ALTERED AUTONOMIC BALANCE IN NORMAL TENSION GLAUCOMA

  • Arijita Banerjee Final Year Postgraduate trainee, MD Physiology, PGIMS Rohtak Haryana India
  • Indu Khurana Senior Professor & Head, MD Physiology PGIMS Rohtak Haryana

Abstract

Objective: To study autonomic imbalance if any in normal tension glaucoma (NTG)patients by heart rate variability (HRV)and head-up tilt (HUT)test.

Methods: The study subjects of age between 45 and 65 years of either sex comprised 20 patients with NTG (Group ІІ)and 20 age- and sex-matched healthy controls (Group І). Different variables of time and frequency domain of HRV were analyzed at rest, during HUT and the recovery period.

Results: Highly significant decrease in value of root mean square successive difference observed in Group ІІ (p<0.000)in comparison to controls. The high-frequency variables (HF [nu]and HF [ms2])were significantly less (p<0.000)and low frequency (LF)/HF ratio was significantly high (p<0.000) in Group ІІ.

Conclusion: During stress test, i.e., HUT there was the greater withdrawal of parasympathetic input to heart; hence, there was relatively over

sympathetic activity due to sympatho-vagal imbalance.

Keywords: Stress test, Sympatho-vagal imbalance, Autonomic function test.

Author Biography

Arijita Banerjee, Final Year Postgraduate trainee, MD Physiology, PGIMS Rohtak Haryana India

MD Physiology

Final year Postgraduate Resident Doctor

References

1. Leske MC. Open-angle glaucoma - An epidemiologic overview.
Ophthalmic Epidemiol 2007;14(4):166-72.
2. Kumarswamy NA, Lam FS, Wang AL, Theoharides TC. Glaucoma: Current and developing concepts for inflammation, pathogenesis and treatment. Eur J Inflamm 2006;4(3):129-37.
3. Shields MB. Textbook of Glaucoma. 3rd ed. Baltimore: Williams and
Wilkins, Lippincott; 1984.
4. Flammer J, Pache M, Resink T. Vasospasm, its role in the pathogenesis of diseases with particular reference to the eye. Prog Retin

Eye Res 2001;20(3):319-49.
5. Flammer J, Mozaffarieh M. Autoregulation, a balancing act between supply and demand. Can J Ophthalmol 2008;43(3):317-21.
6. Gasser P. Ocular vasospasm: A risk factor in the pathogenesis of low-tension glaucoma. Int Ophthalmol 1989;13(4):281-90.
7. Gugleta K, Orgül S, Hasler P, Flammer J. Circulatory response to blood gas perturbations in vasospasm. Invest Ophthalmol Vis Sci
2005;46(9):3288-94.
8. Nicolela MT, Ferrier SN, Morrison CA, Archibald ML, LeVatte TL, Wallace K, et al. Effects of cold-induced vasospasm in glaucoma: The role of endothelin-1. Invest Ophthalmol Vis Sci 2003;44(6):2565-72.
9. Pagani M, Lombardi F, Guzzetti S, Rimoldi O, Furlan R, Pizzinelli P, et al.
Power spectral analysis of heart rate and arterial pressure variabilities as a marker of sympatho-vagal interaction in man and conscious dog. Circ Res 1986;59(2):178-93.
10. Goldberger JJ. Sympathovagal balance: How should we measure it?
Am J Physiol 1999;276(4 Pt 2):H1273-80.
11. Kenny RA, Ingram A, Bayliss J, Sutton R. Head-up tilt: A useful test for investigating unexplained syncope. Lancet 1986;1(8494):1352-5.
12. Gherghel D, Hosking SL, Armstrong R, Cunliffe IA. Autonomic dysfunction in unselected and untreated primary open angle glaucoma patients: A pilot study. Ophthalmic Physiol Opt 2007;27(4):336-41.
13. Sharma P, Paudel BH, Singh PN, Limbu P. Heart rate variability: Response to graded head up tilt in healthy men. Kathmandu Univ Med J (KUMJ)2009;7(27):252-7.
14. Brown SJ, Raman A, Barnes MJ, Mündel T. Autonomic cardiovascular response to acute hypoxia and passive head-up tilting in humans. Eur J Appl Physiol 2013;113(7):1731-6.
15. Kouakam C, Lacroix D, Zghal N, Logier R, Klug D, Le Franc P, et al. Inadequate sympathovagal balance in response to orthostatism in patients with unexplained syncope and a positive head up tilt test. Heart
1999;82(3):312-8.
Statistics
295 Views | 301 Downloads
How to Cite
Banerjee, A., and I. Khurana. “ALTERED AUTONOMIC BALANCE IN NORMAL TENSION GLAUCOMA”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 10, no. 2, Feb. 2017, pp. 175-7, doi:10.22159/ajpcr.2017.v10i2.15001.
Section
Original Article(s)