ABSTRACT
OBJECTIVES: Presence of cardiovascular symptoms in perimenopausal period is suggested to be associated with the decrease of cardiac autonomic nervous system (cANS) regulatory function. AIM: Aim of the study was to evaluate whether menopause affects circadian heart rate variability (HRV). METHOD: 42 healthy women were divided into two equal groups: premenopausal (age 43 +/- 7 years) and postmenopausal (age 53 +/- 3 years, 3.25 +/- 1.6 years after the last menstruation). Menopausal status was verified by plasma estradiol and FSH activities. In both groups the outpatient 24-hrs ECG recordings were carried out. The HRV parameters (SDNN, pNN50, r-MSSD, nLF, nHF) were analysed within the day-time (6 a.m. - 10 p.m.) and the night-time (10 p.m. - 6 a.m.) ECG. RESULTS: Day-time recordings showed higher SDNN (128 +/- 23 vs. 104 +/- 36, p = 0.01), pNN50 (18 +/- 8.3 vs. 7 +/- 4.4 p < 0.001), nLF (74 +/- 11 vs. 33 +/- 5 p < 0.01) in the premenopausal patients and higher nHF in the postmenopausal women (39 +/- 3.4 vs. 26 +/- 11, p < 0.01). In the night-time recordings we observed higher pNN50 (24 +/- 20 vs. 13 +/- 10, p = 0.01) and nLF (66.5 +/- 17 vs. 37 +/- 5.8, p < 0.01) in the premenopausal patients with nHF higher in the postmenopausal group (44 +/- 5.7 vs. 31.4 +/- 17, p < 0.01). In the premenopausal women higher r-MSSD and nHF values were observed at the night time (respectively p = 0.03 and p = 0.04). Simultaneously higher night-time values of pNN50 (p = = 0.03) and nHF (p = 0.001) were noted in the postmenopausal group. CONCLUSIONS: Lower time HRV parameters suggest decreased parasympathetic regulation of the heart. Lower nLF indicates impairment of the arterial baroreceptor reflexes, whereas the increase of nHF requests further studies.
Subject(s)
Arrhythmias, Cardiac/physiopathology , Circadian Rhythm , Heart Rate/physiology , Menopause/physiology , Adult , Electrocardiography, Ambulatory , Estradiol/blood , Female , Heart Conduction System/physiology , Humans , Middle Aged , Premenopause/physiologyABSTRACT
Paroxysmal atrial fibrillation (PAF) is one of the most frequent cardiac arrhythmias. Our purpose in the current study was the presentation of the main PAF aetiology and the most effective methods of therapy. The study revealed that both coronary artery disease and arterial hypertension are the most frequent reasons of PAF whereas acute physical effort seems to be the main triggering factor. Regarding therapy the pharmacological treatment with chinidine or propaphenon is the best way of the PAF episodes management. The study also evaluated the quality of life (QL) of the PAF patients. The subjects complained of decreased QL, which was due to the necessity of change of the previous occupation and/or style of life.
