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Gronwald T, Schaffarczyk M, Hoos O. Orthostatic testing for heart rate and heart rate variability monitoring in exercise science and practice. Eur J Appl Physiol 2024:10.1007/s00421-024-05601-4. [PMID: 39259398 DOI: 10.1007/s00421-024-05601-4] [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: 05/06/2024] [Accepted: 08/28/2024] [Indexed: 09/13/2024]
Abstract
Orthostatic testing, involving the transition from different body positions (e.g., from lying or sitting position to an upright or standing position), offers valuable insights into the autonomic nervous system (ANS) functioning and cardiovascular regulation reflected through complex adjustments in, e.g., measures of heart rate (HR) and heart rate variability (HRV). This narrative review explores the intricate physiological mechanisms underlying orthostatic stress responses and evaluates its significance for exercise science and sports practice. Into this matter, active orthostatic testing (e.g., active standing up) challenges the cardiovascular autonomic function in a different way than a passive tilt test. It is well documented that there is a transient reduction in blood pressure while standing up, leading to a reflex increase in HR and peripheral vasoconstriction. After that acute response systolic and diastolic blood pressures are usually slightly increased compared to supine lying body position. The ANS response to standing is initiated by instantaneous cardiac vagal withdrawal, followed by sympathetic activation and vagal reactivation over the first 25-30 heartbeats. Thus, HR increases immediately upon standing, peaking after 15-20 beats, and is less marked during passive tilting due to the lack of muscular activity. Standing also decreases vagally related HRV indices compared to the supine position. In overtrained endurance athletes, both parasympathetic and sympathetic activity are attenuated in supine and standing positions. Their response to standing is lower than in non-overtrained athletes, with a tendency for further decreased HRV as a sign of pronounced vagal withdrawal and, in some cases, decreased sympathetic excitability, indicating a potential overtraining state. However, as a significant main characteristic, it could be noted that additional pathophysiological conditions consist in a reduced responsiveness or counter-regulation of neural drive in ANS according to an excitatory stimulus, such as an orthostatic challenge. Hence, especially active orthostatic testing could provide additional information about HR(V) reactivity and recovery giving valuable insights into athletes' training status, fatigue levels, and adaptability to workload. Measuring while standing might also counteract the issue of parasympathetic saturation as a common phenomenon especially in well-trained endurance athletes. Data interpretation should be made within intra-individual data history in trend analysis accounting for inter-individual variations in acute responses during testing due to life and physical training stressors. Therefore, additional measures (e.g., psychometrical scales) are required to provide context for HR and HRV analysis interpretation. However, incidence of orthostatic intolerance should be evaluated on an individual level and must be taken into account when considering to implement orthostatic testing in specific subpopulations. Recommendations for standardized testing procedures and interpretation guidelines are developed with the overall aim of enhancing training and recovery strategies. Despite promising study findings in the above-mentioned applied fields, further research, thorough method comparison studies, and systematic reviews are needed to assess the overall perspective of orthostatic testing for training monitoring and fine-tuning of different populations in exercise science and training.
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Affiliation(s)
- Thomas Gronwald
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Am Kaiserkai 1, 20457, Hamburg, Germany.
- G-Lab, Faculty of Applied Sport Sciences and Personality, BSP Business and Law School, Berlin, Germany.
| | - Marcelle Schaffarczyk
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Am Kaiserkai 1, 20457, Hamburg, Germany
| | - Olaf Hoos
- Center for Sports and Physical Education, Faculty of Human Sciences, Julius-Maximilians-University Wuerzburg, Würzburg, Germany
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Mangalam M, Seleznov I, Kolosova E, Popov A, Kelty-Stephen DG, Kiyono K. Postural control in gymnasts: anisotropic fractal scaling reveals proprioceptive reintegration in vestibular perturbation. FRONTIERS IN NETWORK PHYSIOLOGY 2024; 4:1393171. [PMID: 38699200 PMCID: PMC11063314 DOI: 10.3389/fnetp.2024.1393171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 04/05/2024] [Indexed: 05/05/2024]
Abstract
Dexterous postural control subtly complements movement variability with sensory correlations at many scales. The expressive poise of gymnasts exemplifies this lyrical punctuation of release with constraint, from coarse grain to fine scales. Dexterous postural control upon a 2D support surface might collapse the variation of center of pressure (CoP) to a relatively 1D orientation-a direction often oriented towards the focal point of a visual task. Sensory corrections in dexterous postural control might manifest in temporal correlations, specifically as fractional Brownian motions whose differences are more and less correlated with fractional Gaussian noises (fGns) with progressively larger and smaller Hurst exponent H. Traditional empirical work examines this arrangement of lower-dimensional compression of CoP along two orthogonal axes, anteroposterior (AP) and mediolateral (ML). Eyes-open and face-forward orientations cultivate greater variability along AP than ML axes, and the orthogonal distribution of spatial variability has so far gone hand in hand with an orthogonal distribution of H, for example, larger in AP and lower in ML. However, perturbing the orientation of task focus might destabilize the postural synergy away from its 1D distribution and homogenize the temporal correlations across the 2D support surface, resulting in narrower angles between the directions of the largest and smallest H. We used oriented fractal scaling component analysis (OFSCA) to investigate whether sensory corrections in postural control might thus become suborthogonal. OFSCA models raw 2D CoP trajectory by decomposing it in all directions along the 2D support surface and fits the directions with the largest and smallest H. We studied a sample of gymnasts in eyes-open and face-forward quiet posture, and results from OFSCA confirm that such posture exhibits the classic orthogonal distribution of temporal correlations. Head-turning resulted in a simultaneous decrease in this angle Δθ, which promptly reversed once gymnasts reoriented their heads forward. However, when vision was absent, there was only a discernible negative trend in Δθ, indicating a shift in the angle's direction but not a statistically significant one. Thus, the narrowing of Δθ may signify an adaptive strategy in postural control. The swift recovery of Δθ upon returning to a forward-facing posture suggests that the temporary reduction is specific to head-turning and does not impose a lasting burden on postural control. Turning the head reduced the angle between these two orientations, facilitating the release of postural degrees of freedom towards a more uniform spread of the CoP across both dimensions of the support surface. The innovative aspect of this work is that it shows how fractality might serve as a control parameter of adaptive mechanisms of dexterous postural control.
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Affiliation(s)
- Madhur Mangalam
- Division of Biomechanics and Research Development, Department of Biomechanics, and Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE, United States
| | - Ivan Seleznov
- Graduate School of Engineering Science, Osaka University, Osaka, Japan
| | - Elena Kolosova
- National University of Ukraine on Physical Education and Sport, Scientific Research Institute, Kyiv, Ukraine
- Department of Movement Physiology, Bogomoletz Institute of Physiology, Kyiv, Ukraine
| | - Anton Popov
- Department of Electronic Engineering, Igor Sikorsky Kyiv Polytechnic Institute, Kyiv, Ukraine
- Faculty of Applied Sciences, Ukrainian Catholic University, Lviv, Ukraine
| | - Damian G. Kelty-Stephen
- Department of Psychology, State University of New York at New Paltz, New Paltz, NY, United States
| | - Ken Kiyono
- Graduate School of Engineering Science, Osaka University, Osaka, Japan
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Kelty-Stephen DG, Kiyono K, Stergiou N, Mangalam M. Spatial variability and directional shifts in postural control in Parkinson's disease. Clin Park Relat Disord 2024; 10:100249. [PMID: 38803658 PMCID: PMC11129103 DOI: 10.1016/j.prdoa.2024.100249] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024] Open
Abstract
Individuals with Parkinson's disease exhibit tremors, rigidity, and bradykinesia, disrupting normal movement variability and resulting in postural instability. This comprehensive study aimed to investigate the link between the temporal structure of postural sway variability and Parkinsonism by analyzing multiple datasets from young and older adults, including individuals with Parkinson's disease, across various task conditions. We used the Oriented Fractal Scaling Component Analysis (OFSCA), which identifies minimal and maximal long-range correlations within the center of pressure time series, allowing for detecting directional changes in postural sway variability. The objective was to uncover the primary directions along which individuals exerted control during the posture. The results, as anticipated, revealed that healthy adults predominantly exerted control along two orthogonal directions, closely aligned with the anteroposterior (AP) and mediolateral (ML) axes. In stark contrast, older adults and individuals with Parkinson's disease exhibited control along suborthogonal directions that notably diverged from the AP and ML axes. While older adults and those with Parkinson's disease demonstrated a similar reduction in the angle between these two control directions compared to healthy older adults, their reliance on this suborthogonal angle concerning endogenous fractal correlations exhibited significant differences from the healthy aging cohort. Importantly, individuals with Parkinson's disease did not manifest the sensitivity to destabilizing task settings observed in their healthy counterparts, affirming the distinction between Parkinson's disease and healthy aging.
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Affiliation(s)
- Damian G. Kelty-Stephen
- Department of Psychology, State University of New York at New Paltz, New Paltz, NY 12561, USA
| | - Ken Kiyono
- Graduate School of Engineering Science, Osaka University, Osaka 560-8531, Japan
| | - Nick Stergiou
- Division of Biomechanics and Research Development, Department of Biomechanics, Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE 68182, USA
- Department of Physical Education & Sport Science, Aristotle University, Thessaloniki 570 01, Greece
| | - Madhur Mangalam
- Division of Biomechanics and Research Development, Department of Biomechanics, Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE 68182, USA
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Boraschi A, Hafner M, Spiegelberg A, Kurtcuoglu V. Influence of age on the relation between body position and noninvasively acquired intracranial pulse waves. Sci Rep 2024; 14:5493. [PMID: 38448614 PMCID: PMC10918064 DOI: 10.1038/s41598-024-55860-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 02/28/2024] [Indexed: 03/08/2024] Open
Abstract
The capacitive measurement of the head's dielectric properties has been recently proposed as a noninvasive method for deriving surrogates of craniospinal compliance (CC), a parameter used in the evaluation of space-occupying neurological disorders. With the higher prevalence of such disorders in the older compared to the younger population, data on the head's dielectric properties of older healthy individuals would be of particularly high value before assessing pathologic changes. However, so far only measurements on young volunteers (< 30 years) were reported. In the present study, we have investigated the capacitively obtained electric signal known as W in older healthy individuals. Thirteen healthy subjects aged > 60 years were included in the study. W was acquired in the resting state (supine horizontal position), and during head-up and head-down tilting. AMP, the peak-to-valley amplitude of W related to cardiac action, was extracted from W. AMP was higher in this older cohort compared to the previously investigated younger one (0°: 5965 ± 1677 arbitrary units (au)). During head-up tilting, AMP decreased (+ 60°: 4446 ± 1620 au, P < 0.001), whereas it increased during head-down tilting (- 30°: 7600 ± 2123 au, P < 0.001), as also observed in the younger cohort. Our observation that AMP, a metric potentially reflective of CC, is higher in the older compared to the younger cohort aligns with the expected decrease of CC with age. Furthermore, the robustness of AMP is reinforced by the consistent relative changes observed during tilt testing in both cohorts.
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Affiliation(s)
- Andrea Boraschi
- The Interface Group, Institute of Physiology, University of Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland
| | - Matthias Hafner
- The Interface Group, Institute of Physiology, University of Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland
| | - Andreas Spiegelberg
- The Interface Group, Institute of Physiology, University of Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland
| | - Vartan Kurtcuoglu
- The Interface Group, Institute of Physiology, University of Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland.
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland.
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Groppelli A, Rafanelli M, Testa GD, Agusto S, Rivasi G, Carbone E, Soranna D, Zambon A, Castiglioni P, Ungar A, Brignole M, Parati G. Detection of impending reflex syncope by means of an integrated multisensor patch-type recorder. J Hum Hypertens 2023; 37:1098-1104. [PMID: 37208523 DOI: 10.1038/s41371-023-00840-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 04/20/2023] [Accepted: 05/04/2023] [Indexed: 05/21/2023]
Abstract
We assessed the capability of an integrated multisensory patch-type monitor (RootiRx®) in detecting episodes of reflex (pre)syncope induced by tilt table test (TTT). Firstly, we performed an intrapatient comparison of cuffless systolic blood pressure (SBP), R-R interval (RRI) and variability (power spectrum analysis) obtained by means of the RootiRx® with those obtained with conventional methods (CONV) with validated finger pressure devices at baseline in supine position and repeatedly during TTT in 32 patients affected by likely reflex syncope. Secondly, the LF/HF values obtained with RootiRx® during TTT were analyzed in 50 syncope patients. Compared with baseline supine recordings, during TTT a decrement of median SBP was observed with CONV (-53.5 mmHg) but not with RootiRx® ®(-1 mmHg). Conversely, RRI reduction (CONV: 102 ms; RootiRx®: 127 ms) and RRI Low Frequency/High Frequency powers ratio (LF/HF) increase (CONV: 1.6; RootiRx®: 2.5) were similar. The concordance was good for RRI (0.97 [95% CI 0.96-0.98]) and fair for LF/HF ratio (0.69 [95% CI 0.46-0.83]). During the first 5 min of TTT the LF/HF ratio was higher in patients who later developed syncope than in no-syncope patients. This ratio was significantly different among patients with syncope, presyncope or without symptoms at the time of syncope (p value = 0.02). In conclusion, cuffless RootiRx® was unable to detect rapid drops of SBP occurring during impending reflex syncope and thus cannot be used as a diagnostic tool for hypotensive syncope. On the other hand, RRI mean values and LF/HF power ratios obtained with RootiRx® were consistent with those simultaneously obtained using conventional methods.
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Affiliation(s)
- Antonella Groppelli
- IRCCS Istituto Auxologico Italiano, Faint & Fall programme, Cardiology Unit and Department of Cardiology, San Luca Hospital, Milan, Italy
| | - Martina Rafanelli
- Syncope Unit, Division of Geriatric and Intensive Care Medicine, University of Florence and Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Giuseppe Dario Testa
- Syncope Unit, Division of Geriatric and Intensive Care Medicine, University of Florence and Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Samuele Agusto
- Syncope Unit, Division of Geriatric and Intensive Care Medicine, University of Florence and Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Giulia Rivasi
- Syncope Unit, Division of Geriatric and Intensive Care Medicine, University of Florence and Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Erika Carbone
- Biostatistics Unit, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Davide Soranna
- Biostatistics Unit, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Antonella Zambon
- Biostatistics Unit, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - Paolo Castiglioni
- IRCCS Fondazione Don C. Gnocchi ONLUS, Milan, Italy
- Department of Biotechnology and Life sciences (DBSV), University of Insubria, Varese, Italy
| | - Andrea Ungar
- Syncope Unit, Division of Geriatric and Intensive Care Medicine, University of Florence and Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Michele Brignole
- IRCCS Istituto Auxologico Italiano, Faint & Fall programme, Cardiology Unit and Department of Cardiology, San Luca Hospital, Milan, Italy.
| | - Gianfranco Parati
- IRCCS Istituto Auxologico Italiano, Faint & Fall programme, Cardiology Unit and Department of Cardiology, San Luca Hospital, Milan, Italy
- Department of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
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Effect of Lower Limb Venous Dilation on the Autonomic Cardiac Response among Healthy Young Men. Healthcare (Basel) 2023; 11:healthcare11040548. [PMID: 36833082 PMCID: PMC9957185 DOI: 10.3390/healthcare11040548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/21/2023] [Accepted: 02/09/2023] [Indexed: 02/17/2023] Open
Abstract
Venous occlusion of the lower limbs, which simulates edema, can alter heart rate variability (HRV) by increasing feedback information from group III/IV sensory fibers. Our aim was to quantify this effect among healthy young men. The study group included 13 men (mean age, 20.4 years). Venous occlusion of the lower limbs was induced using a pressure cuff around both thighs. The effect of occlusion on autonomic cardiac response was quantified under occlusion pressures of 20, 60, and 100 mmHg. Compression was applied for 5 min. HRV was evaluated from changes in the low-frequency (LF) and high-frequency (HF) power of the electrocardiogram and the resulting LF/HF balance. Near-infrared spectroscopy of the leg was used to quantify the effects of occlusion on deoxyhemoglobin, measured as the area under the curve (HHb-AUC). The occlusion pressure of 100 mmHg induced a significant increase in the LF/HF ratio, compared to the baseline (p < 0.05). HHb-AUC was highest for the 100 mmHg occlusion pressure compared with the 20 and 60 mmHg pressures (p < 0.01). These findings indicate that venous dilation may elicit a shift towards sympathetic dominance in the autonomic balance.
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7
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Nakazato Y, Shimoyama M, Cohen AA, Watanabe A, Kobayashi H, Shimoyama H, Shimoyama H. Intercorrelated variability in blood and hemodynamic biomarkers reveals physiological network in hemodialysis patients. Sci Rep 2023; 13:1660. [PMID: 36717578 PMCID: PMC9886931 DOI: 10.1038/s41598-023-28345-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 01/17/2023] [Indexed: 01/31/2023] Open
Abstract
Increased intra-individual variability of a variety of biomarkers is generally associated with poor health and reflects physiological dysregulation. Correlations among these biomarker variabilities should then represent interactions among heterogeneous biomarker regulatory systems. Herein, in an attempt to elucidate the network structure of physiological systems, we probed the inter-variability correlations of 22 biomarkers. Time series data on 19 blood-based and 3 hemodynamic biomarkers were collected over a one-year period for 334 hemodialysis patients, and their variabilities were evaluated by coefficients of variation. The network diagram exhibited six clusters in the physiological systems, corresponding to the regulatory domains for metabolism, inflammation, circulation, liver, salt, and protein. These domains were captured as latent factors in exploratory and confirmatory factor analyses (CFA). The 6-factor CFA model indicates that dysregulation in each of the domains manifests itself as increased variability in a specific set of biomarkers. Comparison of a diabetic and non-diabetic group within the cohort by multi-group CFA revealed that the diabetic cohort showed reduced capacities in the metabolism and salt domains and higher variabilities of the biomarkers belonging to these domains. The variability-based network analysis visualizes the concept of homeostasis and could be a valuable tool for exploring both healthy and pathological conditions.
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Affiliation(s)
- Yuichi Nakazato
- Division of Nephrology, Yuai Nisshin Clinic, Hakuyukai Medical Corporation, 2-1914-6 Nisshin-Cho, Kita-Ku, Saitama, Saitama, 331-0823, Japan.
| | - Masahiro Shimoyama
- Division of Nephrology, Yuai Clinic, Hakuyukai Medical Corporation, Saitama, Japan
| | - Alan A Cohen
- PRIMUS Research Group, Department of Family Medicine, University of Sherbrooke, Sherbrooke, QC, Canada
- Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, New York, NY, USA
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Akihisa Watanabe
- Division of Nephrology, Yuai Minuma Clinic, Hakuyukai Medical Corporation, Saitama, Japan
| | - Hiroaki Kobayashi
- Division of Nephrology, Yuai Mihashi Clinic, Hakuyukai Medical Corporation, Saitama, Japan
| | - Hirofumi Shimoyama
- Division of Nephrology, Yuai Nisshin Clinic, Hakuyukai Medical Corporation, 2-1914-6 Nisshin-Cho, Kita-Ku, Saitama, Saitama, 331-0823, Japan
| | - Hiromi Shimoyama
- Division of Nephrology, Yuai Clinic, Hakuyukai Medical Corporation, Saitama, Japan
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Ribeiro ASF, Zerolo BE, López-Espuela F, Sánchez R, Fernandes VS. Cardiac System during the Aging Process. Aging Dis 2023:AD.2023.0115. [PMID: 37163425 PMCID: PMC10389818 DOI: 10.14336/ad.2023.0115] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/15/2023] [Indexed: 05/12/2023] Open
Abstract
The aging process is accompanied by a continuous decline of the cardiac system, disrupting the homeostatic regulation of cells, organs, and systems. Aging increases the prevalence of cardiovascular diseases, thus heart failure and mortality. Understanding the cardiac aging process is of pivotal importance once it allows us to design strategies to prevent age-related cardiac events and increasing the quality of live in the elderly. In this review we provide an overview of the cardiac aging process focus on the following topics: cardiac structural and functional modifications; cellular mechanisms of cardiac dysfunction in the aging; genetics and epigenetics in the development of cardiac diseases; and aging heart and response to the exercise.
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Affiliation(s)
| | - Blanca Egea Zerolo
- Escuela de Enfermería y Fisioterapia San Juan de Dios. Universidad Pontificia Comillas, Madrid, Spain
| | - Fidel López-Espuela
- Metabolic Bone Diseases Research Group, Nursing and Occupational Therapy College, University of Extremadura, Caceres, Spain
| | - Raúl Sánchez
- Unidad de Cardiopatías Congénitas, Hospital Universitario La Paz, Madrid, Spain
| | - Vítor S Fernandes
- Departamento de Fisiología, Facultad de Farmacia, Universidad Complutense de Madrid, Madrid, Spain
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Akbarzadeh A, Akbarzadeh F, Kazemi B. Simultaneous beat-to-beat heart rate and systolic blood pressure variability in patients with and without neurally mediated syncope. J Cardiovasc Thorac Res 2022; 14:108-115. [PMID: 35935387 PMCID: PMC9339730 DOI: 10.34172/jcvtr.2022.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 04/29/2022] [Indexed: 11/09/2022] Open
Abstract
Introduction: Autonomic changes play an essential role in the genesis of neurally mediated syncope (NMS). The aim of this study was to compare the changes of the autonomic nervous system (ANS) by measuring spectral indices of beat-to-beat systolic blood pressure and heart rate variability (SBPV and HRV) in ranges of low frequency (LF), high frequency (HF), and the LF/HF ratio during head-up tilt test (HUTT) in patients with and without a syncope response.
Methods: In this case-control study of 46 patients with a suspected history of unexplained syncope, data were recorded separately during the typical three phases of HUTT. Patients who developed syncope were designated as the case group and the rest as the control group. Results: Thirty one patients experienced syncope during HUTT. Resting HRV and SBPV indices were significantly lower in cases than controls. After tilting in the syncope group, both HF and LF powers of SBPV showed a significant and gradual decrease. LF/HF in HRV increased in both groups similarly during the test but in SBPV, mainly driven by oscilations in its LF power, it increased significantly more during the first two phases of the test in syncope patients only to paradoxically decrease during active tilt (P< 0.001). Conclusion: Our findings show an abnormal autonomic function in patients with syncope, both at rest and tilting. Fluctuations of spectral indices of beat-to-beat SBPV, a potential noval index of pure sympathetic activity, show an exaggerated response during tilt and its withdrawal before syncope.
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Affiliation(s)
| | - Fariborz Akbarzadeh
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Babak Kazemi
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Koskela JK, Tahvanainen A, Tikkakoski AJ, Kangas P, Uitto M, Viik J, Kähönen M, Mustonen J, Pörsti I. Resting heart rate predicts cardiac autonomic modulation during passive head-up tilt in subjects without cardiovascular diseases. SCAND CARDIOVASC J 2022; 56:138-147. [PMID: 35652524 DOI: 10.1080/14017431.2022.2079713] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Background Resting heart rate (HR) and its variability (HRV) reflects the cardiac sympathovagal balance that is stimulated by head-up tilting. HRV is influenced by the level of HR, but how much HRV offers additional information about cardiac autonomic tone than HR alone remains unresolved. We examined the relation of resting HR with HRV during head-up tilt. Methods. Hemodynamics of 569 subjects without known cardiovascular diseases and medications with direct cardiovascular effects were recorded using whole-body impedance cardiography, radial pulse wave analysis, and electrocardiography-based HRV analysis during passive head-up tilt. Results. Higher low frequency to the high-frequency ratio (LF/HF) of HRV (reflecting sympathovagal balance) was associated with higher HR in supine (p < .05, both linear regression analysis and variance analysis comparing HR tertiles) and upright postures (p < .001, linear regression analysis). The association of HR with HRV during tilt-testing remained significant when the HR dependence of HRV was mathematically weakened by dividing the HRV power spectra with the fourth power of the average RR-interval. Conclusion. Higher resting HR is related to higher LF/HF both supine and upright, reflecting elevated sympathetic influence on cardiac autonomic modulation. Lower resting HR is associated with lower resting LF/HF, while the differences in LF/HF between the HR tertiles were minor during head-up tilt, suggesting a greater change in cardiac sympathovagal balance in response to upright posture in those with lowest resting HR. Altogether, resting HR well predicts HRV levels during head-up tilt.Trial registration: Clinicaltrialsregister.eu 2006-002065-39, first registered 5 May 2006. ClinicalTrials.gov NCT01742702, first registered 5 December 2012.
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Affiliation(s)
- Jenni K Koskela
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | - Anna Tahvanainen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Heart Hospital, Tampere University Hospital, Tampere, Finland
| | - Antti J Tikkakoski
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Clinical Physiology and Nuclear Medicine, Tampere University Hospital, Tampere, Finland
| | - Pauliina Kangas
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Marko Uitto
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Jari Viik
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Mika Kähönen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Clinical Physiology and Nuclear Medicine, Tampere University Hospital, Tampere, Finland
| | - Jukka Mustonen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | - Ilkka Pörsti
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
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11
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High Skin Sympathetic Nerve Activity in Patients with Recurrent Syncope. J Pers Med 2021; 11:jpm11111053. [PMID: 34834405 PMCID: PMC8620794 DOI: 10.3390/jpm11111053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 10/19/2021] [Accepted: 10/19/2021] [Indexed: 11/29/2022] Open
Abstract
(1) Background: The autonomic imbalance plays a role in vasovagal syncope (VVS) diagnosed by head-up tilting test (HUT). neuECG is a new method of recording skin electrical signals to simultaneously analyze skin sympathetic nerve activity (SKNA) and electrocardiogram. We hypothesize that SKNA is higher in subjects with tilt-positive than tilt-negative and the SKNA surges before syncope. (2) Methods: We recorded neuECG in 41 subjects who received HUT (according to the “Italian protocol”), including rest, tilt-up, provocation and recovery phases. Data were analyzed to determine the average SKNA (aSKNA, μV) per digitized sample. Electrocardiogram was used to calculate standard deviation of normal-to-normal beat intervals (SDNN). The “SKNA-SDNN index” was calculated by rest aSKNA multiplied by the ratio of tilt-up to rest SDNN. (3) Results: 16 of 41 (39%) subjects developed syncope. The aSKNA at rest phase is significantly higher in the tilt-positive (1.21 ± 0.27 µV) than tilt-negative subjects (1.02 ± 0.29 µV) (p = 0.034). There are significant surges and withdraw of aSKNA 30 s before and after syncope (both p ≤ 0.006). SKNA-SDNN index is able to predict syncope (p < 0.001). (4) Conclusion: Higher SKNA at rest phase is associated with positive HUT. The SKNA-SDNN index is a novel marker to predict syncope during HUT.
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Schulz A, Back SN, Schaan VK, Bertsch K, Vögele C. On the construct validity of interoceptive accuracy based on heartbeat counting: Cardiovascular determinants of absolute and tilt-induced change scores. Biol Psychol 2021; 164:108168. [PMID: 34411619 DOI: 10.1016/j.biopsycho.2021.108168] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 08/11/2021] [Accepted: 08/11/2021] [Indexed: 12/18/2022]
Abstract
Interoceptive accuracy (IAcc) as assessed with the heartbeat counting task (IAccHBCT) may be affected by a range of factors including (1.) the ability to adequately detect cardiac signals, indicated by IAcc in a heartbeat discrimination task (IAccHBDT), (2.) cardiac signal properties, affected by sympathetic and parasympathetic tone, and (3.) non-interoceptive processes, including time estimation accuracy (TEAcc). In the current study we investigated the contribution of these factors to absolute and Δ IAccHBCT scores, induced by passive head-up and head-down tilt in 49 healthy individuals. A set of hierarchical regression models showed IAccHBDT scores as the strongest and, across different orthostatic (tilt) conditions, most stable (positive) predictor of absolute and Δ IAccHBCT scores. Neither indicators of cardiac signal properties (except for HR in head-down-tilt), nor TEAcc predicted absolute or Δ IAccHBCT scores. These findings support the convergent and discriminant validity of absolute and Δ IAccHBCT scores.
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Affiliation(s)
- André Schulz
- Clinical Psychophysiology Laboratory, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg.
| | - Sarah N Back
- Clinical Psychophysiology Laboratory, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg; Division of Clinical Psychology and Psychotherapy, Department of Psychology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Violetta K Schaan
- Clinical Psychophysiology Laboratory, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Katja Bertsch
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Claus Vögele
- Clinical Psychophysiology Laboratory, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
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Balasubramanian P, Branen L, Sivasubramanian MK, Monteiro R, Subramanian M. Aging is associated with glial senescence in the brainstem - implications for age-related sympathetic overactivity. Aging (Albany NY) 2021; 13:13460-13473. [PMID: 34038388 PMCID: PMC8202881 DOI: 10.18632/aging.203111] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 04/28/2021] [Indexed: 12/11/2022]
Abstract
Accumulating evidence suggests that the sympathetic nervous system (SNS) overactivity plays a crucial role in age-related increase in the risk for cardiovascular diseases such as hypertension, myocardial infarction, stroke and heart diseases. Previous studies indicate that neuroinflammation in key brainstem regions that regulate sympathetic outflow plays a pathogenic role in aging-mediated sympathoexcitation. However, the molecular mechanisms underlying this phenomenon are not clear. While senescent cells and their secretory phenotype (SASP) have been implicated in the pathogenesis of several age-related diseases, their role in age-related neuroinflammation in the brainstem and SNS overactivity has not been investigated. To test this, we isolated brainstems from young (2-4 months) and aged (24 months) male C57BL/6J mice and assessed senescence using a combination of RNA-in situ hybridization, PCR analysis, multiplex assay and SA-β gal staining. Our results show significant increases in p16Ink4a expression, increased activity of SA-β gal and increases in SASP levels in the aged brainstem, suggesting age-induced senescence in the brainstem. Further, analysis of senescence markers in glial cells enriched fraction from fresh brainstem samples demonstrated that glial cells are more susceptible to senesce with age in the brainstem. In conclusion, our study suggests that aging induces glial senescence in the brainstem which likely causes inflammation and SNS overactivity.
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Affiliation(s)
- Priya Balasubramanian
- Oklahoma Center for Geroscience and Healthy Brain Aging, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Lyndee Branen
- Department of Physiological Sciences, College of Veterinary Medicine, Oklahoma State University, Stillwater, OK 74078, USA
| | - Mahesh Kumar Sivasubramanian
- Department of Physiological Sciences, College of Veterinary Medicine, Oklahoma State University, Stillwater, OK 74078, USA
| | - Raisa Monteiro
- Department of Physiological Sciences, College of Veterinary Medicine, Oklahoma State University, Stillwater, OK 74078, USA
| | - Madhan Subramanian
- Department of Physiological Sciences, College of Veterinary Medicine, Oklahoma State University, Stillwater, OK 74078, USA
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Izzo C, Vitillo P, Di Pietro P, Visco V, Strianese A, Virtuoso N, Ciccarelli M, Galasso G, Carrizzo A, Vecchione C. The Role of Oxidative Stress in Cardiovascular Aging and Cardiovascular Diseases. Life (Basel) 2021; 11:60. [PMID: 33467601 PMCID: PMC7829951 DOI: 10.3390/life11010060] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 12/12/2022] Open
Abstract
Aging can be seen as process characterized by accumulation of oxidative stress induced damage. Oxidative stress derives from different endogenous and exogenous processes, all of which ultimately lead to progressive loss in tissue and organ structure and functions. The oxidative stress theory of aging expresses itself in age-related diseases. Aging is in fact a primary risk factor for many diseases and in particular for cardiovascular diseases and its derived morbidity and mortality. Here we highlight the role of oxidative stress in age-related cardiovascular aging and diseases. We take into consideration the molecular mechanisms, the structural and functional alterations, and the diseases accompanied to the cardiovascular aging process.
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Affiliation(s)
- Carmine Izzo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Baronissi, 84081 Salerno, Italy; (C.I.); (P.V.); (P.D.P.); (V.V.); (A.S.); (N.V.); (M.C.); (G.G.); (A.C.)
| | - Paolo Vitillo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Baronissi, 84081 Salerno, Italy; (C.I.); (P.V.); (P.D.P.); (V.V.); (A.S.); (N.V.); (M.C.); (G.G.); (A.C.)
| | - Paola Di Pietro
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Baronissi, 84081 Salerno, Italy; (C.I.); (P.V.); (P.D.P.); (V.V.); (A.S.); (N.V.); (M.C.); (G.G.); (A.C.)
| | - Valeria Visco
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Baronissi, 84081 Salerno, Italy; (C.I.); (P.V.); (P.D.P.); (V.V.); (A.S.); (N.V.); (M.C.); (G.G.); (A.C.)
| | - Andrea Strianese
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Baronissi, 84081 Salerno, Italy; (C.I.); (P.V.); (P.D.P.); (V.V.); (A.S.); (N.V.); (M.C.); (G.G.); (A.C.)
| | - Nicola Virtuoso
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Baronissi, 84081 Salerno, Italy; (C.I.); (P.V.); (P.D.P.); (V.V.); (A.S.); (N.V.); (M.C.); (G.G.); (A.C.)
| | - Michele Ciccarelli
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Baronissi, 84081 Salerno, Italy; (C.I.); (P.V.); (P.D.P.); (V.V.); (A.S.); (N.V.); (M.C.); (G.G.); (A.C.)
| | - Gennaro Galasso
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Baronissi, 84081 Salerno, Italy; (C.I.); (P.V.); (P.D.P.); (V.V.); (A.S.); (N.V.); (M.C.); (G.G.); (A.C.)
| | - Albino Carrizzo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Baronissi, 84081 Salerno, Italy; (C.I.); (P.V.); (P.D.P.); (V.V.); (A.S.); (N.V.); (M.C.); (G.G.); (A.C.)
- Department of Angio-Cardio-Neurology, Vascular Physiopathology Unit, IRCCS Neuromed, 86077 Pozzilli, Isernia, Italy
| | - Carmine Vecchione
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Baronissi, 84081 Salerno, Italy; (C.I.); (P.V.); (P.D.P.); (V.V.); (A.S.); (N.V.); (M.C.); (G.G.); (A.C.)
- Department of Angio-Cardio-Neurology, Vascular Physiopathology Unit, IRCCS Neuromed, 86077 Pozzilli, Isernia, Italy
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15
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Cain JW, He L, Waldrop L. Modeling action potential reversals in tunicate hearts. Phys Rev E 2020; 102:062421. [PMID: 33466064 DOI: 10.1103/physreve.102.062421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 11/30/2020] [Indexed: 11/07/2022]
Abstract
Tunicates are small invertebrates which possess a unique ability to reverse flow in their hearts. Scientists have debated various theories regarding how and why flow reversals occur. Here we explore the electrophysiological basis for reversals by simulating action potential propagation in an idealized model of the tubelike tunicate heart. Using asymptotic formulas for action potential duration and conduction velocity, we propose tunicate-specific parameters for a two-current ionic model of the action potential. Then, using a kinematic model, we derive analytical criteria for reversals to occur. These criteria inform subsequent numerical simulations of action potential propagation in a fiber paced at both ends. In particular, we explore the role that variability of pacemaker firing rates plays in generating reversals, and we identify various favorable conditions for triggering retrograde propagation. Our analytical framework extends to other species; for instance, it can be used to model competition between the sinoatrial node and abnormal ectopic foci in human heart tissue.
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Affiliation(s)
- John W Cain
- Department of Mathematics, Harvard University, Cambridge, Massachusetts 02138, USA
| | - Luran He
- Department of Mathematics, Harvard University, Cambridge, Massachusetts 02138, USA
| | - Lindsay Waldrop
- Department of Biological Sciences, Chapman University, Orange, California 92866, USA
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16
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Takeshima K, Tanaka K, Mori R, Wakatsuki Y, Onoe H, Sakakibara T, Kitagawa Y, Nakashizuka H, Tsuchiya N. Central serous chorioretinopathy and heart rate variability analysis with a smartphone application. Sci Rep 2020; 10:14949. [PMID: 32917952 PMCID: PMC7486920 DOI: 10.1038/s41598-020-71938-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 08/21/2020] [Indexed: 11/23/2022] Open
Abstract
The purpose of this study was to quantitatively analyze heart rate variability (HRV) in patients with central serous chorioretinopathy (CSC) by using a smartphone-based application (ANBAI: DUMSCO Inc.) for measurement, and to clarify its relationships with CSC. The subjects were 64 CSC patients (mean age 48.7 ± 7.6 years, 57 males and 7 females). After providing consent, the patients downloaded ANBAI apps to their smartphones. HRV was measured by photoelectric volume pulse wave measurement with a smartphone camera each morning for a minimum of 1 week. The primary outcome was to analyze HRV by calculating log LF/HF (Low Frequency/High Frequency components), an index of autonomic tone, which was then compared with a control group of 35,226 individuals from the application. Secondary outcome measures included disease duration, body mass index, exercise habits, smoking history, steroid use, occupation, lifestyle regularity, psychological fatigue, physical fatigue, and average sleep time. The log LF/HF was significantly higher in the patient group than in the control group (P < 0.001). Log LF/HF was significantly lower in patients with exercise habits as a factor contributing to log LF/HF in the patient group (P = 0.019). Analysis of HRV in CSC patients showed an impairment of the autonomic nervous system. Exercise habits may also be associated with CSC.
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Affiliation(s)
- Keigo Takeshima
- Division of Ophthalmology, Nihon University School of Medicine, 1-6 Kandasurugadai Chiyoda-ku, Tokyo, Japan. .,Department of Ophthalmology, Diabetes Center, Tokyo Women's Medical University, Tokyo, Japan.
| | - Koji Tanaka
- Division of Ophthalmology, Nihon University School of Medicine, 1-6 Kandasurugadai Chiyoda-ku, Tokyo, Japan
| | - Ryusaburo Mori
- Division of Ophthalmology, Nihon University School of Medicine, 1-6 Kandasurugadai Chiyoda-ku, Tokyo, Japan
| | - Yu Wakatsuki
- Division of Ophthalmology, Nihon University School of Medicine, 1-6 Kandasurugadai Chiyoda-ku, Tokyo, Japan
| | - Hajime Onoe
- Division of Ophthalmology, Nihon University School of Medicine, 1-6 Kandasurugadai Chiyoda-ku, Tokyo, Japan
| | - Takuya Sakakibara
- Division of Ophthalmology, Nihon University School of Medicine, 1-6 Kandasurugadai Chiyoda-ku, Tokyo, Japan
| | - Yorihisa Kitagawa
- Division of Ophthalmology, Nihon University School of Medicine, 1-6 Kandasurugadai Chiyoda-ku, Tokyo, Japan
| | - Hiroyuki Nakashizuka
- Division of Ophthalmology, Nihon University School of Medicine, 1-6 Kandasurugadai Chiyoda-ku, Tokyo, Japan
| | - Norihiro Tsuchiya
- Division of Ophthalmology, Nihon University School of Medicine, 1-6 Kandasurugadai Chiyoda-ku, Tokyo, Japan.,Omotesando Internal Medicine and Ophthalmology Clinic, Internal Medicine, Tokyo, Japan
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17
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Monfredi O, Lakatta EG. Complexities in cardiovascular rhythmicity: perspectives on circadian normality, ageing and disease. Cardiovasc Res 2020; 115:1576-1595. [PMID: 31150049 DOI: 10.1093/cvr/cvz112] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 02/06/2019] [Accepted: 05/25/2019] [Indexed: 12/13/2022] Open
Abstract
Biological rhythms exist in organisms at all levels of complexity, in most organs and at myriad time scales. Our own biological rhythms are driven by energy emitted by the sun, interacting via our retinas with brain stem centres, which then send out complex messages designed to synchronize the behaviour of peripheral non-light sensing organs, to ensure optimal physiological responsiveness and performance of the organism based on the time of day. Peripheral organs themselves have autonomous rhythmic behaviours that can act independently from central nervous system control but is entrainable. Dysregulation of biological rhythms either through environment or disease has far-reaching consequences on health that we are only now beginning to appreciate. In this review, we focus on cardiovascular rhythms in health, with ageing and under disease conditions.
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Affiliation(s)
- Oliver Monfredi
- Division of Medicine, Department of Cardiology, The Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD, USA.,Laboratory of Cardiovascular Sciences, Intramural Research Program, National Institute on Aging, National Institutes of Health, 251 Bayview Blvd, Baltimore, MD, USA
| | - Edward G Lakatta
- Laboratory of Cardiovascular Sciences, Intramural Research Program, National Institute on Aging, National Institutes of Health, 251 Bayview Blvd, Baltimore, MD, USA
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18
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Heart rate variability in the course of chemotherapy and haematopoietic stem cell transplantation for peadiatric patients with haematological malignancies. Cardiol Young 2020; 30:967-974. [PMID: 32468969 DOI: 10.1017/s1047951120001298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND High-dose chemotherapy and haematopoietic stem cell transplantation are essential for patients with paediatric haematologic diseases, although cardiotoxicity remains a concern. Heart rate variability analysis can evaluate autonomic nervous function interactions with cardiac function. OBJECTIVE This study aimed to characterise heart rate variability differences between patients undergoing chemotherapy and controls, and the effects of haematopoietic stem cell transplantation on the autonomic nervous system in patients with haematological malignancies. METHODS Nineteen patients (11 male, median age: 11.6 years) who received conventional chemotherapy followed by transplantation and 19 non-transplant patients (10 male, median age: 11.5 years) receiving chemotherapy only between 2006 and 2018 for haematological malignancies were retrospectively enrolled. Data from 24-hour Holter monitoring were recorded after chemotherapy and before and after transplantation. Heart rate variability was analysed in patients and 32 matched normal controls. RESULTS There were significant differences between patients and normal controls in all heart rate variability analysis parameters apart from coefficient of variation of RR interval and standard deviation of the average normal RR interval for all 5-minute segments during sleeping. There was a significant difference in the cumulative anthracycline dose and heart rate variability during sleep between the non-transplant and pre-transplant groups. We observed no remarkable differences in time-domain analysis parameters between before and after transplantation, although the low-frequency component of power-spectrum analysis during awake hours was significantly decreased after transplantation. CONCLUSION Conventional chemotherapy for paediatric haematologic diseases may be a risk factor for autonomic dysfunction. Further declines in heart rate variability after transplantation appear minor.
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19
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Reynisson B, Tanghöj G, Naumburg E. QTc interval-dependent body posture in pediatrics. BMC Pediatr 2020; 20:107. [PMID: 32138709 PMCID: PMC7059365 DOI: 10.1186/s12887-020-1959-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 02/04/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Syncope is a common and often benign disorder presenting at the pediatric emergency department. Long-QT syndrome may be presented with syncope, ventricular arrhythmias or sudden death and is vital to exclude as an underlying cause in children presented with syncope. Few studies have assessed QTc in relation to body posture in children. In this study, we assessed the QTc interval while laying down and during active standing in children with known long-QT syndrome compared to healthy controls. METHODS Children aged 1-18 years with long-QT syndrome (N = 17) matched to two healthy controls (N = 34) were included in this case-control study. The ECG standing was performed immediately after the ECG in the supine position. The QTc interval and QTc-difference by changing the body position were calculated. RESULTS All children with long-QT syndrome were treated with propranolol. QTc was prolonged among long-QT syndrome children while lying down and when standing up, compared to controls. A prolongation of QTc appeared when standing up for both cases and controls. There was no significant difference in QTc increase between the groups. A QTc over 440 ms was observed among four cases lying down and in eight cases while standing, but not in any of the controls. The standing test with a cut-off of 440 ms showed a sensitivity of 47% and a specificity of 100% for case-status in our study. CONCLUSION QTc measured on ECG when rapidly rising up is prolonged in both healthy and LQTS children. More importantly, it prolongs more in children with LQTS and increases in pathological levels.
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Affiliation(s)
- Björn Reynisson
- Institution of Clinical Science, Pediatrics, Umeå University, Umeå, Sweden
| | - Gustaf Tanghöj
- Institution of Clinical Science, Pediatrics, Umeå University, Umeå, Sweden
| | - Estelle Naumburg
- Institution of Clinical Science, Pediatrics, Umeå University, Umeå, Sweden.
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Sachse C, Trozic I, Brix B, Roessler A, Goswami N. Sex differences in cardiovascular responses to orthostatic challenge in healthy older persons: A pilot study. Physiol Int 2019; 106:236-249. [DOI: 10.1556/2060.106.2019.16] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background
Premenopausal women show a higher incidence of orthostatic hypotension than age-matched men, but there are limited data available on sex differences in cardiovascular responses to orthostatic challenge in healthy older persons. We investigated sex differences in hemodynamic and autonomic responses to orthostatic challenge in healthy older males and females.
Materials and methods
Fourteen older healthy women and 10 age-matched men performed a sit-to-stand test (5 min of sitting followed by 5 min of standing). A Task Force® Monitor continuously measured the following beat-to-beat hemodynamic parameters: heart rate, systolic blood pressure, diastolic blood pressure, mean blood pressure, stroke index, cardiac index, and total peripheral resistance index. Cardiac autonomic activity, low-frequency (LF: 0.04–0.15 Hz) normalized (LFnuRRI) and high-frequency (HF: 0.15–0.4 Hz) normalized (HFnuRRI) components, and the ratio between LF and HF power (LF/HF) were calculated using power spectral analysis of heart rate variability.
Results
Across all hemodynamic parameters, there were no significant differences between the sexes at baseline and during standing. LFnuRRI (median: 70.2 vs. 52.3, p < 0.05) and LF/HF ratio (median: 2.4 vs. 1.1, p < 0.05) were significantly higher, whereas HFnuRRI (median: 29.8 vs. 47.7, p < 0.05) was lower among women at baseline. All other heart rate variability measures did not differ between the sexes.
Conclusions
The data indicate that older women showed higher sympathetic and lower parasympathetic activity at rest compared to age-matched men. These results are contradictory to the observations from previous studies, which showed a reduced sympathetic and enhanced parasympathetic activity in women in all ages. Further studies are required to determine the underlying mechanisms contributing to higher incidence of orthostatic hypotension in older females.
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Affiliation(s)
- C Sachse
- 1 Gravitational Physiology and Medicine Research Unit, Physiology Division, Otto Loewi Center of Research in Vascular Biology, Immunity and Inflammation, Medical University of Graz, Graz, Austria
| | - I Trozic
- 1 Gravitational Physiology and Medicine Research Unit, Physiology Division, Otto Loewi Center of Research in Vascular Biology, Immunity and Inflammation, Medical University of Graz, Graz, Austria
| | - B Brix
- 1 Gravitational Physiology and Medicine Research Unit, Physiology Division, Otto Loewi Center of Research in Vascular Biology, Immunity and Inflammation, Medical University of Graz, Graz, Austria
| | - A Roessler
- 1 Gravitational Physiology and Medicine Research Unit, Physiology Division, Otto Loewi Center of Research in Vascular Biology, Immunity and Inflammation, Medical University of Graz, Graz, Austria
| | - N Goswami
- 1 Gravitational Physiology and Medicine Research Unit, Physiology Division, Otto Loewi Center of Research in Vascular Biology, Immunity and Inflammation, Medical University of Graz, Graz, Austria
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de Vries CF, Staff RT, Waiter GD, Sokunbi MO, Sandu AL, Murray AD. Motion During Acquisition is Associated With fMRI Brain Entropy. IEEE J Biomed Health Inform 2019; 24:586-593. [PMID: 30946681 DOI: 10.1109/jbhi.2019.2907189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Measures of fMRI brain entropy have been used to investigate age and disease related neural changes. However, it is unclear if movement in the scanner is associated with brain entropy after geometric correction for movement. As age and disease can affect motor control, quantifying and correcting for the influence of movement will avoid false findings. This paper examines the influence of head motion on fMRI brain entropy. Resting-state and task-based fMRI data from 281 individuals born in Aberdeen between 1950 and 1956 were analyzed. The images were realigned, followed by nuisance regression of the head motion parameters. The images were either high-pass filtered (0.008 Hz) or band-pass (0.008-0.1 Hz) filtered in order to compare the two methods; fuzzy approximate entropy and fuzzy sample entropy were calculated for every voxel. Motion was quantified as the mean displacement and mean rotation in three dimensions. Greater mean motion was correlated with decreased entropy for all four methods of calculating entropy. Different movement characteristics produce different patterns of associations, which appear to be artefact. However, across all motion metrics, entropy calculation methods, and scan conditions, a number of regions consistently show a significant negative association: the right cerebellar crus, left precentral gyrus (primary motor cortex), the left postcentral gyrus (primary somatosensory cortex), and the opercular part of the left inferior frontal gyrus. The robustness of our findings at these locations suggests that decreased entropy in specific brain regions may be a marker for decreased motor control.
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The prevalence of cardiovascular autonomic neuropathy and its influence on post induction hemodynamic variables in patients with and without diabetes; A prospective cohort study. PLoS One 2018; 13:e0207384. [PMID: 30475825 PMCID: PMC6261040 DOI: 10.1371/journal.pone.0207384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 10/30/2018] [Indexed: 11/30/2022] Open
Abstract
Background Cardiovascular autonomic neuropathy (CAN) is a known complication of diabetes, but is also diagnosed in patients without diabetes. CAN may be related to perioperative hemodynamic instability. Our objective was to investigate if patients with diabetes would have a higher prevalence of CAN compared to patients without diabetes undergoing surgery. We further studied its relation to changes in post-induction hemodynamic variables. Methods We prospectively included 82 adult patients, 55 with DM, 27 without DM, scheduled for major abdominal or cardiac surgery. Patients performed four autonomic function tests on the day before surgery. Primary outcomes were the prevalence of CAN and the relation between CAN and severe post-induction hypotension, defined as mean arterial pressure (MAP) < 50 mmHg or ≥ 50% decrease from baseline. Secondary outcomes were the relation between CAN, intraoperative hypotension, MAP < 65 mmHg for more than 13 minutes, and the use of vasopressor therapy. Results The prevalence of CAN in patients with or without DM was 71% versus 63%, (p = 0.437). CAN was not associated with severe post induction hypotension (CAN+ vs. CAN–: 21% vs. 19.2%, p = 0.819) nor with intraoperative hypotension (16% vs. 15%, p = 0.937). Patients with definite CAN received more norepinephrine in the perioperative period compared to patients with mild CAN or no CAN (0.07 mcg kg-1 min-1 (0.05–0.08) vs. 0.03 (0.01–0.07) vs. 0.02 (0.01–0.06) respectively, p = 0.001). Conclusions The majority of patients studied had mild to moderate CAN, regardless of the presence of DM. Assessing CAN before surgery did not identify patients at risk for post induction and intraoperative hypotension in our cohort. Trial registration Dutch Trial Registry (www.trialregister.nl) NTR4976.
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Aging-Induced Biological Changes and Cardiovascular Diseases. BIOMED RESEARCH INTERNATIONAL 2018; 2018:7156435. [PMID: 29984246 PMCID: PMC6015721 DOI: 10.1155/2018/7156435] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 04/23/2018] [Accepted: 05/03/2018] [Indexed: 12/12/2022]
Abstract
Aging is characterized by functional decline in homeostatic regulation and vital cellular events. This process can be linked with the development of cardiovascular diseases (CVDs). In this review, we discussed aging-induced biological alterations that are associated with CVDs through the following aspects: (i) structural, biochemical, and functional modifications; (ii) autonomic nervous system (ANS) dysregulation; (iii) epigenetic alterations; and (iv) atherosclerosis and stroke development. Aging-mediated structural and biochemical modifications coupled with gradual loss of ANS regulation, vascular stiffening, and deposition of collagen and calcium often disrupt cardiovascular system homeostasis. The structural and biochemical adjustments have been consistently implicated in the progressive increase in mechanical burden and functional breakdown of the heart and vessels. In addition, cardiomyocyte loss in this process often reduces adaptive capacity and cardiovascular function. The accumulation of epigenetic changes also plays important roles in the development of CVDs. In summary, the understanding of the aging-mediated changes remains promising towards effective diagnosis, discovery of new drug targets, and development of new therapies for the treatment of CVDs.
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Madehkhaksar F, Klenk J, Sczuka K, Gordt K, Melzer I, Schwenk M. The effects of unexpected mechanical perturbations during treadmill walking on spatiotemporal gait parameters, and the dynamic stability measures by which to quantify postural response. PLoS One 2018; 13:e0195902. [PMID: 29672558 PMCID: PMC5908091 DOI: 10.1371/journal.pone.0195902] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Accepted: 04/02/2018] [Indexed: 11/18/2022] Open
Abstract
Most falls occur after a loss of balance following an unexpected perturbation such as a slip or a trip. Greater understanding of how humans control and maintain stability during perturbed walking may help to develop appropriate fall prevention programs. The aim of this study was to examine changes in spatiotemporal gait and stability parameters in response to sudden mechanical perturbations in medio-lateral (ML) and anterior-posterior (AP) direction during treadmill walking. Moreover, we aimed to evaluate which parameters are most representative to quantify postural recovery responses. Ten healthy adults (mean = 26.4, SD = 4.1 years) walked on a treadmill that provided unexpected discrete ML and AP surface horizontal perturbations. Participants walked under no perturbation (normal walking), and under left, right, forward, and backward sudden mechanical perturbation conditions. Gait parameters were computed including stride length (SL), step width (SW), and cadence, as well as dynamic stability in AP- (MoS-AP) and ML- (MoS-ML) directions. Gait and stability parameters were quantified by means, variability, and extreme values. Overall, participants walked with a shorter stride length, a wider step width, and a higher cadence during perturbed walking, but despite this, the effect of perturbations on means of SW and MoS-ML was not statistically significant. These effects were found to be significantly greater when the perturbations were applied toward the ML-direction. Variabilities, as well as extremes of gait-related parameters, showed strong responses to the perturbations. The higher variability as a response to perturbations might be an indicator of instability and fall risk, on the same note, an adaptation strategy and beneficial to recover balance. Parameters identified in this study may represent useful indicators of locomotor adaptation to successfully compensate sudden mechanical perturbation during walking. The potential association of the extracted parameters with fall risk needs to be determined in fall-prone populations.
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Affiliation(s)
- Forough Madehkhaksar
- Department of Sports Sciences, Heidelberg University, Heidelberg, Germany
- Department of Clinical Gerontology and Rehabilitation, Robert-Bosch-Hospital, Stuttgart, Germany
- * E-mail:
| | - Jochen Klenk
- Department of Clinical Gerontology and Rehabilitation, Robert-Bosch-Hospital, Stuttgart, Germany
- Insitute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Kim Sczuka
- Department of Clinical Gerontology and Rehabilitation, Robert-Bosch-Hospital, Stuttgart, Germany
| | - Katharina Gordt
- Department of Clinical Gerontology and Rehabilitation, Robert-Bosch-Hospital, Stuttgart, Germany
- Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany
| | - Itshak Melzer
- Department of Physical Therapy, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Michael Schwenk
- Department of Clinical Gerontology and Rehabilitation, Robert-Bosch-Hospital, Stuttgart, Germany
- Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany
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Monteiro DA, Taylor EW, Sartori MR, Cruz AL, Rantin FT, Leite CAC. Cardiorespiratory interactions previously identified as mammalian are present in the primitive lungfish. SCIENCE ADVANCES 2018; 4:eaaq0800. [PMID: 29507882 PMCID: PMC5833999 DOI: 10.1126/sciadv.aaq0800] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 01/19/2018] [Indexed: 05/31/2023]
Abstract
The present study has revealed that the lungfish has both structural and functional features of its system for physiological control of heart rate, previously considered solely mammalian, that together generate variability (HRV). Ultrastructural and electrophysiological investigation revealed that the nerves connecting the brain to the heart are myelinated, conferring rapid conduction velocities, comparable to mammalian fibers that generate instantaneous changes in heart rate at the onset of each air breath. These respiration-related changes in beat-to-beat cardiac intervals were detected by complex analysis of HRV and shown to maximize oxygen uptake per breath, a causal relationship never conclusively demonstrated in mammals. Cardiac vagal preganglionic neurons, responsible for controlling heart rate via the parasympathetic vagus nerve, were shown to have multiple locations, chiefly within the dorsal vagal motor nucleus that may enable interactive control of the circulatory and respiratory systems, similar to that described for tetrapods. The present illustration of an apparently highly evolved control system for HRV in a fish with a proven ancient lineage, based on paleontological, morphological, and recent genetic evidence, questions much of the anthropocentric thinking implied by some mammalian physiologists and encouraged by many psychobiologists. It is possible that some characteristics of mammalian respiratory sinus arrhythmia, for which functional roles have been sought, are evolutionary relics that had their physiological role defined in ancient representatives of the vertebrates with undivided circulatory systems.
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Affiliation(s)
- Diana A. Monteiro
- Department of Physiological Sciences, Federal University of São Carlos (UFSCar), São Carlos, 13565-905 São Paulo, Brazil
- National Institute of Science and Technology in Comparative Physiology (INCT FisComp), São Carlos, São Paulo, Brazil
| | - Edwin W. Taylor
- Department of Physiological Sciences, Federal University of São Carlos (UFSCar), São Carlos, 13565-905 São Paulo, Brazil
- School of Biosciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Marina R. Sartori
- Department of Zoology, São Paulo State University (UNESP), Rio Claro, São Paulo, Brazil
| | - André L. Cruz
- National Institute of Science and Technology in Comparative Physiology (INCT FisComp), São Carlos, São Paulo, Brazil
- Institute of Biology, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
| | - Francisco T. Rantin
- Department of Physiological Sciences, Federal University of São Carlos (UFSCar), São Carlos, 13565-905 São Paulo, Brazil
- National Institute of Science and Technology in Comparative Physiology (INCT FisComp), São Carlos, São Paulo, Brazil
| | - Cleo A. C. Leite
- Department of Physiological Sciences, Federal University of São Carlos (UFSCar), São Carlos, 13565-905 São Paulo, Brazil
- National Institute of Science and Technology in Comparative Physiology (INCT FisComp), São Carlos, São Paulo, Brazil
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Dantas EM, Kemp AH, Andreão RV, da Silva VJD, Brunoni AR, Hoshi RA, Bensenor IM, Lotufo PA, Ribeiro ALP, Mill JG. Reference values for short-term resting-state heart rate variability in healthy adults: Results from the Brazilian Longitudinal Study of Adult Health-ELSA-Brasil study. Psychophysiology 2018; 55:e13052. [DOI: 10.1111/psyp.13052] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 11/09/2017] [Accepted: 12/05/2017] [Indexed: 12/11/2022]
Affiliation(s)
- Eduardo Miranda Dantas
- Collegiate of Biological Sciences, Federal University of Vale do São Francisco; Petrolina Brazil
| | - Andrew Haddon Kemp
- Department of Psychology, College of Human and Health Sciences; Swansea University; Swansea Wales United Kingdom
- Department of Psychiatry; University of São Paulo; São Paulo Brazil
- School of Psychology; University of Sydney; Sydney Australia
| | | | | | | | | | | | | | - Antonio Luiz Pinho Ribeiro
- Hospital das Clínicas and Faculdade de Medicina, Universidade Federal de Minas Gerais; Belo Horizonte Brazil
| | - José Geraldo Mill
- Department of Physiological Sciences; Federal University of Espírito Santo, Center of Health Sciences; Vitória Brazil
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27
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Junior EC, Oliveira FM. Attenuation of vagal modulation with aging: Univariate and bivariate analysis of HRV. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2017; 2017:3178-3181. [PMID: 29060573 DOI: 10.1109/embc.2017.8037532] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The aging process leads to diverse changes in the human organism, including in autonomic system modulation. In this study, we calculated indices of HRV in frequency (power spectral density, PSD) and time (the impulse response (IR) method) domains, using data from healthy young and elderly volunteers (Fantasia database from Physionet). The results obtained showed that aging leads to an attenuation of vagal modulation of elderly individuals when compared to young volunteers.
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Natarajan A, Xu KS, Eriksson B. Detecting divisions of the autonomic nervous system using wearables. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2017; 2016:5761-5764. [PMID: 28269563 DOI: 10.1109/embc.2016.7592036] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The ability to assess a user's emotional reaction from biometrics has applications in personalization, recommendation, and enhancing user experiences, among other areas. Unfortunately, understanding the connection between biometric signals and user reactions has previously focused on black box techniques that are opaque to the underlying physiology of the user. In this paper, we explore a novel user study connecting biometric reaction to external stimuli and changes in the user's autonomic nervous system. Specifically, we focus on two competing responses, namely the sympathetic and parasympathetic nervous system, and how differing activations are related to different user responses. Our experiments demonstrate how prior psychophysiological research distinguishing this activation can be replicated using biometric data collected from wearables. The insights from this work have applications in better understanding emotional state from biometric sensors.
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Mather M, Joo Yoo H, Clewett DV, Lee TH, Greening SG, Ponzio A, Min J, Thayer JF. Higher locus coeruleus MRI contrast is associated with lower parasympathetic influence over heart rate variability. Neuroimage 2017; 150:329-335. [PMID: 28215623 DOI: 10.1016/j.neuroimage.2017.02.025] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 01/19/2017] [Accepted: 02/10/2017] [Indexed: 12/17/2022] Open
Abstract
The locus coeruleus (LC) is a key node of the sympathetic nervous system and suppresses parasympathetic activity that would otherwise increase heart rate variability. In the current study, we examined whether LC-MRI contrast reflecting neuromelanin accumulation in the LC was associated with high-frequency heart rate variability (HF-HRV), a measure reflecting parasympathetic influences on the heart. Recent evidence indicates that neuromelanin, a byproduct of catecholamine metabolism, accumulates in the LC through young and mid adulthood, suggesting that LC-MRI contrast may be a useful biomarker of individual differences in habitual LC activation. We found that, across younger and older adults, greater LC-MRI contrast was negatively associated with HF-HRV during fear conditioning and spatial detection tasks. This correlation was not accounted for by individual differences in age or anxiety. These findings indicate that individual differences in LC structure relate to key cardiovascular parameters.
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Affiliation(s)
- Mara Mather
- Emotion and Cognition Lab, University of Southern California, 3715 McClintock Ave., Los Angeles, CA 90089, USA.
| | - Hyun Joo Yoo
- Emotion and Cognition Lab, University of Southern California, 3715 McClintock Ave., Los Angeles, CA 90089, USA
| | - David V Clewett
- Emotion and Cognition Lab, University of Southern California, 3715 McClintock Ave., Los Angeles, CA 90089, USA
| | - Tae-Ho Lee
- Emotion and Cognition Lab, University of Southern California, 3715 McClintock Ave., Los Angeles, CA 90089, USA
| | - Steven G Greening
- Emotion and Cognition Lab, University of Southern California, 3715 McClintock Ave., Los Angeles, CA 90089, USA
| | - Allison Ponzio
- Emotion and Cognition Lab, University of Southern California, 3715 McClintock Ave., Los Angeles, CA 90089, USA
| | - Jungwon Min
- Emotion and Cognition Lab, University of Southern California, 3715 McClintock Ave., Los Angeles, CA 90089, USA
| | - Julian F Thayer
- Department of Psychology, The Ohio State University, Columbus, OH, USA
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31
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Xing CY, Tarumi T, Meijers RL, Turner M, Repshas J, Xiong L, Ding K, Vongpatanasin W, Yuan LJ, Zhang R. Arterial Pressure, Heart Rate, and Cerebral Hemodynamics Across the Adult Life Span. Hypertension 2017; 69:712-720. [PMID: 28193707 DOI: 10.1161/hypertensionaha.116.08986] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 01/08/2017] [Accepted: 01/19/2017] [Indexed: 01/15/2023]
Abstract
Age-related alterations in systemic and cerebral hemodynamics are not well understood. The purpose of this study is to characterize age-related alterations in beat-to-beat oscillations in arterial blood pressure (BP), heart rate (HR), cerebral blood flow (CBF), cardiac baroreflex sensitivity, and dynamic cerebral autoregulation across the adult life span. We studied 136 healthy adults aged 21 to 80 years (60% women). Beat-to-beat BP, HR, and CBF velocity were measured at rest and during sit-stand maneuvers to mimic effects of postural changes on BP and CBF. Transfer function analysis was used to assess baroreflex sensitivity and dynamic cerebral autoregulation. Carotid-femoral pulse wave velocity was measured to assess central arterial stiffness. Advanced aging was associated with elevated carotid-femoral pulse wave velocity, systolic and pulse BP, cerebrovascular resistance, and CBF pulsatility, but reduced mean CBF velocity. Compared with the young and middle-aged, older adults had lower beat-to-beat BP, HR, and CBF variability in the low-frequency ranges at rest, but higher BP and CBF variability during sit-stand maneuvers. Baroreflex sensitivity was reduced, whereas dynamic cerebral autoregulation gain was elevated at rest in older adults. Multiple linear regression analysis indicated that systolic BP variability is correlated positively with carotid-femoral pulse wave velocity independent of HR variability. In conclusion, advanced aging is associated with elevated pulsatility in BP and CBF; reduced beat-to-beat low-frequency oscillations in BP, HR, and CBF; and impaired baroreflex sensitivity and dynamic cerebral autoregulation at rest. The augmented BP and CBF variability in older adults during sit-stand maneuvers indicate diminished cardiovascular regulatory capability and increased hemodynamic stress on the cerebral circulation with aging.
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Affiliation(s)
- Chang-Yang Xing
- From the Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas (C.-Y.X., T.T., R.L.M., M.T., J.R., R.Z.); Department of Internal Medicine (C.-Y.X., W.V., R.Z.) and Department of Neurology and Neurotherapeutics (T.T., K.D., R.Z.), University of Texas Southwestern Medical Center, Dallas; Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China (C.-Y.X., L.-J.Y.); Department of Geriatric Medicine, Radboud University Nijmegen Medical Centre, The Netherlands (R.L.M.); and Department of Medicine and Therapeutics, Chinese University of Hong Kong, China (L.X.)
| | - Takashi Tarumi
- From the Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas (C.-Y.X., T.T., R.L.M., M.T., J.R., R.Z.); Department of Internal Medicine (C.-Y.X., W.V., R.Z.) and Department of Neurology and Neurotherapeutics (T.T., K.D., R.Z.), University of Texas Southwestern Medical Center, Dallas; Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China (C.-Y.X., L.-J.Y.); Department of Geriatric Medicine, Radboud University Nijmegen Medical Centre, The Netherlands (R.L.M.); and Department of Medicine and Therapeutics, Chinese University of Hong Kong, China (L.X.)
| | - Rutger L Meijers
- From the Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas (C.-Y.X., T.T., R.L.M., M.T., J.R., R.Z.); Department of Internal Medicine (C.-Y.X., W.V., R.Z.) and Department of Neurology and Neurotherapeutics (T.T., K.D., R.Z.), University of Texas Southwestern Medical Center, Dallas; Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China (C.-Y.X., L.-J.Y.); Department of Geriatric Medicine, Radboud University Nijmegen Medical Centre, The Netherlands (R.L.M.); and Department of Medicine and Therapeutics, Chinese University of Hong Kong, China (L.X.)
| | - Marcel Turner
- From the Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas (C.-Y.X., T.T., R.L.M., M.T., J.R., R.Z.); Department of Internal Medicine (C.-Y.X., W.V., R.Z.) and Department of Neurology and Neurotherapeutics (T.T., K.D., R.Z.), University of Texas Southwestern Medical Center, Dallas; Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China (C.-Y.X., L.-J.Y.); Department of Geriatric Medicine, Radboud University Nijmegen Medical Centre, The Netherlands (R.L.M.); and Department of Medicine and Therapeutics, Chinese University of Hong Kong, China (L.X.)
| | - Justin Repshas
- From the Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas (C.-Y.X., T.T., R.L.M., M.T., J.R., R.Z.); Department of Internal Medicine (C.-Y.X., W.V., R.Z.) and Department of Neurology and Neurotherapeutics (T.T., K.D., R.Z.), University of Texas Southwestern Medical Center, Dallas; Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China (C.-Y.X., L.-J.Y.); Department of Geriatric Medicine, Radboud University Nijmegen Medical Centre, The Netherlands (R.L.M.); and Department of Medicine and Therapeutics, Chinese University of Hong Kong, China (L.X.)
| | - Li Xiong
- From the Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas (C.-Y.X., T.T., R.L.M., M.T., J.R., R.Z.); Department of Internal Medicine (C.-Y.X., W.V., R.Z.) and Department of Neurology and Neurotherapeutics (T.T., K.D., R.Z.), University of Texas Southwestern Medical Center, Dallas; Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China (C.-Y.X., L.-J.Y.); Department of Geriatric Medicine, Radboud University Nijmegen Medical Centre, The Netherlands (R.L.M.); and Department of Medicine and Therapeutics, Chinese University of Hong Kong, China (L.X.)
| | - Kan Ding
- From the Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas (C.-Y.X., T.T., R.L.M., M.T., J.R., R.Z.); Department of Internal Medicine (C.-Y.X., W.V., R.Z.) and Department of Neurology and Neurotherapeutics (T.T., K.D., R.Z.), University of Texas Southwestern Medical Center, Dallas; Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China (C.-Y.X., L.-J.Y.); Department of Geriatric Medicine, Radboud University Nijmegen Medical Centre, The Netherlands (R.L.M.); and Department of Medicine and Therapeutics, Chinese University of Hong Kong, China (L.X.)
| | - Wanpen Vongpatanasin
- From the Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas (C.-Y.X., T.T., R.L.M., M.T., J.R., R.Z.); Department of Internal Medicine (C.-Y.X., W.V., R.Z.) and Department of Neurology and Neurotherapeutics (T.T., K.D., R.Z.), University of Texas Southwestern Medical Center, Dallas; Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China (C.-Y.X., L.-J.Y.); Department of Geriatric Medicine, Radboud University Nijmegen Medical Centre, The Netherlands (R.L.M.); and Department of Medicine and Therapeutics, Chinese University of Hong Kong, China (L.X.)
| | - Li-Jun Yuan
- From the Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas (C.-Y.X., T.T., R.L.M., M.T., J.R., R.Z.); Department of Internal Medicine (C.-Y.X., W.V., R.Z.) and Department of Neurology and Neurotherapeutics (T.T., K.D., R.Z.), University of Texas Southwestern Medical Center, Dallas; Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China (C.-Y.X., L.-J.Y.); Department of Geriatric Medicine, Radboud University Nijmegen Medical Centre, The Netherlands (R.L.M.); and Department of Medicine and Therapeutics, Chinese University of Hong Kong, China (L.X.)
| | - Rong Zhang
- From the Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas (C.-Y.X., T.T., R.L.M., M.T., J.R., R.Z.); Department of Internal Medicine (C.-Y.X., W.V., R.Z.) and Department of Neurology and Neurotherapeutics (T.T., K.D., R.Z.), University of Texas Southwestern Medical Center, Dallas; Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China (C.-Y.X., L.-J.Y.); Department of Geriatric Medicine, Radboud University Nijmegen Medical Centre, The Netherlands (R.L.M.); and Department of Medicine and Therapeutics, Chinese University of Hong Kong, China (L.X.).
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Slepecky M, Kotianova A, Prasko J, Majercak I, Gyorgyova E, Kotian M, Zatkova M, Tonhajzerova I, Chupacova M, Popelkova M. Coping, schemas, and cardiovascular risks - study protocol. Neuropsychiatr Dis Treat 2017; 13:2599-2605. [PMID: 29075121 PMCID: PMC5648306 DOI: 10.2147/ndt.s148837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The aim of this article is to describe the protocol of a trial focusing on the psychological, anthropometric, cardiac, and psychophysiological factors contributing to increased risk of cardiovascular diseases (CVDs). As background, the article provides a short overview of research literature linking personal traits, maladaptive schemas, and coping styles with CVDs through reactivity of the autonomic nervous system.
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Affiliation(s)
- Milos Slepecky
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, Slovak Republic
| | - Antonia Kotianova
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, Slovak Republic
| | - Jan Prasko
- Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital Olomouc, Olomouc, Czech Republic
| | - Ivan Majercak
- 1st Department of Internal Medicine, Faculty of Medicine, Pavol Josef Safarik University in Košice
| | - Erika Gyorgyova
- Internal Medicine and Cardiology Private Practice MUDr Ivan Majercak, Košice
| | - Michal Kotian
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, Slovak Republic.,Psychagogia, Liptovsky Mikulas
| | - Marta Zatkova
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, Slovak Republic
| | - Ingrid Tonhajzerova
- Department of Physiology.,Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
| | - Michaela Chupacova
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, Slovak Republic.,Psychagogia, Liptovsky Mikulas
| | - Marta Popelkova
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, Slovak Republic
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Slepecky M, Kotianova A, Prasko J, Majercak I, Gyorgyova E, Kotian M, Zatkova M, Popelkova M, Ociskova M, Tonhajzerova I. Which psychological, psychophysiological, and anthropometric factors are connected with life events, depression, and quality of life in patients with cardiovascular disease. Neuropsychiatr Dis Treat 2017; 13:2093-2104. [PMID: 28831258 PMCID: PMC5552144 DOI: 10.2147/ndt.s141811] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE The aim of the study was to determine psychological, psychophysiological, and anthropometric factors connected with life events, level of depression, and quality of life in people at risk for cardiovascular disease and healthy controls. METHODS This is a cross-sectional study involving arterial hypertension patients and healthy controls. There were several measurements including physical, anthropological, cardiovascular, and psychophysiological measurements and administration of questionnaires. RESULTS A total of 99 participants were recruited for this study, 54 healthy controls (mean age: 35.59±13.39 years) and 45 patients with cardiovascular disease (CVD) (mean age: 46.33±12.39 years). The healthy controls and the patients with CVD significantly differed in the mean total score of life events, level of depression, quality of life score, temperature, blood pressure (BP), pulse transit time, heart rate, high-frequency total power, heart rate variability total power, waist-to-height ratio (WHtR), body fat percentage, fat control, pulse wave velocity, and augmentation index. In healthy subjects, the total score of the life events was not correlated with any cardiovascular or anthropometric factor. A score of depression significantly correlated with the WHtR, augmentation index, body fat percentage, and fat control. The quality of life - visual scale correlated with the body temperature, BP, and percentage of body fat. In the group of the patients with CVD, the score of the life events did not correlate with any measured cardiovascular or anthropometric factor. The level of depression correlated with the augmentation index. The quality of life - visual scale significantly correlated with body temperature, WHtR, and fat control. CONCLUSION The patients with CVD reported higher scores of life events, worse quality of life, and a greater level of depressive symptoms than healthy controls. In healthy controls, a higher mean total score of life events significantly negatively correlated with high-frequency total power, and the degree of depression correlated with being overweight. In patients with CVD, a score of depression was linked to being overweight.
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Affiliation(s)
- Milos Slepecky
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra
| | - Antonia Kotianova
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra.,Psychagogia, Liptovsky Mikulas, Slovak Republic
| | - Jan Prasko
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra.,Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital Olomouc, Olomouc, Czech Republic
| | - Ivan Majercak
- First Department of Internal Medicine, Faculty of Medicine, Pavol Josef Safarik University in Kosice.,Internal Medicine and Cardiology Private Practice, MUDr Ivan Majercak, Kosice
| | - Erika Gyorgyova
- Internal Medicine and Cardiology Private Practice, MUDr Ivan Majercak, Kosice
| | - Michal Kotian
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra.,Psychagogia, Liptovsky Mikulas, Slovak Republic
| | - Marta Zatkova
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra
| | - Marta Popelkova
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra
| | - Marie Ociskova
- Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital Olomouc, Olomouc, Czech Republic
| | - Ingrid Tonhajzerova
- Department of Physiology and Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia
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Guo H, Schaller F, Tierney N, Smith SA, Shi X. New Insight into the Mechanism of Cardiovascular Dysfunction in the Elderly: Transfer Function Analysis. Exp Biol Med (Maywood) 2016; 230:549-57. [PMID: 16118405 DOI: 10.1177/153537020523000806] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study sought to test the hypothesis that alterations in the relationships between (i) mean arterial pressure (MAP) and heart rate (HR), (ii) cardiac output (CO) and MAP, and (Hi) total Peripheral resistance (TPR) and MAP variability contribute to the diminished dynamic control of cardiovascular function with advanced age. Six-minute hemodynamic data were continuously recorded in 11 elderly (70 ± 2 years) and 11 young (26 ± 1 year) healthy volunteers under supine resting condition and during lower body negative pressure–induced orthostatic challenge. The data were converted using fast Fourier transform, and the ratio of cross-spectra to auto-spectra between two signals (i.e., MAP-HR, CO-MAP, TPR-MAP) was computed for transfer function analysis. In the low-frequency ranges (LF; 0.04–O.14 Hz) and high-frequency ranges (0.15–0.30 Hz), the gain and coherence of the transfer function describing the relationship between MAP-HR signals were significantly greater in younger than in older adults. The phase degree was significantly >0 in both groups under all conditions, suggesting that the MAP variability preceded the HR variability. In contrast, the coherence between CO-MAP signals in both age groups was <0.5, indicating that the beat-to-beat MAP variability was not significantly related to the CO signals. However, the transfer function gain and coherence of TPR-MAP signals were significantly greater in the young group (coherence ≥0.5 in the LF range), suggesting a more effective dynamic vasomotor control. In conclusion, the oscillations in CO-MAP signals are not significantly synchronized or not related in a simply linear fashion in both age groups. The MAP variability is more related to the oscillation of TPR signals in the young group only. Advanced age not only diminishes MAP-HR transfer function gain, but also weakens its coherence. Thus, alterations in the relationship between MAP-HR variability and TPR-MAP variability may significantly contribute to the diminished dynamic control of cardiovascular function manifest in the elderly.
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Affiliation(s)
- Hong Guo
- Department of Integrative Physiology, University of North Texas Health Science Center, 3500 Camp Bowie Boulevard, Fort Worth, TX 76107, USA
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Park KH, Han SJ, Kim HS, Jo SH, Kim SA, Park WJ. Endothelial Function and Cardiovascular Autonomic Activity in Neurally Mediated Syncope. Cardiology 2016; 134:65-71. [PMID: 26928301 DOI: 10.1159/000443519] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 12/21/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The aim of this study was to investigate endothelial function and cardiovascular autonomic activity in patients with neurally mediated syncope (NMS). METHODS Patients with a typical history of NMS were divided according to the result of a head-up tilt (HUT) test. There were 25 patients each in the HUT-positive (HUT+), HUT-negative (HUT-) and control groups. Flow-mediated dilation (FMD) and 24-hour ambulatory electrocardiography (AECG) were performed before the HUT tests. RESULTS The HUT+ group had a significantly higher FMD than that of the HUT- group and the control group (8.8 ± 3.3 vs. 6.4 ± 2.9%, p = 0.006, and 8.8 ± 3.3 vs. 5.7 ± 2.2%, p = 0.001, respectively). On a 24-hour AECG, the parasympathetic indexes of time domain, such as rMSSD and the pNN50, were significantly higher in the HUT+ group than in the HUT- group (39.0 ± 9.6 vs. 31.6 ± 9.6 ms, p = 0.016, and 16.5 ± 8.1 vs. 10.2 ± 7.2%, p = 0.002, respectively) and the control group (39.0 ± 9.6 vs. 28.9 ± 9.6%, p = 0.001 and 16.5 ± 8.1 vs. 8.7 ± 6.7%, p = 0.001, respectively). High-frequency spectra (parasympathetic activity) of the frequency domain showed similar results. CONCLUSIONS Not only parasympathetic activity, but also endothelial function may affect the results of HUT tests in patients with NMS.
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Affiliation(s)
- Kyoung-Ha Park
- Cardiovascular Division, Department of Internal Medicine, Hallym University Medical Center, Anyang, Republic of Korea
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Lu WA, Chen YS, Kuo CD. Increased first and second pulse harmonics in Tai Chi Chuan practitioners. Altern Ther Health Med 2016; 16:87. [PMID: 26931120 PMCID: PMC4774128 DOI: 10.1186/s12906-016-1058-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 02/16/2016] [Indexed: 11/10/2022]
Abstract
Background Tai Chi Chuan (TCC) is known to be a good calisthenics for people. This study examined the relationship between pulse harmonics and autonomic nervous modulation in TCC practitioners. Methods Power spectral measures of right pulse wave and heart rate variability (HRV) measures were compared between TCC practitioners and control subjects. Correlation analyses between pulse harmonics and HRV measures were performed using linear regression analysis. Results At baseline, the total power of pulse (TPp), powers of all individual pulse harmonics, normalized power of the 1st harmonics (nPh1) of TCC practitioners were greater, while the normalized power of the 4th pulse harmonics (nPh4) of TCC practitioners was smaller, than those of the controls. Similarly, the baseline standard deviation (SDRR), coefficient of variation (CVRR), and normalized high-frequency power (nHFP) of RR intervals were smaller, while the normalized very low-frequency power (nVLFP) and low-/high- frequency power ratio (LHR) were larger in the TCC practitioners. The TCC age correlated significantly and negatively with nPh1, and nearly significantly and negatively with nPh2 in the TCC practitioners. Thirty min after TCC exercise, the percentage changes in mRRI, SDRR, TP, VLFP were decreased, while the percentage changes in HR, ULFP, nLFP, and Ph2 were increased, relative to the controls. Correlation analysis shows that the %Ph2 correlates significantly and negatively with %mRRI and significantly and positively with %HR. Conclusion The TCC practitioners had increased baseline total power of pulse and the 1st and 2nd pulse harmonics, and decreased power of the 4th pulse harmonics, along with decreased vagal modulation and increased sympathetic modulation. After TCC exercise, the power of the 2nd harmonics of TCC practitioners was increased which might be related to the increase in HR due to decreased vascular resistance after TCC exercise.
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Noormand R, Shafiee A, Davoodi G, Tavakoli F, Gheini A, Yaminisharif A, Jalali A, Sadeghian S. Age and the Head-Up Tilt Test Outcome in Syncope Patients. Res Cardiovasc Med 2015; 4:e27871. [PMID: 26528449 PMCID: PMC4623382 DOI: 10.5812/cardiovascmed.27871] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 06/23/2015] [Accepted: 07/01/2015] [Indexed: 12/03/2022] Open
Abstract
Background: The head-up tilt test (HUTT) is a useful diagnostic tool for syncope. Objectives: We sought to investigate the outcome of the HUTT in syncope patients and identify the relationship between age and different hemodynamic outcomes. Patients and Methods: In this cross-sectional study, we prospectively enrolled consecutive patients who presented with syncope and underwent the HUTT with a clinical suspicion of neurocardiogenic syncope after the exclusion of orthostatic hypotension cases. The HUTT consisted of consecutive passive and active phases. In the passive phase, the patients were tilted at 70 degrees for 20 minutes; and if negative, the test was repeated with 400 micrograms of sublingual nitroglycerin for another 20 minutes. Positive responses were classified according to the classification of the vasovagal syncope international study (VASIS) and compared for age and gender. Results: A total of 498 patients were enrolled (age = 44.93 ± 18.77 years; male = 271 [54.4%]). Overall, 291 (58.4%) patients had a positive HUTT, while 256 (88.5%) patients had a positive result during the active phase. The test results were as follows: 107 (36.7%) mixed type (VASIS I), 103 (35.3%) cardioinhibitory (VASIS IIA = 44 [15.1%]; VASIS IIB = 59 [20.2%]), and 80 (27.4%) vasodepressive (VASIS III). There was no relationship between gender and syncope type. The trend of the HUTT result significantly changed with age, and the rate of cardioinhibitory syncope decreased after middle ages (P value for trend = 0.02). Conclusions: Hemodynamic response to the HUTT was associated with age. Cardioinhibitory response became less frequent with age due to exaggerated vagal activity in the younger patients as compared with the older subjects.
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Affiliation(s)
- Rezvan Noormand
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Akbar Shafiee
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Gholamreza Davoodi
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Fatemeh Tavakoli
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Alireza Gheini
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Ahmad Yaminisharif
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Arash Jalali
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Saeed Sadeghian
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Saeed Sadeghian, Tehran Heart Center, Tehran University of Medical Sciences, P. O. Box: 1411713138, Tehran, IR Iran. Tel: +98-2188029257, Fax: +98-2188029256, E-mail:
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Heart Rate Variability Analysis in an Experimental Model of Hemorrhagic Shock and Resuscitation in Pigs. PLoS One 2015; 10:e0134387. [PMID: 26247476 PMCID: PMC4527725 DOI: 10.1371/journal.pone.0134387] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 07/03/2015] [Indexed: 01/10/2023] Open
Abstract
Background The analysis of heart rate variability (HRV) has been shown as a promising non-invasive technique for assessing the cardiac autonomic modulation in trauma. The aim of this study was to evaluate HRV during hemorrhagic shock and fluid resuscitation, comparing to traditional hemodynamic and metabolic parameters. Methods Twenty anesthetized and mechanically ventilated pigs were submitted to hemorrhagic shock (60% of estimated blood volume) and evaluated for 60 minutes without fluid replacement. Surviving animals were treated with Ringer solution and evaluated for an additional period of 180 minutes. HRV metrics (time and frequency domain) as well as hemodynamic and metabolic parameters were evaluated in survivors and non-survivors animals. Results Seven of the 20 animals died during hemorrhage and initial fluid resuscitation. All animals presented an increase in time-domain HRV measures during haemorrhage and fluid resuscitation restored baseline values. Although not significantly, normalized low-frequency and LF/HF ratio decreased during early stages of haemorrhage, recovering baseline values later during hemorrhagic shock, and increased after fluid resuscitation. Non-surviving animals presented significantly lower mean arterial pressure (43±7vs57±9 mmHg, P<0.05) and cardiac index (1.7±0.2vs2.6±0.5 L/min/m2, P<0.05), and higher levels of plasma lactate (7.2±2.4vs3.7±1.4 mmol/L, P<0.05), base excess (-6.8±3.3vs-2.3±2.8 mmol/L, P<0.05) and potassium (5.3±0.6vs4.2±0.3 mmol/L, P<0.05) at 30 minutes after hemorrhagic shock compared with surviving animals. Conclusions The HRV increased early during hemorrhage but none of the evaluated HRV metrics was able to discriminate survivors from non-survivors during hemorrhagic shock. Moreover, metabolic and hemodynamic variables were more reliable to reflect hemorrhagic shock severity than HRV metrics.
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Ferrario M, Raimann JG, Larive B, Pierratos A, Thijssen S, Rajagopalan S, Greene T, Cerutti S, Beck G, Chan C, Kotanko P. Non-Linear Heart Rate Variability Indices in the Frequent Hemodialysis Network Trials of Chronic Hemodialysis Patients. Blood Purif 2015; 40:99-108. [PMID: 26159747 DOI: 10.1159/000381665] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 03/16/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Non-linear heart rate variability (HRV) indices were hypothesized to correlate with cardiac function, fluid overload and physical performance in hemodialysis patients. METHODS Twenty-four-hour Holter electrocardiograms were recorded in patients enrolled in the Frequent Hemodialysis Network (FHN) Daily Dialysis Trial. Correlations between non-linear HRV indices and left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), extracellular volume (ECV)/total body water (TBW) ratio, the SF-36 Physical Health Composite (PHC) and Physical Functioning (PF) scores were tested. RESULTS We studied 210 subjects (average age 49.8 ± 13.5 years, 62% men, 42% diabetics). In non-diabetic patients, multiscale entropy (MSE) slope sample entropy (SampEn) and approximate entropy (ApEn) correlated positively with LVEF, PF and PHC and inversely with LVEDV and ECV/TBW. Spectral power slope correlated positively with ECV/TBW (r = 0.27). Irregularity measures (MSE ApEn and MSE SampEn) correlated positively with LVEDV (r = 0.19 and 0.20). CONCLUSION Non-linear HRV indices indicated an association between a deteriorated heart rate regulatory system and impaired cardiac function, fluid accumulation and poor physical condition.
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Affiliation(s)
- Manuela Ferrario
- Politecnico di Milano, Department of Electronics, Information and Bioengineering (DEIB), Milano, Italy
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Nasario-Junior O, Benchimol-Barbosa PR, Pedrosa RC, Nadal J. Assessment of Autonomic Function by Phase Rectification of RRInterval Histogram Analysis in Chagas Disease. Arq Bras Cardiol 2015; 104:450-5. [PMID: 26131700 PMCID: PMC4484677 DOI: 10.5935/abc.20150032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 01/26/2015] [Indexed: 11/20/2022] Open
Abstract
Background In chronic Chagas disease (ChD), impairment of cardiac autonomic function bears
prognostic implications. Phase‑rectification of RR-interval series isolates the
sympathetic, acceleration phase (AC) and parasympathetic, deceleration phase (DC)
influences on cardiac autonomic modulation. Objective This study investigated heart rate variability (HRV) as a function of RR-interval
to assess autonomic function in healthy and ChD subjects. Methods Control (n = 20) and ChD (n = 20) groups were studied. All underwent 60-min
head-up tilt table test under ECG recording. Histogram of RR-interval series was
calculated, with 100 ms class, ranging from 600–1100 ms. In each class, mean
RR-intervals (MNN) and root-mean-squared difference (RMSNN) of consecutive normal
RR-intervals that suited a particular class were calculated. Average of all RMSNN
values in each class was analyzed as function of MNN, in the whole series
(RMSNNT), and in AC (RMSNNAC) and DC (RMSNNDC)
phases. Slopes of linear regression lines were compared between groups using
Student t-test. Correlation coefficients were tested before comparisons. RMSNN was
log-transformed. (α < 0.05). Results Correlation coefficient was significant in all regressions (p < 0.05). In the
control group, RMSNNT, RMSNNAC, and RMSNNDC
significantly increased linearly with MNN (p < 0.05). In ChD, only
RMSNNAC showed significant increase as a function of MNN, whereas
RMSNNT and RMSNNDC did not. Conclusion HRV increases in proportion with the RR-interval in healthy subjects. This
behavior is lost in ChD, particularly in the DC phase, indicating cardiac vagal
incompetence.
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Affiliation(s)
- Olivassé Nasario-Junior
- Programa de Engenharia Biomédica, COPPE, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | - Roberto Coury Pedrosa
- Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Jurandir Nadal
- Programa de Engenharia Biomédica, COPPE, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Morales IO, Landa E, Angeles CC, Toledo JC, Rivera AL, Temis JM, Frank A. Behavior of Early Warnings near the Critical Temperature in the Two-Dimensional Ising Model. PLoS One 2015; 10:e0130751. [PMID: 26103513 PMCID: PMC4477971 DOI: 10.1371/journal.pone.0130751] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 05/23/2015] [Indexed: 11/19/2022] Open
Abstract
Among the properties that are common to complex systems, the presence of critical thresholds in the dynamics of the system is one of the most important. Recently, there has been interest in the universalities that occur in the behavior of systems near critical points. These universal properties make it possible to estimate how far a system is from a critical threshold. Several early-warning signals have been reported in time series representing systems near catastrophic shifts. The proper understanding of these early-warnings may allow the prediction and perhaps control of these dramatic shifts in a wide variety of systems. In this paper we analyze this universal behavior for a system that is a paradigm of phase transitions, the Ising model. We study the behavior of the early-warning signals and the way the temporal correlations of the system increase when the system is near the critical point.
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Affiliation(s)
- Irving O. Morales
- Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, México, D.F., México
- Centro de Ciencias de la Complejidad, Universidad Nacional Autónoma de México, México, D.F., México
- Laboratorio Nacional de Ciencias de la Complejidad, D.F., México
- * E-mail:
| | - Emmanuel Landa
- Instituto de Biociências, Universidad de São Paulo, SP, Brazil
- Laboratorio Nacional de Ciencias de la Complejidad, D.F., México
| | - Carlos Calderon Angeles
- Facultad de Ciencias, Universidad Nacional Autonoma de México, D.F., México
- Laboratorio Nacional de Ciencias de la Complejidad, D.F., México
| | - Juan C. Toledo
- Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, México, D.F., México
- Centro de Ciencias de la Complejidad, Universidad Nacional Autónoma de México, México, D.F., México
- Laboratorio Nacional de Ciencias de la Complejidad, D.F., México
| | - Ana Leonor Rivera
- Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, México, D.F., México
- Centro de Física Aplicada y Tecnología Avanzada, Universidad Nacional Autónoma de México, Querétaro, México
- Laboratorio Nacional de Ciencias de la Complejidad, D.F., México
| | - Joel Mendoza Temis
- Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, México, D.F., México
- Centro de Ciencias de la Complejidad, Universidad Nacional Autónoma de México, México, D.F., México
- Laboratorio Nacional de Ciencias de la Complejidad, D.F., México
| | - Alejandro Frank
- Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, México, D.F., México
- Centro de Ciencias de la Complejidad, Universidad Nacional Autónoma de México, México, D.F., México
- Laboratorio Nacional de Ciencias de la Complejidad, D.F., México
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Droguett VSL, Santos ADC, de Medeiros CE, Marques DP, do Nascimento LS, Brasileiro-Santos MDS. Cardiac autonomic modulation in healthy elderly after different intensities of dynamic exercise. Clin Interv Aging 2015; 10:203-8. [PMID: 25653509 PMCID: PMC4310707 DOI: 10.2147/cia.s62346] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To investigate the heart rate (HR) and its autonomic modulation at baseline and during dynamic postexercise (PEX) with intensities of 40% and 60% of the maximum HR in healthy elderly. Methods This cross-sectional study included ten apparently healthy people who had been submitted to a protocol on a cycle ergometer for 35 minutes. Autonomic modulation was evaluated by spectral analysis of HR variability (HRV). Results A relevant increase in HR response was observed at 15 minutes postexercise with intensities of 60% and 40% of the maximum HR (10±2 bpm versus 5±1 bpm, respectively; P=0.005), and a significant reduction in HRV was also noted with 40% and 60% intensities during the rest period, and significant reduction in HRV (RR variance) was also observed in 40% and 60% intensities when compared to the baseline, as well as between the post-exercise intensities (1032±32 ms versus 905±5 ms) (P<0.001). In the HRV spectral analysis, a significant increase in the low frequency component HRV and autonomic balance at 40% of the maximum HR (68±2 normalized units [nu] versus 55±1 nu and 2.0±0.1 versus 1.2±0.1; P<0.001) and at 60% of the maximum HR (77±1 nu versus 55±1 nu and 3.2±0.1 versus 1.2±0.1 [P<0.001]) in relation to baseline was observed. A significant reduction of high frequency component at 40% and 60% intensities, however, was observed when compared to baseline (31±2 nu and 23±1 nu versus 45±1 nu, respectively; P<0.001). Moreover, significant differences were observed for the low frequency and high frequency components, as well as for the sympathovagal balance between participants who reached 40% and 60% of the maximum HR. Conclusion There was an increase in the HR, sympathetic modulation, and sympathovagal balance, as well as a reduction in vagal modulation in the elderly at both intensities of the PEX.
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Affiliation(s)
| | - Amilton da Cruz Santos
- Department of Physical Education, Federal University of Paraiba, João Pessoa, Paraiba, Brazil
| | | | - Douglas Porto Marques
- Department of Physical Education, Federal University of Paraiba, João Pessoa, Paraiba, Brazil
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Nardelli M, Valenza G, Gentili C, Lanata A, Scilingo EP. Temporal trends of neuro-autonomic complexity during severe episodes of bipolar disorders. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2015; 2014:2948-51. [PMID: 25570609 DOI: 10.1109/embc.2014.6944241] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Bipolar disorder is a chronic psychiatric condition during which patients experience mood swings among depression, hypomania or mania, mixed state (depression-hypomania) and euthymia, i.e., good affective balance. Nowadays, an objective characterization of the temporal trends of the disease as a response to the pharmacological treatment through physiological signatures, especially during severe episodes, is still missing. In this study we show interesting findings relating neuro-autonomic complexity to severe pathological mood states. More specifically, we studied Sample Entropy (SampEn) measures on Heart Rate Variability series gathered from four bipolar patients recruited within the frame of the European project PSYCHE. Patients were monitored through long term ECG recordings from the first hospital admission until clinical remission, i.e., the euthymic state. We observed that a mood transition from mixed-state to euthymia passing through depression can be characterized by increased SampEn values, i.e. as the patient is going to recover, SampEn increases. These results are in agreement with the current literature reporting on the complexity dynamics of the cardiovascular system and can provide a promising and viable clinical decision support to objectify the diagnosis and improve the management of psychiatric disorders.
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Shahrestani S, Stewart EM, Quintana DS, Hickie IB, Guastella AJ. Heart rate variability during adolescent and adult social interactions: a meta-analysis. Biol Psychol 2015; 105:43-50. [PMID: 25559773 DOI: 10.1016/j.biopsycho.2014.12.012] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 12/24/2014] [Accepted: 12/24/2014] [Indexed: 11/25/2022]
Abstract
Social interaction skill is important for psychological wellbeing, stress regulation, protection from disability and overall life satisfaction. Increase in activity of the vagus nerve, measured by heart rate variability (HRV), is associated with social interaction skill and decreased stress. In this meta-analysis we collated statistics from thirteen studies consisting of 787 participants who were participating in social interactions while HRV was simultaneously collected. Results revealed that while dyadic social interactions do not increase HRV generally from a baseline state, negative dyadic social interactions decrease HRV in a manner similar to the Trier Social Stress Task. Further, participants with psychopathology do not show cardiac autonomic flexibility during social interactions as indicated by reductions under stress and increases with subsequently positive social interactions. The role of age, gender and HRV index were also examined as potential moderators of HRV. Implications for health and wellbeing resulting from exposure to negative social interactions are discussed.
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Affiliation(s)
- Sara Shahrestani
- Autism Clinic for Translational Research, Brain and Mind Research Institute, University of Sydney, Australia
| | - Elizabeth M Stewart
- Autism Clinic for Translational Research, Brain and Mind Research Institute, University of Sydney, Australia
| | - Daniel S Quintana
- Autism Clinic for Translational Research, Brain and Mind Research Institute, University of Sydney, Australia
| | - Ian B Hickie
- Autism Clinic for Translational Research, Brain and Mind Research Institute, University of Sydney, Australia
| | - Adam J Guastella
- Autism Clinic for Translational Research, Brain and Mind Research Institute, University of Sydney, Australia.
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Effect of the Postural Challenge on the Dependence of the Cardiovascular Control Complexity on Age. ENTROPY 2014. [DOI: 10.3390/e16126686] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Lee SH, Lu WA, Lee CS, Wang JC, Lin TC, Yang JL, Chan RC, Ko SC, Kuo CD. The therapeutic effect of collateral meridian therapy is comparable to acupoint pressure therapy in treating myofascial pain syndrome. Complement Ther Clin Pract 2014; 20:243-50. [DOI: 10.1016/j.ctcp.2014.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 08/31/2014] [Accepted: 10/09/2014] [Indexed: 10/24/2022]
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Efremov K, Brisinda D, Venuti A, Iantorno E, Cataldi C, Fioravanti F, Fenici R. Heart rate variability analysis during head-up tilt test predicts nitroglycerine-induced syncope. Open Heart 2014; 1:e000063. [PMID: 25332802 PMCID: PMC4195932 DOI: 10.1136/openhrt-2014-000063] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 05/06/2014] [Accepted: 05/28/2014] [Indexed: 01/15/2023] Open
Abstract
Objective The aim of this study was to determine whether or not heart rate variability (HRV) analysis during the first 20 min of head-up tilt testing could predict whether patients will develop syncope after nitroglycerine administration. Design 64 patients with previous loss of consciousness underwent head-up tilt testing with the Italian protocol, which involves the administration of nitroglycerine after 20 min of tilt. HRV parameters were analysed from 5 min intervals selected during pretest supine rest (phase 1), the first 5 min (phase 2) and the last 5 min (phase 3) of passive 20 min of tilting, prior to the administration of nitroglycerine. Differences in power (ms2) of the spectral components between the various phases of tilting were calculated for each patient and expressed as Δ. Results 20 patients (group 1, 9 women, mean age 43.2±24.5 years) had a syncope during tilt testing after nitroglycerine, while the other 44 (group 2, 24 women, mean age 41±20.5 years) did not. In group 1, the HRV spectral parameters high frequency (HF) and total power (TP) had a significant decrement from phases 2 to 3 (p=0.012 and 0.027, respectively), while in group 2 the average HF and TP values did not change. The Δ of spectral parameters between phases 2 and 3 were able to differentiate between the two groups and to predict syncope after nitroglycerine administration (p<0.05). Conclusions HRV analysis within the first 20 min of passive tilting demonstrated that patients with nitroglycerine-induced syncope are characterised by a progressive decrement of parasympathetic activity, which does not occur in patients with a negative response to nitroglycerine. If confirmed on a wider population, HRV analysis could replace nitroglycerine administration and shorten the duration of the tilt test.
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Affiliation(s)
- Kristian Efremov
- Catholic University of the Sacred Heart, Biomagnetism Center, Clinical Physiology , Rome , Italy
| | - Donatella Brisinda
- Catholic University of the Sacred Heart, Biomagnetism Center, Clinical Physiology , Rome , Italy
| | - Angela Venuti
- Catholic University of the Sacred Heart, Biomagnetism Center, Clinical Physiology , Rome , Italy
| | - Emilia Iantorno
- Catholic University of the Sacred Heart, Biomagnetism Center, Clinical Physiology , Rome , Italy
| | - Claudia Cataldi
- Catholic University of the Sacred Heart, Biomagnetism Center, Clinical Physiology , Rome , Italy
| | - Francesco Fioravanti
- Catholic University of the Sacred Heart, Biomagnetism Center, Clinical Physiology , Rome , Italy
| | - Riccardo Fenici
- Catholic University of the Sacred Heart, Biomagnetism Center, Clinical Physiology , Rome , Italy
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Chang LC. The relationship between nature-based tourism and autonomic nervous system function among older adults. J Travel Med 2014; 21:159-62. [PMID: 24612381 DOI: 10.1111/jtm.12108] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 11/07/2013] [Accepted: 11/19/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Nature-based tourism has recently become a topic of interest in health research. This study was aimed at examining relationships among nature-based tourism, stress, and the function of the autonomic nervous system (ANS). METHODS Three hundred and twenty-two older adults living in Taichung City, Taiwan, were selected as participants. Data were collected by a face-to-face survey that included measures of the frequency of participation in domestic and international nature-based tourism and the stress and ANS function of these participants. The data were analyzed using a path analysis. RESULTS The results demonstrated that the frequency of participation in domestic nature-based tourism directly contributed to ANS function and that it also indirectly contributed to ANS function through stress reduction. CONCLUSIONS Domestic nature-based tourism can directly and indirectly contribute to ANS function among older adults. Increasing the frequency of participation in domestic nature-based tourism should be considered a critical element of health programs for older adults.
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Affiliation(s)
- Liang-Chih Chang
- Department of Living Sciences, National Open University, New Taipei City, Taiwan
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50
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Nasario-Junior O, Benchimol-Barbosa PR, Nadal J. Refining the deceleration capacity index in phase-rectified signal averaging to assess physical conditioning level. J Electrocardiol 2013; 47:306-10. [PMID: 24406208 DOI: 10.1016/j.jelectrocard.2013.12.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Indexed: 11/17/2022]
Abstract
BACKGROUND Deceleration capacity (DC) of heart rate is a measure of cardiac vagal modulation. This study introduced a DC adaptation (Modified Index) that measured the velocity of change in the phase-rectified signal averaging curve, and assessed its ability to discriminate athletes from controls. MATERIALS AND METHODS The Modified Index was compared to Standard DC approach in a prospective case-control study. Subjects were classified according to maximal metabolic equivalents as the control group (CG) and athlete group (AG). The Modified Index was compared to Standard DC and classical approaches (RMSSD and HF) by the area under receiver operating characteristic curve (AUC) using 10,000 bootstraps. RESULTS In Standard DC and Modified Index bootstrap median values were (ms), respectively, 11.80 and 17.94 (p<0.01) in CG, and 25.98 and 45.62 in AG (p<0.01). AUC (mean±SD) was 0.70±0.12 for Standard DC and 0.96±0.04 for Modified Index (p<0.01). CONCLUSIONS Modified Index appropriately discriminates athletes from healthy sedentary subjects.
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Affiliation(s)
- Olivassé Nasario-Junior
- Programa de Engenharia Biomédica, COPPE, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | - Jurandir Nadal
- Programa de Engenharia Biomédica, COPPE, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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