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Mikolaskova I, Zvarik M, Hesko P, Kopcova M, Gidron Y, Rajcani J, Hunakova L, Kollarik B. Increased stress burden and electrodermal reactivity in bladder cancer patients in comparison to healthy controls. Heliyon 2024; 10:e34453. [PMID: 39113946 PMCID: PMC11305217 DOI: 10.1016/j.heliyon.2024.e34453] [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: 06/21/2024] [Accepted: 07/09/2024] [Indexed: 08/10/2024] Open
Abstract
The purpose of our study was to assess specific physiological parameters associated with stress responses in bladder cancer (BCa) patients compared to healthy individuals. By examining the transition from a supine to a sitting position, representing a mild physiological load, we investigated the changes in autonomic nervous system (ANS) activity as reflected by alterations in these parameters, indicating shifts in ANS regulation, using non-linear heart rate variability (HRV) parameters (0V%, 2UV%, parasympathetic and sympathetic nervous system - PNS and SNS indices), modified heart rate acceleration (ACmod) and deceleration capacities (DCmod), heart rate (HR), electrodermal activity (EDA), and also their correlations with perceived stress score. Our findings showed that BCa patients (n = 38) exhibited elevated resting HR, heightened SNS index, and increased EDA compared to their healthy counterparts (n = 47), indicating a notable physiological stress burden. The 0V% parameter showed a positive association with the SNS index, ACmod, HR, and EDA parameters, while displaying a negative correlation with the PNS index, DCmod and 2UV%. These non-linear HRV parameters, such as 0V% and 2UV%, offer nuanced insights into the complexities of heartbeat dynamics and autonomic regulation. After the transition from supine to sitting positions, BCa patients displayed higher EDA responses, indicating heightened stress reactivity and ANS sensitivity. These physiological distinctions persisted even when we did not prove differences in the levels of perceived stress between the studied groups. In conclusion, our study emphasizes the significance of identifying cancer patients at risk of ANS dysregulation, paving the way for tailored stress management strategies.
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Affiliation(s)
- I. Mikolaskova
- Institute of Immunology, Faculty of Medicine, Comenius University in Bratislava, Odborarske Namestie 14, 811 08, Bratislava, Slovakia
| | - M. Zvarik
- Department of Nuclear Physics and Biophysics, Faculty of Mathematics, Physics and Computer Science, Comenius University in Bratislava, Mlynska Dolina, 842 48 Bratislava 4, Slovakia
| | - P. Hesko
- Department of Urology, Saints Cyril and Methodius Hospital, University Hospital Bratislava, Antolská 11, 851 07 Bratislava, Slovakia
| | - M. Kopcova
- Institute of Immunology, Faculty of Medicine, Comenius University in Bratislava, Odborarske Namestie 14, 811 08, Bratislava, Slovakia
| | - Y. Gidron
- Department of Nursing, Faculty of Welfare and Health Sciences, University of Haifa, Haifa 3498838, Israel
| | - J. Rajcani
- Department of Psychology, Faculty of Arts, Comenius University, Gondova 2, 81499 Bratislava, Slovakia
| | - L. Hunakova
- Institute of Immunology, Faculty of Medicine, Comenius University in Bratislava, Odborarske Namestie 14, 811 08, Bratislava, Slovakia
| | - B. Kollarik
- Department of Urology, Saints Cyril and Methodius Hospital, University Hospital Bratislava, Antolská 11, 851 07 Bratislava, Slovakia
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Sun D, Li Z, Xu G, Xue J, Wang W, Yin P, Wang M, Shang M, Guo L, Cui Q, Dai Y, Zhang R, Wang X, Song D. Prediction of non-dipper blood pressure pattern in Chinese patients with hypertension using a nomogram model. Front Physiol 2024; 15:1309212. [PMID: 39113937 PMCID: PMC11303159 DOI: 10.3389/fphys.2024.1309212] [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: 10/08/2023] [Accepted: 07/03/2024] [Indexed: 08/10/2024] Open
Abstract
Non-dipper blood pressure has been shown to affect cardiovascular outcomes and cognitive function in patients with hypertension. Although some studies have explored the influencing factors of non-dipper blood pressure, there is still relatively little research on constructing a prediction model. This study aimed to develop and validate a simple and practical nomogram prediction model and explore relevant elements that could affect the dipper blood pressure relationship in patients with hypertension. A convenient sampling method was used to select 356 inpatients with hypertension who visited the Affiliated Hospital of Jining Medical College from January 2022 to September 2022. All patients were randomly assigned to the training cohort (75%, n = 267) and the validation cohort (25%, n = 89). Univariate and multivariate logistic regression were utilized to identify influencing factors. The nomogram was developed and evaluated based on the receiver operating characteristic (ROC) curve, the area under the ROC curve (AUC), and decision curve analyses. The optimal cutoff values for the prevalence of dipper blood pressure were estimated. The nomogram was established using six variables, including age, sex, hemoglobin (Hb), estimated glomerular filtration rate (eGFR), ejection fraction (EF), and heart rate. The AUC was 0.860 in the training cohort. The cutoff values for optimally predicting the prevalence of dipper blood pressure were 41.50 years, 151.00 g/L, 117.53 mL/min/1.73 m2, 64.50%, and 75 beats per minute for age, Hb, eGFR, ejection fraction, and heart rate, respectively. In summary, our nomogram can be used as a simple, plausible, affordable, and widely implementable tool to predict the blood pressure pattern of Chinese patients with hypertension.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Dongmei Song
- Department of Cardiology, Affiliated Hospital of Jining Medical University, Jining, China
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Wang J, Xu J, Yang L, Zhang Y, Wu R, Wang W, Gao C. Heart rate deceleration and acceleration capacities associated with circadian rhythm of blood pressure in essential hypertension. BMC Cardiovasc Disord 2024; 24:257. [PMID: 38760695 PMCID: PMC11100176 DOI: 10.1186/s12872-024-03933-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 05/09/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND This study aimed to investigate the potential association between the circadian rhythm of blood pressure and deceleration capacity (DC)/acceleration capacity (AC) in patients with essential hypertension. METHODS This study included 318 patients with essential hypertension, whether or not they were being treated with anti-hypertensive drugs, who underwent 24-hour ambulatory blood pressure monitoring (ABPM). Patients were categorized into three groups based on the percentage of nocturnal systolic blood pressure (SBP) dipping: the dipper, non-dipper and reverse dipper groups. Baseline demographic characteristics, ambulatory blood pressure monitoring parameters, Holter recordings (including DC and AC), and echocardiographic parameters were collected. RESULTS In this study, the lowest DC values were observed in the reverse dipper group, followed by the non-dipper and dipper groups (6.46 ± 2.06 vs. 6.65 ± 1.95 vs. 8.07 ± 1.79 ms, P < .001). Additionally, the AC gradually decreased (-6.32 ± 2.02 vs. -6.55 ± 1.95 vs. -7.80 ± 1.73 ms, P < .001). There was a significant association between DC (r = .307, P < .001), AC (r=-.303, P < .001) and nocturnal SBP decline. Furthermore, DC (β = 0.785, P = .001) was positively associated with nocturnal SBP decline, whereas AC was negatively associated with nocturnal SBP (β = -0.753, P = .002). By multivariate logistic regression analysis, deceleration capacity [OR (95% CI): 0.705 (0.594-0.836), p < .001], and acceleration capacity [OR (95% CI): 1.357 (1.141-1.614), p = .001] were identified as independent risk factors for blood pressure nondipper status. The analysis of ROC curves revealed that the area under the curve for DC/AC in predicting the circadian rhythm of blood pressure was 0.711/0.697, with a sensitivity of 73.4%/65.1% and specificity of 66.7%/71.2%. CONCLUSIONS Abnormal DC and AC density were correlated with a blunted decline in nighttime SBP, suggesting a potential association between the circadian rhythm of blood pressure in essential hypertension patients and autonomic nervous dysfunction.
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Affiliation(s)
- Jijing Wang
- Department of Cardiopulmonary Function, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, No.7 Weiwu road, Jinshui District, Zhengzhou, Henan, 450003, China
| | - Jinyi Xu
- Department of Cardiopulmonary Function, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, No.7 Weiwu road, Jinshui District, Zhengzhou, Henan, 450003, China
| | - Lihong Yang
- Department of Cardiopulmonary Function, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, No.7 Weiwu road, Jinshui District, Zhengzhou, Henan, 450003, China
| | - You Zhang
- Henan Institute of Cardiovascular Epidemiology, Zhengzhou, China
- Department of Cardiology, Central China Fuwai Hospital of Zhengzhou University, Henan Provincial People's Hospital Heart Center, No. 1 Fuwai Road, Zhengzhou, Henan, 451464, China
| | - Rui Wu
- Department of Cardiopulmonary Function, Central China Fuwai Hospital of Zhengzhou University, Henan Provincial People's Hospital Heart Center, No. 1 Fuwai Road, Zhengzhou, Henan, 451464, China
| | - Wentao Wang
- Department of Cardiopulmonary Function, Central China Fuwai Hospital of Zhengzhou University, Henan Provincial People's Hospital Heart Center, No. 1 Fuwai Road, Zhengzhou, Henan, 451464, China
| | - Chuanyu Gao
- Department of Cardiology, Central China Fuwai Hospital of Zhengzhou University, Henan Provincial People's Hospital Heart Center, No. 1 Fuwai Road, Zhengzhou, Henan, 451464, China.
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Wen PY, Wang GQ, Dou LW, Chen Q, Chen XW, Gong L. A case report of autoimmune GFAP astrocytopathy presenting with abnormal heart rate variability and blood pressure variability. BMC Neurol 2023; 23:24. [PMID: 36647033 PMCID: PMC9843977 DOI: 10.1186/s12883-023-03070-4] [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: 05/03/2022] [Accepted: 01/10/2023] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Autonomic dysfunctions including bladder dysfunction, gastrointestinal dysfunction and orthostasis are common symptoms of autoimmune glial fibrillary acidic protein astrocytopathy (A-GFAP-A); however, cardiac autonomic dysfunction and abnormal circadian rhythm of blood pressure, which can lead to poor prognosis and even sudden cardiac death, has never been reported in A-GFAP-A patient. CASE PRESENTATION A 68-year-old male Chinese patient presented to our hospital with headache, fever, progressive disturbance of consciousness, dysuria, and limb weakness. Abnormal heart rate variability and non-dipper circadian rhythm of blood pressure gradually developed during hospitalization, which is rare in A-GFAP-A. He had positive GFAP IgG in cerebrospinal fluid (CSF). Enhanced brian MRI showed uneven enhancement and T2 hyperintense lesions of medulla oblongata; Cervical spine MRI showed T2 hyperintense lesions in medulla oblongata and upper margin of the T2 vertebral body. A contrast-enhanced thoracic spine MRI showed uneven enhancement and T2 hyperintense lesions of T1 to T6 vertebral segments. After treatment with intravenous immunoglobulin and corticosteroids, the patient's symptoms, including autonomic dysfunction, alleviated dramatically. Finally, his heart rate variability and blood pressure variability became normal. CONCLUSIONS Our case broadens the spectrum of expected symptoms in A-GFAP- A syndromes as it presented with heart rate variability and blood pressure variability.
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Affiliation(s)
- Pu-yuan Wen
- grid.412679.f0000 0004 1771 3402Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China ,grid.440323.20000 0004 1757 3171Department of Neurology, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong China
| | - Guang-qiang Wang
- grid.440323.20000 0004 1757 3171Department of Cardiology, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong China
| | - Lian-wei Dou
- grid.440323.20000 0004 1757 3171Department of Neurology, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong China
| | - Qi Chen
- grid.440323.20000 0004 1757 3171Department of Neurology, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong China
| | - Xian-wen Chen
- grid.412679.f0000 0004 1771 3402Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Li Gong
- grid.440323.20000 0004 1757 3171Department of Neurology, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong China
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Shi P, Li A, Wu L, Yu H. The effect of passive lower limb training on heart rate asymmetry. Physiol Meas 2021; 43. [PMID: 34915452 DOI: 10.1088/1361-6579/ac43c1] [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: 04/01/2021] [Accepted: 12/16/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Heart rate asymmetry (HRA) is an approach for quantitatively assessing the uneven distribution of heart rate accelerations and decelerations for sinus rhythm. We aimed to investigate whether automatic regulation led to HRA alternation during passive lower limb training. METHODS Thirty healthy participants were recruited in this study. The protocol included a baseline (Pre-E) and three passive lower limb training trials (E1, E2 and E3) with a randomized order. Several variance-based HRA variables were established. Heart rate variability (HRV) parameters, i.e., mean RR, SDNN, RMSSD, LF (n.u.), HF (n.u.) and VLF (ms2), and HRA variables, i.e., SD1a, SD1d, SD2a, SD2d, SDNNa and SDNNd, were calculated by using 5-min RR time series, as well as the normalized HRA variables, i.e., C1a, C1d, C2a, C2d, Ca and Cd. RESULTS Our results showed that the performance of HRA was distinguished. The normalized HRA was observed with significant changes in E1, E2 and E3 compared to Pre -E. Moreover, parts of non-normalized HRA variables correlated with HRV parameters, which indicated that HRA might benefit in assessing cardiovascular modulation in passive lower limb training. CONCLUSIONS In summary, this study suggested that passive training led to significant HRA alternation and the application of HRA gave us the possibility for autonomic assessment.
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Affiliation(s)
- Ping Shi
- nstitute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, 580 Jungong Road, Yangpu District, Shanghai, China, shanghai, Shanghai, 200093, CHINA
| | - Anan Li
- nstitute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, no.580 Jungong road, Yangpu district, Shanghai, China, Shanghai, Shanghai, 200093, CHINA
| | - Liang Wu
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, 580 Jungong Road, Yangpu District, Shanghai, China, Shanghai, 200093, CHINA
| | - Hongliu Yu
- nstitute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, 580 Jungong Road, Yangpu District, Shanghai, China, Shanghai, Shanghai, 200093, CHINA
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Yan L, Jin J, Zhao X, Huang X, Zhu W, Jiang S, Gao M, Yuan J. Heart rate acceleration and deceleration capacities associated with circadian blood pressure variation. Ann Noninvasive Electrocardiol 2020; 25:e12748. [PMID: 32103582 PMCID: PMC7358884 DOI: 10.1111/anec.12748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 01/04/2020] [Accepted: 01/08/2020] [Indexed: 12/24/2022] Open
Abstract
Background Heart rate acceleration and deceleration capacities are novel parameters that can quantify sympathetic and vagal modulation. However, how acceleration and deceleration capacities associated with circadian blood pressure (BP) variation remains unknown. Methods A total of 141 patients with essential hypertension were included in our study. Based on the nocturnal decline rate of systolic BP (SBP), patients were divided into two groups, as dippers and nondippers. Baseline demographic characteristics, ambulatory blood pressure monitoring (ABPM) parameters, Holter recordings, and echocardiographic parameters were collected. Results The absolute values of acceleration capacity (AC) (−7.75 [−8.45 ~ −6.3] ms vs. −6.6 [−8.25 ~ −5.2] ms, p = .047) and deceleration capacity (DC) (7.35 [6.1 ~ 8.1] ms vs. 6.3 [5.1 ~ 7.6] ms, p = .042) were significantly higher in dippers than in nondippers. By multivariate logistic regression analysis, left atrial diameter (LAd) was found to be an independent risk factor for nondipper status in acceleration capacity model (odds ratio 1.174, 95% confidence interval 1.019–1.354, p = .027) and deceleration model (odds ratio 1.146, 95% confidence interval 1.003–1.309, p = .045). Sleep SBP was positively correlated to acceleration capacity (r = .256, p = .002) and negatively correlated to deceleration capacity (r = −.194, p = .021). Conclusions The absolute values of acceleration capacity and deceleration capacity were higher in patients with dipper hypertension than in patients with nondipper hypertension. However, acceleration and deceleration capacities were not independent risk factors for blunted BP variation. Sleep SBP seemed to be better correlated to the impairment of autonomic nervous system (ANS) function than other ABPM parameters.
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Affiliation(s)
- Liyuan Yan
- Department of Cardiology, the First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jianling Jin
- Department of Electrocardiography, the First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xin Zhao
- Department of Cardiology, the First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xingmei Huang
- Department of Electrocardiography, the First Affiliated Hospital of Soochow University, Suzhou, China
| | - Wei Zhu
- Department of Electrocardiography, the First Affiliated Hospital of Soochow University, Suzhou, China
| | - Shili Jiang
- Department of Electrocardiography, the First Affiliated Hospital of Soochow University, Suzhou, China
| | - Meiwen Gao
- Department of Electrocardiography, the First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jiamin Yuan
- Department of Cardiology, the First Affiliated Hospital of Soochow University, Suzhou, China
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