{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T03:08:23Z","timestamp":1777950503127,"version":"3.51.4"},"reference-count":49,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T00:00:00Z","timestamp":1704931200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Science and Higher Education\/Military Institute of Medicine\u2013National Research Institute in Warsaw, Poland","award":["453\/WIM"],"award-info":[{"award-number":["453\/WIM"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Acromegaly is a rare, chronic disease that involves structural and functional abnormalities of the cardiovascular system. Acromegaly likely affects interactions between the cardiovascular system and the autonomic nervous system (ANS). Therefore, assessing the relationship between sympathetic\u2013parasympathetic balance by analyzing heart rate variability (HRV) and the hemodynamic profile via impedance cardiography (ICG) may be useful in learning the exact nature of interactions between the ANS and the cardiovascular system. The purpose of this study was to assess a possible association between HRV and ICG-based parameters of cardiac function in patients newly diagnosed with acromegaly. Methods: This observational cohort study was conducted on 33 patients (18 men, mean age of 47 years) newly diagnosed with acromegaly and no significant comorbidities. A correlation analysis (Spearman\u2019s rank coefficient R) of the parameters assessed via ICG and the HRV assessed via 24 h ambulatory electrocardiography was performed. ICG assessments included the following parameters: stroke volume index (SI), cardiac index (CI), acceleration index (ACI), velocity index (VI), and Heather index (HI). The analysis of HRV included both time-domain parameters (pNN50, SDNN, SDSD, rMSSD) and frequency-domain parameters (total power (TP) and its individual frequency bands: low-frequency (LF day\/night), high-frequency (HF day\/night), and the LF\/HF ratio (day\/night)). Results: Frequency-domain HRV analysis showed the following correlations: (1) lower nighttime LF values with higher ACI (R = \u22120.38; p = 0.027) and HI (R = \u22120.46; p = 0.007) values; (2) higher nighttime HF values with higher ACI (R = 0.39; p = 0.027) and HI (R = 0.43; p = 0.014) values; (3) lower nighttime LF\/HF values with higher ACI (R = \u22120.36; p = 0.037) and HI (R = \u22120.42; p = 0.014) values; (4) higher nighttime TP values with higher SI values (R = 0.35; p = 0.049). Time-domain parameters of HRV showed a significant correlation only between the nighttime values of SDSD and SI (R = 0.35; p = 0.049) and between the daytime and nighttime values of SDNN and HR (R = \u22120.50; p = 0.003 and R = \u22120.35; p = 0.046). In multivariate regression, only ACI was revealed to be independently related to HRV. Conclusions: In patients newly diagnosed with acromegaly, the relationship between the sympathetic\u2013parasympathetic balance assessed via HRV and the hemodynamic profile assessed via ICG was revealed. Better function of the left ventricle was associated with a parasympathetic shift in the autonomic balance.<\/jats:p>","DOI":"10.3390\/jcm13020395","type":"journal-article","created":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T03:21:41Z","timestamp":1704943301000},"page":"395","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The Heart\u2019s Function as a Pump Assessed via Impedance Cardiography and the Autonomic System Balance in Patients with Early-Stage Acromegaly"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6881-7525","authenticated-orcid":false,"given":"Agnieszka","family":"Jurek","sequence":"first","affiliation":[{"name":"Department of Cardiology and Internal Medicine, Military Institute of Medicine\u2013National Research Institute, 04-141 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1909-0993","authenticated-orcid":false,"given":"Pawe\u0142","family":"Krzesi\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Internal Medicine, Military Institute of Medicine\u2013National Research Institute, 04-141 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Wierzbowski","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Internal Medicine, Military Institute of Medicine\u2013National Research Institute, 04-141 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8997-6568","authenticated-orcid":false,"given":"Beata","family":"Uzi\u0119b\u0142o-\u017byczkowska","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Internal Medicine, Military Institute of Medicine\u2013National Research Institute, 04-141 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Przemys\u0142aw","family":"Witek","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Endocrinology, and Diabetology, Medical University of Warsaw, 02-091 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grzegorz","family":"Zieli\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Military Institute of Medicine\u2013National Research Institute, 04-141 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Kazimierczak","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Internal Medicine, Military Institute of Medicine\u2013National Research Institute, 04-141 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ma\u0142gorzata","family":"Banak","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Internal Medicine, Military Institute of Medicine\u2013National Research Institute, 04-141 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grzegorz","family":"Gielerak","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Internal Medicine, Military Institute of Medicine\u2013National Research Institute, 04-141 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1016\/S2213-8587(22)00244-3","article-title":"Acromegaly: Pathogenesis, diagnosis, and management","volume":"10","author":"Fleseriu","year":"2022","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1023\/A:1020750514954","article-title":"Cardiovascular complications in acromegaly: Methods of assessment","volume":"4","author":"Vitale","year":"2001","journal-title":"Pituitary"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1712","DOI":"10.1016\/j.ijcard.2012.11.109","article-title":"Cardiovascular involvement in patients affected by acromegaly: An appraisal","volume":"167","author":"Mosca","year":"2012","journal-title":"Int. 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