Alper KEPEZ, Zekeriya DOĞAN, Ceyhun MAMMADOV, Altuğ ÇİNÇİN, Halil ATAŞ, Murat SÜNBÜL, Tarık KIVRAK, Mumune TOPÇU, Bülent MUTLU, Okan ERDOĞAN

Bilinen Kardiyovasküler Hastalığı Olmayan Kimselerde Hiperlipidemi ve Kalp Hızı Değişkenliği Arasındaki İlişkinin Araştırılması

Giriş: Literatürde hiperlipidemi ve kalp hızı değişkenliği (KHD) ilişkisiyle ilgili sınırlı sayıda veri mevcuttur. Çalışmamızın amacı aşikâr kardiyovasküler veya sistemik hastalığı olmayan bireylerin kayıtlarını retrospektif olarak inceleyerek KHD ve hiperlipidemi arasındaki ilişkiyi araştırmaktır. Hastalar ve Yöntem: Ocak 2012 ve Mayıs 2013 tarihleri arasında kliniğimizde 24 saatlik Holter tetkiki yapılan tüm hastaların medikal kayıtları incelendi. Sistemik veya kardiyovasküler hastalığı olmadığına karar verilen kişilerin verileri analizde kullanıldı. Bulgular: Toplam 37 kişinin verisi kullanıldı. Yirmi kişinin hiperlipidemik (10 erkek, yaş: 44.5 ± 11.1) olduğu saptanırken 17 kişinin normal lipit profiline sahip olduğu izlendi (5 erkek, yaş: 33.4 ± 10.6; cinsiyet için p= 0.18 ve yaş için p= 0.004). Hiperlipidemik hasta grubunda normal lipit profili grubuna göre çoğu KHD parametresinin anlamlı derecede deprese olduğu izlendi ancak aritmi prevalansları arasında fark saptanmadı. Lineer regresyon analizinde serum trigliserid düzeyinin RMSSD, PNN50 ve LF/HF oranı ile bağımsız olarak ilişkili olduğu görüldü (sıra ile beta= -0.40, p= 0.02; beta= -0.41, p= 0.012 ve beta= -0.31, p= 0.05). Sonuç: Retrospektif çalışmamız sonucunda hiperlipidemisi olan grupta normal lipit profili olan kişilere göre kalp hızı değişkenliğinin anlamlı derecede deprese olduğu gözlendi. Gözlemlerimiz sonucunda özellikle hipertrigliseridemisi olan hiperlipidemik kişilerin daha yüksek kardiyak sempatik aktivite gösterdikleri ve bu durumun artmış kardiyovasküler morbidite ve mortalite ile ilişkili olabileceği düşünülebilir.

Anahtar Kelimeler:

Hiperlipidemi, holter kaydı, kalp hızı, otonom sinir sistemi

Evaluation of Association Between Hyperlipidemia and Heart Rate Variability in Subjects Without Apparent Cardiovascular Disease

Introduction: There is limited data in the literature regarding the association between hyperlipidemia and heart rate variability (HRV). The aim of the present study is to investigate the association between HRV and hyperlipidemia by retrospectively evaluating the recordings of subjects free of any apparent cardiovascular or systemic disease. Patients and Methods: Medical records of patients to whom 24 hour-Holter recording was performed in our clinic between January 2012 and May 2013 were retrospectively examined. Data of subjects who were determined to be free of any cardiovascular or systemic disease were used in the analysis. Results: Data of 37 subjects were used. There were 20 subjects with hyperlipidemia (10 male, age: 44.5 ± 11.1 years) and 17 subjects with normal lipid profile (5 male, age: 33.4 ± 10.6 years; p= 0.18 for gender and p=0.004 for age). Majority of HRV parameters were found to be significantly depressed in group with hyperlipidemia; however, there were no significant difference between groups regarding prevalence of arrhythmias. Out of components of the lipid profile, linear regression analysis revealed serum triglyceride level to be independently associated variable with RMSSD, PNN50 and LF/HF ratio (in respective order; beta= -0.40, p= 0.02; beta= -0.41, p= 0.012 and beta= -0.31, p= 0.05). Conclusion: Subjects with hyperlipidemia were observed to have significantly depressed HRV compared to subjects with normal lipid profile in our retrospective study. Based on our observations, it may be suggested that patients with hyperlipidemia, in particular with hypertriglyceridemia display higher subtle cardiac sympathetic activity which may be associated with increased cardiovascular morbidity and mortality.

Keywords:

Hyperlipidemia, holter recording, heart rate, autonomic nervous system,

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1. Huikuri HV, Makikallio TH, Airaksinen KE, Seppanen T, Puukka P, Raiha IJ, et al. Power-law relationship of heart rate variability as a predictor of mortality in the elderly. Circulation 1998;97:2031-6.
2. Tsuji H, Larson MG, Venditti FJ Jr, Manders ES, Evans JC, Feldman CL, et al. Impact of heart rate variability on risk for cardiac events: The Framingham Heart Study. Circulation 1996;94:2850-5.
3. Dekker JM, Crow RS, Folsom AR, Hannan PJ, Liao D, Swenne CA, et al. Low heart rate variability in a 2-minute rhythm strip predicts risk of coronary heart disease and mortality from several causes. The ARIC study. Circulation 2000;102:1239-44.
4. Sajadieh A, Nielsen OW, Rasmussen V, Hein HO, Hansen JF. C-reactive protein, heart rate variability and prognosis in community subjects with no apparent heart disease. J Intern Med 2006;260:377-87.
5. Xhyheri B, Manfrini O, Mazzolini M, Pizzi C, Bugiardini R. Heart rate variability today. Prog Cardiovasc Dis 2012;55:321-31.
6. Christensen JH, Toft E, Christensen MS, Schmidt EB. Heart rate variability and plasma lipids in men with and without ischaemic heart disease. Atherosclerosis 1999;145:181-6.
7. Pehlivanidis AN, Athyros VG, Demitriadis DS, Papageorgiou AA, Bouloukos VJ, Kontopoulos AG. Heart rate variability after long-term treatment with atorvastatin in hypercholesterolaemic patients with or without coronary artery disease. Atherosclerosis 2001;157:463-9.
8. Melenovsky V, Wichterle D, Simek J, Malik J, Haas T, Ceska R, et al. M. Effect of atorvastatin and fenofibrate on autonomic tone in subjects with combined hyperlipidemia. Am J Cardiol 2003;92:337-41.
9. Marek M. Task Force of the European Society of Cardiology and the North American Society of Pacing Electrophysiology. Heart rate variability: Standards of measurement, physiological interpretation and clinical use. Circulation 1996;93:1043-65.
10. Kupari M, Virolainen J, Koskinen P, Tikkanen MJ. Short-term heart rate variability and factors modifying the risk of coronary artery disease in a population sample. Am J Cardiol 1993;72:897-903.
11. Nonogaki K. New insights into sympathetic regulation of glucose and fat metabolism. Diabetologia 2000;43:533-49.
12 Harchaoui KE, Visser ME, Kastelein JJ, Stroes ES, Dallinga-Thie GM. Triglycerides and cardiovascular risk. Curr Cardiol Rev 2009;5:216-22.
13. Boullart AC, de Graaf J, Stalenhoef AF. Serum triglycerides and risk of cardiovascular disease. Biochim Biophys Acta 2012;1821:867-75.

ISSN: 2149-2972
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 1990
Yayıncı: Sağlık Bilimleri Üniversitesi, Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi