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Wang S, Peng Y, Wang Y, Li F, Xu Y, Zheng H, Yuan H, Hu C, Liao D, Cai H, Zhang J, Li W, Ding Y, Zhang W, Xue X, Liu X, Zhu L, Liu D, Kang M, Liu L, Chu W, Li X, Luo X, Zou R, Wang C. Relationship between syncopal symptoms and head-up tilt test modes. Cardiol Young 2024:1-6. [PMID: 38577783 DOI: 10.1017/s1047951124000726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
OBJECTIVE Head-up tilt test (HUTT) is an important tool in the diagnosis of pediatric vasovagal syncope. This research will explore the relationship between syncopal symptoms and HUTT modes in pediatric vasovagal syncope. METHODS A retrospective analysis was performed on the clinical data of 2513 children aged 3-18 years, who were diagnosed with vasovagal syncope, from Jan. 2001 to Dec. 2021 due to unexplained syncope or pre-syncope. The average age was 11.76 ± 2.83 years, including 1124 males and 1389 females. The patients were divided into the basic head-up tilt test (BHUT) group (596 patients) and the sublingual nitroglycerine head-up tilt test (SNHUT) group (1917 patients) according to the mode of positive HUTT at the time of confirmed pediatric vasovagal syncope. RESULTS (1) Baseline characteristics: Age, height, weight, heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and composition ratio of syncope at baseline status were higher in the BHUT group than in the SNHUT group (all P < 0.05). (2) Univariate analysis: Age, height, weight, HR, SBP, DBP, and syncope were potential risk factors for BHUT positive (all P < 0.05). (3) Multivariate analysis: syncope was an independent risk factor for BHUT positive, with a probability increase of 121% compared to pre-syncope (P<0.001). CONCLUSION The probability of BHUT positivity was significantly higher than SNHUT in pediatric vasovagal syncope with previous syncopal episodes.
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Affiliation(s)
- Shuo Wang
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yali Peng
- Section of Science and Education, The First People's Hospital of Changde City, Changde, China
| | - Yuwen Wang
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Fang Li
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yi Xu
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Huifen Zheng
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
- Department of Pediatrics, Shenzhen People's Hospital, Shenzhen, China
| | - Heli Yuan
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
- Department of Pediatrics, North China University of Science and Technology Affiliated Hospital, Tangshan, China
| | - Chunyan Hu
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
- Department of Pediatrics, The Second Affiliated Hospital, University of South China, Hengyang, China
| | - Donglei Liao
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Hong Cai
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Juan Zhang
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Wen Li
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yiyi Ding
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
- Department of Pediatrics, The First People's Hospital of Changde City, Changde, China
| | - Wenhua Zhang
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
- Department of Pediatrics, The Third Hospital of Changsha, Changsha, China
| | - Xiaohong Xue
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
- Department of Pediatrics, Hunan Want Want Hospital, Changsha, China
| | - Xiaoyan Liu
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
- Department of Pediatrics, Changsha Central Hospital, University of South China, Changsha, China
| | - Liping Zhu
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
- Department of Neonatology, Changsha Central Hospital, University of South China, Changsha, China
| | - Deyu Liu
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
- Department of Pediatrics, Hunan Lixian People's Hospital, Changde, China
| | - Meihua Kang
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
- Department of Pediatrics, Weijia Pediatric Hospital, Changsha, China
| | - Liping Liu
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
- Department of Pediatric Cardiology, Hunan People's Hospital/First Affiliated Hospital of Hunan Normal University, Changsha, China
| | - Weihong Chu
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
- Department of Pediatrics, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Xiaoming Li
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
- Department of Pediatrics, Jieyang People's Hospital, Jieyang, China
| | - Xuemei Luo
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Runmei Zou
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Cheng Wang
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
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Mujaddadi A, Zaki S, M Noohu M, Naqvi IH, Veqar Z. Predictors of Cardiac Autonomic Dysfunction in Obesity-Related Hypertension. High Blood Press Cardiovasc Prev 2024; 31:77-91. [PMID: 38345729 DOI: 10.1007/s40292-024-00623-7] [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: 09/20/2023] [Accepted: 01/04/2024] [Indexed: 03/12/2024] Open
Abstract
INTRODUCTION Cardiac Autonomic Dysfunction (CAD) is an overlooked cardiovascular risk factor in individuals with obesity-related hypertension. Despite its clinical significance, there is a notable lack of clarity regarding the pathophysiological correlates involved in its onset and progression. AIM The present study aimed to identify potential predictors of CAD in obesity-related hypertension. METHODS A total of 72 participants (34 men and 38 women) were enrolled. Comprehensive evaluations were conducted, including cardiac autonomic function assessments, body composition estimation and biochemical analysis. Participants were categorized as CAD-positive or CAD-negative based on Ewing's criteria for autonomic dysfunction. Univariate logistic regression analysis was performed to identify potential predictors for CAD. Multivariate logistic regression models were further constructed by adjusting clinically relevant covariates to identify independent predictors of CAD. RESULTS Multivariate logistic regression analysis revealed that resting heart rate (HRrest), (odds ratio, confidence interval: 0.85, 0.78-0.93; p = 0.001) and percentage body fat (BF%), (odds ratio, confidence interval: 0.78, 0.64-0.96; p = 0.018) were significant independent predictors of CAD. Receiver Operating Characteristic curve analysis depicted optimal cut-off values for HRrest and BF% as > 74.1 bpm and > 33.6%, respectively. Multicolinearity analysis showed variance inflation factors (VIF) below the cautionary threshold of 3. CONCLUSIONS The HRrest and BF% emerged as significant independent predictors of CAD in obesity-related hypertension. Therapeutic strategies should target HRrest < 74.1 bpm and BF% < 33.6% to mitigate CAD risk in this population. Future trials are required to establish causal relationships and may consider additional confounding variables in obesity-related hypertension.
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Affiliation(s)
- Aqsa Mujaddadi
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India
| | - Saima Zaki
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India
| | - Majumi M Noohu
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India
| | - Irshad Husain Naqvi
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India
- Dr. M.A. Ansari Health Centre, Jamia Millia Islamia (A Central University), New Delhi, 110025, India
| | - Zubia Veqar
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India.
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Relationship between Body Composition and Cardiac Autonomic Regulation in a Large Population of Italian Olympic Athletes. J Pers Med 2022; 12:jpm12091508. [PMID: 36143294 PMCID: PMC9505674 DOI: 10.3390/jpm12091508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 09/08/2022] [Accepted: 09/10/2022] [Indexed: 11/17/2022] Open
Abstract
Athletic performance is determined by many factors, such as cardiorespiratory fitness, muscular strength and psychological features, which all interact simultaneously. The large Italian National Olympic Committee database of Olympic athletes offers a unique healthy population to verify the strength of the interplay among a number of major elements of training, including autonomic nervous system (ANS) modulation, biochemical indicators and body composition, in a system medicine approach. This observational, retrospective study involved 583 individuals. As part of the yearly precompetitive examination, cardiac autonomic (heart rate variability), psychological, physical (cycloergometer stress test), biochemical and body composition (BOD POD) evaluations were performed. In subsequent analysis, we first considered the relationship between body composition and single individual variables in a simple correlation matrix, including a multitude of variables; then, Exploratory Factor Analysis (EFA) restricted the information to six latent domains, each combining congruent information in relation to body composition. Finally, we employed a multiple quantile regression model to evaluate possible relationships between ANSIs (index capable of synthetizing ANS regulation) and the latent domains indicated by EFA reflecting body composition. We observed a clear relationship between ANS and body mass composition parameters, as indicated by both bivariate correlations and the quantile regression result of ANSIs versus the latent domain aggregating mainly body composition data expressed in % (p = 0.002). In conclusion, these results suggest that specific training may elicit parallel adaptation of ANS control and body composition. The analysis of Olympic athletes’ data allowed us to obtain a better understanding of the complex, multidimensional factors involved in determining sport performance. The latter appears to be determined by the simultaneous interaction not only of cardiorespiratory fitness, muscular strength and psychological features, but also of ANS cardiovascular modulation and body composition.
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Escutia-Reyes D, de Jesús Garduño-García J, Emilio-López-Chávez G, Gómez-Villanueva Á, Pliego-Carrillo AC, Soto-Piña AE, Reyes-Lagos JJ. Differences in heart rate variability and body composition in breast cancer survivors and women without cancer. Sci Rep 2021; 11:14460. [PMID: 34262078 PMCID: PMC8280116 DOI: 10.1038/s41598-021-93713-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 06/30/2021] [Indexed: 12/25/2022] Open
Abstract
The aim of this study was to explore cardiac autonomic changes assessed by linear and nonlinear indexes of heart rate variability (HRV) and body composition modifications in breast cancer survivors and cancer-free control women. Women who were breast cancer survivors (BCS, n = 27) and without cancer with similar characteristics (Control, n = 31) were recruited for this study. We calculated some relevant linear and nonlinear parameters of 5 min of RR interval time series such as mean RR interval (RRave), the corrected Poincaré index (cSD1/SD2), the sample entropy (SampEn), the long-term fractal scaling exponent (α2) and 2UV from symbolic dynamics. Additionally, we indirectly assessed body composition measures such as body weight, fat mass, visceral fat rating (VFR), normalized VRF (nVFR), muscle mass, metabolic age, and total body water. We found that diverse HRV indexes and only one body composition measure showed statistical differences (p < 0.05) between the BCS and Control groups. RRave: 729 (648-802) vs. 795 (713-852) ms; cSD2/SD1: 3.4 (2.7-5.0) vs. 2.9 (2.3-3.5); SampEn: 1.5 (1.3-1.8) vs. 1.7 (1.5-1.8); α2: 0.6 (0.3-0.6) vs. 0.5 (0.4-0.5); 2UV: 7.1 (4.3-11.5) vs. 10.8 (6.4-15.7) and nVFR 0.12 (0.11-0.13) vs. 0.10 (0.08-0.12) points/kg, respectively. The nVFR was strongly significantly correlated with several indexes of HRV only in the BCS group.Our findings suggest that BCS exhibit lower parasympathetic cardiac activity and changes in HRV patterns compared to Controls. A concomitant increase of visceral fat, among other factors, may contribute to cardiac autonomic disturbances and changes in HRV patterns in BCS.
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Affiliation(s)
- Daniel Escutia-Reyes
- School of Medicine, Autonomous University of Mexico State (UAEMéx), State of Mexico, 50180, Toluca, Mexico
| | - José de Jesús Garduño-García
- School of Medicine, Autonomous University of Mexico State (UAEMéx), State of Mexico, 50180, Toluca, Mexico
- Regional General Hospital No. 251, Mexican Institute of Social Security (IMSS), State of Mexico, 52148, Metepec, Mexico
| | - Gerardo Emilio-López-Chávez
- Regional General Hospital No. 251, Mexican Institute of Social Security (IMSS), State of Mexico, 52148, Metepec, Mexico
| | - Ángel Gómez-Villanueva
- Regional General Hospital No. 251, Mexican Institute of Social Security (IMSS), State of Mexico, 52148, Metepec, Mexico
| | | | - Alexandra Estela Soto-Piña
- School of Medicine, Autonomous University of Mexico State (UAEMéx), State of Mexico, 50180, Toluca, Mexico
| | - José Javier Reyes-Lagos
- School of Medicine, Autonomous University of Mexico State (UAEMéx), State of Mexico, 50180, Toluca, Mexico.
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