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Recovery of heart rate variability after treadmill exercise analyzed by lagged Poincaré plot and spectral characteristics. Med Biol Eng Comput 2017; 56:221-231. [PMID: 28699055 DOI: 10.1007/s11517-017-1682-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 07/03/2017] [Indexed: 10/19/2022]
Abstract
The aim of this study was to analyze the recovery of heart rate variability (HRV) after treadmill exercise and to investigate the autonomic nervous system response after exercise. Frequency domain indices, i.e., LF(ms2), HF(ms2), LF(n.u.), HF(n.u.) and LF/HF, and lagged Poincaré plot width (SD1 m ) and length (SD2 m ) were introduced for comparison between the baseline period (Pre-E) before treadmill running and two periods after treadmill running (Post-E1 and Post-E2). The correlations between lagged Poincaré plot indices and frequency domain indices were applied to reveal the long-range correlation between linear and nonlinear indices during the recovery of HRV. The results suggested entirely attenuated autonomic nervous activity to the heart following the treadmill exercise. After the treadmill running, the sympathetic nerves achieved dominance and the parasympathetic activity was suppressed, which lasted for more than 4 min. The correlation coefficients between lagged Poincaré plot indices and spectral power indices could separate not only Pre-E and two sessions after the treadmill running, but also the two sessions in recovery periods, i.e., Post-E1 and Post-E2. Lagged Poincaré plot as an innovative nonlinear method showed a better performance over linear frequency domain analysis and conventional nonlinear Poincaré plot.
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Morikawa Y, Takamoto K, Nishimaru H, Taguchi T, Urakawa S, Sakai S, Ono T, Nishijo H. Compression at Myofascial Trigger Point on Chronic Neck Pain Provides Pain Relief through the Prefrontal Cortex and Autonomic Nervous System: A Pilot Study. Front Neurosci 2017; 11:186. [PMID: 28442987 PMCID: PMC5386976 DOI: 10.3389/fnins.2017.00186] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 03/21/2017] [Indexed: 12/15/2022] Open
Abstract
Compression at myofascial trigger points (MTrPs), known as “ischemic compression,” has been reported to provide immediate relief of musculoskeletal pain and reduce the sympathetic activity that exacerbates chronic pain. We conducted a pilot study to investigate the possible involvement of the prefrontal cortex in pain relief obtained by MTrP compression in the present study, and analyzed the relationships among prefrontal hemodynamic activity, activity of the autonomic nervous system, and subjective pain in patients with chronic neck pain, with and without MTrP compression. Twenty-one female subjects with chronic neck pain were randomly assigned to two groups: MTrP compression (n = 11) or Non-MTrP compression (n = 10). Compression for 30 s was conducted 4 times. During the experiment, prefrontal hemodynamic activity [changes in Oxy-hemoglobin (Hb), Deoxy-Hb, and Total-Hb concentrations] and autonomic activity based on heart rate variability (HRV) were monitored by using near infrared spectroscopy (NIRS) and electrocardiography (ECG), respectively. The results indicated that MTrP compression significantly reduced subjective pain compared with Non-MTrP compression. The spectral frequency-domain analyses of HRV indicated that a low frequency (LF) component of HRV was decreased, and a high frequency (HF) component of HRV was increased during MTrP compression, while LF/HF ratio was decreased during MTrP compression. In addition, prefrontal hemodynamic activity was significantly decreased during MTrP compression compared with Non-MTrP compression. Furthermore, changes in autonomic activity were significantly correlated with changes in subjective pain and prefrontal hemodynamic activity. Along with previous studies indicating a role for sympathetic activity in the exacerbation of chronic pain, the present results suggest that MTrP compression in the neck region alters the activity of the autonomic nervous system via the prefrontal cortex to reduce subjective pain.
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Affiliation(s)
- Yoshiki Morikawa
- System Emotional Science, Graduate School of Medicine and Pharmaceutical Sciences, University of ToyamaToyama, Japan
| | - Kouich Takamoto
- Department of Judo Neurophysiotherapy, Graduate School of Medicine and Pharmaceutical Sciences, University of ToyamaToyama, Japan
| | - Hiroshi Nishimaru
- System Emotional Science, Graduate School of Medicine and Pharmaceutical Sciences, University of ToyamaToyama, Japan
| | - Toru Taguchi
- Department of Judo Neurophysiotherapy, Graduate School of Medicine and Pharmaceutical Sciences, University of ToyamaToyama, Japan
| | - Susumu Urakawa
- Department of Judo Neurophysiotherapy, Graduate School of Medicine and Pharmaceutical Sciences, University of ToyamaToyama, Japan
| | - Shigekazu Sakai
- Department of Judo Neurophysiotherapy, Graduate School of Medicine and Pharmaceutical Sciences, University of ToyamaToyama, Japan
| | - Taketoshi Ono
- Department of Judo Neurophysiotherapy, Graduate School of Medicine and Pharmaceutical Sciences, University of ToyamaToyama, Japan
| | - Hisao Nishijo
- System Emotional Science, Graduate School of Medicine and Pharmaceutical Sciences, University of ToyamaToyama, Japan
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Mitz AR, Chacko RV, Putnam PT, Rudebeck PH, Murray EA. Using pupil size and heart rate to infer affective states during behavioral neurophysiology and neuropsychology experiments. J Neurosci Methods 2017; 279:1-12. [PMID: 28089759 PMCID: PMC5346348 DOI: 10.1016/j.jneumeth.2017.01.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 01/03/2017] [Accepted: 01/09/2017] [Indexed: 01/31/2023]
Abstract
BACKGROUND Nonhuman primates (NHPs) are a valuable research model because of their behavioral, physiological and neuroanatomical similarities to humans. In the absence of language, autonomic activity can provide crucial information about cognitive and affective states during single-unit recording, inactivation and lesion studies. Methods standardized for use in humans are not easily adapted to NHPs and detailed guidance has been lacking. NEW METHOD We provide guidance for monitoring heart rate and pupil size in the behavioral neurophysiology setting by addressing the methodological issues, pitfalls and solutions for NHP studies. The methods are based on comparative physiology to establish a rationale for each solution. We include examples from both electrophysiological and lesion studies. RESULTS Single-unit recording, pupil responses and heart rate changes represent a range of decreasing temporal resolution, a characteristic that impacts experimental design and analysis. We demonstrate the unexpected result that autonomic measures acquired before and after amygdala lesions are comparable despite disruption of normal autonomic function. COMPARISON WITH EXISTING METHODS Species and study design differences can render standard techniques used in human studies inappropriate for NHP studies. We show how to manage data from small groups typical of NHP studies, data from the short behavioral trials typical of neurophysiological studies, issues associated with longitudinal studies, and differences in anatomy and physiology. CONCLUSIONS Autonomic measurement to infer cognitive and affective states in NHP is neither off-the-shelf nor onerous. Familiarity with the issues and solutions will broaden the use of autonomic signals in NHP single unit and lesion studies.
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Affiliation(s)
- Andrew R Mitz
- Section on the Neurobiology of Learning and Memory, Laboratory of Neuropsychology, National Institute of Mental Health, Bethesda, MD, USA.
| | - Ravi V Chacko
- Section on the Neurobiology of Learning and Memory, Laboratory of Neuropsychology, National Institute of Mental Health, Bethesda, MD, USA; Washington University School of Medicine, Saint Louis, MO, USA
| | - Philip T Putnam
- Section on the Neurobiology of Learning and Memory, Laboratory of Neuropsychology, National Institute of Mental Health, Bethesda, MD, USA
| | - Peter H Rudebeck
- Section on the Neurobiology of Learning and Memory, Laboratory of Neuropsychology, National Institute of Mental Health, Bethesda, MD, USA; Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Elisabeth A Murray
- Section on the Neurobiology of Learning and Memory, Laboratory of Neuropsychology, National Institute of Mental Health, Bethesda, MD, USA
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Monaco A, Cattaneo R, Ortu E, Constantinescu MV, Pietropaoli D. Sensory trigeminal ULF-TENS stimulation reduces HRV response to experimentally induced arithmetic stress: A randomized clinical trial. Physiol Behav 2017; 173:209-215. [PMID: 28213205 DOI: 10.1016/j.physbeh.2017.02.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 01/29/2017] [Accepted: 02/13/2017] [Indexed: 12/20/2022]
Abstract
Ultra Low Frequency Transcutaneous Electric Nervous Stimulation (ULF-TENS) is extensively used for pain relief and for the diagnosis and treatment of temporomandibular disorders (TMD). In addition to its local effects, ULF-TENS acts on the autonomic nervous system (ANS), with particular reference to the periaqueductal gray (PAG), promoting the release of endogenous opioids and modulating descending pain systems. It has been suggested that the PAG participates in the coupling between the emotional stimulus and the appropriate behavioral autonomic response. This function is successfully investigated by HRV. Therefore, our goal is to investigate the effects of trigeminal ULF-TENS stimulation on autonomic behavior in terms of HRV and respiratory parameters during an experimentally-induced arithmetic stress test in healthy subjects. Thirty healthy women between 25 and 35years of age were enrolled and randomly assigned to either the control (TENS stimulation off) or test group (TENS stimulation on). Heart (HR, LF, HF, LF/HF ratio, DET, RMSSD, PNN50, RR) and respiratory (BR) rate were evaluated under basal, T1 (TENS off/on), and stress (mathematical task) conditions. Results showed that HRV parameters and BR significantly changed during the arithmetic stress paradigm (p<0.01). Independently of stress conditions, TENS and control group could be discriminated only by non-linear HRV data, namely RR and DET (p=0.038 and p=0.027, respectively). During the arithmetic task, LF/HF ratio was the most sensitive parameter to discriminate between groups (p=0.019). Our data suggest that trigeminal sensory ULF-TENS reduces the autonomic response in terms of HRV and BR during acute mental stress in healthy subjects. Future directions of our work aim at applying the HRV and BR analysis, with and without TENS stimulation, to individuals with dysfunctional ANS among those with TMD.
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Affiliation(s)
- Annalisa Monaco
- University of L'Aquila, Department of Life, Health and Environmental Sciences, Division of Dentistry, Building Delta 6, St Salvatore Hospital, Via Vetoio, 67100 L'Aquila, Italy
| | - Ruggero Cattaneo
- University of L'Aquila, Department of Life, Health and Environmental Sciences, Division of Dentistry, Building Delta 6, St Salvatore Hospital, Via Vetoio, 67100 L'Aquila, Italy
| | - Eleonora Ortu
- University of L'Aquila, Department of Life, Health and Environmental Sciences, Division of Dentistry, Building Delta 6, St Salvatore Hospital, Via Vetoio, 67100 L'Aquila, Italy
| | | | - Davide Pietropaoli
- University of L'Aquila, Department of Life, Health and Environmental Sciences, Division of Dentistry, Building Delta 6, St Salvatore Hospital, Via Vetoio, 67100 L'Aquila, Italy.
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Wang A, Yang L, Wen W, Zhang S, Hao D, Khalid SG, Zheng D. Quantification of radial arterial pulse characteristics change during exercise and recovery. J Physiol Sci 2016; 68:113-120. [PMID: 28028653 PMCID: PMC5799316 DOI: 10.1007/s12576-016-0515-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 12/13/2016] [Indexed: 12/02/2022]
Abstract
It is physiologically important to understand the arterial pulse waveform characteristics change during exercise and recovery. However, there is a lack of a comprehensive investigation. This study aimed to provide scientific evidence on the arterial pulse characteristics change during exercise and recovery. Sixty-five healthy subjects were studied. The exercise loads were gradually increased from 0 to 125 W for female subjects and to 150 W for male subjects. Radial pulses were digitally recorded during exercise and 4-min recovery. Four parameters were extracted from the raw arterial pulse waveform, including the pulse amplitude, width, pulse peak and dicrotic notch time. Five parameters were extracted from the normalized radial pulse waveform, including the pulse peak and dicrotic notch position, pulse Area, Area1 and Area2 separated by notch point. With increasing loads during exercise, the raw pulse amplitude increased significantly with decreased pulse period, reduced peak and notch time. From the normalized pulses, the pulse Area, pulse Area1 and Area2 decreased, respectively, from 38 ± 4, 61 ± 5 and 23 ± 5 at rest to 34 ± 4, 52 ± 6 and 13 ± 5 at 150-W exercise load. During recovery, an opposite trend was observed. This study quantitatively demonstrated significant changes of radial pulse characteristics during different exercise loads and recovery phases.
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Affiliation(s)
- Anran Wang
- College of Life Science and Bio-engineering, Beijing University of Technology, 100 Pingluoyuan Chaoyang District, Beijing, 100124, China
| | - Lin Yang
- College of Life Science and Bio-engineering, Beijing University of Technology, 100 Pingluoyuan Chaoyang District, Beijing, 100124, China.
| | - Weimin Wen
- College of Life Science and Bio-engineering, Beijing University of Technology, 100 Pingluoyuan Chaoyang District, Beijing, 100124, China
| | - Song Zhang
- College of Life Science and Bio-engineering, Beijing University of Technology, 100 Pingluoyuan Chaoyang District, Beijing, 100124, China
| | - Dongmei Hao
- College of Life Science and Bio-engineering, Beijing University of Technology, 100 Pingluoyuan Chaoyang District, Beijing, 100124, China
| | - Syed G Khalid
- Health and Wellbeing Academy, Faculty of Medical Science, Anglia Ruskin University, Chelmsford, CM1 1SQ, UK
| | - Dingchang Zheng
- Health and Wellbeing Academy, Faculty of Medical Science, Anglia Ruskin University, Chelmsford, CM1 1SQ, UK
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Pichot V, Roche F, Celle S, Barthélémy JC, Chouchou F. HRVanalysis: A Free Software for Analyzing Cardiac Autonomic Activity. Front Physiol 2016; 7:557. [PMID: 27920726 PMCID: PMC5118625 DOI: 10.3389/fphys.2016.00557] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 11/04/2016] [Indexed: 11/13/2022] Open
Abstract
Since the pioneering studies of the 1960s, heart rate variability (HRV) has become an increasingly used non-invasive tool for examining cardiac autonomic functions and dysfunctions in various populations and conditions. Many calculation methods have been developed to address these issues, each with their strengths and weaknesses. Although, its interpretation may remain difficult, this technique provides, from a non-invasive approach, reliable physiological information that was previously inaccessible, in many fields including death and health prediction, training and overtraining, cardiac and respiratory rehabilitation, sleep-disordered breathing, large cohort follow-ups, children's autonomic status, anesthesia, or neurophysiological studies. In this context, we developed HRVanalysis, a software to analyse HRV, used and improved for over 20 years and, thus, designed to meet laboratory requirements. The main strength of HRVanalysis is its wide application scope. In addition to standard analysis over short and long periods of RR intervals, the software allows time-frequency analysis using wavelet transform as well as analysis of autonomic nervous system status on surrounding scored events and on preselected labeled areas. Moreover, the interface is designed for easy study of large cohorts, including batch mode signal processing to avoid running repetitive operations. Results are displayed as figures or saved in TXT files directly employable in statistical softwares. Recordings can arise from RR or EKG files of different types such as cardiofrequencemeters, holters EKG, polygraphs, and data acquisition systems. HRVanalysis can be downloaded freely from the Web page at: https://anslabtools.univ-st-etienne.frHRVanalysis is meticulously maintained and developed for in-house laboratory use. In this article, after a brief description of the context, we present an overall view of HRV analysis and we describe the methodological approach of the different techniques provided by the software.
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Affiliation(s)
- Vincent Pichot
- EA SNA-EPIS 4607, Department of Clinical and Exercise Physiology, University of Lyon, Jean Monnet University Saint-Etienne, France
| | - Frédéric Roche
- EA SNA-EPIS 4607, Department of Clinical and Exercise Physiology, University of Lyon, Jean Monnet University Saint-Etienne, France
| | - Sébastien Celle
- EA SNA-EPIS 4607, Department of Clinical and Exercise Physiology, University of Lyon, Jean Monnet University Saint-Etienne, France
| | - Jean-Claude Barthélémy
- EA SNA-EPIS 4607, Department of Clinical and Exercise Physiology, University of Lyon, Jean Monnet University Saint-Etienne, France
| | - Florian Chouchou
- NeuroPain Unit, Lyon Neuroscience Research Centre, Institut National de la Santé et de la Recherche Médicale U 1028/Centre National de la Recherche Scientifique UMR 5292, University of Lyon Lyon, France
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Chen WR, Liu HB, Sha Y, Shi Y, Wang H, Yin DW, Chen YD, Shi XM. Effects of Statin on Arrhythmia and Heart Rate Variability in Healthy Persons With 48-Hour Sleep Deprivation. J Am Heart Assoc 2016; 5:JAHA.116.003833. [PMID: 27799236 PMCID: PMC5210325 DOI: 10.1161/jaha.116.003833] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND It has been reported that sleep deprivation is associated with cardiac autonomic disorder, inflammation, and oxidative stress. Statins have significant cardiovascular protective effects in patients with cardiovascular disease. This study aimed to investigate the protective effect of statins on arrhythmia and heart rate variability in young healthy persons after 48-hour sleep deprivation. METHODS AND RESULTS This study enrolled 72 young healthy participants aged 26.5±3.5 years. All participants received 48-hour continuous ambulatory electrocardiogram monitoring. Arrhythmia, time, and frequency domain parameters were analyzed for all participants. The primary end point, low/high frequency ratio, was significantly lower in the statin group than in the control group (2.48±1.12 versus 3.02±1.23, P<0.001). After 48-hour sleep deprivation, low frequency-the frequency of premature atrial complexes and premature ventricular complexes-was significantly decreased in the statin group compared with the control group (P<0.05). There was also a significant increase in high frequency in the statin group compared with the control group (P<0.05). There was a significant decrease in serum high-sensitivity C-reactive protein and malondialdehyde levels after 48-hour sleep deprivation in the statin group compared with the control group (P<0.05). CONCLUSIONS Statin use might be associated with improvement in arrhythmia and heart rate variability in healthy persons with 48-hour sleep deprivation. This finding should be confirmed by larger scale trials. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT02496962.
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Affiliation(s)
- Wei Ren Chen
- Department of South-Building Cardiology, PLA General Hospital, Beijing, China
| | - Hong Bin Liu
- Department of South-Building Cardiology, PLA General Hospital, Beijing, China
| | - Yuan Sha
- Department of South-Building Cardiology, PLA General Hospital, Beijing, China
| | - Yang Shi
- Department of South-Building Cardiology, PLA General Hospital, Beijing, China
| | - Hao Wang
- Department of South-Building Cardiology, PLA General Hospital, Beijing, China
| | - Da Wei Yin
- Department of South-Building Cardiology, PLA General Hospital, Beijing, China
| | - Yun Dai Chen
- Department of Cardiology, PLA General Hospital, Beijing, China
| | - Xiang Min Shi
- Department of Cardiology, PLA General Hospital, Beijing, China
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Arab C, Dias DPM, Barbosa RTDA, Carvalho TDD, Valenti VE, Crocetta TB, Ferreira M, Abreu LCD, Ferreira C. Heart rate variability measure in breast cancer patients and survivors: A systematic review. Psychoneuroendocrinology 2016; 68:57-68. [PMID: 26943345 DOI: 10.1016/j.psyneuen.2016.02.018] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 02/17/2016] [Accepted: 02/18/2016] [Indexed: 12/20/2022]
Abstract
PURPOSE In the current study, we aimed to review literature findings showing the clinical importance of cardiac autonomic modulation assessed by heart rate variability analysis in breast cancer (BC) patients and survivors. METHODS We conducted a systematic review according to The PRISMA Statement in Medline, Scopus and Web of Science (_-2015) databases. The search was limited to articles in English language, published in peer-reviewed journals, and with adult age samples only (e.g., women, patients, or survivors, diagnosed with BC in any stage). We included observational studies and randomized trials. Detailed heart rate variability analysis (instruments, data collection protocol, and analysis methods) was required. Search terms included autonomic nervous system, heart rate variability, sympathetic and parasympathetic nervous system, autonomic dysfunction, vagal nervous and breast neoplasms, breast cancer and breast tumor. RESULTS Twelve studies were included in this review. The clinical importance of cardiac autonomic modulation assessed by heart rate variability analysis in BC patients and survivors is demonstrated by association with effects of BC surgery, and treatments, and the adverse effects of surgery and treatments on survivors (e.g., cardiotoxicity, fatigue, and stress). LIMITATIONS The strength of evidence of included studies is low: small samples size and heterogeneity, presence of confounders, and observational studies design. CONCLUSIONS The heart rate variability analysis could be used as a complementary non-invasive tool for the early diagnosis and better prognosis of autonomic dysfunction, and survival in BC patients. There are many potential clinical applications of heart rate variability analysis in BC patients, and the employment of such approaches could lead to lower impairment of autonomic function in this individuals.
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Affiliation(s)
- Claudia Arab
- Departamento de Medicina (Cardiologia), Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), 715 Napoleão De Barros St., São Paulo, SP 04024-002, Brazil.
| | - Daniel Penteado Martins Dias
- Departamento de Fisiologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), 3900 Bandeirantes Av, Ribeirão Preto, SP 14049-900, Brazil.
| | - Renata Thaís de Almeida Barbosa
- Departamento de Saúde da Coletividade, Faculdade de Medicina do ABC (FMABC), 821 P Rincipe De Gales Av, Santo Andre, SP 09060-650, Brazil.
| | - Tatiana Dias de Carvalho
- Departamento de Saúde da Coletividade, Faculdade de Medicina do ABC (FMABC), 821 P Rincipe De Gales Av, Santo Andre, SP 09060-650, Brazil.
| | - Vitor Engrácia Valenti
- Centro de Estudos do Sistema Nervoso Autônomo, Departamento de Fonoaudiologia, Faculdade de Filosofia e Ciências, Universidade Estadual Paulista "Júlio de Mesquita Filho" (UNESP), 737 Hygino Muzzi Filho Av, Marília, SP 17525-901, Brazil.
| | - Tânia Brusque Crocetta
- Departamento de Saúde da Coletividade, Faculdade de Medicina do ABC (FMABC), 821 P Rincipe De Gales Av, Santo Andre, SP 09060-650, Brazil.
| | - Marcelo Ferreira
- Departamento de Saúde da Coletividade, Faculdade de Medicina do ABC (FMABC), 821 P Rincipe De Gales Av, Santo Andre, SP 09060-650, Brazil.
| | - Luiz Carlos de Abreu
- Departamento de Saúde da Coletividade, Faculdade de Medicina do ABC (FMABC), 821 P Rincipe De Gales Av, Santo Andre, SP 09060-650, Brazil; Faculdade de Saúde Pública, Universidade de São Paulo (USP), 715 Doutor Arnaldo Av, Sao Paulo, SP 01246-904, Brazil.
| | - Celso Ferreira
- Departamento de Medicina (Cardiologia), Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), 715 Napoleão De Barros St., São Paulo, SP 04024-002, Brazil.
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Wang YJ, Wang YZ, Yeh ML. A Prospective Comparison Study of Heart Rate Variability During Menses in Young Women With Dysmenorrhea. Biol Res Nurs 2016; 18:465-72. [DOI: 10.1177/1099800416640875] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background: Numerous studies have demonstrated autonomic abnormalities in various pain conditions. However, few have investigated heart rate variability (HRV) in young women with primary dysmenorrhea, and the conclusions have been inconsistent. More evidence is required to confirm the reported trend for consistent fluctuation of HRV parameters in dysmenorrhea. Purpose: The study’s aim was to determine whether significant differences exist between young women with and without dysmenorrhea for heart rate (HR), blood pressure (BP), and HRV parameters during menses. Design: A prospective comparison design with repeated measures was used. Setting and participants: Sixty-six women aged 18–25 with dysmenorrhea and 54 eumenorrheic women were recruited from a university in northern Taiwan. Methods: High-frequency and low-frequency HRV parameters (HF and LF), LF/HF ratio, BP, and HR were measured daily between 8 p.m. and 10 p.m. from Day 1 to Day 6 during menses. The generalized estimating equation was used to analyze the effects of group, time, and Group × Time interaction on these variables. Results: HF values were significantly lower in the dysmenorrhea than in the eumenorrhea group, but there were no differences in BP, HR, LF, or LF/HF ratio. Conclusion: Reduced HF values reflect reduced parasympathetic activity and autonomic instability in young women with dysmenorrhea. Future longitudinal studies are warranted to examine autonomic regulation in menstrual pain of varying intensities associated with dysmenorrhea-related symptoms and to clarify the causal relationship between dysmenorrhea and HRV fluctuations.
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Affiliation(s)
- Yu-Jen Wang
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan City, Taiwan
| | - Yi-Zen Wang
- National Taiwan University Hospital, Taipei City, Taiwan
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
| | - Mei-Ling Yeh
- Graduate Institute of Integration of Traditional Chinese Medicine with Western Nursing, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
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Zou C, Dong H, Wang F, Gao M, Huang X, Jin J, Zhou B, Yang X. Heart acceleration and deceleration capacities associated with dilated cardiomyopathy. Eur J Clin Invest 2016; 46:312-20. [PMID: 26800852 DOI: 10.1111/eci.12594] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 01/18/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Heart rate deceleration capacity and acceleration capacity are novel autonomic nervous system indicators of cardiac neural regulation. Dilated cardiomyopathy (DCM) changes cardiac electrophysiology; however, how deceleration capacity and acceleration capacity associated with DCM remain unclear. MATERIALS AND METHODS To evaluate the association between heart rate acceleration capacity, deceleration capacity and DCM, 66 DCM patients with DCM and 209 controls were enrolled in the study. Demographic data, echocardiographic data, heart rate variability, deceleration capacity and acceleration capacity were collected. The association pattern between DCM and these indexes were studied by multiple logistic regression analysis. RESULTS Deceleration capacity and acceleration capacity were independent risk factors for DCM with an odds ratio (OR) and 95% confidence interval (CI), determined by multiple logistic regression analysis, of 7·97 (3·87-16·42) and 0·09 (0·05-0·19), respectively. Univariate ordinal logistic regression analysis showed that acceleration capacity, fastest heart rate, standard deviation of normal-to-normal RR intervals (SDNN) and left ventricular ejection fraction (LEVF) associated with heart failure grade. The OR for each covariate was further adjusted for the effects of other significant covariates in multivariate ordinal logistic regression analysis. Acceleration capacity, fastest heart rate and LVEF were still independent risk factors in the final equation with ORs of 1·32 (1·03-1·79), 1·04 (0·01-1·07) and 0·46 (0·23-0·93), respectively. CONCLUSION Heart rate acceleration capacity and deceleration capacity are independent risk factors for DCM, and acceleration capacity is a predictive factor for heart failure exacerbation in patients with DCM.
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Affiliation(s)
- Cao Zou
- Cardiology Department, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Hongkai Dong
- Cardiology Department, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Fengyan Wang
- Cardiology Department, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Meiwen Gao
- Electrocardiography Department, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xingmei Huang
- Electrocardiography Department, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jianling Jin
- Electrocardiography Department, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Bingyuan Zhou
- Echocardiography Department, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiangjun Yang
- Cardiology Department, First Affiliated Hospital of Soochow University, Suzhou, China
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Lin YC, Lin YH, Lo MT, Peng CK, Huang NE, Yang CCH, Kuo TBJ. Novel application of multi dynamic trend analysis as a sensitive tool for detecting the effects of aging and congestive heart failure on heart rate variability. CHAOS (WOODBURY, N.Y.) 2016; 26:023109. [PMID: 26931590 DOI: 10.1063/1.4941673] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The complex fluctuations in heart rate variability (HRV) reflect cardiac autonomic modulation and are an indicator of congestive heart failure (CHF). This paper proposes a novel nonlinear approach to HRV investigation, the multi dynamic trend analysis (MDTA) method, based on the empirical mode decomposition algorithm of the Hilbert-Huang transform combined with a variable-sized sliding-window method. Electrocardiographic signal data obtained from the PhysioNet database were used. These data were from subjects with CHF (mean age = 59.4 ± 8.4), an age-matched elderly healthy control group (59.3 ± 10.6), and a healthy young group (30.3 ± 4.8); the HRVs of these subjects were processed using the MDTA method, time domain analysis, and frequency domain analysis. Among all HRV parameters, the MDTA absolute value slope (MDTS) and MDTA deviation (MDTD) exhibited the greatest area under the curve (AUC) of the receiver operating characteristics in distinguishing between the CHF group and the healthy controls (AUC = 1.000) and between the healthy elderly subject group and the young subject group (AUC = 0.834 ± 0.067 for MDTS; 0.837 ± 0.066 for MDTD). The CHF subjects presented with lower MDTA indices than those of the healthy elderly subject group. Furthermore, the healthy elderly subjects exhibited lower MDTA indices than those of the young controls. The MDTA method can adaptively and automatically identify the intrinsic fluctuation on variable temporal and spatial scales when investigating complex fluctuations in the cardiac autonomic regulation effects of aging and CHF.
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Affiliation(s)
- Yu-Cheng Lin
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Hsuan Lin
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Men-Tzung Lo
- Center for Dynamical Biomarkers and Translational Medicine, National Central University, Jhongli, Taiwan
| | - Chung-Kang Peng
- Center for Dynamical Biomarkers and Translational Medicine, National Central University, Jhongli, Taiwan
| | - Norden E Huang
- Research Center for Adaptive Data Analysis, National Central University, Taoyuan, Taiwan
| | - Cheryl C H Yang
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Terry B J Kuo
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
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Seenivasan P, Easwaran S, Sridhar S, Sinha S. Using Skewness and the First-Digit Phenomenon to Identify Dynamical Transitions in Cardiac Models. Front Physiol 2016; 6:390. [PMID: 26793114 PMCID: PMC4707587 DOI: 10.3389/fphys.2015.00390] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 11/30/2015] [Indexed: 11/13/2022] Open
Abstract
Disruptions in the normal rhythmic functioning of the heart, termed as arrhythmia, often result from qualitative changes in the excitation dynamics of the organ. The transitions between different types of arrhythmia are accompanied by alterations in the spatiotemporal pattern of electrical activity that can be measured by observing the time-intervals between successive excitations of different regions of the cardiac tissue. Using biophysically detailed models of cardiac activity we show that the distribution of these time-intervals exhibit a systematic change in their skewness during such dynamical transitions. Further, the leading digits of the normalized intervals appear to fit Benford's law better at these transition points. This raises the possibility of using these observations to design a clinical indicator for identifying changes in the nature of arrhythmia. More importantly, our results reveal an intriguing relation between the changing skewness of a distribution and its agreement with Benford's law, both of which have been independently proposed earlier as indicators of regime shift in dynamical systems.
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Affiliation(s)
- Pavithraa Seenivasan
- Theoretical Physics Group, The Institute of Mathematical Sciences Chennai, India
| | - Soumya Easwaran
- Theoretical Physics Group, The Institute of Mathematical Sciences Chennai, India
| | - Seshan Sridhar
- Theoretical Physics Group, The Institute of Mathematical SciencesChennai, India; Scimergent Analytics and Education Pvt Ltd.Chennai, India
| | - Sitabhra Sinha
- Theoretical Physics Group, The Institute of Mathematical Sciences Chennai, India
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Comprehensive multilevel in vivo and in vitro analysis of heart rate fluctuations in mice by ECG telemetry and electrophysiology. Nat Protoc 2015; 11:61-86. [PMID: 26658468 DOI: 10.1038/nprot.2015.139] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The normal heartbeat slightly fluctuates around a mean value; this phenomenon is called physiological heart rate variability (HRV). It is well known that altered HRV is a risk factor for sudden cardiac death. The availability of genetic mouse models makes it possible to experimentally dissect the mechanism of pathological changes in HRV and its relation to sudden cardiac death. Here we provide a protocol that allows for a comprehensive multilevel analysis of heart rate (HR) fluctuations. The protocol comprises a set of techniques that include in vivo telemetry and in vitro electrophysiology of intact sinoatrial network preparations or isolated single sinoatrial node (SAN) cells. In vitro preparations can be completed within a few hours, with data acquisition within 1 d. In vivo telemetric ECG requires 1 h for surgery and several weeks for data acquisition and analysis. This protocol is of interest to researchers investigating cardiovascular physiology and the pathophysiology of sudden cardiac death.
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64
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Sympathetic activation and ventricular arrhythmias: New insights from surface electrogram recordings. Heart Rhythm 2015; 12:621-622. [DOI: 10.1016/j.hrthm.2014.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Indexed: 11/17/2022]
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65
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Billman GE, Huikuri HV, Sacha J, Trimmel K. An introduction to heart rate variability: methodological considerations and clinical applications. Front Physiol 2015; 6:55. [PMID: 25762937 PMCID: PMC4340167 DOI: 10.3389/fphys.2015.00055] [Citation(s) in RCA: 126] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 02/09/2015] [Indexed: 11/13/2022] Open
Affiliation(s)
- George E Billman
- Department of Physiology and Cell Biology, The Ohio State University Columbus, OH, USA
| | - Heikki V Huikuri
- Division of Cardiology, Department of Internal Medicine, Institute of Clinical Medicine, University of Oulu Oulu, Finland
| | - Jerzy Sacha
- Department of Cardiology, Regional Medical Center Opole, Poland
| | - Karin Trimmel
- Department of Neurology, Medical University of Vienna Vienna, Austria
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Tang SC, Jen HI, Lin YH, Hung CS, Jou WJ, Huang PW, Shieh JS, Ho YL, Lai DM, Wu AY, Jeng JS, Chen MF. Complexity of heart rate variability predicts outcome in intensive care unit admitted patients with acute stroke . J Neurol Neurosurg Psychiatry 2015; 86:95-100. [PMID: 25053768 DOI: 10.1136/jnnp-2014-308389] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Heart rate variability (HRV) has been proposed as a predictor of acute stroke outcome. This study aimed to evaluate the predictive value of a novel non-linear method for analysis of HRV, multiscale entropy (MSE) and outcome of patients with acute stroke who had been admitted to the intensive care unit (ICU). METHODS The MSE of HRV was analysed from 1 h continuous ECG signals in ICU-admitted patients with acute stroke and controls. The complexity index was defined as the area under the MSE curve (scale 1-20). A favourable outcome was defined as modified Rankin scale 0-2 at 3 months after stroke. RESULTS The trends of MSE curves in patients with atrial fibrillation (AF) (n=77) were apparently different from those in patients with non-AF stroke (n=150) and controls (n=60). In addition, the values of complexity index were significantly lower in the patients with non-AF stroke than in the controls (25.8±.3 vs. 32.3±4.3, p<0.001). After adjustment for clinical variables, patients without AF who had a favourable outcome were significantly related to higher complexity index values (OR=1.15, 95% CI 1.07 to 1.25, p<0.001). Importantly, the area under the receiver operating characteristic curve for predicting a favourable outcome of patients with non-AF stroke from clinical parameters was 0.858 (95% CI 0.797 to 0.919) and significantly improved to 0.903 (95% CI 0.853 to 0.954) after adding on the parameter of complexity index values (p=0.020). CONCLUSIONS In ICU-admitted patients with acute stroke, early assessment of the complexity of HRV by MSE can help in predicting outcomes in patients without AF.
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Affiliation(s)
- Sung-Chun Tang
- Stroke Center and Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan NTU-NTUH-MediaTek Innovative Medical Electronics Research Center, Taipei, Taiwan
| | - Hsiao-I Jen
- NTU-NTUH-MediaTek Innovative Medical Electronics Research Center, Taipei, Taiwan Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan
| | - Yen-Hung Lin
- NTU-NTUH-MediaTek Innovative Medical Electronics Research Center, Taipei, Taiwan Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chi-Sheng Hung
- NTU-NTUH-MediaTek Innovative Medical Electronics Research Center, Taipei, Taiwan Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Wei-Jung Jou
- NTU-NTUH-MediaTek Innovative Medical Electronics Research Center, Taipei, Taiwan Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan
| | - Pei-Wen Huang
- NTU-NTUH-MediaTek Innovative Medical Electronics Research Center, Taipei, Taiwan Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan
| | - Jiann-Shing Shieh
- Department of Mechanical Engineering, Yuan Ze University, Tao-Yuan, Taiwan
| | - Yi-Lwun Ho
- NTU-NTUH-MediaTek Innovative Medical Electronics Research Center, Taipei, Taiwan Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Dar-Ming Lai
- NTU-NTUH-MediaTek Innovative Medical Electronics Research Center, Taipei, Taiwan Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - An-Yeu Wu
- NTU-NTUH-MediaTek Innovative Medical Electronics Research Center, Taipei, Taiwan Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan
| | - Jiann-Shing Jeng
- Stroke Center and Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Fong Chen
- NTU-NTUH-MediaTek Innovative Medical Electronics Research Center, Taipei, Taiwan Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Agorastos A, Kellner M, Stiedl O, Muhtz C, Wiedemann K, Demiralay C. Blunted autonomic reactivity to pharmacological panic challenge under long-term escitalopram treatment in healthy men. Int J Neuropsychopharmacol 2014; 18:pyu053. [PMID: 25522396 PMCID: PMC4376541 DOI: 10.1093/ijnp/pyu053] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Central serotonergic pathways influence brain areas involved in vagal cardiovascular regulation and, thereby, influence sympathetic efferent activity. Selective serotonin reuptake inhibitors (SSRIs) affect multiple serotonergic pathways, including central autonomic pathways. However, only a few studies have assessed SSRI-mediated effects on autonomic reactivity in healthy individuals using heart rate variability (HRV). METHODS The present study assessed the influence of long-term treatment with escitalopram (ESC) on autonomic reactivity to an intravenous application of 50 µg cholecystokinin tetrapeptide (CCK-4) in 30 healthy young men using a double-blind, placebo (PLA)-controlled, randomized, within-subject cross-over design. Main outcome measures were time- and frequency-domain HRV parameters, assessed at both baseline and immediately after CCK-4 application. RESULTS Results showed substantial effects for the treatment × CCK-4 challenge interaction with respect to heart rate (p < 0.001; pη(2) = 0.499), SDNN (p < 0.001; pη(2) = 576), RMSSD (p = 0.015; pη(2) = 194), NN50% (p = 0.008; pη(2) = 0.224), and LF% (p = 0.014; pη(2) = 0.196), and moderate effects with respect HF% (p = 0.099; pη(2) = 0.094), with PLA subjects showing a higher increase in HR and SDNN and a higher decrease in RMSSD, NN50, LF and HF than subjects in the ESC condition. Thus, ESC treatment significantly blunted the autonomic reactivity to CCK-4. Secondary analysis indicated no effect of the 5-HTTLPR polymorphism on CCK-4-induced autonomic response. CONCLUSIONS Our results support findings suggesting an effect of SSRI treatment on autonomic regulation and provide evidence that ESC treatment is associated with blunted autonomic reactivity in healthy men.
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Affiliation(s)
- Agorastos Agorastos
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (Drs Agorastos, Kellner, Muhtz, Wiedemann, and Demiralay); Department of Functional Genomics, Center for Neurogenomics and Cognitive Research, Neuroscience Campus, VU University, Amsterdam, Netherlands (Dr Stiedl); Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Neuroscience Campus, VU University, Amsterdam, Netherlands (Dr Stiedl); Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (Dr Muhtz).
| | - Michael Kellner
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (Drs Agorastos, Kellner, Muhtz, Wiedemann, and Demiralay); Department of Functional Genomics, Center for Neurogenomics and Cognitive Research, Neuroscience Campus, VU University, Amsterdam, Netherlands (Dr Stiedl); Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Neuroscience Campus, VU University, Amsterdam, Netherlands (Dr Stiedl); Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (Dr Muhtz)
| | - Oliver Stiedl
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (Drs Agorastos, Kellner, Muhtz, Wiedemann, and Demiralay); Department of Functional Genomics, Center for Neurogenomics and Cognitive Research, Neuroscience Campus, VU University, Amsterdam, Netherlands (Dr Stiedl); Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Neuroscience Campus, VU University, Amsterdam, Netherlands (Dr Stiedl); Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (Dr Muhtz)
| | - Christoph Muhtz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (Drs Agorastos, Kellner, Muhtz, Wiedemann, and Demiralay); Department of Functional Genomics, Center for Neurogenomics and Cognitive Research, Neuroscience Campus, VU University, Amsterdam, Netherlands (Dr Stiedl); Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Neuroscience Campus, VU University, Amsterdam, Netherlands (Dr Stiedl); Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (Dr Muhtz)
| | - Klaus Wiedemann
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (Drs Agorastos, Kellner, Muhtz, Wiedemann, and Demiralay); Department of Functional Genomics, Center for Neurogenomics and Cognitive Research, Neuroscience Campus, VU University, Amsterdam, Netherlands (Dr Stiedl); Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Neuroscience Campus, VU University, Amsterdam, Netherlands (Dr Stiedl); Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (Dr Muhtz)
| | - Cüneyt Demiralay
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (Drs Agorastos, Kellner, Muhtz, Wiedemann, and Demiralay); Department of Functional Genomics, Center for Neurogenomics and Cognitive Research, Neuroscience Campus, VU University, Amsterdam, Netherlands (Dr Stiedl); Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Neuroscience Campus, VU University, Amsterdam, Netherlands (Dr Stiedl); Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (Dr Muhtz)
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Chouchou F, Desseilles M. Heart rate variability: a tool to explore the sleeping brain? Front Neurosci 2014; 8:402. [PMID: 25565936 PMCID: PMC4263095 DOI: 10.3389/fnins.2014.00402] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 11/19/2014] [Indexed: 12/17/2022] Open
Abstract
Sleep is divided into two main sleep stages: (1) non-rapid eye movement sleep (non-REMS), characterized among others by reduced global brain activity; and (2) rapid eye movement sleep (REMS), characterized by global brain activity similar to that of wakefulness. Results of heart rate variability (HRV) analysis, which is widely used to explore autonomic modulation, have revealed higher parasympathetic tone during normal non-REMS and a shift toward sympathetic predominance during normal REMS. Moreover, HRV analysis combined with brain imaging has identified close connectivity between autonomic cardiac modulation and activity in brain areas such as the amygdala and insular cortex during REMS, but no connectivity between brain and cardiac activity during non-REMS. There is also some evidence for an association between HRV and dream intensity and emotionality. Following some technical considerations, this review addresses how brain activity during sleep contributes to changes in autonomic cardiac activity, organized into three parts: (1) the knowledge on autonomic cardiac control, (2) differences in brain and autonomic activity between non-REMS and REMS, and (3) the potential of HRV analysis to explore the sleeping brain, and the implications for psychiatric disorders.
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Affiliation(s)
- Florian Chouchou
- NeuroPain Unit, Lyon Neuroscience Research Centre, CRNL - INSERM U 1028/CNRS UMR 5292, University of Lyon France ; Department of Psychology, University of Namur Namur, Belgium
| | - Martin Desseilles
- Department of Psychology, University of Namur Namur, Belgium ; Cyclotron Research Centre, University of Liège Liège, Belgium
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Abstract
In a normal human life span, the heart beats about 2 to 3 billion times. Under diseased conditions, a heart may lose its normal rhythm and degenerate suddenly into much faster and irregular rhythms, called arrhythmias, which may lead to sudden death. The transition from a normal rhythm to an arrhythmia is a transition from regular electrical wave conduction to irregular or turbulent wave conduction in the heart, and thus this medical problem is also a problem of physics and mathematics. In the last century, clinical, experimental, and theoretical studies have shown that dynamical theories play fundamental roles in understanding the mechanisms of the genesis of the normal heart rhythm as well as lethal arrhythmias. In this article, we summarize in detail the nonlinear and stochastic dynamics occurring in the heart and their links to normal cardiac functions and arrhythmias, providing a holistic view through integrating dynamics from the molecular (microscopic) scale, to the organelle (mesoscopic) scale, to the cellular, tissue, and organ (macroscopic) scales. We discuss what existing problems and challenges are waiting to be solved and how multi-scale mathematical modeling and nonlinear dynamics may be helpful for solving these problems.
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Affiliation(s)
- Zhilin Qu
- Department of Medicine (Cardiology), David Geffen School of Medicine, University of California, Los Angeles, California 90095, USA
- Correspondence to: Zhilin Qu, PhD, Department of Medicine, Division of Cardiology, David Geffen School of Medicine at UCLA, A2-237 CHS, 650 Charles E. Young Drive South, Los Angeles, CA 90095, Tel: 310-794-6050, Fax: 310-206-9133,
| | - Gang Hu
- Department of Physics, Beijing Normal University, Beijing 100875, China
| | - Alan Garfinkel
- Department of Medicine (Cardiology), David Geffen School of Medicine, University of California, Los Angeles, California 90095, USA
- Department of Integrative Biology and Physiology, University of California, Los Angeles, California 90095, USA
| | - James N. Weiss
- Department of Medicine (Cardiology), David Geffen School of Medicine, University of California, Los Angeles, California 90095, USA
- Department of Physiology, David Geffen School of Medicine, University of California, Los Angeles, California 90095, USA
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Harris PRE, Stein PK, Fung GL, Drew BJ. Heart rate variability measured early in patients with evolving acute coronary syndrome and 1-year outcomes of rehospitalization and mortality. Vasc Health Risk Manag 2014; 10:451-64. [PMID: 25143740 PMCID: PMC4132256 DOI: 10.2147/vhrm.s57524] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE This study sought to examine the prognostic value of heart rate variability (HRV) measurement initiated immediately after emergency department presentation for patients with acute coronary syndrome (ACS). BACKGROUND Altered HRV has been associated with adverse outcomes in heart disease, but the value of HRV measured during the earliest phases of ACS related to risk of 1-year rehospitalization and death has not been established. METHODS Twenty-four-hour Holter recordings of 279 patients with ACS were initiated within 45 minutes of emergency department arrival; recordings with ≥18 hours of sinus rhythm were selected for HRV analysis (number [N] =193). Time domain, frequency domain, and nonlinear HRV were examined. Survival analysis was performed. RESULTS During the 1-year follow-up, 94 patients were event-free, 82 were readmitted, and 17 died. HRV was altered in relation to outcomes. Predictors of rehospitalization included increased normalized high frequency power, decreased normalized low frequency power, and decreased low/high frequency ratio. Normalized high frequency >42 ms(2) predicted rehospitalization while controlling for clinical variables (hazard ratio [HR] =2.3; 95% confidence interval [CI] =1.4-3.8, P=0.001). Variables significantly associated with death included natural logs of total power and ultra low frequency power. A model with ultra low frequency power <8 ms(2) (HR =3.8; 95% CI =1.5-10.1; P=0.007) and troponin >0.3 ng/mL (HR =4.0; 95% CI =1.3-12.1; P=0.016) revealed that each contributed independently in predicting mortality. Nonlinear HRV variables were significant predictors of both outcomes. CONCLUSION HRV measured close to the ACS onset may assist in risk stratification. HRV cut-points may provide additional, incremental prognostic information to established assessment guidelines, and may be worthy of additional study.
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Affiliation(s)
- Patricia R E Harris
- Electrocardiographic Monitoring Research Laboratory, School of Nursing, Department of Physiological Nursing, University of California, San Francisco, CA, USA
| | - Phyllis K Stein
- Heart Rate Variability Laboratory, School of Medicine, Division of Cardiology, Washington University, St Louis, MO, USA
| | - Gordon L Fung
- Cardiology Services, Mount Zion, Department of Medicine, Division of Cardiology, University of California, San Francisco, CA, USA
| | - Barbara J Drew
- School of Nursing, Department of Physiological Nursing, Division of Cardiology, University of California, San Francisco, CA, USA
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Heart rate variability--current diagnosis of the cardiac autonomic neuropathy. A review. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2014; 158:327-38. [PMID: 25004914 DOI: 10.5507/bp.2014.025] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 05/14/2014] [Indexed: 02/06/2023] Open
Abstract
BACKROUND The autonomic nervous system is one of the major homeostatic regulatory systems of the body. Detection of cardiac autonomic neuropathy (CAN), reflected by reduced heart rate variability (HRV), is an independent adverse prognostic factor: sympathovagal balance failure with a sympathetic dominance is the main trigger for lethal arrhythmias and sudden death. METHODS AND RESULTS PubMed database based on original articles from 1983 to 2013 and the author´s clinical experience. This review covers the current status of the methodology and the clinical uses of HRV, especially in the field of internal medicine. CONCLUSION Heart rate variability is making a valuable contribution to the diagnosis of cardiovascular autonomic dysfunction and CAN. It can be assessed from short-term and long-term ECG recordings. It is one of the few methods that allow outpatient CAN diagnosis, monitoring the progress, therapeutic effect and evaluation of patient prognosis. It is used as an independent prognostic factor in combination with other recognized risk factors in risk stratifying after myocardial infarction. It is a unique method of CAN diagnosis particularly in diabetology. Its diagnostic and prognostic potential in other medical fields is being intensively explored.
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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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Modulation of Cardiac Autonomic Dysfunction in Ischemic Stroke following Ayurveda (Indian System of Medicine) Treatment. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 2014:634695. [PMID: 24971149 PMCID: PMC4058279 DOI: 10.1155/2014/634695] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 04/02/2014] [Indexed: 12/23/2022]
Abstract
Objectives. Cardiac autonomic dysfunction in stroke has implications on morbidity and mortality. Ayurveda (Indian system of medicine) describes stroke as pakshaghata. We intended to study the effect of Ayurveda therapies on the cardiac autonomic dysfunction. Methods. Fifty patients of ischemic stroke (middle cerebral artery territory) (mean age 39.26 ± 9.88 years; male 43, female 7) were recruited within one month of ictus. All patients received standard allopathic medications as advised by neurologist. In addition, patients were randomized to receive physiotherapy (Group I) or Ayurveda treatment (Group II) for 14 days. Continuous electrocardiogram and finger arterial pressure were recorded for 15 min before and after treatments and analyzed offline to obtain heart rate and blood pressure variability and baroreflex sensitivity (BRS). Results were analysed by RMANOVA. Results. Patients in Group II showed statistically significant improvement in cardiac autonomic parameters. The standard deviation of normal to normal intervals,and total and low frequency powers were significantly enhanced (F = 8.16, P = 0.007, F = 9.73, P = 0.004, F = 13.51, and P = 0.001, resp.). The BRS too increased following the treatment period (F = 10.129, P = 0.004). Conclusions. The current study is the first to report a positive modulation of cardiac autonomic activity after adjuvant Ayurveda treatment in ischemic stroke. Further long term studies are warranted.
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Association between Information and Communication Technology Usage and the Quality of Sleep among School-Aged Children during a School Week. SLEEP DISORDERS 2014; 2014:315808. [PMID: 24624301 PMCID: PMC3927848 DOI: 10.1155/2014/315808] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 12/10/2013] [Accepted: 12/20/2013] [Indexed: 11/18/2022]
Abstract
Objective. To determine the association between intensity of information and communication technology (ICT) usage and quality of sleep in school-aged children during a school week. Methods. In all 61 subjects, 10–14 years of age, a quasiexperimental laboratory study where criterions for inclusion were absence of prior medical condition and duration of ICT use. A portable device (Holter monitor) was used to measure heart rate variability (HRV) over a 24-hour period, while activity diary was used to record in 15-minute intervals ICT use and sleep and wake up time. Low and high ICT user groups were formed according to their intensity of ICT use. Statistical analysis was done with two independent samples tests and factorial ANCOVA. Results. The higher ICT users showed a lower sleep time standard deviation of normal to normal interval (SDNN) measures in comparison to the low ICT users. Conclusion. The intensive ICT use was associated with poorer quality of sleep indicated by physiological measures among children and adolescents. Knowing the crucial role of healthy sleep in this age, the results are reason for concern.
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The 5-HTTLPR genotype modulates heart rate variability and its adjustment by pharmacological panic challenge in healthy men. J Psychiatr Res 2014; 50:51-8. [PMID: 24342768 DOI: 10.1016/j.jpsychires.2013.11.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 11/25/2013] [Accepted: 11/29/2013] [Indexed: 01/01/2023]
Abstract
Abnormal serotonin transporter (5-HTT) function and autonomic nervous system (ANS) dysregulation has been proposed in panic disorder. However, in contrast to hypothalamo-pituitary-adrenocortical (HPA) functioning, ANS reactivity during panic response has yet not been investigated in humans with respect to the 5-HTT genotype. The present study assessed the influence of challenging by cholecystokinin tetrapeptide (CCK-4) on heart rate variability (HRV) measures, to monitor autonomic reactivity and its relationship to 5-HTT-linked polymorphic region (5-HTTLPR) genotypes. We hypothesized substantial effects of the 5-HTTLPR genotype on autonomic reactivity. We studied 30 healthy young men, 15 of each with the long/long (l/l) or short/short (s/s) genotype for the 5-HTTLPR. All participants received an intravenous application of 50 μg CCK-4. HRV measures were assessed in both groups at baseline and immediately after CCK-4 application. Our results indicated lower parasympathetic activity in s/s carriers during baseline, time and frequency domain measures. CCK-4 application significantly enhanced the sympathetic tone in both groups, leading to diminished group differences. A significant treatment by genotype effect indicated reduced autonomic reactivity to CCK-4 challenge in the s/s compared to l/l carriers. Our findings show enhanced sympathetic and/or diminished cardiac vagal activity under basal conditions and blunted autonomic reactivity in s/s vs. l/l carriers. Our study provides novel data supporting claims that the s/s genotype represents a genetic vulnerability factor associated with inadequate hyporeactivity to stress and extends current knowledge on the impact of the central serotonergic activity on the sympathoadrenal pathway.
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76
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Tonello L, Rodrigues FB, Souza JWS, Campbell CSG, Leicht AS, Boullosa DA. The role of physical activity and heart rate variability for the control of work related stress. Front Physiol 2014; 5:67. [PMID: 24600407 PMCID: PMC3931195 DOI: 10.3389/fphys.2014.00067] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 02/04/2014] [Indexed: 01/05/2023] Open
Abstract
Physical activity (PA) and exercise are often used as tools to reduce stress and therefore the risk for developing cardiovascular diseases (CVD). Meanwhile, heart rate variability (HRV) has been utilized to assess both stress and PA or exercise influences. The objective of the present review was to examine the current literature in regards to workplace stress, PA/exercise and HRV to encourage further studies. We considered original articles from known databases (PubMed, ISI Web of Knowledge) over the last 10 years that examined these important factors. A total of seven studies were identified with workplace stress strongly associated with reduced HRV in workers. Longitudinal workplace PA interventions may provide a means to improve worker stress levels and potentially cardiovascular risk with mechanisms still to be clarified. Future studies are recommended to identify the impact of PA, exercise, and fitness on stress levels and HRV in workers and their subsequent influence on cardiovascular health.
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Affiliation(s)
- Laís Tonello
- Department of Physical Education, Catholic University of Brasilia Brasilia, Brazil
| | - Fábio B Rodrigues
- Department of Physical Education, Catholic University of Brasilia Brasilia, Brazil
| | - Jeniffer W S Souza
- Department of Physical Education, Catholic University of Brasilia Brasilia, Brazil
| | - Carmen S G Campbell
- Department of Physical Education, Catholic University of Brasilia Brasilia, Brazil
| | - Anthony S Leicht
- Institute of Sport and Exercise Science, James Cook University Queensland, QLD, Australia
| | - Daniel A Boullosa
- Department of Physical Education, Catholic University of Brasilia Brasilia, Brazil
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77
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Harris PR, Sommargren CE, Stein PK, Fung GL, Drew BJ. Heart rate variability measurement and clinical depression in acute coronary syndrome patients: narrative review of recent literature. Neuropsychiatr Dis Treat 2014; 10:1335-47. [PMID: 25071372 PMCID: PMC4111661 DOI: 10.2147/ndt.s57523] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
AIM We aimed to explore links between heart rate variability (HRV) and clinical depression in patients with acute coronary syndrome (ACS), through a review of recent clinical research literature. BACKGROUND Patients with ACS are at risk for both cardiac autonomic dysfunction and clinical depression. Both conditions can negatively impact the ability to recover from an acute physiological insult, such as unstable angina or myocardial infarction, increasing the risk for adverse cardiovascular outcomes. HRV is recognized as a reflection of autonomic function. METHODS A narrative review was undertaken to evaluate state-of-the-art clinical research, using the PubMed database, January 2013. The search terms "heart rate variability" and "depression" were used in conjunction with "acute coronary syndrome", "unstable angina", or "myocardial infarction" to find clinical studies published within the past 10 years related to HRV and clinical depression, in patients with an ACS episode. Studies were included if HRV measurement and depression screening were undertaken during an ACS hospitalization or within 2 months of hospital discharge. RESULTS Nine clinical studies met the inclusion criteria. The studies' results indicate that there may be a relationship between abnormal HRV and clinical depression when assessed early after an ACS event, offering the possibility that these risk factors play a modest role in patient outcomes. CONCLUSION While a definitive conclusion about the relevance of HRV and clinical depression measurement in ACS patients would be premature, the literature suggests that these measures may provide additional information in risk assessment. Potential avenues for further research are proposed.
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Affiliation(s)
- Patricia Re Harris
- ECG Monitoring Research Lab, University of California, San Francisco, CA, USA
| | - Claire E Sommargren
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, CA, USA
| | - Phyllis K Stein
- Heart Rate Variability Laboratory, School of Medicine, Washington University, St Louis, MO, USA
| | - Gordon L Fung
- Asian Heart & Vascular Center at Mount Zion, Division of Cardiology, University of California, San Francisco, CA, USA ; Cardiology Consultation Service, Cardiac Noninvasive Laboratory, and The Enhanced External Counterpulsation Unit, Department of Medicine, University of California, San Francisco Medical Center, San Francisco, CA, USA
| | - Barbara J Drew
- Division of Cardiology, University of California, San Francisco, CA, USA ; Department of Physiological Nursing, School of Nursing, University of California, San Francisco, CA, USA
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78
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Basal cardiac autonomic tone is normal in patients with periodic leg movements during sleep. J Neural Transm (Vienna) 2013; 121:385-90. [DOI: 10.1007/s00702-013-1116-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Accepted: 10/31/2013] [Indexed: 10/26/2022]
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79
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Poręba M, Poręba R, Gać P, Usnarska-Zubkiewicz L, Pilecki W, Piotrowicz E, Piotrowicz R, Rusiecki L, Kuliczkowski K, Mazur G, Sobieszczańska M. Heart rate variability and heart rate turbulence in patients with hematologic malignancies subjected to high-dose chemotherapy in the course of hematopoietic stem cell transplantation. Ann Noninvasive Electrocardiol 2013; 19:157-65. [PMID: 24206437 DOI: 10.1111/anec.12108] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND In hematological malignancies, remissions and cures may be achieved by hematopoietic stem cell transplantation (HSCT) following high-dose chemotherapy (HDC). Cardiotoxicity of such therapy has not yet been fully elucidated. Noninvasive approaches allowing to evaluate an autonomic control of the heart function include analyses of both heart rate variability (HRV) and heart rate turbulence (HRT). METHODS In 38 patients with hematological malignancies, 24-hour electrocardiography Holter monitoring , with HRV and HRT analysis before HSCT (A test) and after HSCT (B test), was performed. RESULTS The 24-hour analysis of HRV demonstrated that SDNN, SDNNi, rMSSD, and pNN50 parameters were significantly lower after HSCT as compared to the results obtained before the transplantation (P < 0.05). For period of diurnal activity and for night hours, SDANN, SDNNi, rMSSD, and pNN50 were significantly lower in B test, as compared to the results of A test (P < 0.05). The analysis of HRT demonstrated that turbulence onset parameter was significantly higher, and turbulence slope parameter was significantly lower in B test, as compared to A test (P < 0.05). The multifactorial stepwise backward regression analysis indicated that administration of cyclophosphamide and carmustine and higher concentrations of blood cholesterol represented risk factors for decreased HRV. Cyclophosphamide and higher triglyceride levels represented independent risk factors for decreased HRT. CONCLUSIONS In patients with hematopoietic malignancies treated with HSCT, decreased HRV and HRT were observed after chemotherapy and stem cells administration.
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Affiliation(s)
- Małgorzata Poręba
- Department of Pathophysiology, Wroclaw Medical University, Wroclaw, Poland
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Posokhova E, Ng D, Opel A, Masuho I, Tinker A, Biesecker LG, Wickman K, Martemyanov KA. Essential role of the m2R-RGS6-IKACh pathway in controlling intrinsic heart rate variability. PLoS One 2013; 8:e76973. [PMID: 24204714 PMCID: PMC3812209 DOI: 10.1371/journal.pone.0076973] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 09/05/2013] [Indexed: 11/18/2022] Open
Abstract
Normal heart function requires generation of a regular rhythm by sinoatrial pacemaker cells and the alteration of this spontaneous heart rate by the autonomic input to match physiological demand. However, the molecular mechanisms that ensure consistent periodicity of cardiac contractions and fine tuning of this process by autonomic system are not completely understood. Here we examined the contribution of the m2R-IKACh intracellular signaling pathway, which mediates the negative chronotropic effect of parasympathetic stimulation, to the regulation of the cardiac pacemaking rhythm. Using isolated heart preparations and single-cell recordings we show that the m2R-IKACh signaling pathway controls the excitability and firing pattern of the sinoatrial cardiomyocytes and determines variability of cardiac rhythm in a manner independent from the autonomic input. Ablation of the major regulator of this pathway, Rgs6, in mice results in irregular cardiac rhythmicity and increases susceptibility to atrial fibrillation. We further identify several human subjects with variants in the RGS6 gene and show that the loss of function in RGS6 correlates with increased heart rate variability. These findings identify the essential role of the m2R-IKACh signaling pathway in the regulation of cardiac sinus rhythm and implicate RGS6 in arrhythmia pathogenesis.
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Affiliation(s)
- Ekaterina Posokhova
- Department of Neuroscience, The Scripps Research Institute, Jupiter, Florida, United States of America
| | - David Ng
- Genetic Diseases Research Branch, National Human Genome Research Institute, Bethesda, Maryland, United States of America
| | - Aaisha Opel
- Department of Medicine, University College London, London, United Kingdom
| | - Ikuo Masuho
- Department of Neuroscience, The Scripps Research Institute, Jupiter, Florida, United States of America
| | - Andrew Tinker
- The Heart Centre, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Charterhouse Square, London, United Kingdom
| | - Leslie G. Biesecker
- Genetic Diseases Research Branch, National Human Genome Research Institute, Bethesda, Maryland, United States of America
| | - Kevin Wickman
- Department of Pharmacology, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Kirill A. Martemyanov
- Department of Neuroscience, The Scripps Research Institute, Jupiter, Florida, United States of America
- * E-mail:
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Abstract
Heart rate turbulence (HRT) is a baroreflex-mediated biphasic reaction of heart rate in response to premature ventricular beats. Heart rate turbulence is quantified by: turbulence onset (TO) reflecting the initial acceleration of heart rate following premature beat and turbulence slope (TS) describing subsequent deceleration of heart rate. Abnormal HRT identifies patients with autonomic dysfunction or impaired baroreflex sensitivity due to variety of disorders, but also may reflect changes in autonomic nervous system induced by different therapeutic modalities such as drugs, revascularization, or cardiac resynchronization therapy. More importantly, impaired HRT has been shown to identify patients at high risk of all-cause mortality and sudden death, particularly in postinfarction and congestive heart failure patients. It should be emphasized that abnormal HRT has a well-established role in stratification of postinfarction and heart failure patients with relatively preserved left ventricular ejection fraction. The ongoing clinical trials will document whether HRT can be used to guide implantation of cardioverter-defibrillators in this subset of patients, not covered yet by ICD guidelines. This review focuses on the current state-of-the-art knowledge regarding clinical significance of HRT in detection of autonomic dysfunction and regarding the prognostic significance of this parameter in predicting all-cause mortality and sudden death.
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Affiliation(s)
- Iwona Cygankiewicz
- Department of Electrocardiology, Medical University of Lodz, Sterling Regional Center for Heart Diseases, 91-425 Lodz, Poland.
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Chouchou F, Pichot V, Pépin J, Tamisier R, Celle S, Maudoux D, Garcin A, Lévy P, Barthélémy J, Roche F. Sympathetic overactivity due to sleep fragmentation is associated with elevated diurnal systolic blood pressure in healthy elderly subjects: the PROOF-SYNAPSE study. Eur Heart J 2013; 34:2122-31, 2131a. [DOI: 10.1093/eurheartj/eht208] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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83
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Physick-Sheard PW. Seek and ye shall find: Cardiac arrhythmias in the horse. Equine Vet J 2013; 45:270-2. [DOI: 10.1111/evj.12054] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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84
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Lombardi F. Early repolarization: a benign electrocardiographic pattern or an ominous proarrhythmic sign? J Am Coll Cardiol 2013; 61:870-1. [PMID: 23428219 DOI: 10.1016/j.jacc.2012.11.052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Accepted: 11/25/2012] [Indexed: 01/26/2023]
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85
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Koeman T, Slottje P, Kromhout H, Schouten LJ, Goldbohm RA, van den Brandt PA, Vermeulen R. Occupational exposure to extremely low-frequency magnetic fields and cardiovascular disease mortality in a prospective cohort study. Occup Environ Med 2013; 70:402-7. [DOI: 10.1136/oemed-2012-100889] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Chen WR, Shi XM, Yang TS, Zhao LC, Gao LG. Protective effect of metoprolol on arrhythmia and heart rate variability in healthy people with 24 hours of sleep deprivation. J Interv Card Electrophysiol 2012. [PMID: 23179915 DOI: 10.1007/s10840-012-9728-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE Sleep deprivation, which is a strong stressor, can greatly affect the cardiovascular system of rescue workers. This study aimed to investigate the effect of 24-h sleep deprivation on heart rate variability (HRV) in young healthy people and the protective effect of metoprolol on arrhythmia. METHODS Sixty young, healthy subjects (6 women and 54 men), aged 25 ± 4.5 years, were enrolled in this study. All participants received 24-h continuous ambulatory electrocardiogram monitoring. Arrhythmia, time, and frequency domain parameters were analyzed in subjects at the following three stages: normal sleep stage, sleep deprivation stage, and metoprolol treatment before sleep deprivation stage. RESULTS After 24-h sleep deprivation, the high frequency (HF) of HRV was significantly decreased (p < 0.05), low frequency (LF) was remarkably increased (p < 0.05), and LF/HF was significantly increased compared with those in normal sleep (p < 0.05). Some subjects presented with mild palpitation due to premature atrial complexes and premature ventricular complexes. At the metoprolol treatment stage, compared with the sleep deprivation stage, LF and LF/HF were significantly reduced, HF of HRV was elevated (p < 0.05), and the total amount of premature atrial and ventricular complexes was decreased. CONCLUSION The underlying mechanism of arrhythmia and HRV alteration after 24-h sleep deprivation could be attributable to lower vagal activity and elevated sympathetic activity. Metoprolol improves the change in autonomic nervous system activity after 24-h sleep deprivation, which may be responsible for its protective role on arrhythmia in healthy subjects undergoing sleep deprivation.
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Affiliation(s)
- Wei-ren Chen
- Department of Cardiology (South Building), PLA General Hospital, Beijing, China
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Beuchée A, Hernández AI, Duvareille C, Daniel D, Samson N, Pladys P, Praud JP. Influence of hypoxia and hypercapnia on sleep state-dependent heart rate variability behavior in newborn lambs. Sleep 2012; 35:1541-9. [PMID: 23115403 DOI: 10.5665/sleep.2206] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES Although hypercapnia and/or hypoxia are frequently present during chronic lung disease of infancy and have also been implicated in sudden infant death syndrome (SIDS), their effect on cardiac autonomic regulation remains unclear. The authors' goal is to test that hypercapnia and hypoxia alter sleep-wake cycle-dependent heart rate variability (HRV) in the neonatal period. DESIGN Experimental study measuring HRV during sleep states in lambs randomly exposed to hypercapnia, hypoxia, or air. SETTING University center for perinatal research in ovines (Sherbrooke, Canada). INSERM-university research unit for signal processing (Rennes, France). PARTICIPANTS Six nonsedated, full-term lambs. INTERVENTIONS Each lamb underwent polysomnographic recordings while in a chamber flowed with either air or 21% O(2) + 5% CO(2) (hypercapnia) or 10% O(2) + 0% CO(2) (hypoxia) on day 3, 4, and 5 of postnatal age. MEASUREMENTS AND RESULTS Hypercapnia increased the time spent in wakefulness and hypoxia the time spent in quiet sleep (QS). The state of alertness was the major determinant of HRV characterized with linear or nonlinear methods. Compared with QS, active sleep (AS) was associated with an overall increase in HRV magnitude and short-term self-similarity and a decrease in entropy of cardiac cycle length in air. This AS-related HRV pattern persisted in hypercapnia and was even more pronounced in hypoxia. CONCLUSION Enhancement of AS-related sympathovagal coactivation in hypoxia, together with increased heart rate regularity, may be evidence that AS + hypoxia represent a particularly vulnerable state in early life. This should be kept in mind when deciding the optimal arterial oxygenation target in newborns and when investigating the potential involvement of hypoxia in SIDS pathogenesis.
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Erdem A, Uenishi M, Küçükdurmaz Z, Matsumoto K, Kato R, Hara M, Yazıcı M. Cardiac Autonomic Function Measured by Heart Rate Variability and Turbulence in Pre-hypertensive Subjects. Clin Exp Hypertens 2012; 35:102-7. [DOI: 10.3109/10641963.2012.690475] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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