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Sparacino L, Antonacci Y, Bara C, Valenti A, Porta A, Faes L. A Method to Assess Granger Causality, Isolation and Autonomy in the Time and Frequency Domains: Theory and Application to Cerebrovascular Variability. IEEE Trans Biomed Eng 2024; 71:1454-1465. [PMID: 38055366 DOI: 10.1109/tbme.2023.3340011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
OBJECTIVE Concepts of Granger causality (GC) and Granger autonomy (GA) are central to assess the dynamics of coupled physiologic processes. While causality measures have been already proposed and applied in time and frequency domains, measures quantifying self-dependencies are still limited to the time-domain formulation and lack of clear spectral representation. METHODS We embed into the linear parametric framework for computing GC from a driver X to a target process Y a measure of Granger Isolation (GI) quantifying the part of the dynamics of Y not originating from X, and a new spectral measure of GA assessing frequency-specific patterns of self-dependencies in Y. The measures are illustrated in theoretical simulations and applied to time series of arterial pressure and cerebral blood flow obtained in syncope subjects and healthy controls. RESULTS Simulations show that GI is complementary to GC but not trivially related to it, while GA reflects the regularity of the internal dynamics of the target process. In the application to cerebrovascular interactions, spectral GA quantified the physiological response to postural stress of slow cerebral blood flow oscillations, while spectral GC and GI detected an altered response to orthostasis in syncope subjects, likely related to impaired cerebral autoregulation. CONCLUSION AND SIGNIFICANCE The new spectral measures of GI and GA are useful complements to GC for the analysis of interacting oscillatory processes, and detect pathophysiological responses to postural stress which cannot be traced in the time domain. The thorough assessment of causality, isolation and autonomy opens new perspectives for the analysis of coupled processes in both physiological and clinical investigations.
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Gelpi F, Wu MA, Bari V, Cairo B, De Maria B, Fossali T, Colombo R, Porta A. Autonomic Function and Baroreflex Control in COVID-19 Patients Admitted to the Intensive Care Unit. J Clin Med 2024; 13:2228. [PMID: 38673501 PMCID: PMC11050480 DOI: 10.3390/jcm13082228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 04/08/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Autonomic function and baroreflex control might influence the survival rate of coronavirus disease 2019 (COVID-19) patients admitted to the intensive care unit (ICU) compared to respiratory failure patients without COVID-19 (non-COVID-19). This study describes physiological control mechanisms in critically ill COVID-19 patients admitted to the ICU in comparison to non-COVID-19 individuals with the aim of improving stratification of mortality risk. Methods: We evaluated autonomic and baroreflex control markers extracted from heart period (HP) and systolic arterial pressure (SAP) variability acquired at rest in the supine position (REST) and during a modified head-up tilt (MHUT) in 17 COVID-19 patients (age: 63 ± 10 years, 14 men) and 33 non-COVID-19 patients (age: 60 ± 12 years, 23 men) during their ICU stays. Patients were categorized as survivors (SURVs) or non-survivors (non-SURVs). Results: We found that COVID-19 and non-COVID-19 populations exhibited similar vagal and sympathetic control markers; however, non-COVID-19 individuals featured a smaller baroreflex sensitivity and an unexpected reduction in the HP-SAP association during the MHUT compared to the COVID-19 group. Nevertheless, none of the markers of the autonomic and baroreflex functions could distinguish SURVs from non-SURVs in either population. Conclusions: We concluded that COVID-19 patients exhibited a more preserved baroreflex control compared to non-COVID-19 individuals, even though this information is ineffective in stratifying mortality risk.
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Affiliation(s)
- Francesca Gelpi
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy; (F.G.); (B.C.); (A.P.)
| | - Maddalena Alessandra Wu
- Department of Biomedical and Clinical Sciences, University of Milan, 20157 Milan, Italy;
- Division of Internal Medicine, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, 20157 Milan, Italy
| | - Vlasta Bari
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy; (F.G.); (B.C.); (A.P.)
- Department of Cardiothoracic, Vascular Anaesthesia and Intensive Care, IRCCS Policlinico San Donato, 20097 Milan, Italy
| | - Beatrice Cairo
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy; (F.G.); (B.C.); (A.P.)
| | | | - Tommaso Fossali
- Department of Anesthesiology and Intensive Care, ASST Fatebenefratelli-Sacco, Luigi Sacco Hospital, 20157 Milan, Italy; (T.F.); (R.C.)
| | - Riccardo Colombo
- Department of Anesthesiology and Intensive Care, ASST Fatebenefratelli-Sacco, Luigi Sacco Hospital, 20157 Milan, Italy; (T.F.); (R.C.)
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy; (F.G.); (B.C.); (A.P.)
- Department of Cardiothoracic, Vascular Anaesthesia and Intensive Care, IRCCS Policlinico San Donato, 20097 Milan, Italy
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Perego F, De Maria B, Parati M, Cassetti G, Gorini A, Bari V, Gelpi F, Porta A, Dalla Vecchia LA. Cardiac autonomic profile, perceived stress and environmental comfort in healthy employees during remote and in-office work. Sci Rep 2024; 14:3727. [PMID: 38355646 PMCID: PMC10867114 DOI: 10.1038/s41598-024-54283-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 02/10/2024] [Indexed: 02/16/2024] Open
Abstract
Remote work (REMOTE) causes an overlap between working and domestic demands. The study of the cardiac autonomic profile (CAP) by means of heart rate variability (HRV) provides information about the impact of REMOTE on workers' health. The primary aim was to determine whether CAP, self-perceived stress, environmental and workstation comfort are modified during REMOTE. The secondary aim was to explore how these indices are influenced by individual and environmental work-related factors. Fifty healthy office employees alternating REMOTE and in-office (OFFICE) working were enrolled, rated self-perceived stress, environmental and workstation comfort using a visual analogue scale and performed a 24-h electrocardiogram during REMOTE and OFFICE. Stress was lower (5.6 ± 2.2 vs. 6.4 ± 1.8), environmental comfort higher (7.7 ± 1.9 vs. 7.0 ± 1.5), and the workstation comfort poorer (6.2 ± 1.8 vs. 7.5 ± 1.2) during REMOTE. CAP was similar during REMOTE and OFFICE. CAP was influenced by some work-related factors, including the presence of offspring, absence of a dedicated workspace during REMOTE and number of working hours. All these variables determined a decreased vagal modulation. The working setting seems to impact the levels of perceived stress and comfort, but not the CAP. However, individual and environmental work-related factors reduce cardiac vagal modulation during REMOTE, potentially increasing the risk of developing cardiovascular diseases.
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Affiliation(s)
- Francesca Perego
- Istituti Clinici Scientifici Maugeri IRCCS, Via Camaldoli 64, 20138, Milan, Italy
| | - Beatrice De Maria
- Istituti Clinici Scientifici Maugeri IRCCS, Via Camaldoli 64, 20138, Milan, Italy.
| | - Monica Parati
- Istituti Clinici Scientifici Maugeri IRCCS, Via Camaldoli 64, 20138, Milan, Italy
| | - Giuseppina Cassetti
- Istituti Clinici Scientifici Maugeri IRCCS, Via Camaldoli 64, 20138, Milan, Italy
| | - Alessandra Gorini
- Istituti Clinici Scientifici Maugeri IRCCS, Via Camaldoli 64, 20138, Milan, Italy
- Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, Via Della Commenda 19, 20122, Milan, Italy
| | - Vlasta Bari
- Department of Biomedical Sciences for Health, University of Milan, Via Mangiagalli 31, 20133, Milan, Italy
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Piazza Edmondo Malan 2, San Donato Milanese, 20097, Milan, Italy
| | - Francesca Gelpi
- Department of Biomedical Sciences for Health, University of Milan, Via Mangiagalli 31, 20133, Milan, Italy
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Via Mangiagalli 31, 20133, Milan, Italy
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Piazza Edmondo Malan 2, San Donato Milanese, 20097, Milan, Italy
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Abreu RMD, Cairo B, Rehder-Santos P, da Silva CD, Signini ÉDF, Milan-Mattos JC, Sakaguchi CA, Catai AM, Porta A. Cardiorespiratory coupling is associated with exercise capacity in athletes: A cross-sectional study. Respir Physiol Neurobiol 2024; 320:104198. [PMID: 37956746 DOI: 10.1016/j.resp.2023.104198] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/24/2023] [Accepted: 11/09/2023] [Indexed: 11/15/2023]
Abstract
PURPOSE To determine the association between exercise capacity based on peak oxygen uptake (VO2peak) and resting cardiorespiratory coupling (CRC) levels in athletes and non-athletes' subjects. METHODS A cross-sectional study was carried out in 42 apparently healthy male subjects, aged between 20 and 40 years old. The participants were allocated into athletes (n = 21) and non-athletes (n = 21) groups. Resting electrocardiogram and respiratory movement (RESP) were simultaneously acquired during 15 min in supine position and quiet breathing. The beat-to-beat heart period (HP) and RESP series were determined from the recorded signals. Traditional analysis of HP based on frequency domain indexes was performed considering the high-frequency (0.15 - 0.45 Hz) components. To compute the CRC, the linear association between HP and RESP series was determined via squared coherence function and directionality of interaction was investigated through the causal extension of this approach. The exercise capacity was assessed through incremental cardiopulmonary exercise testing in order to determine the VO2peak. RESULTS Traditional analysis of HP based on high-frequency index was not correlated with exercise capacity in the athletes (r = -0.1, p = 0.5) and non-athletes (r = -0.1, p = 0.3) cohorts. However, resting CRC values was associated with exercise capacity in athletes (r = 0.4, p = 0.03), but not in the non-athletes group (r = -0.2, p = 0.3). CONCLUSION These results suggest that improved resting values of CRC is associated with higher exercise capacity (VO2peak) in endurance athletes. Moreover, frequency domain of HP was not sensitive to identifying this relationship, probably because effects of training on parasympathetic modulation might be affected by respiratory dynamics, and this influence has a directionality (i.e., from RESP to HP).
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Affiliation(s)
- Raphael Martins de Abreu
- LUNEX University, International University of Health, Exercise & Sports S.A. 50, Department of Physiotherapy, Differdange, Luxembourg; LUNEX ASBL Luxembourg Health & Sport Sciences Research Institute, Differdange, Luxembourg; Federal University of São Carlos, Department of Physical Therapy, São Carlos, São Paulo, Brazil.
| | - Beatrice Cairo
- University of Milan, Department of Biomedical Sciences for Health, Milan, Italy
| | - Patricia Rehder-Santos
- Federal University of São Carlos, Department of Physical Therapy, São Carlos, São Paulo, Brazil
| | | | - Étore De Favari Signini
- Federal University of São Carlos, Department of Physical Therapy, São Carlos, São Paulo, Brazil
| | | | - Camila Akemi Sakaguchi
- Appalachian State University, Department of Health, Leisure, and Exercise Science, NC, United States
| | - Aparecida Maria Catai
- Federal University of São Carlos, Department of Physical Therapy, São Carlos, São Paulo, Brazil
| | - Alberto Porta
- University of Milan, Department of Biomedical Sciences for Health, Milan, Italy; IRCCS Policlinico San Donato, Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, San Donato Milanese, Milan, Italy
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Porta A, Gelpi F, Bari V, Cairo B, De Maria B, Tonon D, Rossato G, Faes L. Concomitant evaluation of cardiovascular and cerebrovascular controls via Geweke spectral causality to assess the propensity to postural syncope. Med Biol Eng Comput 2023; 61:3141-3157. [PMID: 37452270 PMCID: PMC10746785 DOI: 10.1007/s11517-023-02885-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023]
Abstract
The evaluation of propensity to postural syncope necessitates the concomitant characterization of the cardiovascular and cerebrovascular controls and a method capable of disentangling closed loop relationships and decomposing causal links in the frequency domain. We applied Geweke spectral causality (GSC) to assess cardiovascular control from heart period and systolic arterial pressure variability and cerebrovascular regulation from mean arterial pressure and mean cerebral blood velocity variability in 13 control subjects and 13 individuals prone to develop orthostatic syncope. Analysis was made at rest in supine position and during head-up tilt at 60°, well before observing presyncope signs. Two different linear model structures were compared, namely bivariate autoregressive and bivariate dynamic adjustment classes. We found that (i) GSC markers did not depend on the model structure; (ii) the concomitant assessment of cardiovascular and cerebrovascular controls was useful for a deeper comprehension of postural disturbances; (iii) orthostatic syncope appeared to be favored by the loss of a coordinated behavior between the baroreflex feedback and mechanical feedforward pathway in the frequency band typical of the baroreflex functioning during the postural challenge, and by a weak cerebral autoregulation as revealed by the increased strength of the pressure-to-flow link in the respiratory band. GSC applied to spontaneous cardiovascular and cerebrovascular oscillations is a promising tool for describing and monitoring disturbances associated with posture modification.
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Affiliation(s)
- Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, 20133, Milan, Italy.
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Via R. Morandi 30, San Donato Milanese, 20097, Milan, Italy.
| | - Francesca Gelpi
- Department of Biomedical Sciences for Health, University of Milan, 20133, Milan, Italy
| | - Vlasta Bari
- Department of Biomedical Sciences for Health, University of Milan, 20133, Milan, Italy
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Via R. Morandi 30, San Donato Milanese, 20097, Milan, Italy
| | - Beatrice Cairo
- Department of Biomedical Sciences for Health, University of Milan, 20133, Milan, Italy
| | | | - Davide Tonon
- Department of Neurology, IRCCS Sacro Cuore Don Calabria Hospital, 37024, Negrar, Verona, Italy
| | - Gianluca Rossato
- Department of Neurology, IRCCS Sacro Cuore Don Calabria Hospital, 37024, Negrar, Verona, Italy
| | - Luca Faes
- Department of Engineering, University of Palermo, 90128, Palermo, Italy
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De Maria B, Dalla Vecchia LA, Bari V, Cairo B, Gelpi F, Perego F, Takahashi ACM, Milan-Mattos JC, Minatel V, Rehder-Santos P, Esler M, Lambert E, Baumert M, Catai AM, Porta A. The degree of engagement of cardiac and sympathetic arms of the baroreflex does not depend on the absolute value and sign of arterial pressure variations. Physiol Meas 2023; 44:114002. [PMID: 37922536 DOI: 10.1088/1361-6579/ad0976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/03/2023] [Indexed: 11/07/2023]
Abstract
Objective.The percentages of cardiac and sympathetic baroreflex patterns detected via baroreflex sequence (SEQ) technique from spontaneous variability of heart period (HP) and systolic arterial pressure (SAP) and of muscle nerve sympathetic activity (MSNA) burst rate and diastolic arterial pressure (DAP) are utilized to assess the level of the baroreflex engagement. The cardiac baroreflex patterns can be distinguished in those featuring both HP and SAP increases (cSEQ++) and decreases (cSEQ--), while the sympathetic baroreflex patterns in those featuring a MSNA burst rate decrease and a DAP increase (sSEQ+-) and vice versa (sSEQ-+). The present study aims to assess the modifications of the involvement of the cardiac and sympathetic arms of the baroreflex with age and postural stimulus intensity.Approach.We monitored the percentages of cSEQ++ (%cSEQ++) and cSEQ-- (%cSEQ--) in 100 healthy subjects (age: 21-70 years, 54 males, 46 females), divided into five sex-balanced groups consisting of 20 subjects in each decade at rest in supine position and during active standing (STAND). We evaluated %cSEQ++, %cSEQ--, and the percentages of sSEQ+- (%sSEQ+-) and sSEQ-+ (%sSEQ-+) in 12 young healthy subjects (age 23 ± 2 years, 3 females, 9 males) undergoing incremental head-up tilt.Main results.We found that: (i) %cSEQ++ and %cSEQ-- decreased with age and increased with STAND and postural stimulus intensity; (ii) %sSEQ+- and %sSEQ-+ augmented with postural challenge magnitude; (iii) the level of cardiac and sympathetic baroreflex engagement did not depend on either the absolute value of arterial pressure or the direction of its changes.Significance.This study stresses the limited ability of the cardiac and sympathetic arms of the baroreflex in controlling absolute arterial pressure values and the equivalent ability of both positive and negative arterial pressure changes in soliciting them.
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Affiliation(s)
| | | | - Vlasta Bari
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Beatrice Cairo
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Francesca Gelpi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | | | | | - Vinicius Minatel
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | | | - Murray Esler
- Human Neurotransmitters Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Elisabeth Lambert
- School of Health Science, Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, Australia
| | - Mathias Baumert
- Discipline of Biomedical Engineering, School of Electrical and Mechanical Engineering, The University of Adelaide, Adelaide, Australia
| | - Aparecida Maria Catai
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
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Bari V, Gelpi F, Cairo B, Anguissola M, Pugliese S, De Maria B, Bertoldo EG, Fiolo V, Callus E, De Vincentiis C, Volpe M, Molfetta R, Ranucci M, Porta A. Characterization of cardiovascular and cerebrovascular controls via spectral causality analysis in patients undergoing surgical aortic valve replacement during a three-month follow-up. Physiol Meas 2023; 44. [PMID: 37703899 DOI: 10.1088/1361-6579/acf992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 09/13/2023] [Indexed: 09/15/2023]
Abstract
Objective.Aortic valve stenosis (AVS) induces left ventricular function adaptations and surgical aortic valve replacement (SAVR) restores blood flow profile across aortic valve. Modifications of cardiac hemodynamics induced by AVS and SAVR might alter cardiovascular (CV) and cerebrovascular (CBV) controls. The study aims at characterizing CV and CBV regulations one day before SAVR (PRE), within one week after SAVR (POST), and after a three-month follow-up (POST3) in 73 AVS patients (age: 63.9 ± 12.9 yrs; 48 males, 25 females) from spontaneous fluctuations of heart period (HP), systolic arterial pressure, mean arterial pressure and mean cerebral blood velocity.Approach.CV and CBV regulations were typified via a bivariate autoregressive approach computing traditional frequency domain markers and causal squared coherence (CK2) from CV and CBV variabilities. Univariate time and frequency domain indexes were calculated as well. Analyses were carried out in frequency bands typical of CV and CBV controls at supine rest and during active standing. A surrogate method was exploited to check uncoupling condition.Main results.We found that: (i) CV regulation is impaired in AVS patients; (ii) CV regulation worsens in POST; (iii) CV regulation recovers in POST3 and CV response to active standing is even better than in PRE; (iv) CBV regulation is preserved in AVS patients; (v) SAVR does not affect CBV control; (vi) parameters of the CBV control in POST3 and PRE are similar.Significance.CK2is particularly useful to characterize CV and CBV controls in AVS patients and to monitor of patient's evolution after SAVR.
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Affiliation(s)
- Vlasta Bari
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Francesca Gelpi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Beatrice Cairo
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Martina Anguissola
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Sara Pugliese
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | | | | | - Valentina Fiolo
- Clinical Psychology Service, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Edward Callus
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Clinical Psychology Service, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | | | - Marianna Volpe
- Department of Cardiac Rehabilitation, IRCCS Policlinico San Donato, Milan, Italy
| | - Raffaella Molfetta
- Department of Cardiac Rehabilitation, IRCCS Policlinico San Donato, Milan, Italy
| | - Marco Ranucci
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
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Shiffer D, Zamunér AR, Minonzio M, Bulgheroni M, Porta A, Leone R, Bottazzi B, Garlanda C, Colotta F, Barbic F, Mantovani A, Furlan R. Soluble interleukin-1 receptor type 2 plasma levels in Parkinson's disease: relationship with cardiac autonomic profile before and after peripheral mechanical somatosensory stimulation. Front Physiol 2023; 14:1168652. [PMID: 37664433 PMCID: PMC10468972 DOI: 10.3389/fphys.2023.1168652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 08/02/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction: Systemic inflammation promotes neurodegeneration in Parkinson's disease (PD). Interleukin-1 receptor type 2 (sIL-1R2) plasma levels increase during inflammation. Data on sIL-1R2 in PD patients and its relationship with PD cardiac autonomic profile are limited, given the possible anti-inflammatory effect of vagal activation. Previously, automated mechanical peripheral somatosensory stimulation (AMPSS) enhanced cardiac vagal modulation. Objectives were to 1) evaluate sIL-1R2 plasma concentrations in PD patients and healthy controls and 2) investigate the correlations between sIL-1R2 and cardiac autonomic indices obtained by spectrum analysis of heart rate variability before and after AMPSS. Methods: sIL-1R2 plasma levels were assessed in 48 PD patients and 50 healthy controls. Electrocardiogram and beat-by-beat arterial pressure were recorded at baseline and after 5 AMPSS sessions in 16 PD patients. Results: PD patients had higher sIL-1R2 levels than controls. In the PD subgroup, an inverse correlation between sIL-1R2 and HFnu was found. There was a negative correlation between changes induced by AMPSS on HFnu and sIL-1R2. Discussion: Higher sIL-1R2 levels in PD patients reflect the inflammatory dysregulation associated with the disease. In PD patients, higher sIL-1R2 was associated with reduced cardiovagal tone. Increased cardiovagal modulation following AMPSS was associated with lower sIL-1R2 levels in Parkinson's disease patients, suggesting inflammatory state improvement.
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Affiliation(s)
- Dana Shiffer
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Internal Medicine, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | | | - Maura Minonzio
- Internal Medicine, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Mara Bulgheroni
- Department of Medicine, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico di San Donato, San Donato Milanese, Italy
| | | | | | - Cecilia Garlanda
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Humanitas Research Hospital, Milan, Italy
| | | | - Franca Barbic
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Internal Medicine, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Alberto Mantovani
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Humanitas Research Hospital, Milan, Italy
- The William Harvey Research Institute, Queen Mary University of London, London, United Kingdom
| | - Raffaello Furlan
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Internal Medicine, IRCCS Humanitas Research Hospital, Rozzano, Italy
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Cairo B, Bari V, Gelpi F, De Maria B, Porta A. Assessing cardiorespiratory interactions via lagged joint symbolic dynamics during spontaneous and controlled breathing. Front Netw Physiol 2023; 3:1211848. [PMID: 37602202 PMCID: PMC10436098 DOI: 10.3389/fnetp.2023.1211848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/13/2023] [Indexed: 08/22/2023]
Abstract
Introduction: Joint symbolic analysis (JSA) can be utilized to describe interactions between time series while accounting for time scales and nonlinear features. JSA is based on the computation of the rate of occurrence of joint patterns built after symbolization. Lagged JSA (LJSA) is obtained from the more classical JSA by introducing a delay/lead between patterns built over the two series and combined to form the joint scheme, thus monitoring coordinated patterns at different lags. Methods: In the present study, we applied LJSA for the assessment of cardiorespiratory coupling (CRC) from heart period (HP) variability and respiratory activity (R) in 19 healthy subjects (age: 27-35 years; 8 males, 11 females) during spontaneous breathing (SB) and controlled breathing (CB). The R rate of CB was selected to be indistinguishable from that of SB, namely, 15 breaths·minute-1 (CB15), or slower than SB, namely, 10 breaths·minute-1 (CB10), but in both cases, very rapid interactions between heart rate and R were known to be present. The ability of the LJSA approach to follow variations of the coupling strength was tested over a unidirectionally or bidirectionally coupled stochastic process and using surrogate data to test the null hypothesis of uncoupling. Results: We found that: i) the analysis of surrogate data proved that HP and R were significantly coupled in any experimental condition, and coupling was not more likely to occur at a specific time lag; ii) CB10 reduced CRC strength at the fastest time scales while increasing that at intermediate time scales, thus leaving the overall CRC strength unvaried; iii) despite exhibiting similar R rates and respiratory sinus arrhythmia, SB and CB15 induced different cardiorespiratory interactions; iv) no dominant temporal scheme was observed with relevant contributions of HP patterns either leading or lagging R. Discussion: LJSA is a useful methodology to explore HP-R dynamic interactions while accounting for time shifts and scales.
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Affiliation(s)
- Beatrice Cairo
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Vlasta Bari
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato Milanese, Milan, Italy
| | - Francesca Gelpi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato Milanese, Milan, Italy
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Porta A, Bari V, Cairo B, Gelpi F, De Maria B, Takahashi ACM, Catai AM. On the Validity of Single Regression Strategy for Granger Causality Assessment in Cardiovascular and Cardiorespiratory Control Studies. Annu Int Conf IEEE Eng Med Biol Soc 2023; 2023:1-4. [PMID: 38083510 DOI: 10.1109/embc40787.2023.10341180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Granger causality (GC) analysis is based on the comparison between prediction error variances computed over the full and restricted models after identifying the coefficients of appropriate vector regressions. GC markers can be computed via a double regression (DR) approach identifying two separate, independent models and a single regression (SR) strategy optimizing the description of the dynamics of the target over the full model and, then, reusing some parts of it in the restricted model. The present study compares the SR and DR strategies over heart period (HP), systolic arterial pressure (SAP) and respiration (R) beat-to-beat series collected during a graded orthostatic challenge induced by head-up tilt in 17 healthy individuals (age: 21-36 yrs; median: 29 yrs; 9 females and 8 males). We found that the DR approach was more powerful than the SR one in detecting the expected stronger involvement of the baroreflex during the challenge, while the expected weaker cardiorespiratory coupling was identified by both SR and DR strategies. The less powerful ability of the SR approach was the result of the greater variance of GC markers compared to the DR strategy. We conclude that, contrary to the suggestions present in literature, the SR approach is not necessarily associated with a smaller dispersion of GC markers. Moreover, we suggest that additional factors, such as the strategy utilized to build embedding spaces and metric utilized to compare prediction error variances, might play an important role in differentiating SR and DR approaches.
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Bari V, Gelpi F, Cairo B, Anguissola M, Pugliese S, De Maria B, Ranucci M, Porta A. Link Between Cardiovascular and Cerebrovascular Controls in Patients Undergoing Surgical Aortic Valve Replacement. Annu Int Conf IEEE Eng Med Biol Soc 2023; 2023:1-4. [PMID: 38082726 DOI: 10.1109/embc40787.2023.10340133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Although the autonomic influence on cardiovascular (CV) and cerebrovascular (CBV) regulations has been widely recognized, their relationship is poorly explored especially in pathological situations. This study investigates the correlation between CV and CBV markers in 73 patients (48 males, age 63.6±13.1 yrs) undergoing surgical aortic valve replacement (SAVR) evaluated before the intervention (PRE), within 1-week post-surgery (POST) and after a 3-month follow-up (POST3). Patients were acquired before and after an orthostatic challenge. Frequency domain analysis assessing transfer function gain (TFG), phase (Ph), and squared coherence (K2) between heart period and systolic arterial pressure was exploited to evaluate CV control. The same frequency domain functions were derived to assess CBV regulation from mean cerebral blood velocity and mean arterial pressure. A correlation analysis between indexes of CV and CBV controls was carried out. Results showed that CV control was impaired in PRE, worsened in POST, and recovered in POST3, while CBV markers were almost unchanged. A significant positive relationship between CV and CBV markers was observed, especially in POST and POST3, thus suggesting that the compensation of a baroreflex impairment with a more efficient CBV control and vice versa. The maintenance of this relationship between CV and CBV controls in patients undergoing SAVR could be fundamental to prevent risky situations.Clinical Relevance- After surgical aortic valve replacement an impaired baroreflex control could be compensated by a more efficient cerebral autoregulation.
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Cairo B, Bari V, de Abreu RM, Gelpi F, De Maria B, Catai AM, Porta A. Characterization of Multiple Regimes of Cardiorespiratory Phase Synchronization in Athletes Undergoing Inspiratory Muscle Training. Annu Int Conf IEEE Eng Med Biol Soc 2023; 2023:1-4. [PMID: 38083759 DOI: 10.1109/embc40787.2023.10339951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Cardiorespiratory phase synchronization (CRPS) is defined as the stable occurrence of n heartbeats within m respiratory cycles according to the n:m phase locking ratio (PLR). Since CRPS is an intermittent phenomenon where different phase synchronization regimes and epochs of phase unlocking can alternate within the same recording, an index of CRPS ideally should assess all potential PLRs present in the recording. However, traditional approaches compute the synchronization index (SYNC%) over a single n:m PLR, namely the one that maximizes CRPS. In the present work, we tested a synchronization index assessing the total percentage of heartbeats coupled to the inspiratory onset regardless of phase locking regimes (SYNC%sum) and we compared its efficacy to the more traditional SYNC%. Analysis was carried out in a cohort of 25 male amateur cyclists (age: 20-40 yrs) undergoing inspiratory muscle training (IMT) at different intensities. CRPS was assessed before and after the IMT protocol, during an experimental condition known to modify CRPS, namely active standing (STAND). We found that after a moderate intensity IMT at 60% of the maximal inspiratory pressure, SYNC%sum could detect the decrease in CRPS following STAND. This result was not visible using the more traditional SYNC%. Therefore, we stress the significant presence of different phase locking regimes in athletes and the importance of accounting for multiple PLRs in CRPS analysis.Clinical Relevance- Multiple phase locking regimes contribute significantly to cardiorespiratory control in amateur cyclists especially after inspiratory muscle training of moderate intensity.
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Gelpi F, Bari V, Cairo B, De Maria B, Wells R, Baumert M, Porta A. Evaluation of cardiovascular and cerebrovascular control mechanisms in postural orthostatic tachycardia syndrome via conditional transfer entropy: the impact of the respiratory signal type. Physiol Meas 2023. [PMID: 37267989 DOI: 10.1088/1361-6579/acdb47] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Closed loop cardiovascular (CV) and cerebrovascular (CBV) variability interactions are assessed via transfer entropy (TE) from systolic arterial pressure (SAP) to heart period (HP) and vice versa and from mean arterial pressure (MAP) to mean cerebral blood velocity (MCBv) and vice versa. This analysis is exploited to assess the efficiency of baroreflex and cerebral autoregulation. This study aims at characterizing CV and CBV controls in postural orthostatic tachycardiac syndrome (POTS) subjects experiencing exaggerated sympathetic response during orthostatic challenge via unconditional TE and TE conditioned on respiratory activity (R). APPROACH In 18 healthy controls (age: 28±13 yrs; 5 males, 13 females) and 15 POTS individuals (age: 29±11 yrs; 3 males, 12 females) we acquired beat-to-beat variability of HP, SAP, MAP and MCBv and two R signals, namely respiratory chest movement (RCM) and capnogram (CAP). Recordings were made at sitting rest and during active standing (STAND). TE was computed via vector autoregressive approach. MAIN RESULTS We found that: i) when assessing CV interactions, the increase of the TE from SAP to HP during STAND, indicating baroreflex activation, is detected solely when conditioning on RCM; ii) when assessing CBV interactions, the impact of R on the TE computation is negligible; iii) POTS shows baroreflex impairment during STAND; iv) POTS exhibits a normal CBV response to STAND. SIGNIFICANCE TE is useful for detecting the impairment of specific regulatory mechanisms in POTS. Moreover, using different R signals highlights the sensitivity of CV and CBV controls to specific R aspects.
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Affiliation(s)
- Francesca Gelpi
- Department of Biomedical Sciences for Health, University of Milan, Via Mangiagalli 31, Milan, Lombardia, 20133, ITALY
| | - Vlasta Bari
- Department of Biomedical Sciences for Health, University of Milan, Via Mangiagalli 31, Milan, Lombardia, 20133, ITALY
| | - Beatrice Cairo
- Department of Biomedical Sciences for Health, University of Milan, Via Mangiagalli 31, Milan, Lombardia, 20133, ITALY
| | - Beatrice De Maria
- Istituti Clinici Scientifici Maugeri SpA IRCCS Milano, Via Camaldoli 64, Milan, Lombardia, 20138, ITALY
| | - Rachel Wells
- Department of Medicine, Royal Adelaide Hospital, Port Road, Adelaide, South Australia, 5000, AUSTRALIA
| | - Mathias Baumert
- School of Electrical and Mechanical Engineering, The University of Adelaide, North Terrace, Adelaide, South Australia, 5005, AUSTRALIA
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Via Mangiagalli 31, Milan, Lombardia, 20133, ITALY
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Porta A, Cairo B, Bari V, Gelpi F, De Maria B, Colombo R. Model-based spectral causality of cardiovascular variability interactions during head-down tilt. Physiol Meas 2023; 44. [PMID: 37072006 DOI: 10.1088/1361-6579/acce1f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 04/18/2023] [Indexed: 04/20/2023]
Abstract
Cardiovascular control mechanisms are commonly studied during baroreceptor unloading induced by head-up tilt. Conversely, the effect of a baroreceptor loading induced by head-down tilt (HDT) is less studied especially when the stimulus is of moderate intensity and using model-based spectral causality markers. Thus, this study computes model-based causality markers in the frequency domain derived via causal squared coherence and Geweke spectral causality approach from heart period (HP) and systolic arterial pressure (SAP) variability series recorded in 12 healthy men (age: from 41 to 71 yrs, median: 57 yrs) during HDT at -25°. The approaches are compared by considering two different bivariate model structures, namely the autoregressive and dynamic adjustment models. Markers are computed in traditional frequency bands utilized in cardiovascular control analysis, namely the low frequency (LF, from 0.04 to 0.15 Hz) and high frequency (HF, from 0.15 to 0.4 Hz) bands. We found that: i) the two spectral causality metrics are deterministically related but spectral causality markers exhibit different discriminative ability; ii) HDT reduces the involvement of the baroreflex in regulating HP-SAP variability interactions in the LF band, while leaving unmodified the action of mechanical feedforward mechanisms in both LF and HF bands; iii) this conclusion does not depend on the model structure. We conclude that HDT can be utilized to reduce the impact of baroreflex and to study the contribution of regulatory mechanisms different from baroreflex to the complexity of cardiovascular control in humans.
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Affiliation(s)
- Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Via Mangiagalli 31, Milan, Lombardia, 20133, ITALY
| | - Beatrice Cairo
- Department of Biomedical Sciences for Health, University of Milan, Via Mangiagalli 31, Milan, Lombardia, 20133, ITALY
| | - Vlasta Bari
- Department of Biomedical Sciences for Health, University of Milan, Via Mangiagalli 31, Milano, Lombardia, 20133, ITALY
| | - Francesca Gelpi
- Department of Biomedical Sciences for Health, University of Milan, via R. Morandi 30, Milan, Lombardia, 20133, ITALY
| | - Beatrice De Maria
- Istituti Clinici Scientifici Maugeri SpA IRCCS Milano, Via Camaldoli 64, Milan, Lombardia, 20138, ITALY
| | - Riccardo Colombo
- "Luigi Sacco" Hospital, Department of Anesthesiology and Intensive Care Unit, ASST Fatebenefratelli Sacco, Via Grassi 74, Milan, Lombardia, 20157, ITALY
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Porta A, Panerai RB. Editorial of the special issue on autonomic nervous system and cerebral blood flow autoregulation. Auton Neurosci 2023; 247:103092. [PMID: 37060726 DOI: 10.1016/j.autneu.2023.103092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2023]
Affiliation(s)
- Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy; Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
| | - Ronney B Panerai
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK; NIHR Leicester Biomedical Research Centre, BHF Cardiovascular Research Centre, Glenfield Hospital, Leicester, UK
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Porta A, Bari V, Gelpi F, Cairo B, De Maria B, Tonon D, Rossato G, Faes L. On the Different Abilities of Cross-Sample Entropy and K-Nearest-Neighbor Cross-Unpredictability in Assessing Dynamic Cardiorespiratory and Cerebrovascular Interactions. Entropy (Basel) 2023; 25:e25040599. [PMID: 37190390 PMCID: PMC10137562 DOI: 10.3390/e25040599] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 03/29/2023] [Accepted: 03/30/2023] [Indexed: 05/17/2023]
Abstract
Nonlinear markers of coupling strength are often utilized to typify cardiorespiratory and cerebrovascular regulations. The computation of these indices requires techniques describing nonlinear interactions between respiration (R) and heart period (HP) and between mean arterial pressure (MAP) and mean cerebral blood velocity (MCBv). We compared two model-free methods for the assessment of dynamic HP-R and MCBv-MAP interactions, namely the cross-sample entropy (CSampEn) and k-nearest-neighbor cross-unpredictability (KNNCUP). Comparison was carried out first over simulations generated by linear and nonlinear unidirectional causal, bidirectional linear causal, and lag-zero linear noncausal models, and then over experimental data acquired from 19 subjects at supine rest during spontaneous breathing and controlled respiration at 10, 15, and 20 breaths·minute-1 as well as from 13 subjects at supine rest and during 60° head-up tilt. Linear markers were computed for comparison. We found that: (i) over simulations, CSampEn and KNNCUP exhibit different abilities in evaluating coupling strength; (ii) KNNCUP is more reliable than CSampEn when interactions occur according to a causal structure, while performances are similar in noncausal models; (iii) in healthy subjects, KNNCUP is more powerful in characterizing cardiorespiratory and cerebrovascular variability interactions than CSampEn and linear markers. We recommend KNNCUP for quantifying cardiorespiratory and cerebrovascular coupling.
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Affiliation(s)
- Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, 20097 Milan, Italy
| | - Vlasta Bari
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, 20097 Milan, Italy
| | - Francesca Gelpi
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy
| | - Beatrice Cairo
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy
| | | | - Davide Tonon
- Department of Neurology, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Verona, Italy
| | - Gianluca Rossato
- Department of Neurology, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Verona, Italy
| | - Luca Faes
- Department of Engineering, University of Palermo, 90128 Palermo, Italy
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Porta A, Gelpi F, Bari V, Cairo B, De Maria B, Takahashi ACM, Catai AM, Colombo R. Changes of the cardiac baroreflex bandwidth during postural challenges. Am J Physiol Regul Integr Comp Physiol 2023; 324:R601-R612. [PMID: 36878488 DOI: 10.1152/ajpregu.00305.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
Baroreflex is commonly typified from heart period (HP) and systolic arterial pressure (SAP) spontaneous variations in the frequency domain mainly by estimating its sensitivity. However, an informative parameter linked to the rapidity of the HP response to SAP changes, such as the baroreflex bandwidth, remains unquantified. We propose a model-based parametric approach for estimating the baroreflex bandwidth from the impulse response function (IRF) of the HP-SAP transfer function (TF). The approach accounts explicitly for the action of mechanisms modifying HP regardless of SAP changes. The method was tested during graded baroreceptor unloading induced by head-up tilt (HUT) at 15°, 30°, 45°, 60°, 75° (T15, T30, T45, T60, and T75) in 17 healthy individuals (age: 21-36 yrs; 9 females and 8 males) and during baroreceptor loading obtained via head-down tilt (HDT) at -25° in 13 healthy men (age: 41-71 yrs). The bandwidth was estimated as the decay constant of the mono-exponential IRF fitting. The method was robust because the mono-exponential fitting described adequately the HP dynamics following an impulse of SAP. We observed that: i) baroreflex bandwidth is reduced during graded HUT and this narrowing is accompanied by the reduction of the bandwidth of mechanisms that modify HP regardless of SAP changes; ii) baroreflex bandwidth is not affected by HDT but that of SAP-unrelated mechanisms becomes wider. This study provides a method for estimating a baroreflex feature that provides different information compared the more usual baroreflex sensitivity while accounting explicitly for the action of mechanisms changing HP irrespective of SAP.
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Affiliation(s)
- Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, San Donato Milanese, Milan, Italy.,Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Francesca Gelpi
- Department of Biomedical Sciences for Health, University of Milan, San Donato Milanese, Milan, Italy
| | - Vlasta Bari
- Department of Biomedical Sciences for Health, University of Milan, San Donato Milanese, Milan, Italy.,Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Beatrice Cairo
- Department of Biomedical Sciences for Health, University of Milan, San Donato Milanese, Milan, Italy
| | | | - Anielle C M Takahashi
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Aparecida M Catai
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Riccardo Colombo
- Department of Anesthesiology and Intensive Care Unit,, ASST Fatebenefratelli Sacco, "Luigi Sacco" Hospital, Milan, Italy
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Coffano C, Porta A, Visconti C, Rabino F, Franzoni G, Picutti B, Lietti L. One-pot lower olefins production from CO2 hydrogenation. Catal Today 2023. [DOI: 10.1016/j.cattod.2023.114133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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Barà C, Sparacino L, Pernice R, Antonacci Y, Porta A, Kugiumtzis D, Faes L. Comparison of discretization strategies for the model-free information-theoretic assessment of short-term physiological interactions. Chaos 2023; 33:033127. [PMID: 37003789 DOI: 10.1063/5.0140641] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 02/17/2023] [Indexed: 06/19/2023]
Abstract
This work presents a comparison between different approaches for the model-free estimation of information-theoretic measures of the dynamic coupling between short realizations of random processes. The measures considered are the mutual information rate (MIR) between two random processes X and Y and the terms of its decomposition evidencing either the individual entropy rates of X and Y and their joint entropy rate, or the transfer entropies from X to Y and from Y to X and the instantaneous information shared by X and Y. All measures are estimated through discretization of the random variables forming the processes, performed either via uniform quantization (binning approach) or rank ordering (permutation approach). The binning and permutation approaches are compared on simulations of two coupled non-identical Hènon systems and on three datasets, including short realizations of cardiorespiratory (CR, heart period and respiration flow), cardiovascular (CV, heart period and systolic arterial pressure), and cerebrovascular (CB, mean arterial pressure and cerebral blood flow velocity) measured in different physiological conditions, i.e., spontaneous vs paced breathing or supine vs upright positions. Our results show that, with careful selection of the estimation parameters (i.e., the embedding dimension and the number of quantization levels for the binning approach), meaningful patterns of the MIR and of its components can be achieved in the analyzed systems. On physiological time series, we found that paced breathing at slow breathing rates induces less complex and more coupled CR dynamics, while postural stress leads to unbalancing of CV interactions with prevalent baroreflex coupling and to less complex pressure dynamics with preserved CB interactions. These results are better highlighted by the permutation approach, thanks to its more parsimonious representation of the discretized dynamic patterns, which allows one to explore interactions with longer memory while limiting the curse of dimensionality.
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Affiliation(s)
- Chiara Barà
- Department of Engineering, University of Palermo, 90128 Palermo, Italy
| | - Laura Sparacino
- Department of Engineering, University of Palermo, 90128 Palermo, Italy
| | - Riccardo Pernice
- Department of Engineering, University of Palermo, 90128 Palermo, Italy
| | - Yuri Antonacci
- Department of Engineering, University of Palermo, 90128 Palermo, Italy
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy
| | - Dimitris Kugiumtzis
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Luca Faes
- Department of Engineering, University of Palermo, 90128 Palermo, Italy
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Aguiar Mesquita Galdino G, Eduardo Virgilio Silva L, Cristina Garcia Moura-Tonello S, Cristina Milan-Mattos J, Nogueira Linares S, Porta A, Marques da Silva T, Fazan R, Beltrame T, Maria Catai A. Heart rate fragmentation is impaired in type 2 diabetes mellitus patients. Diabetes Res Clin Pract 2023; 196:110223. [PMID: 36529300 DOI: 10.1016/j.diabres.2022.110223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/08/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
AIMS To evaluate the heart rate fragmentation (HRF) of type 2 diabetes mellitus (T2DM) patients and its relationship with heart rate variability (HRV) indices. METHODS One hundred sixty-four men, aged 47-57 years were retrospectively analyzed from a database. Participants were T2DM (n = 82) and apparently healthy (n = 82). R-R interval time series recorded by electrocardiogram were collected at the supine position for 10 to 15 min. From HRF, the percentage of inflection points (PIP), percentage of words with zero, one, two, or three inflections points (W0, W1, W2, W3), and percentage with only type hard, soft, or mixed inflections points type (WH, WS, WM) were quantified. RESULTS T2DM presented higher PIP, WS, WM and W3, while WH and W1 was lower compared with healthy (p < 0.05). Moreover, a positive moderate correlation was found between WH and root mean square of the successive R-R differences (RMSSD) and high frequency (HF) indices. In contrast, a negative moderate correlation was found between WS and WM with RMSSD and HF indices. CONCLUSIONS T2DM have increased fragmentation patterns, and words grouped by inflection type are more closely related to HRV. The HRF approach might be useful to assess heart rate dynamic abnormalities in males with type 2 diabetes.
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Affiliation(s)
- Gabriela Aguiar Mesquita Galdino
- Cardiovascular Physical Therapy Laboratory, Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Luiz Eduardo Virgilio Silva
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, SP, Brazil; Department of Biomedical and Health Informatics, The Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | | | - Juliana Cristina Milan-Mattos
- Cardiovascular Physical Therapy Laboratory, Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Stephanie Nogueira Linares
- Cardiovascular Physical Therapy Laboratory, Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy; Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy
| | - Thaís Marques da Silva
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, SP, Brazil
| | - Rubens Fazan
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, SP, Brazil
| | - Thomas Beltrame
- Cardiovascular Physical Therapy Laboratory, Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil; Samsung R&D Institute Brazil - SRBR, Campinas, São Paulo, Brazil
| | - Aparecida Maria Catai
- Cardiovascular Physical Therapy Laboratory, Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil.
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de Abreu RM, Cairo B, Porta A. On the significance of estimating cardiorespiratory coupling strength in sports medicine. Front Netw Physiol 2023; 2:1114733. [PMID: 36926078 PMCID: PMC10013023 DOI: 10.3389/fnetp.2022.1114733] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 12/16/2022] [Indexed: 06/18/2023]
Abstract
The estimation of cardiorespiratory coupling (CRC) is attracting interest in sports physiology as an important tool to characterize cardiac neural regulation genuinely driven by respiration. When applied in sports medicine, cardiorespiratory coupling measurements can provide information on the effects of training, pre-competition stress, as well as cardiovascular adjustments during stressful stimuli. Furthermore, since the cardiorespiratory coupling is strongly affected by physical activity, the study of the cardiorespiratory coupling can guide the application of specific training methods to optimize the coupling between autonomic activity and heart with possible effects on performance. However, a consensus about the physiological mechanisms, as well as methodological gold standard methods to quantify the cardiorespiratory coupling, has not been reached yet, thus limiting its application in experimental settings. This review supports the relevance of assessing cardiorespiratory coupling in the sports medicine, examines the possible physiological mechanisms involved, and lists a series of methodological approaches. cardiorespiratory coupling strength seems to be increased in athletes when compared to sedentary subjects, in addition to being associated with positive physiological outcomes, such as a possible better interaction of neural subsystems to cope with stressful stimuli. Moreover, cardiorespiratory coupling seems to be influenced by specific training modalities, such as inspiratory muscle training. However, the impact of cardiorespiratory coupling on sports performance still needs to be better explored through ad hoc physical exercise tests and protocols. In addition, this review stresses that several bivariate and multivariate methods have been proposed to assess cardiorespiratory coupling, thus opening new possibilities in estimating cardiorespiratory interactions in athletes.
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Affiliation(s)
- Raphael Martins de Abreu
- Department of Physiotherapy, LUNEX University, International University of Health, Exercise & Sports S.A., Differdange, Luxembourg
- LUNEX ASBL Luxembourg Health & Sport Sciences Research Institute, Differdange, Luxembourg
| | - Beatrice Cairo
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Italy
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Costa CM, Porta A, Miura IK, Porta G, Fonseca EA, Pugliese R, Kondo M, Chapchap P, Sindhi R, Feier FH, Seda Neto J. In vitro fertilization: an unexpected finding in a cohort of patients with biliary atresia. Braz J Med Biol Res 2023; 56:e12671. [PMID: 36995875 PMCID: PMC10041673 DOI: 10.1590/1414-431x2023e12671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 02/16/2023] [Indexed: 03/31/2023] Open
Abstract
In biliary atresia (BA), efforts to prevent premature liver transplantation (LT) are aimed at early diagnosis, timing of Kasai-portoenterostomy (KPE), and centralization of care. This report presents the clinical picture, treatment strategies, and outcomes of BA patients with no previous treatment. A retrospective cohort study (Jan/2001 to Jan/2021) was conducted to evaluate the outcome of patients with BA referred to a single team. Study groups were: 1) Kasai-only group (K-only) n=9), 2) LT-only group (n=7), and 3) Kasai+LT group (K+LT) (n=23). Survival with native liver and overall survival were 22.9 and 94.8%, respectively, at 120 months of follow-up. There was no difference in age at KPE in the K-only group (46.8±21.8 days) vs K+LT (52.1±22 days), P=0.4. Ten (25.6%) patients were babies conceived through in vitro fertilization (IVF). Four IVF patients (40%) presented associated congenital heart disease vs 5 patients (17%) in the remaining group (P=0.14). Two of the IVF patients were premature (<37 weeks). Median maternal age at birth was 35 years (33 to 41 years). Excellent patient survival is expected for patients with BA with the available treatment strategies. IVF+BA was an unexpected prevalent association in this cohort, and further studies are required to better understand these findings.
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Affiliation(s)
- C M Costa
- Hepatologia e Transplante Hepático, Hospital Sírio-Libanês, São Paulo, SP, Brasil
- Hepatologia e Transplante Hepático, A.C. Camargo Cancer Center, São Paulo, SP, Brasil
| | - A Porta
- Hepatologia e Transplante Hepático, Hospital Sírio-Libanês, São Paulo, SP, Brasil
- Hepatologia e Transplante Hepático, A.C. Camargo Cancer Center, São Paulo, SP, Brasil
| | - I K Miura
- Hepatologia e Transplante Hepático, Hospital Sírio-Libanês, São Paulo, SP, Brasil
- Hepatologia e Transplante Hepático, A.C. Camargo Cancer Center, São Paulo, SP, Brasil
| | - G Porta
- Hepatologia e Transplante Hepático, Hospital Sírio-Libanês, São Paulo, SP, Brasil
- Hepatologia e Transplante Hepático, A.C. Camargo Cancer Center, São Paulo, SP, Brasil
| | - E A Fonseca
- Hepatologia e Transplante Hepático, Hospital Sírio-Libanês, São Paulo, SP, Brasil
- Hepatologia e Transplante Hepático, A.C. Camargo Cancer Center, São Paulo, SP, Brasil
| | - R Pugliese
- Hepatologia e Transplante Hepático, Hospital Sírio-Libanês, São Paulo, SP, Brasil
- Hepatologia e Transplante Hepático, A.C. Camargo Cancer Center, São Paulo, SP, Brasil
| | - M Kondo
- Hepatologia e Transplante Hepático, Hospital Sírio-Libanês, São Paulo, SP, Brasil
- Hepatologia e Transplante Hepático, A.C. Camargo Cancer Center, São Paulo, SP, Brasil
| | - P Chapchap
- Hepatologia e Transplante Hepático, Hospital Sírio-Libanês, São Paulo, SP, Brasil
| | - R Sindhi
- Hillman Center for Pediatric Transplantation, Thomas E. Starzl Transplantation Institute, Department of Transplant Surgery, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - F H Feier
- Hepatologia e Transplante Hepático, Hospital Sírio-Libanês, São Paulo, SP, Brasil
- Hepatologia e Transplante Hepático, A.C. Camargo Cancer Center, São Paulo, SP, Brasil
| | - J Seda Neto
- Hepatologia e Transplante Hepático, Hospital Sírio-Libanês, São Paulo, SP, Brasil
- Hepatologia e Transplante Hepático, A.C. Camargo Cancer Center, São Paulo, SP, Brasil
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23
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De Favari Signini É, Castro A, Rehder-Santos P, Cristina Millan-Mattos J, Magalhães de Oliveira J, Minatel V, Bianca Falasco Pantoni C, Sobreiro Selistre de Araújo H, Fabrizzi F, Porta A, Gilberto Ferreira A, Vincenzi Oliveira R, Maria Catai A. Integrative perspective of the healthy aging process considering the metabolome, cardiac autonomic modulation and cardiorespiratory fitness evaluated in age groups. Sci Rep 2022; 12:21314. [PMID: 36494472 PMCID: PMC9734749 DOI: 10.1038/s41598-022-25747-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022] Open
Abstract
The aging process causes changes at all organic levels. Although metabolism, cardiac autonomic modulation (CAM), and cardiorespiratory fitness (CRF) are widely studied as a function of age, they are mainly studied in isolation, thus making it difficult to perceive their concomitant variations. This study aimed to investigate the integrated changes that occur in the metabolome, CAM, and CRF throughout aging in apparently healthy individuals. The subjects (n = 118) were divided into five groups according to age (20-29, 30-39, 40-49, 50-59, and 60-70 years old) and underwent blood collection, autonomic assessment, and a cardiopulmonary exercise test for metabolomics analysis using mass spectrometry and nuclear magnetic resonance, cardiac autonomic modulation analysis, and CRF by peak oxygen consumption analysis, respectively. The Tukey's post hoc and effect size with confidence interval were used for variables with a significant one-way ANOVA effect (P < 0.01). The main changes were in the oldest age group, where the CRF, valine, leucine, isoleucine, 3-hydroxyisobutyrate, and CAM reduced and hippuric acid increased. The results suggest significant changes in the metabolome, CAM, and CRF after the age of sixty as a consequence of aging impairments, but with some changes in the metabolic profile that may be favorable to mitigate the aging deleterious effects.
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Affiliation(s)
- Étore De Favari Signini
- grid.411247.50000 0001 2163 588XDepartment of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo Brazil
| | - Alex Castro
- grid.411247.50000 0001 2163 588XDepartment of Chemistry, Federal University of São Carlos, São Carlos, São Paulo Brazil
| | - Patrícia Rehder-Santos
- grid.411247.50000 0001 2163 588XDepartment of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo Brazil
| | - Juliana Cristina Millan-Mattos
- grid.411247.50000 0001 2163 588XDepartment of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo Brazil
| | - Juliana Magalhães de Oliveira
- grid.411247.50000 0001 2163 588XDepartment of Chemistry, Federal University of São Carlos, São Carlos, São Paulo Brazil
| | - Vinicius Minatel
- grid.411247.50000 0001 2163 588XDepartment of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo Brazil
| | - Camila Bianca Falasco Pantoni
- grid.411247.50000 0001 2163 588XDepartment of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo Brazil ,grid.411247.50000 0001 2163 588XDepartment of Gerontology, Federal University of São Carlos, São Carlos, São Paulo Brazil
| | | | - Fernando Fabrizzi
- Penápolis Educational Foundation (FUNEPE), Penápolis, São Paulo Brazil
| | - Alberto Porta
- grid.4708.b0000 0004 1757 2822Department of Biomedical Sciences for Health, University of Milan, Milan, Italy ,Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, Policlinico San Donato, San Donato Milanese, Milan Italy
| | - Antônio Gilberto Ferreira
- grid.411247.50000 0001 2163 588XDepartment of Chemistry, Federal University of São Carlos, São Carlos, São Paulo Brazil
| | - Regina Vincenzi Oliveira
- grid.411247.50000 0001 2163 588XDepartment of Chemistry, Federal University of São Carlos, São Carlos, São Paulo Brazil
| | - Aparecida Maria Catai
- grid.411247.50000 0001 2163 588XDepartment of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo Brazil ,grid.411247.50000 0001 2163 588XCardiovascular Physical Therapy Laboratory, Department of Physical Therapy, Nucleus of Research in Physical Exercise, Federal University of São Carlos, Via Washington Luiz, Km 235, CP: 676, São Carlos, SP 13565-905 Brazil
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24
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Eletto D, Mentucci F, Vllahu M, Voli A, Petrella A, Boccellato F, Meyer TF, Porta A, Tosco A. IFNγ-dependent silencing of TFF1 during Helicobacter pylori infection. Open Biol 2022; 12:220278. [PMID: 36514982 PMCID: PMC9748780 DOI: 10.1098/rsob.220278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Chronic Helicobacter pylori infection is the leading cause of intestinal-type adenocarcinoma, as prolonged Helicobacter colonization triggers chronic active gastritis, which may evolve into adenocarcinoma of the intestinal type. In this environment, cytokines play a significant role in determining the evolution of the infection. In combination with other factors (genetic, environmental and nutritional), the pro-inflammatory response may trigger pro-oncogenic mechanisms that lead to the silencing of tumour-suppressor genes, such as trefoil factor 1 (TFF1). The latter is known to play a protective role by maintaining the gastric mucosa integrity and retaining H. pylori in the mucus layer, preventing the progression of infection and, consequently, the development of gastric cancer (GC). Since TFF1 expression is reduced during chronic Helicobacter infection with a loss of gastric mucosa protection, we investigated the molecular pathways involved in this reduction. Specifically, we evaluated the effect of some pro-inflammatory cytokines on TFF1 regulation in GC and primary gastric cells by RT-qPCR and luciferase reporter assay analyses and the repressor role of the transcription factor C/EBPβ, overexpressed in gastric-intestinal cancer. Our results show that, among several cytokines, IFNγ stimulates C/EBPβ expression, which acts as a negative regulator of TFF1 by binding its promoter at three different sites.
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Affiliation(s)
- D. Eletto
- Department of Pharmacy, University of Salerno, Fisciano, Salerno, Italy
| | - F. Mentucci
- Department of Pharmacy, University of Salerno, Fisciano, Salerno, Italy,PhD Program in Drug Discovery and Development, University of Salerno, Fisciano, Salerno, Italy
| | - M. Vllahu
- Department of Pharmacy, University of Salerno, Fisciano, Salerno, Italy
| | - A. Voli
- Department of Pharmacy, University of Salerno, Fisciano, Salerno, Italy,PhD Program in Drug Discovery and Development, University of Salerno, Fisciano, Salerno, Italy
| | - A. Petrella
- Department of Pharmacy, University of Salerno, Fisciano, Salerno, Italy
| | - F. Boccellato
- Ludwig Institute for Cancer Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford OX3 7DQ, UK
| | - T. F. Meyer
- Department of Molecular Biology, Max Planck Institute for Infection Biology, Berlin, Germany,Laboratory of Infection Oncology, Institute of Clinical Molecular Biology, Christian Albrecht's University of Kiel—University Hospital Schleswig Holstein—Campus Kiel, Kiel, Germany
| | - A. Porta
- Department of Pharmacy, University of Salerno, Fisciano, Salerno, Italy
| | - A. Tosco
- Department of Pharmacy, University of Salerno, Fisciano, Salerno, Italy
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25
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Galdino GAM, Moura-Tonello SCG, Linares SN, Milan-Mattos JC, Spavieri DL, Oliveira SM, Porta A, Beltrame T, Catai AM. Intracranial compliance in type 2 diabetes mellitus and its relationship with the cardiovascular autonomic nervous control. Braz J Med Biol Res 2022; 55:e12150. [PMID: 36102416 PMCID: PMC9467282 DOI: 10.1590/1414-431x2022e12150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 07/11/2022] [Indexed: 11/29/2022] Open
Abstract
The intracranial compliance in type 2 diabetes mellitus (T2DM) patients and the association with cardiovascular autonomic control have not been fully elucidated. The aim of this study was to assess intracranial compliance using the noninvasive intracranial pressure (niICP) and the monitoring of waveform peaks (P1, P2, and P3) and the relationship with cardiovascular autonomic control in T2DM patients. Thirty-two men aged 40-60 years without cardiovascular autonomic neuropathy (CAN) were studied: T2DMG (n=16) and control group CG (n=16). The niICP was evaluated by a noninvasive extracranial sensor placed on the scalp. Cardiovascular autonomic control was evaluated by indices of the baroreflex sensitivity (BRS), from temporal series of R-R intervals of electrocardiogram and systolic arterial pressure, during supine and orthostatic positions. The participants remained in the supine position for 15 min and then 15 min more in orthostatism. T2DMG presented a decrease of the P2/P1 ratio during the orthostatic position (P<0.001). There was a negative moderate correlation between the P2 peak with cardiovascular coupling (K2HP-SAPLF) in supine (r=-0.612, P=0.011) and orthostatic (r=-0.568, P=0.020) positions in T2DMG. We concluded that T2DM patients without CAN and cardiovascular complications presented intracranial compliance similar to healthy subjects. Despite preserved intracranial adjustments, T2DM patients had a response of greater magnitude in orthostatism. In addition, the decoupling between the heart period and blood pressure signal oscillations in low frequency appeared to be related to the worsening of intracranial compliance due to the increased P2 peak.
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Affiliation(s)
- G A M Galdino
- Laboratório de Fisioterapia Cardiovascular, Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - S C G Moura-Tonello
- Laboratório de Fisioterapia Cardiovascular, Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - S N Linares
- Laboratório de Fisioterapia Cardiovascular, Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - J C Milan-Mattos
- Laboratório de Fisioterapia Cardiovascular, Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - D L Spavieri
- Divisão de Ciência de Dados, brain4care, São Carlos, SP, Brasil
| | - S M Oliveira
- Divisão de Ciência de Dados, brain4care, São Carlos, SP, Brasil.,Instituto de Física de São Carlos, Universidade de São Paulo, São Carlos, SP, Brasil
| | - A Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.,Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy
| | - T Beltrame
- Laboratório de Fisioterapia Cardiovascular, Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil.,Samsung R&D Institute Brazil (SRBR), Campinas, SP, Brasil
| | - A M Catai
- Laboratório de Fisioterapia Cardiovascular, Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
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26
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De Maria B, Cassetti G, Clementi L, De Grazia V, Parati M, Perego F, Porta A, Dalla Vecchia LA. Autonomic cardiac profile in male and female healthcare professionals with and without preschoolers: differences evidenced by heart rate variability analysis. Sci Rep 2022; 12:14499. [PMID: 36008506 PMCID: PMC9411539 DOI: 10.1038/s41598-022-18744-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 08/18/2022] [Indexed: 12/04/2022] Open
Abstract
A reduced nocturnal cardiac vagal modulation has been observed in working women with preschoolers. Whether this adaptation also occurs in men remains an open question. The aim of this study was to analyze the cardiac autonomic profile of two groups of healthcare male professionals, one with and one without preschoolers, to be compared to females. Twenty-five working men with preschoolers (M_KID, age 35.41 ± 4.01 years) and 25 without (M_NOKID, 34.48 ± 6.00 years) were compared with 25 working women with preschoolers (W_KID, 37.7 ± 5.6 years) and 25 without (W_NOKID, 35.4 ± 7.2 years). A 24-h Holter electrocardiogram was performed for time and frequency domain analysis of the beat-to-beat variations of RR interval (RR) variability, during daytime (DAY) and nighttime (NIGHT). The power of RR variability in the high frequency band (HFRR) was considered as an index of cardiac vagal modulation. RR variability indices were similar in M_KID and M_NOKID during both DAY and NIGHT. In contrast, W_KID showed a reduced nocturnal HFRR compared to W_NOKID. The comparison of working men with and without preschoolers revealed no differences in the cardiac autonomic profile, in contrast with women. This suggests that sex and/or gender may represent a crucial factor in the cardiac neural control in the parental condition.
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Affiliation(s)
| | | | - Letizia Clementi
- Department of Electronics Information and Bioengineering, Politecnico di Milano, Milan, Italy.,MOX, Department of Mathematics, Politecnico di Milano, Milan, Italy.,CHDS, Center for Health Data Science, Human Technopole, Milan, Italy
| | | | - Monica Parati
- Istituti Clinici Scientifici Maugeri IRCCS, Milan, Italy.,Department of Electronics Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | | | - Alberto Porta
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.,Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
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27
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Pernice R, Sparacino L, Bari V, Gelpi F, Cairo B, Mijatovic G, Antonacci Y, Tonon D, Rossato G, Javorka M, Porta A, Faes L. Spectral decomposition of cerebrovascular and cardiovascular interactions in patients prone to postural syncope and healthy controls. Auton Neurosci 2022; 242:103021. [PMID: 35985253 DOI: 10.1016/j.autneu.2022.103021] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 07/15/2022] [Accepted: 08/05/2022] [Indexed: 10/31/2022]
Abstract
We present a framework for the linear parametric analysis of pairwise interactions in bivariate time series in the time and frequency domains, which allows the evaluation of total, causal and instantaneous interactions and connects time- and frequency-domain measures. The framework is applied to physiological time series to investigate the cerebrovascular regulation from the variability of mean cerebral blood flow velocity (CBFV) and mean arterial pressure (MAP), and the cardiovascular regulation from the variability of heart period (HP) and systolic arterial pressure (SAP). We analyze time series acquired at rest and during the early and late phase of head-up tilt in subjects developing orthostatic syncope in response to prolonged postural stress, and in healthy controls. The spectral measures of total, causal and instantaneous coupling between HP and SAP, and between MAP and CBFV, are averaged in the low-frequency band of the spectrum to focus on specific rhythms, and over all frequencies to get time-domain measures. The analysis of cardiovascular interactions indicates that postural stress induces baroreflex involvement, and its prolongation induces baroreflex dysregulation in syncope subjects. The analysis of cerebrovascular interactions indicates that the postural stress enhances the total coupling between MAP and CBFV, and challenges cerebral autoregulation in syncope subjects, while the strong sympathetic activation elicited by prolonged postural stress in healthy controls may determine an increased coupling from CBFV to MAP during late tilt. These results document that the combination of time-domain and spectral measures allows us to obtain an integrated view of cardiovascular and cerebrovascular regulation in healthy and diseased subjects.
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Affiliation(s)
- Riccardo Pernice
- Department of Engineering, University of Palermo, Viale delle Scienze, Bldg. 9, 90128 Palermo, Italy
| | - Laura Sparacino
- Department of Engineering, University of Palermo, Viale delle Scienze, Bldg. 9, 90128 Palermo, Italy
| | - Vlasta Bari
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Francesca Gelpi
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy; Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Beatrice Cairo
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | - Yuri Antonacci
- Department of Physics and Chemistry "Emilio Segrè", University of Palermo, Viale delle Scienze, Bldg. 17, 90128 Palermo, Italy
| | - Davide Tonon
- Department of Neurology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Gianluca Rossato
- Department of Neurology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Michal Javorka
- Department of Physiology and the Biomedical Center Martin, Comenius University in Bratislava, Jessenius Faculty of Medicine, Martin, Slovakia
| | - Alberto Porta
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy; Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Luca Faes
- Department of Engineering, University of Palermo, Viale delle Scienze, Bldg. 9, 90128 Palermo, Italy.
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28
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Abreu RMD, Porta A, Rehder-Santos P, Cairo B, Sakaguchi CA, da Silva CD, Signini ÉDF, Milan-Mattos JC, Catai AM. Cardiorespiratory coupling strength in athletes and non-athletes. Respir Physiol Neurobiol 2022; 305:103943. [PMID: 35835289 DOI: 10.1016/j.resp.2022.103943] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/21/2022] [Accepted: 07/07/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE Despite the relevant presence of nonlinear components on heart period (HP) likely due to cardiorespiratory coupling (CRC), the HP is frequently analyzed in absence of concomitant recordings of respiratory movements (RESP). This study aims to assess the cardiovascular dynamics and CRC during postural challenge in athletes and non-athletes via joint symbolic analysis (JSA). METHODS A cross-sectional study was conducted in 50 men, aged between 20 and 40 yrs, divided into athletes (n = 25) and non-athletes (n = 25) groups. The electrocardiogram, blood pressure and RESP signals were recorded during 15 min in both supine position (REST) and after active postural maneuver (STAND). From the beat-to-beat series of HP, systolic arterial pressure (SAP) and RESP, we computed the time and frequency domain indexes and baroreflex sensitivity. The JSA was based on the definition of symbolic HP and RESP patterns and on the evaluation of the rate of their simultaneous occurrence in both HP and RESP series. RESULTS The JSA analysis was able to identify higher CRC strength at REST in athletes. Moreover, the response of CRC to STAND depended on the time scales of the analysis and was much more evident in athletes than in non-athletes, thus indicating a more reactive autonomic control in athletes. CONCLUSION Assessing CRC in athletes via JSA provides additional information compared to standard linear time and frequency domain tools likely due to the more relevant presence of nonlinearities in HP-RESP variability relationship.
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Affiliation(s)
- Raphael Martins de Abreu
- LUNEX University, International University of Health, Exercise & Sports S.A. 50, Department of Physiotherapy, Differdange, Luxembourg; LUNEX ASBL Luxembourg Health & Sport Sciences Research Institute, Differdange, Luxembourg; Federal University of São Carlos, Department of Physical Therapy, São Carlos, São Paulo, Brazil.
| | - Alberto Porta
- University of Milan, Department of Biomedical Sciences for Health, Milan, Italy; IRCCS Policlinico San Donato, Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, San Donato Milanese, Milan, Italy
| | - Patricia Rehder-Santos
- Federal University of São Carlos, Department of Physical Therapy, São Carlos, São Paulo, Brazil
| | - Beatrice Cairo
- University of Milan, Department of Biomedical Sciences for Health, Milan, Italy
| | - Camila Akemi Sakaguchi
- Appalachian State University, Department of Health, Leisure, and Exercise Science, NC, USA
| | | | - Étore De Favari Signini
- Federal University of São Carlos, Department of Physical Therapy, São Carlos, São Paulo, Brazil
| | | | - Aparecida Maria Catai
- Federal University of São Carlos, Department of Physical Therapy, São Carlos, São Paulo, Brazil
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29
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Porta A, Bari V, Gelpi F, Cairo B, De Maria B, Tonon D, Rossato G, Faes L. Comparing Cross-Sample Entropy and K-Nearest-Neighbor Cross-Predictability Approaches for the Evaluation of Cardiorespiratory and Cerebrovascular Dynamic Interactions. Annu Int Conf IEEE Eng Med Biol Soc 2022; 2022:127-130. [PMID: 36085935 DOI: 10.1109/embc48229.2022.9871239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Quantification of the cardiorespiratory and cerebrovascular couplings is a relevant clinical issue given that their changes are considered signs of pathological status. The inherent nonlinearity of mechanisms underlying cardiorespiratory and cerebrovascular links requires nonlinear tools for their reliable evaluation. In the present study we compare two nonlinear methods for the assessment of coupling strength between two time series, namely cross-sample entropy (CSampEn) and k-nearest-neighbor cross-predictability (KNNCP). CSampEn uses a strategy that fixes the pattern length, while KNNCP optimizes the pattern length to maximize cross-predictability. CSampEn and KNNCP were applied to the beat-to-beat series of heart period (HP) and respiration (R) during a controlled breathing protocol with the aim at assessing cardiorespiratory coupling and to the beat-to-beat series of mean cerebral blood flow (MCBF) and mean arterial pressure (MAP) during an orthostatic stressor with the aim at evaluating cerebrovascular coupling. Although both the methods have the possibility to quantify the degree of HP-R and MCBF-MAP association, they exhibited different statistical power and even diverse trends in response to the considered physiological challenges. CSampEn and KNNCP are not interchangeable and should be utilized in association more than in alternative for the quantification of the HP-R and MCBF-MAP coupling strength. Clinical Relevance - This study proves that cross-entropy and cross-predictability might lead to different conclusions about cardiorespiratory and cerebrovascular couplings.
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30
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Aguiar Mesquita Galdino G, Virgilio Silva LE, Garcia Moura‐Tonello SC, Milan‐Mattos JC, Nogueira Linares S, Marques da Silva T, Porta A, Fazan R, Beltrame T, Catai AM. Heart Rate Fragmentation in Patients with Type 2 Diabetes Mellitus. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.r4417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | | | - Juliana Cristina Milan‐Mattos
- Cardiovascular Physical Therapy Laboratory, Department of Physical TherapyFederal University of São CarlosSão Carlos
| | - Stephanie Nogueira Linares
- Cardiovascular Physical Therapy Laboratory, Department of Physical TherapyFederal University of São CarlosSão Carlos
| | | | | | - Rubens Fazan
- Ribeirão Preto Medical School, University of São PauloRibeirão Preto
| | - Thomas Beltrame
- Cardiovascular Physical Therapy Laboratory, Department of Physical TherapyFederal University of São CarlosSão Carlos
| | - Aparecida Maria Catai
- Cardiovascular Physical Therapy Laboratory, Department of Physical TherapyFederal University of São CarlosSão Carlos
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De Maria B, Lucini D, Gois MDO, Catai AM, Perego F, Malacarne M, Pagani M, Porta A, Dalla Vecchia LA. Improvement of Sympathovagal Balance by Regular Exercise May Counteract the Ageing Process. A Study by the Analysis of QT Variability. Front Physiol 2022; 13:880250. [PMID: 35514344 PMCID: PMC9065681 DOI: 10.3389/fphys.2022.880250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 04/04/2022] [Indexed: 11/21/2022] Open
Abstract
QT interval (QT) variability analysis provides pathophysiological and prognostic information utilized in cardiac and non-cardiac diseases, complementary to those obtained from the analysis of heart period (HP) variability. An increased QT variability has been associated to a higher risk for cardiac events and poorest prognosis. Autonomic cardiovascular adaptation to internal and external challenges, such those occurring in athletes exposed to high levels of physical stress and in ageing could also be deepen by analyzing QT variability, searching for early prognostic signatures. The aim of the study was to analyze the QT variability and cardiac control complexity in a group of middle-aged half-marathon runners at baseline (B) and at a 10-year follow-up (FU). We found that the overall QT variability decreased at FU, despite the inescapable increase in age (52.3 ± 8.0 years at FU). This change was accompanied by an increase of the HP variability complexity without changes of the QT variability complexity. Of notice, over the years, the group of athletes maintained their regular physical activity by switching to a moderate intensity rather than strenuous. In conclusion, regular and moderate exercise over the years was beneficial for this group of athletes, as reflected by the decreased overall QT variability that is known to be associated to lower cardiovascular risk. The concomitant enhanced cardiac control complexity also suggests a trend opposite to what usually occurs with ageing, resulting in a more flexible cardiac control, typical of younger people.
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Affiliation(s)
| | - Daniela Lucini
- BIOMETRA Department, University of Milan, Milan, Italy.,Exercise Medicine Unit, IRCCS, Istituto Auxologico Italiano, Milan, Italy
| | | | - Aparecida Maria Catai
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | | | - Mara Malacarne
- BIOMETRA Department, University of Milan, Milan, Italy.,Exercise Medicine Unit, IRCCS, Istituto Auxologico Italiano, Milan, Italy
| | - Massimo Pagani
- Exercise Medicine Unit, IRCCS, Istituto Auxologico Italiano, Milan, Italy
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.,Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, Policlinico San Donato, San Donato Milanese, Milan, Italy
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Barbic F, Minonzio M, Cairo B, Shiffer D, Cerina L, Verzeletti P, Badilini F, Vaglio M, Porta A, Santambrogio M, Gatti R, Rigo S, Bisoglio A, Furlan R. Effects of a cool classroom microclimate on cardiac autonomic control and cognitive performances in undergraduate students. Sci Total Environ 2022; 808:152005. [PMID: 34871696 DOI: 10.1016/j.scitotenv.2021.152005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 11/09/2021] [Accepted: 11/23/2021] [Indexed: 06/13/2023]
Abstract
An inverted U-shape relationship between cognitive performance and indoor temperature with best performance peaking at 21.6 °C was previously described. Little is known on classroom temperature reduction effects on cognitive performances and cardiac autonomic profile, during the cold season. Fifteen students underwent electrocardiogram recording during a lecture in two days in December when classroom temperatures were set as neutral (NEUTRAL, 20-22 °C) and cool (COOL, 16-18 °C). Cognitive performance (memory, verbal ability, reasoning, overall cognitive C-score) was assessed by Cambridge Brain Science cognitive evaluation tool. Cardiac autonomic control was evaluated via the analysis of spontaneous fluctuations of heart period, as the temporal distance between two successive R-wave peaks (RR). Spectral analysis provided the power in the high frequency (HF, 0.15-0.40 Hz) and low frequency (LF, 0.04-0.15 Hz) bands of RR variability. Sympatho-vagal interaction was assessed by LF to HF ratio (LF/HF). Symbolic analysis provided the fraction of RR patterns composed by three heart periods with no variation (0 V%) and two variations (2 V%), taken as markers of cardiac sympathetic and vagal modulations, respectively. The students' thermal comfort was assessed during NEUTRAL and COOL trials. Classroom temperatures were 21.5 ± 0.8 °C and 18.4 ± 0.4 °C during NEUTRAL and COOL. Memory, verbal ability, C-Score were greater during COOL (13.01 ± 3.43, 12.32 ± 2.58, 14.29 ± 2.90) compared to NEUTRAL (9.98 ± 2.26, p = 0.002; 8.57 ± 1.07, p = 0.001 and 10.35 ± 3.20, p = 0.001). LF/HF (2.4 ± 1.7) and 0 V% (23.2 ± 11.1%) were lower during COOL compared to NEUTRAL (3.7 ± 2.8, p = 0.042; 28.1 ± 12.2.1%, p = 0.031). During COOL, 2 V% was greater (30.5 ± 10.9%) compared to NEUTRAL (26.2 ± 11.3, p = 0.047). The students' thermal comfort was slightly reduced during COOL compared to NEUTRAL trial. During cold season, a better cognitive performance was obtained in a cooler indoor setting enabling therefore energy saving too.
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Affiliation(s)
- Franca Barbic
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Internal Medicine, Rozzano, Milan, Italy.
| | - Maura Minonzio
- IRCCS Humanitas Research Hospital, Internal Medicine, Rozzano, Milan, Italy
| | - Beatrice Cairo
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Dana Shiffer
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Internal Medicine, Rozzano, Milan, Italy
| | | | | | | | | | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy; Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Marco Santambrogio
- Dipartimento di Informazione, Elettronica e Bioingegneria, Politecnico di Milano, Milan, Italy
| | - Roberto Gatti
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Internal Medicine, Rozzano, Milan, Italy
| | - Stefano Rigo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Andrea Bisoglio
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Raffaello Furlan
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Internal Medicine, Rozzano, Milan, Italy
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Zamunér AR, Minonzio M, Shiffer D, Fornerone R, Cairo B, Porta A, Rigo S, Furlan R, Barbic F. Relationships Between Cardiovascular Autonomic Profile and Work Ability in Patients With Pure Autonomic Failure. Front Hum Neurosci 2022; 15:761501. [PMID: 35002654 PMCID: PMC8733607 DOI: 10.3389/fnhum.2021.761501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 12/02/2021] [Indexed: 11/13/2022] Open
Abstract
Pure autonomic failure (PAF) is a rare disorder belonging to the group of synucleinopathies, characterized by autonomic nervous system degeneration. Severe orthostatic intolerance with recurrent syncope while standing are the two most disabling manifestations. Symptoms may start at middle age, thus affecting people at their working age. The aims of this study were to evaluate the autonomic and work ability impairment of a group of PAF patients and assess the relationships between cardiovascular autonomic control and work ability in these patients. Eleven PAF patients (age 57.3 ± 6.7 years), engaged in work activity, participated in the study. They completed the Composite Autonomic Symptom Score (COMPASS-31, range 0 no symptom-100 maximum symptom intensity) and Work Ability questionnaires (Work Ability Index, WAI, range 7-49; higher values indicate better work ability and lower values indicating unsatisfactory or jeopardized work ability). Electrocardiogram, blood pressure and respiratory activity were continuously recorded for 10 min while supine and during 75° head-up tilt (HUT). Autoregressive spectral analysis of cardiac cycle length approximated as the time distance between two consecutive R-wave peaks (RR) and systolic arterial pressure (SAP) variabilities provided the power in the high frequency (HF, 0.15-0.40 Hz) and low frequency (LF, 0.04-0.15 Hz) bands of RR and SAP variabilities. Cardiac sympatho-vagal interaction was assessed by LF to HF ratio (LF/HF), while the LF power of SAP (LFSAP) quantified the vascular sympathetic modulation. Changes in cardiovascular autonomic indexes induced by HUT were calculated as the delta (Δ) between HUT and supine resting positions. Spearman correlation analysis was applied. PAF patients were characterized by a moderate autonomic dysfunction (COMPASS-31 total score 47.08 ± 20.2) and by a reduction of work ability (WAI 26.88 ± 10.72). Direct significant correlations were found between WAI and ΔLFRR (r = 0.66, p = 0.03) and ΔLF/HFRR (r = 0.70, p = 0.02). Results indicate that patients who were better able to modulate heart rate, as revealed by a greater cardiac sympathetic increase and/or vagal withdrawal during the orthostatic stimulus, were those who reported higher values of WAI. This finding could be relevant to propose new strategies in the occupational environment to prevent early retirement or to extend the working life of these patients.
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Affiliation(s)
- Antonio R Zamunér
- Laboratory of Clinical Research in Kinesiology, Department of Kinesiology, Universidad Católica del Maule, Talca, Chile
| | - Maura Minonzio
- Internal Medicine, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Dana Shiffer
- Internal Medicine, IRCCS Humanitas Research Hospital, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | | | - Beatrice Cairo
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.,Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy
| | - Stefano Rigo
- Internal Medicine, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Raffaello Furlan
- Internal Medicine, IRCCS Humanitas Research Hospital, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Franca Barbic
- Internal Medicine, IRCCS Humanitas Research Hospital, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Italy
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Porta A, Gelpi F, Bari V, Cairo B, De Maria B, Tonon D, Rossato G, Ranucci M, Faes L. Categorizing the Role of Respiration in Cardiovascular and Cerebrovascular Variability Interactions. IEEE Trans Biomed Eng 2021; 69:2065-2076. [PMID: 34905489 DOI: 10.1109/tbme.2021.3135313] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Respiration disturbs cardiovascular and cerebrovascular controls but its role is not fully elucidated. METHODS Respiration can be classified as a confounder if its observation reduces the strength of the causal relationship from source to target. Respiration is a suppressor if the opposite situation holds. We prove that a confounding/suppression (C/S) test can be accomplished by evaluating the sign of net redundancy/synergy balance in the predictability framework based on multivariate autoregressive modelling. In addition, we suggest that, under the hypothesis of Gaussian processes, the C/S test can be given in the transfer entropy decomposition framework as well. Experimental protocols: We applied the C/S test to variability series of respiratory movements, heart period, systolic arterial pressure, mean arterial pressure, and mean cerebral blood flow recorded in 17 pathological individuals (age: 648 yrs; 17 males) before and after induction of propofol-based general anesthesia prior to coronary artery bypass grafting, and in 13 healthy subjects (age: 278 yrs; 5 males) at rest in supine position and during head-up tilt with a table inclination of 60. RESULTS Respiration behaved systematically as a confounder for cardiovascular and cerebrovascular controls. In addition, its role was affected by propofol-based general anesthesia but not by a postural stimulus of limited intensity. CONCLUSION The C/S test can be fruitfully exploited to categorize the role of respiration over causal variability interactions. SIGNIFICANCE The application of the C/S test could favor the comprehension of the role of respiration in cardiovascular and cerebrovascular regulations.
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Nuzzi D, Stramaglia S, Javorka M, Marinazzo D, Porta A, Faes L. Extending the spectral decomposition of Granger causality to include instantaneous influences: application to the control mechanisms of heart rate variability. Philos Trans A Math Phys Eng Sci 2021; 379:20200263. [PMID: 34689615 DOI: 10.1098/rsta.2020.0263] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/15/2021] [Indexed: 06/13/2023]
Abstract
Assessing Granger causality (GC) intended as the influence, in terms of reduction of variance of surprise, that a driver variable exerts on a given target, requires a suitable treatment of 'instantaneous' effects, i.e. influences due to interactions whose time scale is much faster than the time resolution of the measurements, due to unobserved confounders or insufficient sampling rate that cannot be increased because the mechanism of generation of the variable is inherently slow (e.g. the heartbeat). We exploit a recently proposed framework for the estimation of causal influences in the spectral domain and include instantaneous interactions in the modelling, thus obtaining (i) a novel index of undirected instantaneous causality and (ii) a novel measure of GC including instantaneous effects. An effective procedure to speed up the optimization of parameters in this frame is also presented. After illustrating the proposed formalism in a theoretical example, we apply it to two datasets of cardiovascular and respiratory time series and compare the values obtained within the frequency bands of physiological interest by the proposed total measure of causality with those derived from the standard GC analysis. We find that the inclusion of instantaneous causality allows us to correctly disentangle the baroreflex mechanism from the effects related to cardiorespiratory interactions. Moreover, studying how controlling the respiratory rhythm acts on cardiovascular interactions, we document an increase of the direct (non-baroreflex mediated) influence of respiration on the heart rate in the respiratory frequency band when switching from spontaneous to paced breathing. This article is part of the theme issue 'Advanced computation in cardiovascular physiology: new challenges and opportunities'.
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Affiliation(s)
- D Nuzzi
- Dipartimento Interateneo di Fisica, Universitá degli Studi di Bari Aldo Moro, Bari and INFN, Sezione di Bari, 70126 Bari, Italy
| | - S Stramaglia
- Dipartimento Interateneo di Fisica, Universitá degli Studi di Bari Aldo Moro, Bari and INFN, Sezione di Bari, 70126 Bari, Italy
| | - M Javorka
- Department of Physiology, Comenius University in Bratislava, Jessenius Faculty of Medicine, 03601 Martin, Slovakia
| | - D Marinazzo
- Department of Data Analysis, Ghent University, 9000 Ghent, Belgium
| | - A Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Luca Faes
- Dipartimento di Ingegneria, Universitá di Palermo, 90128 Palermo, Italy
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Faes L, Pernice R, Mijatovic G, Antonacci Y, Krohova JC, Javorka M, Porta A. Information decomposition in the frequency domain: a new framework to study cardiovascular and cardiorespiratory oscillations. Philos Trans A Math Phys Eng Sci 2021; 379:20200250. [PMID: 34689619 DOI: 10.1098/rsta.2020.0250] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/21/2020] [Indexed: 06/13/2023]
Abstract
While cross-spectral and information-theoretic approaches are widely used for the multivariate analysis of physiological time series, their combined utilization is far less developed in the literature. This study introduces a framework for the spectral decomposition of multivariate information measures, which provides frequency-specific quantifications of the information shared between a target and two source time series and of its expansion into amounts related to how the sources contribute to the target dynamics with unique, redundant and synergistic information. The framework is illustrated in simulations of linearly interacting stochastic processes, showing how it allows us to retrieve amounts of information shared by the processes within specific frequency bands which are otherwise not detectable by time-domain information measures, as well as coupling features which are not detectable by spectral measures. Then, it is applied to the time series of heart period, systolic and diastolic arterial pressure and respiration variability measured in healthy subjects monitored in the resting supine position and during head-up tilt. We show that the spectral measures of unique, redundant and synergistic information shared by these variability series, integrated within specific frequency bands of physiological interest and reflect the mechanisms of short-term regulation of cardiovascular and cardiorespiratory oscillations and their alterations induced by the postural stress. This article is part of the theme issue 'Advanced computation in cardiovascular physiology: new challenges and opportunities'.
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Affiliation(s)
- Luca Faes
- Department of Engineering, University of Palermo, Palermo, Italy
| | - Riccardo Pernice
- Department of Engineering, University of Palermo, Palermo, Italy
| | - Gorana Mijatovic
- Faculty of Technical Sciences, University of Novi Sad, Novi Sad, Serbia
| | - Yuri Antonacci
- Department of Physics and Chemistry 'Emilio Segrè', University of Palermo, Palermo, Italy
| | - Jana Cernanova Krohova
- Department of Physiology and Biomedical Centre Martin (BioMed Martin), Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia
| | - Michal Javorka
- Department of Physiology and Biomedical Centre Martin (BioMed Martin), Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
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Cairo B, de Abreu RM, Bari V, Gelpi F, De Maria B, Rehder-Santos P, Sakaguchi CA, da Silva CD, De Favari Signini É, Catai AM, Porta A. Optimizing phase variability threshold for automated synchrogram analysis of cardiorespiratory interactions in amateur cyclists. Philos Trans A Math Phys Eng Sci 2021; 379:20200251. [PMID: 34689616 DOI: 10.1098/rsta.2020.0251] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/29/2020] [Indexed: 06/13/2023]
Abstract
We propose a procedure suitable for automated synchrogram analysis for setting the threshold below which phase variability between two marker event series is of such a negligible amount that the null hypothesis of phase desynchronization can be rejected. The procedure exploits the principle of maximizing the likelihood of detecting phase synchronization epochs and it is grounded on a surrogate data approach testing the null hypothesis of phase uncoupling. The approach was applied to assess cardiorespiratory phase interactions between heartbeat and inspiratory onset in amateur cyclists before and after 11-week inspiratory muscle training (IMT) at different intensities and compared to a more traditional approach to set phase variability threshold. The proposed procedure was able to detect the decrease in cardiorespiratory phase locking strength during vagal withdrawal induced by the modification of posture from supine to standing. IMT had very limited effects on cardiorespiratory phase synchronization strength and this result held regardless of the training intensity. In amateur athletes training, the inspiratory muscles did not limit the decrease in cardiorespiratory phase synchronization observed in the upright position as a likely consequence of the modest impact of this respiratory exercise, regardless of its intensity, on cardiac vagal control. This article is part of the theme issue 'Advanced computation in cardiovascular physiology: new challenges and opportunities'.
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Affiliation(s)
- Beatrice Cairo
- Department of Biomedical Sciences for Health, University of Milan, Milan 20133, Italy
| | - Raphael Martins de Abreu
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo 13565-905, Brazil
| | - Vlasta Bari
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan 20097, Italy
| | - Francesca Gelpi
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan 20097, Italy
| | | | - Patrícia Rehder-Santos
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo 13565-905, Brazil
| | - Camila Akemi Sakaguchi
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo 13565-905, Brazil
| | - Claudio Donisete da Silva
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo 13565-905, Brazil
| | - Étore De Favari Signini
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo 13565-905, Brazil
| | - Aparecida Maria Catai
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo 13565-905, Brazil
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan 20133, Italy
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan 20097, Italy
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Gelpi F, Bari V, Cairo B, De Maria B, Tonon D, Rossato G, Faes L, Porta A. Dynamic cerebrovascular autoregulation in patients prone to postural syncope: Comparison of techniques assessing the autoregulation index from spontaneous variability series. Auton Neurosci 2021; 237:102920. [PMID: 34808528 DOI: 10.1016/j.autneu.2021.102920] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 10/20/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022]
Abstract
Three approaches to the assessment of cerebrovascular autoregulation (CA) via the computation of the autoregulation index (ARI) from spontaneous variability of mean arterial pressure (MAP) and mean cerebral blood flow velocity (MCBFV) were applied: 1) a time domain method (TDM); 2) a nonparametric method (nonPM); 3) a parametric method (PM). Performances were tested over matched and surrogate unmatched pairs. Data were analyzed at supine resting (REST) and during the early phase of 60° head-up tilt (TILT) in 13 subjects with previous history of postural syncope (SYNC, age: 28 ± 9 yrs.; 5 males) and 13 control individuals (noSYNC, age: 27 ± 8 yrs.; 5 males). Analysis was completed by computing autonomic markers from heart period (HP) and systolic arterial pressure (SAP) variability series via spectral approach. HP and SAP spectral indexes suggested that noSYNC and SYNC groups exhibited different autonomic responses to TILT. ARI analysis indicated that: i) all methods have a sufficient statistical power to separate matched from unmatched pairs with the exception of nonPM applied to impulse response; ii) ARI estimates derived from different methods might be uncorrelated and, even when correlated, might exhibit a significant bias; iii) orthostatic stressor did not induce any evident ARI change in either noSYNC or SYNC individuals; iv) this conclusion held regardless of the method. Methods for the ARI estimation from spontaneous variability provide different ARIs but none indicate that noSYNC and SYNC subjects have different dynamic component of CA.
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Affiliation(s)
- Francesca Gelpi
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy; Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Vlasta Bari
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Beatrice Cairo
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | - Davide Tonon
- Department of Neurology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Gianluca Rossato
- Department of Neurology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Luca Faes
- Department of Engineering, University of Palermo, Palermo, Italy
| | - Alberto Porta
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy; Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
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Porta A, Gelpi F, Bari V, Cairo B, De Maria B, May Panzetti C, Cornara N, Bertoldo EG, Fiolo V, Callus E, De Vincentiis C, Volpe M, Molfetta R, Ranucci M. Respiration is a Confounder of the Closed Loop Relationship Between Mean Arterial Pressure and Mean Cerebral Blood Flow. Annu Int Conf IEEE Eng Med Biol Soc 2021; 2021:5403-5406. [PMID: 34892348 DOI: 10.1109/embc46164.2021.9630905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This study tested the hypothesis that respiration (RESP) is a confounder or suppressor of the closed loop relationship responsible for the cerebrovascular dynamical interactions as assessed from spontaneous variability of mean arterial pressure (MAP) and mean cerebral blood flow (MCBF). The evaluation was carried out in the information domain via transfer entropy (TE) estimated through a linear model-based approach comparing TE markers computed solely over MAP and MCBF series with TE indexes accounting for the eventual action of RESP over MAP and MCBF. We considered 11 patients (age: 76±5 yrs, 7 males) undergoing surgical aortic valve replacement (SAVR) at supine resting (REST) and during active standing (STAND) before and after SAVR surgery. The decrease of the predictive ability of MCBF to MAP when accounting for RESP compared to the one assessed when disregarding RESP suggested that RESP is a confounder of the link from MCBF to MAP along the Cushing reflex instead of being a suppressor. This result was more evident in POST when autonomic control was dramatically depressed and in an unchallenged condition such as REST. RESP did not affect significantly the link from MAP to MCBF along the pressure-to-flow relationship. Clarification of the type of RESP influence on the MAP-MCBF closed loop relationship could favor a deeper characterization of cerebrovascular interactions and the comprehension of cerebral autoregulation mechanisms.Clinical Relevance- This study suggests that respiration is a confounder of the closed loop relationship between MAP and MCBF, especially of the flow-to-pressure causal link. This result might open new possibilities in elucidating the mechanisms of cerebral autoregulation in healthy and pathological populations.
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Bari V, De Maria B, Cairo B, Gelpi F, Lambert E, Esler M, Baumert M, Porta A. Assessing Correlation between Heart Rate Variability Markers Based on Laguerre Expansion and Direct Measures of Sympathetic Activity during Incremental Head-up Tilt. Annu Int Conf IEEE Eng Med Biol Soc 2021; 2021:5411-5414. [PMID: 34892350 DOI: 10.1109/embc46164.2021.9630873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Traditional frequency domain analysis of heart period (HP) variability allows the estimation of the parasympathetic modulation directed to the heart but the sympathetic one remains largely unknown. Recently, sympathetic and parasympathetic activity indexes (SAI and PAI) have been proposed to address this issue. SAI and PAI were derived from HP variability via the application of an orthonormal Laguerre expansion allowing the separation of HP variations driven by sympathetic and parasympathetic outflows. In this study, SAI and PAI were validated against tonic and variability measures of muscle sympathetic nerve activity (MSNA) and more traditional markers derived from HP variability. Indexes were calculated in 12 healthy subjects (9 females, age from 20 to 36 years, median 22.5 years) undergoing incremental head-up tilt. Results showed that traditional HP and MSNA variability markers as well as SAI and PAI were modified in proportion to the magnitude of the postural challenge. However, SAI was not correlated with any MSNA markers and PAI was not linked to respiratory sinus arrhythmia. SAI and PAI can capture modifications of cardiac control induced by the orthostatic challenge but they might be weak surrogates of vagal and sympathetic activities and/or modulations.Clinical Relevance- SAI and PAI markers are useful to characterize cardiac control but poorly linked with autonomic nervous system state.
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Raglio A, De Maria B, Perego F, Galizia G, Gallotta M, Imbriani C, Porta A, Dalla Vecchia LA. Effects of Algorithmic Music on the Cardiovascular Neural Control. J Pers Med 2021; 11:jpm11111084. [PMID: 34834436 PMCID: PMC8618683 DOI: 10.3390/jpm11111084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/22/2021] [Accepted: 10/22/2021] [Indexed: 12/21/2022] Open
Abstract
Music influences many physiological parameters, including some cardiovascular (CV) control indices. The complexity and heterogeneity of musical stimuli, the integrated response within the brain and the limited availability of quantitative methods for non-invasive assessment of the autonomic function are the main reasons for the scarcity of studies about the impact of music on CV control. This study aims to investigate the effects of listening to algorithmic music on the CV regulation of healthy subjects by means of the spectral analysis of heart period, approximated as the time distance between two consecutive R-wave peaks (RR), and systolic arterial pressure (SAP) variability. We studied 10 healthy volunteers (age 39 ± 6 years, 5 females) both while supine (REST) and during passive orthostatism (TILT). Activating and relaxing algorithmic music tracks were used to produce possible contrasting effects. At baseline, the group featured normal indices of CV sympathovagal modulation both at REST and during TILT. Compared to baseline, at REST, listening to both musical stimuli did not affect time and frequency domain markers of both SAP and RR, except for a significant increase in mean RR. A physiological TILT response was maintained while listening to both musical tracks in terms of time and frequency domain markers, compared to baseline, an increase in mean RR was again observed. In healthy subjects featuring a normal CV neural profile at baseline, algorithmic music reduced the heart rate, a potentially favorable effect. The innovative music approach of this study encourages further research, as in the presence of several diseases, such as ischemic heart disease, hypertension, and heart failure, a standardized musical stimulation could play a therapeutic role.
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Affiliation(s)
- Alfredo Raglio
- IRCCS Istituti Clinici Scientifici Maugeri, 27100 Pavia, Italy; (A.R.); (C.I.)
| | - Beatrice De Maria
- IRCCS Istituti Clinici Scientifici Maugeri, 20138 Milan, Italy; (B.D.M.); (F.P.); (M.G.)
| | - Francesca Perego
- IRCCS Istituti Clinici Scientifici Maugeri, 20138 Milan, Italy; (B.D.M.); (F.P.); (M.G.)
| | | | - Matteo Gallotta
- IRCCS Istituti Clinici Scientifici Maugeri, 20138 Milan, Italy; (B.D.M.); (F.P.); (M.G.)
| | - Chiara Imbriani
- IRCCS Istituti Clinici Scientifici Maugeri, 27100 Pavia, Italy; (A.R.); (C.I.)
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy;
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy
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Bari V, Fantinato A, Vaini E, Gelpi F, Cairo B, De Maria B, Pistuddi V, Ranucci M, Porta A. Impact of propofol general anesthesia on cardiovascular and cerebrovascular closed loop variability interactions. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2021.102735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Dalla Vecchia LA, De Maria B, Cassetti G, Clementi L, De Grazia V, Perego F, Porta A. How the first years of motherhood impact the cardiac autonomic profile of female healthcare professionals: a study by heart rate variability analysis. Sci Rep 2021; 11:8161. [PMID: 33854133 PMCID: PMC8047021 DOI: 10.1038/s41598-021-87596-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 03/18/2021] [Indexed: 01/23/2023] Open
Abstract
The conciliation between career and family is a relevant issue for working women, in particular during the first years of motherhood. Data about the state of the cardiac autonomic regulation in working women with preschoolers are lacking. Aim of this study was to compare the cardiac autonomic profile of female healthcare professionals with and without preschoolers via the analysis of the variability of the time distance between two consecutive R-wave peaks (RR) from standard 24-h Holter electrocardiogram (ECG). Fifty healthy active female healthcare professionals were enrolled: 25 with at least one preschooler (W_KID) and 25 without (W_NOKID). A standard Holter ECG was obtained during a regular working day. Segments of 5000 consecutive RRs were selected during daytime (DAY) and nighttime (NIGHT). Heart rate variability analysis was performed and the following parameters were considered for comparison between the two groups: mean (μRR), variance (σ2RR), and the absolute power in high frequency component (HF) of RR (HFRR) series. HFRR was considered as a marker of vagal cardiac modulation. Only µRR significantly increased from DAY to NIGHT in both groups (699 ± 88 vs 887 ± 140 ms in W_KID and 728 ± 90 vs 942 ± 166 ms in W_NOKID). Instead, σ2RR and HFRR increased from DAY to NIGHT only in W_NOKID (from 3334 ± 2153 to 4816 ± 4063 ms2 and from 356 ± 334 to 1397 ± 1629 ms2, respectively). W_KID showed lower σ2RR and HFRR during NIGHT, compared to W_NOKID (2336 ± 3170 vs 4816 ± 4063 ms2 and 556 ± 950 vs 1397 ± 1629 ms2, respectively). The perceived stress according to the visual analogue scale was similar in the two groups (4.7 ± 2.1 in W_KID, 5.7 ± 2.1 in W_NOKID). The presence of preschoolers lowered nocturnal cardiac vagal modulation in female healthcare professionals. This might represent an adaptation with a finalistic purpose, scilicet the facilitation of a prompt reaction in case of a child’s need.
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Affiliation(s)
| | - Beatrice De Maria
- IRCCS Istituti Clinici Scientifici Maugeri, Via Camaldoli 64, 20138, Milan, Italy
| | - Giuseppina Cassetti
- IRCCS Istituti Clinici Scientifici Maugeri, Via Camaldoli 64, 20138, Milan, Italy
| | - Letizia Clementi
- Department of Electronics Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Valeria De Grazia
- IRCCS Istituti Clinici Scientifici Maugeri, Via Camaldoli 64, 20138, Milan, Italy
| | - Francesca Perego
- IRCCS Istituti Clinici Scientifici Maugeri, Via Camaldoli 64, 20138, Milan, Italy
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.,Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
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Fiogbé E, Vassimon-Barroso V, Catai AM, de Melo RC, Quitério RJ, Porta A, Takahashi ACDM. Complexity of Knee Extensor Torque: Effect of Aging and Contraction Intensity. J Strength Cond Res 2021; 35:1050-1057. [PMID: 30289867 DOI: 10.1519/jsc.0000000000002888] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
Abstract
ABSTRACT Fiogbé, E, Vassimon-Barroso, V, Catai, AM, de Melo, RC, Quitério, RJ, Porta, A, and Takahashi, ACdM. Complexity of knee extensor torque: effect of aging and contraction intensity. J Strength Cond Res 35(4): 1050-1057, 2021-Assessing the knee extensors' torque complexity in older adults is relevant because these muscles are among the most involved in functional daily activities. This study aimed to investigate the effects of aging and isometric contraction intensity on knee extensor torque complexity. Eight young (24 ± 2.8 years) and 13 old adults (63 ± 2.8 years) performed 3 maximal (maximum voluntary contraction [MVC], duration = 10 seconds) and submaximal isometric contractions (SICs, targeted at 15, 30, and 40% of MVC, respectively) of knee extensors. Torque signals were sampled continuously, and the metrics of variability and complexity were calculated basing on the SIC torque data. The coefficient of variation (CV) was used to quantify the torque variability. The torque complexity was determined by calculating the corrected approximate entropy (CApEn) and sample entropy (SampEn) and its normalized versions (NCApEn and NSampEn). Young subjects produced greater isometric torque than older adults, and the CV was similar between both groups except at the highest force level (40% MVC) where young subjects' value was higher. The major novel finding of this investigation was that although the knee extensor torque complexity is reduced in older adults, its relationship with contraction intensity is similar to young subjects. This means that despite the age-related decrease of the interactions between the components of the neuromuscular system, the organization of force control remains preserved in older adults, at least up to just below the force midrange.
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Affiliation(s)
- Elie Fiogbé
- Department of Physiotherapy, Federal University of Sao Carlos, São Carlos-SP, Brazil
| | | | - Aparecida Maria Catai
- Department of Physiotherapy, Federal University of Sao Carlos, São Carlos-SP, Brazil
| | - Ruth Caldeira de Melo
- Department of Gerontology, School of Arts, Sciences and Humanities, University of Sao Paulo, São Paulo-SP, Brazil
| | - Robison José Quitério
- Department of Physiotherapy and Occupational Therapy, Sao Paulo State University, Marília-SP, Brazil
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy ; and
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCSPoliclinico San Donato, San Donato Milanese, Milan, Italy
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Storniolo JL, Cairo B, Porta A, Cavallari P. Symbolic Analysis of the Heart Rate Variability During the Plateau Phase Following Maximal Sprint Exercise. Front Physiol 2021; 12:632883. [PMID: 33833687 PMCID: PMC8021730 DOI: 10.3389/fphys.2021.632883] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/04/2021] [Indexed: 11/17/2022] Open
Abstract
Cardiac autonomic control is commonly assessed via the analysis of fluctuations of the temporal distance between two consecutive R-waves (RR). Cardiac regulation assessment following high intensity physical exercise is difficult due to RR non-stationarities. The very short epoch following maximal sprint exercise when RR remains close to its lowest value, i.e., the PLATEAU, provides the opportunity to evaluate cardiac regulation from stationary RR sequences. The aim of the study is to evaluate cardiac autonomic control during PLATEAU phase following 60-m maximal sprint and compare the results to those derived from sequences featuring the same length as the PLATEAU and derived from pre-exercise and post-exercise periods. These sequences were referred to as PRE and POST sequences. RR series were recorded in 21 subjects (age: 24.9 ± 5.1 years, 15 men and six women). We applied a symbolic approach due to its ability to deal with very short RR sequences. The symbolic approach classified patterns formed by three RRs according to the sign and number of RR variations. Symbolic markers were compared to more classical time and frequency domain indexes. Comparison was extended to simulated signals to explicitly evaluate the suitability of methods to deal with short variability series. A surrogate test was applied to check the null hypothesis of random fluctuations. Over simulated data symbolic analysis was able to separate dynamics with different spectral profiles provided that the frame length was longer than 10 cardiac beats. Over real data the surrogate test indicated the presence of determinism in PRE, PLATEAU, and POST sequences. We found that the rate of patterns with two variations with unlike sign increased during PLATEAU and in POST sequences and the frequency of patterns with no variations remained unchanged during PLATEAU and decreased in POST compared to PRE sequences. Results indicated a sustained sympathetic control along with an early vagal reactivation during PLATEAU and a shift of the sympathovagal balance toward vagal predominance in POST compared to PRE sequences. Time and frequency domains markers were less powerful because they were dominated by the dramatic decrease of RR variance during PLATEAU.
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Affiliation(s)
- Jorge L. Storniolo
- Department of Pathophysiology and Transplantation, Human Physiology Section, University of Milan, Milan, Italy
| | - Beatrice Cairo
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy
| | - Paolo Cavallari
- Department of Pathophysiology and Transplantation, Human Physiology Section, University of Milan, Milan, Italy
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Perego F, De Maria B, Bova M, Petraroli A, Marcelli Cesoni A, De Grazia V, Zingale LC, Porta A, Spadaro G, Dalla Vecchia LA. Analysis of Heart-Rate Variability during Angioedema Attacks in Patients with Hereditary C1-Inhibitor Deficiency. Int J Environ Res Public Health 2021; 18:ijerph18062900. [PMID: 33809031 PMCID: PMC8002127 DOI: 10.3390/ijerph18062900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/01/2021] [Accepted: 03/09/2021] [Indexed: 11/16/2022]
Abstract
C1-inhibitor hereditary angioedema (C1-INH-HAE) is a rare disease characterized by self-limiting edema associated with localized vasodilation due to increased levels of circulating bradykinin. C1-INH-HAE directly influences patients' everyday lives, as attacks are unpredictable in frequency, severity, and the involved anatomical site. The autonomic nervous system could be involved in remission. The cardiac autonomic profile has not yet been evaluated during the attack or prodromal phases. In this study, a multiday continuous electrocardiogram was obtained in four C1-INH-HAE patients until attack occurrence. Power spectral heart rate variability (HRV) indices were computed over the 4 h preceding the attack and during the first 4 h of the attack in three patients. Increased vagal modulation of the sinus node was detected in the prodromal phase. This finding may reflect localized vasodilation mediated by the release of bradykinin. HRV analysis may furnish early markers of an impending angioedema attack, thereby helping to identify patients at higher risk of attack recurrence. In this perspective, it could assist in the timing, titration, and optimization of prophylactic therapy, and thus improve patients' quality of life.
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Affiliation(s)
- Francesca Perego
- Department of Medicine, IRCCS Istituti Clinici Scientifici Maugeri, 20138 Milan, Italy; (A.M.C.); (V.D.G.); (L.C.Z.); (L.A.D.V.)
- Correspondence:
| | - Beatrice De Maria
- Bioengineering Laboratory, IRCCS Istituti Clinici Scientifici Maugeri, 20138 Milan, Italy;
| | - Maria Bova
- Department of Translational Medical Sciences and Center for Basic and Clinical Immunology Research (CISI), University of Naples “Federico II”, 80138 Naples, Italy; (M.B.); (A.P.); (G.S.)
| | - Angelica Petraroli
- Department of Translational Medical Sciences and Center for Basic and Clinical Immunology Research (CISI), University of Naples “Federico II”, 80138 Naples, Italy; (M.B.); (A.P.); (G.S.)
| | - Azzurra Marcelli Cesoni
- Department of Medicine, IRCCS Istituti Clinici Scientifici Maugeri, 20138 Milan, Italy; (A.M.C.); (V.D.G.); (L.C.Z.); (L.A.D.V.)
| | - Valeria De Grazia
- Department of Medicine, IRCCS Istituti Clinici Scientifici Maugeri, 20138 Milan, Italy; (A.M.C.); (V.D.G.); (L.C.Z.); (L.A.D.V.)
| | - Lorenza Chiara Zingale
- Department of Medicine, IRCCS Istituti Clinici Scientifici Maugeri, 20138 Milan, Italy; (A.M.C.); (V.D.G.); (L.C.Z.); (L.A.D.V.)
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy;
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy
| | - Giuseppe Spadaro
- Department of Translational Medical Sciences and Center for Basic and Clinical Immunology Research (CISI), University of Naples “Federico II”, 80138 Naples, Italy; (M.B.); (A.P.); (G.S.)
| | - Laura Adelaide Dalla Vecchia
- Department of Medicine, IRCCS Istituti Clinici Scientifici Maugeri, 20138 Milan, Italy; (A.M.C.); (V.D.G.); (L.C.Z.); (L.A.D.V.)
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De Maria B, Dalla Vecchia LA, Maestri R, Pinna GD, Parati M, Perego F, Bari V, Cairo B, Gelpi F, La Rovere MT, Porta A. Lack of association between heart period variability asymmetry and respiratory sinus arrhythmia in healthy and chronic heart failure individuals. PLoS One 2021; 16:e0247145. [PMID: 33592077 PMCID: PMC7886158 DOI: 10.1371/journal.pone.0247145] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 02/02/2021] [Indexed: 12/02/2022] Open
Abstract
Temporal asymmetry is a peculiar aspect of heart period (HP) variability (HPV). HPV asymmetry (HPVA) is reduced with aging and pathology, but its origin is not fully elucidated. Given the impact of respiration on HPV resulting in the respiratory sinus arrhythmia (RSA) and the asymmetric shape of the respiratory pattern, a possible link between HPVA and RSA might be expected. In this study we tested the hypothesis that HPVA is significantly associated with RSA and asymmetry of the respiratory rhythm. We studied 42 middle-aged healthy (H) subjects, and 56 chronic heart failure (CHF) patients of whom 26 assigned to the New York Heart Association (NYHA) class II (CHF-II) and 30 to NYHA class III (CHF-III). Electrocardiogram and lung volume were monitored for 8 minutes during spontaneous breathing (SB) and controlled breathing (CB) at 15 breaths/minute. The ratio of inspiratory (INSP) to expiratory (EXP) phases, namely the I/E ratio, and RSA were calculated. HPVA was estimated as the percentage of negative HP variations, traditionally measured via the Porta’s index (PI). Departures of PI from 50% indicated HPVA and its significance was tested via surrogate data. We found that RSA increased during CB and I/E ratio was smaller than 1 in all groups and experimental conditions. In H subjects the PI was about 50% during SB and it increased significantly during CB. In both CHF-II and CHF-III groups the PI was about 50% during SB and remained unmodified during CB. The PI was uncorrelated with RSA and I/E ratio regardless of the experimental condition and group. Pooling together data of different experimental conditions did not affect conclusions. Therefore, we conclude that the HPVA cannot be explained by RSA and/or I/E ratio, thus representing a peculiar feature of the cardiac control that can be aroused in middle-aged H individuals via CB.
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Affiliation(s)
| | | | - Roberto Maestri
- IRCCS Istituti Clinici Scientifici Maugeri, Montescano, Pavia, Italy
| | | | - Monica Parati
- IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
- Neuroengineering and Medical Robotics Laboratory, Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | | | - Vlasta Bari
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Beatrice Cairo
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Francesca Gelpi
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | | | - Alberto Porta
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- * E-mail:
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De Maria B, de Oliveira Gois M, Catai AM, Marra C, Lucini D, Porta A, Pagani M, Dalla Vecchia LA. Ten-year follow-up of cardiac function and neural regulation in a group of amateur half-marathon runners. Open Heart 2021; 8:openhrt-2020-001561. [PMID: 33563778 PMCID: PMC7875294 DOI: 10.1136/openhrt-2020-001561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/22/2021] [Accepted: 01/25/2021] [Indexed: 12/02/2022] Open
Abstract
Objective In the last years, a debate exists about type, intensity and frequency of physical exercise that is really indicated to protect healthy subjects from cardiovascular disease. Regular physical training has been associated with an improved cardiovascular risk profile, but it has also been demonstrated that strenuous and uncontrolled physical exercise could be dangerous, in terms of increased cardiovascular morbidity and mortality. In the present study, we evaluated a group of 35 amateur half-marathon runners, who were likewise studied 10 years before (B). The results of B suggested that an increased cardiac sympathetic modulation could potentially represent a negative prognostic factor. The aim of this follow-up was to assess the medium–long-term effects of moderate to vigorous physical training on the cardiovascular neural control, cardiac function and occurrence of cardiovascular diseases. Methods Each enrolled subject underwent: (1) an interview and physical examination to ascertain the presence of cardiovascular disease; (2) standing test to evaluate the cardiovascular neural control by means of heart rate variability (HRV), arterial blood pressure (AP) variability and baroreflex sensitivity (BRS); (3) transthoracic echocardiography to evaluate cardiac function. Results At 10-year follow-up (FU), in this group of middle-aged athletes the occurrence of cardiovascular diseases was low, not unlike that of the overall population. The results of HRV analysis showed a decreased sympathetic and increased vagal modulation directed to the heart, compared with B. In addition, HRV, AP variability and BRS indices showed a physiological response to active standing. Finally, athletes had normal echocardiographic measures. Conclusion We conclude that in our group of athletes a regular moderate–vigorous physical training through the 10 years was quite beneficial as the prevalence of sympathetic cardiac modulation observed at B was not accompanied by increased cardiovascular risk, on the contrary a slight prevalence of vagal indices was observed at FU.
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Affiliation(s)
- Beatrice De Maria
- Department of Cardiology, Istituti Clinici Scientifici Maugeri IRCCS, Milano, Italy
| | | | - Aparecida Maria Catai
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Christian Marra
- Department of Cardiology, Istituti Clinici Scientifici Maugeri IRCCS, Milano, Italy
| | - Daniela Lucini
- Dipartimento di Biotecnologie Mediche e Medicina Traslazionale, University of Milan, Milano, Italy.,Exercise Medicine Unit, Humanitas Clinical and Research Center IRCCS, Rozzano, Italy
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milano, Italy.,Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, Policlinico San Donato, San Donato Milanese, Italy
| | - Massimo Pagani
- Dipartimento di Biotecnologie Mediche e Medicina Traslazionale, University of Milan, Milano, Italy
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Porta A, Fantinato A, Bari V, Gelpi F, Cairo B, De Maria B, Bertoldo EG, Fiolo V, Callus E, De Vincentiis C, Volpe M, Molfetta R, Ranucci M. Evaluation of the impact of surgical aortic valve replacement on short-term cardiovascular and cerebrovascular controls through spontaneous variability analysis. PLoS One 2020; 15:e0243869. [PMID: 33301491 PMCID: PMC7728248 DOI: 10.1371/journal.pone.0243869] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 11/30/2020] [Indexed: 11/25/2022] Open
Abstract
We assessed the effect of surgical aortic valve replacement (SAVR) on cardiovascular and cerebrovascular controls via spontaneous variability analyses of heart period, approximated as the temporal distance between two consecutive R-wave peaks on the electrocardiogram (RR), systolic, diastolic and mean arterial pressure (SAP, DAP and MAP) and mean cerebral blood flow (MCBF). Powers in specific frequency bands, complexity, presence of nonlinear dynamics and markers of cardiac baroreflex and cerebral autoregulation were calculated. Variability series were acquired before (PRE) and after (POST) SAVR in 11 patients (age: 76±5 yrs, 7 males) at supine resting and during active standing. Parametric spectral analysis was performed based on the autoregressive model. Complexity was assessed via a local nonlinear prediction approach exploiting the k-nearest-neighbor strategy. The presence of nonlinear dynamics was checked by comparing the complexity marker computed over the original series with the distribution of the same index assessed over a set of surrogates preserving distribution and power spectral density of the original series. Cardiac baroreflex and cerebral autoregulation were estimated by assessing the transfer function from SAP to RR and from MAP to MCBF and squared coherence function via the bivariate autoregressive approach. We found that: i) orthostatic challenge had no effect on cardiovascular and cerebrovascular control markers in PRE; ii) RR variance was significantly reduced in POST; iii) complexity of SAP, DAP and MAP variabilities increased in POST with a greater likelihood of observing nonlinear dynamics over SAP compared to PRE at supine resting; iv) the amplitude of MCBF variations and MCBF complexity in POST remained similar to PRE; v) cardiac baroreflex sensitivity decreased in POST, while cerebrovascular autoregulation was preserved. SAVR induces important changes of cardiac and vascular autonomic controls and baroreflex regulation in patients exhibiting poor reactivity of cardiovascular regulatory mechanisms, while cerebrovascular autoregulation seems to be less affected.
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Affiliation(s)
- Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy
- * E-mail:
| | - Angela Fantinato
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy
| | - Vlasta Bari
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy
| | - Francesca Gelpi
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy
| | - Beatrice Cairo
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | | | - Valentina Fiolo
- Clinical Psychology Service, IRCCS Policlinico San Donato, Milan, Italy
| | - Edward Callus
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Clinical Psychology Service, IRCCS Policlinico San Donato, Milan, Italy
| | | | - Marianna Volpe
- Department of Cardiac Rehabilitation, IRCCS Policlinico San Donato, Milan, Italy
| | - Raffaella Molfetta
- Department of Cardiac Rehabilitation, IRCCS Policlinico San Donato, Milan, Italy
| | - Marco Ranucci
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy
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50
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Barbic F, Minonzio M, Cairo B, Shiffer D, Zamuner AR, Cavalieri S, Dipaola F, Magnavita N, Porta A, Furlan R. Work Ability Assessment and Its Relationship with Cardiovascular Autonomic Profile in Postural Orthostatic Tachycardia Syndrome. Int J Environ Res Public Health 2020; 17:ijerph17217836. [PMID: 33114659 PMCID: PMC7662324 DOI: 10.3390/ijerph17217836] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/21/2020] [Accepted: 10/21/2020] [Indexed: 12/28/2022]
Abstract
Postural orthostatic tachycardia syndrome (POTS) negatively impacts quality of life. The excessive increase in cardiac sympathetic modulation during standing, which characterizes POTS patients, leads to many symptoms and signs of orthostatic intolerance. Little is known about the consequences of the disease on work performance and its relationship with individual autonomic profiles. Twenty-two POTS patients regularly engaged in working activity (20 females, age 36 ± 12 years) and 18 gender- and age-matched controls underwent a clinical evaluation and filled out the Work Ability Index (WAI) questionnaire. POTS patients completed the Composite Autonomic Symptom Score (COMPASS31) questionnaire, underwent continuous electrocardiogram, blood pressure and respiratory activity recordings while supine and during a 75° head-up tilt (HUT). A power spectrum analysis provided the index of cardiac sympatho-vagal balance (LF/HF). WAI scores were significantly reduced in POTS patients (29.84 ± 1.40) compared to controls (45.63 ± 0.53, p < 0.01). A significant inverse correlation was found between individual WAI and COMPASS31 scores (r = −0.46; p = 0.03), HUT increase in heart rate (r = −0.57; p = 0.01) and LF/HF (r = −0.55; p = 0.01). In POTS patients, the WAI scores were inversely correlated to the intensity of autonomic symptoms and to the excessive cardiac sympathetic activation induced by the gravitational stimulus.
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Affiliation(s)
- Franca Barbic
- Internal Medicine, Humanitas Clinical and Research Center—IRCCS, Via Manzoni 56, 20089 Rozzano-Milan, Italy; (M.M.); (D.S.); (F.D.); (R.F.)
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele-Milan, Italy
- Correspondence:
| | - Maura Minonzio
- Internal Medicine, Humanitas Clinical and Research Center—IRCCS, Via Manzoni 56, 20089 Rozzano-Milan, Italy; (M.M.); (D.S.); (F.D.); (R.F.)
| | - Beatrice Cairo
- Department of Biomedical Sciences for Health, University of Milan, 20122 Milan, Italy; (B.C.); (A.P.)
| | - Dana Shiffer
- Internal Medicine, Humanitas Clinical and Research Center—IRCCS, Via Manzoni 56, 20089 Rozzano-Milan, Italy; (M.M.); (D.S.); (F.D.); (R.F.)
| | | | - Silvia Cavalieri
- Department of Life Sciences & Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (S.C.); (N.M.)
| | - Franca Dipaola
- Internal Medicine, Humanitas Clinical and Research Center—IRCCS, Via Manzoni 56, 20089 Rozzano-Milan, Italy; (M.M.); (D.S.); (F.D.); (R.F.)
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele-Milan, Italy
| | - Nicola Magnavita
- Department of Life Sciences & Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (S.C.); (N.M.)
- Department of Woman, Children & Public Health, Fondazione Policlinico A. Gemelli—IRCCS, 00168 Rome, Italy
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, 20122 Milan, Italy; (B.C.); (A.P.)
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy
| | - Raffaello Furlan
- Internal Medicine, Humanitas Clinical and Research Center—IRCCS, Via Manzoni 56, 20089 Rozzano-Milan, Italy; (M.M.); (D.S.); (F.D.); (R.F.)
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele-Milan, Italy
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