Sickle Cell Disease Subjects Have a Distinct Abnormal Autonomic Phenotype Characterized by Peripheral Vasoconstriction With Blunted Cardiac Response to Head-Up Tilt

Conclusion We have shown that SCD subjects are much more likely than non-SCD subjects to have impaired cardiac, but intact peripheral responses to orthostatic stress induced by HUT. These abnormal responses are associated with low baseline cardiac parasympathetic activity, independent of hemoglobin level. The classification of autonomic phenotypes based on HUT response may have potential use for predicting disease severity, guiding and targeting treatments/interventions to alleviate the risk of adverse outcomes in SCD. Ethics Statement All experiments were conducted at Children’s Hospital Los Angeles (CHLA). The study protocol was approved by the Committee on Clinical Investigations (institutional review board of CHLA). In accordance with CHLA IRB policies, written informed consent or assent (for subjects < 14 years old) was obtained before participation in the study. In addition, parental consent was obtained if the subject was less than 18 years old. Author Contributions TC, MK, RK, JW, and JD designed the study protocols. PC, RK, PS, and JS performed the experimental device setup. PC, RK, PS, SV, CD, and JD ran patient studies and collected the data. PC analyzed the data and wrote the manuscript. WT assisted with software used for data pre-processing. PC, MK, TC, JD, JW, PS, RK, SV, and CD interpreted the results. MK, TC, JW, and JD critically reviewed and edited the manuscript. RK, PS, SV, CD, and JS edited the manuscript. Funding This work was suppor...
Source: Frontiers in Physiology - Category: Physiology Source Type: research