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Liu H, Liang H, Yu X, Han Y, Wang G, Yan M, Wang W, Li S. A study on the immediate effects of enhanced external counterpulsation on physiological coupling. Front Neurosci 2023; 17:1197598. [PMID: 37351421 PMCID: PMC10282182 DOI: 10.3389/fnins.2023.1197598] [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: 03/31/2023] [Accepted: 05/22/2023] [Indexed: 06/24/2023] Open
Abstract
Introduction Enhanced external counterpulsation (EECP) is a non-invasive assisted circulation technique for its clinical application in the rehabilitation and management of ischemic cardiovascular and cerebrovascular diseases, which has complex physiological and hemodynamic effects. However, the effects of EECP on the coupling of physiological systems are still unclear. We aimed to investigate the immediate effects of EECP on the coupling between integrated physiological systems such as cardiorespiratory and cardiovascular systems. Methods Based on a random sham-controlled design, simultaneous electrocardiography, photoplethysmography, bio-electrical impedance, and continuous hemodynamic data were recorded before, during and after two consecutive 30 min EECP in 41 healthy adults. Physiological coupling strength quantified by phase synchronization indexes (PSI), hemodynamic measurements and heart rate variability indices of 22 subjects (female/male: 10/12; age: 22.6 ± 2.1 years) receiving active EECP were calculated and compared with those of 19 sham control subjects (female/male: 7/12; age: 23.6 ± 2.5 years). Results Immediately after the two consecutive EECP interventions, the physiological coupling between respiratory and cardiovascular systems PSIRES-PTT (0.34 ± 0.14 vs. 0.49 ± 0.17, P = 0.002), the physiological coupling between cardiac and cardiovascular systems PSIIBI-PTT (0.41 ± 0.14 vs. 0.52 ± 0.16, P = 0.006) and the total physiological coupling PSItotal (1.21 ± 0.35 vs. 1.57 ± 0.49, P = 0.005) in the EECP group were significantly lower than those before the EECP intervention, while the physiological coupling indexes in the control group did not change significantly (P > 0.05). Conclusion Our study provides evidence that the PSI is altered by immediate EECP intervention. We speculate that the reduced PSI induced by EECP may be a marker of disturbed physiological coupling. This study provides a new method for exploring the mechanism of EECP action and may help to further optimize the EECP technique.
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Affiliation(s)
- Hongyun Liu
- Research Center for Biomedical Engineering, Medical Innovation Research Division, Chinese PLA General Hospital, Beijing, China
- Key Laboratory of Biomedical Engineering and Translational Medicine, Ministry of Industry and Information Technology, Beijing, China
| | - Hui Liang
- Department of Hyperbaric Oxygen, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Xiaohua Yu
- Research Center for Biomedical Engineering, Medical Innovation Research Division, Chinese PLA General Hospital, Beijing, China
- Key Laboratory of Biomedical Engineering and Translational Medicine, Ministry of Industry and Information Technology, Beijing, China
| | - Yi Han
- Research Center for Biomedical Engineering, Medical Innovation Research Division, Chinese PLA General Hospital, Beijing, China
- Key Laboratory of Biomedical Engineering and Translational Medicine, Ministry of Industry and Information Technology, Beijing, China
| | - Guojing Wang
- Research Center for Biomedical Engineering, Medical Innovation Research Division, Chinese PLA General Hospital, Beijing, China
- Key Laboratory of Biomedical Engineering and Translational Medicine, Ministry of Industry and Information Technology, Beijing, China
| | - Muyang Yan
- Department of Hyperbaric Oxygen, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Weidong Wang
- Research Center for Biomedical Engineering, Medical Innovation Research Division, Chinese PLA General Hospital, Beijing, China
- Key Laboratory of Biomedical Engineering and Translational Medicine, Ministry of Industry and Information Technology, Beijing, China
| | - Shijun Li
- Department of Diagnostic Radiology, First Medical Center, Chinese PLA General Hospital, Beijing, China
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Liu H, Liang H, Yu X, Wang G, Han Y, Yan M, Li S, Wang W. Enhanced external counterpulsation modulates the heartbeat evoked potential. Front Physiol 2023; 14:1144073. [PMID: 37078023 PMCID: PMC10106756 DOI: 10.3389/fphys.2023.1144073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 03/23/2023] [Indexed: 04/05/2023] Open
Abstract
Introduction: Accumulating evidence suggests that enhanced external counterpulsation (EECP) influences cardiac functions, hemodynamic characteristics and cerebral blood flow. However, little is known about whether or how the EECP affects the brain-heart coupling to produce these physiological and functional changes. We aimed to determine if the brain-heart coupling is altered during or after EECP intervention by assessing the heartbeat evoked potential (HEP) in healthy adults.Methods: Based on a random sham-controlled design, simultaneous electroencephalography and electrocardiography signals as well as blood pressure and flow status data were recorded before, during and after two consecutive 30-min EECP in 40 healthy adults (female/male: 17/23; age: 23.1 ± 2.3 years). HEP amplitude, frequency domain heart rate variability, electroencephalographic power and hemodynamic measurements of 21 subjects (female/male: 10/11; age: 22.7 ± 2.1 years) receiving active EECP were calculated and compared with those of 19 sham control subjects (female/male: 7/12; age: 23.6 ± 2.5 years).Results: EECP intervention caused immediate obvious fluctuations of HEP from 100 to 400 ms after T-peak and increased HEP amplitudes in the (155–169) ms, (354–389) ms and (367–387) ms time windows after T-peak in the region of the frontal pole lobe. The modifications in HEP amplitude were not associated with changes in the analyzed significant physiological measurements and hemodynamic variables.Discussion: Our study provides evidence that the HEP is modulated by immediate EECP stimuli. We speculate that the increased HEP induced by EECP may be a marker of enhanced brain-heart coupling. HEP may serve as a candidate biomarker for the effects and responsiveness to EECP.
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Affiliation(s)
- Hongyun Liu
- Research Center for Biomedical Engineering, Medical Innovation Research Division, Chinese PLA General Hospital, Beijing, China
- Key Laboratory of Biomedical Engineering and Translational Medicine, Ministry of Industry and Information Technology, Beijing, China
- *Correspondence: Hongyun Liu, ; Muyang Yan, ; Shijun Li, ; Weidong Wang,
| | - Hui Liang
- Department of Hyperbaric Oxygen, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Xiaohua Yu
- Research Center for Biomedical Engineering, Medical Innovation Research Division, Chinese PLA General Hospital, Beijing, China
- Key Laboratory of Biomedical Engineering and Translational Medicine, Ministry of Industry and Information Technology, Beijing, China
| | - Guojing Wang
- Research Center for Biomedical Engineering, Medical Innovation Research Division, Chinese PLA General Hospital, Beijing, China
- Key Laboratory of Biomedical Engineering and Translational Medicine, Ministry of Industry and Information Technology, Beijing, China
| | - Yi Han
- Research Center for Biomedical Engineering, Medical Innovation Research Division, Chinese PLA General Hospital, Beijing, China
- Key Laboratory of Biomedical Engineering and Translational Medicine, Ministry of Industry and Information Technology, Beijing, China
| | - Muyang Yan
- Department of Hyperbaric Oxygen, The First Medical Center, Chinese PLA General Hospital, Beijing, China
- *Correspondence: Hongyun Liu, ; Muyang Yan, ; Shijun Li, ; Weidong Wang,
| | - Shijun Li
- Department of Diagnostic Radiology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
- *Correspondence: Hongyun Liu, ; Muyang Yan, ; Shijun Li, ; Weidong Wang,
| | - Weidong Wang
- Research Center for Biomedical Engineering, Medical Innovation Research Division, Chinese PLA General Hospital, Beijing, China
- Key Laboratory of Biomedical Engineering and Translational Medicine, Ministry of Industry and Information Technology, Beijing, China
- *Correspondence: Hongyun Liu, ; Muyang Yan, ; Shijun Li, ; Weidong Wang,
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Liu H, Yu X, Wang G, Han Y, Wang W. Effects of 24-h acute total sleep deprivation on physiological coupling in healthy young adults. Front Neurosci 2022; 16:952329. [PMID: 36161147 PMCID: PMC9493191 DOI: 10.3389/fnins.2022.952329] [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: 05/25/2022] [Accepted: 08/22/2022] [Indexed: 11/15/2022] Open
Abstract
Sleep deprivation is associated with dysregulation of the autonomic nervous system, adverse cardiovascular events, cognitive and complex motor performance impairment. Less is known about the effects of acute total sleep deprivation (ATSD) on physiological coupling. We aimed to determine the effects of 24-h ATSD on the physiological coupling between complex subsystems by evaluating the cardiorespiratory, cardiovascular and cortico-cardiac interactions. This study enrolled 38 young healthy participants aged 23.2 ± 2.4 years. Multiple synchronous physiological signals including electrocardiography, photoplethysmography, bio-electrical impedance, electroencephalography, and continuous hemodynamic data, were performed over a baseline night after regular sleep and after a night with 24-h ATSD in the supine position. The magnitude squared coherence, phase synchronization index, and heartbeat evoked potential amplitudes, were obtained from 10-min synchronous physiological recordings to estimate the coupling strength between two time series. Parameters of hemodynamic characteristics and heart rate variability were also calculated to quantify autonomic regulation. Results indicated that the magnitude squared coherence (0.38 ± 0.17 vs. 0.29 ± 0.12, p = 0.015) between respiration and heart rate variability along with the magnitude squared coherence (0.36 ± 0.18 vs. 0.27 ± 0.13, p = 0.012) between respiration and pulse transit time were significantly decreased after 24-h ATSD. There were no significant differences (all p > 0.05) in phase synchronization indices, heartbeat evoked potential amplitudes as well as other analyzed measurements between baseline and 24-h ATSD states. We conclude that exposure to 24-h ATSD appears to weaken the cardiorespiratory and respiratory-cardiovascular coupling strength of young healthy adults. These findings suggest that physiological coupling analysis may serve as a complementary approach for characterizing and understanding the complex effects of sleep deprivation.
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Affiliation(s)
- Hongyun Liu
- Medical Innovation Research Division, Research Center for Biomedical Engineering, Chinese PLA General Hospital, Beijing, China
- Key Laboratory of Biomedical Engineering and Translational Medicine, Ministry of Industry and Information Technology, Beijing, China
- *Correspondence: Hongyun Liu,
| | - Xiaohua Yu
- Medical Innovation Research Division, Research Center for Biomedical Engineering, Chinese PLA General Hospital, Beijing, China
- Key Laboratory of Biomedical Engineering and Translational Medicine, Ministry of Industry and Information Technology, Beijing, China
| | - Guojing Wang
- Medical Innovation Research Division, Research Center for Biomedical Engineering, Chinese PLA General Hospital, Beijing, China
- Key Laboratory of Biomedical Engineering and Translational Medicine, Ministry of Industry and Information Technology, Beijing, China
| | - Yi Han
- Medical Innovation Research Division, Research Center for Biomedical Engineering, Chinese PLA General Hospital, Beijing, China
- Key Laboratory of Biomedical Engineering and Translational Medicine, Ministry of Industry and Information Technology, Beijing, China
| | - Weidong Wang
- Medical Innovation Research Division, Research Center for Biomedical Engineering, Chinese PLA General Hospital, Beijing, China
- Key Laboratory of Biomedical Engineering and Translational Medicine, Ministry of Industry and Information Technology, Beijing, China
- Weidong Wang,
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Zhang Y, Wang J, Xing Y, Cui C, Cheng H, Chen Z, Chen H, Liu C, Wang N, Chen M. Dynamics of Cardiac Autonomic Responses During Hemodialysis Measured by Heart Rate Variability and Skin Sympathetic Nerve Activity: The Impact of Interdialytic Weight Gain. Front Physiol 2022; 13:890536. [PMID: 35651871 PMCID: PMC9149205 DOI: 10.3389/fphys.2022.890536] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 04/20/2022] [Indexed: 01/08/2023] Open
Abstract
Background: Autonomic nervous regulation plays a critical role in end-stage kidney disease (ESKD) patients with cardiovascular complications. However, studies on autonomic regulation in ESKD patients are limited to heart rate variability (HRV) analysis. Skin sympathetic nerve activity (SKNA), which noninvasively reflects the sympathetic nerve activity, has not been used in ESKD patients.Methods: Seventy-six patients on maintenance hemodialysis (MHD) treatment (a 4-h HD session, three times a week) were enrolled. Utilizing a noninvasive, single-lead, high-frequency recording system, we analyzed the dynamic change in HRV parameters and SKNA during HD. The different characteristics between the subgroups divided based on interdialytic weight gain (IDWG, <3 kg or ≥3 kg) were also demonstrated.Results: After the HD, values for heart rate (75.1 ± 11.3 to 80.3 ± 12.3 bpm, p < 0.001) and LF/HF (1.92 ± 1.67 to 2.18 ± 2.17, p = 0.013) were significantly higher than baseline. In subgroup analysis, average voltage of skin sympathetic nerve activity (aSKNA) in IDWG ≥3 kg group was lower than the IDWG <3 kg group at the end of MHD (1.06 ± 0.30 vs 1.32 ± 0.61 μV, p = 0.046). Moreover, there was a linear correlation between mean heart rate (HR) and aSKNA in low IDWG patients (p < 0.001), which was not found in high IDWG patients. At the 1-year follow-up, high IDWG patients had a higher incidence of cardiovascular hospitalization (p = 0.046).Conclusions: In MHD patients, a gradual activation of sympathetic nerve activity could be measured by HRV and aSKNA. A lower aSKNA at the end of HD and a loss of HR-aSKNA correlation in overhydrated patients were observed. Extensive volume control is promising to improve the autonomic nervous function and clinical outcomes in this population.
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Affiliation(s)
- Yike Zhang
- Division of Cardiology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jing Wang
- Department of Nephrology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yantao Xing
- School of Instrument Science and Engineering, Southeast University, Nanjing, China
| | - Chang Cui
- Division of Cardiology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hongyi Cheng
- Division of Cardiology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zhenye Chen
- Division of Cardiology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hongwu Chen
- Division of Cardiology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Chengyu Liu
- School of Instrument Science and Engineering, Southeast University, Nanjing, China
| | - Ningning Wang
- Department of Nephrology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- *Correspondence: Ningning Wang, ; Minglong Chen,
| | - Minglong Chen
- Division of Cardiology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- *Correspondence: Ningning Wang, ; Minglong Chen,
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Reduced System Complexity of Heart Rate Dynamics in Patients with Hyperthyroidism: A Multiscale Entropy Analysis. ENTROPY 2022; 24:e24020258. [PMID: 35205552 PMCID: PMC8871399 DOI: 10.3390/e24020258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/04/2022] [Accepted: 02/07/2022] [Indexed: 02/04/2023]
Abstract
Studying heart rate dynamics would help understand the effects caused by a hyperkinetic heart in patients with hyperthyroidism. By using a multiscale entropy (MSE) analysis of heart rate dynamics derived from one-channel electrocardiogram recording, we aimed to compare the system complexity of heart rate dynamics between hyperthyroid patients and control subjects. A decreased MSE complexity index (CI) computed from MSE analysis reflects reduced system complexity. Compared with the control subjects (n = 37), the hyperthyroid patients (n = 37) revealed a significant decrease (p < 0.001) in MSE CI (hyperthyroid patients 10.21 ± 0.37 versus control subjects 14.08 ± 0.21), sample entropy for each scale factor (from 1 to 9), and high frequency power (HF) as well as a significant increase (p < 0.001) in low frequency power (LF) in normalized units (LF%) and ratio of LF to HF (LF/HF). In conclusion, besides cardiac autonomic dysfunction, the system complexity of heart rate dynamics is reduced in hyperthyroidism. This finding implies that the adaptability of the heart rate regulating system is impaired in hyperthyroid patients. Additionally, it might explain the exercise intolerance experienced by hyperthyroid patients. In addition, hyperthyroid patients and control subjects could be distinguished by the MSE CI computed from MSE analysis of heart rate dynamics.
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