Análise autonômica, hemodinâmica e da pressão arterial periférica em indivíduos com hipertensão pulmonar idiopática durante as posturas supino, ortostase e supino com estimulação do nervo trigêmeo

Abstract

Idiopathic pulmonary arterial hypertension (HAPI) is a disease characterized by sustained elevation of pulmonary arterial pressure without known cause, in pulmonary arterial pressure HAPI higher average is 25 mmHg at rest or 30 mmHg with exercise and exclusion of any known disease causing pulmonary arterial hypertension. The HAPI presents important hemodynamic changes with autonomic changes possible. Objective: to analyze the autonomic modulations, hemodynamics and peripheral arterial pressure in healthy individuals and with HAPI during postural changes (supinoortostatismo) and trigeminal nerve stimulation through the cold test on the face in supine position. Method: 15 healthy volunteers were selected (control group-GC) and 15 volunteers diagnosed with HAPI (experimental group-GE), aged between 21 to 70 years for both genders. History of the groups, was held and for the capture of autonomic indices of FC and PA use non-invasive methods with the Finometer ® equipment. Both the GC and GE were evaluated in three cycles – supine, orthostatic, supine with trigeminal nerve stimulation through the cold test on the face; each cycle lasting 10 min. data analysis plan: the figures for VFC, V blood pressure and baroreflex stimulation has been analyzed in the time domain and the frequency. Results with p 0.05 was considered significant. Results individuals with HAPI presented the following results on HRV analysis: VFC (time domain); supine position-SDNN (ms) 53.2 ± 29.7 and cardiovascular manifestations (ms) 55.4 ± 21.0; in standing position – SDNN (ms) 32 ± 21.4 and cardiovascular manifestations (ms) 49.1 ± 23.4; and in the application of ice-SDNN (ms) 67 ± 23.7 and cardiovascular manifestations (ms) 57.1 ± 23.4. HRV (frequency domain); supine position-AF (nu) 42.8 ± 11.3 BF (nu) 57.2 ± 7.2; in standing position – AF (nu) 38 ± 8.2 BF (nu) 62 ± 11.5; and in the application of ice-AF (nu) 43.2 ± 11.3 BF (nu) 56.2 ± 8.4. How the hemodynamic indexes (FC PASPAD), individuals with HAPI presented the following results for FC (bpm)-position bench press – 81.8 ± 11.5; in standing position – 83 ± 6.7; and in the application of ice-79.2 ± 7.3. The SBP (mmHg), supine position-117.4 ± 12.0; in standing position – 125 ± 11.3; and in the application of ice-119.8 ± 10. The DBP (mmHg), supine position – 63.1 ± 7.3; in standing position – 89.2 ± 7.4; and in the application of ice-65 ± 8.8. Conclusion: the HAPI is a disease which presents important hemodynamic changes and these changes can be incluênciadas by autômonicas changes, which we can observe in the case study. However, we can conclude that the individual with HAPI presents autonomic dysfunction by decreasing of parameters of HRV.