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Rodrigues GD, Cordani R, Veneruso M, Chiarella L, Prato G, Ferri R, Carandina A, Tobaldini E, Nobili L, Montano N. Predominant cardiac sympathetic modulation during wake and sleep in patients with Rett syndrome. Sleep Med 2024; 119:188-191. [PMID: 38692221 DOI: 10.1016/j.sleep.2024.04.036] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 04/24/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND Rett syndrome (RTT) is a rare neurological disorder primarily associated with mutations in the methyl-CpG-binding protein 2 (MECP2) gene. The syndrome is characterized by cognitive, social, and physical impairments, as well as sleep disorders and epilepsy. Notably, dysfunction of the autonomic nervous system is a key feature of the syndrome. Although Heart Rate Variability (HRV) has been used to investigate autonomic nervous system dysfunction in RTT during wakefulness, there is still a significant lack of information regarding the same during sleep. Therefore, our aim was to investigate cardiovascular autonomic modulation during sleep in subjects with RTT compared to an age-matched healthy control group (HC). METHOD A complete overnight polysomnographic (PSG) recording was obtained from 11 patients with Rett syndrome (all females, 10 ± 4 years old) and 11 HC (all females, 11 ± 4 years old; p = 0.48). Electrocardiogram and breathing data were extracted from PSG and divided into wake, non-REM, and REM sleep stages. Cardiac autonomic control was assessed using symbolic non-linear heart rate variability analysis. The symbolic analysis identified three patterns: 0 V% (sympathetic), 2UV%, and 2LV% (vagal). RESULTS The 0 V% was higher in the RTT group than in the HC group during wake, non-REM, and REM stages (p < 0.01), while the 2LV and 2UV% were lower during wake and sleep stages (p < 0.01). However, the 0 V% increased similarly from the wake to the REM stage in both RTT and HC groups. CONCLUSIONS Therefore, the sympatho-vagal balance shifted towards sympathetic predominance and vagal withdrawal during wake and sleep in RTT, although cardiac autonomic dynamics were preserved during sleep.
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Affiliation(s)
- Gabriel D Rodrigues
- Department of Clinical Sciences and Community Health, University of Milan, 20122, Milan, Italy
| | - Ramona Cordani
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, And Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Marco Veneruso
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, And Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Lorenzo Chiarella
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, And Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Giulia Prato
- Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Raffaele Ferri
- Sleep Research Center, Department of Neurology I.C, Oasi Research Institute - IRCCS, Troina, EN, Italy
| | - Angelica Carandina
- Department of Clinical Sciences and Community Health, University of Milan, 20122, Milan, Italy; Department of Internal Medicine, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, 20122, Milan, Italy
| | - Eleonora Tobaldini
- Department of Clinical Sciences and Community Health, University of Milan, 20122, Milan, Italy; Department of Internal Medicine, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, 20122, Milan, Italy
| | - Lino Nobili
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, And Maternal and Child Health, University of Genoa, Genoa, Italy; Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
| | - Nicola Montano
- Department of Clinical Sciences and Community Health, University of Milan, 20122, Milan, Italy; Department of Internal Medicine, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, 20122, Milan, Italy.
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Barreto IVPDS, Rodrigues GD, Oliveira JDS, Neves EB, Soares PPDS. Heated environment offsets the cardiovascular responses to prolonged rowing exercise in competitive athletes. J Therm Biol 2023; 115:103603. [PMID: 37327618 DOI: 10.1016/j.jtherbio.2023.103603] [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: 10/14/2022] [Revised: 05/25/2023] [Accepted: 05/26/2023] [Indexed: 06/18/2023]
Abstract
Prolonged rowing exercise sessions are often prescribed considering competitive training schedules, and under hostile environments (e.g., heated ambient). The study aimed to investigate the effect of heat stress (HS) on physical performance, Lactate concentration ([Lac]), and cardiorespiratory responses during prolonged exercise sessions in competitive rowers. Twelve rowers performed preliminary exercise tests (2-km test and five-step incremental lactate test) to assess the target workload intensity corresponding to a 2.5 mmol.L-1 of [Lac]. On two separate days, participants were enrolled in two exercise sessions of 12 km in a rowing machine under HS (∼30 °C) and thermal comfort (TC 22 °C) conditions. Heart rate (HR), stroke volume (SV), cardiac output (CO), oxygen uptake (VO2), [Lac], and the rating of perceptual exertion (RPE) were obtained. From baseline, HS increased the maximum temperature of the face compared to TC. Workload and VO2 reduced while RPE increased at 9- and 12-km of rowing exercise under HS compared to TC. From baseline to the last stage of exercise, HS shifted SV downwards and HR upwards compared to TC. Consequently, CO did not change between thermal conditions (TC vs. HS). Therefore, HS provokes a cardiovascular drift during prolonged rowing in comparison to TC. The last stages of prolonged rowing sessions under HS seem to be critical to physical performance and relative perceptual of effort in rowers.
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Affiliation(s)
- Igor V P Dos S Barreto
- Laboratory of Experimental and Applied Exercise Physiology, Department of Physiology and Pharmacology, Federal Fluminense University, Brazil
| | - Gabriel D Rodrigues
- Laboratory of Experimental and Applied Exercise Physiology, Department of Physiology and Pharmacology, Federal Fluminense University, Brazil; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Josie de S Oliveira
- Laboratory of Experimental and Applied Exercise Physiology, Department of Physiology and Pharmacology, Federal Fluminense University, Brazil
| | - Eduardo B Neves
- Graduate Program in Biomedical Engineering, Federal Technological University of Paraná, Curitiba, Brazil
| | - Pedro Paulo da S Soares
- Laboratory of Experimental and Applied Exercise Physiology, Department of Physiology and Pharmacology, Federal Fluminense University, Brazil.
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Panerai RB, Brassard P, Burma JS, Castro P, Claassen JA, van Lieshout JJ, Liu J, Lucas SJ, Minhas JS, Mitsis GD, Nogueira RC, Ogoh S, Payne SJ, Rickards CA, Robertson AD, Rodrigues GD, Smirl JD, Simpson DM. Transfer function analysis of dynamic cerebral autoregulation: A CARNet white paper 2022 update. J Cereb Blood Flow Metab 2023; 43:3-25. [PMID: 35962478 PMCID: PMC9875346 DOI: 10.1177/0271678x221119760] [Citation(s) in RCA: 34] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Cerebral autoregulation (CA) refers to the control of cerebral tissue blood flow (CBF) in response to changes in perfusion pressure. Due to the challenges of measuring intracranial pressure, CA is often described as the relationship between mean arterial pressure (MAP) and CBF. Dynamic CA (dCA) can be assessed using multiple techniques, with transfer function analysis (TFA) being the most common. A 2016 white paper by members of an international Cerebrovascular Research Network (CARNet) that is focused on CA strove to improve TFA standardization by way of introducing data acquisition, analysis, and reporting guidelines. Since then, additional evidence has allowed for the improvement and refinement of the original recommendations, as well as for the inclusion of new guidelines to reflect recent advances in the field. This second edition of the white paper contains more robust, evidence-based recommendations, which have been expanded to address current streams of inquiry, including optimizing MAP variability, acquiring CBF estimates from alternative methods, estimating alternative dCA metrics, and incorporating dCA quantification into clinical trials. Implementation of these new and revised recommendations is important to improve the reliability and reproducibility of dCA studies, and to facilitate inter-institutional collaboration and the comparison of results between studies.
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Affiliation(s)
- Ronney B Panerai
- Department of Cardiovascular Sciences, University of Leicester and NIHR Biomedical Research Centre, Leicester, UK
| | - Patrice Brassard
- Department of Kinesiology, Faculty of Medicine, and Research Center of the Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, QC, Canada
| | - Joel S Burma
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Pedro Castro
- Department of Neurology, Centro Hospitalar Universitário de São João, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Jurgen Ahr Claassen
- Department of Geriatric Medicine and Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Johannes J van Lieshout
- Department of Internal Medicine, Amsterdam, UMC, The Netherlands and Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, University of Nottingham Medical School, Queen's Medical Centre, UK
| | - Jia Liu
- Institute of Advanced Computing and Digital Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen University Town, Shenzhen, China
| | - Samuel Je Lucas
- School of Sport, Exercise and Rehabilitation Sciences and Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Jatinder S Minhas
- Department of Cardiovascular Sciences, University of Leicester and NIHR Biomedical Research Centre, Leicester, UK
| | - Georgios D Mitsis
- Department of Bioengineering, McGill University, Montreal, Québec, QC, Canada
| | - Ricardo C Nogueira
- Neurology Department, School of Medicine, Hospital das Clinicas, University of São Paulo, São Paulo, Brazil
| | - Shigehiko Ogoh
- Department of Biomedical Engineering, Toyo University, Kawagoe-Shi, Saitama, Japan
| | - Stephen J Payne
- Institute of Applied Mechanics, National Taiwan University, Taipei
| | - Caroline A Rickards
- Department of Physiology & Anatomy, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Andrew D Robertson
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Gabriel D Rodrigues
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Jonathan D Smirl
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - David M Simpson
- Institute of Sound and Vibration Research, University of Southampton, Southampton, UK
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Ferreira FC, Padilha MCSV, Tobadini E, Bellocchi C, Carandina A, Montano N, Soares PPS, Rodrigues GD. Women have a greater cardiac vagal withdrawal to heat stress compared to men. Temperature (Austin) 2022; 10:444-453. [PMID: 38130655 PMCID: PMC10732604 DOI: 10.1080/23328940.2022.2135354] [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: 07/25/2022] [Accepted: 10/07/2022] [Indexed: 10/31/2022] Open
Abstract
The heated environment shifts the sympatho-vagal balance toward sympathetic predominance and vagal withdrawal. Women's heart is more reliant on vagal autonomic control, while men's heart is more dependent on sympathetic control. However, sex differences in cardiovascular autonomic responses to heat stress remain unknown. We aimed to investigate the cardiovascular autonomic regulation under heat stress between sexes. Thirty-two young participants (27 ± 4 years old; 16 women) were enrolled in a single visit, resting for 30min at baseline (thermal reference condition TC; ∼24°C) and 30min under a heated environment (HOT; ∼38°C). Blood pressure (BP), skin temperature, electrocardiogram, and respiratory oscillations were continuously recorded. The heart rate variability (HRV) was assessed by spectral analysis (low-frequency [LFnu; sympathetic and vagal] and high-frequency [HFnu; vagal]), and symbolic analysis (0 V% [sympathetic] and 2UV%, and 2LV% [vagal]). The spontaneous baroreflex sensitivity (BRS) was calculated by the gain between BP and R-R within the LF band (αLF). The estimated maximal aerobic capacity and body surface area were employed as covariates in sex comparisons. The effects of HOT were the following: 1) Women have a greater cardiac vagal withdrawal to heat stress compared to men; 2) Sex differences on cardiac autonomic response to heat stress exist after controlling for the effect of estimated physical fitness and body surface area. Therefore, heat stress provokes a higher vagal withdrawal to the heart in women compared to men. It could be attributed to sex per se since significant differences between men and women were not modified after covariate analysis.
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Affiliation(s)
- Felipe C. Ferreira
- Laboratory of Experimental and Applied Exercise Physiology, Department of Physiology and Pharmacology, Fluminense Federal University, Niterói, Brazil
| | - Michelle Cristina S. V. Padilha
- Laboratory of Experimental and Applied Exercise Physiology, Department of Physiology and Pharmacology, Fluminense Federal University, Niterói, Brazil
| | - Eleonora Tobadini
- Department of Clinical Sciences and Community Health, University of Milan, 20122Milan, Italy
- Department of Internal Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122Milan, Italy
| | - Chiara Bellocchi
- Department of Clinical Sciences and Community Health, University of Milan, 20122Milan, Italy
- Department of Internal Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122Milan, Italy
| | - Angelica Carandina
- Department of Clinical Sciences and Community Health, University of Milan, 20122Milan, Italy
- Department of Internal Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122Milan, Italy
| | - Nicola Montano
- Department of Clinical Sciences and Community Health, University of Milan, 20122Milan, Italy
- Department of Internal Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122Milan, Italy
| | - Pedro Paulo S. Soares
- Laboratory of Experimental and Applied Exercise Physiology, Department of Physiology and Pharmacology, Fluminense Federal University, Niterói, Brazil
| | - Gabriel D. Rodrigues
- Laboratory of Experimental and Applied Exercise Physiology, Department of Physiology and Pharmacology, Fluminense Federal University, Niterói, Brazil
- Department of Clinical Sciences and Community Health, University of Milan, 20122Milan, Italy
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Rodrigues GD, Vicenzi M, Bellocchi C, Beretta L, Carandina A, Tobaldini E, Carugo S, Montano N. The Systolic Pulmonary Arterial Pressure Liaises Impaired Cardiac Autonomic Control to Pro-inflammatory Status in Systemic Sclerosis Patients. Front Cardiovasc Med 2022; 9:899290. [PMID: 35845065 PMCID: PMC9283676 DOI: 10.3389/fcvm.2022.899290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/26/2022] [Indexed: 11/29/2022] Open
Abstract
The current study was undertaken to test the hypothesis that systemic sclerosis (SSc) patients with higher systolic pulmonary arterial pressures (PAPs) present a blunted cardiac autonomic modulation and a pro-inflammatory profile. Thirty-nine SSc patients were enrolled (mean age 57 ± 11 years). ECG and respiration were recorded in the supine (SUP) position and during the active standing (ORT). Heart rate variability (HRV) analysis was performed on samples of 300 beats. The symbolic analysis identified three patterns, 0V%, (sympathetic) and 2UV% and 2LV%, (vagal). The %ΔORT was calculated from the differences between HRV in ORT and SUP, normalized (%) by the HRV values at rest. The PAPs was obtained non-invasively through echocardiography. For the inter-group analysis, participants were allocated in groups with higher (+PAPs ≥ median) and lower PAPs (–PAPs < median) values. At rest, the cardiac sympathetic modulation (represented by 0V%) was positively correlated with PAPs, while parasympathetic modulation (represented by 2LV%) was negatively correlated with PAPs. The dynamic response to ORT (represented by Δ0V% and Δ2LV%), sympathetic and parasympathetic were negatively and positively correlated with PAPs, respectively. The +PAPs group presented a higher inflammatory status and a blunted cardiac autonomic response to ORT (↓Δ0V% and ↑Δ2LV%) compared to the –PAPs group. These findings suggest an interplay among cardiac autonomic control, inflammatory status, and cardiopulmonary mechanics that should be considered for the assessment, monitoring, and treatment of SSc patients.
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Affiliation(s)
- Gabriel D. Rodrigues
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Post Graduation Program in Cardiovascular Sciences, Federal Fluminense University, Niterói, Brazil
- *Correspondence: Gabriel D. Rodrigues,
| | - Marco Vicenzi
- Cardiovascular Disease Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Dyspnea Lab, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Chiara Bellocchi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Department of Internal Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Lorenzo Beretta
- Department of Internal Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Angelica Carandina
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Department of Internal Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Eleonora Tobaldini
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Department of Internal Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefano Carugo
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Cardiovascular Disease Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Nicola Montano
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Department of Internal Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
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Rodrigues GD, Gurgel JL, Gonçalves TR, Soares PPDAS. The Physical Capacity of Rowing Athletes Cannot Reverse the Influence of Age on Heart Rate Variability during Orthostatic Stress. AN ACAD BRAS CIENC 2021; 93:e20201677. [PMID: 34730742 DOI: 10.1590/0001-3765202120201677] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 01/26/2021] [Indexed: 11/22/2022] Open
Abstract
The current study was undertaken to test the hypothesis that the high physical capacity of rowing athletes may not reverse the influence of age on cardiac autonomic control decline estimated by heart rate variability (HRV). Forty-four male subjects divided in four groups: 11 young athletes (YA; 18 ±1 year), 11 young non-athletes (YNA; 20 ±1 year), 11 middle age athletes (MAA; 43 ±6 years) and 11 middle age non-athletes (MNA; 44 ±8 years) participated in the study. Heart rate (HR) was recorded beat-by-beat for 10 minutes in supine (SUP) and 10 min in orthostatic (ORT) positions. HRV was analyzed in the frequency domain to obtain the spectral power in the high (HF) and low frequency (LF) bands, and the changes to ORT (%∆HRV) were calculated (ORT - SUP / SUP). During SUP, HF was lower in MNA and MA compared to YA and YNA, while LF was lower in MNA than YA. For %ΔHRV, %ΔHF was higher in YA than YNA, MA and MNA. The %ΔLF was not different among groups. In conclusion, aging seems to overcome the influence of physical fitness on neural regulation of the heart, as highlighted by the HRV response to active standing.
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Affiliation(s)
- Gabriel D Rodrigues
- Universidade Federal Fluminense, Departmento de Fisiologia e Farmacologia, Rua Professor Hernani Pires de Melo, 101, São Domingos, 24210-130 Niterói, RJ, Brazil
| | - Jonas L Gurgel
- Universidade Federal Fluminense, Departamento de Educação Física e Esportes, Rua Professor Marcos Waldemar de Freitas Reis, s/n, São Domingos, 24210-201 Niterói, RJ, Brazil
| | - Thiago R Gonçalves
- Universidade Federal Fluminense, Departmento de Fisiologia e Farmacologia, Rua Professor Hernani Pires de Melo, 101, São Domingos, 24210-130 Niterói, RJ, Brazil
| | - Pedro Paulo DA S Soares
- Universidade Federal Fluminense, Departmento de Fisiologia e Farmacologia, Rua Professor Hernani Pires de Melo, 101, São Domingos, 24210-130 Niterói, RJ, Brazil
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7
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Tobaldini E, Rodrigues GD, Mantoan G, Monti A, Zelati GC, Furlan L, Tarsia P, Morlacchi LC, Rossetti V, Righi I, Rosso L, Nosotti M, Soares PPS, Montano N, Aliberti S, Blasi F. Effects of bilateral lung transplantation on cardiac autonomic modulation and cardiorespiratory coupling: a prospective study. Respir Res 2021; 22:156. [PMID: 34020646 PMCID: PMC8140499 DOI: 10.1186/s12931-021-01752-6] [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: 12/11/2020] [Accepted: 05/17/2021] [Indexed: 11/16/2022] Open
Abstract
Background Although cardiac autonomic modulation has been studied in several respiratory diseases, the evidence is limited on lung transplantation, particularly on its acute and chronic effects. Thus, we aimed to evaluate cardiac autonomic modulation before and after bilateral lung transplantation (BLT) through a prospective study on patients enrolled while awaiting transplant. Methods Twenty-two patients on the waiting list for lung transplantation (11 women, age 33 [24–51] years) were enrolled in a prospective study at Ospedale Maggiore Policlinico Hospital in Milan, Italy. To evaluate cardiac autonomic modulation, ten minutes ECG and respiration were recorded at different time points before (T0) and 15 days (T1) and 6 months (T2) after bilateral lung transplantation. As to the analysis of cardiac autonomic modulation, heart rate variability (HRV) was assessed using spectral and symbolic analysis. Entropy-derived measures were used to evaluate complexity of cardiac autonomic modulation. Comparisons of autonomic indices at different time points were performed. Results BLT reduced HRV total power, HRV complexity and vagal modulation, while it increased sympathetic modulation in the acute phase (T1) compared to baseline (T0). The HRV alterations remained stable after 6 months (T2). Conclusion BLT reduced global variability and complexity of cardiac autonomic modulation in acute phases, and these alterations remain stable after 6 months from surgery. After BLT, a sympathetic predominance and a vagal withdrawal could be a characteristic autonomic pattern in this population. Supplementary Information The online version contains supplementary material available at 10.1186/s12931-021-01752-6.
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Affiliation(s)
- E Tobaldini
- Department of Internal Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Francesco Sforza St, 35, 20122, Milan, Italy
| | - G D Rodrigues
- Department of Physiology and Pharmacology, Biomedical Institute, Fluminense Federal University, Niterói, 24210-130, Brazil
| | - G Mantoan
- Department of Internal Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Francesco Sforza St, 35, 20122, Milan, Italy
| | - A Monti
- Department of Internal Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Francesco Sforza St, 35, 20122, Milan, Italy
| | - G Coti Zelati
- Department of Internal Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Francesco Sforza St, 35, 20122, Milan, Italy
| | - Ludovico Furlan
- Department of Internal Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Francesco Sforza St, 35, 20122, Milan, Italy
| | - P Tarsia
- Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, 20122, Milan, Italy
| | - L C Morlacchi
- Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, 20122, Milan, Italy
| | - V Rossetti
- Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, 20122, Milan, Italy
| | - I Righi
- Thoracic Surgery and Lung Transplantation Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122, Milan, Italy
| | - L Rosso
- Thoracic Surgery and Lung Transplantation Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122, Milan, Italy
| | - M Nosotti
- Thoracic Surgery and Lung Transplantation Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122, Milan, Italy
| | - P P S Soares
- Department of Physiology and Pharmacology, Biomedical Institute, Fluminense Federal University, Niterói, 24210-130, Brazil
| | - N Montano
- Department of Internal Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122, Milan, Italy. .,Department of Clinical Sciences and Community Health, University of Milan, Francesco Sforza St, 35, 20122, Milan, Italy.
| | - S Aliberti
- Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, 20122, Milan, Italy
| | - F Blasi
- Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, 20122, Milan, Italy
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8
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Tobaldini E, Rodrigues GD, Mantoan G, Monti A, Coti Zelati G, Cirelli C, Tarsia P, Morlacchi LC, Rossetti V, Righi I, Nosotti M, da S. Soares PP, Montano N, Aliberti S, Blasi F. Sympatho-Vagal Dysfunction in Patients with End-Stage Lung Disease Awaiting Lung Transplantation. J Clin Med 2020; 9:jcm9041146. [PMID: 32316428 PMCID: PMC7230240 DOI: 10.3390/jcm9041146] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 03/27/2020] [Accepted: 04/09/2020] [Indexed: 01/28/2023] Open
Abstract
Although the literature demonstrates that cardiac autonomic control (CAC) might be impaired in patients with chronic pulmonary diseases, the interplay between CAC and disease severity in end-stage lung disease has not been studied yet. We investigated the effects of end-stage lung disease on CAC through the analysis of heart rate variability (HRV) among patients awaiting lung transplantation. Forty-nine patients on the waiting list for lung transplantation (LTx; 19 men, age 38 ± 15 years) and 49 healthy non-smoking controls (HC; 22 men, age 40 ± 16 years) were enrolled in a case-control study at Policlinico Hospital in Milan, Italy. LTx patients were divided into two groups, according to disease severity evaluated by the Lung Allocation Score (LAS). To assess CAC, electrocardiogram (ECG) and respiration were recorded at rest for 10 min in supine position and for 10 min during active standing. Spectral analysis identified low and high frequencies (LF, sympathetic, and HF, vagal). Symbolic analysis identified three patterns, i.e., 0V% (sympathetic) and 2UV% and 2LV% (vagal). Compared to HCs, LTx patients showed higher markers of sympathetic modulation and lower markers of vagal modulation. However, more severely affected LTx patients, compared to less severely affected ones, showed an autonomic profile characterized by loss of sympathetic modulation and predominant vagal modulation. This pattern can be due to a loss of sympathetic rhythmic oscillation and a subsequent prevalent respiratory modulation of heart rate in severely affected patients.
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Affiliation(s)
- Eleonora Tobaldini
- Department of Internal Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (E.T.); (G.M.); (A.M.); (G.C.Z.); (C.C.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Gabriel D. Rodrigues
- Department of Physiology and Pharmacology, Biomedical Institute, Fluminense Federal University, Niterói 24210-130, Brazil; (G.D.R.); (P.P.d.S.S.)
| | - Giorgio Mantoan
- Department of Internal Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (E.T.); (G.M.); (A.M.); (G.C.Z.); (C.C.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Alice Monti
- Department of Internal Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (E.T.); (G.M.); (A.M.); (G.C.Z.); (C.C.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Giulia Coti Zelati
- Department of Internal Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (E.T.); (G.M.); (A.M.); (G.C.Z.); (C.C.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Camilla Cirelli
- Department of Internal Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (E.T.); (G.M.); (A.M.); (G.C.Z.); (C.C.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Paolo Tarsia
- Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (P.T.); (L.C.M.); (V.R.); (S.A.); (F.B.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Letizia Corinna Morlacchi
- Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (P.T.); (L.C.M.); (V.R.); (S.A.); (F.B.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Valeria Rossetti
- Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (P.T.); (L.C.M.); (V.R.); (S.A.); (F.B.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Ilaria Righi
- Thoracic Surgery and Lung Transplantation Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (I.R.); (M.N.)
| | - Mario Nosotti
- Thoracic Surgery and Lung Transplantation Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (I.R.); (M.N.)
| | - Pedro Paulo da S. Soares
- Department of Physiology and Pharmacology, Biomedical Institute, Fluminense Federal University, Niterói 24210-130, Brazil; (G.D.R.); (P.P.d.S.S.)
| | - Nicola Montano
- Department of Internal Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (E.T.); (G.M.); (A.M.); (G.C.Z.); (C.C.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
- Correspondence: ; Tel.: +39-025-503-5583
| | - Stefano Aliberti
- Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (P.T.); (L.C.M.); (V.R.); (S.A.); (F.B.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Francesco Blasi
- Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (P.T.); (L.C.M.); (V.R.); (S.A.); (F.B.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
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9
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Rodrigues GD, Gurgel JL, Gonçalves TR, Porto F, Soares PPDS. Influence of breathing patterns and orthostatic stress on postural control in older adults. Geriatr Gerontol Int 2018; 18:692-697. [PMID: 29356276 DOI: 10.1111/ggi.13231] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 10/19/2017] [Accepted: 11/13/2017] [Indexed: 12/13/2022]
Abstract
AIM To investigate the influence of breathing patterns and blood pressure behavior postural control in older adults. METHODS A total of 20 older adults carried out spontaneous, controlled (15 cycles/min) and deep (6 cycles/min) breathing trials, in random order. In this session, the heart rate was recorded continuously and blood pressure measured every 3 min. In addition, the challenge from sitting to an active standing position was carried out with eyes closed during 6 min on a baropodometer plate with electromyography recording. The root mean square (RMS) of electromyography was calculated. RESULTS There were significant differences in the postural control with spontaneous breathing from the first minute (center of pressure [COP]-area 216.40 ± 116.70 mm2 ) in comparison with the third minute (COP-area 79.35 ± 68.11 mm2 ; d = 0.89; P < 0.01) and the sixth minute (COP-area 70.24 ± 41.26 mm2 ; d = 0.60; P < 0.05) of active standing. Furthermore, deep breathing significantly increases the COP-area (158.50 ± 126.2 mm2 ) at the sixth minute of active standing in comparison with spontaneous breathing (70.24 ± 41.26 mm2 ; d = 0.80; P < 0.01). There were also significant differences in systolic blood pressure during spontaneous breathing between the baseline measures (sitting position 123 ± 11 mmHg) and the first minute of active standing (117 ± 13 mmHg; d = 0.24; P < 0.05). Furthermore, electromyography activity of the tibialis anterior increased during the deep (17.52 ± 9.21 RMS) and controlled breathing (16.75 ± 5.26 RMS) compared with the spontaneous condition (14.93 ± 5.56 RMS; d = 0.17; P < 0.05). CONCLUSIONS The present data provide important insight into the respiratory and hemodynamics effects of postural control in older adults. The current data confirm that deep breathing causes periodic perturbation in the neuromuscular compensation of the lower limbs. Geriatr Gerontol Int 2018; 18: 692-697.
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Affiliation(s)
- Gabriel D Rodrigues
- Department of Physiology and Pharmacology, Fluminense Federal University, Niterói, Brazil
| | - Jonas L Gurgel
- Department of Physical Education and Sports, Fluminense Federal University, Niterói, Brazil
| | - Thiago R Gonçalves
- Department of Physiology and Pharmacology, Fluminense Federal University, Niterói, Brazil
| | - Flávia Porto
- Institute of Physical Education and Sports, Rio de Janeiro State University, Rio de Janeiro, Brazil
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10
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Vianna LC, Teixeira AL, Santos TS, Rodrigues GD, Bezerra LA, Soares PP, Oliveira RJ. Symbolic dynamics of heart rate variability in Parkinson's disease patients with orthostatic hypotension. Int J Cardiol 2016; 225:144-146. [PMID: 27721119 DOI: 10.1016/j.ijcard.2016.09.091] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 07/23/2016] [Accepted: 09/24/2016] [Indexed: 11/24/2022]
Affiliation(s)
- Lauro C Vianna
- Faculty of Physical Education, University of Brasília, DF, Brazil.
| | - André L Teixeira
- Faculty of Physical Education, University of Brasília, DF, Brazil
| | - Tácio S Santos
- Faculty of Physical Education, University of Brasília, DF, Brazil
| | - Gabriel D Rodrigues
- Department of Physiology and Pharmacology, Fluminense Federal University, RJ, Brazil
| | - Lidia A Bezerra
- Faculty of Physical Education, University of Brasília, DF, Brazil
| | - Pedro P Soares
- Department of Physiology and Pharmacology, Fluminense Federal University, RJ, Brazil
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11
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de Sousa SC, S Soares PP, Rodrigues GD, Gonçalves TR. Perceived Exertion During Isocaloric Continuous And Interval Training Aerobic Exercise Sessions. Med Sci Sports Exerc 2015. [DOI: 10.1249/01.mss.0000477435.92673.7e] [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: 11/21/2022]
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12
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Cordeiro AC, Moraes AA, Cerutti V, França F, Quiroga B, Amodeo C, Picotti JC, Dutra LV, Rodrigues GD, Amparo FC, Lindholm B, Carrero JJ. Clinical determinants and prognostic significance of the electrocardiographic strain pattern in chronic kidney disease patients. ACTA ACUST UNITED AC 2014; 8:312-20. [DOI: 10.1016/j.jash.2014.02.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 02/21/2014] [Accepted: 02/23/2014] [Indexed: 12/12/2022]
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13
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Rodrigues GD, Gonçalves TR, De Souza SC, Da Silva Soares PP. Comparison of Cardiac Vagal Modulation From the Orthostatic Stress Test Between Untrained Individuals and Athletes. Med Sci Sports Exerc 2014. [DOI: 10.1249/01.mss.0000494205.70884.8a] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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14
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Abstract
Non-Hodgkin lymphomas associated with acquired immunodeficiency syndrome are heterogeneous. Recently, a novel subtype of non-Hodgkin lymphoma occurring mostly in patients with acquired immunodeficiency syndrome has been described and designated as plasmablastic lymphoma. The histomorphologic and immunophenotypic findings of this distinct subtype of non-Hodgkin lymphoma have been characterized previously. Most patients present with oral cavity involvement. We report a case of plasmablastic lymphoma presenting as a lung tumor. To our knowledge, this is the first case report of this unusual subtype of diffuse large B-cell lymphoma in this location.
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MESH Headings
- Acquired Immunodeficiency Syndrome/complications
- Antibodies, Monoclonal
- DNA, Viral/analysis
- Herpesvirus 4, Human/genetics
- Humans
- Immunohistochemistry
- Immunophenotyping
- In Situ Hybridization
- Lung Neoplasms/diagnosis
- Lung Neoplasms/immunology
- Lung Neoplasms/pathology
- Lung Neoplasms/virology
- Lymphoma, AIDS-Related/diagnosis
- Lymphoma, AIDS-Related/immunology
- Lymphoma, AIDS-Related/pathology
- Lymphoma, AIDS-Related/virology
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/pathology
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Membrane Glycoproteins/analysis
- Middle Aged
- Plasma Cells/pathology
- Proteoglycans/analysis
- Syndecans
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Affiliation(s)
- Y Lin
- Department of Pathology, University of Iowa College of Medicine, Iowa City, USA
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