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Yokota H, Edama M, Kawanabe Y, Hirabayashi R, Sekikne C, Akuzawa H, Ishigaki T, Otsuru N, Saito K, Kojima S, Miyaguchi S, Onishi H. Effects of transcutaneous auricular vagus nerve stimulation at left cymba concha on experimental pain as assessed with the nociceptive withdrawal reflex, and correlation with parasympathetic activity. Eur J Neurosci 2024. [PMID: 38469939 DOI: 10.1111/ejn.16305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 02/02/2024] [Accepted: 02/19/2024] [Indexed: 03/13/2024]
Abstract
The aim of this study was to clarify the effects of transcutaneous auricular vagus nerve stimulation (taVNS) to the left cymba concha on the pain perception using nociceptive withdrawal reflex (NWR), which is known to be associated with chronic pain, and to investigate whether there is a relationship between taVNS-induced suppression of the NWR and parasympathetic activation. We applied either 3.0 mA, 100 Hz taVNS for 120 s on the left cymba concha (taVNS condition) or the left earlobe (Sham condition) for 20 healthy adults. NWR threshold was measured before (Baseline), immediately after (Post 0), 10 min (Post 10) and 30 min after (Post 30) stimulation. The NWR threshold was obtained from biceps femoris muscle by applying electrical stimulation to the sural nerve. During taVNS, electrocardiogram was recorded, and changes in autonomic nervous activity measured by heart rate variability (HRV) were analyzed. We found that the NWR thresholds at Post 10 and Post 30 increased compared with baseline in the taVNS group (10 min after: p = .008, 30 min after: p = .008). In addition, increased parasympathetic activity by taVNS correlated with a greater increase in NWR threshold at Post 10 and Post 30 (Post 10: p = .003; Post 30: p = .001). The present results of this single-blinded study demonstrate the pain-suppressing effect of taVNS on NWR threshold and suggest that the degree of parasympathetic activation during taVNS may predict the pain-suppressing effect of taVNS after its application.
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Affiliation(s)
- Hirotake Yokota
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Mutsuaki Edama
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Yurika Kawanabe
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Ryo Hirabayashi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Chie Sekikne
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Hiroshi Akuzawa
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Tomonobu Ishigaki
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Naofumi Otsuru
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Kei Saito
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Sho Kojima
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Shota Miyaguchi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Hideaki Onishi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
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Zhang Y, Bai J, Li L, Yang H, Yang Y, Lv H. Research for correlation between heart rate variability parameters and bone mineral density in patients of type 2 diabetes mellitus. J Endocrinol Invest 2023; 46:79-88. [PMID: 35925468 DOI: 10.1007/s40618-022-01886-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 07/27/2022] [Indexed: 01/12/2023]
Abstract
PURPOSE The relationship of CAN and BMD, fracture risk is still unclear in T2DM. The aim of the present study is to investigate the correlation between heart rate variability (HRV) and BMD in T2DM. METHODS The study included 276 patients with T2DM aged ≥ 50 years, and Cardiovascular Autonomic Reflex Tests (CARTs) were applied to divide patients into two groups: CAN ( ±). 24 h Ambulatory ECG was assessed for HRV, BMD was measured by dual-energy X-ray bone densitometry, and FRAX scores were calculated for 10-year hip fracture risk (HF1) and major osteoporotic fracture risk (MOF). Adjusted regression analysis was performed to investigate influence factors for BMD and fracture risk. ROC curve was used to analyze the optimal cut-off point of LF/HF for screening osteoporosis. RESULTS Baseline data showed significant differences in the duration of T2DM, insulin resistance index (HOMA-IR), 25-hydroxyvitamin D[25(OH)D], femoral neck BMD, hip BMD, lumbar BMD, HF1, and MOF between the CAN ( +) and CAN (-) groups. The proportion of patients with osteoporosis increased as the degree of CAN lesion increased. Correlation analysis showed that LF/HF was significantly correlated with BMD, especially with hip (r = - 0.534, p < 0.001). Regression analysis showed that LF/HF was a risk factor for reduced BMD and increased fracture risk. The optimal cut-point value for LF/HF to predict osteoporosis by ROC curve analysis was 3.17. CONCLUSIONS CAN is associated with reduced BMD and increased fracture risk in patients with T2DM, and LF/HF may have the potential to be a predictor of diabetic osteoporosis and have some clinical value in early diagnosis of diabetic osteoporosis and non-traumatic fractures in T2DM.
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Affiliation(s)
- Y Zhang
- Department of Endocrinology, The First Hospital of Lanzhou University, No.1 Donggang West Road, Lanzhou, 730000, Gansu, People's Republic of China
- The First Clinical Medical College of Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - J Bai
- Department of Endocrinology, The First Hospital of Lanzhou University, No.1 Donggang West Road, Lanzhou, 730000, Gansu, People's Republic of China
- The First Clinical Medical College of Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - L Li
- Department of Endocrinology, The First Hospital of Lanzhou University, No.1 Donggang West Road, Lanzhou, 730000, Gansu, People's Republic of China
- The First Clinical Medical College of Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - H Yang
- Department of Endocrinology, The First Hospital of Lanzhou University, No.1 Donggang West Road, Lanzhou, 730000, Gansu, People's Republic of China
- The First Clinical Medical College of Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Y Yang
- Department of Endocrinology, The First Hospital of Lanzhou University, No.1 Donggang West Road, Lanzhou, 730000, Gansu, People's Republic of China
- The First Clinical Medical College of Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - H Lv
- Department of Endocrinology, The First Hospital of Lanzhou University, No.1 Donggang West Road, Lanzhou, 730000, Gansu, People's Republic of China.
- The First Clinical Medical College of Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China.
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Kusuki H, Tsuchiya Y, Mizutani Y, Nishio M, Oikawa S, Nagata R, Kiriyanagi Y, Horio K, Kojima A, Uchida H, Kojima N, Saito K, Sadanaga T, Hata T. QT Variability Index is Correlated with Autonomic Nerve Activity in Healthy Children. Pediatr Cardiol 2020; 41:1432-1437. [PMID: 32572546 PMCID: PMC7557489 DOI: 10.1007/s00246-020-02399-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 06/12/2020] [Indexed: 11/24/2022]
Abstract
The QT variability index (QTVI), which measures the instability of myocardial repolarization, is usually calculated from a single electrocardiogram (ECG) recording and can be easily applied in children. It is well known that frequency analysis of heart rate variability (HRV) can detect autonomic balance, but it is not clear whether QTVI is correlated with autonomic tone. Therefore, we evaluated the association between QTVI and HRV to elucidate whether QTVI is correlated with autonomic nerve activity. Apparently, healthy 320 children aged 0-7 years who visited Fujita Health University Hospital for heart checkup examinations were included. The RR and QT intervals of 60 continuous heart beats were measured, and the QTVI was calculated using the formula of Berger et al. Frequency analysis of HRV, including the QTVI analysis region, was conducted for 2 min and the ratio of low-frequency (LF) components to high-frequency (HF) components (LF/HF) and HF/(LF + HF) ratio was calculated as indicators of autonomic nerve activity. Then, the correlations between QTVI and these parameters were assessed. QTVI showed a significant positive correlation with LF/HF ratio (r = 0.45, p < 0.001) and negative correlation with HF/(LF + HF) ratio (r = -0.429, p < 0.001). These correlations remained after adjustment for sex and age. QTVI, which is calculated from non-invasive ECG and can detect abnormal myocardial repolarization, is significantly correlated with frequency analysis of HRV parameters. QTVI reflects autonomic nerve balance in children.
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Affiliation(s)
- Hirofumi Kusuki
- grid.256115.40000 0004 1761 798XGraduate School of Health Sciences, Fujita Health University, Toyoake, Aichi Japan
| | - Yuka Tsuchiya
- grid.256115.40000 0004 1761 798XGraduate School of Health Sciences, Fujita Health University, Toyoake, Aichi Japan
| | - Yuri Mizutani
- grid.256115.40000 0004 1761 798XGraduate School of Health Sciences, Fujita Health University, Toyoake, Aichi Japan
| | - Miki Nishio
- grid.256115.40000 0004 1761 798XGraduate School of Health Sciences, Fujita Health University, Toyoake, Aichi Japan
| | - Shota Oikawa
- grid.471500.70000 0004 0649 1576Laboratory of Clinical Medicine, Fujita Health University Hospital, Toyoake, Aichi Japan
| | - Rina Nagata
- grid.471500.70000 0004 0649 1576Laboratory of Clinical Medicine, Fujita Health University Hospital, Toyoake, Aichi Japan
| | - Yumi Kiriyanagi
- grid.471500.70000 0004 0649 1576Laboratory of Clinical Medicine, Fujita Health University Hospital, Toyoake, Aichi Japan
| | - Kayo Horio
- grid.256115.40000 0004 1761 798XDepartment of Physiology, School of Medicine, Fujita Health University, Toyoake, Aichi Japan
| | - Arisa Kojima
- grid.256115.40000 0004 1761 798XDepartment of Pediatrics, School of Medicine, Fujita Health University, Toyoake, Aichi Japan
| | - Hidetoshi Uchida
- grid.256115.40000 0004 1761 798XDepartment of Pediatrics, School of Medicine, Fujita Health University, Toyoake, Aichi Japan
| | - Namiko Kojima
- Department of Pediatrics, Meijyo Hospital, Nagoya, Aichi Japan
| | - Kazuyoshi Saito
- Department of Pediatrics, Meijyo Hospital, Nagoya, Aichi Japan
| | | | - Tadayoshi Hata
- Graduate School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan.
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Bakhsh A, Martin GFJ, Bicknell CD, Pettengell C, Riga C. An Evaluation of the Impact of High-Fidelity Endovascular Simulation on Surgeon Stress and Technical Performance. J Surg Educ 2019; 76:864-871. [PMID: 30527702 DOI: 10.1016/j.jsurg.2018.10.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 09/29/2018] [Accepted: 10/28/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To measure the physiological stress response associated with high-fidelity endovascular team simulation. DESIGN This is a prospective cohort study. SETTING This study was performed at St Mary's Hospital (Imperial College London, London, UK), in a tertiary setting. PARTICIPANTS Thirty-five participants (10 vascular surgical residents, 4 surgical interns, 12 theatre nurses, 2 attending vascular surgeons, 6 medical students and 1 technician) were recruited from the Imperial Vascular Unit at St Mary's Hospital, Imperial College London by direct approach. All participants finished the study. RESULTS Junior surgeons experienced significantly increased sympathetic tone (Low frequency/high frequency (LF/HF) ratio) during team simulation compared to individual simulation (6.01 ± 1.68 vs. 8.32 ± 2.84, p < 0.001). Within team simulation junior surgeons experienced significantly higher heart rate (beats per minute) than their senior counterparts (82 ± 5.83 vs. 76 ± 6.02, p = 0.033). Subjective workload scores (NASA Task Load Index [NASA-TLX]) correlated moderately and significantly with sympathetic tone in surgeons across all stages of simulation. (r = 0.39, p = 0.01). CONCLUSIONS A discrete, measurable increase in stress is experienced by surgeons during high-fidelity endovascular simulation and differentially effects junior surgeons. High-fidelity team simulation may have a role to play in improving nontechnical skill, reducing intra-operative stress, and reducing error.
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Affiliation(s)
- Ali Bakhsh
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom.
| | - Guy F J Martin
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom; Imperial Vascular Unit, Imperial College Healthcare NHS Trust, St Mary's Hospital, London, United Kingdom
| | - Colin D Bicknell
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom; Imperial Vascular Unit, Imperial College Healthcare NHS Trust, St Mary's Hospital, London, United Kingdom
| | - Chris Pettengell
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom; Imperial Vascular Unit, Imperial College Healthcare NHS Trust, St Mary's Hospital, London, United Kingdom
| | - Celia Riga
- Imperial Vascular Unit, Imperial College Healthcare NHS Trust, St Mary's Hospital, London, United Kingdom
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Yu YL, Li NN, Shi MT, Lu HJ. Analysis of heart rate variability-related indexes in the interictal period in patients with focal epilepsy. Life Sci 2018; 209:403-408. [PMID: 30114410 DOI: 10.1016/j.lfs.2018.08.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 08/09/2018] [Accepted: 08/13/2018] [Indexed: 11/24/2022]
Abstract
AIMS Changes in cardiac autonomic nervous function have been evaluated by studying the related indexes of heart rate variability (HRV) in patients with focal epilepsy (FE) in the interictal period. MAIN METHODS A total of 30 FE patients who were treated in our department from July 2015 to May 2017, were included into this study. These patients were divided into three pairs of groups: less frequent seizure group and more frequent seizure group; medication group and non-medication group; <10 years disease group and ≥10 years disease group. In addition, 16 normal healthy subjects were enrolled as the control group. The time domain and frequency domain indexes of HRV indexes between subgroups and the control group were retrospectively analyzed. KEY FINDINGS The low-frequency/high-frequency ratio (LF/HF) in the interictal period was higher in the more frequent seizure group than in the control group and less frequent seizure group (P < 0.05). Furthermore, differences in interictal LF/HF and very low frequency (VLF) between the medication group and non-medication group and control group were statistically significant (P < 0.05). SIGNIFICANCE In interictal period FE patients who present with an imbalance in autonomic nervous function, LF/HF can serve as an indicator to evaluate the interictal cardiac sympathetic activity of FE patients. Furthermore, the dynamic observation of changes in the HRV-related indexes of FE patients can prevent the choice of antiepileptic drugs that affect heart function, which is of guiding significance for evaluating autonomic nervous function.
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Affiliation(s)
- Yun-Li Yu
- Department of Neurology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China.
| | - Na-Na Li
- Department of Neurology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
| | - Meng-Ting Shi
- Department of Neurology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
| | - Hong-Juan Lu
- Department of Neurology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
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Zhu H, Wang H, Liu Z, Li D, Kou G, Li C. Experimental study on the human thermal comfort based on the heart rate variability (HRV) analysis under different environments. Sci Total Environ 2018; 616-617:1124-1133. [PMID: 29096956 DOI: 10.1016/j.scitotenv.2017.10.208] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 09/29/2017] [Accepted: 10/20/2017] [Indexed: 06/07/2023]
Abstract
In order to study the human thermal comfort under different environments, the electrocardiogram (ECG) data of 6 subjects were recorded continuously under 60 environments composed by different air temperature, relative humidity and air speed that were created by an environmental chamber. Based on the ECG data, the frequency-domain method was adopted to obtain the heart rate variability (HRV) results. Among the HRV indices, the ratio of the low frequency power and high frequency power of the HRV analysis results (LF/HF), which reflects the balance of the autonomic nervous system, was selected as an indicator of the thermal comfort in the study. And the effects of air temperature, relative humidity and air speed on LF/HF were scrutinized. Meanwhile, a questionnaire survey was conducted during the experiment to evaluate the thermal comfort of the subjects. And the relationships between mean LF/HF and thermal sensation, mean thermal comfort were established based on the survey. The results showed that different LF/HF was observed under different environments, and that the air temperature had the most significant effects on LF/HF. The changes in the air temperature could easily lead to the excitation of the sympathetic nerve that could promote the activities of the thermoregulatory effectors thus thermal discomfort. Additionally, the fitting curves illustrating the relationships between LF/HF and thermal sensation and thermal comfort showed that the higher LF/HF yielded thermal discomfort, while the low LF/HF indicated a thermally acceptable state.
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Affiliation(s)
- Hui Zhu
- Provincial Engineering Laboratory of Hunan for the Technologies of Building Environment Control, University of South China, Hengyang 421001, China; School of Energy Science and Engineering, Central South University, Changsha 410083, China.
| | - Hanqing Wang
- Provincial Engineering Laboratory of Hunan for the Technologies of Building Environment Control, University of South China, Hengyang 421001, China; Collaborative Innovation Center for Building Energy-conservation and Environment Control, Hunan University of Technology, Zhuzhou 412001, China.
| | - Zhiqiang Liu
- School of Energy Science and Engineering, Central South University, Changsha 410083, China; Collaborative Innovation Center for Building Energy-conservation and Environment Control, Hunan University of Technology, Zhuzhou 412001, China.
| | - Duanru Li
- School of Energy Science and Engineering, Central South University, Changsha 410083, China; Collaborative Innovation Center for Building Energy-conservation and Environment Control, Hunan University of Technology, Zhuzhou 412001, China
| | - Guangxiao Kou
- Collaborative Innovation Center for Building Energy-conservation and Environment Control, Hunan University of Technology, Zhuzhou 412001, China
| | - Can Li
- Collaborative Innovation Center for Building Energy-conservation and Environment Control, Hunan University of Technology, Zhuzhou 412001, China
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Obara T, Nagai K, Shibata S, Hirasawa A, Koshiba H, Hasegawa H, Ebihara T, Kozaki K. Relationship between the severity of cerebral white matter hyperintensities and sympathetic nervous activity in older adults. Geriatr Gerontol Int 2017; 18:569-575. [PMID: 29193629 DOI: 10.1111/ggi.13217] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/11/2017] [Accepted: 10/09/2017] [Indexed: 11/27/2022]
Abstract
AIM White matter hyperintensities (WMH), visualized on brain magnetic resonance imaging, represent an abnormality related to the development of geriatric syndromes. Recently, it has been found that low sympathetic nervous activity might be associated with physical and cognitive dysfunction in older adults. Therefore, we investigated the relationship between the severity of cerebral WMH and sympathetic nervous activity, measured by the heart rate variability. METHODS We carried out a cross-sectional study of 39 older patients. Holter recording was carried out for 30 min. From the RR intervals on the electrocardiogram, the standard deviation of the normal-to-normal intervals, the standard deviation of all normal-to-normal intervals in all the five segments of the entire recording, low frequency (LF), high frequency (HF) and LF/HF were calculated. In regard to the WMH, periventricular hyperintensities and deep white matter hyperintensities (DWMH) were rated according to the Fazekas classification. The WMH were also rated semiquantitatively according to the methods developed by Junque (periventricular hyperintensities) and de Groot (DWMH). RESULTS The LF/HF showed significant negative correlations with the total and regional periventricular hyperintensities, as well as DWMH. Multiple regression analysis showed that the negative associations remained significant between the LF/HF and DWMH (total, temporal, occipital). Furthermore, fall risk index significantly correlated with the LF/HF, total and the occipital DWMH. CONCLUSIONS The severity of the DWMH was associated with the LF/HF and the fall risk, one of the important geriatric syndromes, suggesting that WMH, sympathetic nervous dysfunction and geriatric syndrome are interrelated to each other. Geriatr Gerontol Int 2018; 18: 569-575.
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Affiliation(s)
- Toshimasa Obara
- Department of Geriatric Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Kumiko Nagai
- Department of Geriatric Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Shigeki Shibata
- Department of Geriatric Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Ai Hirasawa
- Department of Geriatric Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Hitomi Koshiba
- Department of Geriatric Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Hiroshi Hasegawa
- Department of Geriatric Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Takae Ebihara
- Department of Geriatric Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Koichi Kozaki
- Department of Geriatric Medicine, Kyorin University School of Medicine, Tokyo, Japan
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Mahajan A, Takamiya T, Benharash P, Zhou W. Effect of thoracic epidural anesthesia on heart rate variability in a porcine model. Physiol Rep 2017; 5:5/7/e13116. [PMID: 28400498 PMCID: PMC5392501 DOI: 10.14814/phy2.13116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 12/07/2016] [Accepted: 12/09/2016] [Indexed: 01/08/2023] Open
Abstract
Heart rate variability (HRV) is increasingly recognized as a means of evaluating autonomic tone. Thoracic epidural anesthesia (TEA) has been previously demonstrated to suppress the electrical storms in patients. However, the effect of TEA on HRV during sympathoexcitation remains unknown. In this study, we aimed to determine the effects of TEA on HRV response to left stellate ganglion stimulation (LSS) in a porcine model. In 12 anesthetized pigs after insertion of an epidural catheter to T1 level, a median sternotomy was performed to expose the heart and the left stellate ganglion. A 56‐electrode sock was used for obtaining epicardial activation recovery interval (ARI). Animal received LSS at 4 Hz for 30 sec. After 30 min of bupivacaine epidural injection, LSS was performed in the same way as the baseline condition. LSS significantly increased low‐frequency normalized units (LF: 44.9 ± 6.7 vs. 13.6 ± 3.1 msec2 baseline, P < 0.05) and decreased high‐frequency normalized units (HF: 11.5 ± 4.6 vs. 41.9 ± 5.1 msec2 baseline, P < 0.05). As a result, LF/HF significantly increased from 0.3 ± 0.2 to 3.9 ± 1.4 during LSS. TEA significantly attenuated the LF/HF from 3.9 ± 1.4 to 1.6 ± 0.8 with increased HF components from 11.5 ± 4.6 to 26.5 ± 3.2 msec2. LF component significantly correlates with global ARI (r = −0.81) and dispersion of repolarization (r = 0.85). HRV can precisely reflect the cardiac autonomic tone and TEA modulates the HRV by enhancing the HF components probably through a parasympathetic nerve system.
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Affiliation(s)
- Arjun Mahajan
- University of California Berkley, Berkley, California
| | - Tatsuo Takamiya
- Department of Anesthesiology, University of California Los Angeles, Los Angeles, California
| | - Peyman Benharash
- Division of Cardiac Surgery, University of California Los Angeles, Los Angeles, California
| | - Wei Zhou
- Department of Anesthesiology, University of California Los Angeles, Los Angeles, California
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Wang F, Liu J, Hong L, Liang B, Graff C, Yang Y, Christiansen M, Olesen SP, Zhang L, Kanters JK. The phenotype characteristics of type 13 long QT syndrome with mutation in KCNJ5 (Kir3.4-G387R). Heart Rhythm 2013; 10:1500-6. [PMID: 23872692 DOI: 10.1016/j.hrthm.2013.07.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND Long QT syndrome type 13 (LQT13) is caused by loss-of-function mutation in the KCNJ5-encoded cardiac G-protein-coupled inward rectifier potassium channel subtype 4 protein. The electrocardiographic (ECG) features of LQT13 are not described yet. OBJECTIVE To describe for the first time in detail the phenotype-genotype relationship of the ECG and clinical features in patients with LQT13. METHODS The 12-lead ECGs, 24-hour Holter recordings, and clinical information from KCNJ5-G387R mutation carriers of a fourth-generation Han Chinese family with LQT13 and a group of healthy Chinese individuals were analyzed. RESULTS Compared with the analysis of the healthy group (n = 8), age- and sex-matched pair analysis revealed that the mutation carriers (n = 8) had ventricular repolarization abnormality results in the prolongation of corrected QT and QTpeak intervals (P < .01); greater combined measure of repolarization morphology (T-wave morphology combination score) based on asymmetry, flatness, and notch (P < .01); and reduced low frequency/high frequency ratio of heart rate variability (P < .01) as a reflection of cardiac autonomic imbalance. Mean heart rate, time domain parameters of heart rate variability, time interval from T-wave peak to T-wave end, and T-wave amplitude were similar. CONCLUSIONS This study demonstrates for the first time the ECG features of patients with LQT13. Our data suggest that QTpeak intervals and T-wave morphology combination score may be the better parameters than the corrected QT interval to predict the phenotype-genotype relationship in patients with LQT13.
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