Premium
A placebo‐controlled study examining the effect of allopurinol on heart rate variability and dysrhythmia counts in chronic heart failure
Author(s) -
Shehab Abdullah M. A.,
Butler Robert,
MacFadyen Robert J.,
Struthers Allan D.
Publication year - 2001
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1046/j.1365-2125.2001.01361.x
Subject(s) - medicine , placebo , heart rate variability , heart failure , cardiology , heart rate , allopurinol , creatinine , confidence interval , renal function , blood pressure , alternative medicine , pathology
Aims Allopurinol improves endothelial function in chronic heart failure by reducing oxidative stress. We wished to explore if such an effect would attenuate autonomic dysfunction in CHF in line with many other effective therapies in CHF. Methods We performed a prospective, randomized, double‐blind cross‐over study in 16 patients with NYHA Class II‐IV chronic heart failure (mean age 67 ± 10 years, 13 male, comparing allopurinol (2 months) at a daily dose of 300 mg (if creatinine < 150 µmol l −1 ) or 100 mg (if creatinine > 150 µmol l −1 ) with matched placebo. Mean heart rate and dysrhythmia counts were recorded from 24 h Holter tapes at monthly intervals for 6 months. We assessed autonomic function using standard time domain heart rate variability parameters (HRV): SDNN, SDANN, SDNN index, rMSSD and TI. Results Allopurinol had no significant effect on heart rate variability compared with placebo; the results are expressed as a difference in means ± s.d. with 95% confidence interval (CI) between allopurinol and placebo: SDNN mean=6.5 ± 4.8 ms, P = 0.18 and 95% CI (−3.7, 17); TI mean=−2.1 ± 1.4, P = 0.16 and 95% CI (−5.2, 0.8); SDANN mean=−2.8 ± 7 ms, P = 0.68 and 95% CI (−18, 12); SDNNi mean=2 ± 6.6, P = 0.7 and 95% CI (−12, 16); RMSSD mean=−0.9 ± 2, P = 0.68 and 95% CI (−5.6, 3.7). For mean heart rate the corresponding results were 0.9 ± 1.4, P = 0.5 and 95% CI (−2, 3.8). Log 24 h ventricular ectopic counts (VEC) were 0.032 ± 0.37, P = 0.7 and 95% CI (−0.1, 0.2). Patient compliance with study medication was good since allopurinol showed its expected effect of reducing plasma uric acid ( P < 0.001). Conclusions Allopurinol at doses, which are known to reduce oxidative stress appear to have no significant effect on resting autonomic tone, as indicated by time domain heart rate variability or on dysrhythmia count in stable heart failure patients.