Statin restores cardiac autonomic response to acute hypoxia in hypercholesterolaemia

Authors

  • Maria S. Brasileiro-Santos,

    1. Instituto do Coração (InCor), Universidade de São Paulo, São Paulo, Brazil
    2. Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
    3. Universidade Federal da Paraíba, João Pessoa, Brazil
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  • José A. S. Barreto-Filho,

    1. Instituto do Coração (InCor), Universidade de São Paulo, São Paulo, Brazil
    2. Universidade Federal de Sergipe, Aracaju, Brazil
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  • Raul D. Santos,

    1. Instituto do Coração (InCor), Universidade de São Paulo, São Paulo, Brazil
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  • Ana P. M. Chacra,

    1. Instituto do Coração (InCor), Universidade de São Paulo, São Paulo, Brazil
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  • Carine Teles Sangaleti,

    1. Instituto do Coração (InCor), Universidade de São Paulo, São Paulo, Brazil
    2. Universidade Estadual do Centro-Oeste do Paraná, Guarapuava, Brazil
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  • Gisele Alvez,

    1. Instituto do Coração (InCor), Universidade de São Paulo, São Paulo, Brazil
    2. Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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  • Otavio Coelho Bezerra,

    1. Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
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  • Luiz Aparecido Bortoloto,

    1. Instituto do Coração (InCor), Universidade de São Paulo, São Paulo, Brazil
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  • Maria C. Irigoyen,

    1. Instituto do Coração (InCor), Universidade de São Paulo, São Paulo, Brazil
    2. Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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  • Fernanda M. Consolim-Colombo

    Corresponding author
    1. Instituto do Coração (InCor), Universidade de São Paulo, São Paulo, Brazil
    2. Universidade Federal de Sergipe, Aracaju, Brazil
    • Correspondence to: Fernanda Marciano Consolim-Colombo, Instituto do Coração (InCor), Unidade de Hipertensão Arterial, Av. Dr. Enéas de Carvalho Aguiar, 44 - Cerqueira César, São Paulo, SP CEP 05403-000, Brazil, Tel.: (5511) 3069-5084; Fax: (5511) 3069 5923; e-mail: hipfernanda@incor.usp.br

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Abstract

Background

Hypercholesterolaemia may alter cardiovascular autonomic function. We investigated the autonomic cardiovascular regulation during normoxia and hypoxia in familial isolated HC patients with or without statin treatment.

Materials and methods

Low (LF-RR) and high (HF-RR) components of spectral analysis of RR interval and systolic arterial pressure (LF-SAP) were obtained during 5 min of normoxia and isocapnic hypoxia (10% O2) in 10 normotensive familial HC patients without medication, in seven HC patients after a 12-week treatment period with 40 mg of simvastatin (HC + SVT) and in eight matched normal volunteers (CO).

Results

The HC patients had significant impairment of cardiac autonomic modulation parameters compared with CO at normoxia, which was maintained or even accentuated during hypoxia; these parameters included lower total variance of RR, increased normalized LF-RR, decreased normalized HF-RR, increased LF-RR/HF-RR ratio, higher LF-SAP component and reduced α index. However, the HC + SVT group had a significant improvement in all parameters: the LF-RR and LF-SAP decreased (indicating a decrease in cardiac and vascular sympathetic activity), the HF-RR increased (indicating an increase in parasympathetic activity) and the spontaneous baroreflex sensitivity improved. These changes were detected at normoxia and were maintained during hypoxia.

Conclusions

Our data are the first to show that isolated HC is characterized by an increase in cardiac and vasomotor sympathetic drive, a decrease in cardiac vagal modulation and baroreflex impairment during normoxia and hypoxia. In addition, our data suggest that statin treatment has a potential role in restoring the physiological cardiovascular autonomic control at baseline and during cardiovascular challenge.

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