Cardiac Rhythm Aberrations in Subacute Sclerosing Panencephalitis: Insights From Heart Rate Variability Analysis.

L. Viswanathan, Bittanakurike C Nagaraj, R. Mundlamuri, Kandavel Thennarasu, R. Kenchaiah, A. Asranna, M. Nagappa, D. Seshagiri, Jitender Saini, Sanjib Sinha
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Abstract

PURPOSE Subacute sclerosing panencephalitis (SSPE) is a fatal neurological disorder resulting from persistent measles virus infection within the brain. Although neurological manifestations have been well-documented, the impact of SSPE on cardiac autonomic function, assessed through heart rate variability (HRV), remains understudied. METHODS In this prospective single-center study conducted from January 2022 to March 2023 in Southern India, 30 consecutive SSPE patients and age- and sex-matched controls underwent electrocardiogram recordings for HRV analysis. Various HRV parameters were assessed, including time-domain metrics (SD of normal-to-normal intervals, root mean square of successive differences between normal heartbeats, percentage of successive normal interbeat intervals greater than 50 msec), SD1 and SD2 for Poincaré plot analysis, and frequency-domain metrics (low frequency %, high frequency %, low frequency:high frequency ratio). RESULTS In the study, SSPE patients exhibited markedly reduced HRV. Specifically, SD of normal-to-normal intervals (P = 0.003), percentage of successive normal interbeat intervals greater than 50 msec (P = 0.03), and SD2 (P = 0.0016) were significantly lower compared with controls. Frequency-domain analysis did not reveal significant distinctions. Correlation analysis demonstrated a negative relationship between percentage of successive normal interbeat intervals greater than 50 msec and SSPE severity (r = -0.37, P = 0.042). Heart rate variability did not significantly differ between SSPE stages or with clinical variables. The interbeat interval range showed a narrower distribution in SSPE subjects. CONCLUSIONS Our study highlights the clinical relevance of HRV analysis in SSPE and autonomic dysfunction throughout the disease course underscoring its importance in SSPE. This investigation provides valuable insights into cardiac autonomic dysfunction probably because of affliction of the central autonomic networks caused by the disease process and may be a contributing factor to mortality in SSPE.
亚急性硬化性泛脑炎的心律失常:心率变异性分析的启示
目的亚急性硬化性泛脑炎(SSPE)是一种致命的神经系统疾病,由脑部持续感染麻疹病毒引起。方法 2022 年 1 月至 2023 年 3 月在印度南部进行的这项前瞻性单中心研究中,30 名连续的 SSPE 患者和年龄与性别匹配的对照组接受了心电图记录,以进行心率变异分析。对各种心率变异参数进行了评估,包括时域指标(正常至正常间期的 SD、正常心跳间连续差值的均方根、连续正常心跳间期大于 50 毫秒的百分比)、用于波恩卡雷图分析的 SD1 和 SD2,以及频域指标(低频百分比、高频百分比、低频:高频比)。具体而言,与对照组相比,正常至正常间期的 SD 值(P = 0.003)、大于 50 毫秒的连续正常搏动间期的百分比(P = 0.03)和 SD2(P = 0.0016)均显著降低。频域分析未发现明显差异。相关分析表明,连续正常心搏间期大于 50 毫秒的百分比与 SSPE 严重程度呈负相关(r = -0.37,P = 0.042)。心率变异性在不同的 SSPE 阶段或与临床变量之间没有明显差异。结论我们的研究强调了心率变异分析在 SSPE 和自律神经功能紊乱整个病程中的临床意义,突出了心率变异分析在 SSPE 中的重要性。这项研究提供了有关心脏自主神经功能障碍的宝贵见解,这可能是由于疾病过程导致中枢自主神经网络受到影响,并可能是导致 SSPE 患者死亡的一个因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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