Assessment of Heart Rate Variability in Patients with Fibroid Uterus

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Background & Aims Uterine leiomyoma's represent 29.4% and 41.4% of the hysterectomies in women aged 18–44 and 45–64, respectively. They are characterized by an increase in smooth muscle cell proliferation and excessive deposition of extracellular matrix proteins, collagens type I and III. The reactive oxygen species (ROS) has been shown to be involved in the signaling pathways of several growth factors that stimulate proliferation of a variety of cell types. The underlying inflammation leads to the genesis of benign tumors and cardiac autonomic dysfunction. The cumulative effect of oxidative stress, inflammation and ageing make these patients more vulnerable for cardiovascular autonomic imbalance. Therefore, the study was conducted to assess the heart rate variability as a non-invasive tool for assessing cardiac autonomic function in these patients. Method Thirty four female patients in the age group of 25–50 yrs with newly diagnosed uterine fibroid were recruited from the department of Obstetrics and Gynaecology of JIPMER. Thirty four female healthy volunteers aged between 25–50 years were recruited as controls. The parameters measured were Basal Heart rate (BHR), Systolic blood pressure (SBP), Diastolic blood pressure (DBP) and Heart rate variability parameters (time and frequency domain indices). Results SBP and diastolic BP were elevated in fibroid patients compared to controls. SBP was statistically significant (P value <0.001). Time domain indices were significantly reduced (SDNN: P < 0.001, RMSSD: P <0.001, PNN50: 0.001) in fibroid patients. Among frequency indices, Total power was significantly reduced (P<0.001), LFnu was significantly high (P<0.001), HFnu was significantly decreased (P<0.001) and LF-HF ratio was significantly increased (P<0.001) in fibroid patients. Conclusion We conclude that fibroid patients have altered autonomic tone in the form of increased sympathetic tone and decreased parasympathetic tone.