1
|
Sammito S, Thielmann B, Klussmann A, Deußen A, Braumann KM, Böckelmann I. Guideline for the application of heart rate and heart rate variability in occupational medicine and occupational health science. J Occup Med Toxicol 2024; 19:15. [PMID: 38741189 DOI: 10.1186/s12995-024-00414-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 04/24/2024] [Indexed: 05/16/2024] Open
Abstract
This updated guideline replaces the "Guideline for the application of heart rate and heart rate variability in occupational medicine and occupational health science" first published in 2014. Based on the older version of the guideline, the authors have reviewed and evaluated the findings on the use of heart rate (HR) and heart rate variability (HRV) that have been published in the meantime and incorporated them into a new version of this guideline.This guideline was developed for application in clinical practice and research purposes in the fields of occupational medicine and occupational science to complement evaluation procedures with respect to exposure and risk assessment at the workplace by the use of objective physiological workload indicators. In addition, HRV is also suitable for assessing the state of health and for monitoring the progress of illnesses and preventive medical measures. It gives an overview of factors influencing the regulation of the HR and HRV at rest and during work. It further illustrates methods for measuring and analyzing these parameters under standardized laboratory and real workload conditions, areas of application as well as the quality control procedures to be followed during the recording and evaluation of HR and HRV.
Collapse
Affiliation(s)
- Stefan Sammito
- Department of Occupational Medicine, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.
- German Air Force Centre of Aerospace Medicine, Experimental Aerospace Medicine Research, Flughafenstraße 1, Cologne, 51147, Germany.
| | - Beatrice Thielmann
- Department of Occupational Medicine, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Andre Klussmann
- Competence Centre Health (CCG), Department Health Sciences, University of Applied Sciences (HAW) Hamburg, Hamburg, Germany
| | - Andreas Deußen
- Department of Physiology, Medical Faculty, TU Dresden, Dresden, Germany
| | | | - Irina Böckelmann
- Department of Occupational Medicine, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| |
Collapse
|
2
|
Ortiz-Guzmán JE, Mollà-Casanova S, Serra-Añó P, Arias-Mutis ÓJ, Calvo C, Bizy A, Alberola A, Chorro FJ, Zarzoso M. Short-Term Heart Rate Variability in Metabolic Syndrome: A Systematic Review and Meta-Analysis. J Clin Med 2023; 12:6051. [PMID: 37762990 PMCID: PMC10532399 DOI: 10.3390/jcm12186051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/05/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Our aim was to determine the differences in short-term heart rate variability (HRV) between patients with metabolic syndrome (MS) and healthy controls. METHODS We searched electronic databases for primary works with short-term HRV recordings (≤30 min) that made comparisons between individuals with MS versus healthy controls. This systematic review and meta-analysis (MA) was performed according to PRISMA guidelines and registered at PROSPERO (CRD42022358975). RESULTS Twenty-eight articles were included in the qualitative synthesis and nineteen met the criteria for the MA. Patients with MS showed decreased SDNN (-0.36 [-0.44, -0.28], p < 0.001), rMSSD (-7.59 [-9.98, -5.19], p < 0.001), HF (-0.36 [-0.51, -0.20], p < 0.00001) and LF (-0.24 [-0.38, -0.1], p = 0.001). In subsequent subanalyses, we found a decrease in SDNN (-0.99 (-1.45, -0.52], p < 0.001), rMSSD (-10.18 [-16.85, -3.52], p < 0.01) and HF (-1.04 [-1.97, -0.1] p < 0.05) in women. In men, only LF showed a significant lower value (-0.26 [-0.5, -0.02], p < 0.05). We could not perform MA for non-linear variables. CONCLUSIONS Patients with MS showed changes in time-domain analyses, with lower values in SDNN and rMSSD. Regarding frequency-domain analyses, MS patients showed a decrease in HF and LF When sex was used as a grouping variable, the MA was only possible in one of both sexes (men or women) in rMSSD and LF/HF. Lastly, when data for both men and women were available, subanalyses showed a different behavior compared to mixed analyses for SDNN, HF and LF, which might point towards a different impact of MS in men and women.
Collapse
Affiliation(s)
- Johan E. Ortiz-Guzmán
- Department of Physiology, Universitat de València, Av. Blasco Ibáñez 15, 46010 Valencia, Spain; (J.E.O.-G.); (C.C.); (A.A.)
| | - Sara Mollà-Casanova
- Department of Physiotherapy, Universitat de València, Street Gascó Oliag 5, 46010 Valencia, Spain; (S.M.-C.); (P.S.-A.)
- UBIC Research Group, Department of Physiotherapy, Universitat de València, Street Gascó Oliag 5, 46010 Valencia, Spain
| | - Pilar Serra-Añó
- Department of Physiotherapy, Universitat de València, Street Gascó Oliag 5, 46010 Valencia, Spain; (S.M.-C.); (P.S.-A.)
- UBIC Research Group, Department of Physiotherapy, Universitat de València, Street Gascó Oliag 5, 46010 Valencia, Spain
| | - Óscar J. Arias-Mutis
- CEU Cardenal Herrera, Department of Biomedical Sciences, Street Lluís Vives 1, 46115 Valencia, Spain; (Ó.J.A.-M.); (A.B.)
- Health Research Institute—Instituto de Investigación Sanitaria del Hospital Clínico Universitario de Valencia (INCLIVA) Valencia, Street Menéndez y Pelayo 4, 46010 Valencia, Spain;
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBER-CV) Madrid, Av. Monforte de Lemos, 3–5, Pavilion 11, Floor 0, 28029 Madrid, Spain
| | - Conrado Calvo
- Department of Physiology, Universitat de València, Av. Blasco Ibáñez 15, 46010 Valencia, Spain; (J.E.O.-G.); (C.C.); (A.A.)
- CSIC-UPV, Instrumentation for Molecular Imaging Technologies Research Institute (I3M), Universitat Politècnica de València, 46022 Valencia, Spain
| | - Alexandra Bizy
- CEU Cardenal Herrera, Department of Biomedical Sciences, Street Lluís Vives 1, 46115 Valencia, Spain; (Ó.J.A.-M.); (A.B.)
| | - Antonio Alberola
- Department of Physiology, Universitat de València, Av. Blasco Ibáñez 15, 46010 Valencia, Spain; (J.E.O.-G.); (C.C.); (A.A.)
| | - Francisco J. Chorro
- Health Research Institute—Instituto de Investigación Sanitaria del Hospital Clínico Universitario de Valencia (INCLIVA) Valencia, Street Menéndez y Pelayo 4, 46010 Valencia, Spain;
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBER-CV) Madrid, Av. Monforte de Lemos, 3–5, Pavilion 11, Floor 0, 28029 Madrid, Spain
- Department of Medicine, Universitat de València, Av. Blasco Ibáñez 15, 46010 Valencia, Spain
| | - Manuel Zarzoso
- Department of Physiotherapy, Universitat de València, Street Gascó Oliag 5, 46010 Valencia, Spain; (S.M.-C.); (P.S.-A.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBER-CV) Madrid, Av. Monforte de Lemos, 3–5, Pavilion 11, Floor 0, 28029 Madrid, Spain
| |
Collapse
|
3
|
Nevels TL, Wirth MD, Ginsberg JP, McLain AC, Burch JB. The role of sleep and heart rate variability in metabolic syndrome: evidence from the Midlife in the United States study. Sleep 2023; 46:zsad013. [PMID: 36727300 PMCID: PMC10171632 DOI: 10.1093/sleep/zsad013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 12/11/2022] [Indexed: 02/03/2023] Open
Abstract
STUDY OBJECTIVES Poor sleep and autonomic dysregulation can both disrupt metabolic processes. This study examined the individual and combined effects of poor sleep and reduced heart rate variability (HRV) on metabolic syndrome among 966 participants in the Midlife in the United States II (MIDUS II) study. METHODS Self-reported sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI). HRV was acquired from 11-minute resting heart rate recordings. Spearman correlations, general linear regression, and logistic regression models were used to examine the study hypotheses. RESULTS Poor sleep quality was associated with metabolic syndrome when global PSQI scores were evaluated as a continuous (odds ratio [OR]: 1.07, 95% confidence interval [CI]: 1.03 to 1.11) or categorical measure (cutoff > 5, OR: 1.58, 95% CI: 1.19 to 2.10), after adjustment for confounding. There also was an association between reduced HRV and metabolic syndrome (ln [HF-HRV] OR: 0.89, 95% CI: 0.80 to 0.99; ln [LF-HRV] OR: 0.82, 95% CI: 0.72 to 0.92; ln [SDRR] OR: 0.59, 95% CI: 0.43 to 0.79; ln [RMSSD] OR: 0.75, 95% CI: 0.60 to 0.94). When the combined effects of poor sleep and low HRV were examined, the association with metabolic syndrome was further strengthened relative to those with normal sleep and HRV. CONCLUSIONS To the best of the author's knowledge, this is the first study to suggest a combined effect of poor sleep and low HRV on the odds of metabolic syndrome.
Collapse
Affiliation(s)
- Torrance L Nevels
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Columbia Veterans Affairs Health Care System, Columbia, SC, USA
- U.S. Military Interservice Physician Assistant Program, MEDCoE, Joint Base San Antonio-Fort Sam Houston, TX, USA
| | - Michael D Wirth
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- College of Nursing, University of South Carolina, Columbia, SC, USA
| | - J P Ginsberg
- Department of Pathology, Microbiology, and Immunology, Saybrook University, Pasadena, CA, USA
| | - Alexander C McLain
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - James B Burch
- Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| |
Collapse
|
4
|
Heart rate variability behavior in young men after short-term carotenoid-containing supplementation. Heliyon 2023; 9:e14102. [PMID: 36923896 PMCID: PMC10009683 DOI: 10.1016/j.heliyon.2023.e14102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 02/15/2023] [Accepted: 02/21/2023] [Indexed: 03/06/2023] Open
Abstract
Background Heart rate variability can reflect the risk of developing cardiovascular disease (CVD), while carotenoids are good for CVD prevention. However, the acute effect of short-term carotenoid-containing supplementation on heart rate variability in young men is unclear. Methods Thirty young men between 20 and 29 years of age without personal or family history of cardiovascular diseases were randomly divided into control and experimental groups. The anthropometric data, physiological parameters, and serum biochemical data were acquired, which were without significant difference between the two groups, at the beginning of trial. The participants in the experimental group consumed one pack of compound nutritional supplements in the morning (e.g., 10 AM) and another pack at night (e.g., 7 PM) each day. Heart rate variability was measured again once a month. Repeated measures analysis of variance with Roy's largest root test and Bonferroni post hoc test were applied for primary outcomes. Results Repeated measures analysis of variance indicated a significant time interaction effect for the estimated marginal means of percussion entropy index scale (T1 versus T3, T1 versus T4, and T2 versus T4 with p = 0.009, 0.005, and 0.032, respectively). Roy's largest root test indicates there were significant differences between the means of the index after the intervention between two groups only on T3 and T4 (p = 0.007, η 2 = 0.232 and p = 0.028, η 2 = 0.162, respectively). Conclusion Short-term carotenoid-containing supplementation could help young men by increasing heart rate variability capacity compared to controls over three months.
Collapse
|
5
|
Endukuru CK, Gaur GS, Yerrabelli D, Sahoo J, Vairappan B, Goud AC. Correlation among Poincare plot and traditional heart rate variability indices in adults with different risk levels of metabolic syndrome: a cross-sectional approach from Southern India. J Basic Clin Physiol Pharmacol 2023:jbcpp-2022-0208. [PMID: 36626361 DOI: 10.1515/jbcpp-2022-0208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 12/24/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVES Heart rate variability (HRV) is an important marker of cardiac autonomic modulation. Metabolic syndrome (MetS) can alter cardiac autonomic modulation, raising the risk of cardiovascular disease (CVD). Poincaré plot analysis (PPA) is a robust scatter plot-based depiction of HRV and carries similar information to the traditional HRV measures. However, no prior studies have examined the relationship between PPA and traditional HRV measures among different risk levels of MetS. We evaluated the association between the Poincare plot and traditional heart rate variability indices among adults with different risk levels of MetS. METHODS We measured anthropometric data and collected fasting blood samples to diagnose MetS. The MetS risk was assessed in 223 participants based on the number of MetS components and was classified as control (n=64), pre-MetS (n=49), MetS (n=56), and severe MetS (n=54). We calculated the Poincaré plot (PP) and traditional HRV measures from a 5 min HRV recording. RESULTS Besides the traditional HRV measures, we found that various HRV indices of PPA showed significant differences among the groups. The severe MetS group had significantly lower S (total HRV), SD1 (short-term HRV), SD2 (long-term HRV), and higher SD2/SD1. The values of S, SD1, SD2, and SD2/SD1 were significantly correlated with most traditional HRV measures. CONCLUSIONS We found gradual changes in HRV patterns as lower parasympathetic and higher sympathetic activity alongside the rising number of MetS components. The HRV indices of PPA integrating the benefits of traditional HRV indices distinguish successfully between different risk levels of MetS and control subjects.
Collapse
Affiliation(s)
- Chiranjeevi Kumar Endukuru
- Department of Physiology, Sri Siddhartha Institute of Medical Sciences & Research Centre, Bengaluru, India
| | - Girwar Singh Gaur
- Department of Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Dhanalakshmi Yerrabelli
- Department of Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Jayaprakash Sahoo
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Balasubramaniyan Vairappan
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Alladi Charanraj Goud
- Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| |
Collapse
|
6
|
Kumar EC, Gaur GS, Yerrabelli D, Sahoo J, Vairappan B, Goud AC. Association between metabolic syndrome components and cardiac autonomic modulation in southern Indian adults with pre-metabolic syndrome: hyperglycemia is the major contributing factor. THE KOREAN JOURNAL OF PHYSIOLOGY & PHARMACOLOGY : OFFICIAL JOURNAL OF THE KOREAN PHYSIOLOGICAL SOCIETY AND THE KOREAN SOCIETY OF PHARMACOLOGY 2023; 27:49-59. [PMID: 36575933 PMCID: PMC9806641 DOI: 10.4196/kjpp.2023.27.1.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 09/28/2022] [Accepted: 10/13/2022] [Indexed: 12/29/2022]
Abstract
Metabolic syndrome (MetS) involves multi-factorial conditions linked to an elevated risk of type 2 diabetes mellitus and cardiovascular disease. Pre-metabolic syndrome (pre-MetS) possesses two MetS components but does not meet the MetS diagnostic criteria. Although cardiac autonomic derangements are evident in MetS, there is little information on their status in pre-MetS subjects. In this study, we sought to examine cardiac autonomic functions in pre-MetS and to determine which MetS component is more responsible for impaired cardiac autonomic functions. A total of 182 subjects were recruited and divided into healthy controls (n=89) and pre-MetS subjects (n=93) based on inclusion and exclusion criteria. We performed biochemical profiles on fasting blood samples to detect pre-MetS. Using standardized protocols, we evaluated anthropometric data, body composition, baroreflex sensitivity (BRS), heart rate variability (HRV), and autonomic function tests (AFTs). We further examined these parameters in pre-MetS subjects for each MetS component. Compared to healthy controls, we observed a significant cardiac autonomic dysfunction (CAD) through reduced BRS, lower overall HRV, and altered AFT parameters in pre-MetS subjects, accompanied by markedly varied anthropometric, clinical and biochemical parameters. Furthermore, all examined BRS, HRV, and AFT parameters exhibited an abnormal trend and significant correlation toward hyperglycemia. This study demonstrates CAD in pre-MetS subjects with reduced BRS, lower overall HRV, and altered AFT parameters. Hyperglycemia was considered an independent determinant of alterations in all the examined BRS, HRV, and AFT parameters. Thus, hyperglycemia may contribute to CAD in pre-MetS subjects before progressing to MetS.
Collapse
Affiliation(s)
- Endukuru Chiranjeevi Kumar
- Department of Physiology, Sri Siddhartha Institute of Medical Sciences & Research Centre, Bangalore 562123, India
| | - Girwar Singh Gaur
- Department of Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605008, India,Correspondence Girwar Singh Gaur, E-mail:
| | - Dhanalakshmi Yerrabelli
- Department of Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605008, India
| | - Jayaprakash Sahoo
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605008, India
| | - Balasubramaniyan Vairappan
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605008, India
| | - Alladi Charanraj Goud
- Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605008, India
| |
Collapse
|
7
|
Seipäjärvi S, Tuomola A, Juurakko J, Rottensteiner M, Rissanen APE, Kurkela J, Kujala U, Laukkanen J, Wikgren J. Measuring psychosocial stress with heart rate variability-based methods in different health and age groups. Physiol Meas 2022; 43. [PMID: 35483348 DOI: 10.1088/1361-6579/ac6b7c] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 04/28/2022] [Indexed: 11/12/2022]
Abstract
Autonomic nervous system function and thereby bodily stress and recovery reactions may be assessed by wearable devices measuring heart rate (HR) and its variability (HRV). So far, the validity of HRV-based stress assessments has been mainly studied in healthy populations. In this study, we determined how psychosocial stress affects physiological and psychological stress responses in both young (18-30 yrs) and middle-aged (45-64 yrs) healthy individuals as well as in patients with arterial hypertension and/or either prior evidence of prediabetes or type 2 diabetes. We also studied how an HRV-based stress index (Relax-Stress Intensity, RSI) relates to perceived stress (PS) and cortisol (CRT) responses during psychosocial stress. APPROACH A total of 197 participants were divided into three groups: 1) healthy young (HY, N=63), 2) healthy middle-aged (HM, N=61) and 3) patients with cardiometabolic risk factors (Pts, N=73, 32-65 yrs). The participants underwent a group version of Trier Social Stress Test (TSST-G). HR, HRV (quantified as root mean square of successive differences of R-R intervals, RMSSD), RSI, PS, and salivary CRT were measured regularly during TSST-G and a subsequent recovery period. MAIN RESULTS All groups showed significant stress reactions during TSST-G as indicated by significant responses of HR, RMSSD, RSI, PS, and salivary CRT. Between-group differences were also observed in all measures. Correlation and regression analyses implied RSI being the strongest predictor of CRT response, while HR was more closely associated with PS. SIGNIFICANCE The HRV-based stress index mirrors responses of CRT, which is an independent marker for physiological stress, around TSST-G. Thus, the HRV-based stress index may be used to quantify physiological responses to psychosocial stress across various health and age groups.
Collapse
Affiliation(s)
- Santtu Seipäjärvi
- Department of Psychology, University of Jyväskylä, Kärki, Mattilanniemi, Jyvaskyla, 40100, FINLAND
| | - Anniina Tuomola
- Department of Psychology, University of Jyväskylä, Kärki, Mattilanniemi, Jyvaskyla, Keski-Suomi, 40100, FINLAND
| | - Joona Juurakko
- Department of Psychology, University of Jyväskylä, Kärki, Mattilanniemi, Jyvaskyla, Keski-Suomi, 40100, FINLAND
| | - Mirva Rottensteiner
- Central Finland Health Care District, Keskussairaalantie 19, Jyvaskyla, Central Finland, 40620, FINLAND
| | - Antti-Pekka E Rissanen
- Central Finland Health Care District, Keskussairaalantie, Jyvaskyla, Central Finland, 40620, FINLAND
| | - Jari Kurkela
- Department of Psychology, University of Jyväskylä, Kärki, Mattilanniemi, Jyvaskyla, Keski-Suomi, 40100, FINLAND
| | - Urho Kujala
- University of Jyväskylä Faculty of Sports and Health Sciences, Rautpohjankatu 8, Jyvaskyla, Keski-Suomi, 40700, FINLAND
| | - Jari Laukkanen
- Central Finland Health Care District, Keskussairaalantie, Jyvaskyla, Central Finland, 40620, FINLAND
| | - Jan Wikgren
- Department of Psychology, University of Jyväskylä, Kärki, Mattilanniemi, Jyvaskyla, Keski-Suomi, 40100, FINLAND
| |
Collapse
|
8
|
Font-Farré M, Farche ACS, de Medeiros Takahashi AC, Guerra-Balic M, Figueroa A, Oviedo GR. Cardiac Autonomic Modulation Response Before, During, and After Submaximal Exercise in Older Adults With Intellectual Disability. Front Physiol 2021; 12:702418. [PMID: 34721053 PMCID: PMC8554113 DOI: 10.3389/fphys.2021.702418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 09/22/2021] [Indexed: 11/23/2022] Open
Abstract
The analysis of the heart rate variability (HRV) consists of changes in the time intervals between consecutive R waves. It provides information on the autonomic nervous system regulation and it is a predictor of adverse cardiovascular events. Several studies analyzed this parameter in youth and adults with Intellectual Disability (ID). Nevertheless, there is a lack of information regarding the HRV before, during, and after exercise in older adults with ID. Therefore, we aimed to describe and compare the cardiac autonomic modulation before, during, and after the six-minute walk test (6MWT) in older adults with and without ID. Twenty-four volunteers with ID and 24 without ID (non-ID) participated in this study. HRV was assessed by R-R intervals at rest, during and after the 6MWT. At rest and recovery periods, the participants remained sited. The symbolic analysis was used to evaluate non-linear HRV components. The recovery HR kinetics was assessed by the mean response time, which is equivalent to time constant (τ)+time delay (TD). Between groups differences in HRV variables were not significant. During the recovery period, HR kinetics time variables showed significant better results in non-ID participants (TD: 6±5s vs. 15±11s; τ: 19±10s vs. 35±17s; and MRT: 25±9s vs. 50±11s, all p<0.050). In conclusion, our results suggest that the HRV in older adults with and without ID is similar during rest, exercise, and recovery. Recovery HR kinetics after the 6MWT was slower in older adults with ID. The reason for these results may be a reduced post-exercise vagal rebound in older adults with ID.
Collapse
Affiliation(s)
- Manel Font-Farré
- Faculty of Psychology, Education and Sport Science Blanquerna, University Ramon Llull, Barcelona, Spain
| | | | | | - Myriam Guerra-Balic
- Faculty of Psychology, Education and Sport Science Blanquerna, University Ramon Llull, Barcelona, Spain
| | - Arturo Figueroa
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, United States
| | - Guillermo R Oviedo
- Faculty of Psychology, Education and Sport Science Blanquerna, University Ramon Llull, Barcelona, Spain.,School of Health Science Blanquerna, University Ramon Llull, Barcelona, Spain
| |
Collapse
|
9
|
Speer KE, McKune AJ, Telford RM, Semple S, Naumovski N, Olive LS, Telford RD. Heart rate variability improves in 3-5-year-old children following a 6-month physical activity-based intervention: the Active Early Learning (AEL) cluster randomised controlled trial. Appl Physiol Nutr Metab 2021; 47:1-9. [PMID: 34432989 DOI: 10.1139/apnm-2021-0207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Heart rate variability (HRV) measurement provides non-invasive assessment of autonomic stability and cardiometabolic disease risk. Insufficient physical activity in early childhood may contribute to negative cardiometabolic health. The Active Early Learning (AEL) study was a 6-month randomised controlled trial investigating the effects of a physical activity-based program incorporating movement within the daily curriculum of preschool children. The current study assessed the effects of the AEL intervention on HRV as a measure of cardiac vagal control. Children aged between 3-5 years and enrolled in a preschool with an attendance of ≥15 children were eligible. Physical activity was recorded using an Actigraph wGT3x accelerometer worn at the waist of participants over 3 consecutive days. A Polar H10 chest strap measured HRV with the HF-band and RMSSD representing cardiac vagal control. After 6 months of the AEL trial, linear mixed model analyses revealed a significant intervention effect for increased HF (p = 0.044). The control group did not demonstrate changes in cardiac vagal control after the intervention ceased. Independent of age, sex, physical activity and BMI, the AEL study elicited significant improvements in the cardiac vagal control of participants who received the intervention. Findings highlight the importance of investigating HRV for assessing the cardiometabolic health in young children. ANZCTR trial registration number: ACTRN12619000638134. Novelty: The AEL curriculum improved child HRV independent of age, sex, physical activity and BMI. Heart rate and RR intervals did not demonstrate changes for the intervention and control groups. Multivariate programs for developing physical competence, confidence, knowledge and motivation may improve child health.
Collapse
Affiliation(s)
- Kathryn E Speer
- Faculty of Health, Discipline of Sport and Exercise Science, University of Canberra, Canberra, ACT, Australia
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Andrew J McKune
- Faculty of Health, Discipline of Sport and Exercise Science, University of Canberra, Canberra, ACT, Australia
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
- Discipline of Biokinetics, Exercise and Leisure Sciences, School of Health Sciences, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
| | - Rohan M Telford
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Stuart Semple
- Faculty of Health, Discipline of Sport and Exercise Science, University of Canberra, Canberra, ACT, Australia
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Nenad Naumovski
- Faculty of Health, Discipline of Nutrition and Dietetics, University of Canberra, Canberra, ACT, Australia
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, ACT, Australia
- Department of Nutrition and Dietetics, Harokopio University, Athens, 17671, Greece
| | - Lisa S Olive
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- Centre for Social and Early Emotional Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Richard D Telford
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| |
Collapse
|
10
|
Effects of long-term fasting and confinement on the cardiovascular activity. Med Biol Eng Comput 2021; 59:1901-1915. [PMID: 34370188 DOI: 10.1007/s11517-021-02380-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 05/08/2021] [Indexed: 10/20/2022]
Abstract
Fasting has been demonstrated to improve health and slow aging in human and other species; however, its impact on the human body in the confined environment is still unclear. This work studies the effects of long-term fasting and confined environment on the cardiovascular activities of human via a 10-day fasting experiment with two groups of subjects being in confined (6 subjects) and unconfined (7 subjects) environments respectively and undergoing the same four-stage fasting/feeding process. It is found that the confinement has significant influences on the autonomic regulation to the heart rate during the fasting process by altering the activity of the parasympathetic nervous system, which is manifested by the significant higher pNN50, rMSSD, and Ln-HF of heart rate variability (HRV) (p < 0.05) and slower heart rate (p < 0.01) in the confined group than that in the unconfined group. Furthermore, the long-term fasting induces a series of changes in both groups, including reduced level of serum sodium (p < 0.01), increased the serum calcium (p < 0.05), prolonged QTc intervals (p < 0.05), and reduced systolic blood pressures (p < 0.05). These effects are potentially negative to human health and therefore need to be treated with caution. Study of the effects of fasting and confinement on the cardiovascular activities.
Collapse
|
11
|
Sangaleti CT, Katayama KY, De Angelis K, Lemos de Moraes T, Araújo AA, Lopes HF, Camacho C, Bortolotto LA, Michelini LC, Irigoyen MC, Olofsson PS, Barnaby DP, Tracey KJ, Pavlov VA, Consolim Colombo FM. The Cholinergic Drug Galantamine Alleviates Oxidative Stress Alongside Anti-inflammatory and Cardio-Metabolic Effects in Subjects With the Metabolic Syndrome in a Randomized Trial. Front Immunol 2021; 12:613979. [PMID: 33776997 PMCID: PMC7991724 DOI: 10.3389/fimmu.2021.613979] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 02/08/2021] [Indexed: 12/13/2022] Open
Abstract
Background: The metabolic syndrome (MetS) is an obesity-associated disorder of pandemic proportions and limited treatment options. Oxidative stress, low-grade inflammation and altered neural autonomic regulation, are important components and drivers of pathogenesis. Galantamine, an acetylcholinesterase inhibitor and a cholinergic drug that is clinically-approved (for Alzheimer's disease) has been implicated in neural cholinergic regulation of inflammation in several conditions characterized with immune and metabolic derangements. Here we examined the effects of galantamine on oxidative stress in parallel with inflammatory and cardio-metabolic parameters in subjects with MetS. Trial Design and Methods: The effects of galantamine treatment, 8 mg daily for 4 weeks or placebo, followed by 16 mg daily for 8 weeks or placebo were studied in randomly assigned subjects with MetS (n = 22 per group) of both genders. Oxidative stress, including superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase activities, lipid and protein peroxidation, and nitrite levels were analyzed before and at the end of the treatment. In addition, plasma cytokine and adipokine levels, insulin resistance (HOMA-IR) and other relevant cardio-metabolic indices were analyzed. Autonomic regulation was also examined by heart rate variability (HRV) before treatment, and at every 4 weeks of treatment. Results: Galantamine treatment significantly increased antioxidant enzyme activities, including SOD [+1.65 USOD/mg protein, [95% CI 0.39-2.92], P = 0.004] and CAT [+0.93 nmol/mg, [95% CI 0.34-1.51], P = 0.01], decreased lipid peroxidation [thiobarbituric acid reactive substances [log scale 0.72 pmol/mg, [95% CI 0.46-1.07], P = 0.05], and systemic nitrite levels [log scale 0.83 μmol/mg protein, [95% CI 0.57-1.20], P = 0.04] compared with placebo. In addition, galantamine significantly alleviated the inflammatory state and insulin resistance, and decreased the low frequency/high frequency ratio of HRV, following 8 and 12 weeks of drug treatment. Conclusion: Low-dose galantamine alleviates oxidative stress, alongside beneficial anti-inflammatory, and metabolic effects, and modulates neural autonomic regulation in subjects with MetS. These findings are of considerable interest for further studies with the cholinergic drug galantamine to ameliorate MetS.
Collapse
Affiliation(s)
- Carine Teles Sangaleti
- Hypertension Unit, University of São Paulo (USP), São Paulo, Brazil
- Postgraduate Program in Health Science, Midwestern State University (UNICENTRO), Paraná, Brazil
| | - Keyla Yukari Katayama
- Nursing Department Graduate Program in Nanosciences and Biosciences, Nove de Julho University (UNINOVE), São Paulo, Brazil
| | - Kátia De Angelis
- Nursing Department Graduate Program in Nanosciences and Biosciences, Nove de Julho University (UNINOVE), São Paulo, Brazil
- Department of Physiology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Tércio Lemos de Moraes
- Nursing Department Graduate Program in Nanosciences and Biosciences, Nove de Julho University (UNINOVE), São Paulo, Brazil
| | | | - Heno F. Lopes
- Hypertension Unit, University of São Paulo (USP), São Paulo, Brazil
- Nursing Department Graduate Program in Nanosciences and Biosciences, Nove de Julho University (UNINOVE), São Paulo, Brazil
| | - Cleber Camacho
- Nursing Department Graduate Program in Nanosciences and Biosciences, Nove de Julho University (UNINOVE), São Paulo, Brazil
| | | | - Lisete Compagno Michelini
- Biomedical Sciences Institute Department of Physiology and Biophysics, University of São Paulo (USP), São Paulo, Brazil
| | | | - Peder S. Olofsson
- Laboratory of Immunobiology, Department of Medicine, Center for Bioelectronic Medicine, Karolinska Institutet, Stockholm, Sweden
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
| | - Douglas P. Barnaby
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
| | - Kevin J. Tracey
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
| | - Valentin A. Pavlov
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
| | - Fernanda Marciano Consolim Colombo
- Hypertension Unit, University of São Paulo (USP), São Paulo, Brazil
- Nursing Department Graduate Program in Nanosciences and Biosciences, Nove de Julho University (UNINOVE), São Paulo, Brazil
| |
Collapse
|
12
|
Plaza-Florido A, Alcantara JMA, Amaro-Gahete FJ, Sacha J, Ortega FB. Cardiovascular Risk Factors and Heart Rate Variability: Impact of the Level of the Threshold-Based Artefact Correction Used to Process the Heart Rate Variability Signal. J Med Syst 2020; 45:2. [PMID: 33237459 DOI: 10.1007/s10916-020-01673-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 11/05/2020] [Indexed: 01/08/2023]
Abstract
The associations between cardiovascular disease (CVD) risk factors and heart rate variability (HRV) have shown some inconsistencies. To examine the impact of the different Kubios threshold-based artefact correction levels on the associations between different CVD risk factors and a heart rate variability (HRV) score in three independent human cohorts. A total of 107 children with overweight/obesity, 132 young adults, and 73 middle-aged adults were included in the present study. Waist circumference and the HRV score were negatively associated using the medium and the strong Kubios filters in children (β = -0.22 and - 0.24, P = 0.03 and 0.02 respectively) and the very strong Kubios filter in middle-aged adults (β = -0.39, P = 0.01). HDL-C was positively associated with the HRV score across Kubios filters (β ranged from 0.21 to 0.31, all P ≤ 0.04), while triglycerides were negatively associated with the HRV score using the very strong Kubios filter in young adults (β = -0.22, P = 0.02). Glucose metabolism markers (glucose, insulin, and HOMA index) were inversely associated with the HRV score across Kubios filters in young adults (β ranged from -0.29 to -0.22; all P ≤ 0.03). Importantly, most of these associations disappeared after including HR as a covariate, especially in children and young adults. It should be mandatory to report the Kubios filter used and to include the HR (as a confounder factor) to allow the comparability of the results across different studies.
Collapse
Affiliation(s)
- Abel Plaza-Florido
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Carretera de Alfacar, s/n CP, 18071, Granada, Spain.
| | - J M A Alcantara
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Carretera de Alfacar, s/n CP, 18071, Granada, Spain
| | - Francisco J Amaro-Gahete
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Carretera de Alfacar, s/n CP, 18071, Granada, Spain.,EFFECTS-262 Research Group, Department of Physiology, School of Medicine, University of Granada, 18071, Granada, Spain
| | - Jerzy Sacha
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland.,Department of Cardiology, University Hospital in Opole, University of Opole, Opole, Poland
| | - Francisco B Ortega
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Carretera de Alfacar, s/n CP, 18071, Granada, Spain
| |
Collapse
|
13
|
Huang WC, Liu WS, Chen TT, Chen WH, Huang WL. Parasympathetic activity as a potential biomarker of negative symptoms in patients with schizophrenia. Asia Pac Psychiatry 2020; 12:e12392. [PMID: 32452616 DOI: 10.1111/appy.12392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Revised: 03/26/2020] [Accepted: 04/22/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Autonomic dysfunction in patients with schizophrenia has raised concern considering the higher cardiovascular mortality and morbidity rate. This phenomenon has been demonstrated using various measurements and is inferred to be associated with demographics, medical treatment, and psychopathology. However, few have targeted the role of negative symptoms within schizophrenia. METHODS Schizophrenia patients with stationary psychopathology were recruited from a chronic ward, a daycare center, and a nonintensive case management program. Demographic data, medication history, the Positive and Negative Syndrome Scale (PANSS) score, the Personal and Social Performance Scale (PSP) score, and the five-minute resting-state heart rate variability (HRV) were collected at trial initiation (Time 1) and a year later (Time 2). The relationships between variables and HRV indices were evaluated using correlation and regression analyses. RESULTS A total of 63 participants were recruited at Time 1, with 29 participants remaining at Time 2. Correlation analyses showed a negative correlation between the PANSS negative score (PANSS-N) and total power (TP), low-frequency power (LF), and high-frequency power (HF) at Time 1. The results were further examined with multiple linear regression analysis and remained significant between the PANSS-N score and HF (β = -0.306, P = .012). A generalized estimating equation model revealed the above negative association to be significant considering both timepoints. DISCUSSION The negative association between negative symptom severity and parasympathetic activity was significant, which may inspire further research into the corresponding treatment, the mechanisms, and the use of HRV as an applicable biomarker for treatment response.
Collapse
Affiliation(s)
- Wei-Chia Huang
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Wei-Shih Liu
- Department of Psychiatry, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan
| | - Tzu-Ting Chen
- Department of Psychiatry, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan
| | - Wen-Hao Chen
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Wei-Lieh Huang
- Department of Psychiatry, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan.,Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| |
Collapse
|
14
|
Changes in hemodynamics associated with metabolic syndrome are more pronounced in women than in men. Sci Rep 2019; 9:18377. [PMID: 31804574 PMCID: PMC6895092 DOI: 10.1038/s41598-019-54926-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 11/18/2019] [Indexed: 01/09/2023] Open
Abstract
The increase in cardiovascular risk associated with metabolic syndrome (MS) seems higher in women than in men. We examined hemodynamics during head-up tilt in 252 men and 250 women without atherosclerosis, diabetes, or antihypertensive medication, mean age 48 years, using whole-body impedance cardiography and radial pulse wave analysis. MS was defined according to Alberti et al. 2009. Men and women with MS presented with corresponding elevations of systolic and diastolic blood pressure (10-14%, p ≤ 0.001) versus controls. Supine pulse wave velocity (16-17%, p < 0.001) and systemic vascular resistance (7-9%, p ≤ 0.026), and upright cardiac output (6-11%, p ≤ 0.008) were higher in both MS groups than controls. Elevation of supine aortic characteristic impedance was higher in women than in men with MS (16% vs. 8%, p = 0.026), and in contrast to men, no upright impedance reduction was observed in women. When upright, women but not men with MS showed faster return of reflected pressure wave (p = 0.036), and smaller decrease in left cardiac work (p = 0.035) versus controls. The faster upright return of reflected pressure, lower upright decrease in left cardiac work, and higher elevation of aortic characteristic impedance may contribute to the greater increase in MS-related cardiovascular risk in women than in men.
Collapse
|
15
|
Slušnienė A, Laucevičius A, Navickas P, Ryliškytė L, Stankus V, Stankus A, Navickas R, Laucevičienė I, Kasiulevičius V. Daily Heart Rate Variability Indices in Subjects with and Without Metabolic Syndrome Before and After the Elimination of the Influence of Day-Time Physical Activity. ACTA ACUST UNITED AC 2019; 55:medicina55100700. [PMID: 31627461 PMCID: PMC6843357 DOI: 10.3390/medicina55100700] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/09/2019] [Accepted: 10/14/2019] [Indexed: 12/30/2022]
Abstract
Background and Objectives: The available research shows conflicting data on the heart rate variability (HRV) in metabolic syndrome (MetS) subjects. The discrepancy suggests a methodical shortcoming: due to the influence of physical activity, the standard measuring of HRV at rest is not comparable with HRV assessment based on 24 h Holter monitoring, which is preferred because of its comprehensiveness. To obtain a more reliable measure and to clarify to what extent HRV is altered in MetS, we assessed a 24 h HRV before and after the elimination of the influence of physical activity. Materials and Methods: We investigated 69 metabolic syndrome (MetS) and 37 control subjects, aged 50–55. In all subjects, 24 h monitoring of electrocardiogram, blood pressure, and actigraphy profiles were conducted. To eliminate the influence of day-time physical activity on RR intervals (RRI), a linear polynomial autoregressive model with exogenous terms (ARX) was used. Standard spectral RRI analysis was performed. Results: Subjects with MetS had blunted HRV; the diurnal SDNN index was reliably lower in the MetS group than in control subjects. The elimination of the influence of physical activity did not reveal a significant HRV change in long-term indices (SDNN, SDANN, and SD2), whilst adjacent RRI values (RMSSD, pNN50, and SD1) and SDNN index significantly increased (p < 0.001). An increase in the latter indices highlighted the HRV difference between the MetS and control groups; a significant (p < 0.001) decrease of all short-term HRV variables was found in the MetS group (p < 0.01), and low-frequency spectral components were less pronounced in the MetS group. Conclusion: The application of a polynomial autoregressive model in 24 h HRV assessment allowed for the exclusion of the influence of physical activity and revealed that MetS is associated with blunted HRV, which reflects mitigated parasympathetic tone.
Collapse
Affiliation(s)
- Anžela Slušnienė
- State Research Institute Centre for Innovative Medicine, LT-08406 Vilnius, Lithuania; (A.S.); (A.L.); (A.S.); (R.N.)
- InMedica, LT-08406 Vilnius, Lithuania
| | - Aleksandras Laucevičius
- State Research Institute Centre for Innovative Medicine, LT-08406 Vilnius, Lithuania; (A.S.); (A.L.); (A.S.); (R.N.)
- InMedica, LT-08406 Vilnius, Lithuania
- Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania; (L.R.); (I.L.); (V.K.)
- Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, LT-08661 Vilnius, Lithuania
| | - Petras Navickas
- InMedica, LT-08406 Vilnius, Lithuania
- Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania; (L.R.); (I.L.); (V.K.)
- Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, LT-08661 Vilnius, Lithuania
- Correspondence:
| | - Ligita Ryliškytė
- Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania; (L.R.); (I.L.); (V.K.)
- Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, LT-08661 Vilnius, Lithuania
| | | | - Albinas Stankus
- State Research Institute Centre for Innovative Medicine, LT-08406 Vilnius, Lithuania; (A.S.); (A.L.); (A.S.); (R.N.)
| | - Rokas Navickas
- State Research Institute Centre for Innovative Medicine, LT-08406 Vilnius, Lithuania; (A.S.); (A.L.); (A.S.); (R.N.)
- Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania; (L.R.); (I.L.); (V.K.)
| | - Ieva Laucevičienė
- Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania; (L.R.); (I.L.); (V.K.)
- Centre of Rehabilitation, Vilnius University Hospital Santaros Klinikos, Physical and Sports Medicine, LT-08661 Vilnius, Lithuania
| | - Vytautas Kasiulevičius
- Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania; (L.R.); (I.L.); (V.K.)
| |
Collapse
|
16
|
Physical activity is associated with cardiac autonomic function in adolescent men. PLoS One 2019; 14:e0222121. [PMID: 31491028 PMCID: PMC6730886 DOI: 10.1371/journal.pone.0222121] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 08/21/2019] [Indexed: 11/19/2022] Open
Abstract
Introduction Moderate to vigorous physical activity (MVPA) has been shown to be associated with autonomic regulation of the heart measured with heart rate variability (HRV). Only a limited amount of studies have examined this relationship among adolescents, and the effects of increasing PA on HRV is not well established. The aim of this study was to investigate how overall self-reported PA associates with HRV in a large population of adolescent men. Methods The study was part of the Finnish MOPO study consisting of 3629 young men (mean age 18, SD 1 years) enrolled for military call-ups in 2009–2013. Overall PA, including both the intensity and frequency of habitual exercise, was assessed by a questionnaire and the respondents categorized into four groups of PA (low, moderate, high and top). Short-term HRV, physical performance and body composition were measured. Results HRV, as indicated by mean ln rMSSD, increased according the PA categories as follows: low (3.65 ms (SD 0.7), p<0.001 vs. other groups), moderate (3.78 ms (0.6) p<0.001), high (3.85 ms (0.6) p<0.001) and top activity (3.93 ms (0.6) p<0.001) According to the multivariable linear regression analysis, a significant positive relationship (β = 0.129, p<0.05) was observed between self-reported PA and ln rMSSD independent of body mass index, waist circumference and fat percentage. Conclusions Physical activity was positively associated with cardiac autonomic regulation, in adolescent men. A linear increase in HRV according to PA was observed, suggesting that even slight increments in PA might be beneficial for cardiac autonomic regulation The results emphasize the importance of physical activity in improving cardiac health in young people.
Collapse
|
17
|
Lozano WM, Calvo CJ, Arias-Mutis OJ, Díaz A, Such-Miquel L, Zhao J, Alberola A, Chorro FJ, Zarzoso M. Diet-Induced Metabolic Syndrome Reduced Heart Rate Variability and Increased Irregularity and Complexity of Short-Term RR Time Series in Rabbits. Animals (Basel) 2019; 9:ani9080572. [PMID: 31426570 PMCID: PMC6719107 DOI: 10.3390/ani9080572] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 08/11/2019] [Accepted: 08/16/2019] [Indexed: 12/27/2022] Open
Abstract
Simple Summary In recent years, obesity and metabolic syndrome (MetS) have become more prevalent, owing to increased unhealthy habits and sedentary lifestyles becoming public health problems. Both conditions are linked with a higher prevalence of sudden cardiac death (SCD), but the exact mechanisms are not known. An autonomic nervous system imbalance can produce atrial and ventricular arrhythmias, which cause SCD, and this can be quantified by analyzing heart rate variability (HRV). We investigated HRV using time-domain, frequency-domain and nonlinear analyses during the development of MetS in rabbits and found HRV modifications that could be associated with the higher prevalence of SCD in this pathological condition. Abstract Metabolic syndrome (MetS) has been linked to a higher prevalence of sudden cardiac death (SCD), but the mechanisms are not well understood. One possible underlying mechanism may be an abnormal modulation of autonomic activity, which can be quantified by analyzing heart rate variability (HRV). Our aim was to investigate the modifications of short-term HRV in an experimental rabbit model during the time-course of MetS development. NZW rabbits were randomly assigned to a control (n = 10) or a MetS group (n = 13), fed 28 weeks with control or high-fat, high-sucrose diets. After anesthesia, a 15-min ECG recording was acquired before diet administration and at weeks 14 and 28. We analyzed short RR time series using time-domain, frequency-domain and nonlinear analyses. A mixed-model factorial ANOVA was used for statistical analysis. Time-domain analysis showed a 52.4% decrease in the standard deviation of heart rate in animals from the MetS group at week 28, but no changes in the rest of parameters. In the frequency domain, we found a 9.7% decrease in the very low frequency and a 380.0% increase of the low frequency bands in MetS animals at week 28, whereas high frequency remained unchanged. Nonlinear analyses showed increased complexity and irregularity of the RR time series in MetS animals.
Collapse
Affiliation(s)
- Wilson M Lozano
- Department of Physiology, Universitat de València, 46010 Valencia, Spain
| | - Conrado J Calvo
- Department of Physiology, Universitat de València, 46010 Valencia, Spain
- Centro de Investigación Biomédica en red (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Oscar J Arias-Mutis
- Department of Physiology, Universitat de València, 46010 Valencia, Spain
- Centro de Investigación Biomédica en red (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Ana Díaz
- Unidad Central de Investigación de Medicina (UCIM), Universitat de València, 46010 Valencia, Spain
| | - Luis Such-Miquel
- Department of Physioterapy, Universitat de València, 46010 Valencia, Spain
| | - Jichao Zhao
- Auckland Bioengineering Institute, The Univeristy of Auckland, 1010 Auckland, New Zealand
| | - Antonio Alberola
- Department of Physiology, Universitat de València, 46010 Valencia, Spain
| | - Francisco J Chorro
- Centro de Investigación Biomédica en red (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Cardiology, Hospital Clínico Universitario, 46010 Valencia, Spain
| | - Manuel Zarzoso
- Department of Physioterapy, Universitat de València, 46010 Valencia, Spain.
| |
Collapse
|
18
|
Calvo CJ, Lozano WM, Arias-Mutis ÓJ, Such-Miquel L, Such L, Genovés P, Guill A, Millet J, Chorro FJ, Alberola A, Pandit SV, Zarzoso M. Modifications of short-term intrinsic pacemaker variability in diet-induced metabolic syndrome: a study on isolated rabbit heart. J Physiol Biochem 2019; 75:173-183. [PMID: 30887428 DOI: 10.1007/s13105-019-00667-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 02/07/2019] [Indexed: 01/09/2023]
Abstract
Metabolic syndrome (MetS) describes a condition associated with multiple diseases concomitantly such as diabetes, hypertension, obesity, and dyslipidemia. It has been linked with higher prevalence of cardiovascular disease, atrial fibrillation, and sudden cardiac death. One of the underlying mechanisms could be altered automaticity, which would reflect modifications of sinus node activity. These phenomena can be evaluated analyzing the components of heart rate variability (HRV). Our aim was to examine the modifications of sinus node variability in an isolated heart model of diet-induced obesity and MetS. Male NZW rabbits were randomly assigned to high-fat (HF, n = 8), control (HF-C, n = 7), high-fat, high-sucrose (HFHS, n = 9), and control (HFHS-C, n = 9) groups, fed with their respective diets during 18/28 weeks. After euthanasia, their hearts were isolated in a Langendorff system. We recorded 10-15 min of spontaneous activity. Short RR time series were analyzed, and standard HRV parameters were determined. One-way ANOVA, Kruskal-Wallis test, and bivariate correlation were used for statistical analysis (p < 0.05). We did find an increase in the complexity and irregularity of intrinsic pacemaker activity as shown by modifications of approximate entropy, sample entropy, minimum multiscale entropy, and complexity index in HFHS animals. Even though no differences were found in standard time and frequency-domain analyses, spectral heterogeneity increased in HFHS group. Animal weight and glucose intolerance were highly correlated with the modifications of intrinsic pacemaker variability. Finally, modifications of intrinsic HRV seemed to be reliant on the number of components of MetS present, given that only HFHS group showed significant changes towards an increased complexity and irregularity of intrinsic pacemaker variability.
Collapse
Affiliation(s)
- Conrado J Calvo
- Department of Physiology, Universitat de València, Valencia, Spain.,CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
| | - Wilson M Lozano
- Department of Physiology, Universitat de València, Valencia, Spain
| | - Óscar J Arias-Mutis
- Department of Physiology, Universitat de València, Valencia, Spain.,CIBERCV, Instituto de Salud Carlos III, Madrid, Spain.,INCLIVA, Valencia, Spain
| | - Luis Such-Miquel
- Department of Physiotherapy, Universitat de València, Valencia, Spain
| | - Luis Such
- Department of Physiology, Universitat de València, Valencia, Spain
| | - Patricia Genovés
- Department of Physiology, Universitat de València, Valencia, Spain.,CIBERCV, Instituto de Salud Carlos III, Madrid, Spain.,INCLIVA, Valencia, Spain
| | - Antonio Guill
- ITACA Institute, Universidad Politécnica de Valencia, Valencia, Spain
| | - José Millet
- ITACA Institute, Universidad Politécnica de Valencia, Valencia, Spain
| | - Francisco J Chorro
- CIBERCV, Instituto de Salud Carlos III, Madrid, Spain.,INCLIVA, Valencia, Spain
| | - Antonio Alberola
- Department of Physiology, Universitat de València, Valencia, Spain
| | - Sandeep V Pandit
- Center for Arrhythmia Research, University of Michigan, Ann Abor, MI, USA
| | - Manuel Zarzoso
- Department of Physiotherapy, Universitat de València, Valencia, Spain.
| |
Collapse
|
19
|
Macagnan FE, Feoli AMP, Russomano T. Acute Physical Effort Increases Sympathovagal Balance Responses to Autonomic Stimulation in Metabolic Syndrome. Metab Syndr Relat Disord 2018; 17:67-74. [PMID: 30325696 DOI: 10.1089/met.2018.0065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND There is little evidence of how metabolic syndrome (MS) affects sympathovagal balance responses to acute physical effort (APE) and autonomic stimulation (AS). This study aimed to evaluate the heart rate variability (HRV) responses to the combined APE and AS challenges. METHODS Fourteen subjects (8 men; 49.15 ± 8.67 years) divided into two groups: 7 healthy volunteers [control group (CG)] and 7 patients with MS. Sympathovagal balance [low frequency (LF)/high frequency (HF) ratio] was accessed by HRV through the beat-to-beat heart rate (HR) electrocardiogram. Other variables analyzed were as follows: HR, RR-interval variance (VAR/ms2), LF and HF normalized units (un). The APE consisted of a 30-min walk at 65%-75% of the age-predicted maximal HR. The AS was achieved by changing from the supine to standing position (activity orthostatic position). RESULTS At rest, all HRV variables differ with on MS, but after APE and AS LF (nu) and HF (nu) become similar to the CG. However, the LF/HF ratio responses to the AS were significantly different after APE, but only in the MS (CG rest: 367% ± 59% vs. recovery 495% ± 116%, P > 0.05; MS rest: 316% ± 88% vs. recovery: 665% ± 165%; P = 0.045). Comparing the difference between AS in rest and recovery (ΔAS = rest - recovery), the LF/HF ratio was notably higher in the MS group (CG: 94% ± 29% vs. MS: 415% ± 76%; P < 0.0001). CONCLUSIONS The APE and AS induced by body posture changes activated a clear distinction in sympathovagal balance response in MS.
Collapse
Affiliation(s)
- Fabrício Edler Macagnan
- 1 Graduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Ana Maria Pandolfo Feoli
- 2 Psychology Graduate Program, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Thais Russomano
- 3 Centre of Human and Applied Physiological Sciences, Department of Physiology, School of Basic and Medical Biosciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| |
Collapse
|
20
|
Kangas P, Tikkakoski A, Uitto M, Viik J, Bouquin H, Niemelä O, Mustonen J, Pörsti I. Metabolic syndrome is associated with decreased heart rate variability in a sex-dependent manner: a comparison between 252 men and 249 women. Clin Physiol Funct Imaging 2018; 39:160-167. [PMID: 30307694 DOI: 10.1111/cpf.12551] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 09/19/2018] [Indexed: 11/30/2022]
Abstract
Impaired heart rate variability (HRV) is associated with increased risk of cardiovascular disease, but evidence regarding alterations of HRV in metabolic syndrome (MetS) remains elusive. In order to examine HRV in MetS, we subjected 501 volunteers without atherosclerosis, diabetes or antihypertensive medication, mean age 48 years, to passive head-up tilt. The subjects were divided to control men (n = 131), men with MetS (n = 121), control women (n = 191) and women with MetS (n = 58) according to the criteria by Alberti et al. (Circulation, 2009, 120, 1640). In unadjusted analyses (i) men and women with MetS had lower total power and high-frequency (HF) power of HRV than controls whether supine or upright (P<0·05 for all). (ii) Supine low-frequency (LF) power of HRV was lower in men (P = 0·012) but not in women (P = 0·064) with MetS than in controls, while men and women with MetS had lower upright LF power of HRV than controls (P <0·01 for both). (iii) The LF:HF ratio did not differ between subjects with and without MetS. After adjustment for age, smoking habits, alcohol intake, height, heart rate and breathing frequency, only the differences in upright total power and HF power of HRV between women with MetS and control women remained significant (P<0·05). In conclusion, reduced total and HF power of HRV in the upright position may partially explain why the relative increase in cardiovascular risk associated with MetS is greater in women than in men. Additionally, the present results emphasize that the confounding factors must be carefully taken into consideration when evaluating HRV.
Collapse
Affiliation(s)
- Pauliina Kangas
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Antti Tikkakoski
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.,Department of Clinical Physiology and Nuclear Medicine, Tampere University Hospital, Tampere, Finland
| | - Marko Uitto
- BioMediTech Institute and Faculty of Biomedical Sciences and Engineering, Tampere University of Technology, Tampere, Finland
| | - Jari Viik
- BioMediTech Institute and Faculty of Biomedical Sciences and Engineering, Tampere University of Technology, Tampere, Finland
| | - Heidi Bouquin
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Onni Niemelä
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.,Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital, Seinäjoki, Finland
| | - Jukka Mustonen
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.,Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | - Ilkka Pörsti
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.,Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| |
Collapse
|
21
|
Hu MX, Penninx BW, de Geus EJ, Lamers F, Kuan DCH, Wright AG, Marsland AL, Muldoon MF, Manuck SB, Gianaros PJ. Associations of immunometabolic risk factors with symptoms of depression and anxiety: The role of cardiac vagal activity. Brain Behav Immun 2018; 73:493-503. [PMID: 29920329 PMCID: PMC7066576 DOI: 10.1016/j.bbi.2018.06.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 05/24/2018] [Accepted: 06/15/2018] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES This study examined 1) the cross-sectional relationships between symptoms of depression/anxiety and immunometabolic risk factors, and 2) whether these relationships might be explained in part by cardiac vagal activity. METHODS Data were drawn from the Adult Health and Behavior registries (n = 1785), comprised of community dwelling adults (52.8% women, aged 30-54). Depressive symptoms were measured with the Center for Epidemiological Studies Depression Scale (CES-D) and the Beck Depression Inventory-II (BDI-II), and anxious symptoms with the Trait Anxiety scale of the State-Trait Anxiety Inventory (STAI-T). Immunometabolic risk factors included fasting levels of triglycerides, high-density lipoproteins, glucose, and insulin, as well as blood pressure, waist circumference, body mass index, C-reactive protein, and interleukin-6. Measures of cardiac autonomic activity were high- and low-frequency indicators of heart rate variability (HRV), standard deviation of normal-to-normal R-R intervals, and the mean of absolute and successive differences in R-R intervals. RESULTS Higher BDI-II scores, in contrast to CES-D and STAI-T scores, were associated with increased immunometabolic risk and decreased HRV, especially HRV likely reflecting cardiac vagal activity. Decreased HRV was also associated with increased immunometabolic risk. Structural equation models indicated that BDI-II scores may relate to immunometabolic risk via cardiac vagal activity (indirect effect: β = .012, p = .046) or to vagal activity via immunometabolic risk (indirect effect: β = -.015, p = .021). CONCLUSIONS Depressive symptoms, as measured by the BDI-II, but not anxious symptoms, were related to elevated levels of immunometabolic risk factors and low cardiac vagal activity. The latter may exhibit bidirectional influences on one another in a meditational framework. Future longitudinal, intervention, an nonhuman animal work is needed to elucidate the precise and mechanistic pathways linking depressive symptoms to immune, metabolic, and autonomic parameters of physiology that predispose to cardiovascular disease risk.
Collapse
Affiliation(s)
- Mandy X. Hu
- Amsterdam Public Health Research Institute, Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands,Corresponding author at: Oldenaller 1, 1081 HJ Amsterdam, The Netherlands. (M.X. Hu)
| | - Brenda W.J.H. Penninx
- Amsterdam Public Health Research Institute, Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Eco J.C. de Geus
- Department of Biological Psychology, VU University, Amsterdam, The Netherlands
| | - Femke Lamers
- Amsterdam Public Health Research Institute, Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Dora C.-H. Kuan
- Department of Psychology, University of Pittsburgh, PA, United States
| | - Aidan G.C. Wright
- Department of Psychology, University of Pittsburgh, PA, United States
| | - Anna L. Marsland
- Department of Psychology, University of Pittsburgh, PA, United States
| | - Matthew F. Muldoon
- Division of Cardiology, Department of Medicine, University of Pittsburgh School of Medicine, PA, United States
| | - Stephen B. Manuck
- Department of Psychology, University of Pittsburgh, PA, United States
| | - Peter J. Gianaros
- Department of Psychology, University of Pittsburgh, PA, United States
| |
Collapse
|
22
|
Carvalho LP, Di Thommazo-Luporini L, Mendes RG, Cabiddu R, Ricci PA, Basso-Vanelli RP, Oliveira-Junior MC, Vieira RP, Bonjorno-Junior JC, Oliveira CR, Luporini RL, Borghi-Silva A. Metabolic syndrome impact on cardiac autonomic modulation and exercise capacity in obese adults. Auton Neurosci 2018; 213:43-50. [PMID: 30005739 DOI: 10.1016/j.autneu.2018.05.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 04/18/2018] [Accepted: 05/17/2018] [Indexed: 10/16/2022]
|
23
|
Cardiac Autonomic Neuropathy as a Result of Mild Hypercaloric Challenge in Absence of Signs of Diabetes: Modulation by Antidiabetic Drugs. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2018; 2018:9389784. [PMID: 29643979 PMCID: PMC5831709 DOI: 10.1155/2018/9389784] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 11/21/2017] [Accepted: 11/29/2017] [Indexed: 12/13/2022]
Abstract
Cardiac autonomic neuropathy (CAN) is an early cardiovascular complication of diabetes occurring before metabolic derangement is evident. The cause of CAN remains elusive and cannot be directly linked to hyperglycemia. Recent clinical data report cardioprotective effects of some antidiabetic drugs independent of their hypoglycemic action. Here, we used a rat model receiving limited daily increase in calories from fat (HC diet) to assess whether mild metabolic challenge led to CAN in absence of interfering effects of hyperglycemia, glucose intolerance, or obesity. Rats receiving HC diet for 12 weeks showed reduction in baroreceptor sensitivity and heart rate variability despite lack of change in baseline hemodynamic and cardiovascular structural parameters. Impairment of cardiac autonomic control was accompanied with perivascular adipose inflammation observed as an increased inflammatory cytokine expression, together with increased cardiac oxidative stress, and signaling derangement characteristic of diabetic cardiomyopathy. Two-week treatment with metformin or pioglitazone rectified the autonomic derangement and corrected the molecular changes. Switching rats to normal chow but not to isocaloric amounts of HC for two weeks reversed CAN. As such, we conclude that adipose inflammation due to increased fat intake might underlie development of CAN and, hence, the beneficial effects of metformin and pioglitazone.
Collapse
|
24
|
Temporal stability and drivers of change in cardiac autonomic nervous system activity. Auton Neurosci 2017; 208:117-125. [PMID: 28774803 DOI: 10.1016/j.autneu.2017.07.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 07/21/2017] [Accepted: 07/24/2017] [Indexed: 11/21/2022]
Abstract
OBJECTIVES This study determined temporal stability of ambulatory measured cardiac autonomic activity for different time periods and investigated potential drivers of changes in this activity. METHODS Data was drawn from baseline (n=2379), 2-year (n=2245), and 6-year (n=1876) follow-up from the Netherlands Study of Depression and Anxiety. Cardiac autonomic activity was measured with heart rate (HR), respiratory sinus arrhythmia (RSA) and pre-ejection period (PEP). Autonomic temporal stability was determined across 2, 4, and 6year intervals. We subsequently examined the association between sociodemographics, lifestyle, mental health, cardiometabolic health, and the use of antidepressant and cardiac medication with change in cardiac autonomic activity. RESULTS Over 2years, stability was good for HR (ICC=0.703), excellent for RSA (ICC=0.792) and moderate for PEP (ICC=0.576). Stability decreased for a 4- (HR ICC=0.688, RSA ICC=0.652 and PEP ICC=0.387) and 6-year interval (HR ICC=0.633, RSA ICC=0.654 and PEP ICC=0.355). The most important determinants for increase in HR were (increase in) smoking, increase in body mass index (BMI) and (starting) the use of antidepressants. Beta-blocking/antiarrhythmic drug use led to a decrease in HR. Decrease in RSA was associated with age, smoking and (starting) antidepressant use. Decrease in PEP was associated with age and (increase in) BMI. CONCLUSIONS Cardiac autonomic measures were rather stable over 2years, but stability decreased with increasing time span. Determinants contributing to cardiac autonomic deterioration were older age, (increase in) smoking and BMI, and (starting) the use of antidepressants. (Starting) the use of cardiac medication improved autonomic function.
Collapse
|
25
|
Kim EY, Lee MY, Kim SH, Ha K, Kim KP, Ahn YM. Diagnosis of major depressive disorder by combining multimodal information from heart rate dynamics and serum proteomics using machine-learning algorithm. Prog Neuropsychopharmacol Biol Psychiatry 2017; 76:65-71. [PMID: 28223106 DOI: 10.1016/j.pnpbp.2017.02.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 02/02/2017] [Accepted: 02/16/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Major depressive disorder (MDD) is a systemic and multifactorial disorder that involves abnormalities in multiple biochemical pathways and the autonomic nervous system. This study applied a machine-learning method to classify MDD and control groups by incorporating data from serum proteomic analysis and heart rate variability (HRV) analysis for the identification of novel peripheral biomarkers. METHODS The study subjects consisted of 25 drug-free female MDD patients and 25 age- and sex-matched healthy controls. First, quantitative serum proteome profiles were analyzed by liquid chromatography-tandem mass spectrometry using pooled serum samples from 10 patients and 10 controls. Next, candidate proteins were quantified with multiple reaction monitoring (MRM) in 50 subjects. We also analyzed 22 linear and nonlinear HRV parameters in 50 subjects. Finally, we identified a combined biomarker panel consisting of proteins and HRV indexes using a support vector machine with recursive feature elimination. RESULTS A separation between MDD and control groups was achieved using five parameters (apolipoprotein B, group-specific component, ceruloplasmin, RMSSD, and SampEn) at 80.1% classification accuracy. A combination of HRV and proteomic data achieved better classification accuracy. CONCLUSIONS A high classification accuracy can be achieved by combining multimodal information from heart rate dynamics and serum proteomics in MDD. Our approach can be helpful for accurate clinical diagnosis of MDD. Further studies using larger, independent cohorts are needed to verify the role of these candidate biomarkers for MDD diagnosis.
Collapse
Affiliation(s)
- Eun Young Kim
- Department of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Min Young Lee
- Institute for Systems Biology, Seattle, WA, United States; Department of Applied Chemistry, College of Applied Science, Kyung Hee University, Yongin, Republic of Korea
| | - Se Hyun Kim
- Department of Neuropsychiatry, Dongguk University Medical School, Dongguk University International Hospital, Goyang, Republic of Korea
| | - Kyooseob Ha
- Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kwang Pyo Kim
- Department of Applied Chemistry, College of Applied Science, Kyung Hee University, Yongin, Republic of Korea
| | - Yong Min Ahn
- Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
| |
Collapse
|
26
|
Dimova R, Tankova T, Guergueltcheva V, Tournev I, Chakarova N, Grozeva G, Dakovska L. Risk factors for autonomic and somatic nerve dysfunction in different stages of glucose tolerance. J Diabetes Complications 2017; 31:537-543. [PMID: 27894750 DOI: 10.1016/j.jdiacomp.2016.11.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 10/26/2016] [Accepted: 11/02/2016] [Indexed: 12/30/2022]
Abstract
AIM The present study evaluates autonomic and somatic nerve function in different stages of glucose tolerance and its correlation with different cardio-metabolic parameters. MATERIAL AND METHODS Four hundred seventy-eight subjects, mean age 49.3±13.7years and mean BMI 31.0±6.2kg/m2, divided according to glucose tolerance: 130 with normal glucose tolerance (NGT), 227 with prediabetes (125 with impaired fasting glucose (IFG) and 102 with isolated impaired glucose tolerance (iIGT)), and 121 with newly-diagnosed T2D (NDT2D), were enrolled. Glucose tolerance was studied during OGTT. Antropometric indices, blood pressure, HbA1c, serum lipids, hsCRP and albumin-to-creatinine ratio were assessed. Body composition was estimated by a bioimpedance method (InBody 720, BioSpace). Tissue AGEs accumulation was assessed by skin autofluorescence (AGE-Reader-DiagnOpticsTM). Electroneurography was performed by electromyograph Dantec Keypoint. Cardiovascular autonomic neuropathy (CAN) was assessed by ANX-3.0 method applying standard clinical tests. RESULTS CAN was found in 12.3% of NGT, 19.8% of prediabetes (13.2% of IFG and 20.6% of iIGT), and 32.2% of NDT2D. The prevalence of diabetic sensory polyneuropathy (DSPN) was 5.7% in prediabetes and 28.6% in NDT2D. The panel of age, QTc interval, waist circumference, diastolic blood pressure, and 120-min plasma glucose was related to sympathetic activity (F [5451]=78.50, p<0.001). The panel of age, waist circumference, and QTc interval was related to parasympathetic power (F [3453]=132.26, p<0.001). HbA1c and age were related to sural SNAP (F [2454]=15.12, p<0.001). HbA1c and AGEs were related to sural SNCV (F [2454]=12.18, p<0.001). CONCLUSIONS Our results demonstrate a high prevalence of autonomic and sensory nerve dysfunction in early stages of glucose intolerance. Age, postprandial glycemia, central obesity, diastolic blood pressure and QTc interval outline as predictive markers of CAN; hyperglycemia, glycation and age of DSPN.
Collapse
Affiliation(s)
- Rumyana Dimova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University Sofia, Sofia, 1431, Bulgaria.
| | - Tsvetalina Tankova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University Sofia, Sofia, 1431, Bulgaria
| | | | - Ivailo Tournev
- Department of Neurology, Medical University Sofia, Sofia, 1431, Bulgaria
| | - Nevena Chakarova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University Sofia, Sofia, 1431, Bulgaria
| | - Greta Grozeva
- Department of Diabetology, Clinical Center of Endocrinology, Medical University Sofia, Sofia, 1431, Bulgaria
| | - Lilia Dakovska
- Department of Diabetology, Clinical Center of Endocrinology, Medical University Sofia, Sofia, 1431, Bulgaria
| |
Collapse
|
27
|
McKune AJ, Peters B, Ramklass SS, van Heerden J, Roberts C, Krejčí J, Botek M. Autonomic cardiac regulation, blood pressure and cardiorespiratory fitness responses to different training doses over a 12 week group program in the elderly. Arch Gerontol Geriatr 2017; 70:130-135. [PMID: 28131974 DOI: 10.1016/j.archger.2017.01.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 01/17/2017] [Accepted: 01/17/2017] [Indexed: 10/20/2022]
Abstract
AIM The study assessed the effects of different weekly training frequencies performed over a 12 week exercise programme (strength, endurance, balance) on autonomic cardiac activity, blood pressure and cardiorespiratory fitness (CRF) in elderly individuals. METHODS Fifty-eight individuals participated in the study: 2TG (N=24, 71.1±6.4 yrs; 19 females, 5 males) performing two, 60min sessions/week; and 3TG (N=34, 72.3±7.9 yrs; 25 females, 9 males) performing three, 60min sessions/week. Time domain and spectral analysis of heart rate variability (HRV) quantified autonomic cardiac regulation. RESULTS Natural logarithm (Ln) transformation was applied to all HRV parameters. There were significant reductions in total power (Ln TP) (p=0.006), low frequency (Ln LF) (p=0.013), high frequency (Ln HF) (p=0.013) and root mean square of successive differences (Ln rMSSD) (p=0.014) post training in 3TG after intervention. Diastolic BP (DBP) decreased significantly in both groups (2TG: P<0.001; 3TG: P<0.001). Both groups showed significant improvements in six-minute walk distance (2TG: P=0.003, 3TG: P=0.001). However, there were significant HRV differences between 2TG and 3TG for Ln TP (P=0.018), Ln LF (P=0.049), Ln HF (P=0.039) and Ln rMSSD (P=0.049). CONCLUSIONS A combined exercise programme resulted in improved DBP and CRF irrespective of training two or three 60min sessions/week. However, training three, sessions/week induced negative health-related changes in autonomic cardiac activity through reducing HRV parasympathetic function, while HRV was maintained in the group training twice a week.
Collapse
Affiliation(s)
- A J McKune
- Discipline of Biokinetics, Exercise and Leisure Sciences, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; Discipline of Sport and Exercise Science, UC-Research Institute for Sport and Exercise, Faculty of Health, University of Canberra, ACT, Australia.
| | - B Peters
- Discipline of Biokinetics, Exercise and Leisure Sciences, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - S S Ramklass
- School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - J van Heerden
- Discipline of Biokinetics, Exercise and Leisure Sciences, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - C Roberts
- Discipline of Biokinetics, Exercise and Leisure Sciences, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; AFC Bournemouth, Bournemouth, United Kingdom
| | - J Krejčí
- Faculty of Physical Culture, Palacký University, Olomouc, Czech Republic
| | - M Botek
- Faculty of Physical Culture, Palacký University, Olomouc, Czech Republic
| |
Collapse
|
28
|
Hu MX, Lamers F, de Geus EJC, Penninx BWJH. Influences of lifestyle factors on cardiac autonomic nervous system activity over time. Prev Med 2017; 94:12-19. [PMID: 27836526 DOI: 10.1016/j.ypmed.2016.11.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 09/08/2016] [Accepted: 11/06/2016] [Indexed: 11/29/2022]
Abstract
Physical activity, alcohol use and smoking might affect cardiovascular disease through modifying autonomic nervous system (ANS) activity. We investigated: 1) whether there are consistent relationships between lifestyle factors and cardiac ANS activity over time, and 2) whether 2-year changes in lifestyle factors relate to 2-year changes in cardiac activity. Baseline (n=2618) and 2-year follow-up (n=2010) data of the Netherlands Study of Depression and Anxiety was combined. Baseline data was collected in the Netherlands from 2004-2007. Lifestyle factors were habitual physical activity, frequency of sport activities, alcohol use, and smoking. Indicators of cardiac activity were heart rate (HR), respiratory sinus arrhythmia (RSA) and pre-ejection period (PEP) (100min of registration). The results showed that high physical activity (-1.8beats/min compared to low activity), high frequency of sport activities ('couple of times/week': -2.5beats/min compared to 'almost never') and mild/moderate alcohol use (-1.2beats/min compared to non-drinking) were related to low HR. Heavy smoking was related to high HR (>30cigarettes/day: +5.1beats/min compared to non-smoking). High frequency of sport activities was associated with high RSA ('couple of times/week':+1.7ms compared to 'almost never') and moderate smoking with longer PEP (11-20cigarettes/day: +2.8ms compared to non-smoking). Associations were consistent across waves. Furthermore, 2-year change in frequency of sport activities and number of smoked cigarettes/day was accompanied by 2-year change in HR (β=-0.076 and β=0.101, respectively) and RSA (β=0.046 and β=-0.040, respectively). Our findings support consistent effects of lifestyle on HR and parasympathetic activity in the expected direction. Cardiac autonomic dysregulation may be partly mediating the relationship between lifestyle and subsequent cardiovascular health.
Collapse
Affiliation(s)
- Mandy Xian Hu
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
| | - Femke Lamers
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - Eco J C de Geus
- Department of Biological Psychology and EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| |
Collapse
|
29
|
Hu MX, Lamers F, Hiles SA, Penninx BWJH, de Geus EJC. Basal autonomic activity, stress reactivity, and increases in metabolic syndrome components over time. Psychoneuroendocrinology 2016; 71:119-26. [PMID: 27262344 DOI: 10.1016/j.psyneuen.2016.05.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 04/29/2016] [Accepted: 05/18/2016] [Indexed: 12/31/2022]
Abstract
CONTEXT Basal autonomic nervous system (ANS) functioning has been linked to the metabolic syndrome (MetS), but the role of ANS reactivity in response to stress remains unclear. OBJECTIVE To examine cross-sectionally and longitudinally to what extent ANS basal level and stress reactivity are related to MetS. DESIGN 2-year and 6-year data from a prospective cohort: the Netherlands Study of Depression and Anxiety. SETTING Participants were recruited from the general community, primary care, and mental health care organizations. PARTICIPANTS 1922 respondents (mean age=43.7years). MAIN OUTCOME MEASURES Indicators of ANS functioning were heart rate (HR), respiratory sinus arrhythmia (RSA) and pre-ejection period (PEP). ANS stress reactivity was measured during a cognitively challenging stressor and a personal-emotional stressor. MetS components included triglycerides, high-density lipoprotein cholesterol, blood pressure, glucose and waist circumference. RESULTS Cross-sectional analyses indicated that higher basal HR, lower basal values of RSA and PEP, and higher RSA reactivity during cognitive challenge were related to less favorable values of almost all individual MetS components. Longitudinal analyses showed that higher basal HR and shorter basal PEP predicted 4-year increase in many MetS abnormalities. Higher RSA stress reactivity during cognitive challenge predicted 4-year increase in number of MetS components. CONCLUSION Higher basal sympathetic, lower basal parasympathetic activity, and increased parasympathetic withdrawal during stress are associated with multiple MetS components, and higher basal sympathetic activity predicts an increase in metabolic abnormalities over time. These findings support a role for ANS dysregulation in the risk for MetS and, consequently, the development of cardiovascular disease.
Collapse
Affiliation(s)
- Mandy X Hu
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Centre, AJ Ernststraat 1187, 1081 HL Amsterdam, The Netherlands.
| | - Femke Lamers
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Centre, AJ Ernststraat 1187, 1081 HL Amsterdam, The Netherlands
| | - Sarah A Hiles
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Centre, AJ Ernststraat 1187, 1081 HL Amsterdam, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Centre, AJ Ernststraat 1187, 1081 HL Amsterdam, The Netherlands
| | - Eco J C de Geus
- Department of Biological Psychology and EMGO Institute for Health and Care Research, VU University, van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands
| |
Collapse
|
30
|
Stuckey MI, Kiviniemi A, Gill DP, Shoemaker JK, Petrella RJ. Associations between heart rate variability, metabolic syndrome risk factors, and insulin resistance. Appl Physiol Nutr Metab 2016; 40:734-40. [PMID: 26140416 DOI: 10.1139/apnm-2014-0528] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The purpose of this study was to examine differences in heart rate variability (HRV) in metabolic syndrome (MetS) and to determine associations between HRV parameters, MetS risk factors, and insulin resistance (homeostasis model assessment for insulin resistance (HOMA-IR)). Participants (n = 220; aged 23-70 years) were assessed for MetS risk factors (waist circumference, blood pressure, fasting plasma glucose, triglycerides, and high-density lipoprotein cholesterol) and 5-min supine HRV (time and frequency domain and nonlinear). HRV was compared between those with 3 or more (MetS+) and those with 2 or fewer MetS risk factors (MetS-). Multiple linear regression models were built for each HRV parameter to investigate associations with MetS risk factors and HOMA-IR. Data with normal distribution are presented as means ± SD and those without as median [interquartile range]. In women, standard deviation of R-R intervals 38.0 [27.0] ms, 44.5 [29.3] ms; p = 0.020), low-frequency power (5.73 ± 1.06 ln ms(2), 6.13 ± 1.05 ln ms(2); p = 0.022), and the standard deviation of the length of the Poincaré plot (46.8 [31.6] ms, 58.4 [29.9] ms; p = 0.014) were lower and heart rate was higher (68 [13] beats/min, 64 [12] beats/min; p = 0. 018) in MetS+ compared with MetS-, with no differences in men. Waist circumference was most commonly associated with HRV, especially frequency domain parameters. HOMA-IR was associated with heart rate. In conclusion, MetS+ women had a less favourable HRV profile than MetS- women, but there were no differences in men. HOMA-IR was associated with heart rate, not HRV.
Collapse
Affiliation(s)
- Melanie I Stuckey
- a Lawson Health Research Institute, Aging Rehabilitation and Geriatric Care Research Centre, 801 Commissioners Road East, London, ON N6C 5J1, Canada.,b School of Kinesiology, University of Western Ontario, London, ON, Canada
| | - Antti Kiviniemi
- c Verve Research, Department of Exercise and Medical Physiology, Kasarmintie 13, PO Box 404, FI-90101 Oulu, Finland
| | - Dawn P Gill
- a Lawson Health Research Institute, Aging Rehabilitation and Geriatric Care Research Centre, 801 Commissioners Road East, London, ON N6C 5J1, Canada.,d Faculty of Health Sciences, Western Centre for Public Health and Family Medicine, University of Western Ontario, London, ON N6A 3K7, Canada.,e School of Public Health, University of Washington, Seattle, WA 98195, USA
| | - J Kevin Shoemaker
- g School of Kinesiology, University of Western Ontario, London, ON N6A 3K7, Canada
| | - Robert J Petrella
- a Lawson Health Research Institute, Aging Rehabilitation and Geriatric Care Research Centre, 801 Commissioners Road East, London, ON N6C 5J1, Canada.,b School of Kinesiology, University of Western Ontario, London, ON, Canada.,f Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON N6A 5B9, Canada
| |
Collapse
|
31
|
Quintana DS, Alvares GA, Heathers JAJ. Guidelines for Reporting Articles on Psychiatry and Heart rate variability (GRAPH): recommendations to advance research communication. Transl Psychiatry 2016; 6:e803. [PMID: 27163204 PMCID: PMC5070064 DOI: 10.1038/tp.2016.73] [Citation(s) in RCA: 222] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 03/18/2016] [Accepted: 03/23/2016] [Indexed: 12/11/2022] Open
Abstract
The number of publications investigating heart rate variability (HRV) in psychiatry and the behavioral sciences has increased markedly in the last decade. In addition to the significant debates surrounding ideal methods to collect and interpret measures of HRV, standardized reporting of methodology in this field is lacking. Commonly cited recommendations were designed well before recent calls to improve research communication and reproducibility across disciplines. In an effort to standardize reporting, we propose the Guidelines for Reporting Articles on Psychiatry and Heart rate variability (GRAPH), a checklist with four domains: participant selection, interbeat interval collection, data preparation and HRV calculation. This paper provides an overview of these four domains and why their standardized reporting is necessary to suitably evaluate HRV research in psychiatry and related disciplines. Adherence to these communication guidelines will help expedite the translation of HRV research into a potential psychiatric biomarker by improving interpretation, reproducibility and future meta-analyses.
Collapse
Affiliation(s)
- D S Quintana
- Division of Mental Health and Addiction, NORMENT, KG Jebsen Centre for Psychosis Research, University of Oslo, Oslo University Hospital, Oslo, Norway,Division of Mental Health and Addiction, NORMENT, KG Jebsen Centre for Psychosis Research, University of Oslo, Oslo University Hospital, Building 49, Oslo University Hospital, Ullevål, Kirkeveien 166, PO Box 4956, Nydalen, Oslo N-0424, Norway. E-mail:
| | - G A Alvares
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia,Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, QLD, Australia
| | - J A J Heathers
- School of Psychology, University of Sydney, Sydney, NSW, Australia,Department of Cardiology and Intensive Therapy, Poznań University of Medical Sciences, Poznań, Poland
| |
Collapse
|
32
|
Meyer ML, Gotman NM, Soliman EZ, Whitsel EA, Arens R, Cai J, Daviglus ML, Denes P, González HM, Moreiras J, Talavera GA, Heiss G. Association of glucose homeostasis measures with heart rate variability among Hispanic/Latino adults without diabetes: the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Cardiovasc Diabetol 2016; 15:45. [PMID: 26983644 PMCID: PMC4793505 DOI: 10.1186/s12933-016-0364-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 03/09/2016] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Reduced heart rate variability (HRV), a measure of cardiac autonomic function, is associated with an increased risk of cardiovascular disease (CVD) and mortality. Glucose homeostasis measures are associated with reduced cardiac autonomic function among those with diabetes, but inconsistent associations have been reported among those without diabetes. This study aimed to examine the association of glucose homeostasis measures with cardiac autonomic function among diverse Hispanic/Latino adults without diabetes. METHODS The Hispanic community Health Study/Study of Latinos (HCHS/SOL; 2008-2011) used two-stage area probability sampling of households to enroll 16,415 self-identified Hispanics/Latinos aged 18-74 years from four USA communities. Resting, standard 12-lead electrocardiogram recordings were used to estimate the following ultrashort-term measures of HRV: RR interval (RR), standard deviation of all normal to normal RR (SDNN) and root mean square of successive differences in RR intervals (RMSSD). Multivariable regression analysis was used to estimate associations between glucose homeostasis measures with HRV using data from 11,994 adults without diabetes (mean age 39 years; 52 % women). RESULTS Higher fasting glucose was associated with lower RR, SDNN, and RMSSD. Fasting insulin and the homeostasis model assessment of insulin resistance was negatively associated with RR, SDNN, and RMSSD, and the association was stronger among men compared with women. RMSSD was, on average, 26 % lower in men with higher fasting insulin and 29 % lower in men with lower insulin resistance; for women, the corresponding estimates were smaller at 4 and 9 %, respectively. Higher glycated hemoglobin was associated with lower RR, SDNN, and RMSSD in those with abdominal adiposity, defined by sex-specific cut-points for waist circumference, after adjusting for demographics and medication use. There were no associations between glycated hemoglobin and HRV measures among those without abdominal adiposity. CONCLUSIONS Impairment in glucose homeostasis was associated with lower HRV in Hispanic/Latino adults without diabetes, most prominently in men and individuals with abdominal adiposity. These results suggest that reduced cardiac autonomic function is associated with metabolic impairments before onset of overt diabetes in certain subgroups, offering clues for the pathophysiologic processes involved as well as opportunity for identification of those at high risk before autonomic control is manifestly impaired.
Collapse
Affiliation(s)
- Michelle L. Meyer
- />University of North Carolina at Chapel Hill, 137 E. Franklin St, Suite 306, Chapel Hill, NC 27514 USA
| | - Nathan M. Gotman
- />University of North Carolina at Chapel Hill, 137 E. Franklin St, Suite 306, Chapel Hill, NC 27514 USA
| | | | - Eric A. Whitsel
- />University of North Carolina at Chapel Hill, 137 E. Franklin St, Suite 306, Chapel Hill, NC 27514 USA
| | - Raanan Arens
- />Division of Respiratory and Sleep Medicine, The Children’s Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY USA
| | - Jianwen Cai
- />University of North Carolina at Chapel Hill, 137 E. Franklin St, Suite 306, Chapel Hill, NC 27514 USA
| | - Martha L. Daviglus
- />University of Illinois at Chicago College of Medicine, Chicago, IL USA
| | | | | | | | | | - Gerardo Heiss
- />University of North Carolina at Chapel Hill, 137 E. Franklin St, Suite 306, Chapel Hill, NC 27514 USA
| |
Collapse
|
33
|
Chang YM, Shiao CC, Huang YT, Chen IL, Yang CL, Leu SC, Su HL, Kao JL, Tsai SC, Jhen RN, Uen CC. Impact of metabolic syndrome and its components on heart rate variability during hemodialysis: a cross-sectional study. Cardiovasc Diabetol 2016; 15:16. [PMID: 26817599 PMCID: PMC4729144 DOI: 10.1186/s12933-016-0328-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 01/04/2016] [Indexed: 12/02/2022] Open
Abstract
Background Both uremia and metabolic syndrome (MetS) affect heart rate variability (HRV) which is a risk factor of poor prognoses. The aim of this study was to evaluate the impact of MetS on HRV among chronic hemodialysis patients. Methods This cross-sectional study was carried out in a teaching hospital in Northern Taiwan from June to August, 2010. Adult patients on chronic hemodialysis without active medical conditions were enrolled. HRV were measured for 4 times on the index hemodialysis day (HRV-0, -1, -2, and -3 at before, initial, middle, and late phases of hemodialysis, respectively), and the baseline demographic data and clinical parameters during the hemodialysis session were documented. Then we evaluated the impacts of MetS and its five components on HRV. Results One hundred and seventy-five patients (100 women, mean age 65.1 ± 12.9 years) were enrolled and included those with MetS (n = 91, 52 %) and without MetS (n = 84, 48 %). The patients with MetS(+) had significantly lower very low frequency, total power, and variance in HRV-0, total power and variance in HRV-2, and variance in HRV-3. (all p ≦ 0.05) When using the individual components of MetS to evaluate the impacts on HRV indices, the fasting plasma glucose (FPG) criterion significantly affected most indices of HRV while other four components including “waist circumference”, “triglycerides”, “blood pressure”, and “high-density lipoprotein” criteria exhibited little impacts on HRV. FPG criterion carried the most powerful influence on cardiac ANS, which was even higher than that of MetS. The HRV of patients with FPG(+) increased initially during the hemodialysis, but turned to decrease dramatically at the late phase of hemodialysis. Conclusions The impact of FPG(+) outstood the influence of uremic autonomic dysfunction, and FPG criterion was the most important one among all the components of MetS to influence HRV. These results underscored the importance of interpretation and management for abnormal glucose metabolism.
Collapse
Affiliation(s)
- Yu-Ming Chang
- Division of Nephrology, Department of Internal Medicine, Saint Mary's Hospital Luodong, No. 160 Chong-Cheng South Road, Loudong, 265, Yilan, Taiwan, ROC
| | - Chih-Chung Shiao
- Division of Nephrology, Department of Internal Medicine, Saint Mary's Hospital Luodong, No. 160 Chong-Cheng South Road, Loudong, 265, Yilan, Taiwan, ROC. .,Saint Mary's Medicine, Nursing and Management College, No. 100, Ln. 265, Sec. 2, Sanxing Rd., Sanxing Township, Yilan County, 266, Taiwan, ROC.
| | - Ya-Ting Huang
- Department of Nursing, Saint Mary's Hospital Luodong, No. 160 Chong-Cheng South Road, Loudong, 265, Yilan, Taiwan, ROC.,Graduate Institute of Clinical Medical Sciences, Chang Gung University, No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan, 33302, Taiwan, ROC
| | - I-Ling Chen
- Department of Nursing, Saint Mary's Hospital Luodong, No. 160 Chong-Cheng South Road, Loudong, 265, Yilan, Taiwan, ROC
| | - Chuan-Lan Yang
- Department of Nursing, Saint Mary's Hospital Luodong, No. 160 Chong-Cheng South Road, Loudong, 265, Yilan, Taiwan, ROC
| | - Show-Chin Leu
- Department of Nursing, Saint Mary's Hospital Luodong, No. 160 Chong-Cheng South Road, Loudong, 265, Yilan, Taiwan, ROC
| | - Hung-Li Su
- Department of Nursing, Saint Mary's Hospital Luodong, No. 160 Chong-Cheng South Road, Loudong, 265, Yilan, Taiwan, ROC
| | - Jsun-Liang Kao
- Division of Nephrology, Department of Internal Medicine, Saint Mary's Hospital Luodong, No. 160 Chong-Cheng South Road, Loudong, 265, Yilan, Taiwan, ROC
| | - Shih-Ching Tsai
- Division of Nephrology, Department of Internal Medicine, Saint Mary's Hospital Luodong, No. 160 Chong-Cheng South Road, Loudong, 265, Yilan, Taiwan, ROC
| | - Rong-Na Jhen
- Division of Nephrology, Department of Internal Medicine, Saint Mary's Hospital Luodong, No. 160 Chong-Cheng South Road, Loudong, 265, Yilan, Taiwan, ROC
| | - Ching-Cherng Uen
- Division of Neurology, Department of Internal Medicine, Saint Mary's Hospital Luodong, No. 160 Chong-Cheng South Road, Loudong, 265, Yilan, Taiwan, ROC
| | | |
Collapse
|
34
|
Kubičková A, Kozumplík J, Nováková Z, Plachý M, Jurák P, Lipoldová J. Heart rate variability analysed by Poincaré plot in patients with metabolic syndrome. J Electrocardiol 2016; 49:23-8. [DOI: 10.1016/j.jelectrocard.2015.11.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Indexed: 11/28/2022]
|
35
|
Vrijkotte TGM, van den Born BJH, Hoekstra CMCA, Gademan MGJ, van Eijsden M, de Rooij SR, Twickler MTB. Cardiac Autonomic Nervous System Activation and Metabolic Profile in Young Children: The ABCD Study. PLoS One 2015; 10:e0138302. [PMID: 26394362 PMCID: PMC4579089 DOI: 10.1371/journal.pone.0138302] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Accepted: 08/28/2015] [Indexed: 12/25/2022] Open
Abstract
Background In adults, increased sympathetic and decreased parasympathetic nervous system activity are associated with a less favorable metabolic profile. Whether this is already determined at early age is unknown. Therefore, we aimed to assess the association between autonomic nervous system activation and metabolic profile and its components in children at age of 5–6 years. Methods Cross-sectional data from an apparently healthy population (within the ABCD study) were collected at age 5–6 years in 1540 children. Heart rate (HR), respiratory sinus arrhythmia (RSA; parasympathetic activity) and pre-ejection period (PEP; sympathetic activity) were assessed during rest. Metabolic components were waist-height ratio (WHtR), systolic blood pressure (SBP), fasting triglycerides, glucose and HDL-cholesterol. Individual components, as well as a cumulative metabolic score, were analyzed. Results In analysis adjusted for child’s physical activity, sleep, anxiety score and other potential confounders, increased HR and decreased RSA were associated with higher WHtR (P< 0.01), higher SBP (p<0.001) and a higher cumulative metabolic score (HR: p < 0.001; RSA: p < 0.01). Lower PEP was only associated with higher SBP (p <0.05). Of all children, 5.6% had 3 or more (out of 5) adverse metabolic components; only higher HR was associated with this risk (per 10 bpm increase: OR = 1.56; p < 0.001). Conclusions This study shows that decreased parasympathetic activity is associated with central adiposity and higher SBP, indicative of increased metabolic risk, already at age 5–6 years.
Collapse
Affiliation(s)
- Tanja G. M. Vrijkotte
- Department of Public Health, Academic Medical Center—University of Amsterdam, Amsterdam, the Netherlands
- * E-mail:
| | - Bert-Jan H. van den Born
- Department of Vascular Medicine, Academic Medical Center—University of Amsterdam, Amsterdam, the Netherlands
| | | | - Maaike G. J. Gademan
- Department of Public Health, Academic Medical Center—University of Amsterdam, Amsterdam, the Netherlands
| | - Manon van Eijsden
- Department of Epidemiology and Health Promotion, Public Health Service of Amsterdam (GGD), Amsterdam, the Netherlands
| | - Susanne R. de Rooij
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, Amsterdam, the Netherlands
| | - Marcel T. B. Twickler
- Department of Endocrinology, Diabetology and Metabolic Diseases, Antwerp University Hospital, Antwerp, Belgium
| |
Collapse
|
36
|
Dimova R, Tankova T, Chakarova N, Groseva G, Dakovska L. Cardiovascular autonomic tone relation to metabolic parameters and hsCRP in normoglycemia and prediabetes. Diabetes Res Clin Pract 2015; 109:262-70. [PMID: 26036955 DOI: 10.1016/j.diabres.2015.05.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 04/05/2015] [Accepted: 05/06/2015] [Indexed: 01/02/2023]
Abstract
AIMS The aim of the study was to evaluate cardiovascular autonomic function (CAF) at different stages of obesity and in the presence of metabolic syndrome (MetS), and its association with metabolic parameters and hsCRP in subjects with normal glucose tolerance (NGT) and prediabetes. METHODS A total of 259 subjects (mean age 47.1 ± 14.6 years, mean BMI 31.4 ± 8.1 kg/m(2)), divided in 2 groups: NGT and prediabetes, and subdivided according to glucose tolerance, BMI and MetS, were enrolled. Anthropometric indices, glucose tolerance, blood pressure, serum lipids and hsCRP were measured. Body composition was estimated by impedance analysis. CAF was assessed by ANX-3.0 method. RESULTS Sympathetic and parasympathetic activity were decreased in severe obesity and MetS as compared to controls in NGT. Negative correlation was observed between sympathetic and parasympathetic tone and BMI, waist circumference, total body fat, visceral fat area (VFA), blood pressure, total and LDL cholesterol, and hsCRP in NGT; and VFA, HbA1c and glycemia in prediabetes. CONCLUSION Obesity and MetS seem to be associated with CAF deterioration, and metabolic parameters and hsCRP correlate with CAF and probably increase cardiovascular risk in NGT, whilst VFA, HbA1c and glycemia significantly influence CAF alterations in prediabetes.
Collapse
Affiliation(s)
- Rumyana Dimova
- Department of Diabetology, Clinical Centre of Endocrinology, Medical University, 2, Zdrave str., Sofia 1431, Bulgaria.
| | - Tsvetalina Tankova
- Department of Diabetology, Clinical Centre of Endocrinology, Medical University, 2, Zdrave str., Sofia 1431, Bulgaria
| | - Nevena Chakarova
- Department of Diabetology, Clinical Centre of Endocrinology, Medical University, 2, Zdrave str., Sofia 1431, Bulgaria
| | - Greta Groseva
- Department of Diabetology, Clinical Centre of Endocrinology, Medical University, 2, Zdrave str., Sofia 1431, Bulgaria
| | - Lilia Dakovska
- Department of Diabetology, Clinical Centre of Endocrinology, Medical University, 2, Zdrave str., Sofia 1431, Bulgaria
| |
Collapse
|
37
|
[Relationship between blood pressure, heart rate and cardiac autonomic dysfunction in non-diabetic obese patients]. Ann Cardiol Angeiol (Paris) 2015; 64:139-44. [PMID: 26047878 DOI: 10.1016/j.ancard.2015.04.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 04/28/2015] [Indexed: 11/23/2022]
Abstract
RATIONALE Some studies suggest that a high heart rate (HR) would be predictive of the incidence of an elevated blood pressure (BP). Cardiac autonomic dysfunction (CAD) affects a high proportion of obese patients. CAD could be involved in BP increase. Our aim was to examine the relationship between CAD, HR and BP in obese patients without known diabetes. PATIENTS AND METHODS We included 428 overweight or obese patients. CAD was assessed by analyzing HR variations during three standard tests (Valsalva, deep breathing, lying-to-standing), which are mostly dependent on vagal control. An oral load in glucose was performed and the Matsuda index was calculated. RESULTS The population was separated in 4 groups according to the grade of CAD (no or only one abnormal test, 2 or 3 abnormal tests) and HR (< or ≥ 75 bpm). Age was similar in the four groups. Systolic (P=0.05), diastolic (P<0.005) and mean BP (P<0.001) differed significantly between the 4 groups, and was the highest in the group of patients who had 2 or 3 abnormal tests and HR ≥ 75 bpm. Matsuda index differed across the groups (P=0.018) and was the lowest in this group. CONCLUSION These data indicate that among overweight or obese patients with a defect in cardiac vagal activity BP is elevated only in those with a high heart rate, which is indicative of a more marked insulin resistance and probably an excess in sympathetic activity.
Collapse
|
38
|
Rodríguez-Colón SM, He F, Bixler EO, Fernandez-Mendoza J, Vgontzas AN, Calhoun S, Zheng ZJ, Liao D. Metabolic syndrome burden in apparently healthy adolescents is adversely associated with cardiac autonomic modulation--Penn State Children Cohort. Metabolism 2015; 64:626-32. [PMID: 25684658 PMCID: PMC4372460 DOI: 10.1016/j.metabol.2015.01.018] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 01/22/2015] [Accepted: 01/28/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Reduced cardiac autonomic modulation (CAM) has been associated with metabolic syndrome (MetS) in adults. However, the association between MetS component cluster and CAM has not been examined in adolescents. METHODS We conducted a cross-sectional analysis using data from the Penn State Child Cohort follow-up examination. CAM was assessed by heart rate variability (HRV) analysis of 39-h RR intervals, including frequency (high frequency, HF; low frequency, LF; and LF/HF ratio) and time (SDNN, standard deviation of all RR intervals; RMSSD, square root of the mean of the sum of the squares of differences between adjacent RR intervals; and HR, heart rate) domain variables. To assess the MetS burden, we used continuous MetS score (cMetS)--sum of the age and sex-adjusted standardized residual (Z-score) of five established MetS components. Linear mixed-effect models were used to analyze the association between cMetS and CAM in the entire population and stratified by gender. RESULTS After adjusting for age, sex, and race, cMetS was significantly associated with reduced HRV and higher HR. With 1 standard deviation increase in cMetS, there was a significant decrease in HF (-0.10 (SE = 0.02)), LF (-0.07 (SE = 0.01)), SDNN (-1.97 (SE = 0.50)), and RMSSD (-1.70 (SE = 0.72)), and increase in LF/HF (0.08 (SE = 0.02)) and HR (1.40 (SE = 0.26)). All cMetS components, with the exception of high-density lipoprotein (HDL), were associated with significantly decreased HRV and increased HR. High blood pressure (MAP) and triglyceride (TG) levels were also associated with an increase in LF/HF and decrease in RMSSD. An increase in high-density lipoprotein was only associated with higher LF and SDNN. Moreover, cMetS and HRV associations were more pronounced in males than in females. The associations between HRV and. MAP, TG, and HDL were more pronounced in females. CONCLUSIONS cMetS score is associated with lower HRV, suggesting an adverse impact on CAM, even in apparently healthy adolescents.
Collapse
Affiliation(s)
- Sol M Rodríguez-Colón
- Department of Public Health Sciences Penn State University College of Medicine, Hershey, PA, 17033.
| | - Fan He
- Department of Public Health Sciences Penn State University College of Medicine, Hershey, PA, 17033.
| | - Edward O Bixler
- Sleep Research &Treatment Center, Department of Psychiatry, Penn State University College of Medicine, Hershey, PA, 17033.
| | - Julio Fernandez-Mendoza
- Sleep Research &Treatment Center, Department of Psychiatry, Penn State University College of Medicine, Hershey, PA, 17033.
| | - Alexandros N Vgontzas
- Sleep Research &Treatment Center, Department of Psychiatry, Penn State University College of Medicine, Hershey, PA, 17033.
| | - Susan Calhoun
- Sleep Research &Treatment Center, Department of Psychiatry, Penn State University College of Medicine, Hershey, PA, 17033.
| | - Zhi-Jie Zheng
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China.
| | - Duanping Liao
- Department of Public Health Sciences Penn State University College of Medicine, Hershey, PA, 17033.
| |
Collapse
|
39
|
Stuckey MI, Tulppo MP, Kiviniemi AM, Petrella RJ. Heart rate variability and the metabolic syndrome: a systematic review of the literature. Diabetes Metab Res Rev 2014; 30:784-93. [PMID: 24816921 DOI: 10.1002/dmrr.2555] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Revised: 04/02/2014] [Accepted: 04/18/2014] [Indexed: 11/09/2022]
Abstract
BACKGROUND A number of cross-sectional studies have examined associations between heart rate variability and metabolic syndrome, but differences in study populations, data collection and analysis methodologies make synthesis difficult. The purpose of this study was to systematically review published primary research examining associations between heart rate variability and metabolic syndrome or its individual risk factors. METHODS A systematic literature search of PubMed and EMBASE was conducted to identify relevant articles published from January 1999 to December 2012. Studies were included if they examined associations between heart rate variability analysed by standard protocols and metabolic syndrome risk factors according to published definitions. All papers were scored with a modified Downs and Black instrument, and data were extracted. RESULTS Fourteen studies were included. Heart rate variability generally was reduced in women with metabolic syndrome compared to those without, while results in men were inconsistent. Time and frequency domain heart rate variability parameters were associated with individual metabolic syndrome risk factors, though sex differences exist. Only two studies considered nonlinear and Poincaré plot heart rate variability parameters, which were reduced in metabolic syndrome. CONCLUSIONS Heart rate variability is altered differently in men and women with metabolic syndrome. Future studies should follow consistent heart rate variability analysis protocols and metabolic syndrome definitions and include more comprehensive analyses to investigate potential mechanisms.
Collapse
Affiliation(s)
- Melanie I Stuckey
- School of Kinesiology, The University of Western Ontario, London, ON, Canada; Aging, Rehabilitation and Geriatric Care Research Centre, Lawson Health Research Institute, London, ON, Canada
| | | | | | | |
Collapse
|
40
|
Cipryan L, Litschmannova M. Intra-session stability of short-term heart rate variability measurement: gender and total spectral power influence. JOURNAL OF HUMAN SPORT AND EXERCISE 2014. [DOI: 10.4100/jhse.2014.91.08] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
|
41
|
Huang F, Dong J, Kong J, Wang H, Meng H, Spaeth RB, Camhi S, Liao X, Li X, Zhai X, Li S, Zhu B, Rong P. Effect of transcutaneous auricular vagus nerve stimulation on impaired glucose tolerance: a pilot randomized study. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 14:203. [PMID: 24968966 PMCID: PMC4227038 DOI: 10.1186/1472-6882-14-203] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Accepted: 05/22/2014] [Indexed: 11/24/2022]
Abstract
Background Impaired glucose tolerance (IGT) is a pre-diabetic state of hyperglycemia that is associated with insulin resistance, increased risk of type II diabetes, and cardiovascular pathology. Recently, investigators hypothesized that decreased vagus nerve activity may be the underlying mechanism of metabolic syndrome including obesity, elevated glucose levels, and high blood pressure. Methods In this pilot randomized clinical trial, we compared the efficacy of transcutaneous auricular vagus nerve stimulation (taVNS) and sham taVNS on patients with IGT. 72 participants with IGT were single-blinded and were randomly allocated by computer-generated envelope to either taVNS or sham taVNS treatment groups. In addition, 30 IGT adults were recruited as a control population and not assigned treatment so as to monitor the natural fluctuation of glucose tolerance in IGT patients. All treatments were self-administered by the patients at home after training at the hospital. Patients were instructed to fill in a patient diary booklet each day to describe any side effects after each treatment. The treatment period was 12 weeks in duration. Baseline comparison between treatment and control group showed no difference in weight, BMI, or measures of systolic blood pressure, diastolic blood pressure, fasting plasma glucose (FPG), 2-hour plasma glucose (2hPG), or glycosylated hemoglobin (HbAlc). Results 100 participants completed the study and were included in data analysis. Two female patients (one in the taVNS group, one in the sham taVNS group) dropped out of the study due to stimulation-evoked dizziness. The symptoms were relieved after stopping treatment. Compared with sham taVNS, taVNS significantly reduced the two-hour glucose tolerance (F(2) = 5.79, p = 0.004). In addition, we found that taVNS significantly decreased (F(1) = 4.21, p = 0.044) systolic blood pressure over time compared with sham taVNS. Compared with the no-treatment control group, patients receiving taVNS significantly differed in measures of FPG (F(2) = 10.62, p < 0.001), 2hPG F(2) = 25.18, p < 0.001) and HbAlc (F(1) = 12.79, p = 0.001) over the course of the 12 week treatment period. Conclusions Our study suggests that taVNS is a promising, simple, and cost-effective treatment for IGT/ pre-diabetes with only slight risk of mild side-effects.
Collapse
|
42
|
Chung MS, Yang AC, Lin YC, Lin CN, Chang FR, Shen SH, Ouyang WC, Loh EW, Chiu HJ. Association of altered cardiac autonomic function with psychopathology and metabolic profiles in schizophrenia. Psychiatry Res 2013; 210:710-5. [PMID: 23978730 DOI: 10.1016/j.psychres.2013.07.034] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Revised: 07/23/2013] [Accepted: 07/27/2013] [Indexed: 12/29/2022]
Abstract
Schizophrenia has been associated with autonomic dysregulation and increased cardiovascular co-morbidity. We hypothesised that autonomic dysregulation in patients with schizophrenia is associated with psychopathology and metabolic profiles. In this study, we aimed to evaluate psychopathology, comprehensive metabolic profiles and cardiac autonomic function using heart-rate variability (HRV) analysis in patients with schizophrenia. A total of 94 patients with schizophrenia and 51 healthy controls were recruited. Each patient underwent a physical examination, laboratory tests and rating scale evaluation, and all subjects underwent a 1-h electrocardiogram monitoring. Analysis of variance was used to compare demographic and HRV variables between control and patient groups. We applied multiple regression analysis with backward selection to examine the association between HRV indices and demographic, metabolic and psychopathology profiles. A decreased HRV was found in patient groups, compared to controls. Reduced vagal-related and complexity domain of HRV indices in patient groups were correlated with increased body mass indices, diastolic pressure, triglycerides, high- and low-density lipoprotein and severity of psychosis mainly in the negative symptom domain. This study provides evidence that altered autonomic function is associated with both psychopathology and metabolic profiles in patients with schizophrenia. These findings may warrant future research in using HRV as objective markers to monitor cardiovascular health and the severity of psychosis in patients with schizophrenia.
Collapse
|
43
|
Seppälä S, Laitinen T, Tarvainen MP, Tompuri T, Veijalainen A, Savonen K, Lakka T. Normal values for heart rate variability parameters in children 6-8 years of age: the PANIC Study. Clin Physiol Funct Imaging 2013; 34:290-6. [PMID: 24666688 DOI: 10.1111/cpf.12096] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Accepted: 10/06/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Measurement of heart rate variability (HRV) is a useful method for examining cardiac autonomic control. HRV has been measured in many studies among adults, but research on this topic among children is limited. We therefore defined reference values for a large number of HRV parameters among children. METHODS The subjects were a population sample of 465 mainly prepubertal children 6-8 years of age. Electrocardiogram (ECG) was recorded at rest, and 1- and 5-min ECG samples were selected for HRV analyses. HRV data were analysed in boys and girls separately to study possible gender differences in HRV parameters. Pearson's coefficients for correlation of age, maturity stage, height, weight and body mass index - standard deviation score (BMI-SDS) with HRV parameters were computed to study whether these factors confounded the definition of the reference values for HRV parameters. RESULTS We found no statistically significant differences in HRV parameters between genders. Therefore, we defined the reference values for all HRV parameters as 5th, 25th, 50th, 75th and 95th percentiles from the ECG samples in all children, but not in boys and girls separately. Age, maturity stage, height, weight and BMI-SDS had weak, if any, associations with HRV parameters, suggesting that they did not confound the definition of the reference values. CONCLUSION Same reference values for HRV parameters can be used in boys and girls. Although 5-min ECG recordings are preferable for measuring HRV, also 1-min recordings provide reliable data on most HRV parameters, especially those that mainly describe cardiac parasympathetic regulation.
Collapse
Affiliation(s)
- Santeri Seppälä
- Department of Physiology, Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
| | | | | | | | | | | | | |
Collapse
|
44
|
Seppälä I, Kleber ME, Lyytikäinen LP, Hernesniemi JA, Mäkelä KM, Oksala N, Laaksonen R, Pilz S, Tomaschitz A, Silbernagel G, Boehm BO, Grammer TB, Koskinen T, Juonala M, Hutri-Kähönen N, Alfthan G, Viikari JSA, Kähonen M, Raitakari OT, März W, Meinitzer A, Lehtimäki T. Genome-wide association study on dimethylarginines reveals novel AGXT2 variants associated with heart rate variability but not with overall mortality. Eur Heart J 2013; 35:524-31. [PMID: 24159190 DOI: 10.1093/eurheartj/eht447] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIMS The purpose of this study was to identify novel genetic variants influencing circulating asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) levels and to evaluate whether they have a prognostic value on cardiovascular mortality. METHODS AND RESULTS We conducted a genome-wide association study on the methylarginine traits and investigated the predictive value of the new discovered variants on mortality. Our meta-analyses replicated the previously known locus for ADMA levels in DDAH1 (rs997251; P = 1.4 × 10(-40)), identified two non-synomyous polymorphisms for SDMA levels in AGXT2 (rs37369; P = 1.4 × 10(-40) and rs16899974; P = 1.5 × 10(-38)) and one in SLC25A45 (rs34400381; P = 2.5 × 10(-10)). We also fine-mapped the AGXT2 locus for further independent association signals. The two non-synonymous AGXT2 variants independently associated with SDMA levels were also significantly related with short-term heart rate variability (HRV) indices in young adults. The major allele (C) of the novel non-synonymous rs16899974 (V498L) variant associated with decreased SDMA levels and an increase in the ratio between the low- and high-frequency spectral components of HRV (P = 0.00047). Furthermore, the SDMA decreasing allele (G) of the non-synomyous SLC25A45 (R285C) variant was associated with a lower resting mean heart rate during the HRV measurements (P = 0.0046), but not with the HRV indices. None of the studied genome-wide significant variants had any major effect on cardiovascular or total mortality in patients referred for coronary angiography. CONCLUSIONS AGXT2 has an important role in SDMA metabolism in humans. AGXT2 may additionally have an unanticipated role in the autonomic nervous system regulation of cardiac function.
Collapse
Affiliation(s)
- Ilkka Seppälä
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere University School of Medicine, Finn-Medi 2, 3rd floor, PO Box 2000, Tampere FI-33521, Finland
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Noble E, Melling J, Shoemaker K, Tikkanen H, Peltonen J, Stuckey M, Petrella RJ. Innovation to Reduce Cardiovascular Complications of Diabetes at the Intersection of Discovery, Prevention and Knowledge Exchange. Can J Diabetes 2013; 37:282-93. [DOI: 10.1016/j.jcjd.2013.07.061] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Revised: 07/27/2013] [Accepted: 07/29/2013] [Indexed: 01/20/2023]
|
46
|
The relationship between mental and physical health: Insights from the study of heart rate variability. Int J Psychophysiol 2013; 89:288-96. [DOI: 10.1016/j.ijpsycho.2013.06.018] [Citation(s) in RCA: 327] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Revised: 06/06/2013] [Accepted: 06/13/2013] [Indexed: 01/18/2023]
|
47
|
Licht CMM, de Geus EJC, Penninx BWJH. Dysregulation of the autonomic nervous system predicts the development of the metabolic syndrome. J Clin Endocrinol Metab 2013; 98:2484-93. [PMID: 23553857 DOI: 10.1210/jc.2012-3104] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
CONTEXT Stress is suggested to lead to metabolic dysregulations as clustered in the metabolic syndrome. Although dysregulation of the autonomic nervous system is found to associate with the metabolic syndrome and its dysregulations, no longitudinal study has been performed to date to examine the predictive value of this stress system in the development of the metabolic syndrome. OBJECTIVE We examined whether autonomic nervous system functioning predicts 2-year development of metabolic abnormalities that constitute the metabolic syndrome. DESIGN Data of the baseline and 2-year follow-up assessment of a prospective cohort: the Netherlands Study of Depression and Anxiety was used. SETTING Participants were recruited in the general community, primary care, and specialized mental health care organizations. PARTICIPANTS A group of 1933 participants aged 18-65 years. MAIN OUTCOME MEASURES The autonomic nervous system measures included heart rate (HR), respiratory sinus arrhythmia (RSA; high RSA reflecting high parasympathetic activity), pre-ejection period (PEP; high PEP reflecting low sympathetic activity), cardiac autonomic balance (CAB), and cardiac autonomic regulation (CAR). Metabolic syndrome was based on the updated Adult Treatment Panel III criteria and included high waist circumference, serum triglycerides, blood pressure, serum glucose, and low high-density lipoprotein (HDL) cholesterol. RESULTS Baseline short PEP, low CAB, high HR, and CAR were predictors of an increase in the number of components of the metabolic syndrome during follow-up. High HR and low CAB were predictors of a 2-year decrease in HDL cholesterol, and 2-year increase in diastolic and systolic blood pressure. Short PEP and high CAR also predicted a 2-year increase in systolic blood pressure, and short PEP additionally predicted 2-year increase in diastolic blood pressure. Finally, a low baseline RSA was predictive for subsequent decreases in HDL cholesterol. CONCLUSION Increased sympathetic activity predicts an increase in metabolic abnormalities over time. These findings suggest that a dysregulation of the autonomic nervous system is an important predictor of cardiovascular diseases and diabetes through dysregulating lipid metabolism and blood pressure over time.
Collapse
Affiliation(s)
- Carmilla M M Licht
- Department of Psychiatry, Vrije Universiteit (VU) University Medical Center Amsterdam, The Netherlands.
| | | | | |
Collapse
|
48
|
Nousen EK, Franco JG, Sullivan EL. Unraveling the mechanisms responsible for the comorbidity between metabolic syndrome and mental health disorders. Neuroendocrinology 2013; 98:254-66. [PMID: 24080959 PMCID: PMC4121390 DOI: 10.1159/000355632] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Accepted: 09/10/2013] [Indexed: 12/25/2022]
Abstract
The increased prevalence and high comorbidity of metabolic syndrome (MetS) and mental health disorders (MHDs) have prompted investigation into the potential contributing mechanisms. There is a bidirectional association between MetS and MHDs including schizophrenia, bipolar disorder, depression, anxiety, attention-deficit/hyperactivity disorder, and autism spectrum disorders. Medication side effects and social repercussions are contributing environmental factors, but there are a number of shared underlying neurological and physiological mechanisms that explain the high comorbidity between these two disorders. Inflammation is a state shared by both disorders, and it contributes to disruptions of neuroregulatory systems (including the serotonergic, dopaminergic, and neuropeptide Y systems) as well as dysregulation of the hypothalamic-pituitary-adrenal axis. MetS in pregnant women also exposes the developing fetal brain to inflammatory factors that predispose the offspring to MetS and psychopathologies. Due to the shared nature of these conditions, treatment should address aspects of both mental health and metabolic disorders. Additionally, interventions that can interrupt the transfer of increased risk of the disorders to the next generation need to be developed. © 2013 S. Karger AG, Basel.
Collapse
Affiliation(s)
- Elizabeth K. Nousen
- Division of Diabetes, Obesity, and Metabolism, Oregon National Primate Research Center, Beaverton, OR, USA
| | - Juliana G. Franco
- Division of Diabetes, Obesity, and Metabolism, Oregon National Primate Research Center, Beaverton, OR, USA
| | - Elinor L. Sullivan
- Division of Diabetes, Obesity, and Metabolism, Oregon National Primate Research Center, Beaverton, OR, USA
- Department of Biology, University of Portland, Portland, OR, USA
| |
Collapse
|
49
|
Jaakkola U, Kakko T, Juonala M, Lehtimäki T, Viikari J, Jääskeläinen AE, Mononen N, Kähönen M, Koskinen T, Keltikangas-Järvinen L, Raitakari O, Kallio J. Neuropeptide Y polymorphism increases the risk for asthma in overweight subjects; protection from atherosclerosis in asthmatic subjects--the cardiovascular risk in young Finns study. Neuropeptides 2012; 46:321-8. [PMID: 23122776 DOI: 10.1016/j.npep.2012.09.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Revised: 09/23/2012] [Accepted: 09/25/2012] [Indexed: 01/22/2023]
Abstract
AIMS The role of neuropeptide Y (NPY) and its gene polymorphisms in the development of atherosclerosis has become increasingly evident. In asthma, NPY has been shown to be involved as immunomodulator. In this study, we investigated the role of two functional NPY polymorphisms, NPY-Leu7Pro (rs16139) and NPY-399C/T (rs16147) and obesity for the development of asthma as well as atherosclerosis in asthmatic and non-asthmatic subjects. Also, we measured heart rate variability (HRV) and NPY in serum since these might contribute through these polymorphisms to both diseases. METHODS AND RESULTS Thousand hundred and seventy six Finnish young adults were genotyped and three groups (G1-G3) were formed based on the observed diplotypes. The NPY-Pro7 allele always co-existed with the NPY-399T allele indicating complete linkage disequilibrium. Here we show that overweight (BMI≥25kg/m2) was associated with 2.5-fold increased risk for asthma in subjects with the NPY-399T allele without NPY-Pro7 allele (G2, n=716). Overweight was also associated with increased atherosclerosis determined by carotid intima media thickness (cIMT), but asthma seemed to be more significant determinant than overweight in determing cIMT having a decreasing effect. NPY concentration in serum was diplotype-driven (G1=792.2(29.5), G2=849.0(18.9), G3=873.9(45.2) pg/ml) and correlated positively with cIMT in the group having NPY-Pro7 allele (G3, n=142). However, the subjects with asthma had a negative NPY-cIMT relationship. Total HRV was increased in asthma and correlated negatively with cIMT irrespective of the NPY genotype. CONCLUSIONS Overweight together with the NPY-399T allele without NPY-Pro7 allele was associated with increased risk for asthma. Atherosclerosis was decreased in subjects with asthma depending on the NPY genotype. The results reveal novel insights into the genetics and biology of the relationship of atherosclerosis and asthma.
Collapse
Affiliation(s)
- U Jaakkola
- Centre for Biotechnology, University of Turku, Turku, Finland
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Effect of age, gender and cardiovascular risk factors on carotid distensibility during 6-year follow-up. The cardiovascular risk in Young Finns study. Atherosclerosis 2012; 224:474-9. [DOI: 10.1016/j.atherosclerosis.2012.04.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2011] [Revised: 03/08/2012] [Accepted: 04/11/2012] [Indexed: 12/18/2022]
|