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KMID : 1151920230050030117
Chronobiology in Medicine
2023 Volume.5 No. 3 p.117 ~ p.126
Differential Profiles of Cortisol, Components of Autonomic Nervous System, and Self-Rated Health in Premature Ventricular Contraction: An Observational Study of Three Circadian Types
Novita Gemalasari Liman

Ahmed Kotb
Ina Susianti Timan
Franciscus D. Suyatna
Salim Harris
Joedo Prihartono
Kristiana Siste
Bambang Budi Siswanto
Abstract
Objective : Premature ventricular contraction (PVC) exhibits one of the three circadian patterns, namely fast-type, slow-type, and independent-type. This study aimed to investigate whether the cortisol-marker of hypothalamic-pituitary-adrenal axis, autonomic nervous system activity, and perceptive self-rated health are associated with the three PVC circadian types.

Methods : This cross-sectional observational study recruited 65 idiopathic PVC subjects (23 fast-, 20 slow-, and 22 independent-type) as well as 5 control subjects. Each subject underwent a 24- hour Holter to examine PVC burden and heart rate variability, collected saliva for cortisol and norepinephrine level measurement at 6?7 am, 10?11 am, and 10?11 pm, and recorded their self-rated health scales. Furthermore, univariate and multiple linear regression were conducted to investigate the associations between the independent variables and PVC burden.

Results : The average PVC burden was 15.7%, 8.5%, and 13.6% in fast-, slow-, and independent-type idiopathic PVCs, respectively. Multiple linear regression showed that the high burden of fast-type idiopathic PVC was associated with higher cortisol levels and lower parasympathetic nervous system tone. The high burden of slow-type idiopathic PVC was associated with lower cortisol levels and lower sympathetic nervous system tone. Meanwhile, in independent-type idiopathic PVC, the high burden was associated with higher cortisol levels and sympathetic nervous system tone as well as lower self-rated health scales.

Conclusion : Each PVC circadian type is uniquely related to hypothalamic-pituitary-adrenal axis, autonomic nervous system, and selfrated health. Assessment of PVC circadian type needs to be carried out routinely considering the differences in the underlying associated factors.
KEYWORD
Circadian rhythm, Premature ventricular contraction, Hypothalamic?pituitary?adrenal axis, Autonomic nervous system, Self-rated health
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