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Monitoring and sensing COVID-19 symptoms as a precaution using electronic wearable devices. INTERNATIONAL JOURNAL OF PERVASIVE COMPUTING AND COMMUNICATIONS 2020. [DOI: 10.1108/ijpcc-06-2020-0067] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose fo this paper is to Monitor and sense the sysmptoms of COVID-19 as a preliminary measure using electronic wearable devices. This variability is sensed by electrocardiograms observed from a multi-parameter monitor and electronic wearable. This field of interest has evolved into a wide area of investigation with today’s advancement in technology of internet of things for immediate sensing and processing information about profound pain. A window span is estimated and reports of profound pain data are used for monitoring heart rate variability (HRV). A median heart rate is considered for comparisons with a diverse range of variable information obtained from sensors and monitors. Observations from healthy patients are introduced to identify how root mean square of difference between inter beat intervals, standard deviation of inter-beat intervals and mean heart rate value are normalized in HRV analysis.
Design/methodology/approach
The function of a human heart relates back to the autonomic nervous system, which organizes and maintains a healthy maneuver of inter connected organs. HRV has to be determined for analyzing and reporting the status of health, fitness, readiness and possibilities for recovery, and thus, a metric for deeming the presence of COVID-19. Identifying the variations in heart rate, monitoring and assessing profound pain levels are potential lives saving measures in medical industries.
Findings
Experiments are proposed to be done in electrical and thermal point of view and this composition will deliver profound pain levels ranging from 0 to 10. Real time detection of pain levels will assist the care takers to facilitate people in an aging population for a painless lifestyle.
Originality/value
The presented research has documented the stages of COVID-19, symptoms and a mechanism to monitor the progress of the disease through better parameters. Risk factors of the disease are carefully analyzed, compared with test results, and thus, concluded that considering the HRV can study better in the presence of ignorance and negligence. The same mechanism can be implemented along with a global positioning system (GPS) system to track the movement of patients during isolation periods. Despite the stringent control measurements for locking down all industries, the rate of affected people is still on the rise. To counter this, people have to be educated about the deadly effects of COVID-19 and foolproof systems should be in place to control the transmission from affected people to new people. Medications to suppress temperatures, will not be sufficient to alter the heart rate variations, and thus, the proposed mechanism implemented the same. The proposed study can be extended to be associated with Government mobile apps for regular and a consortium of single tracking. Measures can be taken to distribute the low-cost proposal to people for real time tracking and regular updates about high and medium risk patients.
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Eggenberger P, Annaheim S, Kündig KA, Rossi RM, Münzer T, de Bruin ED. Heart Rate Variability Mainly Relates to Cognitive Executive Functions and Improves Through Exergame Training in Older Adults: A Secondary Analysis of a 6-Month Randomized Controlled Trial. Front Aging Neurosci 2020; 12:197. [PMID: 32760267 PMCID: PMC7373948 DOI: 10.3389/fnagi.2020.00197] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 06/05/2020] [Indexed: 12/16/2022] Open
Abstract
Heart rate variability (HRV) mirrors autonomic nervous system activities and might serve as a parameter to monitor health status in older adults. However, it is currently unknown which functional health measures, including cognitive, physical, and gait performance parameters, are most strongly related to HRV indices. This knowledge would enable implementing HRV assessments into health monitoring routines and training planning for older adults. Simultaneous cognitive-motor and exergame training may be effective to improve HRV indices but has not been investigated yet. Eighty-nine healthy older adults (≥70 years of age) were randomized into three groups: (1) virtual reality video game dancing, i.e., exergaming (DANCE); (2) treadmill walking with simultaneous verbal memory training (MEMORY); or (3) treadmill walking only (PHYS). Strength and balance exercises complemented each program. Over 6 months, two weekly 1-h training sessions were performed. HRV indices (standard deviation of N-N intervals, SDNN; root mean square of successive R-R interval differences, RMSSD; and absolute power of high-frequency band (0.15-0.4 Hz), HF power) and various measures of cognitive, physical, and gait performance were assessed at baseline and after 3 months and 6 months. Multiple linear regression analyses with planned comparisons were calculated. At baseline, 8-12% of HRV variance was significantly explained by cognitive executive functions and leg strength (inversely related). Verbal long-term memory, aerobic and functional fitness, and gait performance did not contribute to the model (SDNN: R2 = 0.082, p = 0.016; RMSSD: R2 = 0.121, p = 0.013; HF power: R2 = 0.119, p = 0.015). After 6 months, DANCE improved HRV indices, while MEMORY and PHYS did not (time × intervention interactions: first-contrast DANCE/MEMORY vs. PHYS: SDNN p = 0.014 one-tailed, ΔR 2 = 0.020 and RMSSD p = 0.052 one-tailed (trend), ΔR 2 = 0.007; second-contrast DANCE vs. MEMORY: SDNN p = 0.002 one-tailed, ΔR 2 = 0.035, RMSSD p = 0.017 one-tailed, ΔR 2 = 0.012, and HF power p = 0.011 one-tailed, ΔR 2 = 0.013). We conclude that mainly cognitive executive functions are associated with HRV indices and that exergame training improves global and parasympathetic autonomic nervous system activities in older adults. Periodic assessments of HRV in older citizens could be particularly beneficial to monitor cognitive health and provide indications for preventative exercise measures.
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Affiliation(s)
- Patrick Eggenberger
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biomimetic Membranes and Textiles, St. Gallen, Switzerland.,Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Simon Annaheim
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biomimetic Membranes and Textiles, St. Gallen, Switzerland
| | - Kerstin A Kündig
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biomimetic Membranes and Textiles, St. Gallen, Switzerland.,Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - René M Rossi
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biomimetic Membranes and Textiles, St. Gallen, Switzerland
| | - Thomas Münzer
- Geriatrische Klinik St. Gallen, St. Gallen, Switzerland.,Department of Geriatric Medicine, University of Zurich, Zurich, Switzerland
| | - Eling D de Bruin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland.,Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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103
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Monfredi O, Lakatta EG. Complexities in cardiovascular rhythmicity: perspectives on circadian normality, ageing and disease. Cardiovasc Res 2020; 115:1576-1595. [PMID: 31150049 DOI: 10.1093/cvr/cvz112] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 02/06/2019] [Accepted: 05/25/2019] [Indexed: 12/13/2022] Open
Abstract
Biological rhythms exist in organisms at all levels of complexity, in most organs and at myriad time scales. Our own biological rhythms are driven by energy emitted by the sun, interacting via our retinas with brain stem centres, which then send out complex messages designed to synchronize the behaviour of peripheral non-light sensing organs, to ensure optimal physiological responsiveness and performance of the organism based on the time of day. Peripheral organs themselves have autonomous rhythmic behaviours that can act independently from central nervous system control but is entrainable. Dysregulation of biological rhythms either through environment or disease has far-reaching consequences on health that we are only now beginning to appreciate. In this review, we focus on cardiovascular rhythms in health, with ageing and under disease conditions.
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Affiliation(s)
- Oliver Monfredi
- Division of Medicine, Department of Cardiology, The Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD, USA.,Laboratory of Cardiovascular Sciences, Intramural Research Program, National Institute on Aging, National Institutes of Health, 251 Bayview Blvd, Baltimore, MD, USA
| | - Edward G Lakatta
- Laboratory of Cardiovascular Sciences, Intramural Research Program, National Institute on Aging, National Institutes of Health, 251 Bayview Blvd, Baltimore, MD, USA
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104
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Mattoni M, Ahn S, Fröhlich C, Fröhlich F. Exploring the relationship between geomagnetic activity and human heart rate variability. Eur J Appl Physiol 2020; 120:1371-1381. [PMID: 32306151 PMCID: PMC11089572 DOI: 10.1007/s00421-020-04369-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 04/05/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Both geomagnetic and solar activity fluctuate over time and have been proposed to affect human physiology. Heart rate variability (HRV) has substantial health implications regarding the ability to adapt to stressors and has been shown to be altered in many cardiovascular and neurological disorders. Intriguingly, previous work found significant, strong correlations between HRV and geomagnetic/solar activity. The purpose of this study to replicate these findings. We simultaneously measured HRV during a 30-day period. METHODS We recruited 20 healthy participants and measured their HRV for a 30-day period. We also collected geomagnetic and solar activity during this period for investigating their relationship with the HRV data. RESULTS In agreement with previous work, we found several significant correlations between short-term HRV and geophysical time-series. However, after correction for autocorrelation, which is inherent in time-series, the only significant results were an increase in very low frequency during higher local geomagnetic activity and a geomagnetic anticipatory decrease in heart rate a day before the higher global geomagnetic activity. Both correlations were very low. The loss of most significant effects after this correction suggests that previous findings may be a result of autocorrelation. A further note of caution is required since our and the previous studies in the field do not correct for multiple comparisons given the exploratory analysis strategy. CONCLUSION We thus conclude that the effects of geomagnetic and solar activity are (if present) most likely of very small effect size and we question the validity of the previous studies given the methodological concerns we have uncovered with our work.
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Affiliation(s)
- Matthew Mattoni
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
- Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Sangtae Ahn
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
- Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
- School of Electronics Engineering, Kyungpook National University, Daegu, 41556, South Korea
| | - Carla Fröhlich
- Department of Physics, North Carolina State University, Raleigh, NC, 27695, USA
| | - Flavio Fröhlich
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
- Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
- Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
- Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
- Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
- Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
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105
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The link between resting heart rate variability and affective flexibility. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2020; 20:746-756. [DOI: 10.3758/s13415-020-00800-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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106
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Lubberding AF, Pereira L, Xue J, Gottlieb LA, Matchkov VV, Gomez AM, Thomsen MB. Aberrant sinus node firing during β-adrenergic stimulation leads to cardiac arrhythmias in diabetic mice. Acta Physiol (Oxf) 2020; 229:e13444. [PMID: 31953990 DOI: 10.1111/apha.13444] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 12/25/2019] [Accepted: 01/13/2020] [Indexed: 01/08/2023]
Abstract
AIM Cardiovascular complications, including cardiac arrhythmias, result in high morbidity and mortality in patients with type-2 diabetes mellitus (T2DM). Clinical and experimental data suggest electrophysiological impairment of the natural pacemaker of the diabetic heart. The present study examined sinoatrial node (SAN) arrhythmias in a mouse model of T2DM and physiologically probed their underlying cause. METHODS Electrocardiograms were obtained from conscious diabetic db/db and lean control db/+ mice. In vivo SAN function was probed through pharmacological autonomic modulation with isoprenaline, atropine and carbachol. Blood pressure stability and heart rate variability (HRV) were evaluated. Intrinsic SAN function was evaluated through ex vivo imaging of spontaneous Ca2+ transients in isolated SAN preparations. RESULTS While lean control mice showed constant RR intervals during isoprenaline challenge, the diabetic mice experienced SAN arrhythmias with large RR fluctuations in a dose-dependent manner. These arrhythmias were completely abolished by atropine pre-treatment, while carbachol pretreatment significantly increased SAN arrhythmia frequency in the diabetic mice. Blood pressure and HRV were comparable in db/db and db/+ mice, suggesting that neither augmented baroreceptor feedback nor autonomic neuropathy is a likely arrhythmia mechanism. Cycle length response to isoprenaline was comparable in isolated SAN preparations from db/db and db/+ mice; however, Ca2+ spark frequency was significantly increased in db/db mice compared to db/+ at baseline and after isoprenaline. CONCLUSION Our results demonstrate a dysfunction of cardiac pacemaking in an animal model of T2DM upon challenge with a β-adrenergic agonist. Ex vivo, higher Ca2+ spark frequency is present in diabetic mice, which may be directly linked to in vivo arrhythmias.
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Affiliation(s)
- Anniek F. Lubberding
- Department of Biomedical Sciences Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
| | - Laetitia Pereira
- Université Paris‐Saclay Inserm UMR‐S 1180 Châtenay‐Malabry France
| | - Jianbin Xue
- Université Paris‐Saclay Inserm UMR‐S 1180 Châtenay‐Malabry France
| | - Lisa A. Gottlieb
- Department of Biomedical Sciences Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
| | | | - Ana M. Gomez
- Université Paris‐Saclay Inserm UMR‐S 1180 Châtenay‐Malabry France
| | - Morten B. Thomsen
- Department of Biomedical Sciences Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
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107
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Gąsior JS, Zamunér AR, Silva LEV, Williams CA, Baranowski R, Sacha J, Machura P, Kochman W, Werner B. Heart Rate Variability in Children and Adolescents with Cerebral Palsy-A Systematic Literature Review. J Clin Med 2020; 9:jcm9041141. [PMID: 32316278 PMCID: PMC7230809 DOI: 10.3390/jcm9041141] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 04/04/2020] [Accepted: 04/13/2020] [Indexed: 12/14/2022] Open
Abstract
Cardiac autonomic dysfunction has been reported in patients with cerebral palsy (CP). The aim of this study was to assess the existing literature on heart rate variability (HRV) in pediatric patients with CP and a special attention was paid to the compliance of the studies with the current HRV assessment and interpretation guidelines. A systematic review was performed in PubMed, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases searched for English language publications from 1996 to 2019 using Medical Subject Headings (MeSH) terms “heart rate variability” and “cerebral palsy” in conjunction with additional inclusion criteria: studies limited to humans in the age range of 0–18 years and empirical investigations. Out of 47 studies, 12 were included in the review. Pediatric patients with CP presented a significantly higher resting heart rate and reduced HRV, different autonomic responses to movement stimuli compared to children with normal development, but also reduced HRV parameters in the children dependent on adult assistance for mobility compared to those generally independent. None of the included studies contained the necessary details concerning RR intervals acquisition and HRV measurements as recommended by the guidelines. Authors of HRV studies should follow the methodological guidelines and recommendations on HRV measurement, because such an approach may allow a direct comparison of their results.
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Affiliation(s)
- Jakub S. Gąsior
- Faculty of Medical Sciences and Health Sciences, Kazimierz Pulaski University of Technology and Humanities, 26-600 Radom, Poland
- Correspondence: ; Tel.: +48-793-199-222
| | | | - Luiz Eduardo Virgilio Silva
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo 14049-900, Brazil;
| | - Craig A. Williams
- Children’s Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St Luke’s Campus, Exeter EX1 2LU, UK;
| | - Rafał Baranowski
- Department of Heart Rhythm Disorders, National Institute of Cardiology, 04-628 Warsaw, Poland;
| | - Jerzy Sacha
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, 45-758 Opole, Poland;
- Department of Cardiology, University Hospital in Opole, University of Opole, 45-401 Opole, Poland
| | - Paulina Machura
- Department of Gynaecological Endocrinology, Medical University of Warsaw, 00-950 Warsaw, Poland;
| | - Wacław Kochman
- Clinical Department of Cardiology at Bielanski Hospital, National Institute of Cardiology, 01-809 Warsaw, Poland;
| | - Bożena Werner
- Department of Pediatric Cardiology and General Pediatrics, Medical University of Warsaw, 02-091 Warsaw, Poland;
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108
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Comparison of fetal heart rate variability by symbolic dynamics at the third trimester of pregnancy and low-risk parturition. Heliyon 2020; 6:e03485. [PMID: 32195385 PMCID: PMC7075801 DOI: 10.1016/j.heliyon.2020.e03485] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 09/26/2019] [Accepted: 02/20/2020] [Indexed: 12/15/2022] Open
Abstract
Fetal heart rate variability (fHRV) is an essential source of information to monitor fetal well-being during pregnancy. This study aimed to apply a nonlinear approach, known as symbolic dynamics (SD), for comparing human fHRV in the third trimester of pregnancy during active fetal state (TT) and active labor at term (P). We performed a longitudinal, prospective, descriptive, and comparative study composed of 42 longitudinal recordings of 5-minutes of fetal heartbeat interval series. Recordings were collected from 21 low-risk, healthy, pregnant women attending the Maternal and Child Research Center (CIMIGen), Mexico City. We calculated relevant linear parameters of fHRV between TT and P stages, such as the percentage of differences between adjacent RR intervals >5 ms (PRR5, related to vagal modulations) and other SD parameters such as the percentage of no variations between three successive symbols (%0V, reflects sympathetic modulations) and the probability of low variability with a threshold of 4 ms (POLVAR4, associated with a low variability). We identified statistical differences for PRR5 between TT and P (37.13% [28.47-47.60%] vs. 28.84% [19.36-36.76%], p = 0.03), respectively. Also, for 0V% (65.66% [59.01-71.80%] vs. 71.14% [65.94-75.87%], p = 0.03) and for POLVAR4 values (0.06 [0.04-0.11] vs. 0.15 [0.09-0.24], p = 0.002), respectively. Our results indicate that during parturition, the short-term fetal fHRV is decreased, showing a decreased vagal modulations and higher adrenergic response of the heart. These autonomic modifications may result from the fetal response to the stressful inflammatory challenge of labor. We thus confirmed that the analysis of the SD applied to fHRV time series could be a potential clinical biomarker to differentiate the fetal autonomic cardiac condition at different stages of pregnancy.
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109
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Kohajda Z, Tóth N, Szlovák J, Loewe A, Bitay G, Gazdag P, Prorok J, Jost N, Levijoki J, Pollesello P, Papp JG, Varró A, Nagy N. Novel Na +/Ca 2+ Exchanger Inhibitor ORM-10962 Supports Coupled Function of Funny-Current and Na +/Ca 2+ Exchanger in Pacemaking of Rabbit Sinus Node Tissue. Front Pharmacol 2020; 10:1632. [PMID: 32063850 PMCID: PMC7000430 DOI: 10.3389/fphar.2019.01632] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 12/13/2019] [Indexed: 01/01/2023] Open
Abstract
Background and Purpose The exact mechanism of spontaneous pacemaking is not fully understood. Recent results suggest tight cooperation between intracellular Ca2+ handling and sarcolemmal ion channels. An important player of this crosstalk is the Na+/Ca2+ exchanger (NCX), however, direct pharmacological evidence was unavailable so far because of the lack of a selective inhibitor. We investigated the role of the NCX current in pacemaking and analyzed the functional consequences of the If-NCX coupling by applying the novel selective NCX inhibitor ORM-10962 on the sinus node (SAN). Experimental Approach Currents were measured by patch-clamp, Ca2+-transients were monitored by fluorescent optical method in rabbit SAN cells. Action potentials (AP) were recorded from rabbit SAN tissue preparations. Mechanistic computational data were obtained using the Yaniv et al. SAN model. Key Results ORM-10962 (ORM) marginally reduced the SAN pacemaking cycle length with a marked increase in the diastolic Ca2+ level as well as the transient amplitude. The bradycardic effect of NCX inhibition was augmented when the funny-current (If) was previously inhibited and vice versa, the effect of If was augmented when the Ca2+ handling was suppressed. Conclusion and Implications We confirmed the contribution of the NCX current to cardiac pacemaking using a novel NCX inhibitor. Our experimental and modeling data support a close cooperation between If and NCX providing an important functional consequence: these currents together establish a strong depolarization capacity providing important safety factor for stable pacemaking. Thus, after individual inhibition of If or NCX, excessive bradycardia or instability cannot be expected because each of these currents may compensate for the reduction of the other providing safe and rhythmic SAN pacemaking.
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Affiliation(s)
- Zsófia Kohajda
- MTA-SZTE Research Group of Cardiovascular Pharmacology, Hungarian Academy of Sciences, Szeged, Hungary.,Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Noémi Tóth
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Jozefina Szlovák
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Axel Loewe
- Institute of Biomedical Engineering, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Gergő Bitay
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Péter Gazdag
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - János Prorok
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Norbert Jost
- MTA-SZTE Research Group of Cardiovascular Pharmacology, Hungarian Academy of Sciences, Szeged, Hungary.,Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | | | | | - Julius Gy Papp
- MTA-SZTE Research Group of Cardiovascular Pharmacology, Hungarian Academy of Sciences, Szeged, Hungary.,Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - András Varró
- MTA-SZTE Research Group of Cardiovascular Pharmacology, Hungarian Academy of Sciences, Szeged, Hungary.,Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Norbert Nagy
- MTA-SZTE Research Group of Cardiovascular Pharmacology, Hungarian Academy of Sciences, Szeged, Hungary.,Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Szeged, Szeged, Hungary
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110
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Calderón-Juárez M, González-Gómez GH, Echeverría JC, Pérez-Grovas H, Lerma C. Association between Mean Heart Rate and Recurrence Quantification Analysis of Heart Rate Variability in End-Stage Renal Disease. ENTROPY 2020; 22:e22010114. [PMID: 33285890 PMCID: PMC7516420 DOI: 10.3390/e22010114] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 01/09/2020] [Accepted: 01/15/2020] [Indexed: 01/09/2023]
Abstract
Linear heart rate variability (HRV) indices are dependent on the mean heart rate, which has been demonstrated in different models (from sinoatrial cells to humans). The association between nonlinear HRV indices, including those provided by recurrence plot quantitative analysis (RQA), and the mean heart rate (or the mean cardiac period, also called meanNN) has been scarcely studied. For this purpose, we analyzed RQA indices of five minute-long HRV time series obtained in the supine position and during active standing from 30 healthy subjects and 29 end-stage renal disease (ESRD) patients (before and after hemodialysis). In the supine position, ESRD patients showed shorter meanNN (i.e., faster heart rate) and decreased variability compared to healthy subjects. The healthy subjects responded to active standing by shortening the meanNN and decreasing HRV indices to reach similar values of ESRD patients. Bivariate correlations between all RQA indices and meanNN were significant in healthy subjects and ESRD after hemodialysis and for most RQA indices in ESRD patients before hemodialysis. Multiple linear regression analyses showed that RQA indices were also dependent on the position and the ESRD condition. Then, future studies should consider the association among RQA indices, meanNN, and these other factors for a correct interpretation of HRV.
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Affiliation(s)
- Martín Calderón-Juárez
- Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico;
| | | | - Juan C. Echeverría
- Department of Electrical Engineering, Universidad Autónoma Metropolitana, Unidad Iztapalapa, Mexico City 09340, Mexico;
| | - Héctor Pérez-Grovas
- Department of Nephrology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico;
| | - Claudia Lerma
- Department of Electromechanical Instrumentation, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico
- Correspondence: ; Tel.: +52-55-55732911 (ext. 26202)
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111
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Frasch MG, Herry CL, Niu Y, Giussani DA. First evidence that intrinsic fetal heart rate variability exists and is affected by hypoxic pregnancy. J Physiol 2020; 598:249-263. [PMID: 31802494 DOI: 10.1113/jp278773] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 11/11/2019] [Indexed: 02/02/2023] Open
Abstract
KEY POINTS We introduce a technique to test whether intrinsic fetal heart rate variability (iFHRV) exists and we show the utility of the technique by testing the hypothesis that iFHRV is affected by chronic fetal hypoxia, one of the most common adverse outcomes of human pregnancy complicated by fetal growth restriction. Using an established late gestation ovine model of fetal development under chronic hypoxic conditions, we identify iFHRV in isolated fetal hearts and show that it is markedly affected by hypoxic pregnancy. Therefore, the isolated fetal heart has intrinsic variability and carries a memory of adverse intrauterine conditions experienced during the last third of pregnancy. ABSTRACT Fetal heart rate variability (FHRV) emerges from influences of the autonomic nervous system, fetal body and breathing movements, and from baroreflex and circadian processes. We tested whether intrinsic heart rate variability (iHRV), devoid of any external influences, exists in the fetal period and whether it is affected by chronic fetal hypoxia. Chronically catheterized ewes carrying male singleton fetuses were exposed to normoxia (n = 6) or hypoxia (10% inspired O2 , n = 9) for the last third of gestation (105-138 days of gestation (dG); term ∼145 dG) in isobaric chambers. At 138 dG, isolated hearts were studied using a Langendorff preparation. We calculated basal intrinsic FHRV (iFHRV) indices reflecting iFHRV's variability, predictability, temporal symmetry, fractality and chaotic behaviour, from the systolic peaks within 15 min segments in each heart. Significance was assumed at P < 0.05. Hearts of fetuses isolated from hypoxic pregnancy showed approximately 4-fold increases in the Grid transformation as well as the AND similarity index (sgridAND) and a 4-fold reduction in the scale-dependent Lyapunov exponent slope. We also detected a 2-fold reduction in the Recurrence quantification analysis, percentage of laminarity (pL) and recurrences, maximum and average diagonal line (dlmax, dlmean) and the Multiscale time irreversibility asymmetry index. The iHRV measures dlmax, dlmean, pL and sgridAND correlated with left ventricular end-diastolic pressure across both groups (average R2 = 0.38 ± 0.03). This is the first evidence that iHRV originates in fetal life and that chronic fetal hypoxia significantly alters it. Isolated fetal hearts from hypoxic pregnancy exhibit a time scale-dependent higher complexity in iFHRV.
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Affiliation(s)
- Martin G Frasch
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA
| | - Christophe L Herry
- Dynamical Analysis Laboratory, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Youguo Niu
- Department of Physiology Development & Neuroscience, University of Cambridge, Cambridge, UK
| | - Dino A Giussani
- Department of Physiology Development & Neuroscience, University of Cambridge, Cambridge, UK
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112
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Chamarthi B, Vinik A, Ezrokhi M, Cincotta AH. Circadian-timed quick-release bromocriptine lowers elevated resting heart rate in patients with type 2 diabetes mellitus. Endocrinol Diabetes Metab 2020; 3:e00101. [PMID: 31922028 PMCID: PMC6947713 DOI: 10.1002/edm2.101] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 09/09/2019] [Accepted: 10/20/2019] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Sympathetic nervous system (SNS) overactivity is a risk factor for insulin resistance and cardiovascular disease (CVD). We evaluated the impact of bromocriptine-QR, a dopamine-agonist antidiabetes medication, on elevated resting heart rate (RHR) (a marker of SNS overactivity in metabolic syndrome), blood pressure (BP) and the relationship between bromocriptine-QR's effects on RHR and HbA1c in type 2 diabetes subjects. DESIGN AND SUBJECTS RHR and BP changes were evaluated in this post hoc analysis of data from a randomized controlled trial in 1014 type 2 diabetes subjects randomized to bromocriptine-QR vs placebo added to standard therapy (diet ± ≤2 oral antidiabetes medications) for 24 weeks without concomitant antihypertensive or antidiabetes medication changes, stratified by baseline RHR (bRHR). RESULTS In subjects with bRHR ≥70 beats/min, bromocriptine-QR vs placebo reduced RHR by -3.4 beats/min and reduced BP (baseline 130/79; systolic, diastolic, mean arterial BP reductions [mm Hg]: -3.6 [P = .02], -1.9 [P = .05], -2.5 [P = .02]). RHR reductions increased with higher baseline HbA1c (bHbA1c) (-2.7 [P = .03], -5 [P = .002], -6.1 [P = .002] with bHbA1c ≤7, >7, ≥7.5%, respectively] in the bRHR ≥70 group and more so with bRHR ≥80 (-4.5 [P = .07], -7.8 [P = .015], -9.9 [P = .005]). Subjects with bRHR <70 had no significant change in RHR or BP. With bHbA1c ≥7.5%, %HbA1c reductions with bromocriptine-QR vs placebo were -0.50 (P = .04), -0.73 (P = .005) and -1.22 (P = .008) with bRHR <70, ≥70 and ≥80, respectively. With bRHR ≥70, the magnitude of bromocriptine-QR-induced RHR reduction was an independent predictor of bromocriptine-QR's HbA1c lowering effect. CONCLUSION Bromocriptine-QR lowers elevated RHR with concurrent decrease in BP and hyperglycaemia. These findings suggest a potential sympatholytic mechanism contributing to bromocriptine-QR's antidiabetes effect and potentially its previously demonstrated effect to reduce CVD events.
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Affiliation(s)
| | - Aaron Vinik
- Eastern Virginia Medical School Strelitz Diabetes CenterNorfolkVirginia
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113
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Axsom JE, Nanavati AP, Rutishauser CA, Bonin JE, Moen JM, Lakatta EG. Acclimation to a thermoneutral environment abolishes age-associated alterations in heart rate and heart rate variability in conscious, unrestrained mice. GeroScience 2019; 42:217-232. [PMID: 31776883 PMCID: PMC7031176 DOI: 10.1007/s11357-019-00126-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 10/11/2019] [Indexed: 12/15/2022] Open
Abstract
Mice are among the most widely used translational models of cardiovascular aging and offer a method to quickly assess lifespan changes in a controlled environment. The standard laboratory temperature (20-22 °C), however, imposes a cold stress on mice that causes an increase in sympathetic nervous system-mediated activation of brown adipose tissue (BAT) to maintain a core body temperature of 36-37 °C. Thus, while physiologic data obtained recapitulate human physiology to a certain degree, interpretations of previous research in mice may have been contaminated by a cold stress, due to housing mice below their thermoneutral zone (30 °C). The purpose of this investigation was to examine how chronic sympathetic stimulation evoked by acclimation to 20 °C might obscure interpretation of changes in autonomic modulation of heart rate (HR) and heart rate variability (HRV) that accompany advancing age. HR and HRV before and after administration of a dual-autonomic blockade were measured via in-vivo ECG in young (3 months) and aged (30 months) male C57BL/6 telemetry-implanted mice following temperature acclimation for 3 days at 30 °C or 20 °C. Mean basal and intrinsic HR of both young and aged mice became markedly reduced at 30 °C compared to 20 °C. In both age groups, HRV parameters in time, frequency, and non-linear domains displayed increased variability at 30 °C compared to 20 °C under basal conditions. Importantly, age-associated declines in HRV observed at 20 °C were ameliorated when mice were studied at their thermoneutral ambient temperature of 30 °C. Thus, an accurate understanding of autonomic modulation of cardiovascular functions in mice of advanced age requires that they are housed in a metabolically neutral environment.
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Affiliation(s)
- Jessie E Axsom
- Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, 251 Bayview Boulevard, Suite 100, Baltimore, MD, 21224, USA.,School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Alay P Nanavati
- Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, 251 Bayview Boulevard, Suite 100, Baltimore, MD, 21224, USA.,College of Osteopathic Medicine, University of New England, Biddeford, ME, USA
| | - Carolyn A Rutishauser
- Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, 251 Bayview Boulevard, Suite 100, Baltimore, MD, 21224, USA.,Department of Anatomy, Case Western Reserve University, Cleveland, OH, USA
| | - Janet E Bonin
- Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, 251 Bayview Boulevard, Suite 100, Baltimore, MD, 21224, USA.,School of Medicine, University of Maryland, Baltimore, MD, USA
| | - Jack M Moen
- Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, 251 Bayview Boulevard, Suite 100, Baltimore, MD, 21224, USA.,Cellular and Molecular Physiology, Yale University, New Haven, CT, USA
| | - Edward G Lakatta
- Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, 251 Bayview Boulevard, Suite 100, Baltimore, MD, 21224, USA.
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114
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Yeh CH, Juan CH, Yeh HM, Wang CY, Young HWV, Lin JL, Lin C, Lin LY, Lo MT. The critical role of respiratory sinus arrhythmia on temporal cardiac dynamics. J Appl Physiol (1985) 2019; 127:1733-1741. [PMID: 31647722 DOI: 10.1152/japplphysiol.00262.2019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Temporal cardiac properties provide alternative information in analyzing heart rate variability (HRV), which may be disregarded by the standard HRV analyses. Patients with congestive heart failure (CHF) are known to have distinct temporal features from the healthy individuals. However, the underlying mechanism leading to the variation remains unclear. Whether or not these parameters can finely classify the severity for CHF patients is uncertain as well. In this work, an electrocardiogram was monitored in advanced CHF patients using 24-h Holter in four conditions, including baseline, one and three months after atenolol therapy, and healthy individuals. Slope and area under the curve (AUC) of multiscale entropy (MSE) curve over short (scales 1-5) and long (scales 6-20) scales, and detrended fluctuation analysis (DFA) scaling exponents at short (4-11 beats) and intermediate (>11 beats) window sizes were calculated. The results show that short-time scale MSE-derived parameters (slope: -0.08 ± 0.10, -0.03 ± 0.10, 0.02 ± 0.06, 0.08 ± 0.06; AUC: 4.03 ± 2.11, 4.69 ± 1.28, 4.73 ± 0.94, and 6.17 ± 1.23) and short-time scale DFA exponent (0.79 ± 0.16, 0.95 ± 0.22, 1.11 ± 0.19, and 1.35 ± 0.20) can hierarchically classify all four conditions. More importantly, simulated R-R intervals with different fractions and amplitude of respiratory sinus arrhythmia (RSA) components were examined to validate our hypothesis regarding the essentiality of RSA in the improvement of cardiovascular function, and its tight association with unpredictability and fractal property of HRV, which is in line with our hypothesis that RSA contributes significantly to the generation of the unpredictability and fractal behavior of HR dynamics.NEW & NOTEWORTHY Temporal cardiac properties provide useful diagnostic parameters for patients with congestive heart failure (CHF). Our study hierarchically classified CHF patients with β-blocker treatment by using multiscale entropy and detrended fluctuation analysis. Also, we provided the evidence to validate the critical role of respiratory sinus arrhythmia in the fractal properties of heart rate variability.
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Affiliation(s)
- Chien-Hung Yeh
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Chung-Hau Juan
- Department of Biomedical Sciences, National Central University, Taoyuan, Taiwan.,Department of Anesthesiology, Cathay General Hospital, Taipei, Taiwan
| | - Huei-Ming Yeh
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Cheng-Yen Wang
- Department of Biomedical Sciences, National Central University, Taoyuan, Taiwan
| | - Hsu-Wen Vincent Young
- Department of Biomedical Sciences, National Central University, Taoyuan, Taiwan.,Department of Applied Mathematics, Chung Yuan Christian University, Taoyuan, Taiwan
| | - Jiunn-Lee Lin
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chen Lin
- Department of Biomedical Sciences, National Central University, Taoyuan, Taiwan
| | - Lian-Yu Lin
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Men-Tzung Lo
- Department of Biomedical Sciences, National Central University, Taoyuan, Taiwan
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115
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Slušnienė A, Laucevičius A, Navickas P, Ryliškytė L, Stankus V, Stankus A, Navickas R, Laucevičienė I, Kasiulevičius V. Daily Heart Rate Variability Indices in Subjects with and Without Metabolic Syndrome Before and After the Elimination of the Influence of Day-Time Physical Activity. ACTA ACUST UNITED AC 2019; 55:medicina55100700. [PMID: 31627461 PMCID: PMC6843357 DOI: 10.3390/medicina55100700] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/09/2019] [Accepted: 10/14/2019] [Indexed: 12/30/2022]
Abstract
Background and Objectives: The available research shows conflicting data on the heart rate variability (HRV) in metabolic syndrome (MetS) subjects. The discrepancy suggests a methodical shortcoming: due to the influence of physical activity, the standard measuring of HRV at rest is not comparable with HRV assessment based on 24 h Holter monitoring, which is preferred because of its comprehensiveness. To obtain a more reliable measure and to clarify to what extent HRV is altered in MetS, we assessed a 24 h HRV before and after the elimination of the influence of physical activity. Materials and Methods: We investigated 69 metabolic syndrome (MetS) and 37 control subjects, aged 50–55. In all subjects, 24 h monitoring of electrocardiogram, blood pressure, and actigraphy profiles were conducted. To eliminate the influence of day-time physical activity on RR intervals (RRI), a linear polynomial autoregressive model with exogenous terms (ARX) was used. Standard spectral RRI analysis was performed. Results: Subjects with MetS had blunted HRV; the diurnal SDNN index was reliably lower in the MetS group than in control subjects. The elimination of the influence of physical activity did not reveal a significant HRV change in long-term indices (SDNN, SDANN, and SD2), whilst adjacent RRI values (RMSSD, pNN50, and SD1) and SDNN index significantly increased (p < 0.001). An increase in the latter indices highlighted the HRV difference between the MetS and control groups; a significant (p < 0.001) decrease of all short-term HRV variables was found in the MetS group (p < 0.01), and low-frequency spectral components were less pronounced in the MetS group. Conclusion: The application of a polynomial autoregressive model in 24 h HRV assessment allowed for the exclusion of the influence of physical activity and revealed that MetS is associated with blunted HRV, which reflects mitigated parasympathetic tone.
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Affiliation(s)
- Anžela Slušnienė
- State Research Institute Centre for Innovative Medicine, LT-08406 Vilnius, Lithuania; (A.S.); (A.L.); (A.S.); (R.N.)
- InMedica, LT-08406 Vilnius, Lithuania
| | - Aleksandras Laucevičius
- State Research Institute Centre for Innovative Medicine, LT-08406 Vilnius, Lithuania; (A.S.); (A.L.); (A.S.); (R.N.)
- InMedica, LT-08406 Vilnius, Lithuania
- Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania; (L.R.); (I.L.); (V.K.)
- Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, LT-08661 Vilnius, Lithuania
| | - Petras Navickas
- InMedica, LT-08406 Vilnius, Lithuania
- Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania; (L.R.); (I.L.); (V.K.)
- Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, LT-08661 Vilnius, Lithuania
- Correspondence:
| | - Ligita Ryliškytė
- Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania; (L.R.); (I.L.); (V.K.)
- Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, LT-08661 Vilnius, Lithuania
| | | | - Albinas Stankus
- State Research Institute Centre for Innovative Medicine, LT-08406 Vilnius, Lithuania; (A.S.); (A.L.); (A.S.); (R.N.)
| | - Rokas Navickas
- State Research Institute Centre for Innovative Medicine, LT-08406 Vilnius, Lithuania; (A.S.); (A.L.); (A.S.); (R.N.)
- Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania; (L.R.); (I.L.); (V.K.)
| | - Ieva Laucevičienė
- Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania; (L.R.); (I.L.); (V.K.)
- Centre of Rehabilitation, Vilnius University Hospital Santaros Klinikos, Physical and Sports Medicine, LT-08661 Vilnius, Lithuania
| | - Vytautas Kasiulevičius
- Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania; (L.R.); (I.L.); (V.K.)
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116
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Hill CM, Bucks RS, Cellini N, Motamedi S, Carroll A, Heathcote K, Webster R, Simpson D. Cardiac autonomic activity during sleep in high-altitude resident children compared with lowland residents. Sleep 2019; 41:5096697. [PMID: 30219885 DOI: 10.1093/sleep/zsy181] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Indexed: 12/19/2022] Open
Abstract
Study Objectives We aimed to characterize heart-rate variability (HRV) during sleep in Andean children native to high altitude (HA) compared with age, gender, and genetic ancestry-similar low-altitude (LA) children. We hypothesized that the hypoxic burden of sleep at HA could induce variation in HRV. As children have otherwise healthy cardiovascular systems, such alterations could provide early markers of later cardiovascular disease. Methods Twenty-six LA (14F) and 18 HA (8F) children underwent a single night of attended polysomnography. Sleep parameters and HRV indices were measured. Linear mixed models were used to assess HRV differences across sleep stage and altitude group. Results All children showed marked fluctuations in HRV parameters across sleep stages, with higher vagal activity during nonrapid eye movement sleep and greater variability of the heart rate during rapid eye movement (REM). Moreover, HA children showed higher very low-frequency HRV in REM sleep and, after adjusting for heart rate, higher low-to-high frequency ratio in REM sleep compared with children living at lower altitude. Conclusions We confirmed previous findings of a stage-dependent modulation of HRV in Andean children living at both HA and LA. Moreover, we showed subtle alteration of HRV in sleep in HA children, with intriguing differences in the very low-frequency domain during REM sleep. Whether these differences are the results of an adaptation to high-altitude living, or an indirect effect of differences in oxyhemoglobin saturation remains unclear, and further research is required to address these questions.
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Affiliation(s)
- Catherine Mary Hill
- Division of Clinical Experimental Sciences, Faculty of Medicine, University of Southampton, UK.,Southampton Children's Hospital Department of Sleep Medicine, Southampton, UK.,School of Psychological Science, University of Western Australia, Perth, Australia
| | - Romola Starr Bucks
- School of Psychological Science, University of Western Australia, Perth, Australia
| | - Nicola Cellini
- Department of General Psychology, University of Padova, Veneto, Italy
| | - Shayan Motamedi
- Department of Mechanical Engineering, University of Southampton, UK
| | | | - Kate Heathcote
- Department of Otolaryngology, Poole General Hospital, UK
| | - Rebecca Webster
- Laboratory for Cancer Medicine, Harry Perkins Institute of Medical Research and University of Western Australia Centre for Medical Research, Perth, Australia
| | - David Simpson
- Institute of Sound and Vibration Research, University of Southampton, UK
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117
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D’Souza A, Trussell T, Morris GM, Dobrzynski H, Boyett MR. Supraventricular Arrhythmias in Athletes: Basic Mechanisms and New Directions. Physiology (Bethesda) 2019; 34:314-326. [DOI: 10.1152/physiol.00009.2019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Athletes are prone to supraventricular rhythm disturbances including sinus bradycardia, heart block, and atrial fibrillation. Mechanistically, this is attributed to high vagal tone and cardiac electrical and structural remodeling. Here, we consider the supporting evidence for these three pro-arrhythmic mechanisms in athletic human cohorts and animal models, featuring current controversies, emerging data, and future directions of relevance to the translational research agenda.
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Affiliation(s)
- Alicia D’Souza
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| | - Tariq Trussell
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| | - Gwilym M. Morris
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| | - Halina Dobrzynski
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| | - Mark R. Boyett
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
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118
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Abstract
It is established that an intensive training results in a lower average resting heart rate. Management of bradycardia in an athlete can be difficult given the underlying mechanisms are not clearly understood. The authors reviewed the different mechanisms described in the literature, including recent advances in physiology regarding remodeling of ion channels, which may partially explain bradycardia in athletes. Sinus bradycardia amongst athletes, especially endurance focused athletes, is common but difficult to apprehend. The underlying mechanisms are observably of multifactorial origin and likely incompletely elucidated by the current body of knowledge.
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Affiliation(s)
- Benoit Doyen
- Department of Cardiology, CHU UCL Namur , Yvoir , Belgium
| | - David Matelot
- Department of Cardiology, Hopital Pontchaillou , Rennes , France
| | - François Carré
- Department of Cardiology, Hopital Pontchaillou Service de medecine du sport , Rennes , France
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119
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DeRuisseau LR, Receno CN, Heffernan KS, Cunningham CM. Heart rate and blood pressure in male Ts65Dn mice: a model to investigate cardiovascular responses in Down syndrome. Physiol Rep 2019; 7:e14205. [PMID: 31496136 PMCID: PMC6732568 DOI: 10.14814/phy2.14205] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 07/19/2019] [Indexed: 12/19/2022] Open
Abstract
Down syndrome (Ds) is the most common chromosomal cause of intellectual disability that results from triplication of chromosome 21 genes. Lower blood pressure (BP) and heart rate (HR) in response to exercise and other stressors are prevalent in Ds, and are mediated by autonomic dysfunction. The Ts65Dn mouse is a model of Ds that is commonly used in preclinical studies, but has not been formally investigated for cardiovascular responses in conscious mice. Based on human studies of Ds, we hypothesized Ts65Dn would have lower BP and HR, but similar arterial stiffness. BP was quantified in conscious wild-type (WT) and Ts65Dn. A main effect for strain was observed for all BP measures (systolic, diastolic, mean, pulse pressure), with WT higher than Ts65Dn. Pulse wave velocity was similar between WT and Ts65Dn. High-frequency power spectra was higher in WT suggesting autonomic differences between strains. Freely moving HR was higher in WT versus Ts65Dn in both the dark and light cycles, although a main effect of circadian cycle was also present (dark> light). Similar to what is observed in humans, Ts65Dn has a lower BP which may be attributed to autonomic differences and result in preservation of arterial function with advancing age. Ts65Dn thus appears to capture the Ds cardiovascular phenotype across the lifespan. These data support further use of Ts65Dn to investigate mechanisms that may lead to altered BP and HR responses in Ds.
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Affiliation(s)
| | | | | | - Caitlin M. Cunningham
- Department of Mathematics, Statistics, and Computer ScienceLe Moyne CollegeSyracuseNew York
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120
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Ede T, Lecorps B, von Keyserlingk MAG, Weary DM. Symposium review: Scientific assessment of affective states in dairy cattle. J Dairy Sci 2019; 102:10677-10694. [PMID: 31477285 DOI: 10.3168/jds.2019-16325] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 06/29/2019] [Indexed: 12/14/2022]
Abstract
Affective states, which refer to feelings or emotions, are a key component of animal welfare, but these are also difficult to assess. Drawing upon a body of theoretical and applied work, we critically review the scientific literature on the assessment of affective states in animals, drawing examples where possible from research on dairy cattle, and highlighting the strengths and weaknesses of scientific methods used to assess affective states in animals. We adopt the "valence/arousal" framework, describing affect as a 2-dimensional space (with valence referring to whether an experience is positive or negative, and arousal referring to the intensity of the experience). We conclude that spontaneous physiological and behavioral responses typically reflect arousal, whereas learned responses can be valuable when investigating valence. We also conclude that the assessment of affective states can be furthered using mood assessments and that the use of drug treatments with known emotional effects in humans can be helpful in the assessment of specific affective states in animals.
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Affiliation(s)
- Thomas Ede
- Animal Welfare Program, Faculty of Land and Food Systems, University of British Columbia, Vancouver, BC, Canada V6T 1Z6
| | - Benjamin Lecorps
- Animal Welfare Program, Faculty of Land and Food Systems, University of British Columbia, Vancouver, BC, Canada V6T 1Z6
| | - Marina A G von Keyserlingk
- Animal Welfare Program, Faculty of Land and Food Systems, University of British Columbia, Vancouver, BC, Canada V6T 1Z6
| | - Daniel M Weary
- Animal Welfare Program, Faculty of Land and Food Systems, University of British Columbia, Vancouver, BC, Canada V6T 1Z6.
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121
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Constantinescu V, Matei D, Constantinescu I, Cuciureanu DI. Heart Rate Variability and Vagus Nerve Stimulation in Epilepsy Patients. Transl Neurosci 2019; 10:223-232. [PMID: 31497318 PMCID: PMC6708288 DOI: 10.1515/tnsci-2019-0036] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 07/23/2019] [Indexed: 01/01/2023] Open
Abstract
Background Vagus nerve stimulation (VNS) exerts a cortical modulating effect through its diffuse projections, especially involving cerebral structures related to autonomic regulation. The influence of VNS on cardiovascular autonomic function in drug-resistant epilepsy patients is still debated. We aimed to evaluate the impact of VNS on cardiovascular autonomic function in drug-resistant epilepsy patients, after three months of neurostimulation, using the heart rate variability (HRV) analysis. Methodology Multiple Trigonometric Regressive Spectral analysis enables a precise assessment of the autonomic control on the heart rate. We evaluated time and frequency-domain HRV parameters in resting condition and during sympathetic and parasympathetic activation tests in five epilepsy patients who underwent VNS procedure. Results We found appropriate cardiac autonomic responses to sympathetic and parasympathetic activation tests, described by RMSSD, pNN50, HF and LF/HF dynamics after three months of VNS. ON period of the neurostimulation may generate a transient vagal activation reflected on heart rate and RMSSD values, as observed in one of our cases. Conclusion VNS therapy in epilepsy patients seems not to disrupt the cardiac autonomic function. HRV represents a useful tool in evaluating autonomic activity. More extensive studies are needed to further explore cardiac autonomic response after neurostimulation.
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Affiliation(s)
- Victor Constantinescu
- Neurology Department, Faculty of Medicine, University of Medicine and Pharmacy Iasi, Iasi Romania
| | - Daniela Matei
- Department of Biomedical Sciences, Faculty of Medical Bioengineering, University of Medicine and Pharmacy Iasi, Iasi Romania
| | | | - Dan Iulian Cuciureanu
- Neurology Department, Faculty of Medicine, University of Medicine and Pharmacy Iasi, Iasi Romania
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122
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Mulcahy JS, Larsson DEO, Garfinkel SN, Critchley HD. Heart rate variability as a biomarker in health and affective disorders: A perspective on neuroimaging studies. Neuroimage 2019; 202:116072. [PMID: 31386920 DOI: 10.1016/j.neuroimage.2019.116072] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 07/28/2019] [Accepted: 08/02/2019] [Indexed: 12/30/2022] Open
Abstract
The dynamic embodiment of psychological processes is evident in the association of health outcomes, behavioural traits and psychological functioning with Heart Rate Variability (HRV). The dominant high-frequency component of HRV is an index of the central neural control of heart rhythm, mediated via the parasympathetic vagus nerve. HRV provides a potential objective measure of action policies for the adaptive and predictive allostatic regulation of homeostasis within the cardiovascular system. In its support, a network of brain regions (referred to as the 'central autonomic network') maps internal state, and controls autonomic responses. This network includes regions of prefrontal cortex, anterior cingulate cortex, insula, amygdala, periaqueductal grey, pons and medulla. Human neuroimaging studies of neural activation and functional connectivity broadly endorse this architecture, and its link with cardiac regulation at rest and dysregulation in clinical states that include affective disorders. In this review, we appraise neuroimaging research and related evidence for HRV as an informative marker of autonomic integration with affect and cognition, taking a perspective on function and organisation. We consider evidence for the utility of HRV as a metric to inform targeted interventions to improve autonomic and affective dysregulation, and suggest research questions for further investigation.
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Affiliation(s)
- James S Mulcahy
- Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Falmer, BN1 9RY, UK.
| | | | - Sarah N Garfinkel
- Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Falmer, BN1 9RY, UK; Sackler Centre for Consciousness Science, University of Sussex, Falmer, BN1 9RR, UK; Sussex Partnership NHS Foundation Trust, Brighton, BN2 3EW, UK
| | - Hugo D Critchley
- Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Falmer, BN1 9RY, UK; Sackler Centre for Consciousness Science, University of Sussex, Falmer, BN1 9RR, UK; Sussex Partnership NHS Foundation Trust, Brighton, BN2 3EW, UK
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123
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Mulkey SB, Govindan R, Metzler M, Swisher CB, Hitchings L, Wang Y, Baker R, Larry Maxwell G, Krishnan A, du Plessis AJ. Heart rate variability is depressed in the early transitional period for newborns with complex congenital heart disease. Clin Auton Res 2019; 30:165-172. [PMID: 31240423 PMCID: PMC6930356 DOI: 10.1007/s10286-019-00616-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 06/03/2019] [Indexed: 12/17/2022]
Abstract
PURPOSE To compare early changes in autonomic nervous system (ANS) tone between newborns with complex congenital heart disease (CHD) and newborns without CHD. METHODS We performed a case-control study of heart rate variability (HRV) in newborns with complex CHD [transposition of the great arteries (TGA) or hypoplastic left heart syndrome (HLHS)] and low-risk control newborns without CHD. Cases with CHD were admitted following birth to a pediatric cardiac intensive care unit and had archived continuous ECG data. Control infants were prospectively enrolled at birth. ECG data in cases and controls were analyzed for HRV in the time and frequency domains at 24 h of age. We analyzed the following HRV metrics: alpha short (αs), alpha long (αL), root mean square short and long (RMSs and RMSL), low-frequency (LF) power, normalized LF (nLF), high-frequency (HF) power, and normalized HF (nHF). We used ANOVA to compare HRV metrics between groups and to control for medication exposures. RESULTS HRV data from 57 infants with CHD (TGA, n = 33 and HLHS, n = 24) and from 29 controls were analyzed. The HRV metrics αS, RMSL, LF, and nLF were significantly lower in infants with CHD than in the controls. Due to the effect of normalization, nHF was higher in CHD infants (P < 0.0001), although absolute HF was lower (P = 0.0461). After adjusting for medications, αS and nLF remained lower and nHF higher in newborns with CHD (P < 0.0005). CONCLUSIONS Infants with complex CHD have depressed autonomic balance in the early postnatal period, which may complicate the fetal-neonatal transition.
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Affiliation(s)
- Sarah B Mulkey
- Division of Fetal and Transitional Medicine, Children's National Health System, Washington, DC, USA.
- Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
- Department of Neurology, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
| | - Rathinaswamy Govindan
- Division of Fetal and Transitional Medicine, Children's National Health System, Washington, DC, USA
| | - Marina Metzler
- Division of Fetal and Transitional Medicine, Children's National Health System, Washington, DC, USA
| | - Christopher B Swisher
- Division of Fetal and Transitional Medicine, Children's National Health System, Washington, DC, USA
| | - Laura Hitchings
- Division of Fetal and Transitional Medicine, Children's National Health System, Washington, DC, USA
| | - Yunfei Wang
- Biostatistics and Study Methodology, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Robin Baker
- Department of Pediatrics, Inova Children's Hospital, Fairfax, VA, USA
- Fairfax Neonatal Associates, Fairfax, VA, USA
| | - G Larry Maxwell
- Department of Obstetrics and Gynecology, Inova Fairfax Hospital, Fairfax, VA, USA
| | - Anita Krishnan
- Department of Cardiology, Children's National Health System, Washington, DC, USA
- Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Adre J du Plessis
- Division of Fetal and Transitional Medicine, Children's National Health System, Washington, DC, USA
- Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
- Department of Neurology, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
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Laukkanen T, Lipponen J, Kunutsor SK, Zaccardi F, Araújo CGS, Mäkikallio TH, Khan H, Willeit P, Lee E, Poikonen S, Tarvainen M, Laukkanen JA. Recovery from sauna bathing favorably modulates cardiac autonomic nervous system. Complement Ther Med 2019; 45:190-197. [PMID: 31331560 DOI: 10.1016/j.ctim.2019.06.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 06/15/2019] [Accepted: 06/17/2019] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Sauna bathing is becoming a common activity in many countries and it has been linked to favorable health outcomes. However, there is limited data on the heart rate (HR) and heart rate variability (HRV) responses to an acute sauna exposure. DESIGN We conducted a single-group, longitudinal study utilizing a pre-post design to examine acute effects of sauna bathing on the autonomic nervous system as reflected by HRV. A total of 93 participants (mean [SD] age: 52.0 [8.8] years, 53.8% males) with cardiovascular risk factors were exposed to a single sauna session (duration: 30 min; temperature: 73 °C; humidity: 10-20%) and data on HRV variables were collected before, during and after sauna. RESULTS Time and frequency-domain HRV variables were significantly modified (p < 0.001) by the single sauna session, with most of HRV variables tending to return near to baseline values after 30 min recovery. Resting HR was lower at the end of recovery (68/min) compared to pre-sauna (77/min). A sauna session transiently diminished the vagal component, whereas the cooling down period after sauna decreased low frequency power (p < 0.001) and increased high frequency power in HRV (p < 0.001), favorably modulating the autonomic nervous system balance. CONCLUSIONS This study demonstrates that a session of sauna bathing induces an increase in HR. During the cooling down period from sauna bathing, HRV increased which indicates the dominant role of parasympathetic activity and decreased sympathetic activity of cardiac autonomic nervous system. Future randomized controlled studies are needed to show if HR and HRV changes underpins the long-term cardiovascular effects induced by regular sauna bathing.
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Affiliation(s)
- Tanjaniina Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; Central Finland Health Care District, Department of Internal Medicine, Jyväskylä, Finland
| | - Jukka Lipponen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Setor K Kunutsor
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK; Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, UK
| | - Francesco Zaccardi
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
| | | | - Timo H Mäkikallio
- Division of Cardiology, Department of Internal Medicine, Oulu University Hospital, Oulu, Finland
| | - Hassan Khan
- Department of Medicine, Division of Cardiology, Emory University, Atlanta, GA, United States
| | - Peter Willeit
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Earric Lee
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | | | - Mika Tarvainen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Jari A Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; Central Finland Health Care District, Department of Internal Medicine, Jyväskylä, Finland; Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
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125
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Moen JM, Matt MG, Ramirez C, Tarasov KV, Chakir K, Tarasova YS, Lukyanenko Y, Tsutsui K, Monfredi O, Morrell CH, Tagirova S, Yaniv Y, Huynh T, Pacak K, Ahmet I, Lakatta EG. Overexpression of a Neuronal Type Adenylyl Cyclase (Type 8) in Sinoatrial Node Markedly Impacts Heart Rate and Rhythm. Front Neurosci 2019; 13:615. [PMID: 31275103 PMCID: PMC6591434 DOI: 10.3389/fnins.2019.00615] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 05/29/2019] [Indexed: 12/21/2022] Open
Abstract
Heart rate (HR) and HR variability (HRV), predictors of over-all organism health, are widely believed to be driven by autonomic input to the sinoatrial node (SAN), with sympathetic input increasing HR and reducing HRV. However, variability in spontaneous beating intervals in isolated SAN tissue and single SAN cells, devoid of autonomic neural input, suggests that clocks intrinsic to SAN cells may also contribute to HR and HRV in vivo. We assessed contributions of both intrinsic and autonomic neuronal input mechanisms of SAN cell function on HR and HRV via in vivo, telemetric EKG recordings. This was done in both wild type (WT) mice, and those in which adenylyl cyclase type 8 (ADCY8), a main driver of intrinsic cAMP-PKA-Ca2+ mediated pacemaker function, was overexpressed exclusively in the heart (TGAC8). We hypothesized that TGAC8 mice would: (1) manifest a more coherent pattern of HRV in vivo, i.e., a reduced HRV driven by mechanisms intrinsic to SAN cells, and less so to modulation by autonomic input and (2) utilize unique adaptations to limit sympathetic input to a heart with high levels of intrinsic cAMP-Ca2+ signaling. Increased adenylyl cyclase (AC) activity in TGAC8 SAN tissue was accompanied by a marked increase in HR and a concurrent marked reduction in HRV, both in the absence or presence of dual autonomic blockade. The marked increase in intrinsic HR and coherence of HRV in TGAC8 mice occurred in the context of: (1) reduced HR and HRV responses to β-adrenergic receptor (β-AR) stimulation; (2) increased transcription of genes and expression of proteins [β-Arrestin, G Protein-Coupled Receptor Kinase 5 (GRK5) and Clathrin Adaptor Protein (Dab2)] that desensitize β-AR signaling within SAN tissue, (3) reduced transcripts or protein levels of enzymes [dopamine beta-hydorxylase (DBH) and phenylethanolamine N-methyltransferase (PNMT)] required for catecholamine production in intrinsic cardiac adrenergic cells, and (4) substantially reduced plasma catecholamine levels. Thus, mechanisms driven by cAMP-PKA-Ca2+ signaling intrinsic to SAN cells underlie the marked coherence of TGAC8 mice HRV. Adaptations to limit additional activation of AC signaling, via decreased neuronal sympathetic input, are utilized to ensure the hearts survival and prevent Ca2+ overload.
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Affiliation(s)
- Jack M Moen
- Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States.,Cellular and Molecular Physiology, Yale University, New Haven, CT, United States
| | - Michael G Matt
- Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States.,School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Christopher Ramirez
- Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
| | - Kirill V Tarasov
- Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
| | - Khalid Chakir
- Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
| | - Yelena S Tarasova
- Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
| | - Yevgeniya Lukyanenko
- Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
| | - Kenta Tsutsui
- Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
| | - Oliver Monfredi
- Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States.,Department of Cardiovascular and Electrophysiology, The Johns Hopkins Hospital, Baltimore, MD, United States
| | - Christopher H Morrell
- Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States.,Department of Mathematics, Loyola University Maryland, Baltimore, MD, United States
| | - Syevda Tagirova
- Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
| | - Yael Yaniv
- Faculty of Biomedical Engineering, Technion Israel Institute of Technology, Haifa, Israel
| | - Thanh Huynh
- Section on Medical Neuroendocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, United States
| | - Karel Pacak
- Section on Medical Neuroendocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, United States
| | - Ismayil Ahmet
- Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
| | - Edward G Lakatta
- Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
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Marsillio LE, Manghi T, Carroll MS, Balmert LC, Wainwright MS. Heart rate variability as a marker of recovery from critical illness in children. PLoS One 2019; 14:e0215930. [PMID: 31100075 PMCID: PMC6524820 DOI: 10.1371/journal.pone.0215930] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 04/10/2019] [Indexed: 01/05/2023] Open
Abstract
Objectives The purpose of this study was to Identify whether changes in heart rate variability (HRV) could be detected as critical illness resolves by comparing HRV from the time of pediatric intensive care unit (PICU) admission with HRV immediately prior to discharge. We also sought to demonstrate that HRV derived from electrocardiogram (ECG) data from bedside monitors can be calculated in critically-ill children using a real-time, streaming analytics platform. Methods This was a retrospective, observational pilot study of 17 children aged 0 to 18 years admitted to the PICU of a free-standing, academic children’s hospital. Three time-domain measures of HRV were calculated in real-time from bedside monitor ECG data and stored for analysis. Measures included: root mean square of successive differences between NN intervals (RMSSD), percent of successive NN interval differences above 50 ms (pNN50), and the standard deviation of NN intervals (SDNN). Results HRV values calculated from the first and last 24 hours of PICU stay were analyzed. Mixed effects models demonstrated that all three measures of HRV were significantly lower during the first 24 hours compared to the last 24 hours of PICU admission (p<0.001 for all three measures). In models exploring the relationship between time from admission and log HRV values, the predicted average HRV remained consistently higher in the last 24 hours of PICU stay compared to the first 24 hours. Conclusion HRV was significantly lower in the first 24 hours compared to the 24 hours preceding PICU discharge, after resolution of critical illness. This demonstrates that it is feasible to detect changes in HRV using an automated, streaming analytics platform. Continuous tracking of HRV may serve as a marker of recovery in critically ill children.
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Affiliation(s)
- Lauren E. Marsillio
- Division of Critical Care Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, United States of America
- * E-mail:
| | - Tomas Manghi
- Department of Pediatrics, Yale School of Medicine, New Haven, CT, United States of America
| | - Michael S. Carroll
- Data Analytics and Reporting, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, United States of America
| | - Lauren C. Balmert
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
| | - Mark S. Wainwright
- Division of Pediatric Neurology, Department of Neurology, University of Washington, Seattle, WA, United States of America
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127
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Bhogal AS, De Rui M, Pavanello D, El-Azizi I, Rowshan S, Amodio P, Montagnese S, Mani AR. Which heart rate variability index is an independent predictor of mortality in cirrhosis? Dig Liver Dis 2019; 51:695-702. [PMID: 30293892 DOI: 10.1016/j.dld.2018.09.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 08/29/2018] [Accepted: 09/11/2018] [Indexed: 02/09/2023]
Abstract
BACKGROUND Liver cirrhosis is associated with reduced heart rate variability (HRV), which indicates impaired integrity of cardiovascular control in this patient population. There are several different indices for HRV quantification. The present study was designed to: 1) determine which of the HRV indices is best at predicting mortality in patients with cirrhosis; 2) verify if such ability to predict mortality is independent of the severity of hepatic failure. METHODS Ten minutes electrocardiogram was recorded in 74 patients with cirrhosis. Heart rate fluctuations were quantified using statistical, geometrical and non-linear analysis. The patients were followed-up for 18months and information was collected on the occurrence of death/liver transplantation. RESULTS During the follow-up period, 24 patients (32%) died or were transplanted for hepatic decompensation. Cox's regression analysis showed that SDNN (total HRV), cSDNN (corrected SDNN), SD1 (short-term HRV), SD2 (long-terms HRV) and spectral indices could predict survival in these patients. However, only SD2 and cSDNN were shown to be independent of MELD in predicting survival. The prognostic value of HRV indices was independent of age, gender, use of beta blockers, and the aetiology of liver disease. CONCLUSION Two HRV indices were identified that could predict mortality in patients with cirrhosis, independently of MELD. These indices are potentially useful tools for survival prediction.
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Affiliation(s)
- Amar S Bhogal
- Division of Medicine, University College London, London, UK
| | - Michele De Rui
- Department of Medicine, University of Padova, Padova, Italy
| | | | - Ilias El-Azizi
- Division of Medicine, University College London, London, UK
| | - Sadia Rowshan
- Division of Medicine, University College London, London, UK
| | - Piero Amodio
- Department of Medicine, University of Padova, Padova, Italy
| | - Sara Montagnese
- Department of Medicine, University of Padova, Padova, Italy.
| | - Ali R Mani
- Division of Medicine, University College London, London, UK.
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128
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Lundqvist MH, Almby K, Abrahamsson N, Eriksson JW. Is the Brain a Key Player in Glucose Regulation and Development of Type 2 Diabetes? Front Physiol 2019; 10:457. [PMID: 31133864 PMCID: PMC6524713 DOI: 10.3389/fphys.2019.00457] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 04/01/2019] [Indexed: 01/08/2023] Open
Abstract
Ever since Claude Bernards discovery in the mid 19th-century that a lesion in the floor of the third ventricle in dogs led to altered systemic glucose levels, a role of the CNS in whole-body glucose regulation has been acknowledged. However, this finding was later overshadowed by the isolation of pancreatic hormones in the 20th century. Since then, the understanding of glucose homeostasis and pathology has primarily evolved around peripheral mechanism. Due to scientific advances over these last few decades, however, increasing attention has been given to the possibility of the brain as a key player in glucose regulation and the pathogenesis of metabolic disorders such as type 2 diabetes. Studies of animals have enabled detailed neuroanatomical mapping of CNS structures involved in glucose regulation and key neuronal circuits and intracellular pathways have been identified. Furthermore, the development of neuroimaging techniques has provided methods to measure changes of activity in specific CNS regions upon diverse metabolic challenges in humans. In this narrative review, we discuss the available evidence on the topic. We conclude that there is much evidence in favor of active CNS involvement in glucose homeostasis but the relative importance of central vs. peripheral mechanisms remains to be elucidated. An increased understanding of this field may lead to new CNS-focusing pharmacologic strategies in the treatment of type 2 diabetes.
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Affiliation(s)
| | - Kristina Almby
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | | | - Jan W Eriksson
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
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129
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Boyett M, Wang Y, D'Souza A. CrossTalk opposing view: Heart rate variability as a measure of cardiac autonomic responsiveness is fundamentally flawed. J Physiol 2019; 597:2599-2601. [PMID: 31006856 DOI: 10.1113/jp277501] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Affiliation(s)
- Mark Boyett
- Division of Cardiovascular Sciences, University of Manchester, 46 Grafton Street, Manchester, M13 9NT, UK
| | - Yanwen Wang
- Division of Cardiovascular Sciences, University of Manchester, 46 Grafton Street, Manchester, M13 9NT, UK
| | - Alicia D'Souza
- Division of Cardiovascular Sciences, University of Manchester, 46 Grafton Street, Manchester, M13 9NT, UK
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130
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Boyett M, Wang Y, D'Souza A. Rebuttal from Mark Boyett, Yanwen Wang and Alicia D'Souza. J Physiol 2019; 597:2605. [PMID: 31006854 DOI: 10.1113/jp277963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Mark Boyett
- Division of Cardiovascular Sciences, University of Manchester, 46 Grafton Street, Manchester, M13 9NT, UK
| | - Yanwen Wang
- Division of Cardiovascular Sciences, University of Manchester, 46 Grafton Street, Manchester, M13 9NT, UK
| | - Alicia D'Souza
- Division of Cardiovascular Sciences, University of Manchester, 46 Grafton Street, Manchester, M13 9NT, UK
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Estévez-Báez M, Machado C, García-Sánchez B, Rodríguez V, Alvarez-Santana R, Leisman G, Carrera JME, Schiavi A, Montes-Brown J, Arrufat-Pié E. Autonomic impairment of patients in coma with different Glasgow coma score assessed with heart rate variability. Brain Inj 2019; 33:496-516. [PMID: 30755043 DOI: 10.1080/02699052.2018.1553312] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PRIMARY OBJECTIVE The objective of this study is to assess the functional state of the autonomic nervous system in healthy individuals and in individuals in coma using measures of heart rate variability (HRV) and to evaluate its efficiency in predicting mortality. DESIGN AND METHODS Retrospective group comparison study of patients in coma classified into two subgroups, according to their Glasgow coma score, with a healthy control group. HRV indices were calculated from 7 min of artefact-free electrocardiograms using the Hilbert-Huang method in the spectral range 0.02-0.6 Hz. A special procedure was applied to avoid confounding factors. Stepwise multiple regression logistic analysis (SMLRA) and ROC analysis evaluated predictions. RESULTS Progressive reduction of HRV was confirmed and was associated with deepening of coma and a mortality score model that included three spectral HRV indices of absolute power values of very low, low and very high frequency bands (0.4-0.6 Hz). The SMLRA model showed sensitivity of 95.65%, specificity of 95.83%, positive predictive value of 95.65%, and overall efficiency of 95.74%. CONCLUSIONS HRV is a reliable method to assess the integrity of the neural control of the caudal brainstem centres on the hearts of patients in coma and to predict patient mortality.
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Affiliation(s)
- Mario Estévez-Báez
- a Department of Clinical Neurophysiology , Institute of Neurology and Neurosurgery , Havana , Cuba
| | - Calixto Machado
- a Department of Clinical Neurophysiology , Institute of Neurology and Neurosurgery , Havana , Cuba
| | | | | | | | - Gerry Leisman
- d Faculty of Health Sciences , University of Haifa , Haifa , Israel
| | | | - Adam Schiavi
- e Anesthesiology and Critical Care Medicine, Neurosciences Critical Care Division , Johns Hopkins Hospital , Baltimore , MD , USA
| | - Julio Montes-Brown
- f Department of Medicine & Health Science , University of Sonora , Sonora , Mexico
| | - Eduardo Arrufat-Pié
- g Institute of Basic and Preclinical Sciences, "Victoria de Girón" , Havana , Cuba
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Endes K, Köchli S, Zahner L, Hanssen H. Exercise and Arterial Modulation in Children: The EXAMIN YOUTH Study. Front Physiol 2019; 10:43. [PMID: 30774601 PMCID: PMC6367232 DOI: 10.3389/fphys.2019.00043] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 01/16/2019] [Indexed: 12/26/2022] Open
Abstract
Background: Cardiovascular disease (CVD) remains to be one of the most frequent causes of death worldwide. Cardiovascular (CV) risk factors such as hypertension and obesity often manifest in childhood. The study examines the associations of blood pressure, body mass index and physical activity with cardiopulmonary, metabolic, and psychosocial health of children in a systems physiology approach. Methods/Design: This cross-sectional study will be performed in a cohort of 6 to 8 year old school children (n = 1000). As a measure of vascular health, retinal microvascular diameters and large artery pulse wave velocity will be examined. Anthropometric parameters, such as weight, height, body mass index, and blood pressure will be assessed according to standardized protocols for children. Physical fitness and activity will be measured by a 20 m shuttle run, a 20 m sprint and a proxy-reported questionnaire on lifestyle behavior. Spirometry, assessment of heart rate variability and skin advanced glycation end products as well as a flanker test will be performed to determine systemic end organ alterations. Discussion: The study offers a unique integrative primary prevention concept that aims to set the grounds for a healthy and active lifestyle approach during childhood. It will help optimize CV risk stratification to identify children at risk of disease progression later in life. The study will demonstrate the importance of specific CV screening programs in children to reduce the growing burden of CV disease in adulthood. Prospective follow-up studies will have to prove the efficacy of primary prevention programs in children to achieve healthier aging as a long-term goal.
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Affiliation(s)
| | | | | | - Henner Hanssen
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
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de Geus EJC, Gianaros PJ, Brindle RC, Jennings JR, Berntson GG. Should heart rate variability be "corrected" for heart rate? Biological, quantitative, and interpretive considerations. Psychophysiology 2019; 56:e13287. [PMID: 30357862 PMCID: PMC6378407 DOI: 10.1111/psyp.13287] [Citation(s) in RCA: 127] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 08/14/2018] [Accepted: 08/14/2018] [Indexed: 12/30/2022]
Abstract
Metrics of heart period variability are widely used in the behavioral and biomedical sciences, although somewhat confusingly labeled as heart rate variability (HRV). Despite their wide use, HRV metrics are usually analyzed and interpreted without reference to prevailing levels of cardiac chronotropic state (i.e., mean heart rate or mean heart period). This isolated treatment of HRV metrics is nontrivial. All HRV metrics routinely used in the literature exhibit a known and positive relationship with the mean duration of the interval between two beats (heart period): as the heart period increases, so does its variability. This raises the question of whether HRV metrics should be "corrected" for the mean heart period (or its inverse, the heart rate). Here, we outline biological, quantitative, and interpretive issues engendered by this question. We provide arguments that HRV is neither uniformly nor simply a surrogate for heart period. We also identify knowledge gaps that remain to be satisfactorily addressed with respect to assumptions underlying existing HRV correction approaches. In doing so, we aim to stimulate further progress toward the rigorous use and disciplined interpretation of HRV. We close with provisional guidance on HRV reporting that acknowledges the complex interplay between the mean and variability of the heart period.
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Affiliation(s)
- Eco J. C. de Geus
- Department of Biological PsychologyVrije UniversiteitAmsterdamThe Netherlands
| | - Peter J. Gianaros
- Departments of Psychology and PsychiatryUniversity of PittsburghPittsburghPennsylvania
| | - Ryan C. Brindle
- Department of Psychology & Neuroscience ProgramWashington and Lee UniversityLexingtonVirginia
| | - J. Richard Jennings
- Departments of Psychology and PsychiatryUniversity of PittsburghPittsburghPennsylvania
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Gourine AV, Ackland GL. Cardiac Vagus and Exercise. Physiology (Bethesda) 2019; 34:71-80. [PMID: 30540229 PMCID: PMC6383634 DOI: 10.1152/physiol.00041.2018] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 10/26/2018] [Accepted: 10/29/2018] [Indexed: 01/09/2023] Open
Abstract
Lower resting heart rate and high autonomic vagal activity are strongly associated with superior exercise capacity, maintenance of which is essential for general well-being and healthy aging. Recent evidence obtained in experimental studies using the latest advances in molecular neuroscience, combined with human exercise physiology, physiological modeling, and genomic data suggest that the strength of cardiac vagal activity causally determines our ability to exercise.
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Affiliation(s)
- Alexander V Gourine
- Centre for Cardiovascular and Metabolic Neuroscience, Neuroscience, Physiology and Pharmacology, University College London , London , United Kingdom
| | - Gareth L Ackland
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London , London , United Kingdom
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135
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Gąsior JS, Sacha J, Pawłowski M, Zieliński J, Jeleń PJ, Tomik A, Książczyk TM, Werner B, Dąbrowski MJ. Normative Values for Heart Rate Variability Parameters in School-Aged Children: Simple Approach Considering Differences in Average Heart Rate. Front Physiol 2018; 9:1495. [PMID: 30405445 PMCID: PMC6207594 DOI: 10.3389/fphys.2018.01495] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 10/03/2018] [Indexed: 01/01/2023] Open
Abstract
Background: Heart rate variability (HRV) analysis is a clinical tool frequently used to characterize cardiac autonomic status. The aim of this study was to establish normative values for short-term HRV parameters by considering their main determinants in school-aged children. Methods: Five-minute electrocardiograms were taken from 312 non-athlete children (153 boys) at age of 6 to 13 years for computation of conventional time- and frequency-domain HRV parameters. Heart rate (HR), respiratory rate, age, body mass index, and sex were considered as their potential determinants. Multiple regression analysis revealed that HR was the principal predictor of all standard HRV indices. To develop their universal normative limits, standard HRV parameters were corrected for prevailing HR. Results: The HRV correction for HR yielded the parameters which became independent on both sex and HR, and only poorly dependent on age (with small effect size). Normal ranges were calculated for both time- and frequency-domain indices (the latter computed with either fast Fourier transform and autoregressive method). To facilitate recalculation of standard HRV parameters into corrected ones, a calculator was created and attached as a Supplementary Material that can be downloaded and used for both research and clinical purposes. Conclusion: This study provides HRV normative values for school-aged children which have been developed independently of their major determinants. The calculator accessible in the Supplementary Material can considerably simplify determination if HRV parameters accommodate within normal limits.
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Affiliation(s)
- Jakub S Gąsior
- Faculty of Health Sciences and Physical Education, Kazimierz Pulaski University of Technology and Humanities in Radom, Radom, Poland.,Cardiology Clinic of Physiotherapy Division of the 2nd Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Jerzy Sacha
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland.,Department of Cardiology, University Hospital, Faculty of Natural Sciences and Technology, University of Opole, Opole, Poland
| | - Mariusz Pawłowski
- Faculty of Health Sciences and Physical Education, Kazimierz Pulaski University of Technology and Humanities in Radom, Radom, Poland.,Cardiology Clinic of Physiotherapy Division of the 2nd Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Jakub Zieliński
- Department of Biophysics and Human Physiology, Medical University of Warsaw, Warsaw, Poland.,Interdisciplinary Centre for Mathematical and Computational Modelling, University of Warsaw, Warsaw, Poland
| | - Piotr J Jeleń
- Department of Biophysics and Human Physiology, Medical University of Warsaw, Warsaw, Poland
| | - Agnieszka Tomik
- Department of Pediatric Cardiology and General Pediatrics, Medical University of Warsaw, Warsaw, Poland
| | - Tomasz M Książczyk
- Department of Pediatric Cardiology and General Pediatrics, Medical University of Warsaw, Warsaw, Poland
| | - Bożena Werner
- Department of Pediatric Cardiology and General Pediatrics, Medical University of Warsaw, Warsaw, Poland
| | - Marek J Dąbrowski
- Cardiology Clinic of Physiotherapy Division of the 2nd Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
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136
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Kangas P, Tikkakoski A, Uitto M, Viik J, Bouquin H, Niemelä O, Mustonen J, Pörsti I. Metabolic syndrome is associated with decreased heart rate variability in a sex-dependent manner: a comparison between 252 men and 249 women. Clin Physiol Funct Imaging 2018; 39:160-167. [PMID: 30307694 DOI: 10.1111/cpf.12551] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 09/19/2018] [Indexed: 11/30/2022]
Abstract
Impaired heart rate variability (HRV) is associated with increased risk of cardiovascular disease, but evidence regarding alterations of HRV in metabolic syndrome (MetS) remains elusive. In order to examine HRV in MetS, we subjected 501 volunteers without atherosclerosis, diabetes or antihypertensive medication, mean age 48 years, to passive head-up tilt. The subjects were divided to control men (n = 131), men with MetS (n = 121), control women (n = 191) and women with MetS (n = 58) according to the criteria by Alberti et al. (Circulation, 2009, 120, 1640). In unadjusted analyses (i) men and women with MetS had lower total power and high-frequency (HF) power of HRV than controls whether supine or upright (P<0·05 for all). (ii) Supine low-frequency (LF) power of HRV was lower in men (P = 0·012) but not in women (P = 0·064) with MetS than in controls, while men and women with MetS had lower upright LF power of HRV than controls (P <0·01 for both). (iii) The LF:HF ratio did not differ between subjects with and without MetS. After adjustment for age, smoking habits, alcohol intake, height, heart rate and breathing frequency, only the differences in upright total power and HF power of HRV between women with MetS and control women remained significant (P<0·05). In conclusion, reduced total and HF power of HRV in the upright position may partially explain why the relative increase in cardiovascular risk associated with MetS is greater in women than in men. Additionally, the present results emphasize that the confounding factors must be carefully taken into consideration when evaluating HRV.
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Affiliation(s)
- Pauliina Kangas
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Antti Tikkakoski
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.,Department of Clinical Physiology and Nuclear Medicine, Tampere University Hospital, Tampere, Finland
| | - Marko Uitto
- BioMediTech Institute and Faculty of Biomedical Sciences and Engineering, Tampere University of Technology, Tampere, Finland
| | - Jari Viik
- BioMediTech Institute and Faculty of Biomedical Sciences and Engineering, Tampere University of Technology, Tampere, Finland
| | - Heidi Bouquin
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Onni Niemelä
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.,Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital, Seinäjoki, Finland
| | - Jukka Mustonen
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.,Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | - Ilkka Pörsti
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.,Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
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137
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Shokri-Kojori E, Tomasi D, Volkow ND. An Autonomic Network: Synchrony Between Slow Rhythms of Pulse and Brain Resting State Is Associated with Personality and Emotions. Cereb Cortex 2018; 28:3356-3371. [PMID: 29955858 PMCID: PMC6095212 DOI: 10.1093/cercor/bhy144] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 05/15/2018] [Accepted: 05/18/2018] [Indexed: 12/14/2022] Open
Abstract
The sympathetic system's role in modulating vasculature and its influence on emotions and personality led us to test the hypothesis that interactions between brain resting-state networks (RSNs) and pulse amplitude (indexing sympathetic activity) would be associated with emotions and personality. In 203 participants, we characterized RSN spatiotemporal characteristics, and phase-amplitude associations of RSN fluctuations with pulse and respiratory recordings. We found that RSNs are spatially reproducible within participants and were temporally associated with low frequencies (LFs < 0.1 Hz) in physiological signals. LF fluctuations in pulse amplitude were not related to cardiac electrical activity and preceded LF fluctuations in RSNs, while LF respiratory amplitude fluctuations followed LF fluctuations in RSNs. LF phase dispersion (PD) (lack of synchrony) between RSNs and pulse (PDpulse) (not respiratory) correlated with the common variability in measures of personality and emotions, with more synchrony being associated with more positive temperamental characteristics. Voxel-level PDpulse mapping revealed an "autonomic brain network," including sensory cortices and dorsal attention stream, with significant interactions with peripheral signals. Here, we uncover associations between pulse signal amplitude (presumably of sympathetic origin) and brain resting state, suggesting that interactions between central and autonomic nervous systems are important for characterizing personality and emotions.
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Affiliation(s)
- Ehsan Shokri-Kojori
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Dardo Tomasi
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Nora D Volkow
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
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138
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Black N, D'Souza A, Wang Y, Piggins H, Dobrzynski H, Morris G, Boyett MR. Circadian rhythm of cardiac electrophysiology, arrhythmogenesis, and the underlying mechanisms. Heart Rhythm 2018; 16:298-307. [PMID: 30170229 PMCID: PMC6520649 DOI: 10.1016/j.hrthm.2018.08.026] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Indexed: 12/31/2022]
Abstract
Cardiac arrhythmias are a leading cause of cardiovascular death. It has long been accepted that life-threatening cardiac arrhythmias (ventricular tachycardia, ventricular fibrillation, and sudden cardiac death) are more likely to occur in the morning after waking. It is perhaps less well recognized that there is a circadian rhythm in cardiac pacemaking and other electrophysiological properties of the heart. In addition, there is a circadian rhythm in other arrhythmias, for example, bradyarrhythmias and supraventricular arrhythmias. Two mechanisms may underlie this finding: (1) a central circadian clock in the suprachiasmatic nucleus in the hypothalamus may directly affect the electrophysiology of the heart and arrhythmogenesis via various neurohumoral factors, particularly the autonomic nervous system; or (2) a local circadian clock in the heart itself (albeit under the control of the central clock) may drive a circadian rhythm in the expression of ion channels in the heart, which in turn varies arrhythmic substrate. This review summarizes the current understanding of the circadian rhythm in cardiac electrophysiology, arrhythmogenesis, and the underlying molecular mechanisms.
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Affiliation(s)
- Nicholas Black
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| | - Alicia D'Souza
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| | - Yanwen Wang
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| | - Hugh Piggins
- Division of Diabetes, Endocrinology & Gastroenterology, University of Manchester, Manchester, United Kingdom
| | - Halina Dobrzynski
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| | - Gwilym Morris
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| | - Mark R Boyett
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom.
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139
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Oishi K, Himeno Y, Miwa M, Anzai H, Kitajima K, Yasunaka Y, Kumagai H, Ieiri S, Hirooka H. Correcting the Activity-Specific Component of Heart Rate Variability Using Dynamic Body Acceleration Under Free-Moving Conditions. Front Physiol 2018; 9:1063. [PMID: 30131717 PMCID: PMC6091277 DOI: 10.3389/fphys.2018.01063] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 07/17/2018] [Indexed: 11/13/2022] Open
Abstract
Heart rate variability (HRV) analysis is a widely used technique to assess sympatho-vagal regulation in response to various internal or external stressors. However, HRV measurements under free-moving conditions are highly susceptible to subjects’ physical activity levels because physical activity alters energy metabolism, which inevitably modulates the cardiorespiratory system and thereby changes the sympatho-vagal balance, regardless of stressors. Thus, researchers must simultaneously quantify the effect of physical activity on HRV to reliably assess sympatho-vagal balance under free-moving conditions. In the present study, dynamic body acceleration (DBA), which was developed in the field of animal ecology as a quantitative proxy for activity-specific energy expenditure, was used as a factor to correct for physical activity when evaluating HRV in freely moving subjects. Body acceleration and heart inter-beat intervals were simultaneously measured in cattle and sheep, and the vectorial DBA and HRV parameters were evaluated at 5-min intervals. Next, the effects of DBA on the HRV parameters were statistically analyzed. The heart rate (HR) and most of the HRV parameters were affected by DBA in both animal species, and the inclusion of the effect of DBA in the HRV analysis greatly influenced the frequency domain and nonlinear HRV parameters. By removing the effect of physical activity quantified using DBA, we could fairly compare the stress levels of animals with different physical activity levels under different management conditions. Moreover, we analyzed and compared the HRV parameters before and after correcting for the mean HR, with and without inclusion of DBA. The results were somewhat unexpected, as the effect of DBA was a highly significant source of HRV also in parameters corrected for mean HR. In conclusion, the inclusion of DBA as a physical activity index is a simple and useful method for correcting the activity-specific component of HRV under free-moving conditions.
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Affiliation(s)
- Kazato Oishi
- Laboratory of Animal Husbandry Resources, Division of Applied Biosciences, Graduate School of Agriculture, Kyoto University, Kyoto, Japan
| | - Yukiko Himeno
- Department of Bioinformatics, College of Life Sciences, Ritsumeikan University, Shiga, Japan
| | - Masafumi Miwa
- Laboratory of Animal Husbandry Resources, Division of Applied Biosciences, Graduate School of Agriculture, Kyoto University, Kyoto, Japan.,Division of Grassland Farming, Institute of Livestock and Grassland Science, National Agriculture and Food Research Organization (NARO), Tochigi, Japan
| | - Hiroki Anzai
- Laboratory of Animal Husbandry Resources, Division of Applied Biosciences, Graduate School of Agriculture, Kyoto University, Kyoto, Japan.,Department of Animal and Grassland Sciences, Faculty of Agriculture, University of Miyazaki, Miyazaki, Japan
| | - Kaho Kitajima
- Laboratory of Animal Husbandry Resources, Division of Applied Biosciences, Graduate School of Agriculture, Kyoto University, Kyoto, Japan
| | - Yudai Yasunaka
- Laboratory of Animal Husbandry Resources, Division of Applied Biosciences, Graduate School of Agriculture, Kyoto University, Kyoto, Japan
| | - Hajime Kumagai
- Laboratory of Animal Husbandry Resources, Division of Applied Biosciences, Graduate School of Agriculture, Kyoto University, Kyoto, Japan
| | - Seiji Ieiri
- Department of Animal and Grassland Sciences, Faculty of Agriculture, University of Miyazaki, Miyazaki, Japan
| | - Hiroyuki Hirooka
- Laboratory of Animal Husbandry Resources, Division of Applied Biosciences, Graduate School of Agriculture, Kyoto University, Kyoto, Japan
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140
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Lakin R, Guzman C, Izaddoustdar F, Polidovitch N, Goodman JM, Backx PH. Changes in Heart Rate and Its Regulation by the Autonomic Nervous System Do Not Differ Between Forced and Voluntary Exercise in Mice. Front Physiol 2018; 9:841. [PMID: 30061838 PMCID: PMC6055008 DOI: 10.3389/fphys.2018.00841] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 06/14/2018] [Indexed: 12/20/2022] Open
Abstract
Most exercise studies in mice have relied on forced training which can introduce psychological stress. Consequently, the utility of mouse models for understanding exercise-mediated effects in humans, particularly autonomic nervous system (ANS) remodeling, have been challenged. We compared the effects of voluntary free-wheel running vs. non-voluntary swimming on heart function in mice with a focus on the regulation of heart rate (HR) by the ANS. Under conditions where the total excess O2 consumption associated with exercise was comparable, the two exercise models led to similar improvements in ventricular function as well as comparable reductions in HR and its control by parasympathetic nervous activity (PNA) and sympathetic nervous activity (SNA), compared to sedentary mice. Both exercise models also increased HR variability (HRV) by similar amounts, independent of HR reductions. In all mice, HRV depended primarily on PNA, with SNA weakly affecting HRV at low frequencies. The differences in both HR and HRV between exercised vs. sedentary mice were eliminated by autonomic blockade, consistent with the similar intrinsic beating rates observed in atria isolated from exercised vs. sedentary mice. In conclusion, both forced and voluntary exercise induce comparable ventricular physiological remodeling as well as HR reductions and HR-independent enhancements of HRV which were both primarily dependent on increased PNA. New and noteworthy -No previous mouse studies have compared the effects of forced and voluntary exercise on the heart function and its modulation by the autonomic nervous system (ANS).-Both voluntary free-wheel running and forced swimming induced similar improvements in ventricular contractile function, reductions in heart rate (HR) and enhancements of HR variability (HRV).-HR regulation in exercised mice was linked to increased parasympathetic nerve activity and reduced sympathetic nerve activity.- HRV was independent of HR and depended primarily on PNA in both exercised and sedentary mice.- Complete cardiac autonomic blockade eliminated differences in both HR and HRV between exercised and sedentary mice.
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Affiliation(s)
- Robert Lakin
- Department of Exercise Sciences, University of Toronto, Toronto, ON, Canada.,Division of Cardiology, Mount Sinai Hospital, University Health Network, Toronto, ON, Canada
| | - Camilo Guzman
- Department of Biology, York University, Toronto, ON, Canada
| | - Farzad Izaddoustdar
- Division of Cardiology, Mount Sinai Hospital, University Health Network, Toronto, ON, Canada
| | - Nazari Polidovitch
- Division of Cardiology, Mount Sinai Hospital, University Health Network, Toronto, ON, Canada.,Department of Biology, York University, Toronto, ON, Canada
| | - Jack M Goodman
- Department of Exercise Sciences, University of Toronto, Toronto, ON, Canada.,Division of Cardiology, Mount Sinai Hospital, University Health Network, Toronto, ON, Canada
| | - Peter H Backx
- Division of Cardiology, Mount Sinai Hospital, University Health Network, Toronto, ON, Canada.,Department of Biology, York University, Toronto, ON, Canada
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141
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Aboab J, Mayaud L, Sebille V, de Oliveira R, Jourdain M, Annane D. Esmolol indirectly stimulates vagal nerve activity in endotoxemic pigs. Intensive Care Med Exp 2018; 6:14. [PMID: 29974363 PMCID: PMC6031554 DOI: 10.1186/s40635-018-0178-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 05/20/2018] [Indexed: 12/16/2022] Open
Abstract
Background There is an increasing interest in beta-blockade as a therapeutic approach to sepsis following consistent experimental findings of attenuation of inflammation and improved survival with beta1 selective antagonist. However, the mechanism of these beneficial effects remains very uncertain. Thus, this study is aimed at investigating the effects of a beta-1 selective blockade on sympathetic/parasympathetic activity in endotoxin-challenged pigs using heart rate variability. The hypothesis is that an adrenergic blockade could promote parasympathetic activity. Indeed, the increase of parasympathetic activity is a mechanism recently described as beneficial in septic states. Methods Fifty-one endotoxin-challenged pigs were studied. After 30 min of endotoxin infusion and 30 min of evolution without intervention, the pigs were randomly assigned the placebo or esmolol treatment and were observed for 200 min. Overall heart rate variability was assessed continuously, in the temporal domain by standard deviation of RR intervals (SDNN, ms),and in the frequency domain by spectral powers of low frequency (LF, ms2 × 103/Hz) and high frequency (HF, ms2 × 103/Hz) bands. Results Variations of power in these frequency bands were interpreted as putative markers of sympathetic (LF) and parasympathetic (HF) activity. In LPS treated animals, Esmolol did not increase SDNN, but instead decreased LF and increased HF power. Conclusion These spectral modifications associated to a beta-blocker treatment after an endotoxemic challenge are interpreted as a significant decrease of sympathetic activity and an indirect increase of vagal autonomic tone. Electronic supplementary material The online version of this article (10.1186/s40635-018-0178-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jerome Aboab
- Réanimation Polyvalente, Hôpital Raymond Poincaré, AP-HP, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), 104 bd. Raymond Poincaré, 92380, Garches, France. .,Laboratoire d'étude de la réponse neuroendocrine au sepsis, EA4342, Université de Versailles Saint-Quentin-en-Yvelines, 104, bd. Raymond Poincaré, 92380, Garches, France.
| | - Louis Mayaud
- Laboratoire d'étude de la réponse neuroendocrine au sepsis, EA4342, Université de Versailles Saint-Quentin-en-Yvelines, 104, bd. Raymond Poincaré, 92380, Garches, France.,Mensia technologies SA, 130 rue de Lourmel, 75015, Paris, France
| | - Veronique Sebille
- EA 4275, Faculté de Pharmacie, Université de NANTES, 1, rue Gaston Veil, 44035, Nantes Cedex 1, France
| | - Rodrigo de Oliveira
- Laboratoire d'ingénierie des systèmes de Versailles (LISV - UVSQ), 10-12 Avenue de l'Europe, 78140, Velizy, France
| | - Merce Jourdain
- Service de Réanimation Polyvalente, Hôpital Roger Salengro, Rue Emile Laine, 59037, Lille, France
| | - Djillali Annane
- Réanimation Polyvalente, Hôpital Raymond Poincaré, AP-HP, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), 104 bd. Raymond Poincaré, 92380, Garches, France.,Laboratoire d'étude de la réponse neuroendocrine au sepsis, EA4342, Université de Versailles Saint-Quentin-en-Yvelines, 104, bd. Raymond Poincaré, 92380, Garches, France
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142
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Herzig D, Asatryan B, Brugger N, Eser P, Wilhelm M. The Association Between Endurance Training and Heart Rate Variability: The Confounding Role of Heart Rate. Front Physiol 2018; 9:756. [PMID: 29971016 PMCID: PMC6018465 DOI: 10.3389/fphys.2018.00756] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 05/29/2018] [Indexed: 12/19/2022] Open
Abstract
Heart rate variability (HRV) is a widely used marker of cardiac autonomic nervous activity (CANA). Changes in HRV with exercise training have often been interpreted as increases in vagal activity. HRV is strongly associated with heart rate, which in turn, is associated with heart size. There is strong evidence from basic studies that lower heart rate in response to exercise training is caused by morphological and electrical remodeling of the heart. In a cross-sectional study in participants of a 10 mile race, we investigated the influence of endurance exercise on HRV parameters independently of heart size and heart rate. One-hundred-and-seventy-two runners (52 females and 120 males) ranging from novice runners with a first participation to an endurance event to highly trained runners, with up to 15 h of training per week, were included in the analysis. R-R intervals were recorded by electrocardiography over 24 h. Left ventricular end diastolic volume indexed to body surface area (LVEDVI) was assessed by transthoracic echocardiography and peak oxygen consumption (VO2peak) by cardiopulmonary exercise testing. Exercise was quantified by VO2peak, training volume, and race performance. HRV was determined during deep sleep. HRV markers of vagal activity were moderately associated with exercise variables (standardized β = 0.28-0.40, all p < 0.01). These associations disappeared when controlling for heart rate and LVEDVI. Due to the intrinsic association between heart rate and HRV, conclusions based on HRV parameters do not necessarily reflect differences in CANA. Based on current evidence, we discourage the use of HRV as a marker of CANA when measuring the effect of chronic exercise.
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Affiliation(s)
- David Herzig
- University Clinic for Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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143
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van den Berg ME, Rijnbeek PR, Niemeijer MN, Hofman A, van Herpen G, Bots ML, Hillege H, Swenne CA, Eijgelsheim M, Stricker BH, Kors JA. Normal Values of Corrected Heart-Rate Variability in 10-Second Electrocardiograms for All Ages. Front Physiol 2018; 9:424. [PMID: 29755366 PMCID: PMC5934689 DOI: 10.3389/fphys.2018.00424] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 04/05/2018] [Indexed: 11/17/2022] Open
Abstract
Purpose: Heart-rate variability (HRV) measured on standard 10-s electrocardiograms (ECGs) has been associated with increased risk of cardiac and all-cause mortality, but age- and sex-dependent normal values have not been established. Since heart rate strongly affects HRV, its effect should be taken into account. We determined a comprehensive set of normal values of heart-rate corrected HRV derived from 10-s ECGs for both children and adults, covering both sexes. Methods: Five population studies in the Netherlands (Pediatric Normal ECG Study, Leiden University Einthoven Science Project, Prevention of Renal and Vascular End-stage Disease Study, Utrecht Health Project, Rotterdam Study) provided 10-s, 12-lead ECGs. ECGs were stored digitally and analyzed by well-validated analysis software. We included cardiologically healthy participants, 42% being men. Their ages ranged from 11 days to 91 years. After quality control, 13,943 ECGs were available. Heart-rate correction formulas were derived using an exponential model. Two time-domain HRV markers were analyzed: the corrected standard deviation of the normal-to-normal RR intervals (SDNNc) and corrected root mean square of successive RR-interval differences (RMSSDc). Results: There was a considerable age effect. For both SDNNc and RMSSDc, the median and the lower limit of normal decreased steadily from birth until old age. The upper limit of normal decreased until the age of 60, but increased markedly after that age. Differences of the median were minimal between men and women. Conclusion: We report the first comprehensive set of normal values for heart-rate corrected 10-s HRV, which can be of value in clinical practice and in further research.
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Affiliation(s)
- Marten E van den Berg
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Peter R Rijnbeek
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Maartje N Niemeijer
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Gerard van Herpen
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | - Hans Hillege
- Department of Cardiology, University Medical Center Groningen, Groningen, Netherlands
| | - Cees A Swenne
- Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands
| | - Mark Eijgelsheim
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Internal Medicine, University Medical Center Groningen, Groningen, Netherlands
| | - Bruno H Stricker
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands.,Health and Youth Care Inspectorate, Utrecht, Netherlands
| | - Jan A Kors
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, Netherlands
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144
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Cavalcante Neto JL, Zamunér AR, Moreno BC, Silva E, Tudella E. Linear and Nonlinear Analyses of the Cardiac Autonomic Control in Children With Developmental Coordination Disorder: A Case-Control Study. Front Physiol 2018; 9:267. [PMID: 29623050 PMCID: PMC5874518 DOI: 10.3389/fphys.2018.00267] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 03/08/2018] [Indexed: 01/25/2023] Open
Abstract
Children with Developmental Coordination Disorder (DCD) and children at risk for DCD (r-DCD) present motor impairments interfering in their school, leisure and daily activities. In addition, these children may have abnormalities in their cardiac autonomic control, which together with their motor impairments, restrict their health and functionality. Therefore, this study aimed to assess the cardiac autonomic control, by linear and nonlinear analysis, at supine and during an orthostatic stimulus in DCD, r-DCD and typically developed children. Thirteen DCD children (11 boys and 2 girls, aged 8.08 ± 0.79 years), 19 children at risk for DCD (13 boys and 6 girls, aged 8.10 ± 0.96 years) and 18 typically developed children, who constituted the control group (CG) (10 boys and 8 girls, aged 8.50 ± 0.96 years) underwent a heart rate variability (HRV) examination. R-R intervals were recorded in order to assess the cardiac autonomic control using a validated HR monitor. HRV was analyzed by linear and nonlinear methods and compared between r-DCD, DCD, and CG. The DCD group presented blunted cardiac autonomic adjustment to the orthostatic stimulus, which was not observed in r-DCD and CG. Regarding nonlinear analysis of HRV, the DCD group presented lower parasympathetic modulation in the supine position compared to the r-DCD and CG groups. In the within group analysis, only the DCD group did not increase HR from supine to standing posture. Symbolic analysis revealed a significant decrease in 2LV (p < 0.0001) and 2UV (p < 0.0001) indices from supine to orthostatic posture only in the CG. In conclusion, r-DCD and DCD children present cardiac autonomic dysfunction characterized by higher sympathetic, lower parasympathetic and lower complexity of cardiac autonomic control in the supine position, as well as a blunted autonomic adjustment to the orthostatic stimulus. Therefore, cardiovascular health improvement should be part of DCD children's management, even in cases of less severe motor impairment.
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Affiliation(s)
- Jorge L Cavalcante Neto
- Núcleo de Estudos em Neuropediatria e Motricidade, Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Antonio R Zamunér
- Departamento de Kinesiología, Facultad de Ciencias de la Salud, Universidad Católica del Maule, Talca, Chile
| | - Bianca C Moreno
- Pró-Reitoria de Pesquisa e Pós-Graduação, Fisioterapia, Universidade do Sagrado Coração, Bauru, Brazil
| | - Ester Silva
- Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Eloisa Tudella
- Núcleo de Estudos em Neuropediatria e Motricidade, Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, Brazil
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145
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Makowiec D, Wejer D, Graff B, Struzik ZR. Dynamical Pattern Representation of Cardiovascular Couplings Evoked by Head-up Tilt Test. ENTROPY 2018; 20:e20040235. [PMID: 33265326 PMCID: PMC7512750 DOI: 10.3390/e20040235] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 03/23/2018] [Accepted: 03/23/2018] [Indexed: 11/17/2022]
Abstract
Shannon entropy (ShE) is a recognised tool for the quantization of the temporal organization of time series. Transfer entropy (TE) provides insight into the dependence between coupled systems. Here, signals are analysed that were produced by the cardiovascular system when a healthy human underwent a provocation test using the head-up tilt (HUT) protocol. The information provided by ShE and TE is evaluated from two aspects: that of the algorithmic stability and that of the recognised physiology of the cardiovascular response to the HUT test. To address both of these aspects, two types of symbolization of three-element subsequent values of a signal are considered: one, well established in heart rate research, referring to the variability in a signal, and a novel one, revealing primarily the dynamical trends. The interpretation of ShE shows a strong dependence on the method that was used in signal pre-processing. In particular, results obtained from normalized signals turn out to be less conclusive than results obtained from non-normalized signals. Systematic investigations based on surrogate data tests are employed to discriminate between genuine properties—in particular inter-system coupling—and random, incidental fluctuations. These properties appear to determine the occurrence of a high percentage of zero values of TE, which strongly limits the reliability of the couplings measured. Nevertheless, supported by statistical corroboration, we identify distinct timings when: (i) evoking cardiac impact on the vascular system, and (ii) evoking vascular impact on the cardiac system, within both the principal sub-systems of the baroreflex loop.
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Affiliation(s)
- Danuta Makowiec
- Institute of Theoretical Physics and Astrophysics, Faculty of Mathematics, Physics and Informatics, University of Gdańsk, Wita Stwosza 57, 80-308 Gdańsk, Poland
| | - Dorota Wejer
- Institute of Experimental Physics, Faculty of Mathematics, Physics and Informatics, University of Gdańsk, Wita Stwosza 57, 80-308 Gdańsk, Poland
| | - Beata Graff
- Department of Hypertension and Diabetology, Medical University of Gdańsk, M. Skłodowskiej-Curie 3a, 80-210 Gdańsk, Poland
| | - Zbigniew R. Struzik
- Graduate School of Education, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
- RIKEN, Brain Science Institute, 2-1 Hirosawa, Wako-shi 351-0198, Japan
- Correspondence: or ; Tel.: +81-48-462-1111
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146
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Abstract
OBJECTIVE Most midlife women report vasomotor symptoms (VMS), yet their physiology remains poorly understood. This study tested whether acute decreases in cardiac vagal control would occur with VMS in a large sample of women monitored during wake and sleep. METHODS Two hundred and fifteen nonsmoking women aged 40 to 60 years with evidence of VMS were included. Women were free of a history of clinical cardiovascular disease or arrhythmia; or use of insulin, beta blockers, calcium channel blockers, or medications impacting VMS. Women underwent 24 hours of ambulatory monitoring for physiological (sternal skin conductance) and self-report (electronic diary) measurement of VMS; heart rate variability (electrocardiogram); and respiratory rate. Changes in cardiac vagal control as assessed by respiratory sinus arrhythmia during VMS, relative to periods before and after VMS, were tested in linear mixed models. RESULTS Significant decreases in respiratory sinus arrhythmia were observed during physiologically measured VMS relative to periods preceding (b[SE] = 0.13 (0.004), P < 0.0001) and after the vasomotor symptoms (b[SE] = 0.13 (0.004), P < 0.0001), adjusted for age, race, body mass index, and sleep/wake status. Decreases were observed for women not aware of their VMS, and differences persisted controlling for respiration rate. Interactions indicated that respiratory sinus arrhythmia decreases were most pronounced during sleep and for younger women. CONCLUSIONS Physiologically measured VMS were accompanied by an inhibition of cardiac vagal control in a large sample of women. Changes were observed irrespective of whether the VMS were reported, were most pronounced during sleep, and were greatest among younger women. These findings contribute to the understanding of vasomotor symptom physiology.
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147
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Huang Z, Goparaju B, Chen H, Bianchi MT. Heart rate phenotypes and clinical correlates in a large cohort of adults without sleep apnea. Nat Sci Sleep 2018; 10:111-125. [PMID: 29719424 PMCID: PMC5914741 DOI: 10.2147/nss.s155733] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Normal sleep is associated with typical physiological changes in both the central and autonomic nervous systems. In particular, nocturnal blood pressure dipping has emerged as a strong marker of normal sleep physiology, whereas the absence of dipping or reverse dipping has been associated with cardiovascular risk. However, nocturnal blood pressure is not measured commonly in clinical practice. Heart rate (HR) dipping in sleep may be a similar important marker and is measured routinely in at-home and in-laboratory sleep testing. METHODS We performed a retrospective cross-sectional analysis of diagnostic polysomnography in a clinically heterogeneous cohort of n=1047 adults without sleep apnea. RESULTS We found that almost half of the cohort showed an increased HR in stable nonrapid eye movement sleep (NREM) compared to wake, while only 13.5% showed a reduced NREM HR of at least 10% relative to wake. The strongest correlates of HR dipping were younger age and male sex, whereas the periodic limb movement index (PLMI), sleep quality, and Epworth Sleepiness Scale (ESS) scores were not correlated with HR dipping. PLMI was however significantly correlated with metrics of impaired HR variability (HRV): increased low-frequency power and reduced high-frequency power. HRV metrics were unrelated to sleep quality or the ESS value. Following the work of Vgontzas et al, we also analyzed the sub-cohort with insomnia symptoms and short objective sleep duration. Interestingly, the sleep-wake stage-specific HR values depended upon insomnia symptoms more than sleep duration. CONCLUSION While our work demonstrates heterogeneity in cardiac metrics (HR and HRV), the population analysis suggests that pathological signatures of HR (nondipping and elevation) are common even in this cohort selected for the absence of sleep apnea. Future prospective work in clinical populations will further inform risk stratification and set the stage for testing interventions.
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Affiliation(s)
- Zhaoyang Huang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Balaji Goparaju
- Department of Neurology, Division of Sleep Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - He Chen
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, People's Republic of China
| | - Matt T Bianchi
- Department of Neurology, Division of Sleep Medicine, Massachusetts General Hospital, Boston, MA, USA
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148
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Estévez-Báez M, Carricarte-Naranjo C, Jas-García JD, Rodríguez-Ríos E, Machado C, Montes-Brown J, Leisman G, Schiavi A, Machado-García A, Luaces CS, Pié EA. Influence of Heart Rate, Age, and Gender on Heart Rate Variability in Adolescents and Young Adults. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1133:19-33. [PMID: 30414070 DOI: 10.1007/5584_2018_292] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Key autonomic functions are in continuous development during adolescence which can be assessed using the heart rate variability (HRV). However, the influence of different demographic and physiological factors on HRV indices has not been fully explored in adolescents. In this study we aimed to assess the effect of age, gender, and heart rate on HRV indices in two age groups of healthy adolescents (age ranges, 13-16 and 17-20 years) and two groups of healthy young adults (21-24 and 25-30 years). We addressed the issue using 5-min ECG recordings performed in the sitting position in 255 male and female participants. Time, frequency, and informational domains of HRV were calculated. Changes in HRV indices were assessed using a multiple linear regression model to adjust for the effects of heart rate, age, and gender. We found that heart rate produced more significant effects on HRV indices than age or gender. There was a progressive reduction in HRV with increasing age. Sympathetic influence increased with age and parasympathetic influence progressively decreased with age. The influence of gender was manifest only in younger adolescents and young adults. In conclusion, age, gender, and particularly heart rate have a substantial influence on HRV indices, which ought to be considered to avoid biases in the study of the autonomic nervous system development. The lack of the gender-related effects on HRV indices in late adolescence could be related to non-completely achieved maturity of the autonomic mechanisms, which deserves further exploration.
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Affiliation(s)
- Mario Estévez-Báez
- Institute of Neurology and Neurosurgery, Ministry of Health, Havana, Cuba
| | | | | | | | - Calixto Machado
- Institute of Neurology and Neurosurgery, Ministry of Health, Havana, Cuba
| | - Julio Montes-Brown
- Department of Medicine & Health Science, University of Sonora, Hermosillo, Mexico
| | - Gerry Leisman
- Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel. .,National Institute for Brain and Rehabilitation Sciences, Nazareth, Israel. .,Faculty 'Manuel Fajardo', University of the Medical Sciences, Havana, Cuba.
| | - Adam Schiavi
- Anesthesiology and Critical Care Medicine, Neurosciences Critical Care Division, Johns Hopkins Hospital, Baltimore, MD, USA
| | | | | | - Eduardo Arrufat Pié
- Institute of Basic and Preclinical Sciences "Victoria de Girón", Havana, Cuba
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149
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Autonomic regulation of systemic inflammation in humans: A multi-center, blinded observational cohort study. Brain Behav Immun 2018; 67:47-53. [PMID: 28807718 DOI: 10.1016/j.bbi.2017.08.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Revised: 07/12/2017] [Accepted: 08/09/2017] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE Experimental animal models demonstrate that autonomic activity regulates systemic inflammation. By contrast, human studies are limited in number and exclusively use heart rate variability (HRV) as an index of cardiac autonomic regulation. HRV measures are primarily dependent on, and need to be corrected for, heart rate. Thus, independent autonomic measures are required to confirm HRV-based findings. Here, the authors sought to replicate the findings of preceding HRV-based studies by using HRV-independent, exercise-evoked sympathetic and parasympathetic measures of cardiac autonomic regulation to examine the relationship between autonomic function and systemic inflammation. METHODS Sympathetic function was assessed by measuring heart rate changes during unloaded pedaling prior to onset of exercise, divided into quartiles; an anticipatory heart rate (AHRR) rise during this period is evoked by mental stress in many individuals. Parasympathetic function was assessed by heart rate recovery (HRR) 60s after finishing cardiopulmonary exercise testing, divided into quartiles. Parasympathetic dysfunction was defined by delayed heart rate recovery (HRR) ≤12.beats.min-1, a threshold value associated with higher cardiovascular morbidity/mortality in the general population. Systemic inflammation was primarily assessed by neutrophil-lymphocyte ratio (NLR), where a ratio >4 is prognostic across several inflammatory diseases and correlates strongly with elevated plasma levels of pro-inflammatory cytokines. High-sensitivity C-reactive protein (hsCRP) was also measured. RESULTS In 1624 subjects (65±14y; 67.9% male), lower HRR (impaired vagal activity) was associated with progressively higher NLR (p=0.004 for trend across quartiles). Delayed HRR, recorded in 646/1624 (39.6%) subjects, was associated with neutrophil-lymphocyte ratio >4 (relative risk: 1.43 (95%CI: 1.18-1.74); P=0.0003). Similar results were found for hsCRP (p=0.045). By contrast, AHRR was not associated with NLR (relative risk: 1.24 (95%CI: 0.94-1.65); P=0.14). CONCLUSIONS Delayed HRR, a robust measure of parasympathetic dysfunction, is independently associated with leukocyte ratios indicative of systemic inflammation. These results further support a role for parasympathetic modulation of systemic inflammation in humans.
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150
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Altered heart rate regulation by the autonomic nervous system in mice lacking natriuretic peptide receptor C (NPR-C). Sci Rep 2017; 7:17564. [PMID: 29242602 PMCID: PMC5730580 DOI: 10.1038/s41598-017-17690-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 11/29/2017] [Indexed: 02/02/2023] Open
Abstract
Natriuretic peptides (NPs) play essential roles in the regulation of cardiovascular function. NP effects are mediated by receptors known as NPR-A, NPR-B or NPR-C. NPs have potent effects on regulation of heart rate (HR) by the autonomic nervous system (ANS), but the role of NPR-C in these effects has not been investigated. Accordingly, we have used telemetric ECG recordings in awake, freely moving wildtype and NPR-C knockout (NPR-C−/−) mice and performed heart rate variability (HRV) analysis to assess alterations in sympatho-vagal balance on the heart following loss of NPR-C. Our novel data demonstrate that NPR-C−/− mice are characterized by elevations in HR, reductions in circadian changes in HR and enhanced occurrence of sinus pauses, indicating increased arrhythmogenesis and a loss of HRV. Time domain and frequency domain analyses further demonstrate that HRV is reduced in NPR-C−/− mice in association with a reduction in parasympathetic activity. Importantly, the low frequency to high frequency ratio was increased in NPR-C−/− mice indicating that sympathetic activity is also enhanced. These changes in autonomic regulation were confirmed using atropine and propranolol to antagonize the ANS. These findings illustrate that loss of NPR-C reduces HRV due to perturbations in the regulation of the heart by the ANS.
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