Internet 
Українська  English  Русский  

DOI: https://doi.org/10.31071/kit2018.14.04


Inventory reference

ISSN 1812-7231 Klin.inform.telemed. Volume 13, Issue 14, 2018, Pages 32–36


Author(s)

G. Raimondi1, N. Marchitto2, B. Scordamaglia1, A. Ciaramella1, P. Casacci3, M. Pistoia3, S. Sacco1, G. Sancesario4


Institution(s)

1University of Roma "Sapienza", 2ASL Latina, 3Liferesult, 4University "Tor Vergata" Roma


Article title

Effect of acetylcholinesterase inhibitors in the Alzheimer patients on the daily cardiovascular neurovegetative assessment


Abstract (resume)

Introduction. The acetylcholinesterase inhibitor (CI) has recently been used for the treatment of senile dementia of Alzheimer type. Therefore, conflicting results exist in the literature on the action of the CI in the cardiovascular neurovegetative regulation.

Aim. In this concern we worked on the ability to remotely monitor patients with dementia in their own homes, with the support of high-tech devices.

Materials and Methods. We studied 36 patients (17 F and 19 M, 74, 5 ± 8, 4 years). At the patients we installed a new devices "Pulse" for a week. From the device we can obtain a record for 5-minute each hour in which the ECG, breath frequency, body position and activity level are reported.
From the records we can extrapolate by means of KUBIOS-HRV software the HRV analysis, both linear and nonlinear. We divided the patients in two groups: in therapy with CI (19–9 F, 72, 6 ± 7, 6 years) and without CI (17–8 F, 75, 3 ± 10, 1 years). The CI administered generally was Donezepil or rivastigmine.

Result. In the morning the indexes of sympathetic tone were more significant high in the patients with CI inhibitors respect to the patients without CI therapy and to the normal control, no differences were present between the control group and thee patients without CI therapy. Respect to patients without CI therapy in the patients with CI therapy we found a surprisingly greater and significant increase in sympathetic activity in all period considered specially during the night periods despite no difference in HR. In fact the linear and nonlinear indexes of the HRV of sympathetic activity was significantly higher in all considered daily period.

Conclusion. Our data, obtained in telemedicine by means a new device "Pulse", show the sympathetic HRV indexes are significantly high in patients with CI therapy in all period of the day and this fact is more pronounced during the night hours.


Keywords

Telemedicine, HRV, Acetylcholinesterase inhibitor, Alzheimer


References

1. Akselrod S., Gordon D., Ubel F. A., Shannon D. C., Berger A. C., Cohen R. J. Power spectrum analysis of heart rate fluctuation: a quantitative probe of beat-to-beat cardiovascular control. Science. 1981, vol. 213 (4504), pp. 220–222.
https://doi.org/10.1126/science.6166045
PMid:6166045

2. Balocchi R., Cantini F., Varanini M., Raimondi G., Legramante J. M., Macerata A. Revisiting the potential of time-domain indexes in short-term HRV analysis. Biomed. Tech., 2006, iss. 51, pp. 190–193.
https://doi.org/10.1515/BMT.2006.034
PMid:17061936

3. Fukusaki C., Kawakubo K., Yamamoto Y. Assessment of the primary effect of aging on heart rate variability in humans. Clin. Auton. Res., 2000, vol. 10, pp. 123–130.
https://doi.org/10.1007/BF02278016
PMid:10954070

4. Joaquim L. F., Farah V. M., Bernatova I., Fazan R. Jr., Grubbs R., Morris M. Enhanced heart rate variability and baroreflex index after stress and cholinesterase inhibition in mice. Am. J. Physiol. Heart Circ. Physiol., 2004, iss. 287, H251–H257.
https://doi.org/10.1152/ajpheart.01136.2003
PMid:14988080

5. Killian T. J., Robertson D., Biaggioni I., Haile V., Biscaia I., Robertson R. M. Sympathetic nervous system function in man is enhanced by acetylcholinesterase inhibition. Circulation, 1990, iss. 82, III–636.

6. Malliani A., Pagani M., Lombardi F., Cerreti S. Cardiovascular neural regulation explored in the frequency domain. Circulation, 1991, vol. 84, iss. 2, pp. 482–492.
https://doi.org/10.1161/01.CIR.84.2.482
PMid:1860193

7. Martynenko A., Yabluchansky M., Kantor B. Mathematical model of automatic nervous systems. Technology and health care: J. Europ. Society for Engineering and Medicine, 2001, iss. 9, pp. 174–176.

8. Masuda Y., Kawamura A. Acetylcholinesterase Inhibitor (Donepezil Hydrochloride) Reduces Heart Rate Variability. J. Cardiovasc. Pharmacol., 2003, vol. 41, pp. 67–71.

9. Mäkikallio T. H., et al. Prediction of sudden cardiac death by fractal analysis of heart rate variability in elderly subjects. J. Am. Coll. Cardiol., 2001, vol. 37, pp. 1395–1402.
https://doi.org/10.1016/S0735-1097(01)01171-8

10. Raimondi G., Legramante J. M., Scordamaglia B., Masci I., Montanari G., Pampena R., Skroza N., Potenza M. C. Linear and non-linear R-R interval variability analysis in the neurovegetative cardiovascular assessment in Psoriasis and Obesity. Appl. of Inform. Systems in Engineering and Biosci., 2014, pp. 61–69.

11. Raj S. R., Black B. K., Biaggioni I., Harris P. A., Robertson D. Acetylcholinesterase inhibition improves tachycardia in postural tachycardia syndrome. Circulation, 2005, vol. 31, pp. 2734–2740.
https://doi.org/10.1161/CIRCULATIONAHA.104.497594
PMid:15911704

12. Siepmann M., Mück A., Engel S., Rupprecht R. The Influence of Rivastigmine and Donepezil on Heart Rate Variability in Patients with Alzheimer's Disease. German J. Psychiatry, 2006 iss. 9, pp. 133–135.

13. Sindona F., Raimondi G., Pecchia R., Spaziani E., Masci I., Scordamaglia B. The effects of general anaesthesia on heart rate variability during abdominal surgery. J. Medicine, Physiology and Biophysics, 2015, vol. 18, pp. 93–99.

14. Stein R. D., Backman S. B., Collier B., et al. Bradycardia produced by pyridostigmine and physostigmine. Can. J. Anaesth., 1997, vol. 44, pp. 1286–1292.
https://doi.org/10.1007/BF03012778
PMid:9429048

15. Yamamoto Y., Nakamura Y., Sato H., Yamamoto M., Kato K., and Hughson R. L. On the fractal nature of heart rate variability in humans: effects of vagal blockade. Am. J. Physiol. Regul. Integr. Comp. Physiol., 1995, iss. 269, R830–R837.
https://doi.org/10.1152/ajpregu.1995.269.4.R830
PMid:7485600

16. Yamasaki Y., Kodama M., Matsuhisa M., et al. Diurnal heart rate variability in healthy subjects: effects of aging and sex difference. Am. J. Physiol., 1996, iss. 271, H303–310.
https://doi.org/10.1152/ajpheart.1996.271.1.H303
PMid:8760189


Full-text version http://kit-journal.com.ua/en/viewer_en.html?doc/2018_14/004.pdf