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Abstract

OBJECTIVES: Both power spectral analysis of heart rate variability and cardiac iodine-123 metaiodobenzyl-guanidine imaging (MIBG) are useful noninvasive tools to evaluate autonomic nervous activity. We have reported previously that the level of left ventricular hypertrophy correlates with neuronal alterations diagnosed by power spectral analysis in patients with essential hypertension (EHT). The aims of this study are to clarify the relationship between heart rate variability and levels of other target organ damages including renal dysfunction, retinopathy and asymptomatic cerebrovascular damages, and then to prove the correlation between heart rate variability and cardiac MIBG in patients with EHT. METHODS: Hospitalized 95 Patients with EHT (age, 61±10 y.o.; 53 men and 42 women) participated in this study. In all subjects, creatinine clearance (Ccr), Scheie's score, numbers of lacunae and heart rate variability for a 24-h monitoring were determined. As power spectral components, low frequency power (LF: 0.04-0.15 Hz), high frequency one (HF: 0.15-0.4 Hz) and LF/HF ratio were calculated. Cardiac MIBG was performed in 31 patients. Early and late MIBG were evaluated 13 and 300 min after injection, respectively, and then heart-to-mediastinum (H/M) ratio of MIBG uptakes and myocardial washout rate (MWR) were calculated. RESULTS: LF and LF/HF ratio (but not HF) were correlated significantly with Ccr (r= 0.433, p<0.05 and r= 0.423, p<0.05, respectively), and both values were decreased with an increase in Scheie's score of ocular fundus. No significant correlation was observed between heart rate variability and numbers of lacunae. LF was correlated positively with early or late H/M ratio (r= 0.435, p<0.05 or r= 0.445, p<0.05, respectively), and negatively with MWR (r= -0.430, p<0.05). CONCLUSIONS: The levels of renal dysfunction and retinopathy are associated with a decrease in heart rate variability, especially LF components. Combination of power spectral analysis and cardiac MIBG becomes a powerful and interactive noninvasive assessment of autonomic nervous dysfunction in patients with EHT.

End organ damage, MIBG, Heart rate variability
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© American Journal of Hypertension, Ltd. 2001
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