Evaluation of cardiovascular autonomic dysfunction according to heart rate turbulence and variability in patients with benign paroxysmal positional vertigo

Abstract

Introduction: The relationship between benign paroxysmal positional vertigo (BPPV) and cardiovascular autonomic dysfunction is not clear. Disruption of the balance between the sympathetic and parasympathetic systems causes various diseases. It is believed that disorders of the parasympathetic system, particularly, may be responsible for causing BPPV. Heart rate variability (HRV) and HRT (heart rate turbulence), which show autonomic dysfunction, are two non-invasive tests that show the relationship of the heart rate with the autonomic nervous system. The purpose of the present study was to evaluate the relationship between autonomic dysfunction and BPPV in patients with BPPV by using HRV and HRT, which are non-invasive laboratory parameters. Patients and Methods: A total of 100 age- and gender-matched volunteers and 100 patients with BPPV were selected for the study between January 2015 and January 2020. We obtained HRT and HRV parameters from 24-hour ECG Holter recordings. We considered a TO above 0 and a TS above 2.5 to be abnormal. We compared the parameters between groups. Results: A significant difference was observed between the BPPV and control groups in the HRV parameters SDNNI (p= 0.036), SDANN (p= 0.045), and HRT parameter TS (p= 0.048). We showed that abnormal TO (p= 0.025) and TS (p= 0.038) values were significantly higher in the patient group. Conclusion: Parasympathetic autonomic dysfunction was demonstrated by the lower HRV and HRT values observed in the patients with BPPV compared to the control group in the present study. The present findings must be confirmed with a much larger number of patients and multi-center studies.