open access

Vol 17, No 1 (2010)
Original articles
Published online: 2010-01-26
Submitted: 2013-01-14
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Evaluation of autonomic imbalance in patients with heart failure: A preliminary study of pupillomotor function

Anastasia Keivanidou, Dimitris Fotiou, Christos Arnaoutoglou, Marianthi Arnaoutoglou, Fotios Fotiou, Anna Karlovasitou
Cardiol J 2010;17(1):65-72.

open access

Vol 17, No 1 (2010)
Original articles
Published online: 2010-01-26
Submitted: 2013-01-14

Abstract

Background: Purpose of this study was to examine pupil size changes and mobility in normal subjects and in heart failure (HF) patients.
Methods: Sixteen stable patients with New York Heart Association (NYHA) class II or III heart failure and sixteen control subjects were studied. Pupillary reaction to light was recorded and nine parameters from this data were measured, reported and then compared in both groups of subjects.
Results: Patients with HF had abnormal pupillary function compared with normal subjects. Pupillary light reflex variables differed significantly between two groups (p < 0.05) except baseline radius (R1), minimum radius (R2) and time for maximum constriction (T3). A significant decrease in maximum constriction velocity (VCmax; p < 0.001) and maximum constriction acceleration (ACmax; p < 0.001) was observed in HF subjects. Furthermore, significantly higher values in percentage recovery-redilatation (%R; p < 0.001), percentage R2/R1 (%R2/R1; p < 0.05), latency (T1; p < 0.05) and time for maximum velocity (T2; p < 0.05) were found in the same group.
Conclusions: Of the parameters studied, R1 and %R are governed mainly by the action of the sympathetic nervous system, through norepinephrine. The rest are governed mainly by parasympathetic nervous system, through acetylcholine. The results of our study demonstrate generalized adrenergic activation and parasympathetic withdrawal, which are present in HF.
(Cardiol J 2010; 17, 1: 65-72)

Abstract

Background: Purpose of this study was to examine pupil size changes and mobility in normal subjects and in heart failure (HF) patients.
Methods: Sixteen stable patients with New York Heart Association (NYHA) class II or III heart failure and sixteen control subjects were studied. Pupillary reaction to light was recorded and nine parameters from this data were measured, reported and then compared in both groups of subjects.
Results: Patients with HF had abnormal pupillary function compared with normal subjects. Pupillary light reflex variables differed significantly between two groups (p < 0.05) except baseline radius (R1), minimum radius (R2) and time for maximum constriction (T3). A significant decrease in maximum constriction velocity (VCmax; p < 0.001) and maximum constriction acceleration (ACmax; p < 0.001) was observed in HF subjects. Furthermore, significantly higher values in percentage recovery-redilatation (%R; p < 0.001), percentage R2/R1 (%R2/R1; p < 0.05), latency (T1; p < 0.05) and time for maximum velocity (T2; p < 0.05) were found in the same group.
Conclusions: Of the parameters studied, R1 and %R are governed mainly by the action of the sympathetic nervous system, through norepinephrine. The rest are governed mainly by parasympathetic nervous system, through acetylcholine. The results of our study demonstrate generalized adrenergic activation and parasympathetic withdrawal, which are present in HF.
(Cardiol J 2010; 17, 1: 65-72)
Get Citation

Keywords

pupil mobility; heart failure; adrenergic activation; pupillometry; prognosis

About this article
Title

Evaluation of autonomic imbalance in patients with heart failure: A preliminary study of pupillomotor function

Journal

Cardiology Journal

Issue

Vol 17, No 1 (2010)

Pages

65-72

Published online

2010-01-26

Bibliographic record

Cardiol J 2010;17(1):65-72.

Keywords

pupil mobility
heart failure
adrenergic activation
pupillometry
prognosis

Authors

Anastasia Keivanidou
Dimitris Fotiou
Christos Arnaoutoglou
Marianthi Arnaoutoglou
Fotios Fotiou
Anna Karlovasitou

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