Abstract
Altered autonomic cardiac control is associated with severe arrhythmia, heart insufficiency and sudden death.
Aim: To evaluate recovering of autonomic cardiac control in patients with community acquired pneumonia (CAP).
73 patients with nonsevere CAP (nCAP) and 14 patients with severe CAP (sCAP) were studied at the day of hospital admission and in follow-up periods of 3 and 14-16 days after admission. Controls (CG) included 48 healthy subjects. Autonomic cardiac control was estimated via analysis of fluctuations of consecutive RR intervals at 10 min.ECG record. Heart rate variability (HRV) indexes included standard deviation SDNN, coefficient of variation CVNN, 0.04-0.15 Hz and 0.15-0.4 Hz bands spectral power.
At admission HRV indexes were significantly lower in both CAP groups than in CG. All patients showed clinical and functional recovery. nCAP HRV indexes reached CG values on the 15th day after admission. sCAP HRV indexes remained lower than in nCAP and CG.
Figure 1. *p<0.05 between nCAP,sCAP and CG, †between nCAP and sCAP. Extrapolation of trend lines predicts long period of autonomic cardiac control recovery. It will take approximately 3-6 months in sCAP group.
Conclusions: Autonomic cardiac control is significantly altered in patients with CAP. Predicted recovery period may take up to 6 months in patients with severe CAP and extreme physical workload should be limited due to increased cardiovascular risk.
- © 2011 ERS
