Effect of hormone replacement therapy on cardiac autonomic modulation

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• 作者：Natália Maria Perseguini (1)
  Anielle Cristhine de Medeiros Takahashi (2)
  Juliana Cristina Milan (1)
  Patrícia Rehder dos Santos (1)
  Valéria Ferreira Camargo Neves (1)
  Audrey Borghi-Silva (5)
  Ester Silva (1)
  Nicola Montano (3)
  Alberto Porta (4)
  Aparecida Maria Catai (1)
  
• 关键词：Heart rate variability ; Symbolic analysis ; Conditional entropy ; Spectral analysis ; Hormone replacement therapy
• 刊名：Clinical Autonomic Research
• 出版年：2014
• 出版时间：April 2014
• 年：2014
• 卷：24
• 期：2
• 页码：63-70
• 全文大小：202 KB
• 参考文献：1. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology (1996) Heart rate variability: standards of measurement, physiological interpretation and clinical use. Circulation 93:1043-065 CrossRef
  2. Bigger JT Jr, Fleiss JL, Steinman RC, Rolnitzky LM, Kleiger RE, Rottman JN (1992) Frequency domain measures of heart period variability and mortality after myocardial infarction. Circulation 85:164-71. doi:10.1161/01.CIR.85.1.164 CrossRef
  3. Huikuri HV, Makikallio T, Airaksinen KE, Mitrani R, Castellanos A, Myerburg RJ (1999) Measurement of heart rate variability: a clinical tool or a research toy? J Am Coll Cardiol 34:1878-883. doi:10.1016/S0735-1097(99)00468-4 CrossRef
  4. Huikuri HV, Makikallio TH, Perkiomaki J (2003) Measurement of heart rate variability by methods based on nonlinear dynamics. J Electrocardiol 36(Suppl):95-9. doi:10.1016/j.jelectrocard.2003.09.021 CrossRef
  5. Jokinen V, Tapanainen JM, Seppanen T, Huikuri HV (2003) Temporal changes and prognostic significance of measures of heart rate dynamics after acute myocardial infarction in the beta-blocking era. Am J Cardiol 92:907-12. doi:10.1016/S0002-9149(03)00968-8 CrossRef
  6. Makikallio TH, Huikuri HV, Hintze U, Videbaek J, Mitrani RD, Castellanos A, Myerburg RJ, Moller M (2001) Fractal analysis and time- and frequency-domain measures of heart rate variability as predictors of mortality in patients with heart failure. Am J Cardiol 87:178-82. doi:10.1016/S0002-9149(00)01312-6 CrossRef
  7. Makikallio TH, Tapanainen JM, Tulppo MP, Huikuri HV (2002) Clinical applicability of heart rate variability analysis by methods based on nonlinear dynamics. Card Electrophysiol Rev 6:250-55 CrossRef
  8. Porta A, Guzzetti S, Montano N, Furlan R, Pagani M, Malliani A, Cerutti S (2001) Entropy, entropy rate, and pattern classification as tools to typify complexity in short heart period variability series. IEEE Trans Biomed Eng 48:1282-291. doi:10.1109/10.959324 CrossRef
  9. Guzzetti S, Borroni E, Garbelli PE, Ceriani E, Della Bella P, Montano N, Cogliati C, Somers VK, Malliani A, Porta A (2005) Symbolic dynamics of heart rate variability: a probe to investigate cardiac autonomic modulation. Circulation 112:465-70. doi:10.1161/CIRCULATIONAHA.104.518449 CrossRef
  10. Porta A, Tobaldini E, Guzzetti S, Furlan R, Montano N, Gnecchi-Ruscone T (2007) Assessment of cardiac autonomic modulation during graded head-up tilt by symbolic analysis of heart rate variability. Am J Physiol Heart Circ Physiol 293:H702–H708. doi:10.1152/ajpheart.00006.2007 CrossRef
  11. G?k?e M, Burhan K, Yilmaz R, ?rem C, Erd?l C, ?zdemir S (2005) Long term effects of hormone replacement therapy on heart rate variability, QT interval, QT dispersion and frequencies of arrhythmia. Int J Cardiol 99(3):373-79. doi:10.1016/j.ijcard.2003.03.030 CrossRef
  12. Liu CC, Kuo TBJ, Yang CCH (2003) Effects of estrogen on gender-related autonomic differences in humans. Am J Physiol Heart Circ Physiol 285:H2188–H2193. doi:10.1152/ajpheart.00256.2003
  13. Rosano GMC, Patrizi R, Leonardo F, Ponikowski P, Collins P, Sarrel PM, Chierchia SL (1997) Effect of estrogen replacement therapy on heart rate variability and heart rate in healthy postmenopausal women. Am J Cardiol 80(6):815-17. doi:10.1016/S0002-9149(97)00528-6 CrossRef
  14. Neves VFC, Silva de Sá MF, Gallo L Jr, Catai AM, Martins LE, Crescêncio JC, Perpétuo NM, Silva E (2007) Autonomic modulation of heart rate of young and postmenopausal women undergoing estrogen therapy. Braz J Med Biol Res 40(4):491-99. doi:10.1590/S0100-879X2006005000080 CrossRef
  15. De Meersman RE, Zion AS, Giardina EGV, Weir JP, Lieberman JS, Downey JA (1998) Estrogen replacement, vascular distensibility, and blood pressures in postmenopausal women. Am J Physiol Heart Circ Physiol 274:H1539–H1544
  16. Vongpatanasin W, Tuncel M, Mansour Y, Arbique D, Victor RG (2001) Transdermal estrogen replacement therapy decreases sympathetic activity in postmenopausal women. Circulation 103:2903-908. doi:10.1161/01.CIR.103.24.2903 CrossRef
  17. Huikuri HV, Pikkujamsa SM, Airaksinen KE, Ik?heimo MJ, Rantala AO, Kauma H, Lilja M, Kes?niemi YA (1996) Sex-related differences in autonomic modulation of heart rate in middle-aged subjects. Circulation 94(2):122-25. doi:10.1161/01.CIR.94.2.122 CrossRef
  18. Ross RK, Paganini HA, Mack TM, Henderson BE (1989) Cardiovascular benefits of estrogen replacement therapy. Am J Obstet Gynecol 160:1301-306 CrossRef
  19. Adams MR, Kaplan JR, Manuck SB, Koritnik DR, Parks JS, Wolfe MS, Clarkson TB (1990) Inhibition of coronary artery atherosclerosis by 17-beta estradiol in ovariectomized monkeys. Lack of an effect of added progesterone. Arteriosclerosis 10(6):1051-057. doi:10.1161/01.ATV.10.6.1051 CrossRef
  20. Malliani A, Pagani M, Lombardi F, Cerutti S (1991) Cardiovascular neural regulation explored in the frequency domain. Circulation 84:482-92. doi:10.1161/01.CIR.84.2.482 CrossRef
  21. Pagani M, Lombardi F, Guzzetti S, Rimoldi O, Furlan R, Pizzinelli P, Sandrone G, Malfatto G, Dell’Orto S, Piccaluga E (1986) Power spectral analysis of heart rate and arterial pressure variabilities as a marker of sympatho-vagal interaction in man and conscious dog. Circ Res 59(2):178-93. doi:10.1161/01.RES.59.2.178 CrossRef
  22. Porta A, Faes L, Masé M, D’Addio G, Pinna GD, Maestri R, Montano N, Furlan R, Guzzetti S, Nollo G, Malliani A (2007) An integrated approach based on uniform quantization for the evaluation of complexity of short-term heart period variability: application to 24?h Holter recordings in healthy and heart failure humans. Chaos 17(1):015117. doi:10.1063/1.2404630 CrossRef
  23. Christ M, Seyffart K, Wehling M (1999) Attenuation of heart-rate variability in postmenopausal women on progestin-containing hormone replacement therapy. Lancet 353:1939-940. doi:10.1016/S0140-6736(99)00639-X CrossRef
  24. Fernandes EO, Moraes RS, Ferlin EL, Wender MCO, Ribeiro JP (2005) Hormone replacement therapy does not affect the 24-hour heart rate variability in postmenopausal women: results of a randomized, placebo-controlled trial with two regimens. Pacing Clin Electrophysiol 28:S172–S177. doi:10.1111/j.1540-8159.2005.00041.x CrossRef
  25. Lantto H, Haapalahti P, Tuomikoski P, Viitasalo M, V??n?nen H, Sovij?rvi AR, Ylikorkala O, Mikkola TS (2012) Vasomotor hot flashes and heart rate variability: a placebo-controlled trial of postmenopausal hormone therapy. Menopause 19(1):82-8. doi:10.1097/gme.0b013e318221bae8 CrossRef
  26. Hautam?ki H, Haapalahti P, Piiril? P, Tuomikoski P, Sovij?rvi A, Ylikorkala O, Mikkola TS (2012) Effect of hot flushes on cardiovascular autonomic responsiveness: a randomized controlled trial on hormone therapy. Maturitas 72(3):243-48. doi:10.1016/j.maturitas.2012.04.001 CrossRef
  27. Magri F, Gabellieri E, Busconi L, Guazzoni V, Cravello L, Valdes V, Sorrentino AR, Chytiris S, Ferrari E (2006) Cardiovascular, anthropometric and neurocognitive features of healthy postmenopausal women: effects of hormone replacement therapy. Life Sci 78:2625-632. doi:10.1016/j.lfs.2005.10.036 CrossRef
  28. Virtanen I, Ekholm E, Polo-Kantola P, Hiekkanen H, Huikuri H (2008) Postmenopausal estrogen therapy modulates nocturnal nonlinear heart rate dynamics. Menopause 15:693-97. doi:10.1097/gme.0b013e31815dba86 CrossRef
  29. Fletcher SW, Colditz GA (2002) Failure of estrogen plus progestin therapy for prevention. JAMA 288:366-68. doi:10.1001/jama.288.3.366 CrossRef
  30. Takahashi ACM, Porta A, Melo RC, Quitério RJ, da Silva E, Borghi-Silva A, Tobaldini E, Montano N, Catai AM (2012) Aging reduces complexity of heart rate variability assessed by conditional entropy and symbolic analysis. Intern Emerg Med 7(3):229-35. doi:10.1007/s11739-011-0512-z CrossRef
  31. Perseguini NM, Takahashi AC, Rebelatto JR, Silva E, Borghi-Silva A, Porta A, Montano N, Catai AM (2011) Spectral and symbolic analysis of the effect of gender and postural change on cardiac autonomic modulation in healthy elderly subjects. Braz J Med Biol Res 44(1):29-7. doi:10.1590/S0100-879X2010007500137 CrossRef
  32. Porta A, Guzzetti S, Furlan R, Gnecchi-Ruscone T, Montano N, Malliani A (2007) Complexity and non linearity in short-term heart period variability: comparison of methods based on local non linear prediction. IEEE Trans Biomed Eng 54:94-06. doi:10.1109/TBME.2006.883789 CrossRef
  33. Porta A, Castiglioni P, Bari V, Bassani T, Marchi A, Cividjian A, Quintin L, Di Rienzo M (2013) / K-nearest-neighbor conditional entropy approach for the assessment of the short-term complexity of cardiovascular control. Physiol Meas 34:17-3. doi:10.1088/0967-3334/34/1/17 CrossRef
  34. Porta A, Castiglioni P, di Rienzo M, Bari V, Bassani T, Marchi A, Takahashi ACM, Tobaldini E, Montano N, Catai AM, Barbic F, Furlan R, Cividjian A, Quintin L (2012) Short-term complexity indexes of heart period and systolic arterial pressure variabilities provide complementary information. J Appl Physiol 113:1810-820. doi:10.1152/japplphysiol.00755.2012 CrossRef
  35. Albinet CT, Boucard G, Bouquet CA, Audifren M (2010) Increased heart rate variability and executive performance after aerobic training in the elderly. Eur J Appl Physiol 109:617-24. doi:10.1007/s00421-010-1393-y CrossRef
  
• 作者单位：Natália Maria Perseguini (1)
  Anielle Cristhine de Medeiros Takahashi (2)
  Juliana Cristina Milan (1)
  Patrícia Rehder dos Santos (1)
  Valéria Ferreira Camargo Neves (1)
  Audrey Borghi-Silva (5)
  Ester Silva (1)
  Nicola Montano (3)
  Alberto Porta (4)
  Aparecida Maria Catai (1)
  
  1. Cardiovascular Physical Therapy Laboratory, Nucleus of Research in Physical Exercise (NUPEF), Department of Physical Therapy, Federal University of S?o Carlos, UFSCar, Via Washington Luiz, km 235, S?o Carlos, SP, 13565-905, Brazil
  2. Geriatric Physical Therapy Laboratory, Department of Physical Therapy, Federal University of S?o Carlos, UFSCar, Via Washington Luiz, km 235, S?o Carlos, SP, 13565-905, Brazil
  5. Cardiopulmonary Physical Therapy Laboratory, Nucleus of Research in Physical Exercise (NUPEF), Department of Physical Therapy, Federal University of S?o Carlos, UFSCar, Via Washington Luiz, km 235, S?o Carlos, SP, 13565-905, Brazil
  3. Department of Clinical Sciences L. Sacco, Internal Medicine II, L. Sacco Hospital, University of Milan, Milan, Italy
  4. Department of Biomedical Sciences for Health, Galeazzi Orthopaedic Institute, University of Milan, Milan, Italy
  
• ISSN：1619-1560

文摘

Objective To investigate the effects of hormone replacement therapy (HRT) on heart rate variability (HRV) in healthy postmenopausal women. Methods Two groups were evaluated: group 1 (G1): 20 women not undergoing HRT (60?±?5.89?years), group 2 (G2): 20 women undergoing HRT (59?±?5.70?years). The HRTs involved were either conjugated equine estrogen with or without medroxyprogesterone, synthetic estrogen hormone, estradiol associated with norethisterone acetate or isoflavonoids. Electrocardiogram was recorded in the supine position for 10?min. Spectral analysis included low and high frequencies in absolute (LF and HF) and normalized units (LFnu and HFnu), which are predominantly cardiac sympathetic modulation (CSM) and cardiac vagal modulation (CVM) indicators, respectively. The LF/HF ratio was also calculated. Symbolic analysis involved the following indexes: 0V?% (CSM indicator), 1V?% (CSM and CVM indicators), 2LV?% (predominantly CVM indicator) and 2UV?% (CVM indicator). Shannon and conditional entropies were also calculated. Results Spectral analysis demonstrated that HRT affected HRV. LF, LFnu and LF/HF ratio were higher (showing increased CSM), while HFnu was lower (representing decreased CVM) in G2 than in G1. Correlations between complexity indices and HFnu were significant and positive only in G1. Interpretation Women undergoing HRT presented higher CSM and lower CVM than those who were not. Moreover, the expected positive relationship between CVM and complexity of HRV was found only in control group, thus indicating that CVM in women under therapy drop below a minimal value necessary to the association to become apparent, suggesting an unfavorable cardiac autonomic modulation in spite of HRT.