KMID : 1151920230050030117
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Chronobiology in Medicine 2023 Volume.5 No. 3 p.117 ~ p.126
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Differential Profiles of Cortisol, Components of Autonomic Nervous System, and Self-Rated Health in Premature Ventricular Contraction: An Observational Study of Three Circadian Types
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Novita Gemalasari Liman
Ahmed Kotb Ina Susianti Timan Franciscus D. Suyatna Salim Harris Joedo Prihartono Kristiana Siste Bambang Budi Siswanto
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Abstract
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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.
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KEYWORD
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Circadian rhythm, Premature ventricular contraction, Hypothalamic?pituitary?adrenal axis, Autonomic nervous system, Self-rated health
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