Abstract
Background: Alterations of cardiac autonomic control (CAC) are associated with poor outcomes in patients with infectious and non-infectious diseases. No evaluation of CAC in patients with community-acquired pneumonia (CAP) has been performed so far. The aim of the study was to assess CAC in patients with CAP and evaluate the impact of its alterations on disease severity and clinical outcomes in a multicenter, prospective, observational study. Methods: Consecutive patients hospitalized for CAP were enrolled between 2011 and 2013 two university hospitals in Italy. CAC was assessed by linear spectral and non-linear symbolic analysis of heart rate variability. The presence of severe CAP was evaluated on hospital admission. The primary study outcome was time to clinical stability (TCS) during hospitalization. Results: Among the 75 patients enrolled (median age: 75 years; 57 % males), a significantly lower total variability and reduction of sympathetic rhythmical component with predominant respiratory modulation was detected in comparison to controls. Among CAP patients affected by a severe CAP on admission, CAC showed a lower sympathetic modulation and predominant parasympathetic oscillatory rhythm. At the multivariate analysis, variables independently correlated with a TCS >7 days were total power, as marker of total variability, [OR (95 % CI): 0.997 (0.994-1.000), p = 0.0454] and sympathetic modulation [OR (95 % CI): 0.964 (0.932-0.998), p = 0.0367]. Conclusions: Loss of sympathetic rhythmical oscillation is associated with a more severe disease and worse early clinical outcome in hospitalized patients with CAP.
| Original language | English |
|---|---|
| Article number | 98 |
| Journal | Respiratory Research |
| Volume | 17 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Aug 4 2016 |
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Keywords
- Cardiac autonomic control
- Heart rate variability
- Pneumonia
- Spectral analysis
- Symbolic analysis
- Sympathetic
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
Cite this
Cardiovascular autonomic alterations in hospitalized patients with community-acquired pneumonia. / Aliberti, Stefano; Tobaldini, Eleonora; Giuliani, Fabio; Nunziata, Vanessa; Casazza, Giovanni; Suigo, Giulia; D'Adda, Alice; Bonaiti, Giulia; Roveda, Andrea; Queiroz, Andreia; Monzani, Valter; Pesci, Alberto; Blasi, Francesco; Montano, Nicola.
In: Respiratory Research, Vol. 17, No. 1, 98, 04.08.2016.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Cardiovascular autonomic alterations in hospitalized patients with community-acquired pneumonia
AU - Aliberti, Stefano
AU - Tobaldini, Eleonora
AU - Giuliani, Fabio
AU - Nunziata, Vanessa
AU - Casazza, Giovanni
AU - Suigo, Giulia
AU - D'Adda, Alice
AU - Bonaiti, Giulia
AU - Roveda, Andrea
AU - Queiroz, Andreia
AU - Monzani, Valter
AU - Pesci, Alberto
AU - Blasi, Francesco
AU - Montano, Nicola
PY - 2016/8/4
Y1 - 2016/8/4
N2 - Background: Alterations of cardiac autonomic control (CAC) are associated with poor outcomes in patients with infectious and non-infectious diseases. No evaluation of CAC in patients with community-acquired pneumonia (CAP) has been performed so far. The aim of the study was to assess CAC in patients with CAP and evaluate the impact of its alterations on disease severity and clinical outcomes in a multicenter, prospective, observational study. Methods: Consecutive patients hospitalized for CAP were enrolled between 2011 and 2013 two university hospitals in Italy. CAC was assessed by linear spectral and non-linear symbolic analysis of heart rate variability. The presence of severe CAP was evaluated on hospital admission. The primary study outcome was time to clinical stability (TCS) during hospitalization. Results: Among the 75 patients enrolled (median age: 75 years; 57 % males), a significantly lower total variability and reduction of sympathetic rhythmical component with predominant respiratory modulation was detected in comparison to controls. Among CAP patients affected by a severe CAP on admission, CAC showed a lower sympathetic modulation and predominant parasympathetic oscillatory rhythm. At the multivariate analysis, variables independently correlated with a TCS >7 days were total power, as marker of total variability, [OR (95 % CI): 0.997 (0.994-1.000), p = 0.0454] and sympathetic modulation [OR (95 % CI): 0.964 (0.932-0.998), p = 0.0367]. Conclusions: Loss of sympathetic rhythmical oscillation is associated with a more severe disease and worse early clinical outcome in hospitalized patients with CAP.
AB - Background: Alterations of cardiac autonomic control (CAC) are associated with poor outcomes in patients with infectious and non-infectious diseases. No evaluation of CAC in patients with community-acquired pneumonia (CAP) has been performed so far. The aim of the study was to assess CAC in patients with CAP and evaluate the impact of its alterations on disease severity and clinical outcomes in a multicenter, prospective, observational study. Methods: Consecutive patients hospitalized for CAP were enrolled between 2011 and 2013 two university hospitals in Italy. CAC was assessed by linear spectral and non-linear symbolic analysis of heart rate variability. The presence of severe CAP was evaluated on hospital admission. The primary study outcome was time to clinical stability (TCS) during hospitalization. Results: Among the 75 patients enrolled (median age: 75 years; 57 % males), a significantly lower total variability and reduction of sympathetic rhythmical component with predominant respiratory modulation was detected in comparison to controls. Among CAP patients affected by a severe CAP on admission, CAC showed a lower sympathetic modulation and predominant parasympathetic oscillatory rhythm. At the multivariate analysis, variables independently correlated with a TCS >7 days were total power, as marker of total variability, [OR (95 % CI): 0.997 (0.994-1.000), p = 0.0454] and sympathetic modulation [OR (95 % CI): 0.964 (0.932-0.998), p = 0.0367]. Conclusions: Loss of sympathetic rhythmical oscillation is associated with a more severe disease and worse early clinical outcome in hospitalized patients with CAP.
KW - Cardiac autonomic control
KW - Heart rate variability
KW - Pneumonia
KW - Spectral analysis
KW - Symbolic analysis
KW - Sympathetic
UR - http://www.scopus.com/inward/record.url?scp=84988360137&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84988360137&partnerID=8YFLogxK
U2 - 10.1186/s12931-016-0414-8
DO - 10.1186/s12931-016-0414-8
M3 - Article
AN - SCOPUS:84988360137
VL - 17
JO - Respiratory Research
JF - Respiratory Research
SN - 1465-9921
IS - 1
M1 - 98
ER -