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Zhao Y, Yu H, Gong A, Zhang S, Xiao B. Heart rate variability and cardiovascular diseases: A Mendelian randomization study. Eur J Clin Invest 2024; 54:e14085. [PMID: 37641564 DOI: 10.1111/eci.14085] [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: 02/03/2023] [Revised: 06/23/2023] [Accepted: 08/01/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND The causal relationship between heart rate variability and cardiovascular diseases and the associated events is still unclear, and the conclusions of current studies are inconsistent. We aimed to explore the relationship between heart rate variability and cardiovascular diseases and the associated events with the Mendelian randomization study. METHODS We selected normal-to-normal inter-beat intervals (SDNN), root mean square of the successive differences of inter-beat intervals (RMSSD) and peak-valley respiratory sinus arrhythmia or high-frequency power (pvRSA/HF) as the three sets of instrumental variables for heart rate variability. The outcome for cardiovascular diseases included essential hypertension, heart failure, angina pectoris, myocardial infarction, nonischemic cardiomyopathy and arrhythmia. Cardiac arrest, cardiac death and major coronary heart disease event were defined as the related events of cardiovascular diseases. The data for exposures and outcomes were derived from publicly available genome-wide association studies. Inverse variance weighted was used for the main causal estimation. Analyses of heterogeneity and pleiotropy were conducted using the Cochran Q test of Inverse variance weighted and MR-Egger, leave-one-out analysis, and MR-Pleiotropy Residual Sum and Outlier methods. RESULTS The Inverse variance weighted method indicated that genetically predicted pvRSA/HF was associated with the increased risk of cardiac arrest (odds ratio 2.02, 95% confidence interval 1.25-3.28, p = .004). The results were free of heterogeneity and pleiotropy. There were no outliers and the leave-one-out analysis proved that the results were reliable. CONCLUSIONS This study provides genetic evidence that pvRSA/HF is causally related to cardiac arrest.
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Affiliation(s)
- Yan Zhao
- Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Hangtian Yu
- Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Angwei Gong
- Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Shuaidan Zhang
- Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Bing Xiao
- Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
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Stavres J, Aultman RA, Brandner CF, Newsome TA, Vallecillo-Bustos A, Wise HL, Henderson A, Stanfield D, Mannozzi J, Graybeal AJ. Hemodynamic responses to handgrip and metaboreflex activation are exaggerated in individuals with metabolic syndrome independent of resting blood pressure, waist circumference, and fasting blood glucose. Front Physiol 2023; 14:1212775. [PMID: 37608839 PMCID: PMC10441127 DOI: 10.3389/fphys.2023.1212775] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/27/2023] [Indexed: 08/24/2023] Open
Abstract
Introduction: Prior studies report conflicting evidence regarding exercise pressor and metaboreflex responses in individuals with metabolic syndrome (MetS). Purpose: To test the hypotheses that 1) exercise pressor and metaboreflex responses are exaggerated in MetS and 2) these differences may be explained by elevated resting blood pressure. Methods: Blood pressure and heart rate (HR) were evaluated in 26 participants (13 MetS) during 2 min of handgrip exercise followed by 3 min of post-exercise circulatory occlusion (PECO). Systolic (SBP), diastolic (DBP), and mean arterial pressure (MAP), along with HR and a cumulative blood pressure index (BPI), were compared between groups using independent samples t-tests, and analyses of covariance were used to adjust for differences in resting blood pressure, fasting blood glucose (FBG), and waist circumference (WC). Results: ΔSBP (∼78% and ∼54%), ΔMAP (∼67% and ∼55%), and BPI (∼16% and ∼20%) responses were significantly exaggerated in individuals with MetS during handgrip and PECO, respectively (all p ≤ 0.04). ΔDBP, ΔMAP, and BPI responses during handgrip remained significantly different between groups after independently covarying for resting blood pressure (p < 0.01), and after simultaneously covarying for resting blood pressure, FBG, and WC (p ≤ 0.03). Likewise, peak SBP, DBP, MAP, and BPI responses during PECO remained significantly different between groups after adjusting for resting blood pressure (p ≤ 0.03), with peak SBP, MAP, and BPI response remaining different between groups after adjusting for all three covariates simultaneously (p ≤ 0.04). Conclusion: These data suggest that exercise pressor and metaboreflex responses are significantly exaggerated in MetS independent of differences in resting blood pressure, FBG, or WC.
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Affiliation(s)
- Jon Stavres
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, United States
| | - Ryan A. Aultman
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, United States
| | - Caleb F. Brandner
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, United States
| | - Ta’Quoris A. Newsome
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, United States
| | | | - Havens L. Wise
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, United States
| | - Alex Henderson
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, United States
| | - Diavion Stanfield
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, United States
| | - Joseph Mannozzi
- Department of Physiology, Wayne State University School of Medicine, Detroit, MI, United States
| | - Austin J. Graybeal
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, United States
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Dunham CM, Burger AJ, Hileman BM, Chance EA, Hutchinson AE. Bispectral Index Alterations and Associations With Autonomic Changes During Hypnosis in Trauma Center Researchers: Formative Evaluation Study. JMIR Form Res 2021; 5:e24044. [PMID: 34037529 PMCID: PMC8190650 DOI: 10.2196/24044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 02/10/2021] [Accepted: 04/13/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Previous work performed by our group demonstrated that intermittent reductions in bispectral index (BIS) values were found during neurofeedback following mindfulness instructions. Hypnosis was induced to enhance reductions in BIS values. OBJECTIVE This study aims to assess physiologic relaxation and explore its associations with BIS values using autonomic monitoring. METHODS Each session consisted of reading a 4-minute baseline neutral script and playing an 18-minute hypnosis tape to 3 researchers involved in the BIS neurofeedback study. In addition to BIS monitoring, autonomic monitoring was performed, and this included measures of electromyography (EMG), skin temperature, skin conductance, respiratory rate, expired carbon dioxide, and heart rate variability. The resulting data were analyzed using two-tailed t tests, correlation analyses, and multivariate linear regression analyses. RESULTS We found that hypnosis was associated with reductions in BIS (P<.001), EMG (P<.001), respiratory rate (P<.001), skin conductance (P=.006), and very low frequency power (P=.04); it was also associated with increases in expired carbon dioxide (P<.001), skin temperature (P=.04), high frequency power (P<.001), and successive heart interbeat interval difference (P=.04) values. Decreased BIS values were associated with reduced EMG measures (R=0.76; P<.001), respiratory rate (R=0.35; P=.004), skin conductance (R=0.57; P<.001), and low frequency power (R=0.32; P=.01) and with increased high frequency power (R=-0.53; P<.001), successive heart interbeat interval difference (R=-0.32; P=.009), and heart interbeat interval SD (R=-0.26; P=.04) values. CONCLUSIONS Hypnosis appeared to induce mental and physical relaxation, enhance parasympathetic neural activation, and attenuate sympathetic nervous system activity, changes that were associated with BIS values. Findings from this preliminary formative evaluation suggest that the current hypnosis model may be useful for assessing autonomic physiological associations with changes in BIS values, thus motivating us to proceed with a larger investigation in trauma center nurses and physicians.
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Affiliation(s)
| | - Amanda J Burger
- St Elizabeth Youngstown Hospital, Youngstown, OH, United States
| | | | - Elisha A Chance
- St Elizabeth Youngstown Hospital, Youngstown, OH, United States
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A novel parameter is better than the AHI to assess nocturnal hypoxaemia and excessive daytime sleepiness in obstructive sleep apnoea. Sci Rep 2021; 11:4702. [PMID: 33633338 PMCID: PMC7907378 DOI: 10.1038/s41598-021-84239-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 02/12/2021] [Indexed: 01/15/2023] Open
Abstract
To evaluate whether the percentage of total sleep time spent with apnoea and hypopnoea duration time (AHT%) is better than the apnoea-hypopnoea index (AHI) for the assessment of nocturnal hypoxaemia and excessive daytime sleepiness (EDS) in patients with obstructive sleep apnoea (OSA). Patients with suspected OSA were enrolled. Polysomnography, Epworth Sleepiness Scale, self-administered surveys and anthropometric measures were performed. The efficiency of AHT% and the AHI was evaluated for nocturnal hypoxaemia and EDS. A total of 160 eligible participants were analysed. The median AHT% in normal, mild, moderate and severe OSA patients was significantly different in the four-group patients with OSA. Spearman rank correlations analysis found that the associations were stronger between AHT% with percentage of total sleep time and O2 saturation of < 90% and minimum nocturnal oxygen saturation than these parameters with the AHI. AHT% had a greater area under the curve than the AHI for predicting EDS in patients with OSA. AHT% was significantly higher in the EDS group. We present a novel parameter, AHT%, to evaluate nocturnal hypoxaemia and EDS in OSA patients. AHT% partially compensates for the shortcomings of the AHI. AHT% is better than the AHI for assessing nocturnal hypoxaemia and EDS. AHT% reflects different clinical characteristics associated with OSA from a new perspective.
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Mujib Kamal S, Babini MH, Krejcar O, Namazi H. Complexity-Based Decoding of the Coupling Among Heart Rate Variability (HRV) and Walking Path. Front Physiol 2020; 11:602027. [PMID: 33324242 PMCID: PMC7723866 DOI: 10.3389/fphys.2020.602027] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 10/14/2020] [Indexed: 01/04/2023] Open
Abstract
Walking is an everyday activity in our daily life. Because walking affects heart rate variability, in this research, for the first time, we analyzed the coupling among the alterations of the complexity of walking paths and heart rate. We benefited from the fractal theory and sample entropy to evaluate the influence of the complexity of paths on the complexity of heart rate variability (HRV) during walking. We calculated the fractal exponent and sample entropy of the R-R time series for nine participants who walked on four paths with various complexities. The findings showed a strong coupling among the alterations of fractal dimension (an indicator of complexity) of HRV and the walking paths. Besides, the result of the analysis of sample entropy also verified the obtained results from the fractal analysis. In further studies, we can analyze the coupling among the alterations of the complexities of other physiological signals and walking paths.
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Affiliation(s)
| | | | - Ondrej Krejcar
- Center for Basic and Applied Research, Faculty of Informatics and Management, University of Hradec Králové, Hradec Králové, Czechia
| | - Hamidreza Namazi
- School of Engineering, Monash University Malaysia, Selangor, Malaysia.,Center for Basic and Applied Research, Faculty of Informatics and Management, University of Hradec Králové, Hradec Králové, Czechia
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Cao W, Luo J, Xiao Y. A Review of Current Tools Used for Evaluating the Severity of Obstructive Sleep Apnea. Nat Sci Sleep 2020; 12:1023-1031. [PMID: 33239929 PMCID: PMC7680675 DOI: 10.2147/nss.s275252] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 10/08/2020] [Indexed: 12/21/2022] Open
Abstract
Obstructive sleep apnea (OSA) is a common and heterogeneous disease characterized by episodic collapse within the upper airways, which leads to reduced ventilation and adverse consequences, including hypoxia, hypercapnia, sleep fragmentation, and long-term effects such as cardiovascular comorbidities. The clinical diagnosis of OSA and its severity classification are often determined based on the apnea-hypopnea index (AHI), defining the number of apneic and hypopnea events per hour of sleep. However, the limitations of the AHI to assess disease severity have necessitated the exploration of other metrics for additional information to reflect the complexity of OSA. Novel parameters such as the hypoxic burden have the potential to better capture the main features of OSA by maximizing the information available from the polysomnogram. These emerging measures have described multidimensional qualities of sleep-disordered breathing events and breathing irregularity and will ultimately result in better management of OSA.
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Affiliation(s)
- Wenhao Cao
- Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Jinmei Luo
- Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Yi Xiao
- Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
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Xia Y, You K, Xiong Y, Jiang H. Sleep-Disordered Breathing and Peripheral Arterial Disease: Current Evidence. EAR, NOSE & THROAT JOURNAL 2019; 100:185-191. [PMID: 31547705 DOI: 10.1177/0145561319872168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Sleep-disordered breathing (SDB) is associated with atherosclerosis. Peripheral arterial disease (PAD) is a manifestation of atherosclerosis in lower extremity arteries. No systematic review addressing the relationship between PAD and SDB was found. We performed this study aimed to summarize the relationship between SDB and PAD described in current clinical studies. MATERIAL AND METHODS PubMed and Embase electronic databases were searched for clinical articles (published before 3 April, 2019) describing studies that evaluated the association between SDB and PAD. We showed the results involved in the association in clinical studies. RESULTS In total, 8 clinical studies have been included, and most of them were cross-sectional studies. Six articles demonstrated the coexistence of SDB and PAD, evidenced by high prevalence of SDB in patients with PAD and vice versa. Meanwhile, the included studies exhibited independent positive associations between SDB or sleep parameters and PAD after adjusting for multiple confounders. CONCLUSION From present clinical prospective, positive association between SDB and PAD was shown. More prospective, randomized controlled studies are needed to establish the cause-effect relationships involved.
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Affiliation(s)
- Yunyan Xia
- Department of Otorhinolaryngology-Head and Neck Surgery, 117970First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Kai You
- Department of Anesthesiology, 117970First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yuanping Xiong
- Department of Otorhinolaryngology-Head and Neck Surgery, 117970First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Hongqun Jiang
- Department of Otorhinolaryngology-Head and Neck Surgery, 117970First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
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Park SY, Kwak YS, Pekas EJ. Impacts of aquatic walking on arterial stiffness, exercise tolerance, and physical function in patients with peripheral artery disease: a randomized clinical trial. J Appl Physiol (1985) 2019; 127:940-949. [PMID: 31369328 DOI: 10.1152/japplphysiol.00209.2019] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Peripheral artery disease (PAD) is an atherosclerotic disease that is associated with attenuated vascular function, cardiorespiratory capacity, physical function, and muscular strength. It is essential to combat these negative effects on health by incorporating lifestyle interventions to slow disease progression, such as exercise. We sought to examine the effects of aquatic walking exercise on cardiovascular function, cardiorespiratory capacity [maximal volume of oxygen consumption (V̇o2max)], exercise tolerance [6-min walking distance (6MWD)], physical function, muscular strength, and body composition in patients with PAD. Patients with PAD (n = 72) were recruited and randomly assigned to a 12-wk aquatic walking training group (AQ, n = 35) or a control group (CON, n = 37). The AQ group performed walking and leg exercises in waist-to-chest-deep water. Leg arterial stiffness [femoral-to-ankle pulse wave velocity (legPWV)], heart rate (HR), blood pressure (BP), ankle-to-brachial index (ABI), V̇o2max, 6MWD, physical function, muscular strength, body composition, resting metabolic rate (RMR), and flexibility were measured before and after 12 wk. There were significant group × time interactions (P < 0.05) after 12 wk for legPWV and HR, which significantly decreased (P < 0.05) in AQ, and V̇o2max, 6MWD, physical function, and muscular strength, which significantly increased (P < 0.05) in AQ, compared with no changes in CON. There were no significant differences (P > 0.05) for BP, ABI, RMR, or flexibility after 12 wk. Interestingly, there was relatively high adherence (84%) to the aquatic walking exercise program in this population. These results suggest that aquatic walking exercise is an effective therapy to reduce arterial stiffness and resting HR and improve cardiorespiratory capacity, exercise tolerance, physical function, and muscular strength in patients with PAD.NEW & NOTEWORTHY The results of this study reveal for the first time that aquatic walking exercise can decrease arterial stiffness and improve exercise tolerance, cardiorespiratory capacity, and muscular strength in patients with peripheral artery disease (PAD). Aquatic walking exercise training demonstrates relatively high exercise adherence in this population. Aquatic walking exercise training may be a useful therapeutic intervention for improving physical function in patients with PAD.
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Affiliation(s)
- Song-Young Park
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, Nebraska.,Department of Physical Education, Dong-Eui University, Busan, South Korea
| | - Yi-Sub Kwak
- Department of Physical Education, Dong-Eui University, Busan, South Korea
| | - Elizabeth J Pekas
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, Nebraska
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The Relationship Between Rhythm Variability and the Structural and Functional State of the Heart in Patients with Cerebral Atherosclerosis. Fam Med 2019. [DOI: 10.30841/2307-5112.3.2019.178596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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