Christian Gagliardi (Italy)
Alma Mater Studiorum, University of Bologna Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale (DIMES)Author Of 1 Presentation
ASSESSMENT OF CARDIOVASCULAR AUTONOMIC FUNCTION IN HEREDITARY TRANSTHYRETIN AMYLOIDOSIS
- Pietro Guaraldi (Italy)
Abstract
Background and Aims:
Autonomic dysfunction is a key feature of hereditary transthyretin amyloidosis (hATTR). In addition to causing prominent and disabling heterogenic manifestation (orthostatic hypotension, sweating disturbances, erectile and voiding dysfunction, etc.), it carries important prognostic value. The objective of this study was to assess in detail cardiovascular autonomic function throughout a battery of standardized autonomic tests in patients with genetically proven hATTR and healthy controls (HC).
Methods:
Systolic and diastolic blood pressure (SBP, DBP), heart rate (HR) and breathing were continuously monitored at supine rest and during head-up tilt test (HUTT), Valsalva manoeuvre (VM), deep breathing (DB), cold face (IE) test and isometric handgrip (HG) in 19 hATTR and 19 HC.
Results:
During HUTT, hATTR presented significantly lower SBP and DBP values compared to HC, and 6 hATTR patients fulfilled the criteria for orthostatic hypotension. Overshoot and Valsalva ratio were significantly lower in hATTR and pathological in all symptomatic patients. During DB, hATTR presented significantly lower respiratory sinus arrhythmia compared to HC and all symptomatic patients displayed pathological results. SBP, DBP and HR responses to HG were significantly reduced in hATTR compared to HC.
Conclusions:
both cardiovagal and cardiovascular adrenergic function are affected in hATTR, however, cardiovagal dysfunction was more diffused and pronounced.