TY - JOUR
T1 - Analysis of heart-rate variability during angioedema attacks in patients with hereditary c1-inhibitor deficiency
AU - Perego, Francesca
AU - De Maria, Beatrice
AU - Bova, Maria
AU - Petraroli, Angelica
AU - Cesoni, Azzurra Marcelli
AU - De Grazia, Valeria
AU - Zingale, Lorenza Chiara
AU - Porta, Alberto
AU - Spadaro, Giuseppe
AU - Dalla Vecchia, Laura Adelaide
N1 - Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2021/3/2
Y1 - 2021/3/2
N2 - C1-inhibitor hereditary angioedema (C1-INH-HAE) is a rare disease characterized by self-limiting edema associated with localized vasodilation due to increased levels of circulating brady-kinin. C1-INH-HAE directly influences patients’ everyday lives, as attacks are unpredictable in fre-quency, severity, and the involved anatomical site. The autonomic nervous system could be involved in remission. The cardiac autonomic profile has not yet been evaluated during the attack or prodromal phases. In this study, a multiday continuous electrocardiogram was obtained in four C1-INH-HAE patients until attack occurrence. Power spectral heart rate variability (HRV) indices were computed over the 4 h preceding the attack and during the first 4 h of the attack in three patients. Increased vagal modulation of the sinus node was detected in the prodromal phase. This finding may reflect localized vasodilation mediated by the release of bradykinin. HRV analysis may furnish early markers of an impending angioedema attack, thereby helping to identify patients at higher risk of attack recurrence. In this perspective, it could assist in the timing, titration, and optimization of prophylactic therapy, and thus improve patients’ quality of life.
AB - C1-inhibitor hereditary angioedema (C1-INH-HAE) is a rare disease characterized by self-limiting edema associated with localized vasodilation due to increased levels of circulating brady-kinin. C1-INH-HAE directly influences patients’ everyday lives, as attacks are unpredictable in fre-quency, severity, and the involved anatomical site. The autonomic nervous system could be involved in remission. The cardiac autonomic profile has not yet been evaluated during the attack or prodromal phases. In this study, a multiday continuous electrocardiogram was obtained in four C1-INH-HAE patients until attack occurrence. Power spectral heart rate variability (HRV) indices were computed over the 4 h preceding the attack and during the first 4 h of the attack in three patients. Increased vagal modulation of the sinus node was detected in the prodromal phase. This finding may reflect localized vasodilation mediated by the release of bradykinin. HRV analysis may furnish early markers of an impending angioedema attack, thereby helping to identify patients at higher risk of attack recurrence. In this perspective, it could assist in the timing, titration, and optimization of prophylactic therapy, and thus improve patients’ quality of life.
KW - Auto-nomic nervous system
KW - Burden of disease
KW - C1-inhibitor hereditary angioedema
KW - Cardiac neural control
KW - Heart rate variability
KW - Multiday ECG monitoring
KW - Quality of life
KW - Spectral analysis
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U2 - 10.3390/ijerph18062900
DO - 10.3390/ijerph18062900
M3 - Article
AN - SCOPUS:85102369969
VL - 18
SP - 1
EP - 10
JO - International Journal of Environmental Research and Public Health
JF - International Journal of Environmental Research and Public Health
SN - 1661-7827
IS - 6
M1 - 2900
ER -