraction, and end diastolic pressure. These results suggest that impairment of the parasympathetic nervous function is common in coronary artery disease.

Full text

PDF
597

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barber M. J., Mueller T. M., Davies B. G., Gill R. M., Zipes D. P. Interruption of sympathetic and vagal-mediated afferent responses by transmural myocardial infarction. Circulation. 1985 Sep;72(3):623–631. doi: 10.1161/01.cir.72.3.623. [DOI] [PubMed] [Google Scholar]
  2. Bennett T., Farquhar I. K., Hosking D. J., Hampton J. R. Assessment of methods for estimating autonomic nervous control of the heart in patients with diabetes mellitus. Diabetes. 1978 Dec;27(12):1167–1174. doi: 10.2337/diab.27.12.1167. [DOI] [PubMed] [Google Scholar]
  3. Bennett T., Wilcox R. G., Hampton J. R. Cardiovascular reflexes in patients after myocardial infarction. Effect of long-term treatment with beta-adrenoceptor antagonists. Br Heart J. 1980 Sep;44(3):265–270. doi: 10.1136/hrt.44.3.265. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Billman G. E., Schwartz P. J., Stone H. L. Baroreceptor reflex control of heart rate: a predictor of sudden cardiac death. Circulation. 1982 Oct;66(4):874–880. doi: 10.1161/01.cir.66.4.874. [DOI] [PubMed] [Google Scholar]
  5. Billman G. E., Schwartz P. J., Stone H. L. The effects of daily exercise on susceptibility to sudden cardiac death. Circulation. 1984 Jun;69(6):1182–1189. doi: 10.1161/01.cir.69.6.1182. [DOI] [PubMed] [Google Scholar]
  6. Brown K. A., Maloney J. D., Smith C. H., Haritzler G. O., Ilstrup D. M. Carotid sinus reflex in patients undergoing coronary angiography: relationship of degree and location of coronary artery disease to response to carotid sinus massage. Circulation. 1980 Oct;62(4):697–703. doi: 10.1161/01.cir.62.4.697. [DOI] [PubMed] [Google Scholar]
  7. Carson R. P., Lazzara R. Hemodynamic responses initiated by coronary stretch receptors with special reference to coronary arteriography. Am J Cardiol. 1970 May;25(5):571–578. doi: 10.1016/0002-9149(70)90596-5. [DOI] [PubMed] [Google Scholar]
  8. Dibner-Dunlap M. E., Eckberg D. L., Magid N. M., Cintrón-Treviño N. M. The long-term increase of baseline and reflexly augmented levels of human vagal-cardiac nervous activity induced by scopolamine. Circulation. 1985 Apr;71(4):797–804. doi: 10.1161/01.cir.71.4.797. [DOI] [PubMed] [Google Scholar]
  9. Dyrberg T., Benn J., Christiansen J. S., Hilsted J., Nerup J. Prevalence of diabetic autonomic neuropathy measured by simple bedside tests. Diabetologia. 1981 Mar;20(3):190–194. doi: 10.1007/BF00252626. [DOI] [PubMed] [Google Scholar]
  10. Ewing D. J., Borsey D. Q., Bellavere F., Clarke B. F. Cardiac autonomic neuropathy in diabetes: comparison of measures of R-R interval variation. Diabetologia. 1981 Jul;21(1):18–24. doi: 10.1007/BF03216217. [DOI] [PubMed] [Google Scholar]
  11. Ewing D. J., Clarke B. F. Diagnosis and management of diabetic autonomic neuropathy. Br Med J (Clin Res Ed) 1982 Oct 2;285(6346):916–918. doi: 10.1136/bmj.285.6346.916. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. HAN J., GARCIADEJALON P., MOE G. K. ADRENERGIC EFFECTS ON VENTRICULAR VULNERABILITY. Circ Res. 1964 Jun;14:516–524. doi: 10.1161/01.res.14.6.516. [DOI] [PubMed] [Google Scholar]
  13. Hinkle L. E., Jr, Carver S. T., Plakun A. Slow heart rates and increased risk of cardiac death in middle-aged men. Arch Intern Med. 1972 May;129(5):732–748. [PubMed] [Google Scholar]
  14. Hohnloser S. H., Verrier R. L., Lown B. Effects of adrenergic and muscarinic receptor stimulation on serum potassium concentrations and myocardial electrical stability. Cardiovasc Res. 1986 Dec;20(12):891–896. doi: 10.1093/cvr/20.12.891. [DOI] [PubMed] [Google Scholar]
  15. Imaizumi T., Takeshita A., Makino N., Ashihara T., Yamamoto K., Nakamura M. Impaired baroreflex control of vascular resistance and heart rate in acute myocardial infarction. Br Heart J. 1984 Oct;52(4):418–421. doi: 10.1136/hrt.52.4.418. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Katona P. G., Jih F. Respiratory sinus arrhythmia: noninvasive measure of parasympathetic cardiac control. J Appl Physiol. 1975 Nov;39(5):801–805. doi: 10.1152/jappl.1975.39.5.801. [DOI] [PubMed] [Google Scholar]
  17. Katona P. G., Poitras J. W., Barnett G. O., Terry B. S. Cardiac vagal efferent activity and heart period in the carotid sinus reflex. Am J Physiol. 1970 Apr;218(4):1030–1037. doi: 10.1152/ajplegacy.1970.218.4.1030. [DOI] [PubMed] [Google Scholar]
  18. Kirby B. J. Circulatory reflexes in myocardial infarction. Br Heart J. 1977 Feb;39(2):168–172. doi: 10.1136/hrt.39.2.168. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Kleiger R. E., Miller J. P., Bigger J. T., Jr, Moss A. J. Decreased heart rate variability and its association with increased mortality after acute myocardial infarction. Am J Cardiol. 1987 Feb 1;59(4):256–262. doi: 10.1016/0002-9149(87)90795-8. [DOI] [PubMed] [Google Scholar]
  20. Massumi R. A., Mason D. T., Amsterdam E. A., DeMaria A., Miller R. R., Scheinman M. M., Zelis R. Ventricular fibrillation and tachycardia after intravenous atropine for treatment of bradycardias. N Engl J Med. 1972 Aug 17;287(7):336–338. doi: 10.1056/NEJM197208172870706. [DOI] [PubMed] [Google Scholar]
  21. Muscholl E. Peripheral muscarinic control of norepinephrine release in the cardiovascular system. Am J Physiol. 1980 Dec;239(6):H713–H720. doi: 10.1152/ajpheart.1980.239.6.H713. [DOI] [PubMed] [Google Scholar]
  22. O'Brien I. A., O'Hare P., Corrall R. J. Heart rate variability in healthy subjects: effect of age and the derivation of normal ranges for tests of autonomic function. Br Heart J. 1986 Apr;55(4):348–354. doi: 10.1136/hrt.55.4.348. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Pfeifer M. A., Cook D., Brodsky J., Tice D., Reenan A., Swedine S., Halter J. B., Porte D., Jr Quantitative evaluation of cardiac parasympathetic activity in normal and diabetic man. Diabetes. 1982 Apr;31(4 Pt 1):339–345. doi: 10.2337/diab.31.4.339. [DOI] [PubMed] [Google Scholar]
  24. Pfeifer M. A., Weinberg C. R., Cook D., Best J. D., Reenan A., Halter J. B. Differential changes of autonomic nervous system function with age in man. Am J Med. 1983 Aug;75(2):249–258. doi: 10.1016/0002-9343(83)91201-9. [DOI] [PubMed] [Google Scholar]
  25. Ryan C., Hollenberg M., Harvey D. B., Gwynn R. Impaired parasympathetic responses in patients after myocardial infarction. Am J Cardiol. 1976 Jun;37(7):1013–1018. doi: 10.1016/0002-9149(76)90417-3. [DOI] [PubMed] [Google Scholar]
  26. Schwartz P. J., Billman G. E., Stone H. L. Autonomic mechanisms in ventricular fibrillation induced by myocardial ischemia during exercise in dogs with healed myocardial infarction. An experimental preparation for sudden cardiac death. Circulation. 1984 Apr;69(4):790–800. doi: 10.1161/01.cir.69.4.790. [DOI] [PubMed] [Google Scholar]
  27. Tristani F. E., Kamper D. G., McDermott D. J., Peters B. J., Smith J. J. Alterations of postural and Valsalva responses in coronary heart disease. Am J Physiol. 1977 Dec;233(6):H694–H699. doi: 10.1152/ajpheart.1977.233.6.H694. [DOI] [PubMed] [Google Scholar]
  28. Watkins P. J., Mackay J. D. Cardiac denervation in diabetic neuropathy. Ann Intern Med. 1980 Feb;92(2 Pt 2):304–307. doi: 10.7326/0003-4819-92-2-304. [DOI] [PubMed] [Google Scholar]
  29. Wolf M. M., Varigos G. A., Hunt D., Sloman J. G. Sinus arrhythmia in acute myocardial infarction. Med J Aust. 1978 Jul 15;2(2):52–53. doi: 10.5694/j.1326-5377.1978.tb131339.x. [DOI] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES