Impaired heart rate variability in patients with chronic Chagas' disease

Abstract

Spectral analysis of heart rate variability was used to investigate the possible alteration in sympathovagal control of heart rate in patients with Chagas' disease. The study included 31 subjects, divided into three groups: controls, Chagas' 1 (subjects with only positive serology for Chagas' disease) and Chagas' 2 (subjects with positive serology and electrocardiographic abnormalities that are usually found in this disease). The subjects were studied during rest, while standing, and during handgrip exercise. With this approach, the low frequency (approximately 0.1 Hz) spectral component of R-R interval variability is considered to be a marker primarily of sympathetic activity, whereas the high frequency (approximately 0.25 Hz) component, which is related to respiration, seems mainly to reflect vagal activity. We observed significant (p less than 0.05) differences among the three groups during standing: although in the control subjects the low-frequency component increased (delta = 30 +/- 5 normalized units, nu), there was no increase in Chagas' 1 (delta = -1 +/- 8 nu) and Chagas' 2 (delta = -2 +/- 8 nu) patients. During handgrip exercise, another test that is capable of exciting sympathetic outflow, there was an increase of low frequency only in control subjects. These results confirm the occurrence of quantitative and assessable abnormalities in the neural control of heart rate variability in Argentinian patients with chronic Chagas' disease, even in the absence of heart failure.