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Sammito S, Thielmann B, Böckelmann I. Update: factors influencing heart rate variability-a narrative review. Front Physiol 2024; 15:1430458. [PMID: 39165281 PMCID: PMC11333334 DOI: 10.3389/fphys.2024.1430458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 07/22/2024] [Indexed: 08/22/2024] Open
Abstract
Objective Heart rate variability (HRV) is an important non-invasive marker for the assessment of an organism's autonomic physiological regulatory pathways. Lower HRV has been shown to correlate with increased mortality. HRV is influenced by various factors or diseases. The aim of this narrative review is to describe the current state of knowledge on factors influencing HRV and their significance for interpretation. Methods The narrative review only included reviews, meta-analyses, and cohort studies which were published until 2021. HRV confounders were grouped into four categories (non-influenceable physiological factors, diseases, influenceable lifestyle factors and external factors). Results The review found that HRV was decreased not only in non-influenceable physiological factors (e.g., age, gender, ethnicity) but also in connection with various number of acute and chronic diseases (e.g., psychiatric diseases, myocardial infarction, heart failure), influenceable lifestyle factors (e.g., alcohol abuse, overweight, physical activity), and external factors (e.g., heat, noise, shift work, harmful- and hazardous substances). Conclusion In order to improve the quality of HRV studies and to ensure accurate interpretation, it is recommended that confounders be taken into account in future diagnostic measurements or measurements in the workplace (e.g., as part of health promotion measures) in order to counteract data bias.
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Affiliation(s)
- Stefan Sammito
- German Air Force Centre of Aerospace Medicine, Cologne, Germany
- Occupational Medicine, Faculty of Medicine, Otto von Guericke University, Magdeburg, Germany
| | - Beatrice Thielmann
- Occupational Medicine, Faculty of Medicine, Otto von Guericke University, Magdeburg, Germany
| | - Irina Böckelmann
- Occupational Medicine, Faculty of Medicine, Otto von Guericke University, Magdeburg, Germany
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Jhen RN, Wang PC, Chang YM, Kao JL, Wu ECH, Shiao CC. The Clinical Significance and Application of Heart Rate Variability in Dialysis Patients: A Narrative Review. Biomedicines 2024; 12:1547. [PMID: 39062120 PMCID: PMC11275182 DOI: 10.3390/biomedicines12071547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 06/24/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024] Open
Abstract
Autonomic nervous system (ANS) dysfunction is prevalent in end-stage kidney disease (ESKD) patients, carrying significant risks for morbidity and mortality. Heart rate variability (HRV) is a simple and non-invasive method to evaluate ANS functions and predict prognoses in specific patient populations. Since there is a lack of a clear understanding of the clinical significance of HRV in predicting prognoses in ESKD patients, an updated review on this topic is urgently warranted. The clinical significance of HRV in dialysis patients includes its associations with metabolic syndrome, nutritional status, intradialytic hypotension, vascular access failure, major adverse cardiovascular events, and mortality. These findings underscore the essential role of the autonomic reserve, which might denote the elevation of ANS activity as a response to external stimulus. Patients with a higher level of sympathetic activity at the resting stage, but who are unable to adequately elevate their sympathetic activity under stress might be susceptible to a worse outcome in critical circumstances. Further applications of HRV include HRV biofeedback, risk classification, and real-time HRV monitoring. Overall, HRV is an optimal tool for predicting prognoses in dialysis patients. Further study is encouraged in order to gain a clearer understanding of the clinical significance and application of HRV, and thereby enhance the care of ESKD patients.
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Affiliation(s)
- Rong-Na Jhen
- Division of Nephrology, Department of Internal Medicine, Camillian Saint Mary’s Hospital Luodong, No. 160, Zhongzheng S. Rd., Luodong Township, Yilan County 265, Taiwan; (R.-N.J.); (Y.-M.C.); (J.-L.K.)
| | - Ping-Chen Wang
- Department of Medical Research and Education, Camillian Saint Mary’s Hospital Luodong, No. 160, Zhongzheng S. Rd., Luodong Township, Yilan County 265, Taiwan;
| | - Yu-Ming Chang
- Division of Nephrology, Department of Internal Medicine, Camillian Saint Mary’s Hospital Luodong, No. 160, Zhongzheng S. Rd., Luodong Township, Yilan County 265, Taiwan; (R.-N.J.); (Y.-M.C.); (J.-L.K.)
| | - Jsun-Liang Kao
- Division of Nephrology, Department of Internal Medicine, Camillian Saint Mary’s Hospital Luodong, No. 160, Zhongzheng S. Rd., Luodong Township, Yilan County 265, Taiwan; (R.-N.J.); (Y.-M.C.); (J.-L.K.)
| | - Eric Chien-Hwa Wu
- Division of Nephrology, Department of Internal Medicine, Camillian Saint Mary’s Hospital Jiaoxi, No. 129, Sec. 4, Jiaoxi Rd., Jiaoxi Township, Yilan County 262, Taiwan;
| | - Chih-Chung Shiao
- Division of Nephrology, Department of Internal Medicine, Camillian Saint Mary’s Hospital Luodong, No. 160, Zhongzheng S. Rd., Luodong Township, Yilan County 265, Taiwan; (R.-N.J.); (Y.-M.C.); (J.-L.K.)
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Sammito S, Thielmann B, Klussmann A, Deußen A, Braumann KM, Böckelmann I. Guideline for the application of heart rate and heart rate variability in occupational medicine and occupational health science. J Occup Med Toxicol 2024; 19:15. [PMID: 38741189 DOI: 10.1186/s12995-024-00414-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 04/24/2024] [Indexed: 05/16/2024] Open
Abstract
This updated guideline replaces the "Guideline for the application of heart rate and heart rate variability in occupational medicine and occupational health science" first published in 2014. Based on the older version of the guideline, the authors have reviewed and evaluated the findings on the use of heart rate (HR) and heart rate variability (HRV) that have been published in the meantime and incorporated them into a new version of this guideline.This guideline was developed for application in clinical practice and research purposes in the fields of occupational medicine and occupational science to complement evaluation procedures with respect to exposure and risk assessment at the workplace by the use of objective physiological workload indicators. In addition, HRV is also suitable for assessing the state of health and for monitoring the progress of illnesses and preventive medical measures. It gives an overview of factors influencing the regulation of the HR and HRV at rest and during work. It further illustrates methods for measuring and analyzing these parameters under standardized laboratory and real workload conditions, areas of application as well as the quality control procedures to be followed during the recording and evaluation of HR and HRV.
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Affiliation(s)
- Stefan Sammito
- Department of Occupational Medicine, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.
- German Air Force Centre of Aerospace Medicine, Experimental Aerospace Medicine Research, Flughafenstraße 1, Cologne, 51147, Germany.
| | - Beatrice Thielmann
- Department of Occupational Medicine, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Andre Klussmann
- Competence Centre Health (CCG), Department Health Sciences, University of Applied Sciences (HAW) Hamburg, Hamburg, Germany
| | - Andreas Deußen
- Department of Physiology, Medical Faculty, TU Dresden, Dresden, Germany
| | | | - Irina Böckelmann
- Department of Occupational Medicine, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
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Pichot V, Corbier C, Chouchou F, Barthélémy JC, Roche F. CVRanalysis: a free software for analyzing cardiac, vascular and respiratory interactions. Front Physiol 2024; 14:1224440. [PMID: 38250656 PMCID: PMC10797906 DOI: 10.3389/fphys.2023.1224440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 12/13/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction: Simultaneous beat-to-beat R-R intervals, blood pressure and respiration signals are routinely analyzed for the evaluation of autonomic cardiovascular and cardiorespiratory regulations for research or clinical purposes. The more recognized analyses are i) heart rate variability and cardiac coherence, which provides an evaluation of autonomic nervous system activity and more particularly parasympathetic and sympathetic autonomic arms; ii) blood pressure variability which is mainly linked to sympathetic modulation and myogenic vascular function; iii) baroreflex sensitivity; iv) time-frequency analyses to identify fast modifications of autonomic activity; and more recently, v) time and frequency domain Granger causality analyses were introduced for assessing bidirectional causal links between each considered signal, thus allowing the scrutiny of many physiological regulatory mechanisms. Methods: These analyses are commonly applied in various populations and conditions, including mortality and morbidity predictions, cardiac and respiratory rehabilitation, training and overtraining, diabetes, autonomic status of newborns, anesthesia, or neurophysiological studies. Results: We developed CVRanalysis, a free software to analyze cardiac, vascular and respiratory interactions, with a friendly graphical interface designed to meet laboratory requirements. The main strength of CVRanalysis resides in its wide scope of applications: recordings can arise from beat-to-beat preprocessed data (R-R, systolic, diastolic and mean blood pressure, respiration) or raw data (ECG, continuous blood pressure and respiratory waveforms). It has several tools for beat detection and correction, as well as setting of specific areas or events. In addition to the wide possibility of analyses cited above, the interface is also designed for easy study of large cohorts, including batch mode signal processing to avoid running repetitive operations. Results are displayed as figures or saved in text files that are easily employable in statistical softwares. Conclusion: CVRanalysis is freely available at this website: anslabtools.univ-st-etienne.fr. It has been developed using MATLAB® and works on Windows 64-bit operating systems. The software is a standalone application avoiding to have programming skills and to install MATLAB. The aims of this paper area are to describe the physiological, research and clinical contexts of CVRanalysis, to introduce the methodological approach of the different techniques used, and to show an overview of the software with the aid of screenshots.
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Affiliation(s)
- Vincent Pichot
- SAINBIOSE U1059, Inserm, Saint-Etienne Jean-Monnet University, Clinical Physiology and Exercise, CHU of Saint-Etienne, Saint-Etienne, France
| | - Christophe Corbier
- LASPI EA3059, Saint-Etienne Jean-Monnet University, Roanne Technology University Institute, Roanne, France
| | - Florian Chouchou
- IRISSE EA4075, UFR SHE, University of La Réunion, Le Tampon, France
| | - Jean-Claude Barthélémy
- SAINBIOSE U1059, Inserm, Saint-Etienne Jean-Monnet University, Clinical Physiology and Exercise, CHU of Saint-Etienne, Saint-Etienne, France
| | - Frédéric Roche
- SAINBIOSE U1059, Inserm, Saint-Etienne Jean-Monnet University, Clinical Physiology and Exercise, CHU of Saint-Etienne, Saint-Etienne, France
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Lozano WM, Ortiz-Guzmán JE, Arias-Mutis O, Bizy A, Genovés P, Such-Miquel L, Alberola A, Chorro FJ, Zarzoso M, Calvo CJ. Modifications of long-term heart rate variability produced in an experimental model of diet-induced metabolic syndrome. Interface Focus 2023; 13:20230030. [PMID: 38106920 PMCID: PMC10722215 DOI: 10.1098/rsfs.2023.0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 10/13/2023] [Indexed: 12/19/2023] Open
Abstract
Metabolic syndrome (MetS) has been linked to a higher prevalence of cardiac arrhythmias, the most frequent being atrial fibrillation, but the mechanisms are not well understood. One possible underlying mechanism may be an abnormal modulation of autonomic nervous system activity, which can be quantified by analysing heart rate variability (HRV). Our aim was to investigate the modifications of long-term HRV in an experimental model of diet-induced MetS to identify the early changes in HRV and the link between autonomic dysregulation and MetS components. NZW rabbits were randomly assigned to control (n = 10) or MetS (n = 10) groups, fed 28 weeks with high-fat, high-sucrose diet. 24-hour recordings were used to analyse HRV at week 28 using time-domain, frequency-domain and nonlinear analyses. Time-domain analysis showed a decrease in RR interval and triangular index (Ti). In the frequency domain, we found a decrease in the low frequency band. Nonlinear analyses showed a decrease in DFA-α1 and DFA-α2 (detrended fluctuations analysis) and maximum multiscale entropy. The strongest association between HRV parameters and markers of MetS was found between Ti and mean arterial pressure, and Ti and left atrial diameter, which could point towards the initial changes induced by the autonomic imbalance in MetS.
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Affiliation(s)
- W. M. Lozano
- Department of Physiology, Universitat de València, Valencia, Comunitat Valenciana, Spain
- School of Physiotherapy, Universidad Industrial de Santander, Bucaramanga, Santander, Colombia
| | - J. E. Ortiz-Guzmán
- Department of Physiology, Universitat de València, Valencia, Comunitat Valenciana, Spain
| | - O. Arias-Mutis
- Department of Biomedical Sciences, CEU Cardenal Herrera, Moncada, Valenciana, Spain
- Health Research Institute - Instituto de Investigación Sanitaria del Hospital Clínico Universitario de Valencia (INCLIVA), Valencia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBER-CV), Madrid, Spain
| | - A. Bizy
- Department of Biomedical Sciences, CEU Cardenal Herrera, Moncada, Valenciana, Spain
| | - P. Genovés
- Department of Physiology, Universitat de València, Valencia, Comunitat Valenciana, Spain
| | - L. Such-Miquel
- Department of Physiotherapy, Universitat de València, València, Spain
| | - A. Alberola
- Department of Physiology, Universitat de València, Valencia, Comunitat Valenciana, Spain
| | - F. J. Chorro
- Health Research Institute - Instituto de Investigación Sanitaria del Hospital Clínico Universitario de Valencia (INCLIVA), Valencia, Spain
- Department of Medicine, Universitat de València, València, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBER-CV), Madrid, Spain
| | - M. Zarzoso
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBER-CV), Madrid, Spain
- Department of Physiotherapy, Universitat de València, València, Spain
| | - C. J. Calvo
- Department of Physiology, Universitat de València, Valencia, Comunitat Valenciana, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBER-CV), Madrid, Spain
- CSIC-UPV, Instrumentation for Molecular Imaging Technologies Research Institute (I3M), Universitat Politècnica de València, València, Spain
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Ortiz-Guzmán JE, Mollà-Casanova S, Serra-Añó P, Arias-Mutis ÓJ, Calvo C, Bizy A, Alberola A, Chorro FJ, Zarzoso M. Short-Term Heart Rate Variability in Metabolic Syndrome: A Systematic Review and Meta-Analysis. J Clin Med 2023; 12:6051. [PMID: 37762990 PMCID: PMC10532399 DOI: 10.3390/jcm12186051] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/05/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Our aim was to determine the differences in short-term heart rate variability (HRV) between patients with metabolic syndrome (MS) and healthy controls. METHODS We searched electronic databases for primary works with short-term HRV recordings (≤30 min) that made comparisons between individuals with MS versus healthy controls. This systematic review and meta-analysis (MA) was performed according to PRISMA guidelines and registered at PROSPERO (CRD42022358975). RESULTS Twenty-eight articles were included in the qualitative synthesis and nineteen met the criteria for the MA. Patients with MS showed decreased SDNN (-0.36 [-0.44, -0.28], p < 0.001), rMSSD (-7.59 [-9.98, -5.19], p < 0.001), HF (-0.36 [-0.51, -0.20], p < 0.00001) and LF (-0.24 [-0.38, -0.1], p = 0.001). In subsequent subanalyses, we found a decrease in SDNN (-0.99 (-1.45, -0.52], p < 0.001), rMSSD (-10.18 [-16.85, -3.52], p < 0.01) and HF (-1.04 [-1.97, -0.1] p < 0.05) in women. In men, only LF showed a significant lower value (-0.26 [-0.5, -0.02], p < 0.05). We could not perform MA for non-linear variables. CONCLUSIONS Patients with MS showed changes in time-domain analyses, with lower values in SDNN and rMSSD. Regarding frequency-domain analyses, MS patients showed a decrease in HF and LF When sex was used as a grouping variable, the MA was only possible in one of both sexes (men or women) in rMSSD and LF/HF. Lastly, when data for both men and women were available, subanalyses showed a different behavior compared to mixed analyses for SDNN, HF and LF, which might point towards a different impact of MS in men and women.
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Affiliation(s)
- Johan E. Ortiz-Guzmán
- Department of Physiology, Universitat de València, Av. Blasco Ibáñez 15, 46010 Valencia, Spain; (J.E.O.-G.); (C.C.); (A.A.)
| | - Sara Mollà-Casanova
- Department of Physiotherapy, Universitat de València, Street Gascó Oliag 5, 46010 Valencia, Spain; (S.M.-C.); (P.S.-A.)
- UBIC Research Group, Department of Physiotherapy, Universitat de València, Street Gascó Oliag 5, 46010 Valencia, Spain
| | - Pilar Serra-Añó
- Department of Physiotherapy, Universitat de València, Street Gascó Oliag 5, 46010 Valencia, Spain; (S.M.-C.); (P.S.-A.)
- UBIC Research Group, Department of Physiotherapy, Universitat de València, Street Gascó Oliag 5, 46010 Valencia, Spain
| | - Óscar J. Arias-Mutis
- CEU Cardenal Herrera, Department of Biomedical Sciences, Street Lluís Vives 1, 46115 Valencia, Spain; (Ó.J.A.-M.); (A.B.)
- Health Research Institute—Instituto de Investigación Sanitaria del Hospital Clínico Universitario de Valencia (INCLIVA) Valencia, Street Menéndez y Pelayo 4, 46010 Valencia, Spain;
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBER-CV) Madrid, Av. Monforte de Lemos, 3–5, Pavilion 11, Floor 0, 28029 Madrid, Spain
| | - Conrado Calvo
- Department of Physiology, Universitat de València, Av. Blasco Ibáñez 15, 46010 Valencia, Spain; (J.E.O.-G.); (C.C.); (A.A.)
- CSIC-UPV, Instrumentation for Molecular Imaging Technologies Research Institute (I3M), Universitat Politècnica de València, 46022 Valencia, Spain
| | - Alexandra Bizy
- CEU Cardenal Herrera, Department of Biomedical Sciences, Street Lluís Vives 1, 46115 Valencia, Spain; (Ó.J.A.-M.); (A.B.)
| | - Antonio Alberola
- Department of Physiology, Universitat de València, Av. Blasco Ibáñez 15, 46010 Valencia, Spain; (J.E.O.-G.); (C.C.); (A.A.)
| | - Francisco J. Chorro
- Health Research Institute—Instituto de Investigación Sanitaria del Hospital Clínico Universitario de Valencia (INCLIVA) Valencia, Street Menéndez y Pelayo 4, 46010 Valencia, Spain;
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBER-CV) Madrid, Av. Monforte de Lemos, 3–5, Pavilion 11, Floor 0, 28029 Madrid, Spain
- Department of Medicine, Universitat de València, Av. Blasco Ibáñez 15, 46010 Valencia, Spain
| | - Manuel Zarzoso
- Department of Physiotherapy, Universitat de València, Street Gascó Oliag 5, 46010 Valencia, Spain; (S.M.-C.); (P.S.-A.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBER-CV) Madrid, Av. Monforte de Lemos, 3–5, Pavilion 11, Floor 0, 28029 Madrid, Spain
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Stavres J, Aultman RA, Brandner CF, Newsome TA, Vallecillo-Bustos A, Wise HL, Henderson A, Stanfield D, Mannozzi J, Graybeal AJ. Hemodynamic responses to handgrip and metaboreflex activation are exaggerated in individuals with metabolic syndrome independent of resting blood pressure, waist circumference, and fasting blood glucose. Front Physiol 2023; 14:1212775. [PMID: 37608839 PMCID: PMC10441127 DOI: 10.3389/fphys.2023.1212775] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/27/2023] [Indexed: 08/24/2023] Open
Abstract
Introduction: Prior studies report conflicting evidence regarding exercise pressor and metaboreflex responses in individuals with metabolic syndrome (MetS). Purpose: To test the hypotheses that 1) exercise pressor and metaboreflex responses are exaggerated in MetS and 2) these differences may be explained by elevated resting blood pressure. Methods: Blood pressure and heart rate (HR) were evaluated in 26 participants (13 MetS) during 2 min of handgrip exercise followed by 3 min of post-exercise circulatory occlusion (PECO). Systolic (SBP), diastolic (DBP), and mean arterial pressure (MAP), along with HR and a cumulative blood pressure index (BPI), were compared between groups using independent samples t-tests, and analyses of covariance were used to adjust for differences in resting blood pressure, fasting blood glucose (FBG), and waist circumference (WC). Results: ΔSBP (∼78% and ∼54%), ΔMAP (∼67% and ∼55%), and BPI (∼16% and ∼20%) responses were significantly exaggerated in individuals with MetS during handgrip and PECO, respectively (all p ≤ 0.04). ΔDBP, ΔMAP, and BPI responses during handgrip remained significantly different between groups after independently covarying for resting blood pressure (p < 0.01), and after simultaneously covarying for resting blood pressure, FBG, and WC (p ≤ 0.03). Likewise, peak SBP, DBP, MAP, and BPI responses during PECO remained significantly different between groups after adjusting for resting blood pressure (p ≤ 0.03), with peak SBP, MAP, and BPI response remaining different between groups after adjusting for all three covariates simultaneously (p ≤ 0.04). Conclusion: These data suggest that exercise pressor and metaboreflex responses are significantly exaggerated in MetS independent of differences in resting blood pressure, FBG, or WC.
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Affiliation(s)
- Jon Stavres
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, United States
| | - Ryan A. Aultman
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, United States
| | - Caleb F. Brandner
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, United States
| | - Ta’Quoris A. Newsome
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, United States
| | | | - Havens L. Wise
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, United States
| | - Alex Henderson
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, United States
| | - Diavion Stanfield
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, United States
| | - Joseph Mannozzi
- Department of Physiology, Wayne State University School of Medicine, Detroit, MI, United States
| | - Austin J. Graybeal
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, United States
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8
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Zheng M, Erhardt S, Cao Y, Wang J. Emerging Signaling Regulation of Sinoatrial Node Dysfunction. Curr Cardiol Rep 2023; 25:621-630. [PMID: 37227579 DOI: 10.1007/s11886-023-01885-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/14/2023] [Indexed: 05/26/2023]
Abstract
PURPOSE OF REVIEW The sinoatrial node (SAN), the natural pacemaker of the heart, is responsible for generating electrical impulses and initiating each heartbeat. Sinoatrial node dysfunction (SND) causes various arrhythmias such as sinus arrest, SAN block, and tachycardia/bradycardia syndrome. Unraveling the underlying mechanisms of SND is of paramount importance in the pursuit of developing effective therapeutic strategies for patients with SND. This review provides a concise summary of the most recent progress in the signaling regulation of SND. RECENT FINDINGS Recent studies indicate that SND can be caused by abnormal intercellular and intracellular signaling, various forms of heart failure (HF), and diabetes. These discoveries provide novel insights into the underlying mechanisms SND, advancing our understanding of its pathogenesis. SND can cause severe cardiac arrhythmias associated with syncope and an increased risk of sudden death. In addition to ion channels, the SAN is susceptible to the influence of various signalings including Hippo, AMP-activated protein kinase (AMPK), mechanical force, and natriuretic peptide receptors. New cellular and molecular mechanisms related to SND are also deciphered in systemic diseases such as HF and diabetes. Progress in these studies contributes to the development of potential therapeutics for SND.
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Affiliation(s)
- Mingjie Zheng
- Department of Pediatrics, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, 77030, USA
| | - Shannon Erhardt
- Department of Pediatrics, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, 77030, USA
- MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, The University of Texas, Houston, TX, 77030, USA
| | - Yuhan Cao
- Department of Pediatrics, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, 77030, USA
| | - Jun Wang
- Department of Pediatrics, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, 77030, USA.
- MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, The University of Texas, Houston, TX, 77030, USA.
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9
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Nevels TL, Wirth MD, Ginsberg JP, McLain AC, Burch JB. The role of sleep and heart rate variability in metabolic syndrome: evidence from the Midlife in the United States study. Sleep 2023; 46:zsad013. [PMID: 36727300 PMCID: PMC10171632 DOI: 10.1093/sleep/zsad013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 12/11/2022] [Indexed: 02/03/2023] Open
Abstract
STUDY OBJECTIVES Poor sleep and autonomic dysregulation can both disrupt metabolic processes. This study examined the individual and combined effects of poor sleep and reduced heart rate variability (HRV) on metabolic syndrome among 966 participants in the Midlife in the United States II (MIDUS II) study. METHODS Self-reported sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI). HRV was acquired from 11-minute resting heart rate recordings. Spearman correlations, general linear regression, and logistic regression models were used to examine the study hypotheses. RESULTS Poor sleep quality was associated with metabolic syndrome when global PSQI scores were evaluated as a continuous (odds ratio [OR]: 1.07, 95% confidence interval [CI]: 1.03 to 1.11) or categorical measure (cutoff > 5, OR: 1.58, 95% CI: 1.19 to 2.10), after adjustment for confounding. There also was an association between reduced HRV and metabolic syndrome (ln [HF-HRV] OR: 0.89, 95% CI: 0.80 to 0.99; ln [LF-HRV] OR: 0.82, 95% CI: 0.72 to 0.92; ln [SDRR] OR: 0.59, 95% CI: 0.43 to 0.79; ln [RMSSD] OR: 0.75, 95% CI: 0.60 to 0.94). When the combined effects of poor sleep and low HRV were examined, the association with metabolic syndrome was further strengthened relative to those with normal sleep and HRV. CONCLUSIONS To the best of the author's knowledge, this is the first study to suggest a combined effect of poor sleep and low HRV on the odds of metabolic syndrome.
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Affiliation(s)
- Torrance L Nevels
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Columbia Veterans Affairs Health Care System, Columbia, SC, USA
- U.S. Military Interservice Physician Assistant Program, MEDCoE, Joint Base San Antonio-Fort Sam Houston, TX, USA
| | - Michael D Wirth
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- College of Nursing, University of South Carolina, Columbia, SC, USA
| | - J P Ginsberg
- Department of Pathology, Microbiology, and Immunology, Saybrook University, Pasadena, CA, USA
| | - Alexander C McLain
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - James B Burch
- Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
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10
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Ortiz-Guzmán JE, Mollà-Casanova S, Arias-Mutis ÓJ, Bizy A, Calvo C, Alberola A, Chorro FJ, Zarzoso M. Differences in Long-Term Heart Rate Variability between Subjects with and without Metabolic Syndrome: A Systematic Review and Meta-Analysis. J Cardiovasc Dev Dis 2023; 10:jcdd10050203. [PMID: 37233170 DOI: 10.3390/jcdd10050203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/28/2023] [Accepted: 05/05/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Our aim was to determine the impact that metabolic syndrome (MS) produces in long-term heart rate variability (HRV), quantitatively synthesizing the results of published studies to characterize the cardiac autonomic dysfunction in MS. METHODS We searched electronic databases for original research works with long-term HRV recordings (24 h) that compared people with MS (MS+) versus healthy people as a control group (MS-). This systematic review and meta-analysis (MA) was performed according to PRISMA guidelines and registered at PROSPERO (CRD42022358975). RESULTS A total of 13 articles were included in the qualitative synthesis, and 7 of them met the required criteria to be included in the MA. SDNN (-0.33 [-0.57, 0.09], p = 0.008), LF (-0.32 [-0.41, -0.23], p < 0.00001), VLF (-0.21 [-0.31, -0.10], p = 0.0001) and TP (-0.20 [-0.33, -0.07], p = 0.002) decreased in patients with MS. The rMSSD (p = 0.41), HF (p = 0.06) and LF/HF ratio (p = 0.64) were not modified. CONCLUSIONS In long-term recordings (24 h), SDNN, LF, VLF and TP were consistently decreased in patients with MS. Other parameters that could be included in the quantitative analysis were not modified in MS+ patients (rMSSD, HF, ratio LF/HF). Regarding non-linear analyses, the results are not conclusive due to the low number of datasets found, which prevented us from conducting an MA.
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Affiliation(s)
| | - Sara Mollà-Casanova
- UBIC Research Group, Department of Physiotherapy, Universitat de València, 46010 Valencia, Spain
| | - Óscar J Arias-Mutis
- Department of Biomedical Sciences, CEU Cardenal Herrera, 46115 Valencia, Spain
| | - Alexandra Bizy
- Department of Biomedical Sciences, CEU Cardenal Herrera, 46115 Valencia, Spain
| | - Conrado Calvo
- Department of Physiology, Universitat de València, 46010 Valencia, Spain
| | - Antonio Alberola
- Department of Physiology, Universitat de València, 46010 Valencia, Spain
| | - Francisco J Chorro
- Health Research Institute-Instituto de Investigación Sanitaria del Hospital Clínico Universitario de Valencia (INCLIVA), Department of Medicine, Universitat de València, 46010 Valencia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBER-CV), 28029 Madrid, Spain
| | - Manuel Zarzoso
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBER-CV), 28029 Madrid, Spain
- Department of Physiotherapy, Universitat de València, 46010 Valencia, Spain
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11
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Chuangchai W, Pothisiri W, Wonghempoom A. Measuring effects of height on the autonomic nervous system in middle-aged adolescents using the very low frequency band of heart rate variability. ERGONOMICS 2023; 66:569-579. [PMID: 35815817 DOI: 10.1080/00140139.2022.2100931] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 07/04/2022] [Indexed: 06/15/2023]
Abstract
Previous studies have revealed the association between falling accidents and stress, measured via heart rate variability (HRV). However, none have studied this association using the very low frequency (VLF) band of HRV in adolescent populations. This study aimed to fill this gap by recruiting 90 adolescents to perform a light physical task at varying heights. Heart rates were used to calculate short-term HRV. The results showed a positive correlation between VLF bands and parasympathetic indices and a negative correlation with sympathetic indices, demonstrating the balancing effects of the autonomic modulation associated with height. The lowest VLF bands were obtained as 79.25 ms2 at 10 m (p < 0.001) and 62.87 ms2 at 9 m (p < 0.001) for the experienced and non-experienced male groups, respectively, and 28.09 ms2 at 6 m (p = 0.001) for the female group. The results also suggested the need for a relatively lower height restriction for female adolescents than for males.Practitioner summary: Increased working heights can cause stress, which leads to falling accidents. The very low frequency band was shown to be associated with parasympathetic and sympathetic indices. Furthermore, the results suggested that the height limit necessary for providing a safe working environment may be lower for female adolescents than for males.Abbreviations: HRV: heart rate variability; VLF: very low frequency; ms2: absolute power; ANS: autonomic nervous system; PNS: parasympathetic nervous system; SNS: sympathetic nervous system; RR: intervals between two successive peaks of R waves; RMSSD: root mean square of successive RR interval differences; SD1: Poincaré plot index of standard deviation 1; SD2: Poincaré plot index of standard deviation 2; HF: high frequency; LF: low frequency; BMI: body mass index; ECG: electrocardiography; HR: heart rate; FFT: fast Fourier transformation; IQR: interquartile range; r: non-parametric partial correlation coefficient; η2: eta-squared; EM: experienced males; NM: non-experienced males; NF: non-experienced females; EEG: electroencephalogram.
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Affiliation(s)
| | - Wiraporn Pothisiri
- College of Population Studies, Chulalongkorn University, Bangkok, Thailand
| | - Apiruck Wonghempoom
- School of Science, Exercise and Sport Science Program, University of Phayao, Phayao, Thailand
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12
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The Role of Heart Rate Variability (HRV) in Different Hypertensive Syndromes. Diagnostics (Basel) 2023; 13:diagnostics13040785. [PMID: 36832273 PMCID: PMC9955360 DOI: 10.3390/diagnostics13040785] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/05/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
Cardiac innervation by the parasympathetic nervous system (PNS) and the sympathetic nervous system (SNS) modulates the heart rate (HR) (chronotropic activity) and the contraction of the cardiac muscle (inotropic activity). The peripheral vasculature is controlled only by the SNS, which is responsible for peripheral vascular resistance. This also mediates the baroreceptor reflex (BR), which in turn mediates blood pressure (BP). Hypertension (HTN) and the autonomic nervous system (ANS) are closely related, such that derangements can lead to vasomotor impairments and several comorbidities, including obesity, hypertension, resistant hypertension, and chronic kidney disease. Autonomic dysfunction is also associated with functional and structural changes in target organs (heart, brain, kidneys, and blood vessels), increasing cardiovascular risk. Heart rate variability (HRV) is a method of assessing cardiac autonomic modulation. This tool has been used for clinical evaluation and to address the effect of therapeutic interventions. The present review aims (a) to approach the heart rate (HR) as a CV risk factor in hypertensive patients; (b) to analyze the heart rate variability (HRV) as a "tool" to estimate the individual risk stratum for Pre-HTN (P-HTN), Controlled-HTN (C-HTN), Resistant and Refractory HTN (R-HTN and Rf-HTN, respectively), and hypertensive patients with chronic renal disease (HTN+CKD).
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13
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Kumar EC, Gaur GS, Yerrabelli D, Sahoo J, Vairappan B, Goud AC. Association between metabolic syndrome components and cardiac autonomic modulation in southern Indian adults with pre-metabolic syndrome: hyperglycemia is the major contributing factor. THE KOREAN JOURNAL OF PHYSIOLOGY & PHARMACOLOGY : OFFICIAL JOURNAL OF THE KOREAN PHYSIOLOGICAL SOCIETY AND THE KOREAN SOCIETY OF PHARMACOLOGY 2023; 27:49-59. [PMID: 36575933 PMCID: PMC9806641 DOI: 10.4196/kjpp.2023.27.1.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 09/28/2022] [Accepted: 10/13/2022] [Indexed: 12/29/2022]
Abstract
Metabolic syndrome (MetS) involves multi-factorial conditions linked to an elevated risk of type 2 diabetes mellitus and cardiovascular disease. Pre-metabolic syndrome (pre-MetS) possesses two MetS components but does not meet the MetS diagnostic criteria. Although cardiac autonomic derangements are evident in MetS, there is little information on their status in pre-MetS subjects. In this study, we sought to examine cardiac autonomic functions in pre-MetS and to determine which MetS component is more responsible for impaired cardiac autonomic functions. A total of 182 subjects were recruited and divided into healthy controls (n=89) and pre-MetS subjects (n=93) based on inclusion and exclusion criteria. We performed biochemical profiles on fasting blood samples to detect pre-MetS. Using standardized protocols, we evaluated anthropometric data, body composition, baroreflex sensitivity (BRS), heart rate variability (HRV), and autonomic function tests (AFTs). We further examined these parameters in pre-MetS subjects for each MetS component. Compared to healthy controls, we observed a significant cardiac autonomic dysfunction (CAD) through reduced BRS, lower overall HRV, and altered AFT parameters in pre-MetS subjects, accompanied by markedly varied anthropometric, clinical and biochemical parameters. Furthermore, all examined BRS, HRV, and AFT parameters exhibited an abnormal trend and significant correlation toward hyperglycemia. This study demonstrates CAD in pre-MetS subjects with reduced BRS, lower overall HRV, and altered AFT parameters. Hyperglycemia was considered an independent determinant of alterations in all the examined BRS, HRV, and AFT parameters. Thus, hyperglycemia may contribute to CAD in pre-MetS subjects before progressing to MetS.
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Affiliation(s)
- Endukuru Chiranjeevi Kumar
- Department of Physiology, Sri Siddhartha Institute of Medical Sciences & Research Centre, Bangalore 562123, India
| | - Girwar Singh Gaur
- Department of Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605008, India,Correspondence Girwar Singh Gaur, E-mail:
| | - Dhanalakshmi Yerrabelli
- Department of Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605008, India
| | - Jayaprakash Sahoo
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605008, India
| | - Balasubramaniyan Vairappan
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605008, India
| | - Alladi Charanraj Goud
- Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605008, India
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14
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Effects of prolonged working hours on heart rate variability in internal medicine physicians. Sci Rep 2022; 12:18563. [PMID: 36329110 PMCID: PMC9633695 DOI: 10.1038/s41598-022-23538-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022] Open
Abstract
Prior studies have utilized heart rate variability (HRV) as the assessment tools for psychological and physiological stress during 24-h shift. However, data regarding effects of prolonged working hours > 24 h on HRV are limited. We aimed to compare between pre- and post-call HRV among physicians who worked 24 plus 8 h. The study included 60 physicians in the internal medicine training. All subjects underwent Holter ECG monitoring for HRV assessment. We compared between HRV of an 8-h regular workday (8am to 4 pm) before on-call duty (pre-call HRV) and an 8-h workday after 24-h on-call duty (post-call HRV). The mean age was 26 ± 2.5 years. Mean total sleep time during on-call duty was 238.9 ± 88.3 min. In overall population, the time-domain and frequency-domain HRV parameters were not different between pre- and post-call day. However, the physicians reported their sleep time in the 1st quartile (< 180 min) had significant increase in SDNN, pNN50, high frequency (HF), and decrease in low/high frequency ratio (LF/HF). In contrast, the physicians reported their sleep time in the 4th quartile (> 307.5 min) had significant decrease in pNN50, LF, HF, and increase in heart rate. Multiple linear regression revealed total sleep time as an independent factor associated with pre- and post-call HRV alterations. More sleep during on call (> 5 h) was associated with HRV pattern suggesting both increased sympathetic activity and reduced parasympathetic activity, while less sleep (< 3 h) during on call was associated with post-call parasympathetic rebound HRV pattern.
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15
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Seipäjärvi S, Tuomola A, Juurakko J, Rottensteiner M, Rissanen APE, Kurkela J, Kujala U, Laukkanen J, Wikgren J. Measuring psychosocial stress with heart rate variability-based methods in different health and age groups. Physiol Meas 2022; 43. [PMID: 35483348 DOI: 10.1088/1361-6579/ac6b7c] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 04/28/2022] [Indexed: 11/12/2022]
Abstract
Autonomic nervous system function and thereby bodily stress and recovery reactions may be assessed by wearable devices measuring heart rate (HR) and its variability (HRV). So far, the validity of HRV-based stress assessments has been mainly studied in healthy populations. In this study, we determined how psychosocial stress affects physiological and psychological stress responses in both young (18-30 yrs) and middle-aged (45-64 yrs) healthy individuals as well as in patients with arterial hypertension and/or either prior evidence of prediabetes or type 2 diabetes. We also studied how an HRV-based stress index (Relax-Stress Intensity, RSI) relates to perceived stress (PS) and cortisol (CRT) responses during psychosocial stress. APPROACH A total of 197 participants were divided into three groups: 1) healthy young (HY, N=63), 2) healthy middle-aged (HM, N=61) and 3) patients with cardiometabolic risk factors (Pts, N=73, 32-65 yrs). The participants underwent a group version of Trier Social Stress Test (TSST-G). HR, HRV (quantified as root mean square of successive differences of R-R intervals, RMSSD), RSI, PS, and salivary CRT were measured regularly during TSST-G and a subsequent recovery period. MAIN RESULTS All groups showed significant stress reactions during TSST-G as indicated by significant responses of HR, RMSSD, RSI, PS, and salivary CRT. Between-group differences were also observed in all measures. Correlation and regression analyses implied RSI being the strongest predictor of CRT response, while HR was more closely associated with PS. SIGNIFICANCE The HRV-based stress index mirrors responses of CRT, which is an independent marker for physiological stress, around TSST-G. Thus, the HRV-based stress index may be used to quantify physiological responses to psychosocial stress across various health and age groups.
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Affiliation(s)
- Santtu Seipäjärvi
- Department of Psychology, University of Jyväskylä, Kärki, Mattilanniemi, Jyvaskyla, 40100, FINLAND
| | - Anniina Tuomola
- Department of Psychology, University of Jyväskylä, Kärki, Mattilanniemi, Jyvaskyla, Keski-Suomi, 40100, FINLAND
| | - Joona Juurakko
- Department of Psychology, University of Jyväskylä, Kärki, Mattilanniemi, Jyvaskyla, Keski-Suomi, 40100, FINLAND
| | - Mirva Rottensteiner
- Central Finland Health Care District, Keskussairaalantie 19, Jyvaskyla, Central Finland, 40620, FINLAND
| | - Antti-Pekka E Rissanen
- Central Finland Health Care District, Keskussairaalantie, Jyvaskyla, Central Finland, 40620, FINLAND
| | - Jari Kurkela
- Department of Psychology, University of Jyväskylä, Kärki, Mattilanniemi, Jyvaskyla, Keski-Suomi, 40100, FINLAND
| | - Urho Kujala
- University of Jyväskylä Faculty of Sports and Health Sciences, Rautpohjankatu 8, Jyvaskyla, Keski-Suomi, 40700, FINLAND
| | - Jari Laukkanen
- Central Finland Health Care District, Keskussairaalantie, Jyvaskyla, Central Finland, 40620, FINLAND
| | - Jan Wikgren
- Department of Psychology, University of Jyväskylä, Kärki, Mattilanniemi, Jyvaskyla, Keski-Suomi, 40100, FINLAND
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16
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Stress Management Intervention for Leaders Increases Nighttime SDANN: Results from a Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073841. [PMID: 35409525 PMCID: PMC8997599 DOI: 10.3390/ijerph19073841] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/20/2022] [Accepted: 03/21/2022] [Indexed: 02/01/2023]
Abstract
Stress management interventions aim to reduce the disease risk that is heightened by work stress. Possible pathways of risk reduction include improvements in the autonomous nervous system, which is indexed by the measurement of heart rate variability (HRV). A randomized controlled trial on improving stress management skills at work was conducted to investigate the effects of intervention on HRV. A total of 174 lower management employees were randomized into either the waiting list control group (CG) or the intervention group (IG) receiving a 2-day stress management training program and another half-day booster after four and six months. In the trial, 24 h HRV was measured at baseline and after 12 months. Heart rate (HR), root mean square of successive differences (RMSSD), standard deviation of normal-to-normal intervals (SDNN), and standard deviation of the average of normal-to-normal intervals (SDANN) were calculated for 24 h and nighttime periods. Age-adjusted multilevel mixed effects linear regressions with unstructured covariance, time as a random coefficient, and time × group interaction with the according likelihood-ratio tests were calculated. The linear mixed-effect regression models showed neither group effects between IG and CG at baseline nor time effects between baseline and follow-up for SDANN (24 h), SDNN (24 h and nighttime), RMSSD (24 h and nighttime), and HR (24 h and nighttime). Nighttime SDANN significantly improved in the intervention group (z = 2.04, p = 0.041) compared to the control group. The objective stress axis measures (SDANN) showed successful stress reduction due to the training. Nighttime SDANN was strongly associated with minimum HR. Though the effects were small and only visible at night, it is highly remarkable that 3 days of intervention achieved a measurable effect considering that stress is only one of many factors that can influence HR and HRV.
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17
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Nam EC, Chun KJ, Won JY, Kim JW, Lee WH. The differences between daytime and night-time heart rate variability may usefully predict the apnea-hypopnea index in patients with obstructive sleep apnea. J Clin Sleep Med 2022; 18:1557-1563. [PMID: 35088710 DOI: 10.5664/jcsm.9912] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES The association between daytime/night-time heart rate variability (HRV) and the apnea-hypopnea index (AHI) remains unclear. We sought a relationship between AHI and the daytime-to night-time HRV ratio as measured by 24-h Holter monitoring in patients with obstructive sleep apnea (OSA). METHODS We prospectively enrolled 66 patients who visited our sleep clinic complaining of habitual snoring or sleep apnea. All underwent 24-h Holter monitoring (to measure HRV) combined with full-night polysomnography (PSG). Sixty-two met our enrolment criteria. We evaluated the associations between HRV frequency domains and the PSG indices. We also considered medical histories and anthropometric data. RESULTS The night-time very low frequency (VLF), low frequency (LF), and high frequency (HF) HRVs were significantly higher than the daytime values. On correlation analysis, the day/night VLF (r = 0.550, p < 0.001), LF (r = 0.556, p < 0.001), and HF (r = 0.303, p = 0.017) HRVs were significantly related to the AHI. Of the day/night HRV ratios, the VLF (p for trend = 0.003) and LF (p for trend = 0.013) ratios decreased significantly by OSA severity. Multivariable analysis showed that the day/night VLF (β = 16.387, p < 0.001) and day/night LF (β = 25.248, p < 0.001) were independently (and significantly) associated with the AHI. CONCLUSIONS Twenty-four-hour Holter monitoring may usefully predict AHI. The day/night VLF and day/night LF ratios tended to decrease by OSA severity and were independently associated with the AHI.
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Affiliation(s)
- Eui-Cheol Nam
- Departments of Otolaryngology, Kangwon National University Hospital, College of Medicine, Kangwon National University, Chuncheon, Korea
| | - Kwang Jin Chun
- Division of Cardiology, Department of Internal Medicine, Kangwon National University Hospital, College of Medicine, Kangwon National University, Chuncheon, Korea
| | - Jun Yeon Won
- Departments of Otolaryngology, Kangwon National University Hospital, College of Medicine, Kangwon National University, Chuncheon, Korea
| | - Jeong-Whun Kim
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Woo Hyun Lee
- Departments of Otolaryngology, Kangwon National University Hospital, College of Medicine, Kangwon National University, Chuncheon, Korea
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18
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Owari G, Kono K, Nishida Y. Association between Depression and Heart Rate Variability in Rehabilitation Ward Patients with Musculoskeletal Dysfunction: A Pilot Study. Prog Rehabil Med 2022; 7:20220029. [PMID: 35765600 PMCID: PMC9167690 DOI: 10.2490/prm.20220029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 05/10/2022] [Indexed: 11/25/2022] Open
Abstract
Objectives: The purpose of this study was to determine the relationship between depression and heart rate variability (HRV) in rehabilitation ward inpatients. Methods: Depression was assessed using the Self-Rating Depression Scale (SDS) in 10 inpatients in a convalescent rehabilitation ward. We also measured R–R intervals during nighttime rest, evaluated HRV by frequency analysis, and confirmed the association between autonomic activity and depression by calculation of Spearman’s rank correlation coefficient. Results: A negative correlation was found between depression and the very low-frequency (VLF) band of HRV (ρ=−0.70, P<0.05). SDS showed no significant correlation with low-frequency (LF) band (ρ=−0.32, P=0.36) or high-frequency (HF) band (ρ=−0.21, P=0.46). Conclusions: The results of this study suggest that the VLF band of HRV may be an effective indicator of autonomic activity in the evaluation of depression. Further studies are needed to verify the usefulness of the VLF band of HRV as an indicator for detecting depression.
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Affiliation(s)
- Go Owari
- Department of Rehabilitation, Inzai General Hospital, Inzai City, Japan
| | - Kenichi Kono
- Department of Physical Therapy, International University of Health and Welfare, Narita City, Japan
| | - Yusuke Nishida
- Department of Physical Therapy, International University of Health and Welfare, Narita City, Japan
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Al Kury LT, Chacar S, Alefishat E, Khraibi AA, Nader M. Structural and Electrical Remodeling of the Sinoatrial Node in Diabetes: New Dimensions and Perspectives. Front Endocrinol (Lausanne) 2022; 13:946313. [PMID: 35872997 PMCID: PMC9302195 DOI: 10.3389/fendo.2022.946313] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 06/14/2022] [Indexed: 11/14/2022] Open
Abstract
The sinoatrial node (SAN) is composed of highly specialized cells that mandate the spontaneous beating of the heart through self-generation of an action potential (AP). Despite this automaticity, the SAN is under the modulation of the autonomic nervous system (ANS). In diabetes mellitus (DM), heart rate variability (HRV) manifests as a hallmark of diabetic cardiomyopathy. This is paralleled by an impaired regulation of the ANS, and by a pathological remodeling of the pacemaker structure and function. The direct effect of diabetes on the molecular signatures underscoring this pathology remains ill-defined. The recent focus on the electrical currents of the SAN in diabetes revealed a repressed firing rate of the AP and an elongation of its tracing, along with conduction abnormalities and contractile failure. These changes are blamed on the decreased expression of ion transporters and cell-cell communication ports at the SAN (i.e., HCN4, calcium and potassium channels, connexins 40, 45, and 46) which further promotes arrhythmias. Molecular analysis crystallized the RGS4 (regulator of potassium currents), mitochondrial thioredoxin-2 (reactive oxygen species; ROS scavenger), and the calcium-dependent calmodulin kinase II (CaMKII) as metabolic culprits of relaying the pathological remodeling of the SAN cells (SANCs) structure and function. A special attention is given to the oxidation of CaMKII and the generation of ROS that induce cell damage and apoptosis of diabetic SANCs. Consequently, the diabetic SAN contains a reduced number of cells with significant infiltration of fibrotic tissues that further delay the conduction of the AP between the SANCs. Failure of a genuine generation of AP and conduction of their derivative waves to the neighboring atrial myocardium may also occur as a result of the anti-diabetic regiment (both acute and/or chronic treatments). All together, these changes pose a challenge in the field of cardiology and call for further investigations to understand the etiology of the structural/functional remodeling of the SANCs in diabetes. Such an understanding may lead to more adequate therapies that can optimize glycemic control and improve health-related outcomes in patients with diabetes.
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Affiliation(s)
- Lina T. Al Kury
- Department of Health Sciences, College of Natural and Health Sciences, Zayed University, Abu Dhabi, United Arab Emirates
- *Correspondence: Lina T. Al Kury, ; Moni Nader,
| | - Stephanie Chacar
- Department of Physiology and Immunology, College of Medicine and Health Sciences, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Eman Alefishat
- Department of Pharmacology, College of Medicine and Health Sciences, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan
- Center for Biotechnology, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Ali A. Khraibi
- Department of Physiology and Immunology, College of Medicine and Health Sciences, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
- Center for Biotechnology, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Moni Nader
- Department of Physiology and Immunology, College of Medicine and Health Sciences, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
- Center for Biotechnology, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
- *Correspondence: Lina T. Al Kury, ; Moni Nader,
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20
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Claiborne A, Alessio H, Slattery E, Hughes M, Barth E, Cox R. Heart Rate Variability Reflects Similar Cardiac Autonomic Function in Explosive and Aerobically Trained Athletes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010669. [PMID: 34682412 PMCID: PMC8535639 DOI: 10.3390/ijerph182010669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 10/05/2021] [Accepted: 10/11/2021] [Indexed: 11/16/2022]
Abstract
Autonomic cardiac function can be indirectly detected non-invasively by measuring the variation in microtiming of heart beats by a method known as heart rate variability (HRV). Aerobic training for sport is associated with reduced risk for some factors associated with cardiovascular diseases (CVD), but effects on autonomic function in different athlete types are less known. To compare cardiac autonomic modulation using a standard protocol and established CVD risk factors in highly trained intercollegiate athletes competing in aerobic, explosive, and cross-trained sports. A total of 176 college athletes were categorized in distinct sports as explosive (EA), aerobic (AA), or cross-trained (mixed) athletes. Eight different HRV measures obtained at rest were compared across training type and five health factors: systolic (SBP), diastolic blood pressure (DBP), body weight (BW), sex, and race. All athletic types shared favorable HRV measures that correlated with low CVD risk factors and indicated normal sympathovagal balance. A significant correlation was reported between DBP and pNN50 (% RR intervals > 50 ms) (β = -0.214, p = 0.011) and between BW and low-frequency (LF) power (β = 0.205, p = 0.006). Caucasian and African American athletes differed significantly (p < 0.05) with respect to four HRV variables: pNN50, HF power, LF power, and LF/HF ratios. Explosive, aerobic and mixed athletes had similar cardiovascular and autonomic HRV results in all eight HRV parameters measured. All athletes reported LF and pNN50 values that were significantly correlated with two CVD risk factors: DBP and BW. Compared with Caucasian teammates, African American athletes demonstrated lower LF/HF and higher pNN50, indicating an even more favorable resting sympathovagal activity and healthy CV function.
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Affiliation(s)
- Alex Claiborne
- Department of Kinesiology, Nutrition and Health, Miami University, Oxford, OH 45056, USA; (A.C.); (E.S.); (E.B.); (R.C.)
| | - Helaine Alessio
- Department of Kinesiology, Nutrition and Health, Miami University, Oxford, OH 45056, USA; (A.C.); (E.S.); (E.B.); (R.C.)
- Correspondence: ; Tel.: +1-513-529-2700
| | - Eric Slattery
- Department of Kinesiology, Nutrition and Health, Miami University, Oxford, OH 45056, USA; (A.C.); (E.S.); (E.B.); (R.C.)
| | - Michael Hughes
- Department of Statistics, Miami University, Oxford, OH 45056, USA;
| | - Edwin Barth
- Department of Kinesiology, Nutrition and Health, Miami University, Oxford, OH 45056, USA; (A.C.); (E.S.); (E.B.); (R.C.)
| | - Ronald Cox
- Department of Kinesiology, Nutrition and Health, Miami University, Oxford, OH 45056, USA; (A.C.); (E.S.); (E.B.); (R.C.)
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21
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Association between Metabolic Syndrome Components and Cardiac Autonomic Modulation among Children and Adolescents: A Systematic Review and Meta-Analysis. BIOLOGY 2021; 10:biology10080699. [PMID: 34439932 PMCID: PMC8389259 DOI: 10.3390/biology10080699] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 07/19/2021] [Accepted: 07/21/2021] [Indexed: 12/18/2022]
Abstract
Simple Summary The clustering of metabolic syndrome (MetS) risk factors is becoming more prevalent in young people (up to the age of 19 years) leading to the development of type 2 diabetes (T2D) and cardiovascular diseases in early adulthood. The impact of MetS risk factors on cardiac autonomic modulation (CAM) or vice versa have been noted to track from childhood to pre-adolescence and adolescence. Understating associations in this age group may help improve the clinical outcomes of the MetS, even when MetS symptoms are not visible. Potential damage from each individual MetS component and the ability to predict early cardiac damage or upcoming cardiovascular events is very important. Therefore, the present systematic review and meta-analysis investigated the associations between CAM and MetS risk factors individually to verify which MetS risk components were significantly correlated with which heart rate variability (HRV) indices before or at the onset of the MetS among young people. The purpose of this review was to outline the importance of potentially screening HRV indices in young people even with only one MetS risk factor, as a pre-indicator for early cardiovascular risk stratification. Cross-sectional studies that examined the relationship of MetS risk factors with HRV indices were searched using four databases including PubMed, the Cochrane clinical trials library, Medline and the Web of Science. Correlation coefficients with 95% confidence intervals (95% CI), and random effects meta-analyses of the association between MetS risk factors with HRV indices were performed. Our results propose that lipid profiles including high density lipoprotein (HDL) and triglycerides (TGs), waist circumference (WC) and blood pressure (BP) are associated with CAM in young people up to the age of 19 years. The use of HRV indices to predict future MetS risk, and relationships with individual risk factors including HDL, BP, WC and TGs, were established. Furthermore, arterial pressure, respiration, stress and physical activity must be taken into consideration for future studies along with CAM related to young people (up to the age of 19 years), and it is recommended to explore further the associations reported here, as CAM is not the only determinant of neurovisceral regulation. Abstract Background: the clustering of metabolic syndrome (MetS) risk factors is becoming more prevalent in children, leading to the development of type 2 diabetes (T2D) and cardiovascular diseases in early adulthood. The impact of MetS risk factors on cardiac autonomic modulation (CAM) or vice versa has been noted to track from childhood to pre-adolescence and adolescence. Understating associations in this age group may help to improve the clinical outcomes of the MetS, even when MetS symptoms are not visible. Potential damage from each individual MetS component and the ability to predict early cardiac damage or upcoming cardiovascular events is very important. Therefore, the present systematic review and meta-analysis investigated the associations between CAM and MetS risk factors individually to verify which of the MetS risk components were significantly correlated with heart rate variability (HRV) indices before or at the onset of the MetS among young people. The purpose of this review was to outline the importance of potentially screening HRV indices in young people even with only one MetS risk factor, as a pre-indicator for early cardiovascular risk stratification. Methods: cross-sectional studies that examined the relationship of MetS risk factors with HRV indices were searched using four databases including PubMed, the Cochrane clinical trials library, Medline and the Web of Science. Correlation coefficients with 95% confidence intervals (95% CI), and random effects meta-analyses of the association between MetS risk factors with HRV indices were performed. Results: out of 14 cross-sectional studies and one case-control study, 8 studies (10 data sets) provided association data for the meta-analysis. Our results indicated significant positive correlations for systolic blood pressure (SBP) (correlation coefficient 0.13 (95%CI: 0.06; 0.19), I2 = 47.26%) and diastolic blood pressure (DBP) (correlation coefficient 0.09 (95%CI: −0.01; 0.18), I2 = 0%) with a Low Frequency/High Frequency ratio (LF/HF). Significant negative correlations for waist circumference (WC) (correlation coefficient −0.12 (95%CI: −0.19; −0.04), I2 = 51.50%), Triglycerides (TGs) (correlation coefficient −0.09 (95%CI: −0.15; −0.02), I2 = 0%) and ≥2 MetS risk factors (correlation coefficient −0.10 (95%CI: −0.16; −0.03), I2 = 0%); with high frequency (HF) were revealed. Significant positive correlations for high density lipoprotein (HDL) (correlation coefficient 0.08 (95%CI: 0.05; 0.11), I2 = 0%) and significant negative correlations of ≥2 MetS risk (correlation coefficient −0.04 (95%CI: −0.12; 0.03), I2 = 0.0%) with low frequency (LF) were revealed. Significant negative correlations for TGs (correlation coefficient −0.09 (95%CI: −0.23; 0.05), I2 = 2.01%) with a mean square root of the sum of differences between mean time between two successive intervals (rMSSD) and significant positive correlation of HDL (correlation coefficient 0.09 (95%CI: −0.01; 0.19), I2 = 0.33%) with standard deviation of the time between two successive intervals (SDNN) were also revealed. An Egger’s test indicated that there was no obvious publication bias for any of the above relationships except for TGs and rMSSD. The significance level stipulated for the meta-analysis was p < 0.05. Conclusions: lipid profiles (HDL and TGs), WC and BP were associated with CAM in young people up to the age of 19 years. The use of HRV indices to predict future MetS risk, and relationships with individual risk factors including HDL, BP, WC and TGs, were established. Future studies related to young people (up to the age of 19 years) are recommended to explore the associations reported here further.
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22
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Guirado T, Metz L, Pereira B, Bergouignan A, Thivel D, Duclos M. Effects of cycling workstation to get tertiary employee moving on their overall health: study protocol for a REMOVE trial. Trials 2021; 22:359. [PMID: 34022938 PMCID: PMC8140559 DOI: 10.1186/s13063-021-05317-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 05/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sedentary behaviour (SB) and low levels of physical activity (PA) are predictors of morbidity and mortality. Tertiary employees spend a considerable amount of their daily time seated and new efficient strategies to both reduce sedentary time and increase physical activity are needed. In that context, the REMOVE study aims at evaluating the health effects of a 24-week cycling desk intervention among office workers. METHODS A prospective, open-label, multicentre, two-arm parallel, randomized controlled trial (RCT) will be conducted in office-sitting desk workers. Office workers (N = 80) who have 0.8 full time equivalent hours (FTE) and 75% of this time in a sitting position will be recruited from tertiary worksites in Clermont-Ferrand, France. Subjects will be randomly assigned to one of the two following interventions: (i) PPM6: performance of two 30 min of cycling desk (using portable pedal exercise machine-PPM) per working day for 6 months or (ii) CTL_PPM3: 3 months with no intervention (control) followed by 3 months during which workers will be asked to complete two 30 min of PPM per working day. At baseline (T0), at 3 months (T1) and at 6 months (T2) after the start of the interventions, primary outcomes; 7-day PA and SB (3D-accelerometers), secondary outcomes; body composition (bioelectrical impedance), physical fitness (aerobic fitness, upper and lower limb strength), metabolic outcomes (fasting blood samples), self-perceived stress, anxiety, quality of life at work and job strain (questionnaires), tertiary outcomes; resting metabolic rate and cycling energy expenditure (indirect calorimetry) and eating behaviours (questionnaires) will be measured. An ergonomic approach based on observations and individual interviews will be used to identify parameters that could determine adherence. DISCUSSION The REMOVE study will be the first RCT to assess the effects of cycling workstations on objectively measured PA and SB during working and non-working hours and on key physiological and psychological health outcomes. This study will provide important information regarding the implementation of such cycling workstations in office workers and on the associated potential health benefits. TRIAL REGISTRATION ClinicalTrials.gov NCT04153214 . Registered on November 2019, version 1.
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Affiliation(s)
- Terry Guirado
- EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), UE3533, Clermont Auvergne University, F-63171 63170 Aubiere CEDEX, 80026, Clermont-Ferrand, BP, France.,Auvergne Research Center for Human Nutrition (CRNH), 63000, Clermont-Ferrand, France.,Department of Sport Medicine and Functional Explorations, Clermont-Ferrand University Hospital, G. Montpied Hospital, Clermont-Ferrand, France.,INRA, UMR 1019, Clermont-Ferrand, France
| | - Lore Metz
- EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), UE3533, Clermont Auvergne University, F-63171 63170 Aubiere CEDEX, 80026, Clermont-Ferrand, BP, France. .,Auvergne Research Center for Human Nutrition (CRNH), 63000, Clermont-Ferrand, France.
| | - Bruno Pereira
- Clermont-Ferrand University Hospital, Biostatistics Unit (DRCI), Clermont-Ferrand, France
| | - Audrey Bergouignan
- Université de Strasbourg, CNRS, IPHC UMR 7178, F-67000, Strasbourg, France.,Division of Endocrinology, Metabolism and Diabetes, Anschutz Health & Wellness Center, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - David Thivel
- EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), UE3533, Clermont Auvergne University, F-63171 63170 Aubiere CEDEX, 80026, Clermont-Ferrand, BP, France.,Auvergne Research Center for Human Nutrition (CRNH), 63000, Clermont-Ferrand, France
| | - Martine Duclos
- Auvergne Research Center for Human Nutrition (CRNH), 63000, Clermont-Ferrand, France.,Department of Sport Medicine and Functional Explorations, Clermont-Ferrand University Hospital, G. Montpied Hospital, Clermont-Ferrand, France.,INRA, UMR 1019, Clermont-Ferrand, France
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23
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Kim SW, Jung WS, Kim JW, Nam SS, Park HY. Aerobic Continuous and Interval Training under Hypoxia Enhances Endurance Exercise Performance with Hemodynamic and Autonomic Nervous System Function in Amateur Male Swimmers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083944. [PMID: 33918616 PMCID: PMC8068973 DOI: 10.3390/ijerph18083944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/07/2021] [Accepted: 04/07/2021] [Indexed: 12/03/2022]
Abstract
Hypoxic training is often performed by competitive swimmers to enhance their performance in normoxia. However, the beneficial effects of aerobic continuous and interval training under hypoxia on hemodynamic function, autonomic nervous system (ANS) function, and endurance exercise performance remain controversial. Here we investigated whether six weeks of aerobic continuous and interval training under hypoxia can improve hematological parameters, hemodynamic function, ANS function, and endurance exercise performance versus normoxia in amateur male swimmers. Twenty amateur male swimmers were equally assigned to the hypoxic training group or normoxic training group and evaluated before and after six weeks of training. Aerobic continuous and interval training in the hypoxia showed a more significantly improved hemodynamic function (heart rate, −653.4 vs. −353.7 beats/30 min; oxygen uptake, −62.45 vs. −16.22 mL/kg/30 min; stroke volume index, 197.66 vs. 52.32 mL/30 min) during submaximal exercise, ANS function (root mean square of successive differences, 10.15 vs. 3.32 ms; total power, 0.72 vs. 0.20 ms2; low-frequency/high-frequency ratio, −0.173 vs. 0.054), and endurance exercise performance (maximal oxygen uptake, 5.57 vs. 2.26 mL/kg/min; 400-m time trial record, −20.41 vs. −7.91 s) than in the normoxia. These indicate that hypoxic training composed of aerobic continuous and interval exercise improves the endurance exercise performance of amateur male swimmers with better hemodynamic function and ANS function.
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Affiliation(s)
- Sung-Woo Kim
- Physical Activity and Performance Institute, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Korea; (S.-W.K.); (W.-S.J.)
| | - Won-Sang Jung
- Physical Activity and Performance Institute, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Korea; (S.-W.K.); (W.-S.J.)
| | - Jeong-Weon Kim
- Graduate School of Professional Therapy, Gachon University, 1332 Seongnam-daero, Sujeong-gu, Seongnam-si 13306, Korea;
| | - Sang-Seok Nam
- Taekwondo Research Institute of Kukkiwon, 32 Teheran7gil, Gangnam-gu, Seoul 06130, Korea;
| | - Hun-Young Park
- Physical Activity and Performance Institute, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Korea; (S.-W.K.); (W.-S.J.)
- Department of Sports Medicine and Science, Graduate School, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Korea
- Correspondence: ; Tel.: +82-2-2049-6035
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24
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Yamada A, Inoue Y, Shiraishi Y, Seki T, Yambe T. Preliminary Study of an Objective Evaluation Method for Pulse Diagnosis using Radial Artery Pulse Measurement Device. ADVANCED BIOMEDICAL ENGINEERING 2021. [DOI: 10.14326/abe.10.113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Akihiro Yamada
- Institute of Development, Aging and Cancer, Tohoku University
| | - Yusuke Inoue
- Advanced Medical Engineering Research Center, Asahikawa Medical University
| | | | - Takashi Seki
- Integrative Medicine Center, Fuji Toranomon Orthopedic Hospital
| | - Tomoyuki Yambe
- Institute of Development, Aging and Cancer, Tohoku University
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25
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Plaza-Florido A, Alcantara JMA, Amaro-Gahete FJ, Sacha J, Ortega FB. Cardiovascular Risk Factors and Heart Rate Variability: Impact of the Level of the Threshold-Based Artefact Correction Used to Process the Heart Rate Variability Signal. J Med Syst 2020; 45:2. [PMID: 33237459 DOI: 10.1007/s10916-020-01673-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 11/05/2020] [Indexed: 01/08/2023]
Abstract
The associations between cardiovascular disease (CVD) risk factors and heart rate variability (HRV) have shown some inconsistencies. To examine the impact of the different Kubios threshold-based artefact correction levels on the associations between different CVD risk factors and a heart rate variability (HRV) score in three independent human cohorts. A total of 107 children with overweight/obesity, 132 young adults, and 73 middle-aged adults were included in the present study. Waist circumference and the HRV score were negatively associated using the medium and the strong Kubios filters in children (β = -0.22 and - 0.24, P = 0.03 and 0.02 respectively) and the very strong Kubios filter in middle-aged adults (β = -0.39, P = 0.01). HDL-C was positively associated with the HRV score across Kubios filters (β ranged from 0.21 to 0.31, all P ≤ 0.04), while triglycerides were negatively associated with the HRV score using the very strong Kubios filter in young adults (β = -0.22, P = 0.02). Glucose metabolism markers (glucose, insulin, and HOMA index) were inversely associated with the HRV score across Kubios filters in young adults (β ranged from -0.29 to -0.22; all P ≤ 0.03). Importantly, most of these associations disappeared after including HR as a covariate, especially in children and young adults. It should be mandatory to report the Kubios filter used and to include the HR (as a confounder factor) to allow the comparability of the results across different studies.
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Affiliation(s)
- Abel Plaza-Florido
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Carretera de Alfacar, s/n CP, 18071, Granada, Spain.
| | - J M A Alcantara
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Carretera de Alfacar, s/n CP, 18071, Granada, Spain
| | - Francisco J Amaro-Gahete
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Carretera de Alfacar, s/n CP, 18071, Granada, Spain.,EFFECTS-262 Research Group, Department of Physiology, School of Medicine, University of Granada, 18071, Granada, Spain
| | - Jerzy Sacha
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland.,Department of Cardiology, University Hospital in Opole, University of Opole, Opole, Poland
| | - Francisco B Ortega
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Carretera de Alfacar, s/n CP, 18071, Granada, Spain
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26
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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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27
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Lozano WM, Calvo CJ, Arias-Mutis OJ, Díaz A, Such-Miquel L, Zhao J, Alberola A, Chorro FJ, Zarzoso M. Diet-Induced Metabolic Syndrome Reduced Heart Rate Variability and Increased Irregularity and Complexity of Short-Term RR Time Series in Rabbits. Animals (Basel) 2019; 9:ani9080572. [PMID: 31426570 PMCID: PMC6719107 DOI: 10.3390/ani9080572] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 08/11/2019] [Accepted: 08/16/2019] [Indexed: 12/27/2022] Open
Abstract
Simple Summary In recent years, obesity and metabolic syndrome (MetS) have become more prevalent, owing to increased unhealthy habits and sedentary lifestyles becoming public health problems. Both conditions are linked with a higher prevalence of sudden cardiac death (SCD), but the exact mechanisms are not known. An autonomic nervous system imbalance can produce atrial and ventricular arrhythmias, which cause SCD, and this can be quantified by analyzing heart rate variability (HRV). We investigated HRV using time-domain, frequency-domain and nonlinear analyses during the development of MetS in rabbits and found HRV modifications that could be associated with the higher prevalence of SCD in this pathological condition. Abstract Metabolic syndrome (MetS) has been linked to a higher prevalence of sudden cardiac death (SCD), but the mechanisms are not well understood. One possible underlying mechanism may be an abnormal modulation of autonomic activity, which can be quantified by analyzing heart rate variability (HRV). Our aim was to investigate the modifications of short-term HRV in an experimental rabbit model during the time-course of MetS development. NZW rabbits were randomly assigned to a control (n = 10) or a MetS group (n = 13), fed 28 weeks with control or high-fat, high-sucrose diets. After anesthesia, a 15-min ECG recording was acquired before diet administration and at weeks 14 and 28. We analyzed short RR time series using time-domain, frequency-domain and nonlinear analyses. A mixed-model factorial ANOVA was used for statistical analysis. Time-domain analysis showed a 52.4% decrease in the standard deviation of heart rate in animals from the MetS group at week 28, but no changes in the rest of parameters. In the frequency domain, we found a 9.7% decrease in the very low frequency and a 380.0% increase of the low frequency bands in MetS animals at week 28, whereas high frequency remained unchanged. Nonlinear analyses showed increased complexity and irregularity of the RR time series in MetS animals.
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Affiliation(s)
- Wilson M Lozano
- Department of Physiology, Universitat de València, 46010 Valencia, Spain
| | - Conrado J Calvo
- Department of Physiology, Universitat de València, 46010 Valencia, Spain
- Centro de Investigación Biomédica en red (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Oscar J Arias-Mutis
- Department of Physiology, Universitat de València, 46010 Valencia, Spain
- Centro de Investigación Biomédica en red (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Ana Díaz
- Unidad Central de Investigación de Medicina (UCIM), Universitat de València, 46010 Valencia, Spain
| | - Luis Such-Miquel
- Department of Physioterapy, Universitat de València, 46010 Valencia, Spain
| | - Jichao Zhao
- Auckland Bioengineering Institute, The Univeristy of Auckland, 1010 Auckland, New Zealand
| | - Antonio Alberola
- Department of Physiology, Universitat de València, 46010 Valencia, Spain
| | - Francisco J Chorro
- Centro de Investigación Biomédica en red (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Cardiology, Hospital Clínico Universitario, 46010 Valencia, Spain
| | - Manuel Zarzoso
- Department of Physioterapy, Universitat de València, 46010 Valencia, Spain.
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Hansen CS, Færch K, Jørgensen ME, Malik M, Witte DR, Brunner EJ, Tabák AG, Kivimäki M, Vistisen D. Heart Rate, Autonomic Function, and Future Changes in Glucose Metabolism in Individuals Without Diabetes: The Whitehall II Cohort Study. Diabetes Care 2019; 42:867-874. [PMID: 30940642 PMCID: PMC6905499 DOI: 10.2337/dc18-1838] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 01/22/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Autonomic nervous system dysfunction is associated with impaired glucose metabolism, but the temporality of this association remains unclear in individuals without diabetes. We investigated the association of autonomic function with 5-year changes in glucose metabolism in individuals without diabetes. RESEARCH DESIGN AND METHODS Analyses were based on 9,000 person-examinations for 3,631 participants without diabetes in the Whitehall II cohort. Measures of autonomic function included 5-min resting heart rate and six heart rate variability (HRV) indices. Associations between baseline autonomic function measures and 5-year changes in fasting and 2-h plasma glucose, serum insulin concentrations, insulin sensitivity (insulin sensitivity index [ISI0-120] and HOMA of insulin sensitivity), and β-cell function (HOMA of β-cell function) were estimated in models adjusting for age, sex, ethnicity, metabolic factors, and medication. RESULTS A 10-bpm higher resting heart rate was associated with 5-year changes in fasting and 2-h insulin and ISI0-120 of 3.3% change (95% CI 1.8; 4.8), P < 0.001; 3.3% change (1.3; 5.3), P = 0.001; and -1.4% change (-2.4; -0.3), P = 0.009, respectively. In models adjusted for age, sex, and ethnicity, higher baseline values of several HRV indices were associated with a 5-year decrease in fasting and 2-h insulin and ISI0-120. However, significance was lost by full adjustment. A majority of HRV indices exhibited a trend toward higher values being associated with lower insulin levels and higher insulin sensitivity. CONCLUSIONS Higher resting heart rate in individuals without diabetes is associated with future unfavorable changes in insulin levels and insulin sensitivity. Associations may be mediated via autonomic function; however, results are inconclusive. Resting heart rate may be a risk marker for future pathophysiological changes in glucose metabolism.
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Affiliation(s)
| | | | - Marit Eika Jørgensen
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
- National Institute of Public Health, Southern Denmark University, Odense, Denmark
| | - Marek Malik
- National Heart and Lung Institute, Imperial College, London, U.K
| | - Daniel R Witte
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Danish Diabetes Academy, Odense, Denmark
| | - Eric J Brunner
- Department of Epidemiology and Public Health, University College London, London, U.K
| | - Adam G Tabák
- Department of Epidemiology and Public Health, University College London, London, U.K
- Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London, U.K
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29
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Calvo CJ, Lozano WM, Arias-Mutis ÓJ, Such-Miquel L, Such L, Genovés P, Guill A, Millet J, Chorro FJ, Alberola A, Pandit SV, Zarzoso M. Modifications of short-term intrinsic pacemaker variability in diet-induced metabolic syndrome: a study on isolated rabbit heart. J Physiol Biochem 2019; 75:173-183. [PMID: 30887428 DOI: 10.1007/s13105-019-00667-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 02/07/2019] [Indexed: 01/09/2023]
Abstract
Metabolic syndrome (MetS) describes a condition associated with multiple diseases concomitantly such as diabetes, hypertension, obesity, and dyslipidemia. It has been linked with higher prevalence of cardiovascular disease, atrial fibrillation, and sudden cardiac death. One of the underlying mechanisms could be altered automaticity, which would reflect modifications of sinus node activity. These phenomena can be evaluated analyzing the components of heart rate variability (HRV). Our aim was to examine the modifications of sinus node variability in an isolated heart model of diet-induced obesity and MetS. Male NZW rabbits were randomly assigned to high-fat (HF, n = 8), control (HF-C, n = 7), high-fat, high-sucrose (HFHS, n = 9), and control (HFHS-C, n = 9) groups, fed with their respective diets during 18/28 weeks. After euthanasia, their hearts were isolated in a Langendorff system. We recorded 10-15 min of spontaneous activity. Short RR time series were analyzed, and standard HRV parameters were determined. One-way ANOVA, Kruskal-Wallis test, and bivariate correlation were used for statistical analysis (p < 0.05). We did find an increase in the complexity and irregularity of intrinsic pacemaker activity as shown by modifications of approximate entropy, sample entropy, minimum multiscale entropy, and complexity index in HFHS animals. Even though no differences were found in standard time and frequency-domain analyses, spectral heterogeneity increased in HFHS group. Animal weight and glucose intolerance were highly correlated with the modifications of intrinsic pacemaker variability. Finally, modifications of intrinsic HRV seemed to be reliant on the number of components of MetS present, given that only HFHS group showed significant changes towards an increased complexity and irregularity of intrinsic pacemaker variability.
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Affiliation(s)
- Conrado J Calvo
- Department of Physiology, Universitat de València, Valencia, Spain.,CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
| | - Wilson M Lozano
- Department of Physiology, Universitat de València, Valencia, Spain
| | - Óscar J Arias-Mutis
- Department of Physiology, Universitat de València, Valencia, Spain.,CIBERCV, Instituto de Salud Carlos III, Madrid, Spain.,INCLIVA, Valencia, Spain
| | - Luis Such-Miquel
- Department of Physiotherapy, Universitat de València, Valencia, Spain
| | - Luis Such
- Department of Physiology, Universitat de València, Valencia, Spain
| | - Patricia Genovés
- Department of Physiology, Universitat de València, Valencia, Spain.,CIBERCV, Instituto de Salud Carlos III, Madrid, Spain.,INCLIVA, Valencia, Spain
| | - Antonio Guill
- ITACA Institute, Universidad Politécnica de Valencia, Valencia, Spain
| | - José Millet
- ITACA Institute, Universidad Politécnica de Valencia, Valencia, Spain
| | - Francisco J Chorro
- CIBERCV, Instituto de Salud Carlos III, Madrid, Spain.,INCLIVA, Valencia, Spain
| | - Antonio Alberola
- Department of Physiology, Universitat de València, Valencia, Spain
| | - Sandeep V Pandit
- Center for Arrhythmia Research, University of Michigan, Ann Abor, MI, USA
| | - Manuel Zarzoso
- Department of Physiotherapy, Universitat de València, Valencia, Spain.
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30
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Macagnan FE, Feoli AMP, Russomano T. Acute Physical Effort Increases Sympathovagal Balance Responses to Autonomic Stimulation in Metabolic Syndrome. Metab Syndr Relat Disord 2018; 17:67-74. [PMID: 30325696 DOI: 10.1089/met.2018.0065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND There is little evidence of how metabolic syndrome (MS) affects sympathovagal balance responses to acute physical effort (APE) and autonomic stimulation (AS). This study aimed to evaluate the heart rate variability (HRV) responses to the combined APE and AS challenges. METHODS Fourteen subjects (8 men; 49.15 ± 8.67 years) divided into two groups: 7 healthy volunteers [control group (CG)] and 7 patients with MS. Sympathovagal balance [low frequency (LF)/high frequency (HF) ratio] was accessed by HRV through the beat-to-beat heart rate (HR) electrocardiogram. Other variables analyzed were as follows: HR, RR-interval variance (VAR/ms2), LF and HF normalized units (un). The APE consisted of a 30-min walk at 65%-75% of the age-predicted maximal HR. The AS was achieved by changing from the supine to standing position (activity orthostatic position). RESULTS At rest, all HRV variables differ with on MS, but after APE and AS LF (nu) and HF (nu) become similar to the CG. However, the LF/HF ratio responses to the AS were significantly different after APE, but only in the MS (CG rest: 367% ± 59% vs. recovery 495% ± 116%, P > 0.05; MS rest: 316% ± 88% vs. recovery: 665% ± 165%; P = 0.045). Comparing the difference between AS in rest and recovery (ΔAS = rest - recovery), the LF/HF ratio was notably higher in the MS group (CG: 94% ± 29% vs. MS: 415% ± 76%; P < 0.0001). CONCLUSIONS The APE and AS induced by body posture changes activated a clear distinction in sympathovagal balance response in MS.
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Affiliation(s)
- Fabrício Edler Macagnan
- 1 Graduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Ana Maria Pandolfo Feoli
- 2 Psychology Graduate Program, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Thais Russomano
- 3 Centre of Human and Applied Physiological Sciences, Department of Physiology, School of Basic and Medical Biosciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
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31
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Berger C, Casagranda L, Pichot V, Trombert-Paviot B, Faure-Conter C, Freycon C, Isfan F, Guichard I, Durieu I, Garcin A, Roche F, Patural H. Dysautonomia in Childhood Cancer Survivors: A Widely Underestimated Risk. J Adolesc Young Adult Oncol 2018; 8:9-17. [PMID: 30136876 DOI: 10.1089/jayao.2018.0021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Survival rate of childhood cancers is now reaching 80% overall. However, early or late complications related to surgery, chemotherapy, and radiotherapy remain at a high rate and greatly increase the risk of late mortality. The objective of this study is to assess the autonomic nervous system (ANS) activity, measured through heart rate variability indices in childhood cancer survivors compared with healthy controls. METHODS This prospective study included 51 long-term childhood cancer survivors diagnosed before 15 years of age between 1987 and 1992 and controlled for age and sex with healthy volunteers. RESULTS We observed a significant increase in spontaneous heart rate (beats per minute) (67 ± 10 vs. 60 ± 10, p = 0.001), and all the studied parameters showed a significantly altered ANS activity in cases compared with healthy controls. In both groups, the main cofactors of dysautonomia (tobacco, drugs, cannabis, estro-progestative pills, alcohol, limited physical activity) were analyzed without any significant difference. The effect of cancer treatments received was not analyzed due to the small number of participants. CONCLUSION The results showed a significant ANS dysfunction in childhood cancer survivors compared with healthy controls and suggested the value of autonomic screening to underscore and possibly quantify the effect of the cancer treatments in a larger cohort. This evaluation could lead to the recommendation to increase physical activity, the most efficient way known to improve ANS activity, as already shown in other pathologies (breast cancer).
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Affiliation(s)
- Claire Berger
- 1 Department of Pediatric Hematology and Oncology Unit, University Hospital of Saint-Etienne, Saint-Etienne, France.,2 Childhood Cancer Registry of the Rhône-Alpes Region, University of Saint-Etienne, Saint-Etienne, France.,3 Department of Public Health and Medical Informatics, University of Saint-Etienne, Saint-Etienne, France.,4 Host Research Team EA4607 SNA-EPIS (Autonomic Nervous System, Epidemiology, Physiology, Exercise, and Health), Jean Monnet University of Saint-Etienne, PRES (Education and Research Cluster) Lyon, Saint-Etienne, France
| | - Léonie Casagranda
- 1 Department of Pediatric Hematology and Oncology Unit, University Hospital of Saint-Etienne, Saint-Etienne, France.,2 Childhood Cancer Registry of the Rhône-Alpes Region, University of Saint-Etienne, Saint-Etienne, France.,3 Department of Public Health and Medical Informatics, University of Saint-Etienne, Saint-Etienne, France.,4 Host Research Team EA4607 SNA-EPIS (Autonomic Nervous System, Epidemiology, Physiology, Exercise, and Health), Jean Monnet University of Saint-Etienne, PRES (Education and Research Cluster) Lyon, Saint-Etienne, France
| | - Vincent Pichot
- 4 Host Research Team EA4607 SNA-EPIS (Autonomic Nervous System, Epidemiology, Physiology, Exercise, and Health), Jean Monnet University of Saint-Etienne, PRES (Education and Research Cluster) Lyon, Saint-Etienne, France
| | - Béatrice Trombert-Paviot
- 2 Childhood Cancer Registry of the Rhône-Alpes Region, University of Saint-Etienne, Saint-Etienne, France.,3 Department of Public Health and Medical Informatics, University of Saint-Etienne, Saint-Etienne, France.,4 Host Research Team EA4607 SNA-EPIS (Autonomic Nervous System, Epidemiology, Physiology, Exercise, and Health), Jean Monnet University of Saint-Etienne, PRES (Education and Research Cluster) Lyon, Saint-Etienne, France
| | | | - Claire Freycon
- 6 Department of Pediatric Hematology and Oncology Unit, University Hospital of Grenoble, Grenoble, France
| | - Florentina Isfan
- 7 Department of Pediatric Hematology and Oncology Unit, University Hospital Estaing Clermont-Ferrand, Clermont-Ferrand, France
| | - Isabelle Guichard
- 8 Department of Internal Medicine Unit, University Hospital, Saint-Etienne, France
| | - Isabelle Durieu
- 9 Department of Internal Medicine and Vascular Pathology Unit, University Hospital of Lyon Sud, Pierre-Bénite, France
| | - Arnauld Garcin
- 4 Host Research Team EA4607 SNA-EPIS (Autonomic Nervous System, Epidemiology, Physiology, Exercise, and Health), Jean Monnet University of Saint-Etienne, PRES (Education and Research Cluster) Lyon, Saint-Etienne, France.,10 Department of Research and University Hospital, Saint-Etienne Cedex, France
| | - Fréderic Roche
- 4 Host Research Team EA4607 SNA-EPIS (Autonomic Nervous System, Epidemiology, Physiology, Exercise, and Health), Jean Monnet University of Saint-Etienne, PRES (Education and Research Cluster) Lyon, Saint-Etienne, France
| | - Hugues Patural
- 4 Host Research Team EA4607 SNA-EPIS (Autonomic Nervous System, Epidemiology, Physiology, Exercise, and Health), Jean Monnet University of Saint-Etienne, PRES (Education and Research Cluster) Lyon, Saint-Etienne, France.,11 Department of Pediatrics, University Hospital, Saint-Etienne Cedex, France
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32
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Usui H, Nishida Y. The very low-frequency band of heart rate variability represents the slow recovery component after a mental stress task. PLoS One 2017; 12:e0182611. [PMID: 28806776 PMCID: PMC5555691 DOI: 10.1371/journal.pone.0182611] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 07/23/2017] [Indexed: 11/24/2022] Open
Abstract
The very low-frequency (VLF) band of heart rate variability (HRV) has different characteristics compared with other HRV components. Here we investigated differences in HRV changes after a mental stress task. After the task, the high-frequency (HF) band and ratio of high- to low-frequency bands (LF/HF) immediately returned to baseline. We evaluated the characteristics of VLF band changes after a mental stress task. We hypothesized that the VLF band decreases during the Stroop color word task and there would be a delayed recovery for 2 h after the task (i.e., the VLF change would exhibit a “slow recovery”). Nineteen healthy, young subjects were instructed to rest for 10 min, followed by a Stroop color word task for 20 min. After the task, the subjects were instructed to rest for 120 min. For all subjects, R-R interval data were collected; analysis was performed for VLF, HF, and LF/HF ratio. HRV during the rest time and each 15-min interval of the recovery time were compared. An analysis of the covariance was performed to adjust for the HF band and LF/HF ratio as confounding variables of the VLF component. HF and VLF bands significantly decreased and the LF/HF ratio significantly increased during the task compared with those during rest time. During recovery, the VLF band was significantly decreased compared with the rest time. After the task, the HF band and LF/HF ratio immediately returned to baseline and were not significantly different from the resting values. After adjusting for HF and LF/HF ratio, the VLF band had significantly decreased compared with that during rest. The VLF band is the “slow recovery” component and the HF band and LF/HF ratio are the “quick recovery” components of HRV. This VLF characteristic may clarify the unexplained association of the VLF band in cardiovascular disease prevention.
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Affiliation(s)
- Harunobu Usui
- Department of Rehabilitation, AICHI Medical College, Kiyosu City, Aichi, Japan
- * E-mail:
| | - Yusuke Nishida
- Department of Physical Therapy, International University in Health and Welfare, Narita City, Chiba, Japan
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33
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Consolim-Colombo FM, Sangaleti CT, Costa FO, Morais TL, Lopes HF, Motta JM, Irigoyen MC, Bortoloto LA, Rochitte CE, Harris YT, Satapathy SK, Olofsson PS, Akerman M, Chavan SS, MacKay M, Barnaby DP, Lesser ML, Roth J, Tracey KJ, Pavlov VA. Galantamine alleviates inflammation and insulin resistance in patients with metabolic syndrome in a randomized trial. JCI Insight 2017; 2:93340. [PMID: 28724799 DOI: 10.1172/jci.insight.93340] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 06/06/2017] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is an obesity-driven condition of pandemic proportions that increases the risk of type 2 diabetes and cardiovascular disease. Pathophysiological mechanisms are poorly understood, though inflammation has been implicated in MetS pathogenesis. The aim of this study was to assess the effects of galantamine, a centrally acting acetylcholinesterase inhibitor with antiinflammatory properties, on markers of inflammation implicated in insulin resistance and cardiovascular risk, and other metabolic and cardiovascular indices in subjects with MetS. METHODS In this randomized, double-blind, placebo-controlled trial, subjects with MetS (30 per group) received oral galantamine 8 mg daily for 4 weeks, followed by 16 mg daily for 8 weeks or placebo. The primary outcome was inflammation assessed through plasma levels of cytokines and adipokines associated with MetS. Secondary endpoints included body weight, fat tissue depots, plasma glucose, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), cholesterol (total, HDL, LDL), triglycerides, BP, heart rate, and heart rate variability (HRV). RESULTS Galantamine resulted in lower plasma levels of proinflammatory molecules TNF (-2.57 pg/ml [95% CI -4.96 to -0.19]; P = 0.035) and leptin (-12.02 ng/ml [95% CI -17.71 to -6.33]; P < 0.0001), and higher levels of the antiinflammatory molecules adiponectin (2.71 μg/ml [95% CI 1.93 to 3.49]; P < 0.0001) and IL-10 (1.32 pg/ml, [95% CI 0.29 to 2.38]; P = 0.002) as compared with placebo. Galantamine also significantly lowered plasma insulin and HOMA-IR values, and altered HRV. CONCLUSION Low-dose galantamine alleviates inflammation and insulin resistance in MetS subjects. These findings support further study of galantamine in MetS therapy. TRIAL REGISTRATION ClinicalTrials.gov, number NCT02283242. FUNDING Fundação de Amparo a Pesquisa do Estado de São Paulo (FAPESP) and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil, and the NIH.
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Affiliation(s)
- Fernanda M Consolim-Colombo
- University of Sao Paulo, Hypertension Unit, Sao Paulo, Brazil.,Nove de Julho University (UNINOVE), PPG, Sao Paulo, Brazil
| | - Carine T Sangaleti
- University of Sao Paulo, Hypertension Unit, Sao Paulo, Brazil.,Midwestern State University (UNICENTRO), Paraná, Brazil
| | | | | | - Heno F Lopes
- University of Sao Paulo, Hypertension Unit, Sao Paulo, Brazil.,Nove de Julho University (UNINOVE), PPG, Sao Paulo, Brazil
| | | | | | | | | | - Yael Tobi Harris
- Hofstra Northwell School of Medicine at Hofstra University, Division of Endocrinology, Diabetes and Metabolism, Hempstead, New York, USA
| | - Sanjaya K Satapathy
- Methodist University Hospital, University of Tennessee Health Sciences Center, Memphis, Tennessee, USA
| | - Peder S Olofsson
- Center for Biomedical Science, and.,Center for Bioelectronic Medicine, Department of Medicine, Center for Molecular Medicine, Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | | | - Sangeeta S Chavan
- Center for Biomedical Science, and.,Center for Bioelectronic Medicine, The Feinstein Institute for Medical Research, Northwell Health, Manhasset, New York, USA
| | - Meggan MacKay
- Center for Autoimmune & Musculoskeletal Disease, The Feinstein Institute for Medical Research, Northwell Health, Manhasset, New York, USA
| | - Douglas P Barnaby
- Department of Emergency Medicine of Albert Einstein College of Medicine, Bronx, New York, USA
| | | | - Jesse Roth
- Laboratory of Diabetes and Diabetes-related Research, The Feinstein Institute for Medical Research, Northwell Health, Manhasset, New York, USA
| | - Kevin J Tracey
- Center for Biomedical Science, and.,Center for Bioelectronic Medicine, The Feinstein Institute for Medical Research, Northwell Health, Manhasset, New York, USA
| | - Valentin A Pavlov
- Center for Biomedical Science, and.,Center for Bioelectronic Medicine, The Feinstein Institute for Medical Research, Northwell Health, Manhasset, New York, USA
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Feriani DJ, Coelho HJ, Scapini KB, de Moraes OA, Mostarda C, Ruberti OM, Uchida MC, Caperuto ÉC, Irigoyen MC, Rodrigues B. Effects of inspiratory muscle exercise in the pulmonary function, autonomic modulation, and hemodynamic variables in older women with metabolic syndrome. J Exerc Rehabil 2017; 13:218-226. [PMID: 28503537 PMCID: PMC5412498 DOI: 10.12965/jer.1734896.448] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 03/15/2017] [Indexed: 12/22/2022] Open
Abstract
The aim of the present study was to investigate the effects of inspiratory muscle exercise (IME) on metabolic and hemodynamic parameters, cardiac autonomic modulation and respiratory function of older women with metabolic syndrome (MS). For this, sixteen older women with MS and 12 aged-matched controls participated of the present study. Two days before and 2 days after the main experiment, fasting blood samples (i.e., total cholesterol, triglycerides and blood glucose), cardiac autonomic modulation (i.e., heart rate variability), and respiratory muscle function were obtained and evaluated. The sessions of physical exercise was based on a IME, which was performed during 7 days. Each session of IME was performed during 20 min, at 30% of maximal static inspiratory pressure. In the results, MS group presented higher levels of triglycerides, blood glucose, and systolic blood pressure when compared to control group. IME was not able to change these variables. However, although MS group showed impaired respiratory muscle strength and function, as well as cardiac autonomic modulation, IME was able to improve these parameters. Thus, the data showed that seven days of IME are capable to improve respiratory function and cardiac autonomic modulation of older women with MS. These results indicate that IME can be a profitable therapy to counteracting the clinical markers of MS, once repeated sessions of acute IME can cause chronical alterations on respiratory function and cardiac autonomic modulation.
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Affiliation(s)
- Daniele Jardim Feriani
- Faculty of Physical Education, University of Campinas (UNICAMP), Campinas, Brazil.,Human Movement Laboratory, Sao Judas Tadeu University (USJT), São Paulo, Brazil
| | - Hélio José Coelho
- Faculty of Physical Education, University of Campinas (UNICAMP), Campinas, Brazil
| | - Kátia Bilhar Scapini
- Hypertension Unit, Heart Institute (InCor), Medical School of University of Sao Paulo, São Paulo, Brazil
| | | | | | | | - Marco Carlos Uchida
- Faculty of Physical Education, University of Campinas (UNICAMP), Campinas, Brazil
| | | | - Maria Cláudia Irigoyen
- Hypertension Unit, Heart Institute (InCor), Medical School of University of Sao Paulo, São Paulo, Brazil
| | - Bruno Rodrigues
- Faculty of Physical Education, University of Campinas (UNICAMP), Campinas, Brazil
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35
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Abstract
Objective: Polycystic ovary syndrome (PCOS) is an endocrine disease closely related to several risk factors of cardiovascular disease. Obese women with PCOS show altered autonomic modulation. The results of studies investigating cardiac autonomic functions of normal-weight women with PCOS are conflicting. The aim of the study was to assess the reactivity of cardiac sympathovagal balance in normal-weight women with PCOS by heart rate variability analysis. Methods: We examined the heart rate variability in 60 normal-weight women with PCOS and compared them with that in 60 age-matched healthy women having a similar metabolic profile. Time and frequency domain parameters of heart rate variability were analyzed based on 5-min-long continuous electrocardiography recordings for the following 3 periods: (1) during rest in supine position, (2) during controlled breathing, and (3) during isometric handgrip exercise. Results: Time and frequency domain parameters of heart rate variability for the 3 periods assessed were similar in the two groups. Although modified Ferriman–Gallwey score and serum testosterone and luteinizing hormone levels were significantly higher in women with PCOS, homeostatic model assessment-insulin resistance (HOMA-IR) was not different the between the PCOS and control groups. There were no significant correlations between serum testosterone levels and heart rate variability parameters among the study population. Conclusion: The findings of this study suggest that the reactivity of cardiac sympathovagal balance is not altered in normal-weight women with PCOS having a normal HOMA-IR.
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36
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Boudet G, Walther G, Courteix D, Obert P, Lesourd B, Pereira B, Chapier R, Vinet A, Chamoux A, Naughton G, Poirier P, Dutheil F. Paradoxical dissociation between heart rate and heart rate variability following different modalities of exercise in individuals with metabolic syndrome: The RESOLVE study. Eur J Prev Cardiol 2016; 24:281-296. [PMID: 27856807 DOI: 10.1177/2047487316679523] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Aims To analyse the effects of different modalities of exercise training on heart rate variability (HRV) in individuals with metabolic syndrome (MetS). Methods and results Eighty MetS participants (aged 50-70 years) were housed and managed in an inpatient medical centre for 21 days, including weekends. Physical activity and food intake/diet were intensively monitored. Participants were randomly assigned into three training groups, differing only by intensity of exercise: moderate-endurance-moderate-resistance ( re), high-resistance-moderate-endurance ( Re), and moderate-resistance-high-endurance ( rE). HRV was recorded before and after the intervention by 24-hour Holter electrocardiogram. Although mean 24-hour heart rate decreased more in Re than re (-11.6 ± 1.6 vs. -4.8 ± 2.1%; P = 0.010), low frequency/high frequency decreased more in re than Re (-20.4 ± 5.5% vs. + 20.4 ± 9.1%; P = 0.002) and rE (-20.4 ± 5.5% vs. -0.3 ± 11.1%; P = 0.003). Very low frequency increased more in Re than re (+121.2 ± 35.7 vs. 42.9 ± 11.3%; P = 0.004). For all HRV parameters, rE ranged between re and Re values. Low frequency/high frequency changes were linked with visceral fat loss only in re (coefficient 5.9, 95% CI 1.9-10.0; P = 0.004). By day 21, HRV parameters of MetS groups (heart rate -8.6 ± 1.0%, standard deviation of R-R intervals + 34.0 ± 6.6%, total power + 63.3 ± 11.1%; P < 0.001) became closer to values of 50 aged-matched healthy controls. Conclusions A 3-week residential programme with intensive volumes of physical activity (15-20 hours per week) enhanced HRV in individuals with MetS. Participants with moderate intensity of training had greater improvements in sympathovagal balance, whereas those with high intensity in resistance training had greater decreases in heart rate and greater increases in very low frequency. Modality-specific relationships were observed between enhanced HRV and visceral fat loss. Clinical Trial Registration URL: http://www.clinicaltrials.gov . Unique identifier: NCT00917917.
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Affiliation(s)
- Gil Boudet
- 1 University Clermont Auvergne, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), France.,2 University Hospital of Clermont Ferrand (CHU), Preventive and Occupational Medicine, France
| | | | - Daniel Courteix
- 1 University Clermont Auvergne, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), France
| | | | - Bruno Lesourd
- 1 University Clermont Auvergne, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), France
| | - Bruno Pereira
- 4 University Hospital of Clermont Ferrand (CHU), Clinical Research and Innovation Direction, France
| | - Robert Chapier
- 1 University Clermont Auvergne, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), France
| | - Agnès Vinet
- 3 University of Avignon, LaPEC EA4278, France
| | - Alain Chamoux
- 2 University Hospital of Clermont Ferrand (CHU), Preventive and Occupational Medicine, France
| | - Geraldine Naughton
- 5 Australian Catholic University, School of Exercise Science, Faculty of Health, Australia
| | - Paul Poirier
- 6 Centre de recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Canada.,7 Faculté de Pharmacie, Université Laval, Canada
| | - Frédéric Dutheil
- 1 University Clermont Auvergne, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), France.,2 University Hospital of Clermont Ferrand (CHU), Preventive and Occupational Medicine, France.,5 Australian Catholic University, School of Exercise Science, Faculty of Health, Australia.,8 CNRS, UMR 6024, Physiological and Psychosocial Stress, University Clermont Auvergne, France
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Stuckey MI, Kiviniemi A, Gill DP, Shoemaker JK, Petrella RJ. Associations between heart rate variability, metabolic syndrome risk factors, and insulin resistance. Appl Physiol Nutr Metab 2016; 40:734-40. [PMID: 26140416 DOI: 10.1139/apnm-2014-0528] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The purpose of this study was to examine differences in heart rate variability (HRV) in metabolic syndrome (MetS) and to determine associations between HRV parameters, MetS risk factors, and insulin resistance (homeostasis model assessment for insulin resistance (HOMA-IR)). Participants (n = 220; aged 23-70 years) were assessed for MetS risk factors (waist circumference, blood pressure, fasting plasma glucose, triglycerides, and high-density lipoprotein cholesterol) and 5-min supine HRV (time and frequency domain and nonlinear). HRV was compared between those with 3 or more (MetS+) and those with 2 or fewer MetS risk factors (MetS-). Multiple linear regression models were built for each HRV parameter to investigate associations with MetS risk factors and HOMA-IR. Data with normal distribution are presented as means ± SD and those without as median [interquartile range]. In women, standard deviation of R-R intervals 38.0 [27.0] ms, 44.5 [29.3] ms; p = 0.020), low-frequency power (5.73 ± 1.06 ln ms(2), 6.13 ± 1.05 ln ms(2); p = 0.022), and the standard deviation of the length of the Poincaré plot (46.8 [31.6] ms, 58.4 [29.9] ms; p = 0.014) were lower and heart rate was higher (68 [13] beats/min, 64 [12] beats/min; p = 0. 018) in MetS+ compared with MetS-, with no differences in men. Waist circumference was most commonly associated with HRV, especially frequency domain parameters. HOMA-IR was associated with heart rate. In conclusion, MetS+ women had a less favourable HRV profile than MetS- women, but there were no differences in men. HOMA-IR was associated with heart rate, not HRV.
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Affiliation(s)
- Melanie I Stuckey
- a Lawson Health Research Institute, Aging Rehabilitation and Geriatric Care Research Centre, 801 Commissioners Road East, London, ON N6C 5J1, Canada.,b School of Kinesiology, University of Western Ontario, London, ON, Canada
| | - Antti Kiviniemi
- c Verve Research, Department of Exercise and Medical Physiology, Kasarmintie 13, PO Box 404, FI-90101 Oulu, Finland
| | - Dawn P Gill
- a Lawson Health Research Institute, Aging Rehabilitation and Geriatric Care Research Centre, 801 Commissioners Road East, London, ON N6C 5J1, Canada.,d Faculty of Health Sciences, Western Centre for Public Health and Family Medicine, University of Western Ontario, London, ON N6A 3K7, Canada.,e School of Public Health, University of Washington, Seattle, WA 98195, USA
| | - J Kevin Shoemaker
- g School of Kinesiology, University of Western Ontario, London, ON N6A 3K7, Canada
| | - Robert J Petrella
- a Lawson Health Research Institute, Aging Rehabilitation and Geriatric Care Research Centre, 801 Commissioners Road East, London, ON N6C 5J1, Canada.,b School of Kinesiology, University of Western Ontario, London, ON, Canada.,f Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON N6A 5B9, Canada
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A meta-analysis of HIV and heart rate variability in the era of antiretroviral therapy. Clin Auton Res 2016; 26:287-94. [PMID: 27395409 DOI: 10.1007/s10286-016-0366-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 06/10/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Heart rate variability (HRV) has been used to assess autonomic dysfunction since the beginning of the HIV epidemic. Although autonomic failure was commonly detected in HIV and AIDS patients prior to the advent of antiretroviral therapy (ART), the effect of HIV on HRV in the current era of widespread ART availability is more ambiguous. METHODS A systematic search and review was conducted on cross-sectional observational and case-control studies published in the era of ART (1996-2015) that compared HRV between HIV + individuals treated with ART and HIV - controls. Eight out of the 20 studies identified, enrolling a total of 292 HIV + adults (mean age 38.7 years) and 201 HIV seronegative controls (mean age 35.1 years), were included in a meta-analysis based on stringent methodological criteria. RESULTS At rest, individuals with HIV showed lower HRV in the time (g) = -0.72, 95 % CI (-1.03 to -0.42) and low-frequency (LF) domain (g) = -0.51, (-0.81 to -0.21); markers of lower parasympathetic tone in the time (g) = -0.55, (-0.85 to -0.25) and high-frequency (HF) domain (g) = -0.42, (-0.71 to -0.12); and higher LF:HF ratio (g) = 0.46, (0.12-0.86) in the frequency domain, suggestive of parasympathetic withdrawal. CONCLUSION This meta-analysis confirmed, within a relatively young cohort of HIV + adults on ART, a general reduction in autonomic function with a shift toward sympathetic dominance. This shift may predispose HIV patients to early and elevated risk of arrhythmias, cardiac events, and accelerated HIV disease progression.
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Rothberg LJ, Lees T, Clifton-Bligh R, Lal S. Association Between Heart Rate Variability Measures and Blood Glucose Levels: Implications for Noninvasive Glucose Monitoring for Diabetes. Diabetes Technol Ther 2016; 18:366-76. [PMID: 27258123 DOI: 10.1089/dia.2016.0010] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Diabetes mellitus (DM) is a global metabolic epidemic associated with numerous adverse complications. Invasive finger prick tests or invasive monitors are currently the most common means of monitoring and controlling blood glucose levels (BGLs). Heart rate variability (HRV) is a noninvasive measure of the autonomic nervous system, and its dynamic physiological nature may provide an alternative means of blood glucose monitoring. However, the relationship between BGL and HRV parameters remains relatively unknown. MATERIALS AND METHODS Thirty-two participants with diabetes (39.97 ± 17.21 years of age) and 31 without diabetes (27.87 ± 10.55 years of age) participated in the current study. Fasting preceded a 10-min three-lead electrocardiogram (ECG), which was followed by a finger prick blood glucose assessment. Following this, a regular meal was consumed, and 30 min after ingestion, a second postprandial 10-min ECG was obtained, and blood glucose assessment was conducted. RESULTS Low-frequency (LF) power, high-frequency (HF) power, and total power (TP) of HRV were negatively associated with BGL in participants with DM. Additionally, the ratio of LF to HF was positively correlated with BGL. Duration of DM was also associated with multiple HRV parameters, with negative associations to both LF and HF parameters as well as TP. CONCLUSIONS This study demonstrates links between specific HRV variables and BGL. In the future the dynamic nature of HRV could provide a unique and real-time method for monitoring BGL, for continuous noninvasive prediction and/or management of DM.
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Affiliation(s)
- Leon J Rothberg
- 1 Neuroscience Research Unit, School of Life Sciences, University of Technology Sydney , Broadway, New South Wales, Australia
| | - Ty Lees
- 1 Neuroscience Research Unit, School of Life Sciences, University of Technology Sydney , Broadway, New South Wales, Australia
| | - Roderick Clifton-Bligh
- 2 Medicine, Northern Clinical School, Kolling Institute of Medical Research , Sydney, New South Wales, Australia
| | - Sara Lal
- 1 Neuroscience Research Unit, School of Life Sciences, University of Technology Sydney , Broadway, New South Wales, Australia
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Chang YM, Shiao CC, Huang YT, Chen IL, Yang CL, Leu SC, Su HL, Kao JL, Tsai SC, Jhen RN, Uen CC. Impact of metabolic syndrome and its components on heart rate variability during hemodialysis: a cross-sectional study. Cardiovasc Diabetol 2016; 15:16. [PMID: 26817599 PMCID: PMC4729144 DOI: 10.1186/s12933-016-0328-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 01/04/2016] [Indexed: 12/02/2022] Open
Abstract
Background Both uremia and metabolic syndrome (MetS) affect heart rate variability (HRV) which is a risk factor of poor prognoses. The aim of this study was to evaluate the impact of MetS on HRV among chronic hemodialysis patients. Methods This cross-sectional study was carried out in a teaching hospital in Northern Taiwan from June to August, 2010. Adult patients on chronic hemodialysis without active medical conditions were enrolled. HRV were measured for 4 times on the index hemodialysis day (HRV-0, -1, -2, and -3 at before, initial, middle, and late phases of hemodialysis, respectively), and the baseline demographic data and clinical parameters during the hemodialysis session were documented. Then we evaluated the impacts of MetS and its five components on HRV. Results One hundred and seventy-five patients (100 women, mean age 65.1 ± 12.9 years) were enrolled and included those with MetS (n = 91, 52 %) and without MetS (n = 84, 48 %). The patients with MetS(+) had significantly lower very low frequency, total power, and variance in HRV-0, total power and variance in HRV-2, and variance in HRV-3. (all p ≦ 0.05) When using the individual components of MetS to evaluate the impacts on HRV indices, the fasting plasma glucose (FPG) criterion significantly affected most indices of HRV while other four components including “waist circumference”, “triglycerides”, “blood pressure”, and “high-density lipoprotein” criteria exhibited little impacts on HRV. FPG criterion carried the most powerful influence on cardiac ANS, which was even higher than that of MetS. The HRV of patients with FPG(+) increased initially during the hemodialysis, but turned to decrease dramatically at the late phase of hemodialysis. Conclusions The impact of FPG(+) outstood the influence of uremic autonomic dysfunction, and FPG criterion was the most important one among all the components of MetS to influence HRV. These results underscored the importance of interpretation and management for abnormal glucose metabolism.
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Affiliation(s)
- Yu-Ming Chang
- Division of Nephrology, Department of Internal Medicine, Saint Mary's Hospital Luodong, No. 160 Chong-Cheng South Road, Loudong, 265, Yilan, Taiwan, ROC
| | - Chih-Chung Shiao
- Division of Nephrology, Department of Internal Medicine, Saint Mary's Hospital Luodong, No. 160 Chong-Cheng South Road, Loudong, 265, Yilan, Taiwan, ROC. .,Saint Mary's Medicine, Nursing and Management College, No. 100, Ln. 265, Sec. 2, Sanxing Rd., Sanxing Township, Yilan County, 266, Taiwan, ROC.
| | - Ya-Ting Huang
- Department of Nursing, Saint Mary's Hospital Luodong, No. 160 Chong-Cheng South Road, Loudong, 265, Yilan, Taiwan, ROC.,Graduate Institute of Clinical Medical Sciences, Chang Gung University, No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan, 33302, Taiwan, ROC
| | - I-Ling Chen
- Department of Nursing, Saint Mary's Hospital Luodong, No. 160 Chong-Cheng South Road, Loudong, 265, Yilan, Taiwan, ROC
| | - Chuan-Lan Yang
- Department of Nursing, Saint Mary's Hospital Luodong, No. 160 Chong-Cheng South Road, Loudong, 265, Yilan, Taiwan, ROC
| | - Show-Chin Leu
- Department of Nursing, Saint Mary's Hospital Luodong, No. 160 Chong-Cheng South Road, Loudong, 265, Yilan, Taiwan, ROC
| | - Hung-Li Su
- Department of Nursing, Saint Mary's Hospital Luodong, No. 160 Chong-Cheng South Road, Loudong, 265, Yilan, Taiwan, ROC
| | - Jsun-Liang Kao
- Division of Nephrology, Department of Internal Medicine, Saint Mary's Hospital Luodong, No. 160 Chong-Cheng South Road, Loudong, 265, Yilan, Taiwan, ROC
| | - Shih-Ching Tsai
- Division of Nephrology, Department of Internal Medicine, Saint Mary's Hospital Luodong, No. 160 Chong-Cheng South Road, Loudong, 265, Yilan, Taiwan, ROC
| | - Rong-Na Jhen
- Division of Nephrology, Department of Internal Medicine, Saint Mary's Hospital Luodong, No. 160 Chong-Cheng South Road, Loudong, 265, Yilan, Taiwan, ROC
| | - Ching-Cherng Uen
- Division of Neurology, Department of Internal Medicine, Saint Mary's Hospital Luodong, No. 160 Chong-Cheng South Road, Loudong, 265, Yilan, Taiwan, ROC
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Balcioğlu AS, Akinci S, Çiçek D, Eldem HO, Çoner A, Bal UA, Müderrisoğlu H. Which is responsible for cardiac autonomic dysfunction in non-diabetic patients with metabolic syndrome: Prediabetes or the syndrome itself? Diabetes Metab Syndr 2016; 10:S13-S20. [PMID: 26610403 DOI: 10.1016/j.dsx.2015.09.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 09/27/2015] [Indexed: 01/28/2023]
Abstract
AIMS Cardiac autonomic dysfunction (CAD) is associated with both prediabetes and metabolic syndrome (MS). Heart rate variability (HRV) and heart rate turbulence (HRT) are reliable 24-h Holter-ECG findings of cardiac autonomic function. This study aimed to investigate the relation between MS and its components and CAD using HRV and HRT. MATERIALS AND METHODS The study included 80 non-diabetic patients with MS and 70 control subjects. All study population and the patients with MS were further analyzed for each diagnostic component of MS to investigate which criteria impaired HRV and HRT. RESULTS HRV and HRT parameters were disturbed in patients in the MS group. While impairment in HRV and HRT was significantly related to the presence of the fasting plasma glucose (FPG) criterion, there were no differences between groups in terms of the other 4 MS criteria. Moreover, FPG level was significantly correlated with SDNN (r=-0.352, p<0.001), SDNN index (r=-0.423, p<0.001), SDANN (r=-0.301, p<0.001), RMSSD (r=-0.237, p<0.001), pNN50 (r=-0.237, p<0.001), turbulence onset (TO) (r=0.365, p<0.001) and turbulence slope (TS) (r=-0.365, p<0.001). Among the MS diagnostic criteria, only FPG level was an independent determinant of all HRV and HRT parameters. CONCLUSIONS This study confirms the relation between MS and CAD. Increased FPG alone appears to be responsible for the mentioned findings among the 5 diagnostic criteria. Accordingly, CAD may be the result of prediabetes, not MS in patients with MS.
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Affiliation(s)
- Akif Serhat Balcioğlu
- Başkent University, Medical and Research Center of Alanya, Department of Cardiology, Alanya, Antalya, Turkey.
| | - Sinan Akinci
- Başkent University, Medical and Research Center of Alanya, Department of Cardiology, Alanya, Antalya, Turkey
| | - Davran Çiçek
- Başkent University, Medical and Research Center of Alanya, Department of Cardiology, Alanya, Antalya, Turkey
| | - Halil Olcay Eldem
- Başkent University, Medical and Research Center of Alanya, Department of Cardiology, Alanya, Antalya, Turkey
| | - Ali Çoner
- Başkent University, Medical and Research Center of Alanya, Department of Cardiology, Alanya, Antalya, Turkey
| | - Uğur Abbas Bal
- Başkent University, Faculty of Medicine, Department of Cardiology, Ankara, Turkey
| | - Haldun Müderrisoğlu
- Başkent University, Faculty of Medicine, Department of Cardiology, Ankara, Turkey
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Qi Y, Yu Y, Wu Y, Wang S, Yu Q, Shi J, Xu Z, Zhang Q, Fu Y, Fu Y, Kou C. Genetic Variants in Six-Transmembrane Epithelial Antigen of Prostate 4 Increase Risk of Developing Metabolic Syndrome in a Han Chinese Population. Genet Test Mol Biomarkers 2015; 19:666-72. [PMID: 26510124 DOI: 10.1089/gtmb.2015.0104] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Altered expression of six-transmembrane epithelial antigen of prostate 4 (STEAP4) is linked to obesity, insulin insensitivity, metabolic homeostasis, and inflammation. This study assessed STEAP4 single nucleotide polymorphisms (SNPs) for association with a risk in developing metabolic syndrome in a Han Chinese population. METHODS A total of 3375 Han Chinese subjects were included in this case-control study with 1583 metabolic syndrome (MetS) patients and 1792 healthy controls. Four SNPs (rs1981529, rs2040657, rs10263111, rs12386756) were genotyped using polymerase chain reaction and MALDI-TOF-MS. The associations between the STAMP4 SNPs and MetS were then analyzed statistically. RESULTS There was no statistical difference in allele frequency of these four SNPs between the case and control populations. The genotype of rs12386756 was shown to be significantly associated with MetS (p = 0.035). Compared with the AA/GG genotypes, the GA genotype of rs12386756 significantly decreased the risk of developing MetS (OR = 0.77; 95% CI, 0.63-0.94; p = 0.0098). There was also no haplotype that could be associated with the risk of developing MetS. Furthermore, the SNP rs1981529 of STEAP4 was associated with body-mass index, waist circumference, and systolic blood pressure, while SNP rs10263111 was associated with waist circumference and fasting glucose levels. SNP rs12386756 was associated with waist and hip circumferences. CONCLUSION Some SNPs of the STEAP4 gene altered the risk of developing a metabolic syndrome in the Han Chinese population. Further studies must be conducted to understand the role of the STEAP4 gene in the pathogenesis of metabolic syndrome.
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Affiliation(s)
- Yue Qi
- 1 Department of Epidemiology and Biostatistics, School of Public Health, Jilin University , Changchun, China
| | - Yaqin Yu
- 1 Department of Epidemiology and Biostatistics, School of Public Health, Jilin University , Changchun, China
| | - Yanhua Wu
- 1 Department of Epidemiology and Biostatistics, School of Public Health, Jilin University , Changchun, China
| | - Shibin Wang
- 1 Department of Epidemiology and Biostatistics, School of Public Health, Jilin University , Changchun, China
| | - Qiong Yu
- 1 Department of Epidemiology and Biostatistics, School of Public Health, Jilin University , Changchun, China
| | - Jieping Shi
- 1 Department of Epidemiology and Biostatistics, School of Public Health, Jilin University , Changchun, China
| | - Ziqi Xu
- 1 Department of Epidemiology and Biostatistics, School of Public Health, Jilin University , Changchun, China
| | - Qingqing Zhang
- 1 Department of Epidemiology and Biostatistics, School of Public Health, Jilin University , Changchun, China
| | - Yingli Fu
- 1 Department of Epidemiology and Biostatistics, School of Public Health, Jilin University , Changchun, China
| | - Yao Fu
- 2 Chinese Jilin Provincial Center for Disease Control and Prevention , Changchun, China
| | - Changgui Kou
- 1 Department of Epidemiology and Biostatistics, School of Public Health, Jilin University , Changchun, China
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Liao XP, Zhu HW, Zeng F, Tang ZH. The association and interaction analysis of hypertension and uric acid on cardiovascular autonomic neuropathy. J Endocrinol Invest 2015; 38:1075-82. [PMID: 25903694 DOI: 10.1007/s40618-015-0291-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 04/08/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND The purpose of this study was to evaluate associations among hypertension (HTN) and uric acid (UA) with cardiovascular autonomic neuropathy (CAN), and to estimate the extent to which synergistic effects of HTN and UA affect the outcome in a Chinese population. METHOD We conducted a large-scale, population-based study to analyze the association and interaction of the two factors for CAN in a sample of 2092 Chinese people. Univariate and multiple linear regression (MLR) analysis were employed to detect these relationships. Interaction on an additive scale can be calculated by using the relative excess risk due to interaction (RERI), the proportion attributable to interaction (AP), and the synergy index (S). RESULT After adjusting for confounding factors, MLR showed that HTN was independently associated with CAN (P < 0.001). A significant interaction effect of UA and HTN on CAN was detected (P = 0.035; RETI = 1.483, 95 % CI 0.415-2.551; AP = 0.360, 95 % CI -0.043 to 0.76 and S = 1.908, 95 % CI 0.152-3.66). CONCLUSION Our findings suggest that HTN is independently and significantly associated with CAN and offer evidence to support the hypothesis that HTN and UA have interaction effects to influence the progression of CAN.
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Affiliation(s)
- X-P Liao
- Department of Internal Medicine, Shanghai Anting Hospital, Jiading, Shanghai, China.
| | - H-W Zhu
- Department of Internal Medicine, Shanghai Anting Hospital, Jiading, Shanghai, China.
| | - F Zeng
- Department of Endocrinology and Metabolism, Shanghai Tongji Hospital, Tongji University School of Medicine, Room 517, Building 2nd, 389 Xincun Road, Shanghai, 200063, China.
| | - Z-H Tang
- Department of Endocrinology and Metabolism, Shanghai Tongji Hospital, Tongji University School of Medicine, Room 517, Building 2nd, 389 Xincun Road, Shanghai, 200063, China.
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Dimova R, Tankova T, Chakarova N, Groseva G, Dakovska L. Cardiovascular autonomic tone relation to metabolic parameters and hsCRP in normoglycemia and prediabetes. Diabetes Res Clin Pract 2015; 109:262-70. [PMID: 26036955 DOI: 10.1016/j.diabres.2015.05.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 04/05/2015] [Accepted: 05/06/2015] [Indexed: 01/02/2023]
Abstract
AIMS The aim of the study was to evaluate cardiovascular autonomic function (CAF) at different stages of obesity and in the presence of metabolic syndrome (MetS), and its association with metabolic parameters and hsCRP in subjects with normal glucose tolerance (NGT) and prediabetes. METHODS A total of 259 subjects (mean age 47.1 ± 14.6 years, mean BMI 31.4 ± 8.1 kg/m(2)), divided in 2 groups: NGT and prediabetes, and subdivided according to glucose tolerance, BMI and MetS, were enrolled. Anthropometric indices, glucose tolerance, blood pressure, serum lipids and hsCRP were measured. Body composition was estimated by impedance analysis. CAF was assessed by ANX-3.0 method. RESULTS Sympathetic and parasympathetic activity were decreased in severe obesity and MetS as compared to controls in NGT. Negative correlation was observed between sympathetic and parasympathetic tone and BMI, waist circumference, total body fat, visceral fat area (VFA), blood pressure, total and LDL cholesterol, and hsCRP in NGT; and VFA, HbA1c and glycemia in prediabetes. CONCLUSION Obesity and MetS seem to be associated with CAF deterioration, and metabolic parameters and hsCRP correlate with CAF and probably increase cardiovascular risk in NGT, whilst VFA, HbA1c and glycemia significantly influence CAF alterations in prediabetes.
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Affiliation(s)
- Rumyana Dimova
- Department of Diabetology, Clinical Centre of Endocrinology, Medical University, 2, Zdrave str., Sofia 1431, Bulgaria.
| | - Tsvetalina Tankova
- Department of Diabetology, Clinical Centre of Endocrinology, Medical University, 2, Zdrave str., Sofia 1431, Bulgaria
| | - Nevena Chakarova
- Department of Diabetology, Clinical Centre of Endocrinology, Medical University, 2, Zdrave str., Sofia 1431, Bulgaria
| | - Greta Groseva
- Department of Diabetology, Clinical Centre of Endocrinology, Medical University, 2, Zdrave str., Sofia 1431, Bulgaria
| | - Lilia Dakovska
- Department of Diabetology, Clinical Centre of Endocrinology, Medical University, 2, Zdrave str., Sofia 1431, Bulgaria
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Özkeçeci G, Ünlü BS, Dursun H, Akçi Ö, Köken G, Onrat E, Avşar A. Heart rate variability and heart rate turbulence in patients with polycystic ovary syndrome. Anatol J Cardiol 2015; 16:323-7. [PMID: 26488379 PMCID: PMC5336779 DOI: 10.5152/anatoljcardiol.2015.6307] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Cardiac autonomic dysfunction may develop in patients with polycystic ovary syndrome (PCOS). Heart rate variability (HRV) and heart rate turbulence (HRT) are used in assessing cardiac autonomic functions. The goal of this study was to compare the cardiac autonomic functions in patients with PCOS and healthy controls. To our knowledge, this is the first study evaluating cardiac autonomic functions in patients with PCOS with respect to both HRV and HRT. METHODS Twenty-three patients with PCOS (mean age 22.8±3.9 years) and 25 healthy female volunteers who were matched for age and body mass index (BMI) (mean age 23.5±6.2 years) were enrolled in this as case-control study. Twenty-four hour ambulatory electrocardiogram recordings of all participants were taken using Pathfinder software. The time domain parameters of HRV and HRT, including turbulence onset (TO) and turbulence slope, were calculated. Diagnosis of PCOS was made with physical and laboratory findings of hirsutism or biochemical hyperandrogenism and chronic anovulation. Diabetes mellitus, other hormon disorders or hormon therapy, pregnancy, atrial fibrilation, obesite, chronic diseases, disorders of the autonomic nervous system, a history of drug use affecting the autonomic nervous system were excluded. RESULTS There were no significant differences in HRV and HRT parameters between the two groups. Cardiovascular risk factors, such as BMI, blood pressure, fasting blood glucose, and lipid parameters, were also similar. Triangular index measure of HRV was negatively correlated with high density lipoprotein cholesterol levels (r=-0.47, p<0.05), while age and BMI were significantly correlated with TO (r=0.31 and 0.47, respectively; p<0.05 for all). CONCLUSION Cardiac autonomic functions were not found to be altered in patients with PCOS in comparison with healthy controls. These results may be explained with the absence of concomitant cardiovascular risk factors with the patients being in the early stage of the disease.
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Affiliation(s)
- Gülay Özkeçeci
- Department of Cardiology, Faculty of Medicine, Afyon University; Afyonkarahisar-Turkey.
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Zhang J, Zhu J, Ding S, Bao C, Jiang Z, Tang ZH, Mei J. Analysis of the Synergistic Effects of Fasting Plasma Glucose and Hypertension on Cardiovascular Autonomic Neuropathy. Cardiology 2015; 132:58-64. [DOI: 10.1159/000381013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 02/17/2015] [Indexed: 11/19/2022]
Abstract
Background: The purpose of this study was to evaluate the associations of fasting plasma glucose (FPG) and hypertension (HTN) with cardiovascular autonomic neuropathy (CAN) and to estimate the extent to which the synergistic effects of FPG and HTN affect outcomes in a Chinese population. Method: We conducted a large-scale, population-based study to analyze the association and interaction of the two factors with CAN in a sample of 2,092 Chinese people. Univariate and multiple linear regression (MLR) analyses were employed to detect these relationships. Interaction on an additive scale can be calculated by using the relative excess risk due to interaction, the proportion attributable to interaction (AP), and the synergy index (S). Result: After adjusting for confounding factors, MLR showed that FPG and HTN were independently associated with CAN (p < 0.001 for both). A significant synergistic effect of FPG and HTN on CAN was detected (p = 0.046, RETI = 0.733, 95% CI 0.059-1.450; AP = 0.167, 95% CI -0.033 to 0.367; S = 1.275, 95% CI 0.140-2.410). Conclusion: Our findings suggest that FPG and HTN are independently associated with CAN, and they offer evidence to support the hypothesis that FPG and HTN have synergistic effects that influence the progression of CAN.
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Rodríguez-Colón SM, He F, Bixler EO, Fernandez-Mendoza J, Vgontzas AN, Calhoun S, Zheng ZJ, Liao D. Metabolic syndrome burden in apparently healthy adolescents is adversely associated with cardiac autonomic modulation--Penn State Children Cohort. Metabolism 2015; 64:626-32. [PMID: 25684658 PMCID: PMC4372460 DOI: 10.1016/j.metabol.2015.01.018] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 01/22/2015] [Accepted: 01/28/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Reduced cardiac autonomic modulation (CAM) has been associated with metabolic syndrome (MetS) in adults. However, the association between MetS component cluster and CAM has not been examined in adolescents. METHODS We conducted a cross-sectional analysis using data from the Penn State Child Cohort follow-up examination. CAM was assessed by heart rate variability (HRV) analysis of 39-h RR intervals, including frequency (high frequency, HF; low frequency, LF; and LF/HF ratio) and time (SDNN, standard deviation of all RR intervals; RMSSD, square root of the mean of the sum of the squares of differences between adjacent RR intervals; and HR, heart rate) domain variables. To assess the MetS burden, we used continuous MetS score (cMetS)--sum of the age and sex-adjusted standardized residual (Z-score) of five established MetS components. Linear mixed-effect models were used to analyze the association between cMetS and CAM in the entire population and stratified by gender. RESULTS After adjusting for age, sex, and race, cMetS was significantly associated with reduced HRV and higher HR. With 1 standard deviation increase in cMetS, there was a significant decrease in HF (-0.10 (SE = 0.02)), LF (-0.07 (SE = 0.01)), SDNN (-1.97 (SE = 0.50)), and RMSSD (-1.70 (SE = 0.72)), and increase in LF/HF (0.08 (SE = 0.02)) and HR (1.40 (SE = 0.26)). All cMetS components, with the exception of high-density lipoprotein (HDL), were associated with significantly decreased HRV and increased HR. High blood pressure (MAP) and triglyceride (TG) levels were also associated with an increase in LF/HF and decrease in RMSSD. An increase in high-density lipoprotein was only associated with higher LF and SDNN. Moreover, cMetS and HRV associations were more pronounced in males than in females. The associations between HRV and. MAP, TG, and HDL were more pronounced in females. CONCLUSIONS cMetS score is associated with lower HRV, suggesting an adverse impact on CAM, even in apparently healthy adolescents.
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Affiliation(s)
- Sol M Rodríguez-Colón
- Department of Public Health Sciences Penn State University College of Medicine, Hershey, PA, 17033.
| | - Fan He
- Department of Public Health Sciences Penn State University College of Medicine, Hershey, PA, 17033.
| | - Edward O Bixler
- Sleep Research &Treatment Center, Department of Psychiatry, Penn State University College of Medicine, Hershey, PA, 17033.
| | - Julio Fernandez-Mendoza
- Sleep Research &Treatment Center, Department of Psychiatry, Penn State University College of Medicine, Hershey, PA, 17033.
| | - Alexandros N Vgontzas
- Sleep Research &Treatment Center, Department of Psychiatry, Penn State University College of Medicine, Hershey, PA, 17033.
| | - Susan Calhoun
- Sleep Research &Treatment Center, Department of Psychiatry, Penn State University College of Medicine, Hershey, PA, 17033.
| | - Zhi-Jie Zheng
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China.
| | - Duanping Liao
- Department of Public Health Sciences Penn State University College of Medicine, Hershey, PA, 17033.
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Wei YT, Xia DS, Yang WK, Wang XG, Chen XZ, Dong NG. Secretion of adipocytes and macrophages under conditions of inflammation and/or insulin resistance and effect of adipocytes on preadipocytes under these conditions. BIOCHEMISTRY (MOSCOW) 2015; 79:663-71. [PMID: 25108329 DOI: 10.1134/s0006297914070086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The purpose of the present study was to examine changes in preadipocytes following the coculture of preadipocytes and adipocytes and the effects on the secretion of adipocytes and macrophages following induction of inflammation and insulin resistance. Mature adipocytes and RAW264.7 macrophages were treated with lipopolysaccharide and insulin to establish models of inflammation and insulin resistance, respectively. The mRNA expression levels of IL-6, MCP-1, and TNF-α in all adipocyte treatment groups were significantly greater compared with the control, and that of adiponectin was less (P<0.05). In the RAW264.7 macrophages, the mRNA expression levels of IL-6 and TNF-α were greater than those in the control group (P<0.05). Moreover, the results of this study confirmed that adipocytes and macrophages increased the secretion of inflammatory factors under conditions of induced inflammation and insulin resistance. In addition, 3T3-L1 adipocytes inhibited the proliferation and differentiation of preadipocytes when cocultured with adipocytes under conditions of inflammation and/or insulin resistance, and the phenotype of preadipocytes did not change.
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Affiliation(s)
- Yu-Tao Wei
- Department of Thoracic and Cardiovascular Surgery, Hospital of Xingjian Production and Construction Corps, Wulumuqi, Xinjiang, 830002, China
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Usui H, Nishida Y. Relationship between Physical Activity and the Very Low-Frequency Component of Heart Rate Variability after Stroke. J Stroke Cerebrovasc Dis 2015; 24:840-3. [DOI: 10.1016/j.jstrokecerebrovasdis.2014.11.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 11/24/2014] [Indexed: 10/24/2022] Open
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Stuckey MI, Tulppo MP, Kiviniemi AM, Petrella RJ. Heart rate variability and the metabolic syndrome: a systematic review of the literature. Diabetes Metab Res Rev 2014; 30:784-93. [PMID: 24816921 DOI: 10.1002/dmrr.2555] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Revised: 04/02/2014] [Accepted: 04/18/2014] [Indexed: 11/09/2022]
Abstract
BACKGROUND A number of cross-sectional studies have examined associations between heart rate variability and metabolic syndrome, but differences in study populations, data collection and analysis methodologies make synthesis difficult. The purpose of this study was to systematically review published primary research examining associations between heart rate variability and metabolic syndrome or its individual risk factors. METHODS A systematic literature search of PubMed and EMBASE was conducted to identify relevant articles published from January 1999 to December 2012. Studies were included if they examined associations between heart rate variability analysed by standard protocols and metabolic syndrome risk factors according to published definitions. All papers were scored with a modified Downs and Black instrument, and data were extracted. RESULTS Fourteen studies were included. Heart rate variability generally was reduced in women with metabolic syndrome compared to those without, while results in men were inconsistent. Time and frequency domain heart rate variability parameters were associated with individual metabolic syndrome risk factors, though sex differences exist. Only two studies considered nonlinear and Poincaré plot heart rate variability parameters, which were reduced in metabolic syndrome. CONCLUSIONS Heart rate variability is altered differently in men and women with metabolic syndrome. Future studies should follow consistent heart rate variability analysis protocols and metabolic syndrome definitions and include more comprehensive analyses to investigate potential mechanisms.
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Affiliation(s)
- Melanie I Stuckey
- School of Kinesiology, The University of Western Ontario, London, ON, Canada; Aging, Rehabilitation and Geriatric Care Research Centre, Lawson Health Research Institute, London, ON, Canada
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