AI Article Synopsis
- The study investigates cardiac autonomic control (CAC) in patients with community-acquired pneumonia (CAP) for the first time, linking alterations in CAC to disease severity and clinical outcomes.
- Among 75 CAP patients studied, results showed a significant decrease in heart rate variability and sympathetic modulation compared to healthy controls, particularly in those with severe CAP.
- Key findings indicate that reduced sympathetic oscillation correlates with longer time to clinical stability during hospitalization, suggesting that monitoring CAC could help predict patient outcomes.
Article Abstract
Background: Alterations of cardiac autonomic control (CAC) are associated with poor outcomes in patients with infectious and non-infectious diseases. No evaluation of CAC in patients with community-acquired pneumonia (CAP) has been performed so far. The aim of the study was to assess CAC in patients with CAP and evaluate the impact of its alterations on disease severity and clinical outcomes in a multicenter, prospective, observational study.
Methods: Consecutive patients hospitalized for CAP were enrolled between 2011 and 2013 two university hospitals in Italy. CAC was assessed by linear spectral and non-linear symbolic analysis of heart rate variability. The presence of severe CAP was evaluated on hospital admission. The primary study outcome was time to clinical stability (TCS) during hospitalization.
Results: Among the 75 patients enrolled (median age: 75 years; 57 % males), a significantly lower total variability and reduction of sympathetic rhythmical component with predominant respiratory modulation was detected in comparison to controls. Among CAP patients affected by a severe CAP on admission, CAC showed a lower sympathetic modulation and predominant parasympathetic oscillatory rhythm. At the multivariate analysis, variables independently correlated with a TCS >7 days were total power, as marker of total variability, [OR (95 % CI): 0.997 (0.994-1.000), p = 0.0454] and sympathetic modulation [OR (95 % CI): 0.964 (0.932-0.998), p = 0.0367].
Conclusions: Loss of sympathetic rhythmical oscillation is associated with a more severe disease and worse early clinical outcome in hospitalized patients with CAP.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4973093 | PMC |
| http://dx.doi.org/10.1186/s12931-016-0414-8 | DOI Listing |
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