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Zhang Y, Han L, Shi L, Gao M, Chen J, Ding Y. Reduced heart rate variability is associated with altered clinical laboratory profile in people living with HIV. Brain Behav Immun Health 2024; 41:100858. [PMID: 39308958 PMCID: PMC11414568 DOI: 10.1016/j.bbih.2024.100858] [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: 05/13/2024] [Revised: 08/14/2024] [Accepted: 09/07/2024] [Indexed: 09/25/2024] Open
Abstract
Background We compared heart rate variability (HRV) indices between people living with HIV (PLWH) and HIV-negative individuals to ascertain the independent association between HIV infection and reduced HRV, and further investigated whether distinct clinical laboratory profiles exist between PLWH with and without reduced HRV. Methods This cross-sectional analysis included 304 PLWH and 147 HIV-negative individuals with comparable age and sex. Thirty-two routine clinical laboratory indices (including hematology and biochemistry) closest to the survey were extracted from the Electronic Medical Record System. HRV indices were divided into two categories: low (lowest quartile, Q1) and moderate-to-high (combined, Q2‒Q4). Results The time domain indices, ln(SDNN), ln(RMSSD), and ln(PNN50), as well as the frequency domain indices, ln(HF), ln(LF), and ln(VLF), were all significantly reduced in PLWH versus HIV-negative individuals (all p < 0.05). These associations remained for ln(SDNN), ln(PNN50), ln(HF) and ln(LF) even after adjusting for potential confounders in multivariable models. PLWH with low HRV indices exhibited distinct clinical laboratory profiles that were characterized by an elevation in fasting plasma glucose, white blood cell count, neutrophil count, neutrophil%, and a reduction in albumin, total protein, urine creatinine, lymphocyte%, red blood cell count (RBC) and nadir CD4 count. The final stepwise logistic regression models for low SDNN included older age, decreased total cholesterol levels, elevated neutrophil count, and the use of antidiabetic medications, whereas the final model for low LF included older age, reduced RBC and the use of antidiabetic medications. Conclusion PLWH exhibit impaired parasympathetic activity, as evidenced by reduced SDNN, PNN50, LF and HF. Furthermore, PLWH who have reduced HRV indices exhibits distinct clinical laboratory profiles that are related to systematic inflammatory response and diabetes.
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Affiliation(s)
- Yunqiu Zhang
- Department of Epidemiology, School of Public Health, And Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Lei Han
- Jing’an District Center for Disease Control and Prevention, Shanghai, China
| | - Luqian Shi
- Department of Epidemiology, School of Public Health, And Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Meiyang Gao
- Department of Epidemiology, School of Public Health, And Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Jun Chen
- Department of Infectious Diseases and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Yingying Ding
- Department of Epidemiology, School of Public Health, And Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
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Chang LH, Huang MH, Lin IM. Developing a Five-Minute Normative Database of Heart Rate Variability for Diagnosing Cardiac Autonomic Dysregulation for Patients with Major Depressive Disorder. SENSORS (BASEL, SWITZERLAND) 2024; 24:4003. [PMID: 38931788 PMCID: PMC11207773 DOI: 10.3390/s24124003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 06/07/2024] [Accepted: 06/16/2024] [Indexed: 06/28/2024]
Abstract
Heart rate variability (HRV) is related to cardiac vagal control and emotional regulation and an index for cardiac vagal control and cardiac autonomic activity. This study aimed to develop the Taiwan HRV normative database covering individuals aged 20 to 70 years and to assess its diagnosing validity in patients with major depressive disorder (MDD). A total of 311 healthy participants were in the HRV normative database and divided into five groups in 10-year age groups, and then the means and standard deviations of the HRV indices were calculated. We recruited 272 patients with MDD for cross-validation, compared their HRV indices with the normative database, and then converted them to Z-scores to explore the deviation of HRV in MDD patients from healthy groups. The results found a gradual decline in HRV indices with advancing age in the HC group, and females in the HC group exhibit higher cardiac vagal control and parasympathetic activity than males. Conversely, patients in the MDD group demonstrate lower HRV indices than those in the HC group, with their symptoms of depression and anxiety showing a negative correlation with HRV indices. The Taiwan HRV normative database has good psychometric characteristics of cross-validation.
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Affiliation(s)
- Li-Hsin Chang
- Department of Psychology, College of Humanities and Social Sciences, Kaohsiung Medical University, Kaohsiung 807378, Taiwan; (L.-H.C.); (M.-H.H.)
| | - Min-Han Huang
- Department of Psychology, College of Humanities and Social Sciences, Kaohsiung Medical University, Kaohsiung 807378, Taiwan; (L.-H.C.); (M.-H.H.)
| | - I-Mei Lin
- Department of Psychology, College of Humanities and Social Sciences, Kaohsiung Medical University, Kaohsiung 807378, Taiwan; (L.-H.C.); (M.-H.H.)
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 807378, Taiwan
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3
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Aschbacher K, Mather M, Lehrer P, Gevirtz R, Epel E, Peiper NC. Real-time heart rate variability biofeedback amplitude during a large-scale digital mental health intervention differed by age, gender, and mental and physical health. Psychophysiology 2024; 61:e14533. [PMID: 38454612 DOI: 10.1111/psyp.14533] [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: 04/13/2023] [Revised: 12/06/2023] [Accepted: 01/08/2024] [Indexed: 03/09/2024]
Abstract
Heart rate variability biofeedback (HRVB) is an efficacious treatment for depression and anxiety. However, translation to digital mental health interventions (DMHI) requires computing and providing real-time HRVB metrics in a personalized and user-friendly fashion. To address these gaps, this study validates a real-time HRVB feedback algorithm and characterizes the association of the main algorithmic summary metric-HRVB amplitude-with demographic, psychological, and health factors. We analyzed HRVB data from 5158 participants in a therapist-supported DMHI incorporating slow-paced breathing to treat depression or anxiety symptoms. A real-time feedback metric of HRVB amplitude and a gold-standard research metric of low-frequency (LF) power were computed for each session and then averaged within-participants over 2 weeks. We provide HRVB amplitude values, stratified by age and gender, and we characterize the multivariate associations of HRVB amplitude with demographic, psychological, and health factors. Real-time HRVB amplitude correlated strongly (r = .93, p < .001) with the LF power around the respiratory frequency (~0.1 Hz). Age was associated with a significant decline in HRVB (β = -0.46, p < .001), which was steeper among men than women, adjusting for demographic, psychological, and health factors. Resting high- and low-frequency power, body mass index, hypertension, Asian race, depression symptoms, and trauma history were significantly associated with HRVB amplitude in multivariate analyses (p's < .01). Real-time HRVB amplitude correlates highly with a research gold-standard spectral metric, enabling automated biofeedback delivery as a potential treatment component of DMHIs. Moreover, we identify demographic, psychological, and health factors relevant to building an equitable, accurate, and personalized biofeedback user experience.
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Affiliation(s)
| | - Mara Mather
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
- Department of Psychology, University of Southern California, Los Angeles, California, USA
- Department of Biomedical Engineering, University of Southern California, Los Angeles, California, USA
| | - Paul Lehrer
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Monmouth Junction, New Jersey, USA
| | - Richard Gevirtz
- Department of Clinical Psychology, California School of Professional Psychology, Alliant International University, San Diego, California, USA
| | - Elissa Epel
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Nicholas C Peiper
- Meru Health, San Mateo, California, USA
- Department of Epidemiology and Population Health, University of Louisville, Louisville, Kentucky, USA
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Oh SK, Won YJ, Lim BG. Surgical pleth index monitoring in perioperative pain management: usefulness and limitations. Korean J Anesthesiol 2024; 77:31-45. [PMID: 36926752 PMCID: PMC10834712 DOI: 10.4097/kja.23158] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 03/16/2023] [Accepted: 03/16/2023] [Indexed: 03/18/2023] Open
Abstract
Surgical pleth index (SPI) monitoring is a representative, objective nociception-monitoring device that measures nociception using photoplethysmographic signals. It is easy to apply to patients and the numerical calculation formula is intuitively easy to understand; therefore, its clinical interpretation is simple. Several studies have demonstrated its efficacy and utility. Compared with hemodynamic parameters, the SPI can detect the degree of nociception during surgery under general anesthesia with greater accuracy, and therefore can provide better guidance for the administration of various opioids, including remifentanil, fentanyl, and sufentanil. Indeed, SPI-guided analgesia is associated with lower intraoperative opioid consumption, faster patient recovery, and comparable or lower levels of postoperative pain and rates of adverse events compared with conventional analgesia. In addition, SPI monitoring allows for the degree of postoperative pain and analgesic requirements to be predicted through the SPI values immediately before patient arousal. However, because patient age, effective circulating volume, position, concomitant medication and anesthetic regimen and level of consciousness may be confounding factors in SPI monitoring, clinicians must be careful when interpreting SPI values. In addition, as SPI values can differ depending on anesthetic and analgesic regimens and the underlying disease, an awareness of the effects of these variables with an understanding of the advantages and disadvantages of SPI monitoring compared to other nociception monitoring devices is essential. Therefore, this review aimed to help clinicians perform optimal SPI-guided analgesia and to assist with the establishment of future research designs through clarifying current usefulness and limitations of SPI monitoring in perioperative pain management.
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Affiliation(s)
- Seok Kyeong Oh
- Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Young Ju Won
- Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Byung Gun Lim
- Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
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Mograss M, Frimpong E, Vilcourt F, Chouchou F, Zvionow T, Dang-Vu TT. The effects of acute exercise and a nap on heart rate variability and memory in young sedentary adults. Psychophysiology 2024; 61:e14454. [PMID: 37855092 DOI: 10.1111/psyp.14454] [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: 05/04/2023] [Revised: 08/29/2023] [Accepted: 09/20/2023] [Indexed: 10/20/2023]
Abstract
Recent evidence suggests that the autonomic nervous system can contribute to memory consolidation during sleep. Whether fluctuations in cardiac autonomic activity during sleep following physical exercise contribute to the process of memory consolidation has not been studied. We assessed the effects of a non-rapid eye movement (NREM) nap following acute exercise on cardiac autonomic regulation assessed with heart rate variability (HRV) to examine if HRV influences memory processes. Fifty-six (59% female) healthy young adults (23.14 ± 3.74 years) were randomly allocated to either the exercise plus nap (ExNap, n = 27) or nap alone (NoExNap, n = 29) groups. The ExNap group performed a 40-minute moderate-intensity cycling, while the NoExNap group was sedentary prior to learning 45 neutral pictures for a later test. Subsequently, participants underwent a 60-minute NREM nap while measuring EKG, followed by a visual recognition test. Our results indicated that heart rate did not significantly differ between the groups (p = .243), whereas vagally mediated HRV indices were lower in the ExNap group compared to the NoExNap group (p < .05). There were no significant differences in sleep variables between the groups (p > .05). Recognition accuracy was significantly higher in the ExNap group than in the NoExNap group (p = .027). In addition, the recognition accuracy of the ExNap group was negatively associated with vagally mediated HRV (p < .05). Pre-nap acute exercise appears to attenuate parasympathetic activity and to alter the relationship between memory and cardiac autonomic activity.
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Affiliation(s)
- Melodee Mograss
- Sleep, Cognition and Neuroimaging Laboratory, Concordia University, Montreal, Quebec, Canada
- Department of Health, Kinesiology & Applied Physiology, Concordia University, Montreal, Quebec, Canada
- Department of Psychology, Concordia University, Montreal, Quebec, Canada
- PERFORM Centre, Concordia University, Montreal, Quebec, Canada
| | - Emmanuel Frimpong
- Sleep, Cognition and Neuroimaging Laboratory, Concordia University, Montreal, Quebec, Canada
- Department of Health, Kinesiology & Applied Physiology, Concordia University, Montreal, Quebec, Canada
- PERFORM Centre, Concordia University, Montreal, Quebec, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada
| | - Franck Vilcourt
- IRISSE Laboratory (EA4075), UFR SHE, University of La Réunion, Le Tampon, France
| | - Florian Chouchou
- IRISSE Laboratory (EA4075), UFR SHE, University of La Réunion, Le Tampon, France
| | - Tehila Zvionow
- Sleep, Cognition and Neuroimaging Laboratory, Concordia University, Montreal, Quebec, Canada
- Department of Health, Kinesiology & Applied Physiology, Concordia University, Montreal, Quebec, Canada
| | - Thien Thanh Dang-Vu
- Sleep, Cognition and Neuroimaging Laboratory, Concordia University, Montreal, Quebec, Canada
- Department of Health, Kinesiology & Applied Physiology, Concordia University, Montreal, Quebec, Canada
- PERFORM Centre, Concordia University, Montreal, Quebec, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada
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Chou YT, Sun ZJ, Shao SC, Yang YC, Lu FH, Chang CJ, Liao TC, Li CY, Chen THH, Wu JS, Lai ECC. Autonomic modulation and the risk of dementia in a middle-aged cohort: A 17-year follow-up study. Biomed J 2023; 46:100576. [PMID: 36581249 PMCID: PMC10749883 DOI: 10.1016/j.bj.2022.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 12/20/2022] [Accepted: 12/20/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Altered autonomic modulation, measured by heart rate variability (HRV), has been found to be associated with dementia risk in the elderly. However, long-term follow-up study evaluating the association between autonomic modulation from middle-age and the incidence of dementia has been limited. METHODS This retrospective cohort analyzed data from Taiwan's National Health Insurance Database covering the period from 2001 to 2017, with a linkage to citywide health examinations conducted by Tainan Metropolitan City, Taiwan. We included subjects aged 45-64 years. The mean follow-up period was 15.75 ± 3.40 years. The measurements of HRV included resting heart rate, high frequency (HF), low frequency (LF), standard deviation of normal-to-normal R-R intervals (SDNN), ratio between the 30th and 15th R-R interval after standing up from the supine position (30/15 ratio), ratio between the R-R intervals during expiration and inspiration, and the ratio between the high- and low-frequency components (LF/HF). The main study outcome was the incidence of dementia. We performed multivariable Cox proportional hazard regression models to compare the risk of dementia among different HRV subgroups. RESULTS We included 565 participants with a mean age of 53 (SD: 6) years, of whom 44% were male. The risk of dementia was significantly increased in association with lower parasympathetic HRV modulation, including SDNN (HR: 3.23, 95% CI: 1.55-6.73) and 30/15 ratio (HR: 3.52, 95%CI: 1.67-7.42). Moreover, the risk of dementia was increased in subjects with higher LF/HF ratios (HR: 2.05, 95% CI: 1.12-3.72). CONCLUSIONS Lower parasympathetic activity and higher sympathetic-vagal imbalance in middle-age were associated with dementia risk.
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Affiliation(s)
- Yu-Tsung Chou
- Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Zih-Jie Sun
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Family Medicine, National Cheng Kung University Hospital Dou-Liou Branch, College of Medicine, National Cheng Kung University, Yunlin, Taiwan
| | - Shih-Chieh Shao
- School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Pharmacy, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Yi-Ching Yang
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Feng-Hwa Lu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Jen Chang
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Family Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
| | - Tzu-Chi Liao
- School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Yi Li
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Tony Hsiu-Hsi Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Jin-Shang Wu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Family Medicine, National Cheng Kung University Hospital Dou-Liou Branch, College of Medicine, National Cheng Kung University, Yunlin, Taiwan; Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Edward Chia-Cheng Lai
- School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Hunakova L, Sabaka P, Zvarik M, Mikolaskova I, Gidron Y, Bucova M. Linear and non‑linear indices of vagal nerve in relation to sex and inflammation in patients with Covid‑19. Biomed Rep 2023; 19:80. [PMID: 37829259 PMCID: PMC10565716 DOI: 10.3892/br.2023.1662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 07/18/2023] [Indexed: 10/14/2023] Open
Abstract
Hyperinflammation is one of the most important pathophysiological risk factors for poor prognosis in patients with coronavirus disease-2019 (Covid-19). Low vagal neuro-immune modulation can lead into this kind of immune dysregulation. The association between vagal activity, sex and inflammatory markers were investigated in patients with Covid-19. A total of 19 patients with Covid-19 were included in the present study. Vagus nerve activity was indexed by heart rate variability (HRV) derived from electrocardiogram at hospital admission. Linear HRV parameters included the root mean square of successive RR interval differences (RMSSD) and high-frequency HRV (HF-HRV), while non-linear parameters included 2 UV%. Immune/inflammatory parameters included C-reactive protein (CRP), interleukin-6 (IL-6), neutrophil/lymphocyte ratio (NLR), systemic inflammatory index (SII), and procalcitonin (PCT). It has been revealed that both linear HRV indices HF-HRV and RMSSD, are significantly negatively correlated with CRP and IL-6, independent of age. The non-linear index of 2 UV% is significantly negatively correlated with NLR and SII, which reflect subtle changes in the response of immunocompetent cells. Patients that received high-flow nasal oxygen therapy had significantly higher IL-6 and CRP levels and lower levels of HF-HRV and RMSSD. These patients also had a significantly longer length of stay in hospital (LOS) than patients receiving low-flow oxygen therapy. Men had higher plasma PCT levels and longer LOS in hospital than women, and PCT statistically explained (mediated) the association between sex and LOS. The present study showed different correlations of linear and non-linear vagal indexes of HRV and inflammatory markers in patients with Covid-19. Significant sex differences in certain inflammatory markers were also observed, which may very well verify previous findings of poor prognosis in men with Covid-19. HRV reflects a continuous interaction between the sympathetic and parasympathetic autonomic nervous systems, which are affected by mental or physical stress, and certain disease states. The increased sympathetic and decreased parasympathetic vagal tone contribute to a higher risk of diseases associated with inflammation, cardiovascular disease, cancer, pulmonary diseases and other pathologies, including infectious diseases such as Covid-19. The present study showed that higher RMSSD (a marker of vagal activity) in Covid-19 patients is associated with lower levels of inflammatory biomarkers, a lower need for treatment and is negatively correlated with intensive care unit admission, leading to a shorter hospital stay. These findings support the idea that activation of vagus nerve may help certain Covid-19 patients by reducing the cytokine storm and excessive inflammation.
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Affiliation(s)
- Luba Hunakova
- Institute of Immunology, Faculty of Medicine, Comenius University, 813 72 Bratislava, Slovakia
| | - Peter Sabaka
- Department of Infectology and Geographical Medicine, Faculty of Medicine, Comenius University, 833 05 Bratislava, Slovakia
- Department of Infectology and Geographical Medicine, University Hospital Bratislava, 833 05 Bratislava, Slovakia
| | - Milan Zvarik
- Department of Nuclear Physics and Biophysics, Faculty of Mathematics, Physics and Computer Science, Comenius University, 84248 Bratislava, Slovakia
| | - Iveta Mikolaskova
- Institute of Immunology, Faculty of Medicine, Comenius University, 813 72 Bratislava, Slovakia
| | - Yori Gidron
- Department of Nursing, Faculty of Welfare and Health Sciences, University of Haifa, Haifa 3498838, Israel
| | - Maria Bucova
- Institute of Immunology, Faculty of Medicine, Comenius University, 813 72 Bratislava, Slovakia
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Choi J, Cha W, Park MG. Evaluation of the effect of photoplethysmograms on workers' exposure to methyl bromide using second derivative. Front Public Health 2023; 11:1224143. [PMID: 37818301 PMCID: PMC10560719 DOI: 10.3389/fpubh.2023.1224143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 09/12/2023] [Indexed: 10/12/2023] Open
Abstract
Methyl bromide (MB) is worldwide the only effective fumigant heavily used for quarantine pre-shipment treatment and has a critical use exemption for soil fumigations due to its excellent permeability and insecticidal effect. However, MB should be replaced as it is an an ozone-depleting substance and also highly toxic to humans. Recently, MB has been shown to be hazardous even for asymptomatic workers, affecting their central and autonomic nervous systems. However, the effects of MB exposure on vascular health have not been explored. This study aimed to determine whether MB affects the arterial system of asymptomatic workers. We measured the second derivative of the photoplethysmogram (SDPTG) indices, which are indicators of vascular load and aging, and urinary bromide ion (Br-) concentrations in 44 fumigators (study group) and 20 inspectors (control group) before and after fumigation. In fumigators, the mean values of post-work SDPTG indices (b/a, c/a, d/a, e/a, and SDPTG aging index) and Br- levels were significantly changed compared to their pre-work values (p < 0.05), indicating a negative effect on their cardiovascular health. In contrast, SDPTG indices and Br- levels in inspectors did not show any differences before and after work. All SDPTG indices except c/a showed significant correlations with Br- levels in all individuals (p < 0.05). In conclusion, the Br- levels and SDPTG indices of fumigators varied after MB work, and they experienced negative effects on their health despite being asymptomatic.
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Affiliation(s)
- Jungmi Choi
- Human Anti-Aging Standards Research Institute, Uiryeong-gun, Gyeongsangnam-do, Republic of Korea
| | - Wonseok Cha
- Human Anti-Aging Standards Research Institute, Uiryeong-gun, Gyeongsangnam-do, Republic of Korea
| | - Min-Goo Park
- Department of Bioenvironmental Chemistry, Jeonbuk National University, Jeonju, Republic of Korea
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9
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Kuntic M, Kuntic I, Hahad O, Lelieveld J, Münzel T, Daiber A. Impact of air pollution on cardiovascular aging. Mech Ageing Dev 2023; 214:111857. [PMID: 37611809 DOI: 10.1016/j.mad.2023.111857] [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: 07/06/2023] [Accepted: 08/19/2023] [Indexed: 08/25/2023]
Abstract
The world population is aging rapidly, and by some estimates, the number of people older than 60 will double in the next 30 years. With the increase in life expectancy, adverse effects of environmental exposures start playing a more prominent role in human health. Air pollution is now widely considered the most detrimental of all environmental risk factors, with some studies estimating that almost 20% of all deaths globally could be attributed to poor air quality. Cardiovascular diseases are the leading cause of death worldwide and will continue to account for the most significant percentage of non-communicable disease burden. Cardiovascular aging with defined pathomechanisms is a major trigger of cardiovascular disease in old age. Effects of environmental risk factors on cardiovascular aging should be considered in order to increase the health span and reduce the burden of cardiovascular disease in older populations. In this review, we explore the effects of air pollution on cardiovascular aging, from the molecular mechanisms to cardiovascular manifestations of aging and, finally, the age-related cardiovascular outcomes. We also explore the distinction between the effects of air pollution on healthy aging and disease progression. Future efforts should focus on extending the health span rather than the lifespan.
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Affiliation(s)
- Marin Kuntic
- University Medical Center Mainz, Department for Cardiology 1, Molecular Cardiology, Mainz, Germany
| | - Ivana Kuntic
- University Medical Center Mainz, Department for Cardiology 1, Molecular Cardiology, Mainz, Germany
| | - Omar Hahad
- University Medical Center Mainz, Department for Cardiology 1, Molecular Cardiology, Mainz, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Rhine-Main, Mainz, Germany
| | - Jos Lelieveld
- Max Planck Institute for Chemistry, Atmospheric Chemistry, Mainz, Germany
| | - Thomas Münzel
- University Medical Center Mainz, Department for Cardiology 1, Molecular Cardiology, Mainz, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Rhine-Main, Mainz, Germany.
| | - Andreas Daiber
- University Medical Center Mainz, Department for Cardiology 1, Molecular Cardiology, Mainz, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Rhine-Main, Mainz, Germany.
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10
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Choi J, Park MG. Variations in the Second Derivative of a Photoplethysmogram with Age in Healthy Korean Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:236. [PMID: 36612558 PMCID: PMC9819370 DOI: 10.3390/ijerph20010236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 06/17/2023]
Abstract
Second derivative of photoplethysmogram (SDPTG) indices correlate with aging and vascular health. The trend of SDPTG indices with age has not yet been studied in the Korean population. Various SDPTG indices were measured in 300 healthy Koreans (150 men and 150 women), aged 19−69 years, stratified into five age groups consisting of 60 people (30 men and 30 women) in each age group from their 20s to 60s. The values of the SDPTG indices clearly showed distinct variations with age in healthy Korean groups (p < 0.001 for all indices). b/a increased linearly with age (y = 0.0045x − 0.803), as did SDPTG aging index (SDPTG-AI) (y = 0.0162x − 1.1389). c/a decreased linearly with age (y = −0.0044x + 0.1017), as did d/a (y = −0.0062x + 0.034) and e/a (y = −0.001x + 0.2002). A significant sex difference was shown in b/a and e/a ratios and SDPTG-AI (p < 0.001 for all indices); women had a higher b/a ratio (−0.55 ± 0.14 versus −0.65 ± 0.13) and SDPTG-AI (−0.33 ± 0.3 versus −0.52 ± 0.33) and a lower e/a ratio (0.13 ± 0.06 versus 0.18 ± 0.07) than men. A linear regression model of diverse SDPTG indices was provided according to the age of healthy Koreans, which may be valuable in preventing diseases related to vascular conditions by estimating the degradation of arterial function.
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Affiliation(s)
- Jungmi Choi
- Human Anti-Aging Standards Research Institute, Uiryeong 52111, Republic of Korea
| | - Min-Goo Park
- Department of Bioenvironmental Chemistry, Jeonbuk National University, Jeonju 54896, Republic of Korea
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Jiang Y, Yabluchanskiy A, Deng J, Amil FA, Po SS, Dasari TW. The role of age-associated autonomic dysfunction in inflammation and endothelial dysfunction. GeroScience 2022; 44:2655-2670. [PMID: 35773441 PMCID: PMC9768093 DOI: 10.1007/s11357-022-00616-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 06/22/2022] [Indexed: 01/23/2023] Open
Abstract
Aging of the cardiovascular regulatory function manifests as an imbalance between the sympathetic and parasympathetic (vagal) components of the autonomic nervous system (ANS). The most characteristic change is sympathetic overdrive, which is manifested by an increase in the muscle sympathetic nerve activity (MSNA) burst frequency with age. Age-related changes that occur in vagal nerve activity is less clear. The resting tonic parasympathetic activity can be estimated noninvasively by measuring the increase in heart rate occurring in response to muscarinic cholinergic receptor blockade; animal study models have shown this to diminish with age. Humoral, cellular, and neural mechanisms work together to prevent non-resolving inflammation. This review focuses on the mechanisms underlying age-related alternations in the ANS and how an imbalance in the ANS, evaluated by MSNA and heart rate variability (HRV), potentially facilitates inflammation when the homeostatic mechanisms between reflex neural circuits and the immune system are compromised, particularly the dysfunction of the cholinergic anti-inflammatory reflex. Physiologically, the efferent arm of this reflex acts via the [Formula: see text] 7 nicotinic acetylcholine receptors expressed in macrophages, monocytes, dendritic cells, T cells, and endothelial cells to curb the release of inflammatory cytokines, in which inhibition of NF‑κB nuclear translocation and activation of a JAK/STAT-mediated signaling cascade in macrophages and other immune cells are implicated. This reflex is likely to become less adequate with advanced age. Consequently, a pro-inflammatory state induced by reduced vagus output with age is associated with endothelial dysfunction and may significantly contribute to the development and propagation of atherosclerosis, heart failure, and hypertension. The aim of this review is to summarize the relationship between ANS dysfunction, inflammation, and endothelial dysfunction in the context of aging. Meanwhile, this review also attempts to describe the role of HRV measures as a predictor of the level of inflammation and endothelial dysfunction in the aged population and explore the possible therapeutical effects of vagus nerve stimulation.
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Affiliation(s)
- Yunqiu Jiang
- Cardiovascular Section, Department of Internal Medicine, University of Oklahoma Health Sciences Center, 800 SL Young Blvd, COM 5400, Oklahoma City, OK, 73104, USA
| | - Andriy Yabluchanskiy
- Center for Geroscience and Healthy Brain Aging, Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Jielin Deng
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China
- Cardiovascular Research Institute, Wuhan University, Wuhan, 430060, China
- Hubei Key Laboratory of Cardiology, Wuhan, 430060, China
| | - Faris A Amil
- Cardiovascular Section, Department of Internal Medicine, University of Oklahoma Health Sciences Center, 800 SL Young Blvd, COM 5400, Oklahoma City, OK, 73104, USA
| | - Sunny S Po
- Cardiovascular Section, Department of Internal Medicine, University of Oklahoma Health Sciences Center, 800 SL Young Blvd, COM 5400, Oklahoma City, OK, 73104, USA
- Heart Rhythm Institute, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Tarun W Dasari
- Cardiovascular Section, Department of Internal Medicine, University of Oklahoma Health Sciences Center, 800 SL Young Blvd, COM 5400, Oklahoma City, OK, 73104, USA.
- Heart Rhythm Institute, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
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Martínez-González-Moro I, Albertus Cámara I, Paredes Ruiz MJ. Influences of Intense Physical Effort on the Activity of the Autonomous Nervous System and Stress, as Measured with Photoplethysmography. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16066. [PMID: 36498140 PMCID: PMC9735638 DOI: 10.3390/ijerph192316066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 11/27/2022] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
Background: The autonomic nervous system, which is composed of the sympathetic and parasympathetic nervous system, is closely related to the cardiovascular system. The temporal variation between each of the intervals between the consecutive “R” waves of an electrocardiogram is known as heart rate variability. Depending on the type of activity, both systems can be activated, and also influence the interval between “R” waves. Currently, with advancements in technology and electronic devices, photoplethysmography is used. Photoplethysmography detects changes in the intensity of reflected light that allow differentiation between systole and diastole and, therefore, determines the heart rate, its frequency and its variations. In this way, changes in the autonomic nervous system can be detected by devices such as the Max Pulse®. Objective: To determine whether the information provided by Max Pulse® on autonomic balance and stress is modified after intense physical exercise, thereby determining whether there is a relationship with body composition, and also whether there are differences with respect to gender. Materials and Methods: Fifty-three runners (38.9% female) with a mean age of 31.3 ± 8.1 years participated in the study. Two measurements (before and after intense physical effort) were performed with the Max Pulse® device. The flotoplethysmography measurement lasted 3 min, and was performed in the supine position. The exercise test was performed on a treadmill. It was initiated at a speed of 6 and 7 km/h for women and men, respectively. Subjects indicated the end of the test by making a hand gesture when unable to continue the test. Results: Autonomic nervous system activity and mental stress values decreased significantly (p < 0.05) in men and women, while autonomic nervous system balance decreased only in women. Physical stress increased (p < 0.05) in both sexes. Conclusions: Intense exercise causes changes in variables that assess autonomic nervous system balance and stress, as measured by a device based on photoplethysmography. The changes are evident in both sexes, and are not related to body composition.
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Cautionary Observations Concerning the Introduction of Psychophysiological Biomarkers into Neuropsychiatric Practice. PSYCHIATRY INTERNATIONAL 2022. [DOI: 10.3390/psychiatryint3020015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The combination of statistical learning technologies with large databases of psychophysiological data has appropriately generated enthusiastic interest in future clinical applicability. It is argued here that this enthusiasm should be tempered with the understanding that significant obstacles must be overcome before the systematic introduction of psychophysiological measures into neuropsychiatric practice becomes possible. The objective of this study is to identify challenges to this effort. The nonspecificity of psychophysiological measures complicates their use in diagnosis. Low test-retest reliability complicates use in longitudinal assessment, and quantitative psychophysiological measures can normalize in response to placebo intervention. Ten cautionary observations are introduced and, in some instances, possible directions for remediation are suggested.
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Concurrent chemoradiation therapy is associated with an accelerated risk of cardiovascular autonomic dysfunction in patients with nasopharyngeal carcinoma: A 9-year prospective follow-up study. Radiother Oncol 2022; 170:129-135. [DOI: 10.1016/j.radonc.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 03/04/2022] [Accepted: 03/06/2022] [Indexed: 01/17/2023]
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Wang J, Xu Z, Lv K, Ye Y, Luo D, Wan L, Zhou F, Yu A, Wang S, Liu J, Gao L. The Predictive Value of Serum Calcium on Heart Rate Variability and Cardiac Function in Type 2 Diabetes Patients. Front Endocrinol (Lausanne) 2022; 13:864008. [PMID: 35498438 PMCID: PMC9047897 DOI: 10.3389/fendo.2022.864008] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 03/03/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cardiovascular autonomic neuropathy (CAN) is common in patients with type 2 diabetes mellitus (T2DM), mainly presented as decreased heart rate variability (HRV) which often leads to cardiac death. However, HRV measurement is not convenient in most clinics. Therefore, identifying high-risk patients for CAN in diabetes with easier measurements is crucial for the early intervention and prevention of catastrophic consequences. METHODS In this cross-sectional study, 675 T2DM patients with normocalcemia were selected. Of these, they were divided into two groups: normal HRV group (n = 425, 100 ms≤ SDNN ≤180 ms) vs. declined HRV group (n = 250, SDNN <100 ms). All patients' clinical data were collected and the correlation of clinical variables with HRV were analyzed by correlation and logistic regression analysis. The area below the ROC curve was used to evaluate the predictive performance of serum calcium on HRV. RESULTS In this study, declines in HRV were present in 37.0% of T2DM patients. Significant differences in albumin-adjusted serum calcium levels (CaA) (8.86 ± 0.27 vs. 9.13 ± 0.39 mg/dl, p <0.001) and E/A (0.78 ± 0.22 vs. 0.83 ± 0.26, p = 0.029) were observed between declined HRV and normal HRV groups. Bivariate linear correlation analysis showed that CaA and E/A were positively correlated with HRV parameters including SDNN (p < 0.001), SDNN index (p < 0.001), and Triangle index (p < 0.05). The AUC in the ROC curve for the prediction of CaA on HRV was 0.730 (95% CI (0.750-0.815), p < 0.001). The cutoff value of CaA was 8.87 mg/dl (sensitivity 0.644, specificity 0.814). The T2DM patients with CaA <8.87 mg/dl had significantly lower HRV parameters (SDNN, SDNN index, rMSSD, and triangle index) than those with CaA ≥8.87 mg/dl (p < 0.01, respectively). Multivariate logistic regression analysis showed a significantly increased risk of declined HRV in subjects with CaA level <8.87 mg/dl [OR (95% CI), 0.049 (0.024-0.099), p < 0.001]. CONCLUSIONS Declined HRV is associated with a lower CaA level and worse cardiac function. The serum calcium level can be used for risk evaluation of declined HRV in T2DM patients even within the normocalcemic range.
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Affiliation(s)
- Junyi Wang
- Department of Endocrinology & Metabolism, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zihui Xu
- Department of Endocrinology & Metabolism, Renmin Hospital of Wuhan University, Wuhan, China
| | - Kang Lv
- Shenzhen University, College of Big Data and Internet, Shenzhen, China
| | - Yingchun Ye
- Department of Endocrinology & Metabolism, Renmin Hospital of Wuhan University, Wuhan, China
| | - Deng Luo
- Department of Endocrinology & Metabolism, Renmin Hospital of Wuhan University, Wuhan, China
| | - Li Wan
- Department of Endocrinology & Metabolism, Renmin Hospital of Wuhan University, Wuhan, China
| | - Fen Zhou
- Department of Endocrinology & Metabolism, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ailin Yu
- Department of Endocrinology & Metabolism, Renmin Hospital of Wuhan University, Wuhan, China
| | - Shuo Wang
- Department of Endocrinology & Metabolism, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jingcheng Liu
- Department of Endocrinology & Metabolism, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ling Gao
- Department of Endocrinology & Metabolism, Renmin Hospital of Wuhan University, Wuhan, China
- *Correspondence: Ling Gao,
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Preoperative heart rate variability analysis is as a potential simple and easy measure for predicting perioperative delirium in esophageal surgery. Ann Med Surg (Lond) 2021; 70:102856. [PMID: 34584685 PMCID: PMC8452778 DOI: 10.1016/j.amsu.2021.102856] [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: 08/03/2021] [Revised: 09/09/2021] [Accepted: 09/10/2021] [Indexed: 11/23/2022] Open
Abstract
Background Delirium is one of the most common but severe perioperative complications. Autonomic activity evaluated by heart rate variability (HRV) has been recently reported as a useful tool for prediction and for early detection of delirium in acute care medicine, especially in postoperative intensive care unit (ICU) patients. We hypothesized that HRV, by 3-lead electrocardiogram (ECG), one day prior to surgery might correlate with the presence of postoperative delirium. Materials and methods This study was cohort prospective pilot study. We measured preoperative HRV and postoperative delirium in patients who underwent surgery for elective esophageal cancer. ECG of the participants was performed for 10 min 6–12 h preceding surgery. Postoperatively, patients were admitted to the ICU or critical care unit and stayed for at least 3 days. Delirium was diagnosed by psychiatrist rounds twice a day. Results Delirium was assessed for 3 days after surgery and 30 patients performed the study. Seven patients developed delirium during their ICU stay, while the remaining twenty-three did not. After HRV analysis, the preoperative high frequency power in delirium patients was significantly lower than that in non-delirium patient. Other parameters of HRV, including lower frequency power, total power and the ratio showed no statistically significant difference between the groups. Conclusion The results of current study demonstrated that preoperative measurement of HRV may be a useful predictor of delirium. Further investigation could pave the way to a non-invasive, minimally stressful method of predicting postoperative delirium. Delirium is one of the most common and severe postoperative complications. Delirium prediction can provide better treatment for patients. Heart rate variability analysis might predict delirium in esophageal cancer surgery.
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Hsu HC, Lee HF, Lin MH. Exploring the Association between Sleep Quality and Heart Rate Variability among Female Nurses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5551. [PMID: 34067371 PMCID: PMC8196961 DOI: 10.3390/ijerph18115551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 05/17/2021] [Accepted: 05/20/2021] [Indexed: 11/16/2022]
Abstract
The quality of nurses' work has a direct effect on patient health, and poor sleep has been positively associated with nurses' medical errors. The aim of this study was to investigate the relationship between quality of sleep and heart rate variability (HRV) among female nurses. A descriptive cross-sectional correlational study design was used in January 2014 to study female nurses (n = 393) employed in a medical center in Taiwan. Data were obtained from several questionnaires. HRV was analyzed with five-minute recordings of heart rate signals obtained using a Heart Rater SA-3000P. Approximately 96% of the participants self-reported a poor quality of sleep. Compared to non-shift nurses, significant decreases were found in total power (TP) and low-frequency HRV among shift-work nurses. However, negative correlations were found between sleep quality and HRV, including total power, low frequency, and the low frequency/high frequency ratio (r = -0.425, p < 0.05; r = -0.269, -0.266, p < 0.05). In a stepwise multiple regression analysis, 23.1% of variance in quality of sleep can be explained by TP and heart rate. The sleep quality of female nurses was poor and this affected their autonomic nervous system, which can contribute unfavorable consequences for their health.
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Affiliation(s)
- Hsiu-Chin Hsu
- Department of Graduate Institute of Health Care, Chang Gung University of Science and Technology, and Department of Internal Medicine, Chang Gung Memorial Hospital, Tao-Yuan 333, Taiwan;
| | - Hsiu-Fang Lee
- Department of Nursing, Chang Gung Memorial Hospital, Tao-Yuan 333, Taiwan;
| | - Mei-Hsiang Lin
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan
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