1
|
Shankhwar V, Urvec J, Steuber B, Schmid Zalaudek K, Saloň A, Hawliczek A, Bergauer A, Aljasmi K, Abdi A, Naser A, Himeidi M, Alsuwaidi H, Du Plessis S, Alsheikh-Ali A, Kellett C, Bayoumi R, Blaber AP, Goswami N. Effects of menstrual cycle on hemodynamic and autonomic responses to central hypovolemia. Front Cardiovasc Med 2024; 11:1290703. [PMID: 38361585 PMCID: PMC10867210 DOI: 10.3389/fcvm.2024.1290703] [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: 09/07/2023] [Accepted: 01/17/2024] [Indexed: 02/17/2024] Open
Abstract
Background Estrogen and progesterone levels undergo changes throughout the menstrual cycle. Existing literature regarding the effect of menstrual phases on cardiovascular and autonomic regulation during central hypovolemia is contradictory. Aims and study This study aims to explore the influence of menstrual phases on cardiovascular and autonomic responses in both resting and during the central hypovolemia induced by lower body negative pressure (LBNP). This is a companion paper, in which data across the menstrual phases from healthy young females, whose results are reported in Shankwar et al. (2023), were further analysed. Methods The study protocol consisted of three phases: (1) 30 min of supine rest; (2) 16 min of four LBNP levels; and (3) 5 min of supine recovery. Hemodynamic and autonomic responses (assessed via heart rate variability, HRV) were measured before-, during-, and after-LBNP application using Task Force Monitor® (CNSystems, Graz, Austria). Blood was also collected to measure estrogen and progesterone levels. Results In this companion paper, we have exclusively assessed 14 females from the previous study (Shankwar et al., 2023): 8 in the follicular phase of the menstrual cycle (mean age 23.38 ± 3.58 years, height 166.00 ± 5.78 cm, weight 57.63 ± 5.39 kg and BMI of 20.92 ± 1.96 25 kg/m2) and 6 in the luteal phase (mean age 22.17 ± 1.33 years, height 169.83 ± 5.53 cm, weight 62.00 ± 7.54 kg and BMI of 21.45 ± 2.63 kg/m2). Baseline estrogen levels were significantly different from the follicular phase as compared to the luteal phase: (33.59 pg/ml, 108.02 pg/ml, respectively, p < 0.01). Resting hemodynamic variables showed no difference across the menstrual phases. However, females in the follicular phase showed significantly lower resting values of low-frequency (LF) band power (41.38 ± 11.75 n.u. and 58.47 ± 14.37 n.u., p = 0.01), but higher resting values of high frequency (HF) band power (58.62 ± 11.75 n.u. and 41.53 ± 14.37 n.u., p = 0.01), as compared to females in the luteal phase. During hypovolemia, the LF and HF band powers changed only in the follicular phase F(1, 7) = 77.34, p < 0.0001 and F(1, 7) = 520.06, p < 0.0001, respectively. Conclusions The menstrual phase had an influence on resting autonomic variables, with higher sympathetic activity being observed during the luteal phase. Central hypovolemia leads to increased cardiovascular and autonomic responses, particularly during the luteal phase of the menstrual cycle, likely due to higher estrogen levels and increased sympathetic activity.
Collapse
Affiliation(s)
- Vishwajeet Shankhwar
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Janez Urvec
- Faculty of Mechanical Engineering, University of Ljubljana, Ljubljana, Slovenia
| | - Bianca Steuber
- Division of Physiology, Otto Löwi Research Center of Vascular Biology, Immunity and Inflammation, Medical University of Graz, Graz, Austria
| | - Karin Schmid Zalaudek
- Division of Physiology, Otto Löwi Research Center of Vascular Biology, Immunity and Inflammation, Medical University of Graz, Graz, Austria
| | - Adam Saloň
- Division of Physiology, Otto Löwi Research Center of Vascular Biology, Immunity and Inflammation, Medical University of Graz, Graz, Austria
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Lillehammer, Norway
| | - Anna Hawliczek
- Division of Physiology, Otto Löwi Research Center of Vascular Biology, Immunity and Inflammation, Medical University of Graz, Graz, Austria
| | - Andrej Bergauer
- Department of Surgery, General Hospital (LKH) Südsteiermark, Wagna, Austria
| | - Khawla Aljasmi
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Asrar Abdi
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Asmaa Naser
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Maya Himeidi
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Hanan Alsuwaidi
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Stefan Du Plessis
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Alawi Alsheikh-Ali
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Catherine Kellett
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Riad Bayoumi
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Andrew Phillip Blaber
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
| | - Nandu Goswami
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
- Division of Physiology, Otto Löwi Research Center of Vascular Biology, Immunity and Inflammation, Medical University of Graz, Graz, Austria
- Department of Integrative Medicine, Alma Mater Europea, Maribor, Slovenia
| |
Collapse
|
2
|
Jacob DW, Morgenthaler LD, Harper JL, Limberg JK. The forearm vascular response to sympathetic activation is attenuated in female, but not male, participants following acute intermittent hypoxia. J Appl Physiol (1985) 2023; 135:352-361. [PMID: 37410902 PMCID: PMC10396222 DOI: 10.1152/japplphysiol.00760.2022] [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: 12/16/2022] [Revised: 06/05/2023] [Accepted: 06/30/2023] [Indexed: 07/08/2023] Open
Abstract
Acute exposure to hypoxia promotes both an increase in sympathetic nervous system activity (SNA) and local vasodilation. In rodents, intermittent hypoxia (IH)-mediated increases in SNA are associated with an increase in blood pressure in males but not females; notably, the protective effect of female sex is lost following ovariectomy. These data suggest the vascular response to hypoxia and/or SNA following IH may be sex- and/or hormone specific-although mechanisms are unclear. We hypothesized that hypoxia-mediated vasodilation and SNA-mediated vasoconstriction would be unchanged following acute IH in male adults. We further hypothesized that hypoxic vasodilation would be augmented and SNA-mediated vasoconstriction would be attenuated in female adults following acute IH, with the greatest effect when endogenous estradiol was high. Twelve male (25 ± 1 yr) and 10 female (25 ± 1 yr) participants underwent 30 min of IH. Females were studied in a low (early follicular) and high (late follicular) estradiol state. Preceding and following IH, participants completed two trials [steady-state hypoxia and cold pressor test (CPT)], where forearm blood flow and blood pressure were measured and used to determine forearm vascular conductance (FVC). The FVC response to hypoxia (P = 0.67) and sympathetic activation (P = 0.73) were unchanged following IH in males. There was no effect of IH on hypoxic vasodilation in females, regardless of estradiol state (P = 0.75). In contrast, the vascular response to sympathetic activation was attenuated in females following IH (P = 0.02), independent of estradiol state (P = 0.65). Present data highlight sex-related differences in neurovascular responsiveness following acute IH.NEW & NOTEWORTHY We examined the effects of acute intermittent hypoxia (AIH) on the vascular response to sympathetic activation and acute hypoxia. Present findings show, despite no effect of AIH on the vascular response to hypoxia, the forearm vasoconstrictor response to acute sympathetic activation is attenuated in females following AIH, independent of estradiol state. These data provide mechanistic understanding of potential benefits of AIH, as well as the impact of biological sex.
Collapse
Affiliation(s)
- Dain W Jacob
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri, United States
| | - Leandra D Morgenthaler
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri, United States
| | - Jennifer L Harper
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri, United States
| | - Jacqueline K Limberg
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri, United States
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri, United States
| |
Collapse
|
3
|
Bačkorová B, Lazúrová I. Selected biomarkers of orthostatic intolerance. VNITRNI LEKARSTVI 2023; 69:15-19. [PMID: 37827818 DOI: 10.36290/vnl.2023.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
Orthostatic intolerance (OI) is defined as a group of diseases which symptoms are typically manifested in a standing position. These symptoms result from cerebral hypoperfusion and disappear in the supine position. We include postural orthostatic intolerance syndrome (POTS), orthostatic hypotension (OH) and vasovagal orthostatic syncope in this group of diseases. Each of them have similar clinical presentation (blurred vision, weakness, dizziness, nausea, headaches, fatigue). However, they vary from each other in biochemical, autonomic and hemodynamic characteristics. The aim of the work is to provide an overview of humoral and non-human markers that are involved in the etiopathogenesis of orthostatic intolerance.
Collapse
|
4
|
Stute NL, Szeghy RE, Mackowski NS. All is fair in menstruation, POTS, and… war? J Physiol 2022; 600:4055-4057. [PMID: 35913261 DOI: 10.1113/jp283297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Nina L Stute
- Signature Tracking for Optimized Nutrition and Training Lab, Air Force Research Labs, Wright Patterson Air Force Base, Dayton, OH
| | - Rachel E Szeghy
- Exercise Respiratory and Physiology Lab, Department of Health & Exercise Science, Appalachian State University, Boone, NC
| | - Nicholas S Mackowski
- Signature Tracking for Optimized Nutrition and Training Lab, Air Force Research Labs, Wright Patterson Air Force Base, Dayton, OH
| |
Collapse
|
5
|
Ely BR, Francisco MA, Halliwill JR, Bryan SD, Comrada LN, Larson EA, Brunt VE, Minson CT. Heat therapy reduces sympathetic activity and improves cardiovascular risk profile in women who are obese with polycystic ovary syndrome. Am J Physiol Regul Integr Comp Physiol 2019; 317:R630-R640. [PMID: 31483156 DOI: 10.1152/ajpregu.00078.2019] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Polycystic ovary syndrome (PCOS) affects up to 15% of women and is associated with increased risk of obesity and cardiovascular disease. Repeated passive heat exposure [termed "heat therapy" (HT)] is a lifestyle intervention with the potential to reduce cardiovascular risk in obesity and PCOS. Women with obesity (n = 18) with PCOS [age 27 ± 4 yr, body mass index (BMI) 41.3 ± 4.7 kg/m2] were matched for age and BMI, then assigned to HT (n = 9) or time control (CON; n = 9). HT subjects underwent 30 one-hour hot tub sessions over 8-10 wk, whereas CON subjects did not undergo HT. Muscle sympathetic nerve activity (MSNA), blood pressure, cholesterol, C-reactive protein, and markers of vascular function were assessed at the start (Pre) and end (Post) of 8-10 wk. These measures included carotid and femoral artery wall thickness and flow-mediated dilation (FMD), measured both before and after 20 min of ischemia-20 min of reperfusion (I/R) stress. HT subjects exhibited reduced MSNA burst frequency (Pre: 20 ± 8 bursts/min, Post: 13 ± 5 bursts/min, P = 0.012), systolic (Pre: 124 ± 5 mmHg, Post: 114 ± 6 mmHg; P < 0.001) and diastolic blood pressure (Pre: 77 ± 6 mmHg, Post: 68 ± 3 mmHg; P < 0.001), C-reactive protein (Pre: 19.4 ± 13.7 nmol/L, Post: 15.2 ± 12.3 nmol/L; P = 0.018), total cholesterol (Pre: 5.4 ± 1.1 mmol/L, Post: 5.0 ± 0.8 mmol/L; P = 0.028), carotid wall thickness (Pre: 0.054 ± 0.005 cm, Post: 0.044 ± 0.005 cm; P = 0.010), and femoral wall thickness (Pre: 0.056 ± 0.009 cm, Post: 0.042 ± 0.005 cm; P = 0.003). FMD significantly improved in HT subjects over time following I/R (Pre: 5.6 ± 2.5%, Post: 9.5 ± 1.7%; P < 0.001). No parameters changed over time in CON, and BMI did not change in either group. These findings indicate that HT reduces sympathetic nerve activity, provides protection from I/R stress, and substantially improves cardiovascular risk profiles in women who are obese with PCOS.
Collapse
Affiliation(s)
- Brett R Ely
- Department of Human Physiology, University of Oregon, Eugene, Oregon.,Department of Sport and Movement Science, Salem State University, Salem, Massachusetts
| | | | - John R Halliwill
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Samantha D Bryan
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Lindan N Comrada
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Emily A Larson
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Vienna E Brunt
- Department of Human Physiology, University of Oregon, Eugene, Oregon.,Department of Integrative Physiology, University of Colorado, Boulder, Colorado
| | | |
Collapse
|
6
|
Bryarly M, Phillips LT, Fu Q, Vernino S, Levine BD. Postural Orthostatic Tachycardia Syndrome. J Am Coll Cardiol 2019; 73:1207-1228. [DOI: 10.1016/j.jacc.2018.11.059] [Citation(s) in RCA: 93] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 11/01/2018] [Accepted: 11/05/2018] [Indexed: 12/26/2022]
|
7
|
Stewart JM, Suggs M, Merchant S, Sutton R, Terilli C, Visintainer P, Medow MS. Postsynaptic α1-Adrenergic Vasoconstriction Is Impaired in Young Patients With Vasovagal Syncope and Is Corrected by Nitric Oxide Synthase Inhibition. Circ Arrhythm Electrophysiol 2017; 9:CIRCEP.115.003828. [PMID: 27444639 DOI: 10.1161/circep.115.003828] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 06/15/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Syncope is a sudden transient loss of consciousness and postural tone with spontaneous recovery; the most common form is vasovagal syncope (VVS). During VVS, gravitational pooling excessively reduces central blood volume and cardiac output. In VVS, as in hemorrhage, impaired adrenergic vasoconstriction and venoconstriction result in hypotension. We hypothesized that impaired adrenergic responsiveness because of excess nitric oxide can be reversed by reducing nitric oxide. METHODS AND RESULTS We recorded cardiopulmonary dynamics in supine syncope patients and healthy volunteers (aged 15-27 years) challenged with a dose-response using the α1-agonist phenylephrine (PE), with and without the nitric oxide synthase inhibitor N(G)-monomethyl-L-arginine, monoacetate salt (L-NMMA). Systolic and diastolic pressures among control and VVS were the same, although they increased after L-NMMA and saline+PE (volume and pressor control for L-NMMA). Heart rate was significantly reduced by L-NMMA (P<0.05) for control and VVS compared with baseline, but there was no significant difference in heart rate between L-NMMA and saline+PE. Cardiac output and splanchnic blood flow were reduced by L-NMMA for control and VVS (P<0.05) compared with baseline, while total peripheral resistance increased (P<0.05). PE dose-response for splanchnic flow and resistance were blunted for VVS compared with control after saline+PE, but enhanced after L-NMMA (P<0.001). Postsynaptic α1-adrenergic vasoconstrictive impairment was greatest in the splanchnic vasculature, and splanchnic blood flow was unaffected by PE. Forearm and calf α1-adrenergic vasoconstriction were unimpaired in VVS and unaffected by L-NMMA. CONCLUSIONS Impaired postsynaptic α1-adrenergic vasoconstriction in young adults with VVS can be corrected by nitric oxide synthase inhibition, demonstrated with our use of L-NMMA.
Collapse
Affiliation(s)
- Julian M Stewart
- From the Departments of Pediatrics (J.M.S., S.M., C.T., M.S.M.), Physiology (J.M.S., M.S., M.S.M.), New York Medical College, Valhalla, NY; The National Heart & Lung Institute, Imperial College, London, United Kingdom (R.S.); and Department of Medicine, Baystate Medical Center, Springfield & Tufts University School of Medicine, MA (P.V.).
| | - Melissa Suggs
- From the Departments of Pediatrics (J.M.S., S.M., C.T., M.S.M.), Physiology (J.M.S., M.S., M.S.M.), New York Medical College, Valhalla, NY; The National Heart & Lung Institute, Imperial College, London, United Kingdom (R.S.); and Department of Medicine, Baystate Medical Center, Springfield & Tufts University School of Medicine, MA (P.V.)
| | - Sana Merchant
- From the Departments of Pediatrics (J.M.S., S.M., C.T., M.S.M.), Physiology (J.M.S., M.S., M.S.M.), New York Medical College, Valhalla, NY; The National Heart & Lung Institute, Imperial College, London, United Kingdom (R.S.); and Department of Medicine, Baystate Medical Center, Springfield & Tufts University School of Medicine, MA (P.V.)
| | - Richard Sutton
- From the Departments of Pediatrics (J.M.S., S.M., C.T., M.S.M.), Physiology (J.M.S., M.S., M.S.M.), New York Medical College, Valhalla, NY; The National Heart & Lung Institute, Imperial College, London, United Kingdom (R.S.); and Department of Medicine, Baystate Medical Center, Springfield & Tufts University School of Medicine, MA (P.V.)
| | - Courtney Terilli
- From the Departments of Pediatrics (J.M.S., S.M., C.T., M.S.M.), Physiology (J.M.S., M.S., M.S.M.), New York Medical College, Valhalla, NY; The National Heart & Lung Institute, Imperial College, London, United Kingdom (R.S.); and Department of Medicine, Baystate Medical Center, Springfield & Tufts University School of Medicine, MA (P.V.)
| | - Paul Visintainer
- From the Departments of Pediatrics (J.M.S., S.M., C.T., M.S.M.), Physiology (J.M.S., M.S., M.S.M.), New York Medical College, Valhalla, NY; The National Heart & Lung Institute, Imperial College, London, United Kingdom (R.S.); and Department of Medicine, Baystate Medical Center, Springfield & Tufts University School of Medicine, MA (P.V.)
| | - Marvin S Medow
- From the Departments of Pediatrics (J.M.S., S.M., C.T., M.S.M.), Physiology (J.M.S., M.S., M.S.M.), New York Medical College, Valhalla, NY; The National Heart & Lung Institute, Imperial College, London, United Kingdom (R.S.); and Department of Medicine, Baystate Medical Center, Springfield & Tufts University School of Medicine, MA (P.V.).
| |
Collapse
|
8
|
Stewart JM, Sutton R, Kothari ML, Goetz AM, Visintainer P, Medow MS. Nitric oxide synthase inhibition restores orthostatic tolerance in young vasovagal syncope patients. Heart 2017; 103:1711-1718. [PMID: 28501796 DOI: 10.1136/heartjnl-2017-311161] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 03/21/2017] [Accepted: 03/21/2017] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Syncope is sudden transient loss of consciousness and postural tone with spontaneous recovery; the most common form is vasovagal syncope (VVS). We previously demonstrated impaired post-synaptic adrenergic responsiveness in young VVS patients was reversed by blocking nitric oxide synthase (NOS). We hypothesised that nitric oxide may account for reduced orthostatic tolerance in young recurrent VVS patients. METHODS We recorded haemodynamics in supine VVS and healthy volunteers (aged 15-27 years), challenged with graded lower body negative pressure (LBNP) (-15, -30, -45 mm Hg each for 5 min, then -60 mm Hg for a maximum of 50 min) with and without NOS inhibitor NG-monomethyl-L-arginine acetate (L-NMMA). Saline plus phenylephrine (Saline+PE) was used as volume and pressor control for L-NMMA. RESULTS Controls endured 25.9±4.0 min of LBNP during Saline+PE compared with 11.6±1.4 min for fainters (p<0.001). After L-NMMA, control subjects endured 24.8±3.2 min compared with 22.6±1.6 min for fainters. Mean arterial pressure decreased more in VVS patients during LBNP with Saline+PE (p<0.001) which was reversed by L-NMMA; cardiac output decreased similarly in controls and VVS patients and was unaffected by L-NMMA. Total peripheral resistance increased for controls but decreased for VVS during Saline+PE (p<0.001) but was similar following L-NMMA. Splanchnic vascular resistance increased during LBNP in controls, but decreased in VVS patients following Saline+PE which L-NMMA restored. CONCLUSIONS We conclude that arterial vasoconstriction is impaired in young VVS patients, which is corrected by NOS inhibition. The data suggest that both pre- and post-synaptic arterial vasoconstriction may be affected by nitric oxide.
Collapse
Affiliation(s)
- Julian M Stewart
- Departments of Pediatrics, New York Medical College, Valhalla, New York, USA.,Departments of Physiology, New York Medical College, Valhalla, New York, USA
| | - Richard Sutton
- The National Heart & Lung Institute, Imperial College, London, UK
| | - Mira L Kothari
- Departments of Pediatrics, New York Medical College, Valhalla, New York, USA
| | - Amanda M Goetz
- Departments of Pediatrics, New York Medical College, Valhalla, New York, USA
| | - Paul Visintainer
- Baystate Medical Center, University of Massachusetts School of Medicine 4, Springfield MA, USA
| | - Marvin Scott Medow
- Departments of Pediatrics, New York Medical College, Valhalla, New York, USA.,Departments of Physiology, New York Medical College, Valhalla, New York, USA
| |
Collapse
|
9
|
Ruzieh M, Baugh A, Dasa O, Parker RL, Perrault JT, Renno A, Karabin BL, Grubb B. Effects of intermittent intravenous saline infusions in patients with medication—refractory postural tachycardia syndrome. J Interv Card Electrophysiol 2017; 48:255-260. [DOI: 10.1007/s10840-017-0225-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 01/24/2017] [Indexed: 10/20/2022]
|
10
|
Reulecke S, Charleston-Villalobos S, Voss A, González-Camarena R, González-Hermosillo J, Gaitán-González MJ, Hernández-Pacheco G, Schroeder R, Aljama-Corrales T. Orthostatic stress causes immediately increased blood pressure variability in women with vasovagal syncope. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2016; 127:185-196. [PMID: 26775735 DOI: 10.1016/j.cmpb.2015.12.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 12/11/2015] [Accepted: 12/17/2015] [Indexed: 06/05/2023]
Abstract
The cardiovascular and respiratory autonomic nervous regulation has been studied mainly by hemodynamic responses during different physical stressors. In this study, dynamics of autonomic response to an orthostatic challenge was investigated by hemodynamic variables and by diverse linear and nonlinear indices calculated from time series of beat-to-beat intervals (BBI), respiratory cycle duration (RESP), systolic (SYS) and diastolic (DIA) blood pressure. This study included 16 young female patients (SYN) with vasovagal syncope and 12 age-matched female controls (CON). The subjects were enrolled in a head-up tilt (HUT) test, breathing normally, including 5min of baseline (BL, supine position) and 18min of 70° orthostatic phase (OP). To increase the time resolution of the analysis the time series were segmented in five-minute overlapping windows with a shift of 1min. Hemodynamic parameters did not show any statistical differences between SYN and CON. Time domain linear analysis revealed increased respiratory frequency and increased blood pressure variability (BPV) in patients during OP meaning increased sympathetic activity and vagal withdrawal. Frequency domain analysis confirmed a predominance of sympathetic tone by steadily increased values of low over high frequency power in BBI and of low frequency power in SYS and DIA in patients during OP. The nonlinear analysis by symbolic dynamics seemed to be highly suitable for differentiation of SYN and CON in the early beginning of OP, i.e., 5min after tilt-up. In particular the index SYS_plvar3 showed less patterns of low variability in patients reflecting a steadily increase in both BPV and sympathetic activity. The proposed dynamical analysis could lead to a better understanding of the temporal underlying mechanisms in healthy subjects and patients under orthostatic stress.
Collapse
Affiliation(s)
- S Reulecke
- Universidad Autónoma Metropolitana, Electrical Engineering Department, Mexico City, Mexico
| | | | - A Voss
- University of Applied Sciences Jena, Department of Medical Engineering and Biotechnology, Jena, Germany
| | - R González-Camarena
- Universidad Autónoma Metropolitana, Health Science Department, Mexico City, Mexico
| | | | - M J Gaitán-González
- Universidad Autónoma Metropolitana, Health Science Department, Mexico City, Mexico
| | | | - R Schroeder
- University of Applied Sciences Jena, Department of Medical Engineering and Biotechnology, Jena, Germany
| | - T Aljama-Corrales
- Universidad Autónoma Metropolitana, Electrical Engineering Department, Mexico City, Mexico
| |
Collapse
|