Blood pressure, sympathovagal tone, exercise capacity and metabolic status are linked in Turner syndrome
Objectives We studied cardiac autonomic changes in relation to metabolic factors, body composition and 24‐hour ambulatory blood pressure measurements in Turner syndrome patients without known hypertension. Design Cross sectional. Patients Participants were 48 TS women and 24 healthy female controls...
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Published in | Clinical endocrinology (Oxford) Vol. 91; no. 1; pp. 148 - 155 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
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England
Wiley Subscription Services, Inc
01.07.2019
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Abstract | Objectives
We studied cardiac autonomic changes in relation to metabolic factors, body composition and 24‐hour ambulatory blood pressure measurements in Turner syndrome patients without known hypertension.
Design
Cross sectional.
Patients
Participants were 48 TS women and 24 healthy female controls aged over 18 years.
Methods
Short‐term power spectral analysis was obtained in supine‐standing‐supine position. Bedside tests included three conventional cardiovascular reflex tests of heart rate response to standing up, heart rate response to deep breathing and blood pressure response to standing up. Mean heart rate during the last 2 minutes of work was used to calculate the maximal aerobic power (VO2max).
Results
We found a significantly higher mean reciprocal of the heart rate per second (RR) in TS. Testing for interaction between position and status (TS or control), there were highly significant differences between TS and controls in high‐frequency (HF) power, the coefficient of component variation (square root of HF power/mean RR) and low‐frequency (LF): HF ratio, with a dampened decline in vagal activity among TS during standing. Bedside test showed TS had a significantly higher diastolic BP in the supine position compared to controls, and the adaptive rise in BP, when changing to upright position was reduced. VO2max and self‐reported level of physical activity were significantly correlated to systolic ambulatory blood pressure both 24‐hour and night diastolic ambulatory blood pressure.
Conclusion
Vagal tone and modulation of the sympathovagal balance during alteration in body position are impaired in TS. These changes can be risk factors for cardiovascular disease. |
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AbstractList | ObjectivesWe studied cardiac autonomic changes in relation to metabolic factors, body composition and 24‐hour ambulatory blood pressure measurements in Turner syndrome patients without known hypertension.DesignCross sectional.PatientsParticipants were 48 TS women and 24 healthy female controls aged over 18 years.MethodsShort‐term power spectral analysis was obtained in supine‐standing‐supine position. Bedside tests included three conventional cardiovascular reflex tests of heart rate response to standing up, heart rate response to deep breathing and blood pressure response to standing up. Mean heart rate during the last 2 minutes of work was used to calculate the maximal aerobic power (VO2max).ResultsWe found a significantly higher mean reciprocal of the heart rate per second (RR) in TS. Testing for interaction between position and status (TS or control), there were highly significant differences between TS and controls in high‐frequency (HF) power, the coefficient of component variation (square root of HF power/mean RR) and low‐frequency (LF): HF ratio, with a dampened decline in vagal activity among TS during standing. Bedside test showed TS had a significantly higher diastolic BP in the supine position compared to controls, and the adaptive rise in BP, when changing to upright position was reduced. VO2max and self‐reported level of physical activity were significantly correlated to systolic ambulatory blood pressure both 24‐hour and night diastolic ambulatory blood pressure.ConclusionVagal tone and modulation of the sympathovagal balance during alteration in body position are impaired in TS. These changes can be risk factors for cardiovascular disease. Abstract Objectives We studied cardiac autonomic changes in relation to metabolic factors, body composition and 24‐hour ambulatory blood pressure measurements in Turner syndrome patients without known hypertension. Design Cross sectional. Patients Participants were 48 TS women and 24 healthy female controls aged over 18 years. Methods Short‐term power spectral analysis was obtained in supine‐standing‐supine position. Bedside tests included three conventional cardiovascular reflex tests of heart rate response to standing up, heart rate response to deep breathing and blood pressure response to standing up. Mean heart rate during the last 2 minutes of work was used to calculate the maximal aerobic power (VO 2max ). Results We found a significantly higher mean reciprocal of the heart rate per second (RR) in TS. Testing for interaction between position and status (TS or control), there were highly significant differences between TS and controls in high‐frequency (HF) power, the coefficient of component variation (square root of HF power/mean RR) and low‐frequency (LF): HF ratio, with a dampened decline in vagal activity among TS during standing. Bedside test showed TS had a significantly higher diastolic BP in the supine position compared to controls, and the adaptive rise in BP, when changing to upright position was reduced. VO 2max and self‐reported level of physical activity were significantly correlated to systolic ambulatory blood pressure both 24‐hour and night diastolic ambulatory blood pressure. Conclusion Vagal tone and modulation of the sympathovagal balance during alteration in body position are impaired in TS. These changes can be risk factors for cardiovascular disease. Objectives We studied cardiac autonomic changes in relation to metabolic factors, body composition and 24‐hour ambulatory blood pressure measurements in Turner syndrome patients without known hypertension. Design Cross sectional. Patients Participants were 48 TS women and 24 healthy female controls aged over 18 years. Methods Short‐term power spectral analysis was obtained in supine‐standing‐supine position. Bedside tests included three conventional cardiovascular reflex tests of heart rate response to standing up, heart rate response to deep breathing and blood pressure response to standing up. Mean heart rate during the last 2 minutes of work was used to calculate the maximal aerobic power (VO2max). Results We found a significantly higher mean reciprocal of the heart rate per second (RR) in TS. Testing for interaction between position and status (TS or control), there were highly significant differences between TS and controls in high‐frequency (HF) power, the coefficient of component variation (square root of HF power/mean RR) and low‐frequency (LF): HF ratio, with a dampened decline in vagal activity among TS during standing. Bedside test showed TS had a significantly higher diastolic BP in the supine position compared to controls, and the adaptive rise in BP, when changing to upright position was reduced. VO2max and self‐reported level of physical activity were significantly correlated to systolic ambulatory blood pressure both 24‐hour and night diastolic ambulatory blood pressure. Conclusion Vagal tone and modulation of the sympathovagal balance during alteration in body position are impaired in TS. These changes can be risk factors for cardiovascular disease. We studied cardiac autonomic changes in relation to metabolic factors, body composition and 24-hour ambulatory blood pressure measurements in Turner syndrome patients without known hypertension. Cross sectional. Participants were 48 TS women and 24 healthy female controls aged over 18 years. Short-term power spectral analysis was obtained in supine-standing-supine position. Bedside tests included three conventional cardiovascular reflex tests of heart rate response to standing up, heart rate response to deep breathing and blood pressure response to standing up. Mean heart rate during the last 2 minutes of work was used to calculate the maximal aerobic power (VO ). We found a significantly higher mean reciprocal of the heart rate per second (RR) in TS. Testing for interaction between position and status (TS or control), there were highly significant differences between TS and controls in high-frequency (HF) power, the coefficient of component variation (square root of HF power/mean RR) and low-frequency (LF): HF ratio, with a dampened decline in vagal activity among TS during standing. Bedside test showed TS had a significantly higher diastolic BP in the supine position compared to controls, and the adaptive rise in BP, when changing to upright position was reduced. VO and self-reported level of physical activity were significantly correlated to systolic ambulatory blood pressure both 24-hour and night diastolic ambulatory blood pressure. Vagal tone and modulation of the sympathovagal balance during alteration in body position are impaired in TS. These changes can be risk factors for cardiovascular disease. |
Author | Mortensen, Kristian H. Hjerrild, Britta E. Brun, Sara Andersen, Niels H. Gravholt, Claus H. Hansen, Klavs W. Berglund, Agnethe |
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BackLink | https://www.ncbi.nlm.nih.gov/pubmed/30954026$$D View this record in MEDLINE/PubMed |
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Copyright | 2019 John Wiley & Sons Ltd 2019 John Wiley & Sons Ltd. Copyright © 2019 John Wiley & Sons Ltd |
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Notes | Funding information This work was supported by grants from the Lundbeck Foundation, the Augustinus Foundation, The Toyota Foundation, the Aase og Einar Danielsen Foundation, the Novo Nordisk Foundation (NNF13OC0003234, NNF15OC0016474), ‘Fonden til lægevidenskabens fremme’ and the Familien Hede Nielsen Foundation. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
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A validation study publication-title: Int J Obes contributor: fullname: Heitmann BL – ident: e_1_2_8_32_1 doi: 10.1210/jc.2004-1939 – ident: e_1_2_8_2_1 doi: 10.1530/EJE-17-0430 – ident: e_1_2_8_5_1 doi: 10.1210/jc.2008-1049 – ident: e_1_2_8_23_1 doi: 10.2337/diacare.21.7.1062 – ident: e_1_2_8_18_1 doi: 10.1016/0008-6363(96)00116-2 – ident: e_1_2_8_15_1 doi: 10.1186/1532-429X-13-24 – ident: e_1_2_8_28_1 doi: 10.1161/CIRCULATIONAHA.106.685487 – ident: e_1_2_8_25_1 doi: 10.1503/cmaj.150535 – ident: e_1_2_8_10_1 doi: 10.1046/j.1365-2265.2002.01596.x – ident: e_1_2_8_29_1 doi: 10.1136/heartjnl-2018-313716 |
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We studied cardiac autonomic changes in relation to metabolic factors, body composition and 24‐hour ambulatory blood pressure measurements in Turner... We studied cardiac autonomic changes in relation to metabolic factors, body composition and 24-hour ambulatory blood pressure measurements in Turner syndrome... Abstract Objectives We studied cardiac autonomic changes in relation to metabolic factors, body composition and 24‐hour ambulatory blood pressure measurements... ObjectivesWe studied cardiac autonomic changes in relation to metabolic factors, body composition and 24‐hour ambulatory blood pressure measurements in Turner... OBJECTIVESWe studied cardiac autonomic changes in relation to metabolic factors, body composition and 24-hour ambulatory blood pressure measurements in Turner... |
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StartPage | 148 |
SubjectTerms | autonomic nervous system biomarkers Blood pressure Body composition Cardiovascular diseases Genetic disorders Heart rate human Metabolism Physical activity physical conditioning Risk factors Turner's syndrome Vagus nerve |
Title | Blood pressure, sympathovagal tone, exercise capacity and metabolic status are linked in Turner syndrome |
URI | https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fcen.13983 https://www.ncbi.nlm.nih.gov/pubmed/30954026 https://www.proquest.com/docview/2239145586 https://search.proquest.com/docview/2204697416 |
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