Heart Rate Variability Based Prediction of Personalized Drug Therapeutic Response: The Present Status and the Perspectives

Discrete Heart Rate Values or Continuous Streams? Representation, Variability, and Meaningful Use of Vital Sign Data

Documentation and review of patient heart rate are a fundamental process across a myriad of clinical settings. While historically recorded manually, bedside monitors now provide for the automated collection of such data. Despite the availability of continuous streaming data, patients' charts continue to reflect only a subset of this information as snapshots recorded throughout a hospitalization. Over the past decade, prominent works have explored the implications of such practices and established fundamental differences in the alignment of discrete charted vitals and steaming data captured by monitoring systems. Limited work has examined the temporal properties of these differences, how they manifest, and their relation to clinical applications. The work presented in this article addresses this disparity, providing evidence that differences between charting techniques extend to measures of variability. Our results demonstrate how variability manifests with respect to temporal elements of charting timing and how it can facilitate personalized care by contextualizing deviations in magnitude. This work also highlights the utility of variability metrics with relation to clinical measures including associations to severity scores and a case study utilizing complex variability metrics derived from the complete set of monitor data.

Corticosteroids and circadian rhythms in the cardiovascular system

The mineralocorticoid receptor (MR) plays a central role in cardiac physiological function and disease and is thus an attractive therapeutic target for patients with heart failure. However, the incidence of significant side effects from mineralocorticoid receptor antagonist (MRA) treatment has led to investigation of new mechanisms that may enhance MR targeted therapies. Recent studies have identified the circadian clock as a novel, reciprocal interacting partner of the MR in the heart. While the closely related glucocorticoid receptor (GR) and its ligand, cortisol (corticosterone in rodents), are established regulators of the circadian clock, new data suggest that the MR can also regulate circadian clock gene expression and timing. This review will discuss the role of the MR and its ligands in the regulation of the circadian clock in the heart and the implications of dysregulation of these systems for cardiac disease progression, and for MR activation.

Data-driven microbiota biomarker discovery for personalized drug therapy of cardiovascular disease

Cardiovascular disease (CVD) is the most wide-spread disorder all over the world. The personalized and precision diagnosis, treatment and prevention of CVD is still a challenge. With the developing of metagenome sequencing technologies and the paradigm shifting to data-driven discovery in life science, the computer aided microbiota biomarker discovery for CVD is becoming reality. We here summarize the data resources, knowledgebases and computational models available for CVD microbiota biomarker discovery, and review the present status of the findings about the microbiota patterns associated with the therapeutic effects on CVD. The future challenges and opportunities of the translational informatics on the personalized drug usages in CVD diagnosis, prognosis and treatment are also discussed.