Heart Rate Variability and Autonomic Modulations in Preeclampsia

• Published in: PloS one Vol. 11; no. 4; p. e0152704
• Main Authors: Musa, Shaza M, Adam, Ishag, Lutfi, Mohamed F
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 04.04.2016; Public Library of Science (PLoS)
• Subjects: Adult; Age; Analysis; Autonomic nervous system; Biology and Life Sciences; Blood pressure; Case-Control Studies; Control methods; Diagnosis; Disease; Female; Health aspects; Health sciences; Heart diseases; Heart Rate; High frequencies; Humans; Hypertension; Low frequencies; Maternal mortality; Medical research; Medicine; Medicine and Health Sciences; Parasympathetic nervous system; Parasympathetic Nervous System - physiopathology; Pathological physiology; Patients; Physiology; Power; Pre-eclampsia; Pre-Eclampsia - physiopathology; Preeclampsia; Pregnancy; Pregnant women; Research and Analysis Methods; Studies; Systematic review; Thyroid gland; Variability; Very Low Frequencies; Womens health; Sudan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0152704

Although the exact pathophysiology of preeclampsia is not well understood, autonomic nervous system imbalance is suggested as one of the main factors. To investigate heart rate variability (HRV) and autonomic modulations in Sudanese pregnant women with preeclampsia. A case-control study (60 women in each arm) was conducted at Omdurman Maternity Hospital-Sudan, during the period from June to August, 2014. Cases were women presented with preeclampsia and healthy pregnant women were the controls. Studied groups were matched for important determinants of HRV. Natural logarithm (Ln) of total power (TP), high frequency (HF), low frequency (LF) and very low frequency (VLF) were used to determine HRV. Normalized low and high frequencies (LF Norm and HF Norm) were used to evaluate sympathetic and parasympathetic autonomic modulations respectively. Patients with preeclampsia achieved significantly higher LF Norm [49.80 (16.25) vs. 44.55 (19.15), P = 0.044] and LnLF/HF [0.04 (0.68) vs. -0.28 (0.91), P = 0.023] readings, but lower HF Norm [49.08 (15.29) vs. 55.87 (19.56), P = 0.012], compared with healthy pregnant women. Although all other HRV measurements were higher in the patients with preeclampsia compared with the controls, only LnVLF [4.50 (1.19) vs. 4.01 (1.06), P = 0.017] and LnLF [4.01 (1.58) vs. 3.49 (1.23), P = 0.040] reached statistical significance. The study adds further evidence for the dominant cardiac sympathetic modulations on patients with preeclampsia, probably secondary to parasympathetic withdrawal in this group. However, the higher LnVLF and LnLF readings achieved by preeclamptic women compared with the controls are unexpected in the view that augmented sympathetic modulations usually depresses all HRV parameters including these two measures.