Autonomic dysfunction in HIV patients on antiretroviral therapy: studies of heart rate variability
- 1 November 2007
- journal article
- research article
- Published by Wiley in Clinical Physiology and Functional Imaging
- Vol. 27 (6), 363-367
- https://doi.org/10.1111/j.1475-097x.2007.00760.x
Abstract
The presence of autonomic dysfunction in HIV patients is largely unknown. Early studies found autonomic dysfunction in patients with AIDS. Introduction of highly active antiretroviral combination therapy (ART) has dramatically changed the course of the disease and improved prognosis and decreased morbidity. At present it is not known whether introduction of ART also has decreased autonomic dysfunction. To evaluate whether autonomic dysfunction is present in an ART-treated HIV population. HIV patients receiving ART for at least 3 years (n = 16) and an age-matched control group of healthy volunteers (n = 12) were included. All were non-smokers, non-diabetic and had never received medication for dyslipidaemia or hypertension. Following a 10 min resting period a 5 min ECG recording was performed. Heart rate variability (HRV) analysis was performed in accordance with current guidelines and data reported as median (interquartile range). The resting heart rate was higher in HIV patients compared with controls [69 (62-74) versus 57 (52-60); P<0.001]. Total HRV measured as standard deviation of normal-to-normal (SONN) was lower in the HIV group compared with the controls [36 (25-55) versus 74 (57-84) ms; P<0.01] as was parasympathetic activity measured as square root of the mean squared difference of successive normal-to-normal intervals (RMSSD) [22 (9-30) versus 35 (24-62) ms; P<0.05]. Low frequency power was lower in the HIV group compared with the control group [294 (161-602) versus 946 (711-1668) ms(2); P<0.01]. High frequency power as well as systolic and diastolic blood pressure did not differ between the groups. The HIV patients in ART have increased resting heart rate and decreased short-term heart rate variability indicating parasympathetic dysfunction.Keywords
This publication has 19 references indexed in Scilit:
- Spatially distinct and functionally independent mechanisms of axonal degeneration in a model of HIV-associated sensory neuropathyBrain, 2006
- Power Spectral Analysis of Heart Rate Variability in HIV‐Infected and AIDS PatientsPacing and Clinical Electrophysiology, 2006
- Heart rate variability in human immunodeficiency virus-positive individualsInternational Journal of Cardiology, 2004
- Cardiovascular autonomic dysfunction in Africans infected with human immunodeficiency virusJournal of the Royal Society of Medicine, 2002
- Mitochondrial Alterations with Mitochondrial DNA Depletion in the Nerves of AIDS Patients with Peripheral Neuropathy Induced by 2′3′-Dideoxycytidine (ddC)Laboratory Investigation, 2001
- Cardiac autonomic dysfunction in AIDS is not secondary to heart failureInternational Journal of Cardiology, 2000
- Sympathovagal BalanceCirculation, 1997
- Heart rate variability: Standards of measurement, physiological interpretation, and clinical useEuropean Heart Journal, 1996
- Autonomic function and human immunodeficiency virus infectionNeurology, 1990
- CARDIORESPIRATORY ARREST AND AUTONOMIC NEUROPATHY IN AIDSThe Lancet, 1987