Autonomic cardiovascular response during post-occlusive reactive hyperaemia test comparing healthy and sickle cell anemic patients

Abstract

Introduction: Although the sickle cell disease (sicklemia) is characterized by significant m icrocirculatory dysfunction, in is not clear whether regulatory physiological phenomena associated with hemodynamic response during reactive hyperaemia post -occlusive test are affected. Objective: We sought to determine autonomic cardiovascular responses during reactive hyperaemia post-occlusive test in healthy and sicklemic patients. Methods: Using a quasi-experimental design with 25 healthy subjects and 18 sicklemic patients, we studied the effects of reactive hyperaemia on vascular and cardiac variables. Following 10 min for acclimation, we evaluated 5 min before (basal), 10 min during post-occlusive reactive hyperaemia test on the lower right limb, while performing Pulse Rate Variability (PRV), obtained by the Pulse Peak In tervals of the photoplethysmographic signal (Angiodin® PD 3000 device) on the first finger of the lower right limb. Pulse Peak Intervals were analyzed using frequency (Welch) and time-frequency (Wavelet) methods of the bands of high frequency (HF: 0.15–0.4) and low frequency (LF: 0.04–0.15), as well as temporal and nonlinear (Sample Entropy) analysis. Results: We observe an increase (p<0,05) in the basal state of the suggestive indicators of sympathetic (LF, LF/HF) activity in post-occlusive reactive hyperaemia test during the 5 first minutes, which tend to be lower in the last 5 minutes of recuperation besides a significant increase in all indicators of the PRV existed in the basal state in healthy regarding sicklemic patients. With time-frequency analysis, we found that the LF/HF peak of response to the post-occlusive reactive hyperaemia test occurs more rapidly in healthy compared to sicklemic patients. Conclusions: The sympathetic cardiovascular response during post-occlusive reactive hyperaemia test in sicklemic patients is smaller and slower than in healthy subjects, which suggest that in this disease there are physiopathologic phenomena that affect regional vascular responsiveness to ischemia.Support or Funding Information NoneTime-frequency sympathetic-vagal balance of Pulse Rate Variability during the reative hyperaemia post-occlusive test in healthy subjectsTime-frequency sympathetic-vagal balance of Pulse Rate Variability during the reative hyperaemia post-occlusive test in sicklemic patients