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Is heart rate variability a valuable method to investigate cardiac autonomic dysfunction in subjects with leukemia? A systematic review to evaluate its importance in clinical practice

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Abstract

Impaired cardiovascular and autonomic function during treatment and during recovery from leukemia has been indicated. In this context, heart rate variability (HRV) is a non-invasive measure that describes the oscillations of the intervals between consecutive heart beats (RR intervals), influenced by the autonomic nervous system. We intend to review literature showing HRV changes in leukemia subjects. The articles selected in the current review were attained up to March 2018, and the search was limited to articles in English language, published in peer-reviewed journals, with both adult and child age samples. The articles were investigated in the five electronic databases: PubMed, Physiotherapy Evidence Database (PEDro), Cochrane Clinical Trials, Scientific Electronic Library Online (SciELO), and Excerpta Medica dataBASE (EMBASE). Towards the end of the research, 9 studies were included. Subjects undergoing treatment for leukemia have reduced HRV, signifying decreased vagal control of heart rate. The subjects that undertook leukemia treatment and their survivors experienced a reduction in HRV with subsequent recovery, but the recovery time is ill defined. HRV is reduced in leukemia subjects who progress to neuropathy secondary to chemotherapy, accompanied by cardiac dysfunction. We advocate the use of HRV to evaluate autonomic function and decide the treatment to prevent autonomic impairment in leukemia subjects.

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Funding

Dr. Vitor E. Valenti receives financial support from the National Council for Scientific and Technological Development (CNPq, Brazil) and Foundation of Support for Research from Sao Paulo state (FAPESP).

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Authors and Affiliations

  1. Autonomic Nervous System Center, Sao Paulo State University, UNESP, Presidente Prudente, SP, Brazil

    Jociele M. Kirizawa & Vitor E. Valenti

  2. Cardiorespiratory Research Group, Department of Biological and Medical Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Headington Campus, Gipsy Lane, Oxford, OX3 0BP, UK

    David M. Garner

  3. Department of Medicine (Cardiology), Federal University of São Paulo (UNIFESP), Sao Paulo, SP, Brazil

    Claudia Arab

  4. UNESP, Av. Hygino Muzzi Filho, 737, Mirante, Marília, SP, 17.525-900, Brazil

    Vitor E. Valenti

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  1. Jociele M. Kirizawa
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  3. Claudia Arab
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  4. Vitor E. Valenti
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Correspondence to Vitor E. Valenti.

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Kirizawa, J.M., Garner, D.M., Arab, C. et al. Is heart rate variability a valuable method to investigate cardiac autonomic dysfunction in subjects with leukemia? A systematic review to evaluate its importance in clinical practice. Support Care Cancer 28, 35–42 (2020). https://doi.org/10.1007/s00520-019-05047-x

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  • DOI: https://doi.org/10.1007/s00520-019-05047-x

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