Modulação autonômica cardíaca e sua relação com a capacidade pulmonar em indivíduos com paralisia bulbar progressiva e esclerose lateral amiotrófica

• Autor(a) principal: Pimentel, Renata Martins [UNIFESP]
• Data de Publicação: 2018
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=6526267; https://repositorio.unifesp.br/handle/11600/52114
• topic: Amyotrophic lateral sclerosis; Bulbar palsy; Progressive; Heart rate; Autonomic nervous system; Respiratory capacity; Esclerose amiotrófica lateral; Paralisia bulbar progressiva; Frequência cardíaca; Sistema nervoso autônomo; Capacidade pulmonar

Introduction: Motor neuron diseases (MND), characterized by amyotrophic lateral sclerosis (ALS) and progressive bulbar palsy (PBP), is defined by progressive, irreversible and incapacitating motor paralysis with survival from two to five years after the beginning of the symptomatology. Death is traditionally related to ventilatory impairment and / or systemic complications, although unexplained sudden death is not infrequent. Considering that DNM may compromise other systems, including the autonomic nervous system, proposed to evaluate the cardiac autonomic modulation and relation with pulmonary capacity in patients with ALS and PBP. Method: A total of 91 patients were analyzed: 58 with diagnosis of Amyotrophic Lateral Sclerosis and 33 with Progressive Bulbar Palsy. Clinical diagnoses were obtained from medical observations; the data collection and data were obtained from the Research Section of Neuromuscular Diseases of UNIFESPEPM. In these patients, heart rate variability and spirometry were performed. Thus, they were classified according to Forced Vital Capacity (FVC) with values greater than and less than 50%. In addition, subsequently the statistical analysis. Results: Patients with ALS and PBP presented significant differences in linear indices SDNN, pNN50, RMSSD when compared to normal values; there was no significant difference between the PBP and ALS groups in the linear indices. However, in the nonlinear indices, it was observed that the α1 index was higher in the ALS group when compared to PBP. However, when compared to FVC, there was a lower value in the pNN50 index, only in the PBP group, especially in those patients requiring noninvasive ventilation. Conclusion: There was a decrease in global variability and parasympathetic hypoactivity in relation to normality; strong shortterm fractal correlation in the ELA group in relation to PBP group; lower parasympathetic activity in patients with noninvasive mechanical ventilation.