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Belinchón-deMiguel P, Navarro-Jiménez E, Laborde-Cárdenas CC, Clemente-Suárez VJ. Evolutionary Echoes: A Four-Day Fasting and Low-Caloric Intake Study on Autonomic Modulation and Physiological Adaptations in Humans. Life (Basel) 2024; 14:456. [PMID: 38672727 PMCID: PMC11051148 DOI: 10.3390/life14040456] [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: 03/01/2024] [Revised: 03/18/2024] [Accepted: 03/18/2024] [Indexed: 04/28/2024] Open
Abstract
This study evaluates the psychophysiological response to a simulated hunter-gatherer endurance task with restricted caloric intake over four days. It assesses changes in body composition, autonomic modulation, and physical and cognitive performance. Participants underwent daily 8 h fasted walks followed by a 150 kcal meal to replicate hunter-gatherer activity and dietary patterns. Measurements of metabolic, respiratory, and subjective well-being, along with heart rate variability (HRV) monitoring, were conducted pre- and post-activity to evaluate the impact of endurance activity under caloric restriction. We found weight loss, decreased body and visceral fat, and reduced skeletal muscle mass and water percentage. High sympathetic activation and stable urinary markers, except for increased proteinuria, indicated stress responses and muscular degradation. Elevated perceived exertion post-exercise with good adaptation to prolonged effort underlines the body's adaptability to ancestral lifestyle conditions, highlighting the connection among endurance, nutrition, and psychophysiological health.
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Affiliation(s)
- Pedro Belinchón-deMiguel
- Department of Nursing, Faculty of Sport Sciences and Physiotherapy, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain;
| | - Eduardo Navarro-Jiménez
- Grupo de Investigacion en Microbiología y Biotecnología (IMB), Universidad Libre, Barranquilla 080003, Colombia;
| | | | - Vicente Javier Clemente-Suárez
- Department of Nursing, Faculty of Sport Sciences and Physiotherapy, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain;
- Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla 080002, Colombia
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Stavrakis S, Chakraborty P, Farhat K, Whyte S, Morris L, Abideen Asad ZU, Karfonta B, Anjum J, Matlock HG, Cai X, Yu X. Noninvasive Vagus Nerve Stimulation in Postural Tachycardia Syndrome: A Randomized Clinical Trial. JACC Clin Electrophysiol 2024; 10:346-355. [PMID: 37999672 DOI: 10.1016/j.jacep.2023.10.015] [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: 04/04/2023] [Revised: 09/18/2023] [Accepted: 10/17/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Low-level transcutaneous stimulation of the auricular branch of the vagus nerve at the tragus is antiarrhythmic and anti-inflammatory in animals and humans. Preliminary studies show that transcutaneous vagus nerve stimulation (tVNS) is beneficial in animal models of postural tachycardia syndrome (POTS). OBJECTIVES In this study the authors conducted a sham-controlled, double-blind, randomized clinical trial to examine the effect of tVNS on POTS over a 2-month period relative to sham stimulation. METHODS tVNS (20 Hz, 1 mA below discomfort threshold) was delivered using an ear clip attached to either the tragus (active; n = 12) or the ear lobe (sham; n = 14) for 1 hour daily over a 2-month period. Postural tachycardia was assessed during the baseline and 2-month visit. Heart rate variability based on 5-minute electrocardiogram, serum cytokines, and antiautonomic autoantibodies were measured at the respective time points. RESULTS Mean age was 34 ± 11 years (100% female; 81% Caucasian). Adherence to daily stimulation was 83% in the active arm and 86% in the sham arm (P > 0.05). Postural tachycardia was significantly less in the active arm compared with the sham arm at 2 months (mean postural increase in heart rate 17.6 ± 9.9 beats/min vs 31.7 ± 14.4 beats/min; P = 0.01). Antiadrenergic autoantibodies and inflammatory cytokines were lower in the active arm compared with the sham arm at 2 months (P < 0.05). Heart rate variability was better in the active arm. No device-related side effects were observed. CONCLUSIONS Our results support the emerging paradigm of noninvasive neuromodulation to treat POTS. Mechanistically, this effect appears to be related to reduction of antiautonomic autoantibodies and inflammatory cytokines, and improvement in autonomic tone. Further studies are warranted. (Autoimmune Basis for Postural Tachycardia Syndrome; NCT05043051).
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Affiliation(s)
- Stavros Stavrakis
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
| | | | - Kassem Farhat
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Seabrook Whyte
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Lynsie Morris
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | | | - Brittany Karfonta
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Juvaria Anjum
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - H Greg Matlock
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Xue Cai
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Xichun Yu
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
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Yuan C, Wu S, Wu Y, Tian C, Wang Z, Zhang X. Effects of Traditional Chinese Medicine "Fuzheng Qingdu Decoction" on Autonomic Function and Cancer-Related Symptoms in Patients with Advanced Gastric Cancer undergoing Chemotherapy: A Controlled Trial. Integr Cancer Ther 2024; 23:15347354241229414. [PMID: 38323452 PMCID: PMC10851715 DOI: 10.1177/15347354241229414] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 12/16/2023] [Accepted: 01/15/2024] [Indexed: 02/08/2024] Open
Abstract
OBJECTIVE To evaluate the effects of Fuzheng Qingdu Decoction (FZQDD) on the autonomic function and cancer-related symptoms of patients with advanced gastric cancer undergoing chemotherapy to verify its clinical efficacy. METHODS Sixty-two patients with stage III or IV gastric cancer were included in this study. The patients were divided into 2 groups: the chemotherapy (33 patients) and chemotherapy with FZQDD (29 patients) groups. The primary outcome was the autonomic function of the patients before and after the interventions. The parameters that were used to assess autonomic function were deceleration capacity (DC) and acceleration capacity (AC) of heart rate and heart rate variability (HRV), which comprised standard deviation of the normal-normal interval (SDNN), root mean square of successive interval differences (RMSSD), low-frequency power (LF), high-frequency power (HF), total power (TP), and LF-HF ratio. The secondary outcomes were cancer-related symptoms and the quality of life. RESULTS DC and HRV parameters (ie, SDNN, RMSSD, LF, HF, and TP) were significantly decreased in the chemotherapy group; however, AC significantly increased after the interventions. No significant differences were observed in the DC, AC, and HRV parameters before and after the interventions in the chemotherapy with FZQDD group. Nevertheless, the changes in DC, AC, and HRV parameters (SDNN, RMSSD, HF, and TP) before and after the interventions were statistically significant between both the groups. FZQDD significantly improved the cancer-related symptoms and the quality of life of the patients. CONCLUSIONS Oxaliplatin combined with S-1 (tegafur, gimeracil, and oteracil potassium) can impair autonomic modulation in patients with advanced gastric cancer. FZQDD can alleviate autonomic dysfunction by increasing the parasympathetic activity and decreasing the sympathetic tone, helping patients restore the dynamic sympathovagal balance, and significantly improving the cancer-related symptoms and the quality of life of patients.
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Affiliation(s)
- Chengjia Yuan
- Clinical Traditional Chinese Medical College, Yangzhou University, Yangzhou, Jiangsu, China
| | - Shuang Wu
- Clinical Traditional Chinese Medical College, Yangzhou University, Yangzhou, Jiangsu, China
| | - Yang Wu
- Clinical Traditional Chinese Medical College, Yangzhou University, Yangzhou, Jiangsu, China
| | - Cuiling Tian
- Clinical Traditional Chinese Medical College, Yangzhou University, Yangzhou, Jiangsu, China
| | - Zaichuan Wang
- Clinical Traditional Chinese Medical College, Yangzhou University, Yangzhou, Jiangsu, China
| | - Xiaochun Zhang
- Clinical Traditional Chinese Medical College, Yangzhou University, Yangzhou, Jiangsu, China
- Yangzhou Hospital of Traditional Chinese Medicine, Yangzhou, Jiangsu, China
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Wu S, Guan W, Zhao H, Li G, Zhou Y, Shi B, Zhang X. Prognostic role of short-term heart rate variability and deceleration/acceleration capacities of heart rate in extensive-stage small cell lung cancer. Front Physiol 2023; 14:1277383. [PMID: 38028778 PMCID: PMC10663334 DOI: 10.3389/fphys.2023.1277383] [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] [Received: 08/14/2023] [Accepted: 10/26/2023] [Indexed: 12/01/2023] Open
Abstract
Background: Prior research suggests that autonomic modulation investigated by heart rate variability (HRV) might act as a novel predictive biomarker for cancer prognosis, such as in breast cancer and pancreatic cancer. It is not clear whether there is a correlation between autonomic modulation and prognosis in patients with extensive-stage small cell lung cancer (ES-SCLC). Therefore, the purpose of the study was to examine the association between short-term HRV, deceleration capacity (DC) and acceleration capacity (AC) of heart rate and overall survival in patients with ES-SCLC. Methods: We recruited 40 patients with ES-SCLC, and 39 were included in the final analysis. A 5-min resting electrocardiogram of patients with ES-SCLC was collected using a microelectrocardiogram recorder to analyse short-term HRV, DC and AC. The following HRV parameters were used: standard deviation of the normal-normal intervals (SDNN) and root mean square of successive interval differences (RMSSD). Overall survival of patients with ES-SCLC was defined as time from the date of electrocardiogram measurement to the date of death or the last follow-up. Follow-up was last performed on 07 June 2023. There was a median follow-up time of 42.2 months. Results: Univariate analysis revealed that the HRV parameter SDNN, as well as DC significantly predicted the overall survival of ES-SCLC patients (all p < 0.05). Multivariate analysis showed that the HRV parameters SDNN (hazard ratio = 5.254, 95% CI: 1.817-15.189, p = 0.002), RMSSD (hazard ratio = 3.024, 95% CI: 1.093-8.372, p = 0.033), as well as DC (hazard ratio = 3.909, 95% CI: 1.353-11.293, p = 0.012) were independent prognostic factors in ES-SCLC patients. Conclusion: Decreased HRV parameters (SDNN, RMSSD) and DC are independently associated with shorter overall survival in ES-SCLC patients. Autonomic nervous system function (assessed based on HRV and DC) may be a new biomarker for evaluating the prognosis of patients with ES-SCLC.
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Affiliation(s)
- Shuang Wu
- School of Medicine, Yangzhou University, Yangzhou, Jiangsu, China
- Department of Radiation Oncology, First Affiliated Hospital, Bengbu Medical College, Bengbu, Anhui, China
| | - Weizheng Guan
- School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, China
- Anhui Key Laboratory of Computational Medicine and Intelligent Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Huan Zhao
- School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, China
- Anhui Key Laboratory of Computational Medicine and Intelligent Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Guangqiao Li
- School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, China
- Anhui Key Laboratory of Computational Medicine and Intelligent Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Yufu Zhou
- Department of Radiation Oncology, First Affiliated Hospital, Bengbu Medical College, Bengbu, Anhui, China
| | - Bo Shi
- School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, China
- Anhui Key Laboratory of Computational Medicine and Intelligent Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Xiaochun Zhang
- School of Medicine, Yangzhou University, Yangzhou, Jiangsu, China
- Department of Oncology, Yangzhou Hospital of Traditional Chinese Medicine, Yangzhou, Jiangsu, China
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Wu S, Guan W, Zhao H, Li G, Zhou Y, Shi B, Zhang X. Assessment of short-term effects of thoracic radiotherapy on the cardiovascular parasympathetic and sympathetic nervous systems. Front Neurosci 2023; 17:1256067. [PMID: 37732299 PMCID: PMC10507252 DOI: 10.3389/fnins.2023.1256067] [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] [Received: 07/10/2023] [Accepted: 08/22/2023] [Indexed: 09/22/2023] Open
Abstract
Background Prior research suggests that cardiovascular autonomic dysfunction might be an early marker of cardiotoxicity induced by antitumor treatment and act as an early predictor of cardiovascular disease-related morbidity and mortality. The impact of thoracic radiotherapy on the parasympathetic and sympathetic nervous systems, however, remains unclear. Therefore, this study aimed to evaluate the short-term effects of thoracic radiotherapy on the autonomic nervous system, using deceleration capacity (DC), acceleration capacity (AC) of heart rate, and heart rate variability (HRV) as assessment tools. Methods A 5 min electrocardiogram was collected from 58 thoracic cancer patients before and after thoracic radiotherapy for DC, AC, and HRV analysis. HRV parameters employed included the standard deviation of the normal-normal interval (SDNN), root mean square of successive interval differences (RMSSD), low frequency power (LF), high frequency power (HF), total power (TP), and the LF to HF ratio. Some patients also received systemic therapies alongside radiotherapy; thus, patients were subdivided into a radiotherapy-only group (28 cases) and a combined radiotherapy and systemic therapies group (30 cases) for additional subgroup analysis. Results Thoracic radiotherapy resulted in a significant reduction in DC (8.5 [5.0, 14.2] vs. 5.3 [3.5, 9.4], p = 0.002) and HRV parameters SDNN (9.9 [7.03, 16.0] vs. 8.2 [6.0, 12.4], p = 0.003), RMSSD (9.9 [6.9, 17.5] vs. 7.7 [4.8, 14.3], p = 0.009), LF (29 [10, 135] vs. 24 [15, 50], p = 0.005), HF (35 [12, 101] vs. 16 [9, 46], p = 0.002), TP (74 [41, 273] vs. 50 [33, 118], p < 0.001), and a significant increase in AC (-8.2 [-14.8, -4.9] vs. -5.8 [-10.1, -3.3], p = 0.003) and mean heart rate (79.8 ± 12.6 vs. 83.9 ± 13.6, p = 0.010). Subgroup analysis indicated similar trends in mean heart rate, DC, AC, and HRV parameters (SDNN, RMSSD, LF, HF, TP) in both the radiotherapy group and the combined treatment group post-radiotherapy. No statistically significant difference was noted in the changes observed in DC, AC, and HRV between the two groups pre- and post-radiotherapy. Conclusion Thoracic radiotherapy may induce cardiovascular autonomic dysfunction by reducing parasympathetic activity and enhancing sympathetic activity. Importantly, the study found that the concurrent use of systemic therapies did not significantly amplify or contribute to the alterations in autonomic function in the short-term following thoracic radiotherapy. DC, AC and HRV are promising and feasible biomarkers for evaluating autonomic dysfunction caused by thoracic radiotherapy.
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Affiliation(s)
- Shuang Wu
- School of Medicine, Yangzhou University, Yangzhou, China
- Department of Radiation Oncology, First Affiliated Hospital, Bengbu Medical College, Bengbu, China
| | - Weizheng Guan
- School of Medical Imaging, Bengbu Medical College, Bengbu, China
- Anhui Key Laboratory of Computational Medicine and Intelligent Health, Bengbu Medical College, Bengbu, China
| | - Huan Zhao
- School of Medical Imaging, Bengbu Medical College, Bengbu, China
- Anhui Key Laboratory of Computational Medicine and Intelligent Health, Bengbu Medical College, Bengbu, China
| | - Guangqiao Li
- School of Medical Imaging, Bengbu Medical College, Bengbu, China
- Anhui Key Laboratory of Computational Medicine and Intelligent Health, Bengbu Medical College, Bengbu, China
| | - Yufu Zhou
- Department of Radiation Oncology, First Affiliated Hospital, Bengbu Medical College, Bengbu, China
| | - Bo Shi
- School of Medical Imaging, Bengbu Medical College, Bengbu, China
- Anhui Key Laboratory of Computational Medicine and Intelligent Health, Bengbu Medical College, Bengbu, China
| | - Xiaochun Zhang
- School of Medicine, Yangzhou University, Yangzhou, China
- Department of Oncology, Yangzhou Hospital of Traditional Chinese Medicine, Yangzhou, China
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Patel ABU, Bibawy PPWM, Althonayan JIM, Majeed Z, Gan WL, Abbott TEF, Ackland GL. Effect of transauricular nerve stimulation on perioperative pain: a single-blind, analyser-masked, randomised controlled trial. Br J Anaesth 2023; 130:468-476. [PMID: 36822987 PMCID: PMC10080471 DOI: 10.1016/j.bja.2022.12.025] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/05/2022] [Accepted: 12/22/2022] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND Activation of central autonomic pathways, including those regulating the arterial baroreflex, might reduce acute pain. We tested the hypothesis that transcutaneous auricular nerve stimulation (TAN) reduces pain after orthopaedic trauma surgery through autonomic modulation. METHODS A total of 86 participants aged >18 yr were randomly assigned to 50 min of either sham or active bilateral TAN, undertaken before, and again 24 h after, surgery for orthopaedic trauma. The primary outcome was absolute change in pain 24 h postoperatively, comparing the 100 mm visual analogue scale (VAS) before and after TAN. Secondary outcomes included the minimal clinically important difference in pain (>10 mm increase or reduction in VAS) before/after surgery, using intention-to-treat analysis. Holter monitoring, the analysis of which was masked to allocation, quantified autonomic modulation of heart rate. RESULTS From June 22, 2021 to July 7, 2022, 79/86 participants (49 yr; 45% female) completed TAN before and after surgery. For the primary outcome, the mean reduction in VAS was 19 mm (95% confidence interval [CI]: 12-26) after active TAN (n=40), vs 10 mm (95% CI: 3-17) after sham TAN (n=39; P=0.023). A minimally clinically important reduction in postoperative pain occurred in 31/40 (78%) participants after active TAN, compared with 15/39 (38%) allocated to sham TAN (odds ratio 5.51 [95% CI: 2.06-14.73]; P=0.001). Only active TAN increased heart rate variability (log low-frequency power increased by 0.19 ms2 [0.01-0.37 ms2]). Prespecified adverse events (auricular skin irritation) occurred in six participants receiving active TAN, compared with two receiving sham TAN. CONCLUSION Bilateral TAN reduces perioperative pain through autonomic modulation. These proof-of-concept data support a non-pharmacological, generalisable approach to improve perioperative analgesia.
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Affiliation(s)
- Amour B U Patel
- Translational Medicine and Therapeutics, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary, University of London, London, UK
| | - Phillip P W M Bibawy
- Barts and the London School of Medicine and Dentistry, Queen Mary, University of London, UK
| | | | - Zehra Majeed
- Translational Medicine and Therapeutics, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary, University of London, London, UK
| | - Weng L Gan
- Barts and the London School of Medicine and Dentistry, Queen Mary, University of London, UK
| | - Tom E F Abbott
- Translational Medicine and Therapeutics, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary, University of London, London, UK
| | - Gareth L Ackland
- Translational Medicine and Therapeutics, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary, University of London, London, UK.
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Rubio-Zarapuz A, Apolo-Arenas MD, Clemente-Suárez VJ, Costa AR, Pardo-Caballero D, Parraca JA. Acute Effects of a Session with The EXOPULSE Mollii Suit in a Fibromyalgia Patient: A Case Report. Int J Environ Res Public Health 2023; 20:2209. [PMID: 36767576 PMCID: PMC9915440 DOI: 10.3390/ijerph20032209] [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] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain and associated fatigue, sleep disturbances, and other cognitive and somatic symptoms. A multidisciplinary approach including pharmacological therapies along with behavioral therapy, exercise, patient education, and pain management is a possible solution for the treatment of this disease. The EXOPULSE Mollii® method (EXONEURAL NETWORK AB, Danderyd, Sweden) is an innovative approach for non-invasive and self-administered electrical stimulation with multiple electrodes incorporated in a full-body suit, with already proven benefits for other diseases. Therefore, the present case report study aims to evaluate the effects that a 60 min session with the EXOPULSE Mollii suit has on a female fibromyalgia patient. After the intervention, we can conclude that a 60 min session with the EXOPULSE Mollii suit has beneficial effects on pain perception, muscle oxygenation, parasympathetic modulation, and function in a female fibromyalgia patient.
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Affiliation(s)
- Alejandro Rubio-Zarapuz
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain
| | - María Dolores Apolo-Arenas
- Facultad de Medicina y Ciencias de la Salud, Research Group FhysioH, Universidad de Extremadura, 06006 Badajoz, Spain
| | | | - Ana Rodrigues Costa
- Departamento de Ciências Médicas e da Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7004-516 Évora, Portugal
| | - David Pardo-Caballero
- AlgeaSalud, Clinica Neurorrehabilitación Deportiva, Avenida de Elvas, 06006 Badajoz, Spain
| | - Jose A. Parraca
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7004-516 Évora, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7004-516 Évora, Portugal
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Endukuru CK, Gaur GS, Yerrabelli D, Sahoo J, Vairappan B, Goud AC. Correlation among Poincare plot and traditional heart rate variability indices in adults with different risk levels of metabolic syndrome: a cross-sectional approach from Southern India. J Basic Clin Physiol Pharmacol 2023:jbcpp-2022-0208. [PMID: 36626361 DOI: 10.1515/jbcpp-2022-0208] [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: 08/04/2022] [Accepted: 12/24/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVES Heart rate variability (HRV) is an important marker of cardiac autonomic modulation. Metabolic syndrome (MetS) can alter cardiac autonomic modulation, raising the risk of cardiovascular disease (CVD). Poincaré plot analysis (PPA) is a robust scatter plot-based depiction of HRV and carries similar information to the traditional HRV measures. However, no prior studies have examined the relationship between PPA and traditional HRV measures among different risk levels of MetS. We evaluated the association between the Poincare plot and traditional heart rate variability indices among adults with different risk levels of MetS. METHODS We measured anthropometric data and collected fasting blood samples to diagnose MetS. The MetS risk was assessed in 223 participants based on the number of MetS components and was classified as control (n=64), pre-MetS (n=49), MetS (n=56), and severe MetS (n=54). We calculated the Poincaré plot (PP) and traditional HRV measures from a 5 min HRV recording. RESULTS Besides the traditional HRV measures, we found that various HRV indices of PPA showed significant differences among the groups. The severe MetS group had significantly lower S (total HRV), SD1 (short-term HRV), SD2 (long-term HRV), and higher SD2/SD1. The values of S, SD1, SD2, and SD2/SD1 were significantly correlated with most traditional HRV measures. CONCLUSIONS We found gradual changes in HRV patterns as lower parasympathetic and higher sympathetic activity alongside the rising number of MetS components. The HRV indices of PPA integrating the benefits of traditional HRV indices distinguish successfully between different risk levels of MetS and control subjects.
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Affiliation(s)
- Chiranjeevi Kumar Endukuru
- Department of Physiology, Sri Siddhartha Institute of Medical Sciences & Research Centre, Bengaluru, India
| | - Girwar Singh Gaur
- Department of Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Dhanalakshmi Yerrabelli
- Department of Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Jayaprakash Sahoo
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Balasubramaniyan Vairappan
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Alladi Charanraj Goud
- Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
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Villafaina S, Tomas-Carus P, Silva V, Costa AR, Fernandes O, Parraca JA. The Behavior of Muscle Oxygen Saturation, Oxy and Deoxy Hemoglobin during a Fatigue Test in Fibromyalgia. Biomedicines 2023; 11. [PMID: 36672640 DOI: 10.3390/biomedicines11010132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 12/31/2022] [Accepted: 01/04/2023] [Indexed: 01/07/2023] Open
Abstract
Previous studies have reported that people with fibromyalgia (FM) could suffer from mitochondrial dysfunction. However, the consumption of muscle oxygen during physical exercise has been poorly studied. Therefore, this study aimed to explore the response of muscle oxygen during a fatigue protocol in people with FM and healthy controls (HC). In addition, the peak torque and the total work were assessed. A total of 31 participants (eighteen were people with fibromyalgia and thirteen were healthy controls) were enrolled in this cross-sectional study. All the participants underwent a fatigue protocol consisting of 20 repetitions at 180°·s−1 of quadriceps flexions and extensions using a Biodex System 3. The muscle oxygen saturation (SmO2), total hemoglobin (THb), deoxygenated hemoglobin (HHb) and oxygenated hemoglobin (O2Hb) values were measured using a portable near-infrared spectroscopy (NIRS) device. Significant differences between people with FM and healthy controls were found at baseline: SmO2 (FM: 56.03 ± 21.36; HC: 77.41 ± 10.82; p = 0.036), O2Hb (FM: 6.69 ± 2.59; HC: 9.37 ± 1.31; p = 0.030) and HHb (FM: 5.20 ± 2.51; HC: 2.73 ± 1.32; p = 0.039); during the fatigue protocol: SmO2 (FM: 48.54 ± 19.96; HC: 58.87 ± 19.72; p = 0.038), O2Hb (FM: 5.70 ± 2.34; HC: 7.06 ± 2.09; p = 0.027) and HHb (FM: 5.69 ± 2.65; HC: 4.81 ± 2.39; p = 0.048); and in the recovery at three min and six min for SmO2, O2Hb and HHb (p < 0.005). Furthermore, healthy control values of SmO2, O2Hb and HHb have been significantly altered by the fatigue protocol (p < 0.005). In contrast, people with FM did not show any significant alteration in these values. Moreover, significant differences were found in the peak torque at extension (FM: 62.48 ± 24.45; HC: 88.31 ± 23.51; p = 0.033) and flexion (FM: 24.16 ± 11.58; HC: 42.05 ± 9.85; p = 0.010), and the total work performed at leg extension (FM: 1039.78 ± 434.51; HC: 1535.61 ± 474.22; p = 0.007) and flexion (FM: 423.79 ± 239.89; HC: 797.16 ± 194.37; p = 0.005).
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Inbaraj G, Arjun K, Meghana A, Preethish-Kumar V, John AP, Polavarapu K, Nashi S, Sekar D, Udupa K, Prathuysha PV, Prasad K, Bardhan M, Raju TR, Kramer BW, Nalini A, Sathyaprabha TN. Neuro-Cardio- Autonomic Modulations in Children with Duchenne Muscular Dystrophy. J Neuromuscul Dis 2023; 10:227-238. [PMID: 36847014 DOI: 10.3233/jnd-221621] [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: 02/23/2023]
Abstract
BACKGROUND AND OBJECTIVE Duchenne muscular dystrophy (DMD) is a degenerative X-linked muscle disease. Death frequently results from complications in cardiopulmonary systems. Preclinical/early diagnosis of cardiac autonomic abnormalities may aid initiate cardioprotective therapy and enhance prognosis. METHODS A cross sectional, prospective study of 38 DMD boys compared with 37 age-matched healthy controls was conducted. Lead II electrocardiography and beat-to-beat blood pressure were recorded to assess heart rate variability (HRV), blood pressure variability (BPV), and baroreceptor sensitivity (BRS) in a standardized environment. Data were analysed and correlated with disease severity and genotype. RESULTS In the DMD group, the median age at assessment was 8 years [IQR 7-9 years], the median age at disease onset was 3 years [IQR, 2-6 years], and the mean duration of illness was 4 years [IQR, 2.5-5]. DNA sequencing showed deletions in 34/38 (89.5 %) and duplications in 4/38 (10.5%) patients. The median heart rate in DMD children was significantly higher [101.19 (Range, 94.71-108.49)] /min compared to controls [81 (Range, 76.2-92.76)] /min (p < 0.05). All the assessed HRV and BPV parameters were significantly impaired in DMD cases except for the coefficient of variance of systolic blood pressure. Further, BRS parameters were also significantly reduced in DMD, excluding alpha-LF. A positive correlation was found between alpha HF with age at onset and duration of illness. CONCLUSION This study demonstrates a distinct early impairment of neuro-cardio-autonomic regulation in DMD. Simple yet effective non-invasive techniques such as HRV, BPV, and BRS may help identify cardiac dysfunction in a pre-clinical state, paving the way for early cardio-protective therapies and limiting disease progression in DMD patients.
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Affiliation(s)
- Ganagarajan Inbaraj
- Department of Neurophysiology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Krishnamurthy Arjun
- Department of CSE, School of Engineering, Dayananda Sagar University, Bangalore
| | - Adoor Meghana
- Department of Neurophysiology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | | | - Anu P John
- Department of Neurophysiology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Kiran Polavarapu
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Saraswati Nashi
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Deepha Sekar
- Department of Molecular Genetics, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Kaviraja Udupa
- Department of Neurophysiology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Parthipulli V Prathuysha
- Department of Biostatistics, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Krishna Prasad
- Department of Neurophysiology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Mainak Bardhan
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Trichur R Raju
- Department of Neurophysiology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Boris W Kramer
- Department of Paediatrics, School of Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Atchayaram Nalini
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Talakad N Sathyaprabha
- Department of Neurophysiology, National Institute of Mental Health and Neurosciences, Bangalore, India
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Villafaina S, Crespo M, Martínez-Gallego R, Fuentes-García JP. Heart Rate Variability in Elite International ITF Junior Davis Cup Tennis Players. Biology (Basel) 2022; 12:17. [PMID: 36671710 PMCID: PMC9855644 DOI: 10.3390/biology12010017] [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] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/04/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
The aim of the present study was to investigate the evolution of the HRV during an international team tennis tournament in elite junior tennis players. A total of 11 tennis players, with a mean age of 15.36 (0.67) from six nationalities, participated in this cross-sectional study. Participants were measured one day before the event, before the first match, and before the second match of the ITF Junior Davis Cup event. Each of the registers lasted 5 min and the time domain, frequency domain and non-linear variables were extracted. The tournament took place in Valencia (Spain). Results showed that there was not a significant decrease in the heart rate variability (HRV) induced by precompetitive stress. However, significant differences (p-value < 0.05) were found between baseline and second match pre-competition HRV values in low frequency (LFNu) (p-value = 0.008) and high frequency (HFNu) power (p-value = 0.008), LF/HF ratio (p-value = 0.008) and Sample Entropy (SampEn) (p-value = 0.033) variables. Furthermore, cognitive anxiety (measured by CSAI-2r) (p-value = 0.017) and anxiety (measured by STAI-S) (p-value = 0.042) were higher before the first match than before the second match. Coaches and physical trainers could use HRV to control and manage the precompetitive anxiety of junior tennis players. The experience in international tournaments and the familiarization with the environment in the second match could explain these results.
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Affiliation(s)
- Santos Villafaina
- Facultad de Ciencias del Deporte, Universidad de Extremadura, Avda: Universidad S/N, 10003 Cáceres, Spain
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7005-849 Évora, Portugal
| | - Miguel Crespo
- Development Department, International Tennis Federation, London SW15 5XZ, UK
| | | | - Juan Pedro Fuentes-García
- Facultad de Ciencias del Deporte, Universidad de Extremadura, Avda: Universidad S/N, 10003 Cáceres, Spain
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12
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Machado E, Jannuzzi F, Telles S, Oliveira C, Madeira I, Sicuro F, Souza MDG, Monteiro A, Bouskela E, Collett-Solberg P, Farinatti P. A Recreational Swimming Intervention during the Whole School Year Improves Fitness and Cardiometabolic Risk in Children and Adolescents with Overweight and Obesity. Int J Environ Res Public Health 2022; 19:17093. [PMID: 36554976 PMCID: PMC9778733 DOI: 10.3390/ijerph192417093] [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] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 12/14/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
The benefits of swimming as a treatment for overweight children are undefined. We investigated the effects of recreational swimming on cardiometabolic risk in children/adolescents with normal and excess weight. Participants (n = 49, 26 girls, 10.3 ± 1.8 y) were grouped as 'eutrophic swimming' (EU-Swim, n = 14); 'excess weight swimming' (EW-Swim, n = 20) with an 'obese swimming' subgroup (OB-Swim, n = 10); and 'excess weight sedentary' (EW-Sed, n = 15) with an 'obese sedentary' subgroup (OB-Sed, n = 11). Swimming (50 min, twice/week, moderate-vigorous intensity) was an extra activity during the school year (6 + 3 months with a 3-month school break). Nutritional status, blood pressure (BP), physical activity, cardiorespiratory fitness, biochemical variables, autonomic modulation, endothelial function, abdominal fat, and carotid thickness were assessed at baseline, 6, and 12 months. Greater improvements (p < 0.05) occurred in EW-Swim vs. EW-Sed in body mass index (z-BMI, -16%, d+ 0.52), waist-to-height ratio (W/H, -8%, d+ 0.59-0.79), physical activity (37-53%, d+ 1.8-2.2), cardiorespiratory fitness (30-40%, d+ 0.94-1.41), systolic BP (SBP, -6-8%, d+ 0.88-1.17), diastolic BP (DBP, -9-10%, d+ 0.70-0.85), leptin (-14-18%, d+ 0.29-0.41), forearm blood flow (FBF, 26-41%, d+ 0.53-0.64), subcutaneous fat (SAT, -6%, d+ 0.18), and intra-abdominal fat (VAT, -16%, d+ 0.63). OB-Swim showed improvements vs. OB-Sed in TNFα (-17%, d+ 1.15) and adiponectin (22%, d+ 0.40). Swimming improved fitness and cardiometabolic risk in children/adolescents with overweight/obesity. (TCTR20220216001).
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Affiliation(s)
- Elisabeth Machado
- Clinical and Experimental Research Laboratory on Vascular Biology, Biomedical Center, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil
| | - Fernanda Jannuzzi
- Department of Pediatrics, Faculty of Medical Sciences, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil
| | - Silvio Telles
- Laboratory of Physical Activity and Health Promotion, Institute of Physical Education and Sports, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil
| | - Cecilia Oliveira
- Institute of Nutrition, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil
| | - Isabel Madeira
- Department of Pediatrics, Faculty of Medical Sciences, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil
| | - Fernando Sicuro
- Clinical and Experimental Research Laboratory on Vascular Biology, Biomedical Center, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil
- Centre for Environment and Marine Studies, Department of Biology, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Maria das Graças Souza
- Clinical and Experimental Research Laboratory on Vascular Biology, Biomedical Center, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil
| | - Alexandra Monteiro
- Department of Radiology, Faculty of Medical Sciences, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil
| | - Eliete Bouskela
- Clinical and Experimental Research Laboratory on Vascular Biology, Biomedical Center, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil
| | - Paulo Collett-Solberg
- Department of Pediatrics, Faculty of Medical Sciences, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil
| | - Paulo Farinatti
- Laboratory of Physical Activity and Health Promotion, Institute of Physical Education and Sports, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil
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Ji N, Li Y, Wei J, Chen F, Xu L, Li G, Lin WH. Autonomic modulation by low-intensity focused ultrasound stimulation of the vagus nerve. J Neural Eng 2022; 19. [PMID: 36541473 DOI: 10.1088/1741-2552/aca8cd] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/05/2022] [Indexed: 12/12/2022]
Abstract
Objective.Our previous study has shown that low-intensity focused ultrasound stimulation (FUS) of the vagus nerve could modulate blood pressure (BP), but its underlying mechanisms remain unclear. We hypothesized that low-intensity FUS of the vagus nerve would regulate autonomic function and thus BP.Approach.17 anesthetized spontaneously hypertensive rats were treated with low-intensity FUS of the left vagus nerve for 15 min each trial. Continuous BP, heart rate, respiration rate (RR), and core body temperature were simultaneously recorded to evaluate the effects on BP and other physiological parameters. Heart rate variability (HRV), systolic BP variability, and baroreflex sensitivity were computed to evaluate the autonomic modulation function. A Control-sham group without stimulation and another Control-FUS group with non-target stimulation were also examined to exclude the influence of potential confounding factors on autonomic modulation.Main results.A prolonged significant decrease in BP, pulse pressure, RR, the normalized low-frequency power of HRV, and the low-to-high frequency power ratio of HRV were found after the low-intensity FUS of the left vagus nerve in comparison with the baseline and those of the control groups, demonstrating that activities of the sympathetic nervous system were inhibited. The prolonged significant increase of the normalized high-frequency power of HRV suggested the activation of parasympathetic activity.Significance.Low-intensity FUS of the left vagus nerve effectively improved the autonomic function by activating parasympathetic efferent and inhibiting sympathetic efferent, which contributes to BP reduction. The findings shed light on the hypotensive mechanism underlying FUS.
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Affiliation(s)
- Ning Ji
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang 110819, People's Republic of China.,CAS Key Lab of Human-Machine Intelligence-Synergy Systems and Research Center for Neural Engineering, Shenzhen Institutes of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS), Shenzhen 518055, People's Republic of China
| | - Yuanheng Li
- CAS Key Lab of Human-Machine Intelligence-Synergy Systems and Research Center for Neural Engineering, Shenzhen Institutes of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS), Shenzhen 518055, People's Republic of China
| | - Jingjing Wei
- CAS Key Lab of Human-Machine Intelligence-Synergy Systems and Research Center for Neural Engineering, Shenzhen Institutes of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS), Shenzhen 518055, People's Republic of China.,Department of Human Anatomy, Zhuhai Campus of Zunyi Medical University, Zhuhai 519041, People's Republic of China
| | - Fei Chen
- Department of Electrical and Electronic Engineering, Southern University of Science and Technology, Shenzhen 518055, People's Republic of China
| | - Lisheng Xu
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang 110819, People's Republic of China
| | - Guanglin Li
- CAS Key Lab of Human-Machine Intelligence-Synergy Systems and Research Center for Neural Engineering, Shenzhen Institutes of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS), Shenzhen 518055, People's Republic of China
| | - Wan-Hua Lin
- CAS Key Lab of Human-Machine Intelligence-Synergy Systems and Research Center for Neural Engineering, Shenzhen Institutes of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS), Shenzhen 518055, People's Republic of China
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Corrêa FI, Souza PHL, Uehara L, Ritti-Dias RM, Oliveira da Silva G, Segheto W, Pacheco-Barrios K, Fregni F, Corrêa JCF. Transcutaneous Auricular Vagus Nerve Stimulation Improves Inflammation but Does Not Interfere with Cardiac Modulation and Clinical Symptoms of Individuals with COVID-19: A Randomized Clinical Trial. Life (Basel) 2022; 12:life12101644. [PMID: 36295080 PMCID: PMC9604701 DOI: 10.3390/life12101644] [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: 09/19/2022] [Revised: 10/12/2022] [Accepted: 10/15/2022] [Indexed: 11/16/2022] Open
Abstract
Transcranial auricular vagus nerve stimulation (taVNS) has shown effectiveness in reducing inflammation and depression. Thus, this study evaluated its effect on inflammation, cardiac autonomic modulation, and clinical symptoms in individuals affected by COVID-19. Methods: There were 52 randomized participants hospitalized with COVID-19 diagnosis who were to receive active (a-taVNS) or sham taVNS (s-taVNS) for 90 min twice a day for seven consecutive days. Interleukin 6 (IL-6), 10 (IL-10), cortisol, C-reactive protein (CRP), heart rate variability (HRV), and clinical symptoms were assessed before and after seven days of treatment. There were also seven- and fourteen-day follow-ups for clinical symptoms, including anxiety and depression levels, as well as a six-month follow-up for memory and attention levels. Results: There was significant reduction in CRP −23.9%, (95% CI −46.3 to −1.4) and IL-6 −37.7%, (95% CI −57.6 to −17.7) for the a-taVNS group. There were no changes in IL-10, cortisol levels, or in HRV results (p > 0.05) in both groups. There were no changes regarding clinical symptoms, except for a significant decrease in depression level (−2.85, 95% CI −5.44 to −0.27) in the a-taVNS group. Conclusion: taVNS showed effects on CRP, IL-6, and depression levels; however, it did not affect other clinical symptoms.
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Affiliation(s)
- Fernanda Ishida Corrêa
- Doctoral and Master’s Programs in Rehabilitation Sciences, Nove de Julho University, São Paulo 01525-000, Brazil
- Correspondence: ; Tel.: +55-11-973440380
| | - Paulo Henrique Leite Souza
- Doctoral and Master’s Programs in Rehabilitation Sciences, Nove de Julho University, São Paulo 01525-000, Brazil
| | - Laura Uehara
- Doctoral and Master’s Programs in Rehabilitation Sciences, Nove de Julho University, São Paulo 01525-000, Brazil
| | - Raphael Mendes Ritti-Dias
- Doctoral and Master’s Programs in Rehabilitation Sciences, Nove de Julho University, São Paulo 01525-000, Brazil
| | - Gustavo Oliveira da Silva
- Doctoral and Master’s Programs in Rehabilitation Sciences, Nove de Julho University, São Paulo 01525-000, Brazil
| | - Wellington Segheto
- Doctoral and Master’s Programs in Rehabilitation Sciences, Nove de Julho University, São Paulo 01525-000, Brazil
| | - Kevin Pacheco-Barrios
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
- Unidad de Investigación para la Generación y Síntesede Evidencias en Salud, Universidad San Ignacio de Loyola, Lima 15024, Peru
| | - Felipe Fregni
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - João Carlos Ferrari Corrêa
- Doctoral and Master’s Programs in Rehabilitation Sciences, Nove de Julho University, São Paulo 01525-000, Brazil
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Popa IP, Haba MȘC, Mărănducă MA, Tănase DM, Șerban DN, Șerban LI, Iliescu R, Tudorancea I. Modern Approaches for the Treatment of Heart Failure: Recent Advances and Future Perspectives. Pharmaceutics 2022; 14:pharmaceutics14091964. [PMID: 36145711 PMCID: PMC9503448 DOI: 10.3390/pharmaceutics14091964] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 11/16/2022] Open
Abstract
Heart failure (HF) is a progressively deteriorating medical condition that significantly reduces both the patients’ life expectancy and quality of life. Even though real progress was made in the past decades in the discovery of novel pharmacological treatments for HF, the prevention of premature deaths has only been marginally alleviated. Despite the availability of a plethora of pharmaceutical approaches, proper management of HF is still challenging. Thus, a myriad of experimental and clinical studies focusing on the discovery of new and provocative underlying mechanisms of HF physiopathology pave the way for the development of novel HF therapeutic approaches. Furthermore, recent technological advances made possible the development of various interventional techniques and device-based approaches for the treatment of HF. Since many of these modern approaches interfere with various well-known pathological mechanisms in HF, they have a real ability to complement and or increase the efficiency of existing medications and thus improve the prognosis and survival rate of HF patients. Their promising and encouraging results reported to date compel the extension of heart failure treatment beyond the classical view. The aim of this review was to summarize modern approaches, new perspectives, and future directions for the treatment of HF.
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Affiliation(s)
- Irene Paula Popa
- Cardiology Clinic, “St. Spiridon” County Clinical Emergency Hospital, 700111 Iași, Romania
| | - Mihai Ștefan Cristian Haba
- Cardiology Clinic, “St. Spiridon” County Clinical Emergency Hospital, 700111 Iași, Romania
- Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Minela Aida Mărănducă
- Department of Physiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Daniela Maria Tănase
- Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
- Internal Medicine Clinic, “St. Spiridon” County Clinical Emergency Hospital, 700115 Iași, Romania
| | - Dragomir N. Șerban
- Department of Physiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Lăcrămioara Ionela Șerban
- Department of Physiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Radu Iliescu
- Department of Pharmacology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Ionuț Tudorancea
- Cardiology Clinic, “St. Spiridon” County Clinical Emergency Hospital, 700111 Iași, Romania
- Department of Physiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
- Correspondence:
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Miller DJ, Sargent C, Roach GD. A Validation of Six Wearable Devices for Estimating Sleep, Heart Rate and Heart Rate Variability in Healthy Adults. Sensors (Basel) 2022; 22:s22166317. [PMID: 36016077 PMCID: PMC9412437 DOI: 10.3390/s22166317] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [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: 07/29/2022] [Revised: 08/16/2022] [Accepted: 08/16/2022] [Indexed: 05/27/2023]
Abstract
The primary aim of this study was to examine the validity of six commonly used wearable devices, i.e., Apple Watch S6, Garmin Forerunner 245 Music, Polar Vantage V, Oura Ring Generation 2, WHOOP 3.0 and Somfit, for assessing sleep. The secondary aim was to examine the validity of the six devices for assessing heart rate and heart rate variability during, or just prior to, night-time sleep. Fifty-three adults (26 F, 27 M, aged 25.4 ± 5.9 years) spent a single night in a sleep laboratory with 9 h in bed (23:00-08:00 h). Participants were fitted with all six wearable devices-and with polysomnography and electrocardiography for gold-standard assessment of sleep and heart rate, respectively. Compared with polysomnography, agreement (and Cohen's kappa) for two-state categorisation of sleep periods (as sleep or wake) was 88% (κ = 0.30) for Apple Watch; 89% (κ = 0.35) for Garmin; 87% (κ = 0.44) for Polar; 89% (κ = 0.51) for Oura; 86% (κ = 0.44) for WHOOP and 87% (κ = 0.48) for Somfit. Compared with polysomnography, agreement (and Cohen's kappa) for multi-state categorisation of sleep periods (as a specific sleep stage or wake) was 53% (κ = 0.20) for Apple Watch; 50% (κ = 0.25) for Garmin; 51% (κ = 0.28) for Polar; 61% (κ = 0.43) for Oura; 60% (κ = 0.44) for WHOOP and 65% (κ = 0.52) for Somfit. Analyses regarding the two-state categorisation of sleep indicate that all six devices are valid for the field-based assessment of the timing and duration of sleep. However, analyses regarding the multi-state categorisation of sleep indicate that all six devices require improvement for the assessment of specific sleep stages. As the use of wearable devices that are valid for the assessment of sleep increases in the general community, so too does the potential to answer research questions that were previously impractical or impossible to address-in some way, we could consider that the whole world is becoming a sleep laboratory.
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Tornero-Aguilera JF, Sánchez-Molina J, Parraca JA, Morais A, Clemente-Suárez VJ. Are Crohn's Disease Patients Limited in Sport Practise? An UltraEndurance Case-Control Study Response. Int J Environ Res Public Health 2022; 19:10007. [PMID: 36011641 PMCID: PMC9407764 DOI: 10.3390/ijerph191610007] [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] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
The aim of this study was to analyze the psychophysiological response of a Crohn's Disease patient in an ultra-endurance event. The psychophysiological responses of a Crohn's Disease and non-Crohn's Disease participant were analysed before during and after an 8 h ultra-endurance running event. Results showed how Crohn's patient presented a similar psychophysiological response than non-Crohn's participant in the ultra-endurance event, except for a higher pre- and post-event sympathetic modulation, lower event sympathetic tone, and lower event body temperature. This study could contribute to improving physical activity recommendations for persons with Crohn's Disease and open a new research line for an improved understanding of psychophysiological modifications of Crohn's Disease patients during exercise.
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Affiliation(s)
- José Francisco Tornero-Aguilera
- Faculty of Sports Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain
- Research Center in Applied Combat (CESCA), 45007 Toledo, Spain
| | | | - Jose A. Parraca
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7004-516 Évora, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7004-516 Évora, Portugal
| | - Ana Morais
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7004-516 Évora, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7004-516 Évora, Portugal
| | - Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain
- Research Center in Applied Combat (CESCA), 45007 Toledo, Spain
- Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla 080002, Colombia
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Santos S, Parraca JA, Fernandes O, Villafaina S, Clemente-Suarez VJ, Melo F. The Effect of Expertise during Simulated Flight Emergencies on the Autonomic Response and Operative Performance in Military Pilots. Int J Environ Res Public Health 2022; 19:9141. [PMID: 35897511 DOI: 10.3390/ijerph19159141] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 07/24/2022] [Accepted: 07/25/2022] [Indexed: 02/01/2023]
Abstract
Heart rate variability (HRV) and performance response during emergency flight maneuvers were analyzed. Two expert pilots (ages 35 and 33) and two rookie pilots (ages 25) from the Portuguese Air Force participated in this case-control report study. Participants had to complete the following emergency protocols in a flight simulator: (1) take-off engine failure, (2) flight engine failure close to the base, (3) flight engine failure far away from the base, and (4) alternator failure. The HRV was collected during all these maneuvers, as well as the performance data (the time it took to go through the emergency protocol and the subjective information from the flight simulator operator). Results regarding autonomic modulation showed a higher sympathetic response during the emergency maneuvers when compared to baseline. In some cases, there was also a higher sympathetic response during the emergency maneuvers when compared with the take-off protocol. Regarding performance data, the expert pilots accomplished the missions in less time than the rookie pilots. Autonomic modulation measured from HRV through portable devices can easily relay important information. This information is relevant since characterizing these maneuvers can provide helpful information to design training strategies to improve those psychophysiological responses.
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Sánchez-Conde P, Beltrán-Velasco AI, Clemente-Suárez VJ. Analysis of the Objective and Subjective Stress Response of Students and Professors in Practical Nursing Exams and Their Relationship with Academic Performance. Int J Environ Res Public Health 2022; 19:ijerph19159121. [PMID: 35897482 PMCID: PMC9332375 DOI: 10.3390/ijerph19159121] [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] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 07/21/2022] [Accepted: 07/23/2022] [Indexed: 12/04/2022]
Abstract
The aim of the present research was to analyse the objective and subjective stress responses of students in a clinical case evaluation and the correlation with academic performance, as well as to analyse the differences in grade and difficulty perceptions between students and professors that designed the clinical case. A sample of 103 first-year students from a nursing degree was studied. In this sample, the objective stress was analysed by measuring the autonomic modulation (through the heart rate variability); moreover, the subjective stress was analysed using the SUDS scale. Furthermore, the difficulty perception and academic performance were measured using scales for both students and professors. The measures were taken before and after the clinical exams. A large subjective and objective stress response was observed at the beginning of the clinical case, and this response was related to a high academic performance perception. Upon completion of the clinical evaluation, both the stress response and the academic performance perception decreased. The professors and students presented different grade and difficulty perceptions concerning the clinical case.
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Affiliation(s)
- Paula Sánchez-Conde
- Faculty of Sports Sciences, Universidad Europea de Madrid, 28001 Madrid, Spain; (P.S.-C.); (A.I.B.-V.)
| | | | - Vicente Javier Clemente-Suárez
- Department of Psychology, Faculty of Life and Natural Sciences, University of Nebrija, 28240 Madrid, Spain
- Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla 080001, Colombia
- Correspondence:
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20
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García-Ceberino JM, Fuentes-García JP, Villafaina S. Impact of Basketball Match on the Pre-Competitive Anxiety and HRV of Youth Female Players. Int J Environ Res Public Health 2022; 19:7894. [PMID: 35805552 PMCID: PMC9265481 DOI: 10.3390/ijerph19137894] [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: 05/30/2022] [Revised: 06/22/2022] [Accepted: 06/25/2022] [Indexed: 02/01/2023]
Abstract
The present study aimed to investigate the impact of a basketball competition on the pre-competitive anxiety and Heart Rate Variability (HRV) of young female basketball players. A total of 12 female basketball players participated in this cross-sectional study. Girls had a mean age of 14 (1.41) years old and a mean experience of 4 (0.85) years practicing basketball. The pre-competitive anxiety and the HRV was assessed the week before and immediately before and after the match. Results showed a significant reduction (p-value < 0.05) of the several HRV variables after the match compared to baseline and pre-competition measures. However, differences between baseline and pre-competition were not found. Furthermore, a significant increase in somatic anxiety after the competition was reported. Taking into account HRV, somatic anxiety, and cognitive anxiety results, young female basketball players did not exhibit an increase in pre-competition anxiety. HRV measurements before competition can help coaches and physical trainers to identify female players with higher pre-competitive anxiety and propose intervention to manage it. Future studies should investigate the impact of coaches and parents on the pre-competitive anxiety of female and male basketball players.
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Affiliation(s)
- Juan M. García-Ceberino
- Faculty of Humanities and Social Sciences, University of Isabel I, 09003 Burgos, Spain;
- Optimization of Training and Sports Performance Research Group (GOERD), University of Extremadura, 10003 Cáceres, Spain
| | - Juan Pedro Fuentes-García
- Universidad de Extremadura, Facultad de Ciencias del Deporte, Av. de la Universidad S/N, 10003 Cáceres, Spain;
| | - Santos Villafaina
- Universidad de Extremadura, Facultad de Ciencias del Deporte, Av. de la Universidad S/N, 10003 Cáceres, Spain;
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7004-516 Évora, Portugal
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21
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Ramírez-Adrados A, Fernández-Elías VE, Fernández-Martínez S, Martínez-Pascual B, Gonzalez-de-Ramos C, Clemente-Suárez VJ. The Effect of Studying a Double Degree in the Psychophysiological Stress Response in the Bachelor's Thesis Defense. Int J Environ Res Public Health 2022; 19:ijerph19031207. [PMID: 35162228 PMCID: PMC8835440 DOI: 10.3390/ijerph19031207] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/18/2022] [Accepted: 01/20/2022] [Indexed: 02/01/2023]
Abstract
The aim of this research was to analyze the effect of studying a single or double degree in the psychophysiological stress response and academic performance of university students in their bachelor's thesis defense. We analyzed the autonomic stress response, cortical arousal, subjective distress perception, and the sense of objective and subjective academic fulfilment of 84 single-degree physiotherapy students and 26 double-degree sport sciences and physiotherapy students during their bachelor's thesis defense. The results showed that the bachelor's thesis defense was a stressful event for double-degree students, showing an activation of the sympathetic nervous system and presenting a higher autonomic habituation response for the double degree students compared to the single degree students. We found higher mean grades during the whole degree and higher grades in the written and oral bachelor's thesis academic achievements for single-degree students compared to double-degree students. No significant differences were found between single-degree and double-degree students in subjective distress perception and cortical arousal. No correlation was found between academic performance variables and subjective distress perception, cortical arousal, and autonomic modulation variables. We conclude that the bachelor's thesis defense produces a large anticipatory anxiety response in single-degree physiotherapy students and in double-degree sport sciences and physiotherapy students. Double-degree students showed higher levels of habituation and adaptability to the stressful event, with a better autonomic response. Academic achievements were significantly higher among single-degree students compared to the double-degree group.
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Affiliation(s)
- Ana Ramírez-Adrados
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (A.R.-A.); (V.E.F.-E.); (S.F.-M.); (B.M.-P.); (C.G.-d.-R.)
| | - Valentín E. Fernández-Elías
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (A.R.-A.); (V.E.F.-E.); (S.F.-M.); (B.M.-P.); (C.G.-d.-R.)
| | - Silvia Fernández-Martínez
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (A.R.-A.); (V.E.F.-E.); (S.F.-M.); (B.M.-P.); (C.G.-d.-R.)
| | - Beatriz Martínez-Pascual
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (A.R.-A.); (V.E.F.-E.); (S.F.-M.); (B.M.-P.); (C.G.-d.-R.)
| | - Cristina Gonzalez-de-Ramos
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (A.R.-A.); (V.E.F.-E.); (S.F.-M.); (B.M.-P.); (C.G.-d.-R.)
| | - Vicente Javier Clemente-Suárez
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (A.R.-A.); (V.E.F.-E.); (S.F.-M.); (B.M.-P.); (C.G.-d.-R.)
- Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla 080002, Colombia
- Correspondence: ; Tel.: +34-902-232-350; Fax: +34-911-413-585
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22
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Stavrakis S, Elkholey K, Morris L, Niewiadomska M, Asad ZUA, Humphrey MB. Neuromodulation of Inflammation to Treat Heart Failure With Preserved Ejection Fraction: A Pilot Randomized Clinical Trial. J Am Heart Assoc 2022; 11:e023582. [PMID: 35023349 PMCID: PMC9238491 DOI: 10.1161/jaha.121.023582] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background A systemic proinflammatory state plays a central role in the development of heart failure with preserved ejection fraction. Low‐level transcutaneous vagus nerve stimulation suppresses inflammation in humans. We conducted a sham‐controlled, double‐blind, randomized clinical trial to examine the effect of chronic low‐level transcutaneous vagus nerve stimulation on cardiac function, exercise capacity, and inflammation in patients with heart failure with preserved ejection fraction. Methods and Results Patients with heart failure with preserved ejection fraction and at least 2 additional comorbidities (obesity, diabetes, hypertension, or age ≥65 years) were randomized to either active (tragus) or sham (earlobe) low‐level transcutaneous vagus nerve stimulation (20 Hz, 1 mA below discomfort threshold), for 1 hour daily for 3 months. Echocardiography, 6‐minute walk test, quality of life, and serum cytokines were assessed at baseline and 3 months. Fifty‐two patients (mean age 70.4±9.2 years; 70% female) were included (active, n=26; sham, n=26). Baseline characteristics were balanced between the 2 arms. Adherence to the protocol of daily stimulation was >90% in both arms (P>0.05). While the early mitral inflow Doppler velocity to the early diastolic mitral annulus velocity ratio did not differ between groups, global longitudinal strain and tumor necrosis factor‐α levels at 3 months were significantly improved in the active compared with the sham arm (−18.6%±2.5% versus −16.0%±2.4%, P=0.002; 8.9±2.8 pg/mL versus 11.3±2.9 pg/mL, P=0.007, respectively). The reduction in tumor necrosis factor‐α levels correlated with global longitudinal strain improvement (r=−0.73, P=0.001). Quality of life was better in the active arm. No device‐related side effects were observed. Conclusions Neuromodulation with low‐level transcutaneous vagus nerve stimulation over 3 months resulted in a significant improvement in global longitudinal strain, inflammatory cytokines, and quality of life in patients with heart failure with preserved ejection fraction. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT03327649.
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Affiliation(s)
| | - Khaled Elkholey
- University of Oklahoma Health Science Center Oklahoma City OK
| | - Lynsie Morris
- University of Oklahoma Health Science Center Oklahoma City OK
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23
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Wu S, Chen M, Wang J, Shi B, Zhou Y. Association of Short-Term Heart Rate Variability With Breast Tumor Stage. Front Physiol 2021; 12:678428. [PMID: 34566672 PMCID: PMC8461241 DOI: 10.3389/fphys.2021.678428] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 08/18/2021] [Indexed: 11/13/2022] Open
Abstract
Cardiac autonomic modulation, assessed by heart rate variability (HRV), is associated with tumor pathogenesis and development as well as invasion and metastasis. This study aimed to examine this association in breast cancer (BC) patients. A total of 133 patients (average age 49.2years) with BC or benign breast tumors were divided into three groups: benign group, early-stage group, and advanced-stage group. About 5-min resting ECG was collected for the analysis of linear and nonlinear HRV parameters. Multiple logistic regression models were performed to test the independent contribution of HRV to breast tumor stage. The advanced-stage group had significantly reduced HRV compared to the benign and early-stage groups. In particular, for each 1-SD increase in SD2, SD of normal-to-normal intervals, very-low frequency, total power, and low frequency, the odds of having advanced staging decreased by 69.3, 64.3, 58.3, 53.3, and 65.9%, respectively. These associations were independent of age, body mass index, mean heart rate (HR), and respiratory rate (RR). These findings suggest an association between HRV and breast tumor stage, and HRV parameters may help construct an effective early diagnostic and clinical prognostic model.
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Affiliation(s)
- Shuang Wu
- Department of Radiation Oncology, First Affiliated Hospital, Bengbu Medical College, Bengbu, China
| | - Man Chen
- Department of Radiation Oncology, First Affiliated Hospital, Bengbu Medical College, Bengbu, China
| | - Jingfeng Wang
- School of Medical Imaging, Bengbu Medical College, Bengbu, China.,Anhui Key Laboratory of Computational Medicine and Intelligent Health, Bengbu Medical College, Bengbu, China
| | - Bo Shi
- School of Medical Imaging, Bengbu Medical College, Bengbu, China.,Anhui Key Laboratory of Computational Medicine and Intelligent Health, Bengbu Medical College, Bengbu, China
| | - Yufu Zhou
- Department of Radiation Oncology, First Affiliated Hospital, Bengbu Medical College, Bengbu, China
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24
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Lavín-Pérez AM, Collado-Mateo D, Mayo X, Liguori G, Humphreys L, Jiménez A. Can Exercise Reduce the Autonomic Dysfunction of Patients With Cancer and Its Survivors? A Systematic Review and Meta-Analysis. Front Psychol 2021; 12:712823. [PMID: 34504462 PMCID: PMC8422989 DOI: 10.3389/fpsyg.2021.712823] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 06/09/2021] [Accepted: 07/12/2021] [Indexed: 12/17/2022] Open
Abstract
Background: Cancer therapies have increased patient survival rates, but side effects such as cardiotoxicity and neurotoxicity can lead to autonomic nervous and cardiovascular system dysfunction. This would result in a decrease in parasympathetic activity and the enhancement of sympathetic activity. Heart rate variability (HRV), which reflects autonomic modulation, is a valuable physiological tool since it correlates with cancer-related fatigue, stress, depression, and mortality in patients with cancer. Objective: This study aimed to analyze the effects of exercise programs on the autonomic modulation, measured by the HRV of patients with cancer and its survivors. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and the quality of the articles was assessed with the Physiotherapy Evidence Database (PEDro) scale. The meta-analysis statistic procedure was performed by using RevMan software version 5.3. Results: From the 252 articles found, six studies were included in the review involving 272 participants aged 30–75 years. Exercise programs had a mean length of 10.4 ± 4.6 weeks, a frequency of 3 ± 1.4 days/week, and a mean duration of 78 ± 23.9 min. In time-domain HRV measures, exercise may increase in the SD of normal-to-normal intervals [p < 0.00001, with a mean difference (MD) of 12.79 ms from 9.03 to 16.55] and a decreased root mean square of successive R–R interval differences (p = 0.002, with an MD of 13.08 ms from 4.90 to 21.27) in comparison with control groups (CG). The frequency-domain data reveal that the exercise group (EG) improve significantly more than the CGs in low frequency [absolute power: p < 0.0001, with a standardized mean difference (SMD) of 0.97 from 0.61 to 1.34; relative power: p = 0.04, with an MD = −7.70 from −15.4 to −0.36], high-frequency [absolute power: p = 0.001, with a SMD of 1.49 from 0.32 to 2.66; relative power: p = 0.04, with an MD of 8.00 normalized units (n.u.) from 0.20 to 15.80], and low-to-high frequency ratio (p = 0.007 with an MD of −0.32 from −0.55 to −0.09). Conclusion: Exercise programs could lead to positive effects on the autonomic modulation of patients with cancer and its survivors. More beneficial changes may occur with resistance and endurance workouts. However, due to the low number of interventions performed, further research is needed to substantiate the findings and to provide additional insights regarding the exercise intensity required to increase the autonomic modulation of the patient.
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Affiliation(s)
- Ana Myriam Lavín-Pérez
- PhD International School, Program of Epidemiology and Public Health (Interuniversity), Rey Juan Carlos University, Móstoles, Spain.,Centre for Sport Studies, Rey Juan Carlos University, Fuenlabrada, Spain.,GO fitLAB, Ingesport, Madrid, Spain
| | | | - Xián Mayo
- Centre for Sport Studies, Rey Juan Carlos University, Fuenlabrada, Spain
| | - Gary Liguori
- College of Health Sciences, University of Rhode Island, Kingston, NY, United States
| | - Liam Humphreys
- Advanced Wellbeing Research Centre, College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield, United Kingdom
| | - Alfonso Jiménez
- Centre for Sport Studies, Rey Juan Carlos University, Fuenlabrada, Spain.,GO fitLAB, Ingesport, Madrid, Spain.,Advanced Wellbeing Research Centre, College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield, United Kingdom
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25
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Ayuso-Moreno RM, Fuentes-García JP, Nobari H, Villafaina S. Impact of the Result of Soccer Matches on the Heart Rate Variability of Women Soccer Players. Int J Environ Res Public Health 2021; 18:9414. [PMID: 34501999 DOI: 10.3390/ijerph18179414] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/01/2021] [Accepted: 09/05/2021] [Indexed: 11/18/2022]
Abstract
The present study aimed to evaluate the effects of a match lost and a match won on post-competitive heart rate variability (HRV) in semi-professional female soccer athletes. A total of 13 players, with a mean age of 23.75 (5.32), from the Cáceres Women Football Club of the Spanish Second National Division participated in our study. They were evaluated in two microcycles which correspond to a match lost and a match won. For each microcycle, baseline and post-competitive measures were collected. Results indicate that HRV was significantly reduced before a match lost and won. Significant differences in HRV variables were observed when compared the lost match, and the match won. Results highlight the importance and usefulness of analyzing the HRV as an indicator of post-competitive fatigue in semiprofessional soccer players. Therefore, a competition’s results could be considered a relevant variable to consider when programming training load.
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26
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Stavrakis S, Kulkarni K, Singh JP, Katritsis DG, Armoundas AA. Autonomic Modulation of Cardiac Arrhythmias: Methods to Assess Treatment and Outcomes. JACC Clin Electrophysiol 2021; 6:467-483. [PMID: 32439031 DOI: 10.1016/j.jacep.2020.02.014] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 02/06/2020] [Accepted: 02/14/2020] [Indexed: 02/08/2023]
Abstract
The autonomic nervous system plays a central role in the pathogenesis of multiple cardiac arrhythmias, including atrial fibrillation and ventricular tachycardia. As such, autonomic modulation represents an attractive therapeutic approach in these conditions. Notably, autonomic modulation exploits the plasticity of the neural tissue to induce neural remodeling and thus obtain therapeutic benefit. Different forms of autonomic modulation include vagus nerve stimulation, tragus stimulation, renal denervation, baroreceptor activation therapy, and cardiac sympathetic denervation. This review seeks to highlight these autonomic modulation therapeutic modalities, which have shown promise in early preclinical and clinical trials and represent exciting alternatives to standard arrhythmia treatment. We also present an overview of the various methods used to assess autonomic tone, including heart rate variability, skin sympathetic nerve activity, and alternans, which can be used as surrogate markers and predictors of the treatment effect. Although the use of autonomic modulation to treat cardiac arrhythmias is supported by strong preclinical data and preliminary studies in humans, in light of the disappointing results of a number of recent randomized clinical trials of autonomic modulation therapies in heart failure, the need for optimization of the stimulation parameters and rigorous patient selection based on appropriate biomarkers cannot be overemphasized.
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Affiliation(s)
- Stavros Stavrakis
- Heart Rhythm Institute, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
| | - Kanchan Kulkarni
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Jagmeet P Singh
- Cardiology Division, Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Antonis A Armoundas
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts, USA; Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA.
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27
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Tran MV, Marceau E, Liu Y, Sallam K, Medina P, Liu C, Sayed N, Muller MD, Liang DH, Chen IY. Coronary Artery Vasospasm Requiring Cardiac Autotransplantation Yet Controlled With Tobacco. JACC Case Rep 2021; 3:1177-1181. [PMID: 34401754 PMCID: PMC8353556 DOI: 10.1016/j.jaccas.2021.03.018] [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: 12/28/2020] [Revised: 03/18/2021] [Accepted: 03/25/2021] [Indexed: 11/25/2022]
Abstract
Coronary artery vasospasm is typically managed through avoidance of triggers and with symptomatic treatments with calcium channel blockers and long-acting nitrates. Here, we report a rare case of medically refractory coronary artery vasospasm associated with genetic predispositions that initially required cardiac autotransplantation followed paradoxically by nicotine for long-term symptomatic control. (Level of Difficulty: Intermediate.)
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Affiliation(s)
- Matthew V. Tran
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, USA
- Medical Service, Cardiology Section, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | - Eric Marceau
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, USA
- Medical Service, Cardiology Section, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | - Yu Liu
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, USA
| | - Karim Sallam
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, USA
- Medical Service, Cardiology Section, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
- Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Pedro Medina
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, USA
- Medical Service, Cardiology Section, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | - Chun Liu
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, USA
| | - Nazish Sayed
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, USA
| | - Matthew D. Muller
- Department of Anesthesiology and Perioperative Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - David H. Liang
- Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California, USA
- Dr. David Liang, Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Room H-2157, MC5233, Stanford, California 94305-5233, USA.
| | - Ian Y. Chen
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, USA
- Medical Service, Cardiology Section, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
- Addresses for correspondence: Dr. Ian Y. Chen, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Avenue, Suite 111C, Palo Alto, California 94304, USA. @IanChenMD
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28
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Kowlgi GN, Cha YM. Continuous Infusion Versus Single Injection for Stellate Ganglion Blockade: Less Is Not More? JACC Clin Electrophysiol 2021; 7:461-462. [PMID: 33888267 DOI: 10.1016/j.jacep.2020.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 10/14/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Gurukripa N Kowlgi
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Yong-Mei Cha
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
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29
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Yang AHX, Khwaounjoo P, Cakmak YO. Directional effects of whole-body spinning and visual flow in virtual reality on vagal neuromodulation. J Vestib Res 2021; 31:479-494. [PMID: 34024797 DOI: 10.3233/ves-201574] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Neural circuits allow whole-body yaw rotation to modulate vagal parasympathetic activity, which alters beat-to-beat variation in heart rate. The overall output of spinning direction, as well as vestibular-visual interactions on vagal activity still needs to be investigated. OBJECTIVE This study investigated direction-dependent effects of visual and natural vestibular stimulation on two autonomic responses: heart rate variability (HRV) and pupil diameter. METHODS Healthy human male subjects (n = 27) underwent constant whole-body yaw rotation with eyes open and closed in the clockwise (CW) and anticlockwise (ACW) directions, at 90°/s for two minutes. Subjects also viewed the same spinning environments on video in a VR headset. RESULTS CW spinning significantly decreased parasympathetic vagal activity in all conditions (CW open p = 0.0048, CW closed p = 0.0151, CW VR p = 0.0019,), but not ACW spinning (ACW open p = 0.2068, ACW closed p = 0.7755, ACW VR p = 0.1775,) as indicated by an HRV metric, the root mean square of successive RR interval differences (RMSSD). There were no direction-dependent effects of constant spinning on sympathetic activity inferred through the HRV metrics, stress index (SI), sympathetic nervous system index (SNS index) and pupil diameter. Neuroplasticity in the CW eyes closed and CW VR conditions post stimulation was observed. CONCLUSIONS Only one direction of yaw spinning, and visual flow caused vagal nerve neuromodulation and neuroplasticity, resulting in an inhibition of parasympathetic activity on the heart, to the same extent in either vestibular or visual stimulation. These results indicate that visual flow in VR can be used as a non-electrical method for vagus nerve inhibition without the need for body motion in the treatment of disorders with vagal overactivity. The findings are also important for VR and spinning chair based autonomic nervous system modulation protocols, and the effects of motion integrated VR.
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Affiliation(s)
| | - Prashanna Khwaounjoo
- Department of Anatomy, University of Otago, Dunedin, New Zealand.,Medtech Core NZ, Auckland, New Zealand
| | - Yusuf Ozgur Cakmak
- Department of Anatomy, University of Otago, Dunedin, New Zealand.,Medtech Core NZ, Auckland, New Zealand.,Brain Health Research Centre, Dunedin, New Zealand.,Centre for Health Systems and Technology, Dunedin, New Zealand
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30
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Zheng L, Sun W, Qiao Y, Hou B, Guo J, Killu A, Yao Y. Symptomatic Premature Ventricular Contractions in Vasovagal Syncope Patients: Autonomic Modulation and Catheter Ablation. Front Physiol 2021; 12:653225. [PMID: 34012407 PMCID: PMC8126685 DOI: 10.3389/fphys.2021.653225] [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: 01/14/2021] [Accepted: 04/13/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction There has been limited reports about the comorbid premature ventricular contractions (PVCs) and vasovagal syncope (VVS). Deceleration capacity (DC) was demonstrated to be a quantitative evaluation to assess the cardiac vagal activity. This study sought to report the impact of autonomic modulation on symptomatic PVCs in VVS patients. Methods and Results Twenty-six VVS patients with symptomatic idiopathic PVCs were consecutively enrolled. Identification and catheter ablation of left atrial ganglionated plexi (GP) and PVCs were performed in 26 and 20 patients, respectively. Holter 24 h-electrocardiograms were performed before and after the procedure to evaluate DC and PVCs occurrence. Eighteen patients were subtyped as DC-dependent PVCs (D-PVCs) and eight as DC-independent PVCs groups (I-PVCs). In D-PVCs group, circadian rhythm of hourly PVCs was positively correlated with hourly DC (P < 0.05) while there was no correlation in I-PVCs group (P > 0.05). Fifty-three GPs with positive vagal response were successfully elicited (2.0 ± 0.8 per patient). PVCs failed to occur spontaneously nor to be induced in six patients. In the remaining 20 patients, PVCs foci identified were all located in the ventricular outflow tract region. Post-ablation DC decreased significantly from baseline (P < 0.05). During mean follow-up of 10.64 ± 6.84 months, syncope recurred in one patient and PVCs recurred in another. PVCs burden of the six patients in whom neither catheter ablation nor antiarrhythmic drugs were applied demonstrated a significant decrease during follow-up (P = 0.037). Conclusion Autonomic activities were involved in the occurrence of symptomatic idiopathic PVCs in some VVS patients. D-PVCs might be facilitated by increased vagal activities. Catheter ablation of GP and PVCs foci may be an effective, safe treatment in patients with concomitant VVS and idiopathic PVCs.
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Affiliation(s)
- Lihui Zheng
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wei Sun
- Department of General Medicine, Monash Health, Melbourne, VIC, Australia
| | - Yu Qiao
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bingbo Hou
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jinrui Guo
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ammar Killu
- Department of Cardiovascular Disease, Mayo Clinic, Rochester, MN, United States
| | - Yan Yao
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Oliveira-Junior SA, Boullosa D, Mendonça MLM, Vieira LFC, Mattos WW, Amaral BOC, Lima-Borges DS, Reis FA, Cezar MDM, Vanderlei LCM, Martinez PF. Effects of Circuit Weight-Interval Training on Physical Fitness, Cardiac Autonomic Control, and Quality of Life in Sedentary Workers. Int J Environ Res Public Health 2021; 18:4606. [PMID: 33925277 PMCID: PMC8123620 DOI: 10.3390/ijerph18094606] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/10/2021] [Accepted: 02/10/2021] [Indexed: 11/16/2022]
Abstract
Sedentary behaviors, those that involve sitting and low levels of energy expenditure, have been associated with several adverse cardiometabolic effects. This study evaluated the chronic effects of a combined circuit weight interval training (CWIT) on physical fitness, quality of life, and heart rate variability (HRV), and compared the effects of CWIT-induced autonomic adaptations on different postures in adult sedentary workers. Twenty-seven sedentary workers (age 36.9 ± 9.2 years old, 13 men and 14 women) were divided into two groups: control, who continued their sedentary behavior, and experimental, who were submitted to a CWIT for 12 weeks, completing two ~40 min sessions per week. Monitoring of 8th, 16th, and 24th sessions revealed a moderate training load during sessions. Participants exhibited an improved aerobic capacity (VO2max, 34.03 ± 5.36 vs. 36.45 ± 6.05 mL/kg/min, p < 0.05) and flexibility (22.6 ± 11.4 vs. 25.3 ± 10.1 cm, p < 0.05) after the training period. In addition, they showed greater quality of life scores. However, the CWIT did not change body composition. Interestingly, more HRV parameters were improved in the seated position. The CWIT used in the current study was associated with improvements in several fitness and quality of life parameters, as well as in cardiac autonomic control of HR in adult sedentary workers. Examination of different body positions when evaluating changes in HRV appears to be a relevant aspect to be considered in further studies. Future randomized controlled trials (RCTs) with larger samples of both sexes should confirm these promising results.
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Affiliation(s)
- Silvio A. Oliveira-Junior
- Integrated Institute of Health, Federal University of Mato Grosso do Sul—UFMS, Campo Grande 79070-900, MS, Brazil; (D.B.); (M.L.M.M.); (L.F.C.V.); (W.W.M.); (B.O.C.A.); (D.S.L.-B.); (P.F.M.)
| | - Daniel Boullosa
- Integrated Institute of Health, Federal University of Mato Grosso do Sul—UFMS, Campo Grande 79070-900, MS, Brazil; (D.B.); (M.L.M.M.); (L.F.C.V.); (W.W.M.); (B.O.C.A.); (D.S.L.-B.); (P.F.M.)
| | - Maria L. M. Mendonça
- Integrated Institute of Health, Federal University of Mato Grosso do Sul—UFMS, Campo Grande 79070-900, MS, Brazil; (D.B.); (M.L.M.M.); (L.F.C.V.); (W.W.M.); (B.O.C.A.); (D.S.L.-B.); (P.F.M.)
| | - Larissa F. C. Vieira
- Integrated Institute of Health, Federal University of Mato Grosso do Sul—UFMS, Campo Grande 79070-900, MS, Brazil; (D.B.); (M.L.M.M.); (L.F.C.V.); (W.W.M.); (B.O.C.A.); (D.S.L.-B.); (P.F.M.)
| | - Wania W. Mattos
- Integrated Institute of Health, Federal University of Mato Grosso do Sul—UFMS, Campo Grande 79070-900, MS, Brazil; (D.B.); (M.L.M.M.); (L.F.C.V.); (W.W.M.); (B.O.C.A.); (D.S.L.-B.); (P.F.M.)
| | - Bruna O. C. Amaral
- Integrated Institute of Health, Federal University of Mato Grosso do Sul—UFMS, Campo Grande 79070-900, MS, Brazil; (D.B.); (M.L.M.M.); (L.F.C.V.); (W.W.M.); (B.O.C.A.); (D.S.L.-B.); (P.F.M.)
| | - Dayanne S. Lima-Borges
- Integrated Institute of Health, Federal University of Mato Grosso do Sul—UFMS, Campo Grande 79070-900, MS, Brazil; (D.B.); (M.L.M.M.); (L.F.C.V.); (W.W.M.); (B.O.C.A.); (D.S.L.-B.); (P.F.M.)
| | - Filipe A. Reis
- Department of Physical Therapy, Anhanguera University—UNIDERP, Campo Grande 79003-010, MS, Brazil;
| | - Marcelo D. M. Cezar
- Department of Physical Education, Itapeva Social and Agrarian Sciences College—FAIT, Itapeva 18412-000, SP, Brazil;
| | - Luiz C. M. Vanderlei
- Department of Physical Therapy, Sao Paulo State University—UNESP, Presidente Prudente 19060-900, SP, Brazil;
| | - Paula F. Martinez
- Integrated Institute of Health, Federal University of Mato Grosso do Sul—UFMS, Campo Grande 79070-900, MS, Brazil; (D.B.); (M.L.M.M.); (L.F.C.V.); (W.W.M.); (B.O.C.A.); (D.S.L.-B.); (P.F.M.)
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Ramírez-Adrados A, Martínez-Pascual B, Gonzalez-de-Ramos C, Fernández-Martínez S, Fernández-Elías VE, Clemente-Suárez VJ. The Impact of Nationality on the Psychophysiological Stress Response and Academic Fulfilment in the Final Degree Dissertation. Int J Environ Res Public Health 2021; 18:4035. [PMID: 33921295 PMCID: PMC8069971 DOI: 10.3390/ijerph18084035] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/07/2021] [Accepted: 04/09/2021] [Indexed: 01/30/2023]
Abstract
The aims of this study were: i. to analyze the effect of nationality on the psychophysiological stress response of physiotherapy last year students in their final degree dissertations; and ii. to analyze the relationship between the stress response and academic results according to nationality. We evaluated the autonomic stress response, cortical arousal, distress subjective perception, and objective and subjective academic fulfilment in Spanish, Italian, and French physiotherapy students during their final degree dissertation. Results showed a large anticipatory anxiety response before the dissertation in the three student groups. Only the Spanish group showed an increased tendency in the habituation process, reducing the psychophysiological stress response during the dissertation, while the Italian and French groups maintained a large sympathetic activation until the end of the dissertation. Cortical arousal and subjective perception of distress were similar in the three nationalities. In addition, no correlation between academic fulfilment and autonomic modulation was found. We concluded that there was no nationality effect in the psychophysiological stress response of physiotherapy last year students in their final degree dissertation, all of them showing a large anticipatory anxiety response.
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Affiliation(s)
- Ana Ramírez-Adrados
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (A.R.-A.); (B.M.-P.); (C.G.-d.-R.); (S.F.-M.); (V.E.F.-E.)
| | - Beatriz Martínez-Pascual
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (A.R.-A.); (B.M.-P.); (C.G.-d.-R.); (S.F.-M.); (V.E.F.-E.)
| | - Cristina Gonzalez-de-Ramos
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (A.R.-A.); (B.M.-P.); (C.G.-d.-R.); (S.F.-M.); (V.E.F.-E.)
| | - Silvia Fernández-Martínez
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (A.R.-A.); (B.M.-P.); (C.G.-d.-R.); (S.F.-M.); (V.E.F.-E.)
| | - Valentín Emilio Fernández-Elías
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (A.R.-A.); (B.M.-P.); (C.G.-d.-R.); (S.F.-M.); (V.E.F.-E.)
| | - Vicente Javier Clemente-Suárez
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (A.R.-A.); (B.M.-P.); (C.G.-d.-R.); (S.F.-M.); (V.E.F.-E.)
- Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla 080007, Colombia
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Abstract
BACKGROUND: The delayed blood pressure recovery (BPR) at post-exercise has been in association with a major risk of cardiovascular disease and death. OBJECTIVE: The study focused on evaluating the systolic and diastolic blood pressure recovery (SBPR, DBPR) and the autonomic modulation following treadmill exercise in healthy young adults. Although considerable literature had been published about BPR and HRV, the association between BPR and ultra-short-term HRV has not yet been completely described. METHODS: Fifteen subjects performed exercise with three different intensities on a treadmill, the speed was 6 km/h, 9 km/h, 12 km/h, respectively. SBP and DBP was measured per 30 s in each trial. The synchronous 5-min electrocardiogram (ECG) signals were recorded and HRV30s parameters including SDNN30s, RMSSD30s, SDNN30s/RMSSD30s, SD130s, SD230s and SD130s/SD230s were calculated every 30 s periods in 5 min ECG signals to match the corresponding BPR. RESULTS: The intraclass correlation coefficient (ICC) values and the Bland-Altman plots indicated good consistency and repeatability between HRV30s and HRV5min at three post-exercise trials, with most ICC values > 0.75. Besides, SBPR and DBPR generally decreased and returned to the Rest level in 5 mins. The Spearman correlation coefficients showed strong relationships between BPR and HRV30s sympathetic-vagal balance parameters, i.e., ratio SDNN/RMSSD and ratio SD1/SD2. CONCLUSIONS: These observations represented a new insight into the cardiovascular regulation at post-exercise, which could contribute to physical exercise areas in the future.
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Affiliation(s)
| | - Ping Shi
- Corresponding author: Ping Shi, Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai, China. Tel.: +86 15871374614; E-mail:
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Humm SM, Erb EK, Tagesen EC, Kingsley JD. Sex-Specific Autonomic Responses to Acute Resistance Exercise. ACTA ACUST UNITED AC 2021; 57:medicina57040307. [PMID: 33805238 PMCID: PMC8064347 DOI: 10.3390/medicina57040307] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 03/21/2021] [Accepted: 03/22/2021] [Indexed: 11/17/2022]
Abstract
Background and Objectives: Acute resistance exercise (RE) reduces vagal modulation and increases sympathovagal balance, which increases the risk for arrythmias. Few studies have examined sex differences in autonomic modulation after acute RE. The purpose of this investigation was to examine sex-specific responses to acute RE on autonomic modulation. Materials and Methods: Twenty-one resistance-trained individuals (men n = 11, women n = 10) between the ages of 19 and 25 y were analyzed for autonomic modulation in response to acute RE and a control (CON). Measures of autonomic modulation were collected at rest, 15 (R15), and 30 (R30) min following both conditions. Heart rate (HR), log transformed root mean square of successive differences (lnRMSSD), total power (lnTP), low-frequency power (lnLF), high-frequency power (lnHF), sample entropy (SampEn), and Lempel-Ziv entropy (LZEn) were measured at all time points. A three-way repeated analysis of variance (ANOVA) was used to analyze sex (men, women) across condition (RE, CON) and time (Rest, R15, R30). Results: The results are similar for all heart rate variability (HRV) variables at rest for both conditions (RE, CON). SampEn was significantly higher in men compared to women at rest for both conditions (p = 0.03), with no differences in LZEn (p > 0.05). There were no significant (p > 0.05) three-way interactions on any variables. Condition by time interactions demonstrated that both sexes increase in HR (p = 0.0001) and lnLF/HF ratio (p = 0.001), but decreases in lnRMSSD (p = 0.0001), lnTP (p < 0.0001), lnLF (p < 0.0001), lnHF (p = 0.0001), and LZEn (p = 0.009) at R15 and R30 compared to rest following acute RE and were different from CON. Condition by time interaction (p = 0.017) demonstrated that SampEn was attenuated at R15 compared to rest, and the CON, but not R30 following acute RE. Conclusion: Although SampEn is more complex at rest in men compared to women, autonomic modulation responses between sexes following acute RE appear to be similar.
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Sangaleti CT, Katayama KY, De Angelis K, Lemos de Moraes T, Araújo AA, Lopes HF, Camacho C, Bortolotto LA, Michelini LC, Irigoyen MC, Olofsson PS, Barnaby DP, Tracey KJ, Pavlov VA, Consolim Colombo FM. The Cholinergic Drug Galantamine Alleviates Oxidative Stress Alongside Anti-inflammatory and Cardio-Metabolic Effects in Subjects With the Metabolic Syndrome in a Randomized Trial. Front Immunol 2021; 12:613979. [PMID: 33776997 PMCID: PMC7991724 DOI: 10.3389/fimmu.2021.613979] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 02/08/2021] [Indexed: 12/13/2022] Open
Abstract
Background: The metabolic syndrome (MetS) is an obesity-associated disorder of pandemic proportions and limited treatment options. Oxidative stress, low-grade inflammation and altered neural autonomic regulation, are important components and drivers of pathogenesis. Galantamine, an acetylcholinesterase inhibitor and a cholinergic drug that is clinically-approved (for Alzheimer's disease) has been implicated in neural cholinergic regulation of inflammation in several conditions characterized with immune and metabolic derangements. Here we examined the effects of galantamine on oxidative stress in parallel with inflammatory and cardio-metabolic parameters in subjects with MetS. Trial Design and Methods: The effects of galantamine treatment, 8 mg daily for 4 weeks or placebo, followed by 16 mg daily for 8 weeks or placebo were studied in randomly assigned subjects with MetS (n = 22 per group) of both genders. Oxidative stress, including superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase activities, lipid and protein peroxidation, and nitrite levels were analyzed before and at the end of the treatment. In addition, plasma cytokine and adipokine levels, insulin resistance (HOMA-IR) and other relevant cardio-metabolic indices were analyzed. Autonomic regulation was also examined by heart rate variability (HRV) before treatment, and at every 4 weeks of treatment. Results: Galantamine treatment significantly increased antioxidant enzyme activities, including SOD [+1.65 USOD/mg protein, [95% CI 0.39-2.92], P = 0.004] and CAT [+0.93 nmol/mg, [95% CI 0.34-1.51], P = 0.01], decreased lipid peroxidation [thiobarbituric acid reactive substances [log scale 0.72 pmol/mg, [95% CI 0.46-1.07], P = 0.05], and systemic nitrite levels [log scale 0.83 μmol/mg protein, [95% CI 0.57-1.20], P = 0.04] compared with placebo. In addition, galantamine significantly alleviated the inflammatory state and insulin resistance, and decreased the low frequency/high frequency ratio of HRV, following 8 and 12 weeks of drug treatment. Conclusion: Low-dose galantamine alleviates oxidative stress, alongside beneficial anti-inflammatory, and metabolic effects, and modulates neural autonomic regulation in subjects with MetS. These findings are of considerable interest for further studies with the cholinergic drug galantamine to ameliorate MetS.
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Affiliation(s)
- Carine Teles Sangaleti
- Hypertension Unit, University of São Paulo (USP), São Paulo, Brazil
- Postgraduate Program in Health Science, Midwestern State University (UNICENTRO), Paraná, Brazil
| | - Keyla Yukari Katayama
- Nursing Department Graduate Program in Nanosciences and Biosciences, Nove de Julho University (UNINOVE), São Paulo, Brazil
| | - Kátia De Angelis
- Nursing Department Graduate Program in Nanosciences and Biosciences, Nove de Julho University (UNINOVE), São Paulo, Brazil
- Department of Physiology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Tércio Lemos de Moraes
- Nursing Department Graduate Program in Nanosciences and Biosciences, Nove de Julho University (UNINOVE), São Paulo, Brazil
| | | | - Heno F. Lopes
- Hypertension Unit, University of São Paulo (USP), São Paulo, Brazil
- Nursing Department Graduate Program in Nanosciences and Biosciences, Nove de Julho University (UNINOVE), São Paulo, Brazil
| | - Cleber Camacho
- Nursing Department Graduate Program in Nanosciences and Biosciences, Nove de Julho University (UNINOVE), São Paulo, Brazil
| | | | - Lisete Compagno Michelini
- Biomedical Sciences Institute Department of Physiology and Biophysics, University of São Paulo (USP), São Paulo, Brazil
| | | | - Peder S. Olofsson
- Laboratory of Immunobiology, Department of Medicine, Center for Bioelectronic Medicine, Karolinska Institutet, Stockholm, Sweden
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
| | - Douglas P. Barnaby
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
| | - Kevin J. Tracey
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
| | - Valentin A. Pavlov
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
| | - Fernanda Marciano Consolim Colombo
- Hypertension Unit, University of São Paulo (USP), São Paulo, Brazil
- Nursing Department Graduate Program in Nanosciences and Biosciences, Nove de Julho University (UNINOVE), São Paulo, Brazil
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Abdelnabi M, Zaki M, Sadaka M, Nawar M. Effects of coronary revascularization by elective percutaneous coronary intervention on cardiac autonomic modulation assessed by heart rate variability: a single-center prospective cohort study. Am J Cardiovasc Dis 2021; 11:164-175. [PMID: 33815932 PMCID: PMC8012296] [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] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 01/29/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To study the effects of coronary revascularization using elective percutaneous coronary intervention (PCI) on autonomic modulation assessed by heart rate variability measurement (HRV) in coronary artery disease (CAD) patients. METHODS A single-center prospective cohort study included 100 patients were included undergoing elective PCI excluding those with contraindication to contrast or dual antiplatelet therapy, atrial fibrillation or multiple premature beats, receiving anti-arrhythmic drugs and those who underwent previous PCI or coronary artery bypass graft (CABG). Short-term measurement of time domain parameters (mean, SDNN, RMSSD) and frequency domain parameters (LF component, HF component, LF/HF ratio) of HRV was performed at the same time of the day, pre-PCI, 24 hours and 6 months post-PCI by CheckMyheart™ handheld HRV device. 5-min HRV analysis software was used to interpret the data using standard methods of HRV measurement of the Task Force of The European Society of Cardiology (ESC) and The North American Society of Pacing and Electrophysiology. SYNTAX (SX) score was calculated before PCI and residual SYNTAX (rSS) score was calculated after PCI using SYNTAX score calculator software. RESULTS The mean age of the studied population was 56.89±10.75 years with 85% males. HRV time and frequency domain parameters showed a statistically significant improvement at different time intervals (before PCI, 24 hours and 6 months after PCI) (p-value <0.001). HRV time and frequency domain measures showed a statistically significant difference between time and frequency domain HRV parameters 24 hours and 6 months after PCI in patients who had complete revascularization (CR) with those who had incomplete revascularization (IR). (p-value <0.001). CONCLUSION Autonomic modulation in CAD patients was improved by coronary revascularization using PCI assessed by serial HRV measurement. Patients with CR had better autonomic modulation than those with IR assessed by HRV 24 and 6 months after PCI.
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Affiliation(s)
- Mahmoud Abdelnabi
- Cardiology and Angiology Unit, Clinical and Experimental Internal Medicine Department, Medical Research Institute, Alexandria UniversityAlexandria, Egypt
| | - Moataz Zaki
- Cardiology and Angiology Unit, Clinical and Experimental Internal Medicine Department, Medical Research Institute, Alexandria UniversityAlexandria, Egypt
| | - Mohamed Sadaka
- Cardiology Department, Faculty of Medicine, Alexandria UniversityAlexandria, Egypt
| | - Moustafa Nawar
- Cardiology Department, Faculty of Medicine, Alexandria UniversityAlexandria, Egypt
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Silva LRB, Gentil P, Seguro CS, de Oliveira GT, Silva MS, Zamunér AR, Beltrame T, Rebelo ACS. High Fasting Glycemia Predicts Impairment of Cardiac Autonomic Control in Adults With Type 2 Diabetes: A Case-Control Study. Front Endocrinol (Lausanne) 2021; 12:760292. [PMID: 34858333 PMCID: PMC8630737 DOI: 10.3389/fendo.2021.760292] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 10/22/2021] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Type 2 diabetes (T2D) is characterized by a metabolic disorder that elevates blood glucose concentration. Chronic hyperglycemia has been associated with several complications in patients with T2D, one of which is cardiac autonomic dysfunction that can be assessed from heart rate variability (HRV) and heart rate recovery (HRR) response, both associated with many aspects of health and fitness, including severe cardiovascular outcomes. OBJECTIVE To evaluate the effects of T2D on cardiac autonomic modulation by means of HRV and HRR measurements. MATERIALS AND METHODS This study has an observational with case-control characteristic and involved ninety-three middle-aged adults stratified into two groups (control group - CG, n = 34; diabetes group - DG, n = 59). After signing the free and informed consent form, the patients were submitted to the evaluation protocols, performed biochemical tests to confirm the diagnosis of T2D, collection of R-R intervals for HRV analysis and cardiopulmonary effort test to quantify HRR. RESULTS At rest, the DG showed a reduction in global HRV (SDNN= 19.31 ± 11.72 vs CG 43.09 ± 12.74, p < 0.0001), lower parasympathetic modulation (RMSSD= 20.49 ± 14.68 vs 52.41 ± 19.50, PNN50 = 4.76 ± 10.53 vs 31.24 ± 19.24, 2VD%= 19.97 ± 10.30 vs 28.81 ± 9.77, p < 0.0001 for both indices) and higher HRrest when compared to CG. After interruption of physical exercise, a slowed heart rate response was observed in the DG when compared to the CG. Finally, a simple linear regression showed that fasting glycemia was able to predict cardiac autonomic involvement in volunteers with T2D. CONCLUSION Patients with T2D presented lower parasympathetic modulation at rest and slowed HRR after physical exercise, which may be associated with higher cardiovascular risks. The findings show the glycemic profile as an important predictor of impaired cardiac autonomic modulation.
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Affiliation(s)
- Lucas Raphael Bento Silva
- Department of Physical Education, Araguaia University Center, Goiânia, Brazil
- Post-Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiânia, Brazil
- *Correspondence: Lucas Raphael Bento Silva,
| | - Paulo Gentil
- Post-Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiânia, Brazil
- Faculty of Physical Education and Dance, Federal University of Goias, Goiânia, Brazil
- Hypertension League, Federal University of Goias, Goiânia, Brazil
| | - Camila Simões Seguro
- Post-Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiânia, Brazil
| | | | - Maria Sebastiana Silva
- Post-Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiânia, Brazil
- Faculty of Physical Education and Dance, Federal University of Goias, Goiânia, Brazil
| | - Antônio Roberto Zamunér
- Laboratory of Clinical Research in Kinesiology, Department of Kinesiology, Universidad Católica del Maule, Talca, Chile
| | - Thomas Beltrame
- Institute of Computing, University of Campinas, São Paulo, Brazil
- Department of Physical Therapy, Federal University of São Carlos, São Paulo, Brazil
| | - Ana Cristina Silva Rebelo
- Post-Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiânia, Brazil
- Faculty of Physical Education and Dance, Federal University of Goias, Goiânia, Brazil
- Department of Morphology, Institute of Biological Sciences, Federal University of Goias, Goiânia, Brazil
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Mostarda C, Barboza CDA, Cutrim AL, Silva-Filho AC, Dias CJ, Brito-Monzani JDO, Rodrigues B. Obesity as an additional factor for autonomic imbalance and poor sleep behavior in chronic obstructive pulmonary disease: a case-control study. Clinics (Sao Paulo) 2021; 76:e1826. [PMID: 33503172 PMCID: PMC7798128 DOI: 10.6061/clinics/2021/e1826] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 09/02/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES We compared the autonomic modulation and sleep behavior of eutrophic and overweight patients with chronic obstructive pulmonary disease (COPD). METHODS COPD participants were divided into the overweight and eutrophic groups. Pulmonary function, blood pressure, body composition, autonomic modulation, and the Pittsburgh Sleep Quality Index score were assessed. Participants performed the six-minute walk test for functional assessment. RESULTS Spirometric variables obtained in eutrophic and overweight individuals with COPD showed no statistically different results. We observed that the SDNN index indicated lower overall variability (p=0.003), and root mean square of successive differences between normal heart beats (RMSSD) (p=0.04) indicated lower parasympathetic modulation in the overweight group than observed in the eutrophic group. The indexes of the frequency domain presented lower values of total variability (p<0.01), low frequency bands (p<0.01), and high frequency (p=0.02), suggesting a higher sympathetic modulation and reduced parasympathetic modulation of the overweight group compared to eutrophic group. The overweight group also showed reduced sleep quality than the eutrophic group. CONCLUSION Overweight COPD patients showed lower autonomic modulation and impaired sleep quality, latency, and efficiency as compared eutrophic subjects. These results reinforce the importance of weight control and the acquisition of healthy habits in this population.
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Affiliation(s)
- Cristiano Mostarda
- Laboratorio de Adaptacoes Cardiovasculares ao Exercicio (LACORE), Universidade Federal do Maranhao, Sao Luis, MA, BR
- Programa de Pos-Graduacao em Educacao Fisica, Universidade Federal do Maranhao, Sao Luis, MA, BR
- Centro de Reabilitacao Cardiopulmonar, Hospital Universitario “Presidente Dutra”, Universidade Federal do Maranhao, Sao Luis, MA, BR
| | | | - Ana Lídia Cutrim
- Laboratorio de Adaptacoes Cardiovasculares ao Exercicio (LACORE), Universidade Federal do Maranhao, Sao Luis, MA, BR
- Programa de Pos-Graduacao em Educacao Fisica, Universidade Federal do Maranhao, Sao Luis, MA, BR
| | - Antonio Carlos Silva-Filho
- Laboratorio de Adaptacoes Cardiovasculares ao Exercicio (LACORE), Universidade Federal do Maranhao, Sao Luis, MA, BR
- Programa de Pos-Graduacao em Educacao Fisica, Universidade Federal do Maranhao, Sao Luis, MA, BR
| | - Carlos José Dias
- Laboratorio de Adaptacoes Cardiovasculares ao Exercicio (LACORE), Universidade Federal do Maranhao, Sao Luis, MA, BR
- Centro de Reabilitacao Cardiopulmonar, Hospital Universitario “Presidente Dutra”, Universidade Federal do Maranhao, Sao Luis, MA, BR
| | - Janaina De Oliveira Brito-Monzani
- Laboratorio de Adaptacoes Cardiovasculares ao Exercicio (LACORE), Universidade Federal do Maranhao, Sao Luis, MA, BR
- Programa de Pos-Graduacao em Educacao Fisica, Universidade Federal do Maranhao, Sao Luis, MA, BR
| | - Bruno Rodrigues
- Faculdade de Educacao Fisica, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, BR
- *Corresponding author. E-mail:
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do Nascimento Vinholes L, Sousa da Silva A, Marinho Tassi E, Corrêa Borges de Lacerda G. Heart rate variability in frontal lobe epilepsy: Association with SUDEP risk. Acta Neurol Scand 2021; 143:62-70. [PMID: 32749695 DOI: 10.1111/ane.13330] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 07/16/2020] [Accepted: 07/28/2020] [Indexed: 01/18/2023]
Abstract
OBJECTIVES Frontal lobe epilepsy (FLE) may impair autonomic heart rate modulation. Decreased heart rate variability (HRV) may enhance risk of sudden death. Our objective was to describe whole day and wakefulness/sleep HRV parameters from FLE patients in comparison with those of healthy controls and correlate HRV parameters to SUDEP-7 scores. METHODS Ten patients with FLE and 15 healthy controls underwent a 24-hour electrocardiogram holter. The SUDEP-7 score was calculated for patients. Subgroups were identified according to active epilepsy, number of generalized seizures, cognitive deficit, medication load, and time-length of epilepsy. Time-domain SDNN, SDNNi, SDANN, rMSDD, and pNN50 and frequency-domain LF, HF, and LF/HF parameters were analyzed. Wilcoxon and Spearman correlation tests were used. A P < .05 was considered significant. RESULTS Patients SDNN, SDNNi, rMSSD, and pNN50 were decreased in 24-hour recordings. Although a tendency for a protective effect of sleep was seen for both patients and controls, intragroup comparisons of sleeping/waking states revealed a significant increase in sleep rMSSD (P = .046) and pNN50 (P = .041) only for controls. All 24-hour time-domain parameters and LF were inversely and significantly correlated to SUDEP-7, particularly SDANN (ρ = -0.896, P = .00019), known to deteriorate with diminished physical activity and decreased in patients with more generalized seizures. Wakefulness parameters did not correlate to SUDEP-7, whereas correlations to sleep parameters were very strong, particularly with rMSSD (ρ = -0.945, P = .00012). Cognitive deficit was associated with decreased pNN50, sleep pNN50, and LH. CONCLUSION HRV is impaired in patients with FLE. Low HRV scores are associated with increased risk for SUDEP as measured by the SUDEP-7 score.
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Affiliation(s)
| | - Alexandre Sousa da Silva
- Mathematics and Statistical Department Universidade Federal do Estado do Rio de Janeiro (UniRio) Rio de Janeiro Brazil
| | - Eduardo Marinho Tassi
- Cardiology Department Universidade Federal do Estado do Rio de Janeiro (UniRio) Rio de Janeiro Brazil
| | - Glenda Corrêa Borges de Lacerda
- Neurology Post‐Graduation Program Neurology Department Universidade Federal do Estado do Rio de Janeiro (UniRio) Rio de Janeiro Brazil
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Jordão MR, Pessoa FG, Fonseca KC, Zanoni F, Salemi VM, Souza LE, Ribeiro ON, Fernandes F, Irigoyen MC, Moreira LFP, Mady C, Ramires FJA. Effects of sympathectomy on myocardium remodeling and function. Clinics (Sao Paulo) 2021; 76:e1958. [PMID: 33503174 PMCID: PMC7798118 DOI: 10.6061/clinics/2021/e1958] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 09/08/2020] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES To evaluate the effects of sympathectomy on the myocardium in an experimental model. METHODS The study evaluated three groups of male Wistar rats: control (CT; n=15), left unilateral sympathectomy (UNI; n=15), and bilateral sympathectomy (BIL; n=31). Sympathectomy was performed by injection of absolute alcohol into the space of the spinous process of the C7 vertebra. After 6 weeks, we assessed the chronotropic properties at rest and stress, cardiovascular autonomic modulation, myocardial and peripheral catecholamines, and beta-adrenergic receptors in the myocardium. The treadmill test consisted of an escalated protocol with a velocity increment until the maximal velocity tolerated by the animal was reached. RESULTS The bilateral group had higher levels of peripheral catecholamines, and consequently, a higher heart rate (HR) and blood pressure levels. This suggests that the activation of a compensatory pathway in this group may have deleterious effects. The BIL group had basal tachycardia immediately before the exercise test and increased tachycardia at peak exercise (p<0.01); the blood pressure had the same pattern (p=0.0365). The variables related to autonomic modulation were not significantly different between groups, with the exception of the high frequency (HF) variable, which showed significant differences in CT vs UNI. There was no significant difference in beta receptor expression between groups. There was a higher concentration of peripheral norepinephrine in the BIL group (p=0.0001), and no significant difference in myocardial norepinephrine (p=0.09). CONCLUSION These findings suggest that an extra cardiac compensatory pathway increases the sympathetic tonus and maintains a higher HR and higher levels of peripheral catecholamines in the procedure groups. The increase in HF activity can be interpreted as an attempt to increase the parasympathetic tonus to balance the greater sympathetic activity.
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Affiliation(s)
- Maurício Rodrigues Jordão
- Instituto do Coracao (InCor), Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Fernanda G. Pessoa
- Instituto do Coracao (InCor), Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Keila C.B. Fonseca
- Instituto do Coracao (InCor), Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Fernando Zanoni
- Instituto do Coracao (InCor), Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Vera M.C. Salemi
- Instituto do Coracao (InCor), Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Leandro E. Souza
- Instituto do Coracao (InCor), Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Orlando N. Ribeiro
- Instituto do Coracao (InCor), Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Fábio Fernandes
- Instituto do Coracao (InCor), Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Maria Claudia Irigoyen
- Instituto do Coracao (InCor), Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Luiz Felipe P. Moreira
- Instituto do Coracao (InCor), Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Charles Mady
- Instituto do Coracao (InCor), Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Felix Jose Alvarez Ramires
- Instituto do Coracao (InCor), Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
- *Corresponding author. E-mail:
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Sanghai S, Abbott NJ, Dewland TA, Henrikson CA, Elman MR, Wollenberg M, Ivie R, Gonzalez-Sotomayor J, Nazer B. Stellate Ganglion Blockade With Continuous Infusion Versus Single Injection for Treatment of Ventricular Arrhythmia Storm. JACC Clin Electrophysiol 2020; 7:452-460. [PMID: 33358672 DOI: 10.1016/j.jacep.2020.09.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 06/07/2020] [Revised: 09/04/2020] [Accepted: 09/05/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES This study sought to compare the efficacy and safety of single-injection stellate ganglion block (SGB) with a novel continuous-infusion SGB procedure. BACKGROUND SGB for ventricular arrhythmia (VA) storm is typically performed with a single injection of local anesthetic agents. METHODS Eighteen patients underwent left-sided SGB (9 single injection and 9 continuous infusion). The number of implantable cardioverter-defibrillator therapies and sustained VAs/24 h were compared between the pre-SGB and post-SGB periods. Adverse effects of SGB and in-hospital outcomes were also compared. RESULTS The mean age was 61.1 ± 13.7 years. The presenting arrhythmia was ventricular tachycardia in 13 (72%) patients, ventricular fibrillation in 4 (22%), and both in 1 (6%). Single-injection SGB reduced VA/24 h by a median of 0.3 (interquartile range: 0.2 to 0.9), which was a 45% reduction (p = 0.008), resulting in 5 of 9 patients with no recurrent VA. Continuous-infusion SGB reduced VA/24 h by a median of 2.0 (interquartile range: 1.3 to 3.0), which was a 94% reduction (p = 0.004), resulting in 7 of 9 patients with no recurrent VA (p = 0.006 for comparison with single injection). Transient left arm weakness and voice hoarseness were each noted in 1 patient in both groups. Repeat SGB was required in 4 (44%) patients in the single-injection group. In-hospital outcomes were similar between the groups. CONCLUSIONS In patients with VA storm, SGB performed via both continuous-infusion and single-injection approaches provided significant reductions in VA burden. Compared to single-injection SGB, continuous-infusion was associated with a greater reduction in VA burden and similar adverse events, without the need for repeat procedures.
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Affiliation(s)
- Saket Sanghai
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Nicholas J Abbott
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Thomas A Dewland
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Charles A Henrikson
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Miriam R Elman
- Biostatistics and Design Program, Oregon Health and Science University-Portland State University School of Public Health, Portland, Oregon, USA
| | - Michael Wollenberg
- Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, Portland, Oregon, USA
| | - Ryan Ivie
- Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, Portland, Oregon, USA
| | - Julio Gonzalez-Sotomayor
- Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, Portland, Oregon, USA
| | - Babak Nazer
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA.
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Holmes CJ, Fedewa MV, Winchester LJ, MacDonald HV, Wind SA, Esco MR. Validity of Smartphone Heart Rate Variability Pre- and Post-Resistance Exercise. Sensors (Basel) 2020; 20:s20205738. [PMID: 33050249 PMCID: PMC7600564 DOI: 10.3390/s20205738] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/02/2020] [Accepted: 10/06/2020] [Indexed: 12/28/2022]
Abstract
The aim was to examine the validity of heart rate variability (HRV) measurements from photoplethysmography (PPG) via a smartphone application pre- and post-resistance exercise (RE) and to examine the intraday and interday reliability of the smartphone PPG method. Thirty-one adults underwent two simultaneous ultrashort-term electrocardiograph (ECG) and PPG measurements followed by 1-repetition maximum testing for back squats, bench presses, and bent-over rows. The participants then performed RE, where simultaneous ultrashort-term ECG and PPG measurements were taken: two pre- and one post-exercise. The natural logarithm of the root mean square of successive normal-to-normal (R-R) differences (LnRMSSD) values were compared with paired-sample t-tests, Pearson product correlations, Cohen’s d effect sizes (ESs), and Bland–Altman analysis. Intra-class correlations (ICC) were determined between PPG LnRMSSDs. Significant, small–moderate differences were found for all measurements between ECG and PPG: BasePre1 (ES = 0.42), BasePre2 (0.30), REPre1 (0.26), REPre2 (0.36), and REPost (1.14). The correlations ranged from moderate to very large: BasePre1 (r = 0.59), BasePre2 (r = 0.63), REPre1 (r = 0.63), REPre2 (r = 0.76), and REPost (r = 0.41)—all p < 0.05. The agreement for all the measurements was “moderate” (0.10–0.16). The PPG LnRMSSD exhibited “nearly-perfect” intraday reliability (ICC = 0.91) and “very large” interday reliability (0.88). The smartphone PPG was comparable to the ECG for measuring HRV at rest, but with larger error after resistance exercise.
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Affiliation(s)
- Clifton J. Holmes
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO 63110, USA
- Department of Kinesiology, University of Alabama, Tuscaloosa, AL 35487, USA; (M.V.F.); (L.J.W.); (H.V.M.); (S.A.W.); (M.R.E.)
- Correspondence: ; Tel.: +1-314-422-3291
| | - Michael V. Fedewa
- Department of Kinesiology, University of Alabama, Tuscaloosa, AL 35487, USA; (M.V.F.); (L.J.W.); (H.V.M.); (S.A.W.); (M.R.E.)
| | - Lee J. Winchester
- Department of Kinesiology, University of Alabama, Tuscaloosa, AL 35487, USA; (M.V.F.); (L.J.W.); (H.V.M.); (S.A.W.); (M.R.E.)
| | - Hayley V. MacDonald
- Department of Kinesiology, University of Alabama, Tuscaloosa, AL 35487, USA; (M.V.F.); (L.J.W.); (H.V.M.); (S.A.W.); (M.R.E.)
| | - Stefanie A. Wind
- Department of Kinesiology, University of Alabama, Tuscaloosa, AL 35487, USA; (M.V.F.); (L.J.W.); (H.V.M.); (S.A.W.); (M.R.E.)
| | - Michael R. Esco
- Department of Kinesiology, University of Alabama, Tuscaloosa, AL 35487, USA; (M.V.F.); (L.J.W.); (H.V.M.); (S.A.W.); (M.R.E.)
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Turri-Silva N, Ricci-Vitor AL, Cipriano G, Garner D, Netto J, Giacon T, Destro Christofaro DG, Marques Vanderlei LC. Functional Resistance Training Superiority Over Conventional Training in Metabolic Syndrome: A Randomized Clinical Trial. Res Q Exerc Sport 2020; 91:415-424. [PMID: 31906814 DOI: 10.1080/02701367.2019.1679333] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 10/07/2019] [Indexed: 06/10/2023]
Abstract
Metabolic syndrome (MetS) is a growing epidemic related with higher values of blood pressure (BP) and autonomic dysfunction. Scientific evidence has been indicating that functional resistance training (FRT) is superior over conventional (CRT) for muscle fatigue and pain, yet its effects on autonomic modulation (AM), BP and heart rate in MetS are unclear. We theorized that FRT can be superior to CRT in MetS patients because of larger muscle activation. This study compares FRT and CRT on AM, blood pressure, heart rate and muscle strength. Thirty-eight sex and age matched individuals (40 to 60 years) were randomized for FRT or CRT, with training intensity varying gradually from 30%-100% of one maximal repetition test (1MR), 3 times/week for 30 sessions. All outcomes were evaluated at baseline and post training. AM was assessed by heart rate variability (mean RR, RMSSD, SDNN, LF, HF, TINN, RRtri, SD1 and SD2). BP (mmHg) was obtained by cuff measures. Muscle strength was assessed by 1MR. An increase in cardiac parasympathetic activity was observed in individuals allocated to FRT in comparison to CRT group (RMSSD ∆40%; SD1 ∆39%; and HF ms 2 ∆80%). Moreover, just FRT was capable of reducing BP post intervention (SBP from 129.21 ± 19.02 to 118.94 ± 14.14 mmHg, p < .009,/d/ = 0.49; DBP from 85.26 ± 11.48 to 77.76 ± 8.93 mmHg, p < .01,/d/ = 0.51). Both groups had a similar increase in muscle strength and no changes between HR. Progressive FRT was more beneficial to CRT regarding AM, increasing vagal activity, and reducing blood pressure in MetS individuals.
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Maggioni MA, Rundfeldt LC, Gunga HC, Joerres M, Merati G, Steinach M. The Advantage of Supine and Standing Heart Rate Variability Analysis to Assess Training Status and Performance in a Walking Ultramarathon. Front Physiol 2020; 11:731. [PMID: 32792964 PMCID: PMC7394006 DOI: 10.3389/fphys.2020.00731] [Citation(s) in RCA: 2] [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: 03/01/2020] [Accepted: 06/04/2020] [Indexed: 12/11/2022] Open
Abstract
Cardiac autonomic modulation of heart rate, assessed by heart rate variability (HRV), is commonly used to monitor training status. HRV is usually measured in athletes after awakening in the morning in the supine position. Whether recording during standing reveals additional information compared to supine remains unclear. We aimed to evaluate the association between short-duration HRV, assessed both in the supine and standing position, and a low-intensity long-duration performance (walking ultramarathon), as well as training experience. Twenty-five competitors in a 100 km walking ultramarathon underwent pre-race supine (12 min) and standing (6 min) HR recordings, whereas performance and subjective training experience were assessed post-race. There were no significant differences in both supine and standing HRV between finishers (n = 14) and non-finishers (n = 11, mean distance 67 km). In finishers, a slower race velocity was significantly correlated with a higher decrease in parasympathetic drive during position change [larger decrease in High Frequency power normalized units (HFnu: r = −0.7, p = 0.01) and higher increase in the detrended fluctuation analysis alpha 1 index (DFA1: r = 0.6, p = 0.04)]. Highly trained athletes accounted for higher HFnu during standing compared to poorly trained competitors (+11.5, p = 0.01). Similarly, greater training volume (total km/week) would predict higher HFnu during standing (r = 0.5, p = 0.01). HRV assessment in both supine and standing position may provide additional information on the dynamic adaptability of cardiac autonomic modulation to physiologic challenges and therefore be more valuable for performance prediction than a simple assessment of supine HRV. Self-reported training experience may reliably associate with parasympathetic drive, therefore indirectly predicting long-term aerobic performance in ultramarathon walking races.
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Affiliation(s)
- Martina Anna Maggioni
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Physiology, Center for Space Medicine and Extreme Environments, Berlin, Germany.,Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Lea Christiane Rundfeldt
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Physiology, Center for Space Medicine and Extreme Environments, Berlin, Germany
| | - Hanns-Christian Gunga
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Physiology, Center for Space Medicine and Extreme Environments, Berlin, Germany
| | - Marc Joerres
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Physiology, Center for Space Medicine and Extreme Environments, Berlin, Germany
| | - Giampiero Merati
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.,IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Mathias Steinach
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Physiology, Center for Space Medicine and Extreme Environments, Berlin, Germany
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Prell R, Opatz O, Merati G, Gesche B, Gunga HC, Maggioni MA. Heart Rate Variability, Risk-Taking Behavior and Resilience in Firefighters During a Simulated Extinguish-Fire Task. Front Physiol 2020; 11:482. [PMID: 32754042 PMCID: PMC7381295 DOI: 10.3389/fphys.2020.00482] [Citation(s) in RCA: 5] [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: 12/02/2019] [Accepted: 04/20/2020] [Indexed: 01/10/2023] Open
Abstract
Firefighters face a high-risk potential, thus their psychological ability to cope with critical or traumatic events is a crucial characteristic. This study examines correlations between cardiac autonomic modulation, risk-taking behavior, and resilience in professional firefighters. Twenty male professional firefighters underwent a 20 min beat-to-beat heart rate (HR) monitoring at baseline in the morning upon awakening, then before, during and after a realistic deployment in a container, systematically set on fire. Risk-taking behavior, resilience, and subjective stress were assessed by specific validated tools after deployment: the Risk-taking Scale (R-1), the Resilience Scale (RS-13), and the multi-dimensional NASA-Task Load Index. The cardiac autonomic modulation at rest and in response to stress was assessed by classic indexes of heart rate variability (HRV) as RMSSD and LF/HF ratio. Results showed that: (i) risk-taking behavior correlated with a withdrawal in vagal indices, shifted the baseline sympathovagal balance toward sympathetic predominance (LF/HF ratio r(8) = 0.522, p = 0.01), and increased mean HR both in baseline and during physical exercise (r(8) = 0.526, p = 0.01 and r(8) = 0.445, p = 0.05, respectively); (ii) resilience was associated with higher vagal indices (RMSSD r(18) = 0.288, p = 0.04), and with a baseline sympathovagal balance shifted toward parasympathetic predominance (LF/HF ratio r(18) = −0.289, p = 0.04). Associations of risk-taking behavior and resilience with cardiac autonomic modulation could be demonstrated, showing that HRV may be a valuable monitoring tool in this specific population; however further studies are warranted for validation.
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Affiliation(s)
- Rebecca Prell
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Physiology Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany.,Berlin Fire Department, Berlin, Germany
| | - Oliver Opatz
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Physiology Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany
| | - Giampiero Merati
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.,IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Björn Gesche
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Physiology Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany
| | - Hanns-Christian Gunga
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Physiology Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany
| | - Martina A Maggioni
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Physiology Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany.,Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
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Liao TW, Lo LW, Lin YJ, Chang SL, Hu YF, Wu CI, Chung FP, Chao TF, Liao JN, Chen SA. Autonomic modulation before and after paroxysmal atrial fibrillation events in patients with ischemic heart disease. Ann Noninvasive Electrocardiol 2020; 25:e12767. [PMID: 32452603 DOI: 10.1111/anec.12767] [Citation(s) in RCA: 2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 03/29/2020] [Accepted: 04/09/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The autonomic activity plays a critical role in generating paroxysmal atrial fibrillation (PAF). This study aimed to evaluate the changes in the autonomic nerve activity before and after PAF events in patients with and without ischemic heart disease (IHD). METHODS The study included 49 patients (71.43 ± 12.24 years old, 26 males) with PAF events lasting more than 30 s during 24-hr ambulatory Holter monitoring. The 20-min intervals before and after PAF events were divided into eight segments of 5 min each. Heart rate variability (HRV) analyses of the time and frequency domains were applied to each time segment. RESULTS Patients with IHD had significant increases in the root mean square successive differences (r-MSSD, p = .008) and HF component (p = .04), followed by a significant increase in the LF/HF ratio (p = .02) preceding the onset of PAF. Patients without IHD had only a significant increase in the r-MSSD (p = .045) preceding the onset of PAF. During the termination of PAF events, patients in both the IHD and control groups had a significantly decreased r-MSSD and HF, respectively. CONCLUSION Ischemic heart disease causes a sympathovagal imbalance in the initiation of PAF. Decreased parasympathetic activity regulated the termination of PAF in both the IHD and control groups. The modification of the autonomic nervous system (ANS) activity should be individualized due to the autonomic complexity in AF arrhythmogenesis and termination.
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Affiliation(s)
- Ting-Wei Liao
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Li-Wei Lo
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Clinical Medicine, Cardiovascular Research Institute, National Yang-Ming University, Taipei, Taiwan
| | - Yenn-Jiang Lin
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Clinical Medicine, Cardiovascular Research Institute, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Lin Chang
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Clinical Medicine, Cardiovascular Research Institute, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Feng Hu
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Clinical Medicine, Cardiovascular Research Institute, National Yang-Ming University, Taipei, Taiwan
| | - Cheng-I Wu
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Clinical Medicine, Cardiovascular Research Institute, National Yang-Ming University, Taipei, Taiwan
| | - Fa-Po Chung
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Clinical Medicine, Cardiovascular Research Institute, National Yang-Ming University, Taipei, Taiwan
| | - Tze-Fan Chao
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Clinical Medicine, Cardiovascular Research Institute, National Yang-Ming University, Taipei, Taiwan
| | - Jo-Nan Liao
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Clinical Medicine, Cardiovascular Research Institute, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Ann Chen
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Clinical Medicine, Cardiovascular Research Institute, National Yang-Ming University, Taipei, Taiwan
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Kusayama T, Chen PS. Propranolol or SGB, That Is the Question. JACC Clin Electrophysiol 2020; 6:572-573. [PMID: 32439043 DOI: 10.1016/j.jacep.2020.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 01/31/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Takashi Kusayama
- Krannert Institute of Cardiology, Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA; Department of Cardiology, Kanazawa University Graduate School of Medical Sciences, Ishikawa, Japan
| | - Peng-Sheng Chen
- Krannert Institute of Cardiology, Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
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Tornero-Aguilera JF, Sanchez-Molina J, Fernández-Elías VE, Clemente-Suárez VJ. Psychophysiological Stress Response of Novice Cavers in a Speleology Route. Wilderness Environ Med 2020; 31:259-265. [PMID: 32416959 DOI: 10.1016/j.wem.2020.02.001] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 02/10/2020] [Accepted: 02/11/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Speleology/Caving is a recreational outdoor activity that has drawn an increasing number of participants in recent years, but there is little information on the physiological and psychological demands of this outdoor activity. This research aimed to analyze the psychophysiological response of novice cavers to a caving route. METHODS Modifications in autonomic modulation, ratings of perceived exertion, and perceived stress were evaluated in physically active participants before, during, and after a caving route of 3-h duration. RESULTS Eighteen participants were assessed. We found an anticipatory anxiety response in the participants before starting the route and significant increases in the ratings of perceived exertion, stress perception, autonomous sympathetic modulation as evaluated by heart rate variability while on the route, and sympathetic modulation 30 min after finishing the caving route. CONCLUSIONS A speleology route produced an anticipatory anxiety response, an increase in the sympathetic stress response, fatigue symptoms at the autonomic nervous system level, and low perception of stress and effort compared with the autonomic stress response. This information could help to better prepare participants for this demanding event, potentially avoiding accidents and injuries and increasing safety for cavers.
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Affiliation(s)
- José Francisco Tornero-Aguilera
- Research Center in Applied Combat (CESCA), Toledo, Spain; Faculty of Sports Science, Universidad Europea de Madrid, Madrid, Spain
| | | | | | - Vicente Javier Clemente-Suárez
- Research Center in Applied Combat (CESCA), Toledo, Spain; Faculty of Sports Science, Universidad Europea de Madrid, Madrid, Spain; Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla, Colombia.
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49
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Fudim M, Qadri YJ, Waldron NH, Boortz-Marx RL, Ganesh A, Patel CB, Podgoreanu MV, Sun AY, Milano CA, Tong BC, Harpole DH, Mathew JP, Piccini JP. Stellate Ganglion Blockade for the Treatment of Refractory Ventricular Arrhythmias. JACC Clin Electrophysiol 2020; 6:562-571. [PMID: 32439042 DOI: 10.1016/j.jacep.2019.12.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 09/23/2019] [Revised: 12/13/2019] [Accepted: 12/27/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This study sought to describe our institutional experience with establishing a neurocardiology service in an attempt to provide autonomic modulation as a treatment for ventricular arrhythmias (VAs). BACKGROUND Treatment-refractory VAs are commonly driven and exacerbated by heightened sympathetic tone. METHODS Among patients referred to the neurocardiology service (August 2016 to December 2018), we performed ultrasound-based, bilateral, temporary stellate ganglion blockade (SGB) in 20 consecutive patients. We analyzed outcomes of interest including sustained VA or VA requiring defibrillation in the 24 and 48 h before and 24 and 48 h after SGB. RESULTS The majority of patients were men (n = 19, 95%), with a mean age of 58 ± 14 years. At the time of SGB, 10 (50%) were on inotropic support and 9 (45%) were on mechanical circulatory support. Besides 1 case of hoarseness, there were no apparent procedural complications. SGB was associated with a reduction in the number of VA episodes from the 24 h before (median 5.5 [interquartile range (IQR): 2.0 to 15.8]) to 24 h after SGB (median 0 [IQR: 0 to 3.8]) (p < 0.001). The number of defibrillation events decreased from 2.5 (IQR: 0 to 10.3) to 0 (IQR: 0 to 2.5) (p = 0.002). Similar findings were observed over the 48-h period before and after the SGB. Overall, 9 of 20 (45%) patients had a complete response with no recurrence of ventricular tachycardia (VT) or ventricular fibrillation (VF) for 48 h after SGB. Four (20%) patients had no recurrent VT or VF following SGB through discharge. Similar response rates were observed in those with ischemic (median 6 [IQR: 1.8 to 18.8] to 0.5 [IQR: 0 to 5.3] events; p = 0.031) and nonischemic (median 3.5 [IQR: 1.8 to 6.8] to 0 [IQR: 0 to 1.3] events; p = 0.012) cardiomyopathy. CONCLUSIONS Minimally invasive, ultrasound-guided bilateral SGB appears safe and provides substantial reduction in VA burden with approximately 1 in 2 patients exhibiting complete suppression of VT or VF for 48 h.
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Affiliation(s)
- Marat Fudim
- Duke Cardiology, Duke University Medical Center, Durham, North Carolina, USA; Duke Clinical Research Institute, Durham, North Carolina, USA.
| | - Yawar J Qadri
- Duke Anesthesiology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Nathan H Waldron
- Duke Anesthesiology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Richard L Boortz-Marx
- Duke Anesthesiology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Arun Ganesh
- Duke Anesthesiology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Chetan B Patel
- Duke Cardiology, Duke University Medical Center, Durham, North Carolina, USA
| | - Mihai V Podgoreanu
- Duke Anesthesiology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Albert Y Sun
- Duke Cardiology, Duke University Medical Center, Durham, North Carolina, USA
| | - Carmelo A Milano
- Division of Cardiothoracic Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - Betty C Tong
- Division of Cardiothoracic Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - David H Harpole
- Duke Center for Atrial Fibrillation, Duke University Medical Center, Duke University, Durham, North Carolina, USA
| | - Joseph P Mathew
- Duke Anesthesiology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Jonathan P Piccini
- Duke Cardiology, Duke University Medical Center, Durham, North Carolina, USA; Duke Clinical Research Institute, Durham, North Carolina, USA
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50
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Heinz G, De Angelis K, Dal Corso S, Sousa MHGD, Viana A, Dos Santos F, Corrêa JCF, Corrêa FI. Effects of Transcranial Direct Current Stimulation (tDCS) and Exercises Treadmill on Autonomic Modulation of Hemiparetic Patients Due To Stroke-Clinic Test, Controlled, Randomized, Double-Blind. Front Neurol 2020; 10:1402. [PMID: 32038465 PMCID: PMC6988776 DOI: 10.3389/fneur.2019.01402] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 10/23/2019] [Accepted: 12/20/2019] [Indexed: 11/13/2022] Open
Abstract
Background: After a Stroke, there is an autonomic nervous system (ANS) changes. Transcranial Direct Current Stimulation (tDCS) can promote the reorganization of the affected circuits. Objective: To evaluate the effects of tDCS applied before a session of physical activity on the treadmill, in the modulation of the autonomic nervous system of post-stroke patients. Methodology: Cross-over study, were randomized 12 adult hemiparetic subjects in 2 groups, Group 1 (active tDCS before exercise on the treadmill) and Group 2 (sham tDCS before exercise on the treadmill). Stimulation times were 20 min; treadmill time was 20 min. The heart rate variability (HRV) and Variability of Systolic Blood Pressure (VSBP) were evaluated for 15 min, in 3 periods (pre and post tDCS and during exercise recovery on the treadmill). Results: There was no difference in the VSBP and the HRV between the groups, compared with the baseline data; however, in the intragroup analysis, the parasympathetic modulation after active tDCS increased by 18% over baseline by the RMSSD with IC 95% (−7.85 to −0.34). In group 1, the post-tDCS active and post-exercise periods presented a value of variance above baseline, indicating a better prognosis. In group 2, there was a significant reduction of 38% of Variance values (p = 0.003) after tDCS sham. Conclusion: tDCS does not generate immediate effects on HRV and VSBP, except for intragroup comparison, which has greater participation in parasympathetic modulation in the group receiving active tDCS.
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Affiliation(s)
- Glauber Heinz
- Doctorate and Master Program in Rehabilitation Science of University Nove de Julho, UNINOVE, São Paulo, Brazil
| | - Katia De Angelis
- Doctorate and Master Program in Medicine School of University Nove de Julho, UNINOVE, São Paulo, Brazil
| | - Simone Dal Corso
- Doctorate and Master Program in Rehabilitation Science of University Nove de Julho, UNINOVE, São Paulo, Brazil
| | - Maria Helena Gomes De Sousa
- Doctorate and Master Program in Rehabilitation Science of University Nove de Julho, UNINOVE, São Paulo, Brazil
| | - Ariane Viana
- Doctorate and Master Program in Medicine School of University Nove de Julho, UNINOVE, São Paulo, Brazil
| | - Fernando Dos Santos
- Arterial Hypertension Unit, Instituto do Coração (InCor), Medical School of Universidade de São Paulo, São Paulo, Brazil
| | - João Carlos Ferrari Corrêa
- Doctorate and Master Program in Rehabilitation Science of University Nove de Julho, UNINOVE, São Paulo, Brazil
| | - Fernanda Ishida Corrêa
- Doctorate and Master Program in Rehabilitation Science of University Nove de Julho, UNINOVE, São Paulo, Brazil
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