Deterioration of the circadian variation of heart rate variability in Brugada syndrome may contribute to the pathogenesis of ventricular fibrillation

ブルガダ症候群における心拍変動の日内変動の低下が心室細動発生機序に寄与している可能性がある

德山 丈仁

Aims: Abnormal sympathetic innervation triggers ventricular fibrillation (VF). We examined the circadianvariation of autonomic nervous system and its relevance to risk stratification of VF in patients withBrugada syndrome (Brs). Methods: We enrolled 12 male Brs patients with documented VF (Brs-S; mean age, 42 ± 4 years), 17without documented VF (Brs-N; mean age 48 ± 4 years), and 16 age- and gender-matched controls. Theclinical data, 12-lead electrocardiography (ECG), signal-averaged ECG, electrophysiological study (EPS),and heart rate variability from 24 h Holter ECG were compared between the groups. Results: The low frequency components (LF) in Brs-S and Brs-N and high frequency components (HF)in Brs-S patients were significantly lower than in the controls (409.8 ± 128.6 ms2, 329.5 ± 108 ms2vs.945.3 ± 111.3 ms2; 135.1 ± 73.8 ms2vs. 391.8 ± 63.9 ms2, respectively). The circadian variation of the LFand LF/HF decreased in the Brs patients, the standard deviation (SD) of LF/HF (<2.5) and SD of LF (<400 ms2)had sufficiently high sensitivity (96.6%) and specificity (92.9%) for the diagnosis of Brs. Most of the Brs-Spatients (83.3%) were located under the line formed by the SD/mean of HF = SD/mean of LF in the scatterplots. Conclusion: Lack of the circadian variation of autonomic function occurs in Brs, and this may contributeto the pathogenesis of VF.

Ventricular fibrillation

Circadian rhythm

Autonomic nervous system

医学 [ 490 ]

英語

Takehito Tokuyama, Yukiko Nakano, Akinori Awazu, Yuko Uchimura-Makita, Mai Fujiwra, Yoshikazu Watanabe, Akinori Sairaku, Kenta Kajihara, Chikaaki Motoda, Noboru Oda and Yasuki Kihara; Deterioration of the circadian variation of heart rate variability in Brugada syndrome may contribute to the pathogenesis of ventricularfibrillation, Journal of Cardiology, Volume 64, Issue 2, August 2014, Pages 133-138 (DOI: 10.1016/j.jjcc.2013.12.001) ～を参照している

[DOI] http://doi.org/10.1016/j.jjcc.2013.12.001 ～を参照している

広島大学