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Campos LA, Baltatu OC, Senar S, Ghimouz R, Alefishat E, Cipolla-Neto J. Multiplatform-Integrated Identification of Melatonin Targets for a Triad of Psychosocial-Sleep/Circadian-Cardiometabolic Disorders. Int J Mol Sci 2023; 24:ijms24010860. [PMID: 36614302 PMCID: PMC9821171 DOI: 10.3390/ijms24010860] [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: 11/08/2022] [Revised: 12/10/2022] [Accepted: 12/30/2022] [Indexed: 01/05/2023] Open
Abstract
Several psychosocial, sleep/circadian, and cardiometabolic disorders have intricately interconnected pathologies involving melatonin disruption. Therefore, we hypothesize that melatonin could be a therapeutic target for treating potential comorbid diseases associated with this triad of psychosocial-sleep/circadian-cardiometabolic disorders. We investigated melatonin's target prediction and tractability for this triad of disorders. The melatonin's target prediction for the proposed psychosocial-sleep/circadian-cardiometabolic disorder triad was investigated using databases from Europe PMC, ChEMBL, Open Targets Genetics, Phenodigm, and PheWAS. The association scores for melatonin receptors MT1 and MT2 with this disorder triad were explored for evidence of target-disease predictions. The potential of melatonin as a tractable target in managing the disorder triad was investigated using supervised machine learning to identify melatonin activities in cardiovascular, neuronal, and metabolic assays at the cell, tissue, and organism levels in a curated ChEMBL database. Target-disease visualization was done by graphs created using "igraph" library-based scripts and displayed using the Gephi ForceAtlas algorithm. The combined Europe PMC (data type: text mining), ChEMBL (data type: drugs), Open Targets Genetics Portal (data type: genetic associations), PhenoDigm (data type: animal models), and PheWAS (data type: genetic associations) databases yielded types and varying levels of evidence for melatonin-disease triad correlations. Of the investigated databases, 235 association scores of melatonin receptors with the targeted diseases were greater than 0.2; to classify the evidence per disease class: 37% listed psychosocial disorders, 9% sleep/circadian disorders, and 54% cardiometabolic disorders. Using supervised machine learning, 546 cardiovascular, neuronal, or metabolic experimental assays with predicted or measured melatonin activity scores were identified in the ChEMBL curated database. Of 248 registered trials, 144 phase I to IV trials for melatonin or agonists have been completed, of which 33.3% were for psychosocial disorders, 59.7% were for sleep/circadian disorders, and 6.9% were for cardiometabolic disorders. Melatonin's druggability was evidenced by evaluating target prediction and tractability for the triad of psychosocial-sleep/circadian-cardiometabolic disorders. While melatonin research and development in sleep/circadian and psychosocial disorders is more advanced, as evidenced by melatonin association scores, substantial evidence on melatonin discovery in cardiovascular and metabolic disorders supports continued R&D in cardiometabolic disorders, as evidenced by melatonin activity scores. A multiplatform analysis provided an integrative assessment of the target-disease investigations that may justify further translational research.
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Affiliation(s)
- Luciana Aparecida Campos
- Center of Innovation, Technology, and Education (CITE) at Anhembi Morumbi University—Anima Institute, Sao Jose dos Campos Technology Park, Sao Jose dos Campos 12247-016, Brazil
- Department of Public Health and Epidemiology, College of Medicine and Health Science, Khalifa University, Abu Dhabi P.O. Box 127788, United Arab Emirates
- Correspondence: (L.A.C.); (O.C.B.)
| | - Ovidiu Constantin Baltatu
- Center of Innovation, Technology, and Education (CITE) at Anhembi Morumbi University—Anima Institute, Sao Jose dos Campos Technology Park, Sao Jose dos Campos 12247-016, Brazil
- Department of Public Health and Epidemiology, College of Medicine and Health Science, Khalifa University, Abu Dhabi P.O. Box 127788, United Arab Emirates
- Correspondence: (L.A.C.); (O.C.B.)
| | | | - Rym Ghimouz
- Fatima College of Health Sciences, Abu Dhabi P.O. Box 3798, United Arab Emirates
| | - Eman Alefishat
- Department of Pharmacology, College of Medicine and Health Science, Khalifa University, Abu Dhabi P.O. Box 127788, United Arab Emirates
- Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman 11942, Jordan
- Center for Biotechnology, Khalifa University, Abu Dhabi P.O. Box 127788, United Arab Emirates
| | - José Cipolla-Neto
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-000, Brazil
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Dias RA, de Faria Cardoso C, Ghimouz R, Nono DA, Silva JA, Acuna J, Baltatu OC, Campos LA. Quantitative cardiac autonomic outcomes of hydrotherapy in women during the first stage of labor. Front Med (Lausanne) 2023; 9:987636. [PMID: 36660001 PMCID: PMC9844258 DOI: 10.3389/fmed.2022.987636] [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: 07/06/2022] [Accepted: 09/05/2022] [Indexed: 01/04/2023] Open
Abstract
Introduction Most hydrotherapy studies during childbirth report findings related to pain using a widespread set of subjective measures. In this study, ECG biomarkers as quantitative cardiac autonomic outcomes were used to assess the effects of warm shower hydrotherapy on laboring women during the first stage of labor. Methods This was a prospective single-blind cohort study on stage I delivering women. Their cardiac autonomic function was assessed using heart rate variability (HRV) measures during a deep breathing test using point-of-care testing comprised of an HRV scanner system with wireless ECG enabling real-time data analysis and visualization. Labor pain and anxiety were assessed using the Visual Analog Scale for Pain (VASP) and the Beck Anxiety Inventory (BAI). A total of 105 pregnant women in the first stage of labor who received warm shower hydrotherapy, intravenous analgesia (scopolamine + sodium dipyrone), or spinal anesthetic (bupivacaine + morphine) were enrolled. Results In women during the first stage of labor, parasympathetic modulation reflected through RMSSD (root mean square of successive RR interval differences) was significantly reduced by hydrotherapy and intravenous analgesia (before vs. after mean rank diff. 35.73 and 65.93, respectively, p < 0.05). Overall HRV (SDNN, standard deviation of RR intervals) was significantly decreased only by intravenous analgesia (before vs. after mean rank diff. 65.43, p < 0.001). Mean heart rate was significantly increased by intravenous analgesia, while spinal anesthesia reduced it, and hydrotherapy did not alter it (before vs. after mean rank diff. -49.35*, 70.38*, -24.20 NS , respectively, *p < 0.05, NS not significant). Conclusion This study demonstrates that warm shower therapy may impact the sympathovagal balance via parasympathetic withdrawal in women during the initial stage of labor. The findings of this study provide quantitative support for using warm shower hydrotherapy during labor via point-of-care testing. The dependability of hydrotherapy as a non-pharmacological treatment is linked to the completion of more clinical research demonstrating quantitative evidence via outcome biomarkers to support indications on stress and birth progress.
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Affiliation(s)
- Raquel Aparecida Dias
- Center of Innovation, Technology and Education (CITE) at Anhembi Morumbi University—Anima Institute, São José dos Campos Technology Park, São José dos Campos, Brazil
| | - Cláudia de Faria Cardoso
- Center of Innovation, Technology and Education (CITE) at Anhembi Morumbi University—Anima Institute, São José dos Campos Technology Park, São José dos Campos, Brazil
| | - Rym Ghimouz
- Fatima College of Health Sciences, Abu Dhabi, United Arab Emirates
| | - Daniel Alessander Nono
- Center for Special Technologies, National Institute for Space Research (INPE), São José dos Campos, Brazil
| | | | - Juan Acuna
- Department of Public Health and Epidemiology, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Ovidiu Constantin Baltatu
- Center of Innovation, Technology and Education (CITE) at Anhembi Morumbi University—Anima Institute, São José dos Campos Technology Park, São José dos Campos, Brazil,Department of Public Health and Epidemiology, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates,*Correspondence: Ovidiu Constantin Baltatu,
| | - Luciana Aparecida Campos
- Center of Innovation, Technology and Education (CITE) at Anhembi Morumbi University—Anima Institute, São José dos Campos Technology Park, São José dos Campos, Brazil,Department of Public Health and Epidemiology, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates,Luciana Aparecida Campos,
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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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Shi L, Bi D, Luo J, Chen W, Yang C, Zheng Y, Hao J, Chang K, Li B, Liu C, Ta D. Associations between electrocardiogram and carotid ultrasound parameters: a healthy chinese group study. Front Physiol 2022; 13:976254. [PMID: 36003640 PMCID: PMC9393264 DOI: 10.3389/fphys.2022.976254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 07/07/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Electrocardiogram (ECG) and carotid ultrasound (CUS) are important tools for the diagnosis and prediction of cardiovascular disease (CVD). This study aimed to investigate the associations between ECG and CUS parameters and explore the feasibility of assessing carotid health with ECG. Methods: This cross-sectional cohort study enrolled 319 healthy Chinese subjects. Standard 12-lead ECG parameters (including the ST-segment amplitude [STA]), CUS parameters (intima-media thickness [IMT] and blood flow resistance index [RI]), and CVD risk factors (including sex, age, and systolic blood pressure [SBP]) were collected for analysis. Participants were divided into the high-level RI group (average RI ≥ 0.76, n = 171) and the normal RI group (average RI < 0.76, n = 148). Linear and stepwise multivariable regression models were performed to explore the associations between ECG and CUS parameters. Results: Statistically significant differences in sex, age, SBP, STA and other ECG parameters were observed in the normal and the high-level RI group. The STA in lead V3 yielded stronger significant correlations (r = 0.27–0.42, p < 0.001) with RI than STA in other leads, while ECG parameters yielded weak correlations with IMT (|r| ≤ 0.20, p < 0.05). STA in lead V2 or V3, sex, age, and SBP had independent contributions (p < 0.01) to predicting RI in the stepwise multivariable models, although the models for IMT had only CVD risk factors (age, body mass index, and triglyceride) as independent variables. The prediction model for RI in the left proximal common carotid artery (CCA) had higher adjusted R2 (adjusted R2 = 0.31) than the model for RI in the left middle CCA (adjusted R2 = 0.29) and the model for RI in the right proximal CCA (adjusted R2 = 0.20). Conclusion: In a cohort of healthy Chinese individuals, the STA was associated with the RI of CCA, which indicated that ECG could be utilized to assess carotid health. The utilization of ECG might contribute to a rapid screening of carotid health with convenient operations.
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Affiliation(s)
- Lingwei Shi
- Center for Biomedical Engineering, School of Information Science and Technology, Fudan University, Shanghai, China
| | - Dongsheng Bi
- Center for Biomedical Engineering, School of Information Science and Technology, Fudan University, Shanghai, China
| | - Jingchun Luo
- Human Phenome Institute, Fudan University, Shanghai, China
| | - Wei Chen
- Center for Biomedical Engineering, School of Information Science and Technology, Fudan University, Shanghai, China
- Human Phenome Institute, Fudan University, Shanghai, China
| | - Cuiwei Yang
- Center for Biomedical Engineering, School of Information Science and Technology, Fudan University, Shanghai, China
| | - Yan Zheng
- Human Phenome Institute, Fudan University, Shanghai, China
| | - Ju Hao
- Human Phenome Institute, Fudan University, Shanghai, China
| | - Ke Chang
- Center for Biomedical Engineering, School of Information Science and Technology, Fudan University, Shanghai, China
| | - Boyi Li
- Academy for Engineering and Technology, Fudan University, Shanghai, China
- *Correspondence: Boyi Li, ; Chengcheng Liu,
| | - Chengcheng Liu
- Academy for Engineering and Technology, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Medical Image Computing and Computer Assisted Intervention, Fudan University, Shanghai, China
- *Correspondence: Boyi Li, ; Chengcheng Liu,
| | - Dean Ta
- Center for Biomedical Engineering, School of Information Science and Technology, Fudan University, Shanghai, China
- Human Phenome Institute, Fudan University, Shanghai, China
- Academy for Engineering and Technology, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Medical Image Computing and Computer Assisted Intervention, Fudan University, Shanghai, China
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Engström G, Hamrefors V, Fedorowski A, Persson A, Johansson ME, Ostenfeld E, Goncalves I, Markstad H, Johnson LSB, Persson M, Carlson J, Platonov PG. Cardiovagal Function Measured by the Deep Breathing Test: Relationships With Coronary Atherosclerosis. J Am Heart Assoc 2022; 11:e024053. [PMID: 35352566 PMCID: PMC9075454 DOI: 10.1161/jaha.121.024053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background The cardiovagal function can be assessed by quantification of respiratory sinus arrhythmia (RSA) during a deep breathing test. However, population studies of RSA and coronary atherosclerosis are lacking. This population‐based study examined the relationship between RSA during deep breathing and coronary atherosclerosis, assessed by coronary artery calcium score (CACS). Methods and Results SCAPIS (Swedish Cardiopulmonary Bioimage Study) randomly invited men and women aged 50 to 64 years from the general population. CACS was obtained from computed tomography scanning, and deep breathing tests were performed in 4654 individuals. Expiration–inspiration differences (E‐Is) of heart rates were calculated, and reduced RSA was defined as E‐I in the lowest decile of the population. The relationship between reduced RSA and CACS (CACS≥100 or CACS≥300) was calculated using multivariable‐adjusted logistic regression. The proportion of CACS≥100 was 24% in the lowest decile of E‐I and 12% in individuals with E‐I above the lowest decile (P<0.001), and the proportion of CACS≥300 was 12% and 4.8%, respectively (P<0.001). The adjusted odds ratio (OR) for CACS≥100 was 1.42 (95% CI, 1.10–1.84) and the adjusted OR for CACS≥300 was 1.62 (95% CI, 1.15–2.28), when comparing the lowest E‐I decile with deciles 2 to 10. Adjusted ORs per 1 SD lower E‐I were 1.17 (P=0.001) for CACS≥100 and 1.28 (P=0.001) for CACS≥300. Conclusions Low RSA during deep breathing is associated with increased coronary atherosclerosis as assessed by CACS, independently of traditional cardiovascular risk factors. Cardiovagal dysfunction could be a prevalent and modifiable risk factor for coronary atherosclerosis in the general population.
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Affiliation(s)
- Gunnar Engström
- Department of Clinical Sciences in Malmö Lund University Malmö Sweden
| | - Viktor Hamrefors
- Department of Clinical Sciences in Malmö Lund University Malmö Sweden.,Department of Internal Medicine Skåne University Hospital Malmö Sweden
| | - Artur Fedorowski
- Department of Clinical Sciences in Malmö Lund University Malmö Sweden.,Department of Cardiology Skåne University Hospital Malmö Sweden
| | - Anders Persson
- Department of Clinical Sciences in Malmö Lund University Malmö Sweden
| | - Maria E Johansson
- Department of Physiology Institute of Neuroscience and PhysiologyUniversity of Gothenburg Sweden
| | - Ellen Ostenfeld
- Department of Clinical Sciences in Lund Lund University Lund Sweden.,Department of Medical Imaging and Clinical Physiology Skåne University Hospital Lund Sweden
| | - Isabel Goncalves
- Department of Clinical Sciences in Malmö Lund University Malmö Sweden.,Department of Cardiology Skåne University Hospital Malmö Sweden
| | - Hanna Markstad
- Department of Clinical Sciences in Malmö Lund University Malmö Sweden.,Department of Medical Imaging and Clinical Physiology Skåne University Hospital Lund Sweden
| | - Linda S B Johnson
- Department of Clinical Sciences in Malmö Lund University Malmö Sweden
| | | | - Jonas Carlson
- Department of Clinical Sciences in Lund Lund University Lund Sweden
| | - Pyotr G Platonov
- Department of Clinical Sciences in Lund Lund University Lund Sweden
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Park MJ, Choi KM. Association between Variability of Metabolic Risk Factors and Cardiometabolic Outcomes. Diabetes Metab J 2022; 46:49-62. [PMID: 35135078 PMCID: PMC8831817 DOI: 10.4093/dmj.2021.0316] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 12/07/2021] [Indexed: 11/10/2022] Open
Abstract
Despite strenuous efforts to reduce cardiovascular disease (CVD) risk by improving cardiometabolic risk factors, such as glucose and cholesterol levels, and blood pressure, there is still residual risk even in patients reaching treatment targets. Recently, researchers have begun to focus on the variability of metabolic variables to remove residual risks. Several clinical trials and cohort studies have reported a relationship between the variability of metabolic parameters and CVDs. Herein, we review the literature regarding the effect of metabolic factor variability and CVD risk, and describe possible mechanisms and potential treatment perspectives for reducing cardiometabolic risk factor variability.
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Affiliation(s)
- Min Jeong Park
- Division of Endocrinology & Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Kyung Mook Choi
- Division of Endocrinology & Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- Corresponding author: Kyung Mook Choi https://orcid.org/0000-0001-6175-0225 Division of Endocrinology & Metabolism, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul 08308, Korea E-mail:
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Khatri G, Singh M, Bika S, Joshi K, Swami N. Carotid intima–Media thickness: An independent risk factor for stroke prediction – A call for revised framingham score system. J ANAT SOC INDIA 2022. [DOI: 10.4103/jasi.jasi_212_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Association between Levels of Urine Di-(2-ethylhexyl)phthalate Metabolites and Heart Rate Variability in Young Adults. TOXICS 2021; 9:toxics9120351. [PMID: 34941785 PMCID: PMC8709404 DOI: 10.3390/toxics9120351] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/29/2021] [Accepted: 12/08/2021] [Indexed: 12/17/2022]
Abstract
Phthalate exposure is associated with cardiovascular risk. Among the various phthalates, di-(2-ethylhexyl) phthalate (DEHP) is a deleterious plasticizer in our daily lives. This study investigated the association between DEHP exposure and the alteration of heart rate variability (HRV). During 2017–2019, we recruited 974 young adults to investigate the effects of living environments and dietary habits on cardiometabolic disorders in Taiwan. We quantitatively analyzed urinary metabolites of DHEP. A continuous electrocardiogram was recorded to obtain a 5-min ECG. Time-domain and frequency-domain HRV analyses were performed. Multiple linear regression showed that urinary oxidized DEHP metabolites MEHHP and MEOHP were associated with decreased HRV after controlling for associated cardiovascular risk factors. A higher MEHHP level was associated with a lower triangular interpolation of NN interval histogram (TINN), very low frequency (VLF), and low frequency/high frequency (LF/HF) ratio. A higher MEOHP level was associated with a decreased LF/HF ratio. In addition, trend analysis showed that higher MEHHP and MEOHP quantiles were significantly associated with a decreased LF/HF ratio. DEHP is a potentially harmful and invisible chemical. The urinary DEHP metabolites MEHHP and MEOHP are associated with decreased HRV, indicating an adverse effect on autonomic balance in young adults in Taiwan.
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Saboo N, Kacker S, Rathore J. Correlation of Heart Rate Variability with Carotid Intima Media Thickness after 6 Month of Yoga Intervention in Prediabetics. Int J Yoga 2021; 14:198-205. [PMID: 35017861 PMCID: PMC8691437 DOI: 10.4103/ijoy.ijoy_74_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 08/02/2021] [Accepted: 08/10/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Atherosclerotic carotid intimamedia thickness (CIMT) may be associated with alterations in the autonomic functions. The aim of this study was to investigate the effect of 6-month yoga intervention on heart rate variability (HRV) and CIMT in elderly subjects and the correlation between HRV and CIMT. METHODOLOGY This was a randomized controlled study, in which a total of 250 subjects were enrolled. Randomization and allocation in yoga and control groups were performed using computer-generated random numbers. The CIMT was determined by B-mode ultrasonography, and cardiac autonomic function was determined through frequency domain parameter of HRV measures at baseline and after 6 months of yoga intervention. RESULTS Participants had a mean age of 45.4 ± 6.4 years, and a mean CIMT in control (0.70 ± 0.05) and study group (0.69 ± 0.073), and low frequency/high frequency (LF/HF) ratio in control (2.20 ± 1.05) and study group (0.57 ± 0.54). Yoga group had evidence of increased vagal activity in the frequency domain (HF and LF/HF ratio, P < 0.001) with respect to control group. Moreover, a study group showed lower intimamedia thickness (IMT) than control subjects (P < 0.01). In the whole population, LF/HF ratio positively and significantly correlated (r = 0.665, P < 0.01) to IMT. CONCLUSION This study demonstrated that, after yoga intervention, LF/HF ratio is positively correlated with CIMT, a putative index of atherosclerosis, confirming cardiac autonomic neuropathy as a part of the pathophysiological pathway for atherosclerosis. It confirms that the regular yoga represents a valuable strategy to counter impairments of cardiac autonomic activity and artery structural changes.
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Affiliation(s)
- Neha Saboo
- Department of Physiology, Rajasthan University of Health Sciences, Jaipur, Rajasthan, India
| | - Sudhanshu Kacker
- Department of Physiology, Rajasthan University of Health Sciences, Jaipur, Rajasthan, India,Address for correspondence: Dr. Sudhanshu Kacker, Department of Physiology, Rajasthan University of Health Sciences, Pratap Nagar, Jaipur, Rajasthan, India. E-mail:
| | - Jeevraj Rathore
- Department of Radiology, Rajasthan University of Health Sciences, Jaipur, Rajasthan, India
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de Faria Cardoso C, Ohe NT, Bader Y, Afify N, Al-Homedi Z, Alwedami SM, O'Sullivan S, Campos LA, Baltatu OC. Heart Rate Variability Indices as Possible Biomarkers for the Severity of Post-traumatic Stress Disorder Following Pregnancy Loss. Front Psychiatry 2021; 12:700920. [PMID: 35058809 PMCID: PMC8763675 DOI: 10.3389/fpsyt.2021.700920] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 11/02/2021] [Indexed: 12/30/2022] Open
Abstract
Background: Psychological distress, such as posttraumatic stress disorder (PTSD), is commonly evaluated using subjective questionnaires, a method prone to self-report bias. The study's working hypothesis was that levels of autonomic dysfunction determined by heart rate variability (HRV) measures are associated with the severity of PTSD in women following pregnancy loss. Methods: This was an observational prospective cohort study with 53 patients enrolled. The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) PTSD scale (PCL-5) was used to assess the severity of PTSD in women after pregnancy loss. The cardiac autonomic function was assessed using HRV measurements during a deep breathing test using an HRV scanner system with wireless ECG enabling real-time data analysis and visualization. HRV measures were: standard deviation (SD) of normal R-R wave intervals [SDNN, ms], square root of the mean of the sum of the squares of differences between adjacent normal R wave intervals [RMSSD, ms], and the number of all R-R intervals in which the change in consecutive normal sinus intervals exceeds 50 milliseconds divided by the total number of R-R intervals measured [pNN50 = (NN50/n-1)*100%] [pNN50%]. Results: The PCL-5 scores had a statistically significant association with HRV indices (SDNN; RMSSD, and pNN50%). Patients with PTSD had similar mean heart rate values as compared to patients without PTSD (PCL-5), but significantly higher SDNN [median[IQR, interquartile range]: 90.1 (69.1-112.1) vs. 52.5 (36.8-65.6)], RMSSD [59.4 (37.5-74.9) vs. 31.9 (19.3 - 44.0)], and PNN50% values [25.7 (16.4-37.7) vs. 10.6 (1.5-21.9)]. The SDNN of the deep breathing test HRV was effective at distinguishing between patients with PTSD and those without, with an AUC = 0.83 +/- 0.06 (95 % CI 0.94, p = 0.0001) of the ROC model. Conclusions: In this study, HRV indices as biomarkers of cardiac dysautonomia were found to be significantly related to the severity of PTSD symptoms in women after pregnancy loss.
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Affiliation(s)
- Cláudia de Faria Cardoso
- Center of Innovation, Technology and Education (CITE), Anhembi Morumbi University, Sao Jose dos Campos, Brazil
| | - Natalia Tiemi Ohe
- Center of Innovation, Technology and Education (CITE), Anhembi Morumbi University, Sao Jose dos Campos, Brazil
| | - Yazan Bader
- Emory University, Atlanta, GA, United States
| | - Nariman Afify
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Zahrah Al-Homedi
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Salma Malalla Alwedami
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Siobhán O'Sullivan
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Luciana Aparecida Campos
- Center of Innovation, Technology and Education (CITE), Anhembi Morumbi University, Sao Jose dos Campos, Brazil.,College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Ovidiu Constantin Baltatu
- Center of Innovation, Technology and Education (CITE), Anhembi Morumbi University, Sao Jose dos Campos, Brazil.,College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
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11
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Al Tunaiji H, Al Qubaisi M, Dalkilinc M, Campos LA, Ugwuoke NV, Alefishat E, Aloum L, Ross R, Almahmeed W, Baltatu OC. Impact of COVID-19 Pandemic Burnout on Cardiovascular Risk in Healthcare Professionals Study Protocol: A Multicenter Exploratory Longitudinal Study. Front Med (Lausanne) 2020; 7:571057. [PMID: 33415114 PMCID: PMC7783289 DOI: 10.3389/fmed.2020.571057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 11/23/2020] [Indexed: 01/19/2023] Open
Abstract
Introduction: The coronavirus disease 2019 (COVID-19) pandemic has created new and unpredictable challenges for healthcare systems. Healthcare professionals are heavily affected by this rapidly changing situation, especially frontline healthcare professionals who are directly engaged in the diagnosis, treatment, and care of patients with COVID-19 and may experience psychological burdens. The objective of this study is to explore the evolution of psychosocial, cardiovascular, and immune markers in healthcare professionals with different levels of exposure to the COVID-19 pandemic. Methods and Analysis: This is a STROBE compliant, blended, exploratory study involving online and onsite approaches that use wearable monitoring. A planned random probability sample of residents, staff physicians, nurses, and auxiliary healthcare professionals will be recruited. The study sample will be stratified by exposure to the COVID-19 pandemic. As a first step, recruitment will be conducted online, with e-consent and using e-surveys with Maslach Burnout Inventory, Fuster-BEWAT score, and sociodemographic characteristics. Onsite visits will be planned for the second step where participants will receive a wearable setup that will measure heart rate, actimetry, and sleep quality monitoring, which will be used together with blood sampling for immune biomarkers. Steps 1 and 2 will then be repeated at 2-3 months, and 6 months. Power BI and Tableau will be used for data visualization, while front-end data capture will be used for data collection using specific survey/questionnaires, which will enable data linkage between e-surveys, internet of things wearable devices, and clinical laboratory data. Clinical Trial Registration: ClinicalTrials.gov; Identifier: NCT04422418.
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Affiliation(s)
| | - Mai Al Qubaisi
- Zayed Military Hospital, Abu Dhabi, United Arab Emirates
| | | | - Luciana Aparecida Campos
- College of Health Sciences, Abu Dhabi University, Abu Dhabi, United Arab Emirates.,Center of Innovation, Technology and Education (CITE), Sao Jose dos Campos Technology Park, Sao Jose dos Campos, Brazil.,Institute of Biomedical Engineering, Anhembi Morumbi University-Laureate International Universities, Sao Jose dos Campos, Brazil
| | | | - Eman Alefishat
- College of Medicine & Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Lujain Aloum
- College of Medicine & Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Ramzy Ross
- Myriad Global Solutions, Abu Dhabi, United Arab Emirates
| | - Wael Almahmeed
- Heart & Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Ovidiu Constantin Baltatu
- Center of Innovation, Technology and Education (CITE), Sao Jose dos Campos Technology Park, Sao Jose dos Campos, Brazil.,Institute of Biomedical Engineering, Anhembi Morumbi University-Laureate International Universities, Sao Jose dos Campos, Brazil.,College of Medicine & Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
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12
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Mauricio D, Alonso N, Gratacòs M. Chronic Diabetes Complications: The Need to Move beyond Classical Concepts. Trends Endocrinol Metab 2020; 31:287-295. [PMID: 32033865 DOI: 10.1016/j.tem.2020.01.007] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 11/22/2019] [Accepted: 01/09/2020] [Indexed: 12/11/2022]
Abstract
Chronic-diabetes-related complications simultaneously compromise both the micro- and macrovascular trees, with target organs considered as the paradigm of large vessel injury also entailing microangiopathic changes. However, complications independent or partially independent from vascular damage are often overlooked. This includes neuronal dysfunction (e.g., retinal neurodegeneration), interstitial injury (e.g., tubulointerstitial disease), metabolic damage (e.g., in the heart and liver), and nonclassical conditions such as cognitive decline, impaired pulmonary function, or increased risk of cancer. In this scenario, researchers, endocrinologists and primary care physicians should have a holistic view of the disease and pay further attention to all organs and all potential clinical repercussions, which would certainly contribute to a more rational and integrated patient health care.
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Affiliation(s)
- Dídac Mauricio
- DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain; CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Barcelona, Spain; Department of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Barcelona, Spain.
| | - Núria Alonso
- CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Barcelona, Spain; Department of Endocrinology and Nutrition, Health Sciences Research Institute & University Hospital Germans Trias i Pujol, Badalona, Spain
| | - Mònica Gratacòs
- DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
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13
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Campos LA, Bueno C, Barcelos IP, Halpern B, Brito LC, Amaral FG, Baltatu OC, Cipolla-Neto J. Melatonin Therapy Improves Cardiac Autonomic Modulation in Pinealectomized Patients. Front Endocrinol (Lausanne) 2020; 11:239. [PMID: 32431667 PMCID: PMC7213221 DOI: 10.3389/fendo.2020.00239] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 04/01/2020] [Indexed: 12/20/2022] Open
Abstract
The purpose of this investigational study was to assess the effects of melatonin replacement therapy on cardiac autonomic modulation in pinealectomized patients. This was an open-label, single-arm, single-center, proof-of-concept study consisting of a screening period, a 3-month treatment period with melatonin (3 mg/day), and a 6-month washout period. The cardiac autonomic function was determined through heart rate variability (HRV) measures during polysomnography. Pinealectomized patients (n = 5) with confirmed absence of melatonin were included in this study. Melatonin treatment increased vagal-dominated HRV indices including root mean square of the successive R-R interval differences (RMSSD) (39.7 ms, 95% CI 2.0-77.4, p = 0.04), percentage of successive R-R intervals that differ by more than 50 ms (pNN50) (17.1%, 95% CI 9.1-25.1, p = 0.003), absolute power of the high-frequency band (HF power) (1,390 ms2, 95% CI 511.9-2,267, p = 0.01), and sympathetic HRV indices like standard deviation of normal R-R wave interval (SDNN) (57.6 ms, 95% CI 15.2-100.0, p = 0.02), and absolute power of the low-frequency band (LF power) (4,592 ms2, 95% CI 895.6-8,288, p = 0.03). These HRV indices returned to pretreatment values when melatonin treatment was discontinued. The HRV entropy-based regularity parameters were not altered in this study, suggesting that there were no significant alterations of the REM-NREM ratios between the time stages of the study. These data show that 3 months of melatonin treatment may induce an improvement in cardiac autonomic modulation in melatonin-non-proficient patients. ClinicalTrials.gov Identifier: NCT03885258.
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Affiliation(s)
- Luciana Aparecida Campos
- Center of Innovation, Technology and Education (CITE) at São José dos Campos Technology Park, São Paulo, Brazil
- Institute of Biomedical Engineering, Anhembi Morumbi University, Laureate International Universities, São José dos Campos, Brazil
- College of Health Sciences, Abu Dhabi University, Abu Dhabi, United Arab Emirates
| | - Clarissa Bueno
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
- Department of Pediatric Neurology, Hospital das Clínicas of University of São Paulo Medical School, São Paulo, Brazil
| | - Isabella P. Barcelos
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Bruno Halpern
- Department of Endocrinology and Metabolism, Hospital das Clínicas of University of São Paulo Medical School, São Paulo, Brazil
| | - Leandro C. Brito
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Fernanda G. Amaral
- Department of Physiology, Federal University of São Paulo, São Paulo, Brazil
| | - Ovidiu Constantin Baltatu
- Center of Innovation, Technology and Education (CITE) at São José dos Campos Technology Park, São Paulo, Brazil
- Institute of Biomedical Engineering, Anhembi Morumbi University, Laureate International Universities, São José dos Campos, Brazil
- Department of Pharmacology and Therapeutics, College of Medicine & Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
- *Correspondence: Ovidiu Constantin Baltatu
| | - José Cipolla-Neto
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
- José Cipolla-Neto
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14
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Hoshi RA, Santos IS, Dantas EM, Andreão RV, Mill JG, Goulart AC, Lotufo PA, Bensenor I. Relationship between heart rate variability and carotid intima-media thickness in the Brazilian Longitudinal Study of Adult Health - ELSA-Brasil. Clin Physiol Funct Imaging 2019; 40:122-130. [PMID: 31821714 DOI: 10.1111/cpf.12613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 12/06/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Both increased carotid intima-media thickness (cIMT) and low heart rate variability (HRV) have been associated with cardiovascular mortality and morbidity. Thus, the aim of this study was to investigate whether cardio autonomic alterations are accompanied or not by subclinical atherosclerosis in participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). METHODS cIMT measures and 5-min HRV analyses were performed in apparently healthy adults. Heart rate variability was evaluated by linear time and frequency domain analyses. cIMT was defined as the average between the mean left and mean right cIMT values and was analysed as continuous and categorized variables (P≥75 or P<75). Multiple linear models using continuous variables and multivariate logistic regression with categorized cIMT and HRV quartiles were performed. RESULTS Out of 7256 participants eligible for analyses, 23·4% presented cIMT ≥ 75th percentile. Heart rate variability variables were reduced in cIMT ≥ P75 in comparison with cIMT < P75: SDNN 33·0 versus 37·0 ms, P<0·001; RMSSD 22·0 versus 26·0 ms, P<0·001; LF 191·0 versus 260·0 ms2 , P<0·001; HF 164·0 versus 238·5 ms2 , P<0·001. In crude analysis, an increased odds ratio for cIMT ≥ P75 was verified within the lowest two quartiles of LF and HF, but significances did not remain after adjustments for anthropometric and clinical variables. CONCLUSIONS Considering the entire sample, subjects with cIMT ≥ P75 presented lower HRV values, but no independent relationships were detected between cIMT and HRV after multivariate adjustment.
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Affiliation(s)
- Rosangela A Hoshi
- Center for Clinical and Epidemiological Research of University Hospital, University of Sao Paulo, Sao Paulo, Brazil
| | - Itamar S Santos
- Center for Clinical and Epidemiological Research of University Hospital, University of Sao Paulo, Sao Paulo, Brazil
| | - Eduardo M Dantas
- Department of Biological Sciences, Federal University of Vale do Sao Francisco, Petrolina, Brazil
| | - Rodrigo V Andreão
- Department of Electrical Engineering, Federal Institute of Espirito Santo, Vitória, Brazil
| | - José G Mill
- Department of Physiological Sciences, Federal University of Espirito Santo, Vitória, Brazil
| | - Alessandra C Goulart
- Center for Clinical and Epidemiological Research of University Hospital, University of Sao Paulo, Sao Paulo, Brazil
| | - Paulo A Lotufo
- Center for Clinical and Epidemiological Research of University Hospital, University of Sao Paulo, Sao Paulo, Brazil
| | - Isabela Bensenor
- Center for Clinical and Epidemiological Research of University Hospital, University of Sao Paulo, Sao Paulo, Brazil
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15
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De Smidt JJA, Odendaal HJ, Nel DG, Nolan H, Du Plessis C, Brink LT, Oelofse A. In utero teratogen exposure and cardiometabolic risk in 5-year-old children: a prospective pediatric study. J Matern Fetal Neonatal Med 2019; 34:3740-3749. [PMID: 31762362 DOI: 10.1080/14767058.2019.1692337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Background: Aorta and carotid intima-media thickness (IMT) is a measure of subclinical atherosclerosis and useful to assess cardiometabolic risk in the young. The in utero milieu may involve cardiometabolic programing and the development of cardiometabolic risk factors in children. Maternal smoking, alcohol consumption, and micronutrient deficiencies during pregnancy influence the development of the cardiovascular system through a process of DNA methylation.Aim: To explore an association between maternal smoking and alcohol consumption during pregnancy and intima media thickness in 5-year-old children for a low-income setting.Methods: Data were collected from 500 mother-child pairs at antenatal clinic visit, at birth, and at age 5 years. Anthropometric measurements were collected at birth and again at age 5 years. As well as clinical and ultrasound measurements at age 5 years. Clinical measurements, at age 5 years, included blood pressure, mean arterial pressure, and heart rate. Ultrasound measurements of the aorta and carotid arteries IMT were performed at age 5 years. Main outcome of interest was effect of dual teratogen exposure on the ultrasound measures IMT as indication of cardiometabolic risk.Results: cIMT was significantly higher in children exposed to both alcohol and nicotine during pregnancy compared to those not exposed (p = .008). In separate linear models, dual in utero exposure (beta = 0.12; p = .01) and male sex (beta = 0.14; p = .01) were associated with higher right cIMT values (F(6,445) = 5.20; R2 = 0.07, p < .01); male sex (beta = 0.13; p = .01) and low birth weight (beta = 0.07; p = .01) with higher left cIMT value (F(4,491) = 4.49; R2 = 0.04; p = .01); and males sex (beta = 0.11; p = .02) with higher aorta IMT (F(6,459) = 5.63; R2 = 0.07; p < .01). Significant positive correlations between maternal measures of adiposity, maternal MUAC (r = 0.10; p = .03), and maternal BMI (r = 0.12; p < .01) and right cIMT measurements adjusted for the BMI of the child at age 5 years as covariate. Blood pressure measurements at age 5 years were not significantly associated with IMT but, instead, correlated significantly and positively with the BMI of the child at age 5 years (p < .01).Conclusion: Children exposed to both maternal smoking and alcohol consumption during pregnancy presented with cardiometabolic risk factors 5 years after birth. In addition, maternal adiposity, male sex, and low birth weight were associated with higher IMT at age 5 years.
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Affiliation(s)
- J J A De Smidt
- Department of Medical Biosciences, University of the Western Cape, South Africa
| | - H J Odendaal
- Department of Obstetrics and Gynecology, Stellenbosch University, Stellenbosch, South Africa
| | - D G Nel
- Department of Statistics and Actuarial Science, Stellenbosch University, Stellenbosch, South Africa
| | - H Nolan
- Department of Obstetrics and Gynecology, Stellenbosch University, Stellenbosch, South Africa
| | - C Du Plessis
- Department of Obstetrics and Gynecology, Stellenbosch University, Stellenbosch, South Africa
| | - L T Brink
- Department of Obstetrics and Gynecology, Stellenbosch University, Stellenbosch, South Africa
| | - A Oelofse
- Department of Medical Biosciences, University of the Western Cape, South Africa
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16
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Kang SJ, Ko KJ. Association between resting heart rate, VO 2max and carotid intima-media thickness in middle-aged men. IJC HEART & VASCULATURE 2019; 23:100347. [PMID: 30976652 PMCID: PMC6441756 DOI: 10.1016/j.ijcha.2019.100347] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 03/13/2019] [Accepted: 03/17/2019] [Indexed: 11/24/2022]
Abstract
Introduction Low resting heart rate (RHR) and high cardiorespiratory fitness (VO2max) are associated with a reduction in cardiovascular events (CV). Carotid intima-media thickness (CIMT) has been suggested as a predictor of CV. The purpose of this study was to investigate the association between RHR, VO2max and CIMT. Methods The subjects of this study were 707 males aged 40–50 who visited the National Health Center of South Korea, a health examination institution, from 2010 to 2016. RHR was measured using electrocardiogram. RHR was divided into 4 levels (<60 beats per minute; bpm, 60–69 bpm, 70–79 bpm, ≥80 bpm). VO2max was measured by grade exercise test. Subject's VO2max was divided into 3 levels (first, second and third tertiles). CIMT was measured by B-mode ultrasound. Carotid atherosclerosis was defined as CIMT >1 mm. Results There was no significant difference in CIMT according to RHR level and there was no correlation between RHR and CIMT. High and middle VO2max group had significant lower CIMT than low VO2max group (P < 0.001). There was also a correlation between VO2max and CIMT (R = −0.129, P < 0.001). The low VO2max group showed 3.56-fold (95% CI, 1.77–7.16) higher relative risk of carotid atherosclerosis than the high VO2max group. Conclusion These results suggest that cardiovascular fitness index VO2max is associated to CIMT in middle-aged men. In addition, this study shows that VO2max are important indicators for the prevalence of carotid atherosclerosis.
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Affiliation(s)
- Seol-Jung Kang
- Department of Physical Education, Changwon National University, Republic of Korea
| | - Kwang-Jun Ko
- Department of Sports Medicine, National Fitness Center, Republic of Korea
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17
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Sleep, Autonomic Nervous Function and Atherosclerosis. Int J Mol Sci 2019; 20:ijms20040794. [PMID: 30781734 PMCID: PMC6412503 DOI: 10.3390/ijms20040794] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 02/04/2019] [Accepted: 02/07/2019] [Indexed: 12/12/2022] Open
Abstract
Behavioral and psychosocial factors related to development of cardiovascular disease have been gaining increased attention. Notably, sleep is considered to be one of the most important behavioral factors involved in progression of atherosclerosis and cardiovascular events, with autonomic nervous function a potential mechanism. Several studies have shown associations of sleep and autonomic dysfunction with major surrogate markers of atherosclerosis, such as carotid intima-media thickness and arterial stiffness. Endocrinological, immunological, oxidative, inflammatory, and metabolic responses, as well as endothelial dysfunction may mediate the effects of the autonomic nervous system. For this review, we examined recent findings related to sleep, autonomic nervous dysfunction, and atherosclerosis, with the aim of understanding the involved pathophysiological mechanisms.
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18
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Medeiros TKDS, Dobre M, da Silva DMB, Brateanu A, Baltatu OC, Campos LA. Intrapartum Fetal Heart Rate: A Possible Predictor of Neonatal Acidemia and APGAR Score. Front Physiol 2018; 9:1489. [PMID: 30405441 PMCID: PMC6204407 DOI: 10.3389/fphys.2018.01489] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 10/02/2018] [Indexed: 12/20/2022] Open
Abstract
Background: Predicting perinatal outcomes based on patterns of fetal heart rate (FHR) remains a challenge. The aim of this study was to evaluate intrapartum FHR variability as predictor for neonatal acidemia and APGAR score. Methods: This was a retrospective observational study of 552 childbirths. Multivariable linear regression models were used to assess the association between FHR variability and each of the following outcomes: arterial cord blood pH and base deficit, Apgar 1, and 5 scores. Variables used for adjustment were maternal age, comorbidities (gestational diabetes, preeclampsia, maternal fever, and hypertension), parity, gravidity, uterine contractions, and newborn gestational age, and weight at birth. Results: The following factors were associated with an increased risk of metabolic acidosis and low Apgar scores at birth: increased mean and coefficient of variation (CV) of the FHR, type of delivery and decreased parity. Each 10-beat/min increase in the FHR was associated with an increase of 0.43 mEq/L in the base deficit, and a decrease of 0.01 in the pH, 0.2 in the Apgar 1, and 0.14 in the Apgar 5 scores. Each 10% increase in the CV of the FHR was associated with an increase of 4.05 mEq/L in the base deficit and a decrease of 0.13 in the pH, 1.31 in the Apgar 1, and 0.86 in the Apgar 5 scores. Conclusion: These data suggest the intrapartum FHR variability is physiologically relevant and can be used for predicting the acidemia and Apgar scores at birth of the newborn infants without severe cases of morbidity and from uncomplicated pregnancies.
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Affiliation(s)
- Thâmila Kamila de Souza Medeiros
- Center of Innovation, Technology and Education at Anhembi Morumbi University - Laureate International Universities, São José dos Campos, Brazil.,School of Health Sciences at Anhembi Morumbi University - Laureate International Universities, São José dos Campos, Brazil
| | - Mirela Dobre
- Division of Nephrology and Hypertension, University Hospitals, Cleveland, OH, United States
| | - Daniela Monteiro Baptista da Silva
- Center of Innovation, Technology and Education at Anhembi Morumbi University - Laureate International Universities, São José dos Campos, Brazil.,School of Health Sciences at Anhembi Morumbi University - Laureate International Universities, São José dos Campos, Brazil
| | - Andrei Brateanu
- Medicine Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Ovidiu Constantin Baltatu
- Center of Innovation, Technology and Education at Anhembi Morumbi University - Laureate International Universities, São José dos Campos, Brazil.,School of Health Sciences at Anhembi Morumbi University - Laureate International Universities, São José dos Campos, Brazil
| | - Luciana Aparecida Campos
- Center of Innovation, Technology and Education at Anhembi Morumbi University - Laureate International Universities, São José dos Campos, Brazil.,School of Health Sciences at Anhembi Morumbi University - Laureate International Universities, São José dos Campos, Brazil
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19
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Adoor M, Jaideep SS, Sujan MU, Kramer BW, Raju TR, Sathyaprabha TN. Influence of age and gender on blood pressure variability and baroreflex sensitivity in a healthy population in the Indian sub-continent. J Basic Clin Physiol Pharmacol 2018; 29:329-337. [PMID: 30007058 DOI: 10.1515/jbcpp-2017-0125] [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] [Received: 08/09/2017] [Accepted: 01/03/2018] [Indexed: 11/15/2022]
Abstract
Background The current exploratory study was aimed at estimating measures of blood pressure variability (BPV) and baroreflex sensitivity (BRS) in a healthy population in the Indian sub-continent. Methods One hundred and forty-two healthy subjects were recruited for the study. Blood pressure (BP) was recorded continuously for 15 min using the Finometer (Finapres Medical Systems, The Netherlands). For offline analysis, Nevrokard cardiovascular parameter analysis (CVPA) software (version 2.1.0) was used for BPV analysis. BRS was determined by spectral and sequence methods. One-way ANOVA and Bonferroni's test were used to compare parameters. Pearson's correlation coefficient was employed to look for possible associations between age and other continuous variables. Results Out of 196 screened volunteers, 54 were excluded and 142 subjects were grouped based on ages as 10-19 years (group 1), 20-29 years (group 2), 30-39 years (group 3), 40-49 years (group 4), and 50-59 years (group 5). Within groups, body mass index (BMI, p=0.000) and BP (systolic and diastolic) were significantly different. Post hoc analysis showed mean blood pressure (MBP) and diastolic blood pressure (DBP) differing significantly between groups 1 and 4 (p<0.05 for both) along with other cardiovascular parameters. Age correlated positively with BMI and all parameters of BP. Significant gender differences were observed for stroke volume, cardiac output, up BRS, total BRS, peripheral resistance (PR), and aortic impedance. Conclusions Our study has provided reference values for BPV and BRS in an Indian population. It also indicates age-related neurocardiac imbalance and possible utility of these tests for screening at the start of neurocardiac damage in a healthy population.
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Affiliation(s)
- Meghana Adoor
- Departments of Neurophysiology, National Institute of Mental Health and Neuroscience (NIMHANS), Bangalore, India
| | - Sriranjini S Jaideep
- Ramaiah Indic Specialty Ayurveda (RISA), Gokula Education Foundation (Medical), Bangalore, India
| | - M U Sujan
- Departments of Neurophysiology, National Institute of Mental Health and Neuroscience (NIMHANS), Bangalore, India
| | - Boris W Kramer
- Department of Pediatrics, School of Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - T R Raju
- Departments of Neurophysiology, National Institute of Mental Health and Neuroscience (NIMHANS), Bangalore, India
| | - Talakad N Sathyaprabha
- Departments of Neurophysiology, National Institute of Mental Health and Neuroscience (NIMHANS), Bangalore 560 029, Karnataka, India, Phone: +91 80 26 995 172, Fax: +91 80 26564830
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20
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Tolentino JC, Schmidt SL. DSM-5 Criteria and Depression Severity: Implications for Clinical Practice. Front Psychiatry 2018; 9:450. [PMID: 30333763 PMCID: PMC6176119 DOI: 10.3389/fpsyt.2018.00450] [Citation(s) in RCA: 118] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 08/30/2018] [Indexed: 11/15/2022] Open
Abstract
Background: Depression diagnosis requires five or more symptoms (Diagnostic and Statistical Manual of Mental Disorders-DSM-5). One of them must be either Depressed mood or Anhedonia, named main criteria. Although the secondary symptoms can be divided into somatic and non-somatic clusters, the DSM-5 identify depression in all or none fashion. In contrast, depression severity is a continuous variable. Therefore, it is commonly assessed with scales such as the Hamilton Depression Rating Scale (HAMD). Previously, we reported that patients with moderate depression (MD) exhibit greater impairments in cardiac-autonomic modulation than severely depressed (SD) patients. However, clinicians usually do not use scales. Objective: To verify whether the DSM-5 symptoms would be able to discriminate SD from MD and MD from non-depressed (ND) subjects. Material and Methods: Depression was diagnosed based on the Structured Clinical Interview for DSM-5® Disorders. The HAMD evaluated depression severity. In depressed subjects, MD and SD were defined considering the HAMD scores. ND was defined considering both the absence of DSM-5 criteria for depression and the HAMD score. Among 782 outpatients, 46 SD were found. MD and ND subjects were randomly sampled to match the demographic variables of the SD group. Results: Discriminant analysis showed that Depressed Mood was the most reliable symptom to discriminate ND from MD. Anhedonia discriminated SD from MD. Among the secondary DSM-5 criteria, the somatic cluster discriminated ND from MD and the non-somatic cluster SD from MD patients. Discussion: The presence of the somatic cluster in MD may indicate decreased vagal tone and/or increased sympathetic tone, leading to higher cardiovascular risk. As SD is associated with the non-somatic cluster, these patients are at risk of committing suicide. The DSM-5 symptoms exhibited by the patient may help the choice of adequate pharmacological treatment. This would avoid the use of antidepressants that unnecessarily increase cardiac risk in MD. When the symptom cluster suggests SD, the treatment must focus on the prevention of suicide. Conclusions: Depression severity may be inferred based on the DSM-5 criteria. The presence of the Anhedonia main criterium accompanied by non-somatic criteria indicate SD. The Depressive Mood criterium followed by somatic criteria suggest MD.
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Affiliation(s)
- Julio C Tolentino
- Department of Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sergio L Schmidt
- Department of Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
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