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Weiss SJ, Keeton VF, Leung C, Niemann S. Infant emotion regulation in the context of stress: Effects of heart rate variability and temperament. Stress Health 2024; 40:e3373. [PMID: 38268180 DOI: 10.1002/smi.3373] [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] [Received: 02/01/2023] [Revised: 09/27/2023] [Accepted: 01/08/2024] [Indexed: 01/26/2024]
Abstract
Stressful events are inherently emotional. As a result, the ability to regulate emotions is critical in responding effectively to stressors. Differential abilities in the management of stress appear very early in life, compelling a need to better understand factors that may shape the capacity for emotion regulation (ER). Variations in both biologic and behavioural characteristics are thought to influence individual differences in ER development. We sought to determine the differential contributions of temperament and heart rate variability (HRV; an indicator of autonomic nervous system function) to infant resting state emotionality and emotional reactivity in response to a stressor at 6 months of age. Participants included 108 mother-infant dyads. Mothers completed a measure of infant temperament at 6 months postnatal. Mother and infant also participated in a standardized stressor (the Repeated Still Face Paradigm) at that time. Electrocardiographic data were acquired from the infant during a baseline resting state and throughout the stressor. Fast Fourier Transformation was used to analyse the high frequency (HF) domain of HRV, a measure of parasympathetic nervous system activity. Infant ER was measured via standardized coding of emotional distress behaviours from video-records at baseline and throughout the stressor. Severity of mothers' depressive symptoms was included as a covariate in analyses. Results of linear regression indicate that neither temperament nor HRV were associated significantly with an infant's emotional resting state, although a small effect size was found for the relationship between infant negative affectivity and greater emotional distress (β = 0.23, p = 0.08) prior to the stressor. Higher HF-HRV (suggesting parasympathetic dominance) was related to greater emotional distress in response to the stressor (β = 0.34, p = 0.009). This greater emotional reactivity may reflect a more robust capacity to mount an emotional response to the stressor when infants encounter it from a bedrock of parasympathetic activation. Findings may inform eventual markers for assessment of ER in infancy and areas for intervention to enhance infant management of emotions, especially during stressful events.
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Affiliation(s)
- Sandra J Weiss
- Department of Community Health Systems, University of California, San Francisco, California, USA
| | - Victoria F Keeton
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, California, USA
| | - Cherry Leung
- Department of Community Health Systems, University of California, San Francisco, California, USA
| | - Sandra Niemann
- Department of Community Health Systems, University of California, San Francisco, California, USA
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Champeroux P, Thireau J, Le Guennec JY, Fares R. In silico modelling of stroke volume, cardiac output and systemic vascular resistance in cardiovascular safety pharmacology studies by telemetry. J Pharmacol Toxicol Methods 2024; 127:107512. [PMID: 38719163 DOI: 10.1016/j.vascn.2024.107512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 04/26/2024] [Accepted: 05/04/2024] [Indexed: 05/13/2024]
Abstract
The principle of proportionality of the systolic area of the central aortic pressure to stroke volume (SV) has been long known. The aim of the present work was to evaluate an in silico solution derived from this principle for modelling SV (iSV model) in cardiovascular safety pharmacology studies by telemetry. Blood pressure was measured in the abdominal aorta in accordance with standard practice. Central aortic pressure was modelled from the abdominal aortic pressure waveform using the N-point moving average (NPMA) method for beat-to-beat estimation of SV. First, the iSV was compared to the SV measured by ultrasonic flowmetry in the ascending aorta (uSV) after various pharmacological challenges in beagle dogs anaesthetised with etomidate/fentanyl. The iSV showed minimal bias (0.2 mL i.e. 2%) and excellent agreement with uSV. Then, previous telemetry studies including reference vasoactive and inotropic compounds were retrospectively reanalysed to model drug effects on stroke volume (iSV), cardiac output (iCO) and systemic vascular resistance (iSVR). Among them, the examples of nicardipine and isoprenaline highlight risks of erroneous or biased estimation of drug effects from the abdominal aortic pressure due to pulse pressure amplification. Furthermore, the examples of verapamil, quinidine and moxifloxacin show that iSV, iCO and iSVR are earlier biomarkers than blood pressure itself for predicting drug effect on blood pressure. This in silico modelling approach included in vivo telemetry safety pharmacology studies can be considered as a New Approach Methodology (NAM) that provides valuable additional information and contribute to improving non-clinical translational research to the clinic.
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Affiliation(s)
| | - Jérôme Thireau
- Laboratoire PHYMEDEXP, Université de Montpellier, INSERM, CNRS, 371 Avenue du doyen G. Giraud, 34295 Montpellier, Cedex 05, France
| | - Jean-Yves Le Guennec
- Laboratoire PHYMEDEXP, Université de Montpellier, INSERM, CNRS, 371 Avenue du doyen G. Giraud, 34295 Montpellier, Cedex 05, France
| | - Raafat Fares
- ERBC France, Chemin de Montifault, 18800 Baugy, France
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Lin Y, Xu S, Peng Y, Li S, Huang X, Chen L. Preoperative slow-wave sleep is associated with postoperative delirium after heart valve surgery: A prospective pilot study. J Sleep Res 2023; 32:e13920. [PMID: 37147892 DOI: 10.1111/jsr.13920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 02/28/2023] [Accepted: 04/18/2023] [Indexed: 05/07/2023]
Abstract
Postoperative delirium (POD) is a very common neurological complication after valve surgery. Some studies have shown that preoperative sleep disorder is associated with POD, but the correlation between preoperative slow wave sleep (SWS) and POD remains unclear. Therefore, this study aims to identify the correlation between preoperative slow wave sleep and postoperative delirium in patients with heart valve disease. This was a prospective, observational study of elective valve surgery patients admitted to the Heart Medical Center between November 2021 and July 2022. Polysomnography (PSG) was used to monitor sleep architecture from 9:30 p.m. for 1 night before surgery to 6:30 a.m. on the day of surgery. Patients were assessed for postoperative delirium from postoperative day 1 to extubation or day 5 by using the Richmond Agitation/Sedation Scale (RASS) and the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). A total of 60 elective valve surgery patients were enrolled in this study. Prolonged N1 (11.44%) and N2 (58.62%) sleep, decreased N3 sleep (8.75%) and REM sleep (18.24%) within normal limits were the overall sleep architecture. Compared with patients without POD, patients with POD had less slow wave sleep 1 night before surgery (5.77% vs 10.88%, p < 0.001). After adjusting for confounding factors, slow wave sleep (OR: 0.647, 95% CI 0.493-0.851, p = 0.002) was found to be a protective factor for postoperative delirium. The preoperative SWS is a predictive factor of the POD in patients undergoing valve surgery. But further studies with larger sample sizes are still needed to elucidate the relationship between preoperative slow wave sleep and postoperative delirium.
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Affiliation(s)
- Yanjuan Lin
- Department of Nursing, Fujian Medical University Union Hospital, Fuzhou, China
| | - Shurong Xu
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Yanchun Peng
- Department of Cardiac Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Sailan Li
- Department of Cardiac Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Xizhen Huang
- Department of Cardiac Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Liangwan Chen
- Department of Cardiac Surgery, Fujian Medical University Union Hospital, Fuzhou, China
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Fares R, Champéroux P. Simultaneous assessment of central nervous and respiratory systems using jacketed telemetry in socially-housed rats: Application of the "3Rs" principles in core battery safety pharmacology studies. J Pharmacol Toxicol Methods 2023; 121:107268. [PMID: 37146838 DOI: 10.1016/j.vascn.2023.107268] [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: 01/28/2023] [Revised: 04/11/2023] [Accepted: 04/21/2023] [Indexed: 05/07/2023]
Abstract
Central nervous (CNS) and respiratory systems are routinely investigated in safety pharmacology core battery studies. For small molecules, the assessment of both vital organ systems is frequently done in rats in two distinct studies. With the advent of a miniaturized technology of jacketed external telemetry for rats (DECRO system), the simultaneous assessment of modified Irwin's or functional observational battery (FOB) test and respiratory (Resp) studies has become possible within a single study. Therefore, the objectives of this study were to perform the FOB and the Resp studies simultaneously in pair-housed rats fitted with jacketed telemetry, and to assess the feasibility and the outcome of this combination in control, baclofen, caffeine, and clonidine treated groups, i.e., with three agents having both respiratory and CNS effects. Our results provided evidence that performing both Resp and FOB assessment simultaneously in the same rat was feasible and the outcome was successful. The expected CNS and respiratory effects of the 3 reference compounds were accurately captured in each assay confirming the results' relevance. In addition, heart rate and activity level were recorded as additional parameters making this design as an enhanced approach for nonclinical safety assessment in rats. This work provides clear evidence that the "3Rs" principles can be effectively applied in core battery safety pharmacology studies while remaining in compliance with worldwide regulatory guidelines. Both reduction in animal use and refinements in procedures are demonstrated with this model.
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Boulay E, Miraucourt LS, Pugsley MK, Abernathy MM, Chui R, Dalton J, Demers M, Dybdal N, Gazaille E, Greiter-Wilke A, Hoffmann P, Huang H, LaDuke C, Norton K, Pierson JB, Reeves I, Roche B, Rossman EI, Schultze AE, Tang HM, Wisialowski T, Authier S. The incidence of spontaneous arrhythmias in telemetered beagle dogs, Göttingen Minipigs and Cynomolgus non-human primates: A HESI consortium retrospective analysis. J Pharmacol Toxicol Methods 2023; 121:107266. [PMID: 36963703 DOI: 10.1016/j.vascn.2023.107266] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 03/17/2023] [Accepted: 03/20/2023] [Indexed: 03/26/2023]
Abstract
INTRODUCTION Characterization of the incidence of spontaneous arrhythmias to identify possible drug-related effects is often an important part of the analysis in safety pharmacology studies using telemetry. METHODS A retrospective analysis in non-clinical species with and without telemetry transmitters was conducted. Electrocardiograms (24 h) from male and female beagle dogs (n = 131), Göttingen minipigs (n = 108) and cynomolgus non-human primates (NHP; n = 78) were analyzed. RESULTS Ventricular tachycardia (VT) was observed in 3% of the dogs but was absent in minipigs and NHPs. Ventricular fibrillation (VF) was not observed in the 3 species. Ventricular premature beats (VPBs) were more frequent during daytime and atrioventricular blocks (AVBs) were more frequent at night in all species. A limited number of animals exhibited a high arrhythmia frequency and there was no correlation between animals with higher frequency of an arrhythmia type and the frequency of other arrythmias in the same animals. Clinical chemistry or hematology parameters were not different with or without telemetry devices. NHP with a transmural left ventricular pressure (LVP) catheter exhibited a greater incidence of VPBs and PJCs compared to telemetry animals without LVP. DISCUSSION All species were similar with regards to the frequency of ventricular ectopic beats (26-46%) while the dog seemed to have more frequent junctional complexes and AVB compared to NHP and minipigs. Arrhythmia screening may be considered during pre-study evaluations, to exclude animals with abnormally high arrhythmia incidence.
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Affiliation(s)
- Emmanuel Boulay
- Charles River, Laval, Canada; Faculty of Veterinary Medicine, University of Montreal, QC, Canada
| | | | | | | | - Ray Chui
- Cardiovascular Analytics, Newbury Park, CA, USA
| | | | - Marjorie Demers
- Faculty of Veterinary Medicine, University of Montreal, QC, Canada
| | | | - Elissa Gazaille
- Faculty of Veterinary Medicine, University of Montreal, QC, Canada
| | - Andrea Greiter-Wilke
- Roche Pharma Research and Early Development, Pharmaceutical Sciences, Roche Innovation Center, Basel, Switzerland
| | | | | | | | | | | | | | | | | | | | | | | | - Simon Authier
- Charles River, Laval, Canada; Faculty of Veterinary Medicine, University of Montreal, QC, Canada.
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Champéroux P, Fares R, Bastogne T, Richard S, Le Guennec JY, Thireau J. Contribution of hemodynamic side effects and associated autonomic reflexes to ventricular arrhythmias triggering by torsadogenic hERG blocking drugs. Br J Pharmacol 2022; 179:4549-4562. [PMID: 35751378 PMCID: PMC9543494 DOI: 10.1111/bph.15905] [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: 11/16/2021] [Revised: 05/16/2022] [Accepted: 06/01/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND PURPOSES Several hERG blocking drugs known for their propensity to trigger Torsades de Pointes (TdP) were reported to induce a sympatho-vagal coactivation and to enhance High Frequency heart rate (HFHR) and QT oscillations (HFQT) from telemetric data. The present work aims to characterise the underlying mechanism(s) leading to these autonomic changes. EXPERIMENTAL APPROACH Effects of 15 torsadogenic hERG blocking drugs (astemizole, chlorpromazine, cisapride, droperidol, ibutilide, dofetilide, haloperidol, moxifloxacin, pimozide, quinidine, risperidone, sotalol, sertindole, terfenadine, thioridazine) were assessed by telemetry in beagle dogs. Hemodynamic effects on diastolic and systolic arterial pressure were analysed from the first doses causing QTc prolongation and/or HFQT oscillations enhancement. Autonomic control changes were analysed with the High Frequency Autonomic Modulation (HFAM) model. KEY RESULTS Except moxifloxacin and quinidine, all torsadogenic hERG blockers induced parasympathetic activation or sympatho-vagal coactivation combined with enhancement of HFQT oscillations. These autonomic effects result from reflex compensatory mechanisms in response to mild hemodynamic side effects. These hemodynamic mechanisms were characterised by transient HR acceleration during HF oscillations. A phenomenon of concealed QT prolongation was unmasked for several torsadogenic hERG blockers under β-adrenoceptors blockade by atenolol. Resulting enhancement of HFQT oscillations was shown to contribute directly to triggering of dofetilide induced ventricular arrhythmias. CONCLUSIONS AND IMPLICATIONS This work supports for the first time a contribution of hemodynamic side properties to ventricular arrhythmias triggering by torsadogenic hERG blocking drugs. These hemodynamic side effects may constitute a second component of their arrhythmic profile acting as a trigger alongside their intrinsic arrhythmogenic electrophysiological properties.
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Affiliation(s)
| | - Raafat Fares
- ERBC France, Chemin de Montifault, Baugy, France
| | - Thierry Bastogne
- CRAN CNRS UMR 7039, Université de Lorraine, Vandœuvre-lès-Nancy, France
| | | | - Jean-Yves Le Guennec
- Laboratoire PHYMEDEXP, Université de Montpellier, INSERM, CNRS, Montpellier cedex, France
| | - Jérôme Thireau
- Laboratoire PHYMEDEXP, Université de Montpellier, INSERM, CNRS, Montpellier cedex, France
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Heart rate variability comparison between young males after 4-6 weeks from the end of SARS-CoV-2 infection and controls. Sci Rep 2022; 12:8832. [PMID: 35614330 PMCID: PMC9130989 DOI: 10.1038/s41598-022-12844-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 05/11/2022] [Indexed: 11/11/2022] Open
Abstract
Due to the prolonged inflammatory process induced by infection of the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), indices of autonomic nervous system dysfunction may persist long after viral shedding. Previous studies showed significant changes in HRV parameters in severe (including fatal) infection of SARS-CoV-2. However, few studies have comprehensively examined HRV in individuals who previously presented as asymptomatic or mildly symptomatic cases of COVID-19. In this study, we examined HRV in asymptomatic or mildly symptomatic individuals 5–7 weeks following positive confirmation of SARS-CoV-2 infection. Sixty-five ECG Holter recordings from young (mean age 22.6 ± 3.4 years), physically fit male subjects 4–6 weeks after the second negative test (considered to be the start of recovery) and twenty-six control male subjects (mean age 23.2 ± 2.9 years) were considered in the study. Night-time RR time series were extracted from ECG signals. Selected linear as well as nonlinear HRV parameters were calculated. We found significant differences in Porta’s symbolic analysis parameters V0 and V2 (p < 0.001), α2 (p < 0.001), very low-frequency component (VLF; p = 0.022) and respiratory peak (from the PRSA method; p = 0.012). These differences may be caused by the changes of activity of the parasympathetic autonomic nervous system as well as by the coupling of respiratory rhythm with heart rate due to an increase in pulmonary arterial vascular resistance. The results suggest that the differences with the control group in the HRV parameters, that reflect the functional state of the autonomic nervous system, are measurable after a few weeks from the beginning of the recovery even in the post-COVID group—a young and physically active population. We indicate HRV sensitive markers which may be used in long-term monitoring of patients after recovery.
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Arel E, Rolland L, Thireau J, Torrente AG, Bechard E, Bride J, Jopling C, Demion M, Le Guennec JY. The Effect of Hypothermia and Osmotic Shock on the Electrocardiogram of Adult Zebrafish. BIOLOGY 2022; 11:biology11040603. [PMID: 35453802 PMCID: PMC9025276 DOI: 10.3390/biology11040603] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/08/2022] [Accepted: 04/13/2022] [Indexed: 11/16/2022]
Abstract
Simple Summary Assessing cardiac toxicity of new drugs is a requirement for their approval. One of the parameters which is carefully looked at is the QT interval, which is determined using an electrocardiogram (ECG). Before undertaking clinical trials using human patients, it is important to first perform pre-clinical tests using animal models. Zebrafish are widely used to study cardiac physiology and several reports suggest that although ECG measurement can be performed, the recording configuration appears to affect the results. Our research aimed to provide a comprehensive characterization of adult zebrafish ECG to determine the best practice for using this model during cardiac toxicity trials. We tested three recording configurations and determined that exposing the heart provided the most reliable and reproducible ECG recordings. We also determined the most accurate correction to apply to calculate the corrected QT, which makes the QT interval independent of the heart rate, a critical parameter when assessing drug cardiac toxicity. Overall, our study highlights the best conditions to record zebrafish ECG and demonstrates their utility for cardiac toxicity testing. Abstract The use of zebrafish to explore cardiac physiology has been widely adopted within the scientific community. Whether this animal model can be used to determine drug cardiac toxicity via electrocardiogram (ECG) analysis is still an ongoing question. Several reports indicate that the recording configuration severely affects the ECG waveforms and its derived-parameters, emphasizing the need for improved characterization. To address this problem, we recorded ECGs from adult zebrafish hearts in three different configurations (unexposed heart, exposed heart, and extracted heart) to identify the most reliable method to explore ECG recordings at baseline and in response to commonly used clinical therapies. We found that the exposed heart configuration provided the most reliable and reproducible ECG recordings of waveforms and intervals. We were unable to determine T wave morphology in unexposed hearts. In extracted hearts, ECG intervals were lengthened and P waves were unstable. However, in the exposed heart configuration, we were able to reliably record ECGs and subsequently establish the QT-RR relationship (Holzgrefe correction) in response to changes in heart rate.
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Affiliation(s)
- Elodie Arel
- PhyMedExp, Université de Montpellier, Inserm U1046, UMR CNRS 9412, 34090 Montpellier, France; (E.A.); (J.T.); (E.B.); (J.B.); (M.D.); (J.-Y.L.G.)
- Institut de génomique fonctionnelle (IGF), Université de Montpellier, Inserm U1191, UMR CNRS 5203, 34094 Montpellier, France; (L.R.); (A.G.T.)
| | - Laura Rolland
- Institut de génomique fonctionnelle (IGF), Université de Montpellier, Inserm U1191, UMR CNRS 5203, 34094 Montpellier, France; (L.R.); (A.G.T.)
| | - Jérôme Thireau
- PhyMedExp, Université de Montpellier, Inserm U1046, UMR CNRS 9412, 34090 Montpellier, France; (E.A.); (J.T.); (E.B.); (J.B.); (M.D.); (J.-Y.L.G.)
| | - Angelo Giovanni Torrente
- Institut de génomique fonctionnelle (IGF), Université de Montpellier, Inserm U1191, UMR CNRS 5203, 34094 Montpellier, France; (L.R.); (A.G.T.)
| | - Emilie Bechard
- PhyMedExp, Université de Montpellier, Inserm U1046, UMR CNRS 9412, 34090 Montpellier, France; (E.A.); (J.T.); (E.B.); (J.B.); (M.D.); (J.-Y.L.G.)
| | - Jamie Bride
- PhyMedExp, Université de Montpellier, Inserm U1046, UMR CNRS 9412, 34090 Montpellier, France; (E.A.); (J.T.); (E.B.); (J.B.); (M.D.); (J.-Y.L.G.)
- Institut de génomique fonctionnelle (IGF), Université de Montpellier, Inserm U1191, UMR CNRS 5203, 34094 Montpellier, France; (L.R.); (A.G.T.)
| | - Chris Jopling
- Institut de génomique fonctionnelle (IGF), Université de Montpellier, Inserm U1191, UMR CNRS 5203, 34094 Montpellier, France; (L.R.); (A.G.T.)
- Correspondence:
| | - Marie Demion
- PhyMedExp, Université de Montpellier, Inserm U1046, UMR CNRS 9412, 34090 Montpellier, France; (E.A.); (J.T.); (E.B.); (J.B.); (M.D.); (J.-Y.L.G.)
| | - Jean-Yves Le Guennec
- PhyMedExp, Université de Montpellier, Inserm U1046, UMR CNRS 9412, 34090 Montpellier, France; (E.A.); (J.T.); (E.B.); (J.B.); (M.D.); (J.-Y.L.G.)
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Rollo E, Marotta J, Callea A, Brunetti V, Vollono C, Scala I, Imperatori C, Frisullo G, Broccolini A, Della Marca G. Heart rate variability and delirium in acute non-cardioembolic stroke: a prospective, cross-sectional, cohort study. Neurol Sci 2022; 43:2423-2431. [PMID: 34586543 PMCID: PMC8918184 DOI: 10.1007/s10072-021-05621-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 09/17/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Delirium is an acute fluctuating disorder of attention and awareness. It is associated with autonomic dysfunction and increased mortality. The primary endpoint of our study was to measure autonomic activity in acute stroke patients, by means of heart rate variability analysis, in order to identify autonomic modifications that can predispose to delirium. METHODS Patients were consecutively enrolled from the stroke unit. Inclusion criteria were age ≥ 18 years and diagnosis of stroke with onset within the previous 72 h confirmed by neuroimaging. Exclusion criteria were atrial fibrillation, congestive heart failure, and conditions requiring intensive care unit. Patients were evaluated by means of Richmond Agitation Sedation Scale (RASS) and Confusion Assessment Method-Intensive Care Unit (CAM-ICU) at baseline, after 72 h, or when symptoms suggesting delirium occurred. For each patient, ECG was recorded at baseline assessment and HRV analysis was conducted on five consecutive minutes of artifact-free ECG traces. RESULTS Fifty-six ECGs were available for analysis. During the study period, 11 patients developed delirium. Patients with and without delirium did not differ for sex, age, severity of stroke, and comorbidities. The delirium group had greater standard deviation of the heart rate (DLR - :9.16 ± 8.28; DLR + : 14.36 ± 5.55; p = 0.026) and lower power spectral density of the HF component (DLR - : 38.23 ± 19.23 n.u.; DLR + : 25.75 ± 8.77 n.u.; p = 0.031). CONCLUSIONS Acute non-cardioembolic stroke patients with increased variability of heart rate and decreased vagal control are at risk for delirium.
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Affiliation(s)
- Eleonora Rollo
- Department of Neurosciences, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168, Rome, Italy.
| | - Jessica Marotta
- UOC Neuroriabilitazione Ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Antonio Callea
- Department of Neurosciences, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168, Rome, Italy
| | - Valerio Brunetti
- Dipartimento Scienze Dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Catello Vollono
- Dipartimento Scienze Dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Irene Scala
- Department of Neurosciences, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168, Rome, Italy
| | | | - Giovanni Frisullo
- Dipartimento Scienze Dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Aldobrando Broccolini
- Department of Neurosciences, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168, Rome, Italy
- Dipartimento Scienze Dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giacomo Della Marca
- Department of Neurosciences, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168, Rome, Italy
- Dipartimento Scienze Dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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10
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Risueno-Segovia C, Koç O, Champéroux P, Hage SR. Cardiovascular mechanisms underlying vocal behavior in freely moving macaque monkeys. iScience 2022; 25:103688. [PMID: 35036873 PMCID: PMC8749184 DOI: 10.1016/j.isci.2021.103688] [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: 08/10/2021] [Revised: 12/01/2021] [Accepted: 12/22/2021] [Indexed: 11/30/2022] Open
Abstract
Communication is a keystone of animal behavior. However, the physiological states underlying natural vocal signaling are still largely unknown. In this study, we investigated the correlation of affective vocal utterances with concomitant cardiorespiratory mechanisms. We telemetrically recorded electrocardiography, blood pressure, and physical activity in six freely moving and interacting cynomolgus monkeys (Macaca fascicularis). Our results demonstrate that vocal onsets are strengthened during states of sympathetic activation, and are phase locked to a slower Mayer wave and a faster heart rate signal at ∼2.5 Hz. Vocalizations are coupled with a distinct peri-vocal physiological signature based on which we were able to predict the onset of vocal output using three machine learning classification models. These findings emphasize the role of cardiorespiratory mechanisms correlated with vocal onsets to optimize arousal levels and minimize energy expenditure during natural vocal production. Cardiovascular signals are measured telemetrically in freely moving macaques A distinct cardiovascular physiological signature is present before vocal onset Vocal onsets are phase locked to the Mayer wave and heart rate signals Vocal onsets prediction is performed using machine learning classification models
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Affiliation(s)
- Cristina Risueno-Segovia
- Neurobiology of Social Communication, Department of Otolaryngology-Head and Neck Surgery, Hearing Research Centre, University of Tübingen, Medical Center, Elfriede-Aulhorn-Strasse 5, 72076 Tübingen, Germany.,Werner Reichardt Centre for Integrative Neuroscience, University of Tübingen, Otfried-Müller-Street 25, 72076 Tübingen, Germany.,Graduate School of Neural and Behavioural Sciences-International Max Planck Research School, University of Tübingen, Österberg-Street 3, 72074 Tübingen, Germany
| | - Okan Koç
- Werner Reichardt Centre for Integrative Neuroscience, University of Tübingen, Otfried-Müller-Street 25, 72076 Tübingen, Germany
| | - Pascal Champéroux
- European Research Biology Center, ERBC, Chemin de Montifault, 18800 Baugy, France
| | - Steffen R Hage
- Neurobiology of Social Communication, Department of Otolaryngology-Head and Neck Surgery, Hearing Research Centre, University of Tübingen, Medical Center, Elfriede-Aulhorn-Strasse 5, 72076 Tübingen, Germany.,Werner Reichardt Centre for Integrative Neuroscience, University of Tübingen, Otfried-Müller-Street 25, 72076 Tübingen, Germany
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11
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Sadeghi M, Sasangohar F, McDonald AD. Toward a Taxonomy for Analyzing the Heart Rate as a Physiological Indicator of Posttraumatic Stress Disorder: Systematic Review and Development of a Framework. JMIR Ment Health 2020; 7:e16654. [PMID: 32706710 PMCID: PMC7407264 DOI: 10.2196/16654] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 03/11/2020] [Accepted: 04/03/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is a prevalent psychiatric condition that is associated with symptoms such as hyperarousal and overreactions. Treatments for PTSD are limited to medications and in-session therapies. Assessing the way the heart responds to PTSD has shown promise in detecting and understanding the onset of symptoms. OBJECTIVE This study aimed to extract statistical and mathematical approaches that researchers can use to analyze heart rate (HR) data to understand PTSD. METHODS A scoping literature review was conducted to extract HR models. A total of 5 databases including Medical Literature Analysis and Retrieval System Online (Medline) OVID, Medline EBSCO, Cumulative Index to Nursing and Allied Health Literature (CINAHL) EBSCO, Excerpta Medica Database (Embase) Ovid, and Google Scholar were searched. Non-English language studies, as well as studies that did not analyze human data, were excluded. A total of 54 studies that met the inclusion criteria were included in this review. RESULTS We identified 4 categories of models: descriptive time-independent output, descriptive and time-dependent output, predictive and time-independent output, and predictive and time-dependent output. Descriptive and time-independent output models include analysis of variance and first-order exponential; the descriptive time-dependent output model includes a classical time series analysis and mixed regression. Predictive time-independent output models include machine learning methods and analysis of the HR-based fluctuation-dissipation method. Finally, predictive time-dependent output models include the time-variant method and nonlinear dynamic modeling. CONCLUSIONS All of the identified modeling categories have relevance in PTSD, although the modeling selection is dependent on the specific goals of the study. Descriptive models are well-founded for the inference of PTSD. However, there is a need for additional studies in this area that explore a broader set of predictive models and other factors (eg, activity level) that have not been analyzed with descriptive models.
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Affiliation(s)
- Mahnoosh Sadeghi
- Department of Industrial and Systems Engineering, Texas A&M University, College Station, TX, United States
| | - Farzan Sasangohar
- Department of Industrial and Systems Engineering, Texas A&M University, College Station, TX, United States
- Center for Outcomes Research, Houston Methodist Hospital, Houston, TX, United States
| | - Anthony D McDonald
- Department of Industrial and Systems Engineering, Texas A&M University, College Station, TX, United States
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12
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Champéroux P, Fesler P, Judé S, Richard S, Le Guennec JY, Thireau J. High-frequency autonomic modulation: a new model for analysis of autonomic cardiac control. Br J Pharmacol 2018; 175:3131-3143. [PMID: 29723392 PMCID: PMC6031873 DOI: 10.1111/bph.14354] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 04/18/2018] [Accepted: 04/24/2018] [Indexed: 12/19/2022] Open
Abstract
Background and Purpose Increase in high‐frequency beat‐to‐beat heart rate oscillations by torsadogenic hERG blockers appears to be associated with signs of parasympathetic and sympathetic co‐activation which cannot be assessed directly using classic methods of heart rate variability analysis. The present work aimed to find a translational model that would allow this particular state of the autonomic control of heart rate to be assessed. Experimental Approach High‐frequency heart rate and heart period oscillations were analysed within discrete 10 s intervals in a cohort of 200 healthy human subjects. Results were compared to data collected in non‐human primates and beagle dogs during pharmacological challenges and torsadogenic hERG blockers exposure, in 127 genotyped LQT1 patients on/off β‐blocker treatment and in subgroups of smoking and non‐smoking subjects. Key Results Three states of autonomic modulation, S1 (parasympathetic predominance) to S3 (reciprocal parasympathetic withdrawal/sympathetic activation), were differentiated to build a new model of heart rate variability referred to as high‐frequency autonomic modulation. The S2 state corresponded to a specific state during which both parasympathetic and sympathetic systems were coexisting or co‐activated. S2 oscillations were proportionally increased by torsadogenic hERG‐blocking drugs, whereas smoking caused an increase in S3 oscillations. Conclusions and Implications The combined analysis of the magnitude of high‐frequency heart rate and high‐frequency heart period oscillations allows a refined assessment of heart rate autonomic modulation applicable to long‐term ECG recordings and offers new approaches to assessment of the risk of sudden death both in terms of underlying mechanisms and sensitivity.
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Affiliation(s)
| | - Pierre Fesler
- Department of Internal Medicine, Hopital Lapeyronie, Montpellier, France.,Laboratoire PHYMEDEXP,INSERM U1046, CNRS UMR 9214, Université de Montpellier, CHU Arnaud de Villeneuve, Montpellier Cedex 05, 34295, France
| | - Sebastien Judé
- Centre de Recherches Biologiques, CERB, Baugy, 18800, France
| | - Serge Richard
- Centre de Recherches Biologiques, CERB, Baugy, 18800, France
| | - Jean-Yves Le Guennec
- Laboratoire PHYMEDEXP,INSERM U1046, CNRS UMR 9214, Université de Montpellier, CHU Arnaud de Villeneuve, Montpellier Cedex 05, 34295, France
| | - Jérôme Thireau
- Laboratoire PHYMEDEXP,INSERM U1046, CNRS UMR 9214, Université de Montpellier, CHU Arnaud de Villeneuve, Montpellier Cedex 05, 34295, France
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