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Moghtadaei M, Dorey TW, Rose RA. Evaluation of non-linear heart rate variability using multi-scale multi-fractal detrended fluctuation analysis in mice: Roles of the autonomic nervous system and sinoatrial node. Front Physiol 2022; 13:970393. [PMID: 36237525 PMCID: PMC9552224 DOI: 10.3389/fphys.2022.970393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/18/2022] [Indexed: 11/16/2022] Open
Abstract
Nonlinear analyses of heart rate variability (HRV) can be used to quantify the unpredictability, fractal properties and complexity of heart rate. Fractality and its analysis provides valuable information about cardiovascular health. Multi-Scale Multi-Fractal Detrended Fluctuation Analysis (MSMFDFA) is a complexity-based algorithm that can be used to quantify the multi-fractal dynamics of the HRV time series through investigating characteristic exponents at different time scales. This method is applicable to short time series and it is robust to noise and nonstationarity. We have used MSMFDFA, which enables assessment of HRV in the frequency ranges encompassing the very-low frequency and ultra-low frequency bands, to jointly assess multi-scale and multi-fractal dynamics of HRV signals obtained from telemetric ECG recordings in wildtype mice at baseline and after autonomic nervous system (ANS) blockade, from electrograms recorded from isolated atrial preparations and from spontaneous action potential recordings in isolated sinoatrial node myocytes. Data demonstrate that the fractal profile of the intrinsic heart rate is significantly different from the baseline heart rate in vivo, and it is also altered after ANS blockade at specific scales and fractal order domains. For beating rate in isolated atrial preparations and intrinsic heart rate in vivo, the average fractal structure of the HRV increased and multi-fractality strength decreased. These data demonstrate that fractal properties of the HRV depend on both ANS activity and intrinsic sinoatrial node function and that assessing multi-fractality at different time scales is an effective approach for HRV assessment.
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Affiliation(s)
- Motahareh Moghtadaei
- Department of Cardiac Sciences, Cumming School of Medicine, Libin Cardiovascular Institute, University of Calgary, Calgary, AB, Canada
- Department of Physiology and Pharmacology, Cumming School of Medicine, Libin Cardiovascular Institute, University of Calgary, Calgary, AB, Canada
| | - Tristan W. Dorey
- Department of Cardiac Sciences, Cumming School of Medicine, Libin Cardiovascular Institute, University of Calgary, Calgary, AB, Canada
- Department of Physiology and Pharmacology, Cumming School of Medicine, Libin Cardiovascular Institute, University of Calgary, Calgary, AB, Canada
| | - Robert A. Rose
- Department of Cardiac Sciences, Cumming School of Medicine, Libin Cardiovascular Institute, University of Calgary, Calgary, AB, Canada
- Department of Physiology and Pharmacology, Cumming School of Medicine, Libin Cardiovascular Institute, University of Calgary, Calgary, AB, Canada
- *Correspondence: Robert A. Rose,
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Kiuchi S, Hisatake S, Kabuki T, Oka T, Dobashi S, Fujii T, Sano T, Ikeda T. Bisoprolol transdermal patch improves orthostatic hypotension in patients with chronic heart failure and hypertension. Clin Exp Hypertens 2020; 42:539-544. [PMID: 32009474 DOI: 10.1080/10641963.2020.1723616] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
β blockers (BBs) play an important role in heart failure (HF) treatment. However, orthostatic hypotension (OH) is sometimes caused by BBs. The bisoprolol transdermal patch works more slowly and is long acting compared with the bisoprolol fumarate tablet. The risk of OH may be reduced by using the bisoprolol transdermal patch. We evaluated 57 consecutive patients who were taking the bisoprolol fumarate tablet for chronic HF with hypertension from November 2016 to September 2017. We switched the patients to the bisoprolol transdermal patch. Because 12 of 57 subjects could not continue using the bisoprolol transdermal patch, we analyzed the remaining 45 patients. We investigated BP, blood tests, and changes in BP from supine to standing positions before and after 6 months of switching from tablet to patch. OH was diagnosed by observing a systolic/diastolic BP drop of at least 20/10 mmHg or an absolute systolic BP (sBP) of <90 mmHg from the standing position. No significant changes were observed in the BP and BPs from supine to standing positions, whereas log brain natriuretic peptide was significantly reduced after switching from patch to tablet (2.102 to 2.070pg/dl, P = .039). OH, which occurred in originally 17 patients, showed improvement and eventually appeared in 4 patients. In these patients, changes in BP from supine to standing positions were also significantly improved (changes in sBP, -11 to -6mmHg, P = .016). This study demonstrated that switching from the bisoprolol fumarate tablet to transdermal patch reduced the morbidity of OH in HF patients.
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Affiliation(s)
- Shunsuke Kiuchi
- Department of Cardiovascular Medicine, Toho University Graduate School of Medicine , Tokyo, Japan
| | - Shinji Hisatake
- Department of Cardiovascular Medicine, Toho University Graduate School of Medicine , Tokyo, Japan
| | - Takayuki Kabuki
- Department of Cardiovascular Medicine, Toho University Graduate School of Medicine , Tokyo, Japan
| | - Takashi Oka
- Department of Cardiovascular Medicine, Toho University Graduate School of Medicine , Tokyo, Japan
| | - Shintaro Dobashi
- Department of Cardiovascular Medicine, Toho University Graduate School of Medicine , Tokyo, Japan
| | - Takahiro Fujii
- Department of Cardiovascular Medicine, Toho University Graduate School of Medicine , Tokyo, Japan
| | - Takahide Sano
- Department of Cardiovascular Medicine, Toho University Graduate School of Medicine , Tokyo, Japan
| | - Takanori Ikeda
- Department of Cardiovascular Medicine, Toho University Graduate School of Medicine , Tokyo, Japan
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Sairaku A, Nakano Y, Shiode N, Suenari K, Oda N, Ono K, Kihara Y. Head-to-head comparison of the heart rate variability between the bisoprolol transdermal patch and bisoprolol fumarate tablet. Cardiovasc Ther 2018; 36:e12325. [DOI: 10.1111/1755-5922.12325] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 01/16/2018] [Accepted: 02/15/2018] [Indexed: 12/30/2022] Open
Affiliation(s)
- Akinori Sairaku
- Department of Cardiovascular Medicine; Hiroshima University Graduate School of Biomedical and Health Sciences; Hiroshima Japan
| | - Yukiko Nakano
- Department of Cardiovascular Medicine; Hiroshima University Graduate School of Biomedical and Health Sciences; Hiroshima Japan
| | - Nobuo Shiode
- Department of Cardiology; Hiroshima City Hospital; Hiroshima Japan
| | | | - Nozomu Oda
- Department of Cardiovascular Medicine; Hiroshima University Graduate School of Biomedical and Health Sciences; Hiroshima Japan
- Department of Cardiology; Yanai Medical Center; Yanai Japan
| | - Koichi Ono
- Department of Cardiology; Innoshima Medical Association Hospital; Onomichi Japan
| | - Yasuki Kihara
- Department of Cardiovascular Medicine; Hiroshima University Graduate School of Biomedical and Health Sciences; Hiroshima Japan
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Martiniano EC, Santana MDR, Barros ÉLD, do Socorro da Silva M, Garner DM, de Abreu LC, Valenti VE. Musical auditory stimulus acutely influences heart rate dynamic responses to medication in subjects with well-controlled hypertension. Sci Rep 2018; 8:958. [PMID: 29343839 PMCID: PMC5772659 DOI: 10.1038/s41598-018-19418-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 11/20/2017] [Indexed: 01/16/2023] Open
Abstract
Music can improve the efficiency of medical treatment when correctly associated with drug action, reducing risk factors involving deteriorating cardiac function. We evaluated the effect of musical auditory stimulus associated with anti-hypertensive medication on heart rate (HR) autonomic control in hypertensive subjects. We evaluated 37 well-controlled hypertensive patients designated for anti-hypertensive medication. Heart rate variability (HRV) was calculated from the HR monitor recordings of two different, randomly sorted protocols (control and music) on two separate days. Patients were examined in a resting condition 10 minutes before medication and 20 minutes, 40 minutes and 60 minutes after oral medication. Music was played throughout the 60 minutes after medication with the same intensity for all subjects in the music protocol. We noted analogous response of systolic and diastolic arterial pressure in both protocols. HR decreased 60 minutes after medication in the music protocol while it remained unchanged in the control protocol. The effects of anti-hypertensive medication on SDNN (Standard deviation of all normal RR intervals), LF (low frequency, nu), HF (high frequency, nu) and alpha-1 scale were more intense in the music protocol. In conclusion, musical auditory stimulus increased HR autonomic responses to anti-hypertensive medication in well-controlled hypertensive subjects.
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Affiliation(s)
- Eli Carlos Martiniano
- Núcleo de Estudos em Ciências Fisiológicas e Farmacêuticas, Faculdade de Juazeiro do Norte, Juazeiro do Norte, CE, Brazil.,Laboratório de Delineamento de Estudos e Escrita Científica, Faculdade de Medicina do ABC, Santo André, SP, Brazil
| | - Milana Drumond Ramos Santana
- Núcleo de Estudos em Ciências Fisiológicas e Farmacêuticas, Faculdade de Juazeiro do Norte, Juazeiro do Norte, CE, Brazil. .,Laboratório de Delineamento de Estudos e Escrita Científica, Faculdade de Medicina do ABC, Santo André, SP, Brazil.
| | - Érico Luiz Damasceno Barros
- Núcleo de Estudos em Ciências Fisiológicas e Farmacêuticas, Faculdade de Juazeiro do Norte, Juazeiro do Norte, CE, Brazil.,Laboratório de Delineamento de Estudos e Escrita Científica, Faculdade de Medicina do ABC, Santo André, SP, Brazil
| | - Maria do Socorro da Silva
- Núcleo de Estudos em Ciências Fisiológicas e Farmacêuticas, Faculdade de Juazeiro do Norte, Juazeiro do Norte, CE, Brazil.,Laboratório de Delineamento de Estudos e Escrita Científica, Faculdade de Medicina do ABC, Santo André, SP, Brazil
| | - David Matthew Garner
- Cardiorespiratory Research Group, Department of Biological and Medical Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Gipsy Lane, Oxford, OX3 0BP, United Kingdom
| | - Luiz Carlos de Abreu
- Laboratório de Delineamento de Estudos e Escrita Científica, Faculdade de Medicina do ABC, Santo André, SP, Brazil
| | - Vitor E Valenti
- Centro de Estudos do Sistema Nervoso Autônomo (CESNA), Departamento de Fonoaudiologia, Faculdade de Filosofia e Ciências, UNESP, Marília, SP, Brazil
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Yaniv Y, Lyashkov AE, Lakatta EG. The fractal-like complexity of heart rate variability beyond neurotransmitters and autonomic receptors: signaling intrinsic to sinoatrial node pacemaker cells. ACTA ACUST UNITED AC 2013; 2. [PMID: 26709383 DOI: 10.4172/2329-6607.1000111] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The heart rate and rhythm are controlled by complex chaotic neural, chemical and hormonal networks which are not strictly regular, but exhibit fluctuations across multiple time scales. A careful assessment of the heart rate variability (HRV) offers clues to this complexity. A reduction in HRV, specifically in advanced age, is associated with increase in morbidity and mortality. Mechanisms that induce this decrease, however, have not been fully elucidated. The classical literature characterizes changes in HRV as a result of changes in the balance of competing influences of the sympathetic and parasympathetic autonomic impulses delivered to the heart. It has now become clear, however, that the heart rate and HRV are also determined by intrinsic properties of the pacemaker cells that comprise sinoatrial node, and that these properties respond to autonomic receptor stimulation in a non-linear mode. That HRV is determined by both the intrinsic properties of pacemaker cells in the sinoatrial node and the competing influences of the two branches of the autonomic neural input to the cells requires an expansion of our perspective about mechanisms that govern HRV in the normal heart, and how HRV changes with aging in health and in heart diseases.
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Affiliation(s)
- Yael Yaniv
- Laboratory of Cardiovascular Science, Biomedical Research Center, Intramural Research Program, National Institute on Aging, NIH, Baltimore, Maryland, USA
| | - Alexey E Lyashkov
- Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, 733 North Broadway, Baltimore, Maryland, USA
| | - Edward G Lakatta
- Laboratory of Cardiovascular Science, Biomedical Research Center, Intramural Research Program, National Institute on Aging, NIH, Baltimore, Maryland, USA
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Pugsley MK, Gallacher DJ, Towart R, Authier S, Curtis MJ. Methods in safety pharmacology in focus. J Pharmacol Toxicol Methods 2008; 58:69-71. [PMID: 18707009 DOI: 10.1016/j.vascn.2008.07.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2008] [Accepted: 07/12/2008] [Indexed: 11/29/2022]
Abstract
This focused issue of the Journal of Pharmacological and Toxicological Methods is the fifth to highlight Methods in Safety Pharmacology and includes a number of articles from the 7th Annual Safety Pharmacology Society (SPS) meeting that was held in Edinburgh, Scotland, September 19-21, 2007. However, unlike issues of the past, in which content predominantly focused on cardiovascular issues (specifically QT interval prolongation, QT-HR correction methods and validation of non-clinical cardiovascular models) this issue is composed of a number of non-cardiovascular methods papers and review articles. Of particular interest to readers will be articles related to CNS studies, in particular neurobehavioral assessments in non-human primates and the effects of drugs in juvenile and adult rats (an article that may be relevant in light of recent EU/US pediatric legislation). While cardiovascular function may not dominate there are several useful methodological papers including an assessment of cardiovascular sensitivity of drugs in conscious and anesthetized non-human primates, and a mathematical model (fractal analysis) applied to canine heartbeat dynamics. A first for the journal is a paper by Vargas et al., (2008-this issue) in which members of the SPS formed a working group in order to assess and review safety pharmacology testing of biological therapeutic agents (specifically monoclonal antibodies, mAbs). The group provides recommendations that will likely shape regulatory strategy and discussions in the yet to be fully discussed area of biological safety testing. In the tradition of obtaining a perspective on industry safety pharmacology program practices Lindgren et al., (2008-this issue) provide the results of a recent SPS survey that examines ICH S7A and S7B trends, aspects of early 'frontloading' safety studies, abuse and dependence liability and Contract Research Organization (CRO) tests/assays used in safety assessment of core battery and supplementary organ systems. In keeping with the translation track aspect of the 2007 meeting is an overview of the Distinguished Service Award lecture to Dr. T. Hammond that discusses many aspects of safety pharmacology including its evolution, impact, value and translation of non-clinical findings to humans. Finally, perspectives are presented on the use of the zebrafish as an early safety pharmacology-screening assay.
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Affiliation(s)
- Michael K Pugsley
- Johnson & Johnson PR&D, Global Preclinical Toxicology/Pathology, Raritan, NJ 00869, USA.
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