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Güngör AK, Topçu H, Aldhahi MI, Al-Mhanna SB, Gülü M. Resistance Training to Muscle Failure with Variable Load Intensities: Implications for Post-Exercise Blood Pressure and Heart Rate Variability in Trained Men. J Clin Med 2024; 13:2296. [PMID: 38673569 PMCID: PMC11051069 DOI: 10.3390/jcm13082296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 04/10/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
Background: The modulation of cardiac sympathovagal balance alters following acute resistance training (RT) sessions. Nevertheless, the precise influence of RT at varying load intensities on this physiological response remains to be fully elucidated. Therefore, the aim of this study was to compare the time course of recovery following low- (40%), moderate- (60%), and high- (80%) load-intensity RT protocols performed up to muscle repetition failure in resistance-trained men. Method: Sixteen young, resistance-trained men (mean age: 21.6 ± 2.5 years, mean height: 175.7 ± 8.9 cm, mean weight: 77.1 ± 11.3 kg) participated in a randomized crossover experimental design involving three sessions, each taken to the point of muscle failure. These sessions were characterized by different load intensities: low (40% of 1-repetition maximum, 1RM), moderate (60% of 1RM), and high (80% of 1RM). The exercise regimen comprised four exercises-back squat (BS), bench press (BnP), barbell row (BR), and shoulder press (SP)-with each exercise consisting of three sets. Throughout each session, heart rate variability (HRV) and blood pressure (BP) parameters were assessed both pre-exercise and during a 40 min post-exercise period, segmented into 10 min intervals for stabilization. Statistical analysis involved the use of a repeated measures ANOVA. Results: It was observed that the 40% and 60% RT sessions resulted in a significantly higher root mean square of successive R-R intervals (RMSSD) value compared to the 80% RT session in the post-exercise recovery process in 30 min (respectively, p = 0.025; p = 0.028) and 40 min (respectively, p = 0.031; p = 0.046), while the 40% and 60% RT sessions produced similar responses. The 40% RT session was significantly higher in the high frequency (HF) value post-exercise in 40 min compared to the 80% RT session (p = 0.045). Conclusions: Our findings suggest that engaging in resistance training (RT) sessions to muscle failure at an intensity of 80% induces acute increases in sympathetic activity, potentially leading to elevated cardiovascular stress. For individuals with normal blood pressure, it is advisable to opt for lighter loads and higher repetition volumes when prescribing RT, as heavier-load RT may carry an increased risk of cardiac-related factors.
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Affiliation(s)
- Ali Kamil Güngör
- Department of Coaching Education, Faculty of Sport Sciences, Bursa Uludağ University, 16059 Bursa, Türkiye;
| | - Hüseyin Topçu
- Department of Physical Education and Sport, Faculty of Sport Sciences, Bursa Uludağ University, 16059 Bursa, Türkiye;
| | - Monira I. Aldhahi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Sameer Badri Al-Mhanna
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia;
| | - Mehmet Gülü
- Department of Sports Management, Faculty of Sport Sciences, Kirikkale University, 71450 Kirikkale, Türkiye
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Silva LRB, Gentil P, Seguro CS, de Oliveira JCM, Silva MS, Marques VA, Beltrame T, Rebelo ACS. High-Intensity Interval Training Improves Cardiac Autonomic Function in Patients with Type 2 Diabetes: A Randomized Controlled Trial. Biology (Basel) 2022; 11:biology11010066. [PMID: 35053064 PMCID: PMC8773290 DOI: 10.3390/biology11010066] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/23/2021] [Accepted: 12/28/2021] [Indexed: 02/04/2023]
Abstract
Different exercise models have been used in patients with type 2 diabetes mellitus (T2D), like moderate intensity continuous training (MICT) and high intensity interval training (HIIT); however, their effects on autonomic modulation are unknown. The present study aimed to compare the effects of different exercise modes on autonomic modulation in patients with T2D. In total, 44 adults with >5 years of T2D diagnosis were recruited and stratified into three groups: HIIT-30:30 (n = 15, age 59.13 ± 5.57 years) that performed 20 repetitions of 30 s at 100% of VO2peak with passive recovery, HIIT-2:2 (n = 14, age 61.20 ± 2.88) that performed 5 repetitions of 2 min at 100% of VO2peak with passive recovery, and MICT (n = 15, age 58.50 ± 5.26) that performed 14 min of continuous exercise at 70% of VO2peak. All participants underwent anamnesis and evaluation of cardiorespiratory fitness and cardiac autonomic modulation. All protocols were equated by total distance and were performed two times per week for 8 weeks. Group × time interactions were observed for resting heart rate (HRrest) [F(2.82) = 3.641; p = 0.031] and SDNN [F(2.82) = 3.462; p = 0.036]. Only the HIIT-30:30 group significantly reduced SDNN (p = 0.002 and 0.025, respectively). HRrest reduced more in the HIIT-30:30 group compared with the MICT group (p = 0.038). Group × time interactions were also observed for offTAU [F(2.82) = 3.146; p = 0.048] and offTMR [F(2.82) = 4.424; p = 0.015]. The MICT group presented increased values of offTAU compared with the HIIT-30:30 and HIIT-2:2 groups (p = 0.001 and 0.013, respectively), representing a slower HR response after eight weeks of intervention. HIIT, specially HIIT-30:30, represents a promising measure for improving autonomic modulation in patients with T2D.
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Affiliation(s)
- Lucas Raphael Bento Silva
- Department of Physical Education, Araguaia University Center, Goiania 74223-060, Brazil;
- Post-Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiania 74605-050, Brazil; (P.G.); (V.A.M.); (A.C.S.R.)
- Correspondence:
| | - Paulo Gentil
- Post-Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiania 74605-050, Brazil; (P.G.); (V.A.M.); (A.C.S.R.)
- Faculty of Physical Education and Dance, Federal University of Goiás, Goiania 74690-900, Brazil;
- Hypertension League, Federal University of Goias, Goiania 74605-020, Brazil
| | - Camila Simões Seguro
- Post-Graduate Program in Nutrition and Health, Faculty of Nutrition, Federal University of Goias, Goiania 74605-080, Brazil;
| | - Jordana Campos Martins de Oliveira
- Department of Physical Education, Araguaia University Center, Goiania 74223-060, Brazil;
- Post-Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiania 74605-050, Brazil; (P.G.); (V.A.M.); (A.C.S.R.)
| | - Maria Sebastiana Silva
- Faculty of Physical Education and Dance, Federal University of Goiás, Goiania 74690-900, Brazil;
| | - Vitor Alves Marques
- Post-Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiania 74605-050, Brazil; (P.G.); (V.A.M.); (A.C.S.R.)
| | - Thomas Beltrame
- Institute of Computing, University of Campinas, Campinas 13083-852, Brazil;
- Department of Physiotherapy, Federal University of Sao Carlos, Sao Carlos 13565-905, Brazil
| | - Ana Cristina Silva Rebelo
- Post-Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiania 74605-050, Brazil; (P.G.); (V.A.M.); (A.C.S.R.)
- Faculty of Physical Education and Dance, Federal University of Goiás, Goiania 74690-900, Brazil;
- Department of Morphology, Institute of Biological Sciences, Federal University of Goiás, Goiania 74690-900, Brazil
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Font-Farré M, Farche ACS, de Medeiros Takahashi AC, Guerra-Balic M, Figueroa A, Oviedo GR. Cardiac Autonomic Modulation Response Before, During, and After Submaximal Exercise in Older Adults With Intellectual Disability. Front Physiol 2021; 12:702418. [PMID: 34721053 PMCID: PMC8554113 DOI: 10.3389/fphys.2021.702418] [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: 04/29/2021] [Accepted: 09/22/2021] [Indexed: 11/23/2022] Open
Abstract
The analysis of the heart rate variability (HRV) consists of changes in the time intervals between consecutive R waves. It provides information on the autonomic nervous system regulation and it is a predictor of adverse cardiovascular events. Several studies analyzed this parameter in youth and adults with Intellectual Disability (ID). Nevertheless, there is a lack of information regarding the HRV before, during, and after exercise in older adults with ID. Therefore, we aimed to describe and compare the cardiac autonomic modulation before, during, and after the six-minute walk test (6MWT) in older adults with and without ID. Twenty-four volunteers with ID and 24 without ID (non-ID) participated in this study. HRV was assessed by R-R intervals at rest, during and after the 6MWT. At rest and recovery periods, the participants remained sited. The symbolic analysis was used to evaluate non-linear HRV components. The recovery HR kinetics was assessed by the mean response time, which is equivalent to time constant (τ)+time delay (TD). Between groups differences in HRV variables were not significant. During the recovery period, HR kinetics time variables showed significant better results in non-ID participants (TD: 6±5s vs. 15±11s; τ: 19±10s vs. 35±17s; and MRT: 25±9s vs. 50±11s, all p<0.050). In conclusion, our results suggest that the HRV in older adults with and without ID is similar during rest, exercise, and recovery. Recovery HR kinetics after the 6MWT was slower in older adults with ID. The reason for these results may be a reduced post-exercise vagal rebound in older adults with ID.
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Affiliation(s)
- Manel Font-Farré
- Faculty of Psychology, Education and Sport Science Blanquerna, University Ramon Llull, Barcelona, Spain
| | | | | | - Myriam Guerra-Balic
- Faculty of Psychology, Education and Sport Science Blanquerna, University Ramon Llull, Barcelona, Spain
| | - Arturo Figueroa
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, United States
| | - Guillermo R Oviedo
- Faculty of Psychology, Education and Sport Science Blanquerna, University Ramon Llull, Barcelona, Spain.,School of Health Science Blanquerna, University Ramon Llull, Barcelona, Spain
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Supriya R, Li FF, Yang YD, Liang W, Baker JS. Association between Metabolic Syndrome Components and Cardiac Autonomic Modulation among Children and Adolescents: A Systematic Review and Meta-Analysis. Biology (Basel) 2021; 10:699. [PMID: 34439932 DOI: 10.3390/biology10080699] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 07/19/2021] [Accepted: 07/21/2021] [Indexed: 12/18/2022]
Abstract
Simple Summary The clustering of metabolic syndrome (MetS) risk factors is becoming more prevalent in young people (up to the age of 19 years) leading to the development of type 2 diabetes (T2D) and cardiovascular diseases in early adulthood. The impact of MetS risk factors on cardiac autonomic modulation (CAM) or vice versa have been noted to track from childhood to pre-adolescence and adolescence. Understating associations in this age group may help improve the clinical outcomes of the MetS, even when MetS symptoms are not visible. Potential damage from each individual MetS component and the ability to predict early cardiac damage or upcoming cardiovascular events is very important. Therefore, the present systematic review and meta-analysis investigated the associations between CAM and MetS risk factors individually to verify which MetS risk components were significantly correlated with which heart rate variability (HRV) indices before or at the onset of the MetS among young people. The purpose of this review was to outline the importance of potentially screening HRV indices in young people even with only one MetS risk factor, as a pre-indicator for early cardiovascular risk stratification. Cross-sectional studies that examined the relationship of MetS risk factors with HRV indices were searched using four databases including PubMed, the Cochrane clinical trials library, Medline and the Web of Science. Correlation coefficients with 95% confidence intervals (95% CI), and random effects meta-analyses of the association between MetS risk factors with HRV indices were performed. Our results propose that lipid profiles including high density lipoprotein (HDL) and triglycerides (TGs), waist circumference (WC) and blood pressure (BP) are associated with CAM in young people up to the age of 19 years. The use of HRV indices to predict future MetS risk, and relationships with individual risk factors including HDL, BP, WC and TGs, were established. Furthermore, arterial pressure, respiration, stress and physical activity must be taken into consideration for future studies along with CAM related to young people (up to the age of 19 years), and it is recommended to explore further the associations reported here, as CAM is not the only determinant of neurovisceral regulation. Abstract Background: the clustering of metabolic syndrome (MetS) risk factors is becoming more prevalent in children, leading to the development of type 2 diabetes (T2D) and cardiovascular diseases in early adulthood. The impact of MetS risk factors on cardiac autonomic modulation (CAM) or vice versa has been noted to track from childhood to pre-adolescence and adolescence. Understating associations in this age group may help to improve the clinical outcomes of the MetS, even when MetS symptoms are not visible. Potential damage from each individual MetS component and the ability to predict early cardiac damage or upcoming cardiovascular events is very important. Therefore, the present systematic review and meta-analysis investigated the associations between CAM and MetS risk factors individually to verify which of the MetS risk components were significantly correlated with heart rate variability (HRV) indices before or at the onset of the MetS among young people. The purpose of this review was to outline the importance of potentially screening HRV indices in young people even with only one MetS risk factor, as a pre-indicator for early cardiovascular risk stratification. Methods: cross-sectional studies that examined the relationship of MetS risk factors with HRV indices were searched using four databases including PubMed, the Cochrane clinical trials library, Medline and the Web of Science. Correlation coefficients with 95% confidence intervals (95% CI), and random effects meta-analyses of the association between MetS risk factors with HRV indices were performed. Results: out of 14 cross-sectional studies and one case-control study, 8 studies (10 data sets) provided association data for the meta-analysis. Our results indicated significant positive correlations for systolic blood pressure (SBP) (correlation coefficient 0.13 (95%CI: 0.06; 0.19), I2 = 47.26%) and diastolic blood pressure (DBP) (correlation coefficient 0.09 (95%CI: −0.01; 0.18), I2 = 0%) with a Low Frequency/High Frequency ratio (LF/HF). Significant negative correlations for waist circumference (WC) (correlation coefficient −0.12 (95%CI: −0.19; −0.04), I2 = 51.50%), Triglycerides (TGs) (correlation coefficient −0.09 (95%CI: −0.15; −0.02), I2 = 0%) and ≥2 MetS risk factors (correlation coefficient −0.10 (95%CI: −0.16; −0.03), I2 = 0%); with high frequency (HF) were revealed. Significant positive correlations for high density lipoprotein (HDL) (correlation coefficient 0.08 (95%CI: 0.05; 0.11), I2 = 0%) and significant negative correlations of ≥2 MetS risk (correlation coefficient −0.04 (95%CI: −0.12; 0.03), I2 = 0.0%) with low frequency (LF) were revealed. Significant negative correlations for TGs (correlation coefficient −0.09 (95%CI: −0.23; 0.05), I2 = 2.01%) with a mean square root of the sum of differences between mean time between two successive intervals (rMSSD) and significant positive correlation of HDL (correlation coefficient 0.09 (95%CI: −0.01; 0.19), I2 = 0.33%) with standard deviation of the time between two successive intervals (SDNN) were also revealed. An Egger’s test indicated that there was no obvious publication bias for any of the above relationships except for TGs and rMSSD. The significance level stipulated for the meta-analysis was p < 0.05. Conclusions: lipid profiles (HDL and TGs), WC and BP were associated with CAM in young people up to the age of 19 years. The use of HRV indices to predict future MetS risk, and relationships with individual risk factors including HDL, BP, WC and TGs, were established. Future studies related to young people (up to the age of 19 years) are recommended to explore the associations reported here further.
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Torres-Arellano JM, Echeverría JC, Ávila-Vanzzini N, Springall R, Toledo A, Infante O, Bojalil R, Cossío-Aranda JE, Fajardo E, Lerma C. Cardiac Autonomic Response to Active Standing in Calcific Aortic Valve Stenosis. J Clin Med 2021; 10:2004. [PMID: 34067025 DOI: 10.3390/jcm10092004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 04/25/2021] [Accepted: 05/03/2021] [Indexed: 01/02/2023] Open
Abstract
Aortic stenosis is a progressive heart valve disorder characterized by calcification of the leaflets. Heart rate variability (HRV) analysis has been proposed for assessing the heart response to autonomic activity, which is documented to be altered in different cardiac diseases. The objective of the study was to evaluate changes of HRV in patients with aortic stenosis by an active standing challenge. Twenty-two volunteers without alterations in the aortic valve (NAV) and twenty-five patients diagnosed with moderate and severe calcific aortic valve stenosis (AVS) participated in this cross-sectional study. Ten minute electrocardiograms were performed in a supine position and in active standing positions afterwards, to obtain temporal, spectral, and scaling HRV indices: mean value of all NN intervals (meanNN), low-frequency (LF) and high-frequency (HF) bands spectral power, and the short-term scaling indices (α1 and αsign1). The AVS group showed higher values of LF, LF/HF and αsign1 compared with the NAV group at supine position. These patients also expressed smaller changes in meanNN, LF, HF, LF/HF, α1, and αsign1 between positions. In conclusion, we confirmed from short-term recordings that patients with moderate and severe calcific AVS have a decreased cardiac parasympathetic supine response and that the dynamic of heart rate fluctuations is modified compared to NAV subjects, but we also evidenced that they manifest reduced autonomic adjustments caused by the active standing challenge.
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Palmeira AC, Farah BQ, da Silva GO, Moreira SR, de Barros MVG, Correia MDA, Cucato GG, Ritti-Dias RM. Effects of isometric handgrip training on blood pressure among hypertensive patients seen within public primary healthcare: a randomized controlled trial. SAO PAULO MED J 2021; 139:648-656. [PMID: 34787298 PMCID: PMC9634841 DOI: 10.1590/1516-3180.2020.0796.r1.22042021] [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: 12/28/2020] [Accepted: 04/22/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Meta-analyses have demonstrated that isometric handgrip training (IHT) decreases blood pressure in hypertensive individuals. Nonetheless, most studies were conducted in laboratory settings and its effects in real-world settings remain unclear. OBJECTIVE To analyze the effects of IHT on office and ambulatory blood pressure in hypertensive patients attended within primary healthcare. DESIGN AND SETTING Randomized controlled trial conducted in primary healthcare units within the Family Health Program, Petrolina, Pernambuco, Brazil. METHODS 63 hypertensive patients (30-79 years old; 70% female) were randomly allocated into IHT or control groups. IHT was performed three times per week (4 x 2 minutes at 30% of maximal voluntary contraction, one-minute rest between bouts, alternating the hands). Before and after the 12-week training period, office and ambulatory blood pressure and heart rate variability were obtained. The significance level was set at P < 0.05 (two-tailed testing) for all analyses. RESULTS IHT significantly decreased office systolic blood pressure (IHT: 129 ± 4 versus 121 ± 3 mmHg, P < 0.05; control: 126 ± 4 versus 126 ± 3 mmHg, P > 0.05), whereas there was no effect on diastolic blood pressure (IHT: 83 ± 3 versus 79 ± 2 mmHg, P > 0.05; control: 81 ± 3 versus 77 ± 3 mmHg, P > 0.05). Heart rate variability and ambulatory blood pressure were not altered by the interventions (P > 0.05 for all). CONCLUSION IHT reduced office systolic blood pressure in hypertensive patients attended within primary care. However, there were effects regarding diastolic blood pressure, ambulatory blood pressure or heart rate variability. CLINICALTRIALS.GOV IDENTIFIER NCT03216317.
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Affiliation(s)
- Aline Cabral Palmeira
- MSc. Professor, Physiotherapy and Nursing Departments, Faculdade São Francisco de Juazeiro (FASJ), Juazeiro (BA), Brazil.
| | - Breno Quintella Farah
- PhD. Professor, Physical Education Department, Universidade Federal Rural de Pernambuco, Recife (PE), Brazil; Associate Researcher, Postgraduate Program on Physical Education, Universidade Federal do Pernambuco (UFPE), Recife (PE), Brazil.
| | - Gustavo Oliveira da Silva
- MSc. Doctoral Student, Postgraduate Program on Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo (SP), Brazil.
| | - Sérgio Rodrigues Moreira
- PhD. Professor, Postgraduate Program on Physical Education, Universidade Federal do Vale do São Francisco (UNIVASF), Petrolina (PE), Brazil.
| | | | - Marilia de Almeida Correia
- PhD. Professor, Postgraduate Program on Medicine, Universidade Nove de Julho (UNINOVE), São Paulo (SP), Brazil.
| | - Gabriel Grizzo Cucato
- PhD. Professor, Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom.
| | - Raphael Mendes Ritti-Dias
- PhD. Professor, Postgraduate Program on Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo (SP), Brazil.
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Constantinescu V, Matei D, Constantinescu I, Cuciureanu DI. Cardiac autonomic modulation in drug-resistant epilepsy patients after vagus nerve stimulation therapy. Neurol Neurochir Pol 2020; 54:329-336. [PMID: 32557527 DOI: 10.5603/pjnns.a2020.0044] [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: 09/25/2019] [Revised: 04/14/2020] [Accepted: 04/24/2020] [Indexed: 11/25/2022]
Abstract
The positive effect of vagus nerve stimulation (VNS) in patients with drug-resistant epilepsy is considered to be mediated by the afferent pathways of the vagus nerve, but the efferent pathways may influence the cardiac autonomic activity. AIM OF THE STUDY To assess the effects of VNS on cardiac autonomic modulation in epilepsy patients, over three months of neurostimulation. CLINICAL RATIONALE FOR THE STUDY Linear and non-linear heart rate variability (HRV) analysis can provide information on the sympathovagal balance and reveal particularities of the central control of the autonomic cardiovascular function. MATERIALS AND METHODS Using Biopac Acquisition System, we analysed HRV parameters in resting condition and during sympathetic and parasympathetic activation tests in five patients with drug-resistant epilepsy, who underwent VNS procedure. RESULTS During the sympathetic and vagal activation tests, all five patients presented normal responses of cardiac autonomic activity, reflected in RMSSD, HFnu and LF/HF dynamics in both HRV evaluations. No bradycardia, cardiac arrhythmia or orthostatic hypotension was registered during the two evaluations. CONCLUSIONS Our results indicate that VNS appears not to alter the cardiac autonomic function after three months of neurostimulation. HRV analysis is a useful tool for evaluating cardiac autonomic modulation in epilepsy patients during VNS therapy. CLINICAL IMPLICATIONS Patients with decreased HRV should be periodically monitored. Cardiac changes in patients with epilepsy are important because of the additional risk of arrhythmias mediated through the autonomic dysfunction.
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Affiliation(s)
- Victor Constantinescu
- University of Medicine and Pharmacy, Universitatii street No 16, 700115 Iasi, Romania
| | - Daniela Matei
- University of Medicine and Pharmacy, Universitatii street No 16, 700115 Iasi, Romania.
| | - Irina Constantinescu
- Department of Neurology, Regional Hospital of Orléans, 14 Avenue de l'Hôpital, 45100 Orléans, France
| | - Dan Iulian Cuciureanu
- University of Medicine and Pharmacy, Universitatii street No 16, 700115 Iasi, Romania
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Constantinescu V, Matei D, Constantinescu I, Cuciureanu DI. Heart Rate Variability and Vagus Nerve Stimulation in Epilepsy Patients. Transl Neurosci 2019; 10:223-232. [PMID: 31497318 PMCID: PMC6708288 DOI: 10.1515/tnsci-2019-0036] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 06/04/2019] [Accepted: 07/23/2019] [Indexed: 01/01/2023] Open
Abstract
Background Vagus nerve stimulation (VNS) exerts a cortical modulating effect through its diffuse projections, especially involving cerebral structures related to autonomic regulation. The influence of VNS on cardiovascular autonomic function in drug-resistant epilepsy patients is still debated. We aimed to evaluate the impact of VNS on cardiovascular autonomic function in drug-resistant epilepsy patients, after three months of neurostimulation, using the heart rate variability (HRV) analysis. Methodology Multiple Trigonometric Regressive Spectral analysis enables a precise assessment of the autonomic control on the heart rate. We evaluated time and frequency-domain HRV parameters in resting condition and during sympathetic and parasympathetic activation tests in five epilepsy patients who underwent VNS procedure. Results We found appropriate cardiac autonomic responses to sympathetic and parasympathetic activation tests, described by RMSSD, pNN50, HF and LF/HF dynamics after three months of VNS. ON period of the neurostimulation may generate a transient vagal activation reflected on heart rate and RMSSD values, as observed in one of our cases. Conclusion VNS therapy in epilepsy patients seems not to disrupt the cardiac autonomic function. HRV represents a useful tool in evaluating autonomic activity. More extensive studies are needed to further explore cardiac autonomic response after neurostimulation.
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Affiliation(s)
- Victor Constantinescu
- Neurology Department, Faculty of Medicine, University of Medicine and Pharmacy Iasi, Iasi Romania
| | - Daniela Matei
- Department of Biomedical Sciences, Faculty of Medical Bioengineering, University of Medicine and Pharmacy Iasi, Iasi Romania
| | | | - Dan Iulian Cuciureanu
- Neurology Department, Faculty of Medicine, University of Medicine and Pharmacy Iasi, Iasi Romania
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Fortes Silva HE, de Almeida RS, Silveira DB, Llaguno M, Resende LAPR, Dias da Silva VJ, Correia D. Cardiac autonomic modulation and long-term use of amiodarone in patients with chronic Chagasic cardiopathy. Pacing Clin Electrophysiol 2018; 41:788-798. [PMID: 29781516 DOI: 10.1111/pace.13384] [Citation(s) in RCA: 3] [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: 10/04/2017] [Accepted: 04/24/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Patients with chronic Chagas cardiopathy (CCC), which may be associated with cardiac arrhythmias, frequently use amiodarone, an antiarrhythmic drug that, experimentally, appears to modulate the cardiac autonomic function. OBJECTIVE The present cross-sectional observational study aimed to evaluate autonomic cardiac modulation in patients with CCC undergoing chronic amiodarone therapy. METHODS Three groups were investigated: Group 1 included patients with CCC not treated with amiodarone (n = 27); Group 2 included patients with CCC with prolonged use (at least 6 months) of amiodarone (n = 16); and Group 3 included non-Chagasic control patients (n = 23). All patients underwent a complete clinical and laboratory assessment, followed by autonomic function tests, consisting of a basal continuous electrocardiogram in the resting supine position for 10 minutes, followed by a change the orthostatic posture for a further 5 minutes. Heart rate variability (HRV) parameters (median and interquartile interval) were quantified using linear methods in the time- and frequency-domains (autoregressive spectral analysis) and nonlinear methods, including symbolic analysis. RESULTS Patients with CCC using amiodarone had changes in HRV suggestive of an offset in the sympatho-vagal balance with a vagal modulation predominance (normalized HF, 49.7[27.4] vs 31.1[22.8] [P < 0.05]; and percentage 2V, 40.1 [14.6] vs 21.5 [13.4] [P < 0.05] vs untreated CCC group). These changes were further accompanied by increases in parameters indicative of greater complexity of HRV. CONCLUSIONS The deviation in the sympatho-vagal balance and the increase in the complexity of HRV strongly suggest that amiodarone may have a cardioprotective effect, in addition to its antiarrhythmic effects, which could increase the survival of these patients.
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Affiliation(s)
- Henriette Elena Fortes Silva
- Division of Infectious Diseases, Internal Medicine Department, Triangulo Mineiro Federal University, Uberaba, MG, Brazil
| | - Renan Sandoval de Almeida
- Division of Infectious Diseases, Internal Medicine Department, Triangulo Mineiro Federal University, Uberaba, MG, Brazil
| | - Danilo Batista Silveira
- Division of Infectious Diseases, Internal Medicine Department, Triangulo Mineiro Federal University, Uberaba, MG, Brazil
| | - Maurício Llaguno
- Division of Infectious Diseases, Internal Medicine Department, Triangulo Mineiro Federal University, Uberaba, MG, Brazil
| | | | - Valdo José Dias da Silva
- Department of Physiology, Natural and Biological Sciences Institute, Triangulo Mineiro Federal University, Uberaba, MG, Brazil
| | - Dalmo Correia
- Division of Infectious Diseases, Internal Medicine Department, Triangulo Mineiro Federal University, Uberaba, MG, Brazil
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Jarczok MN, Aguilar-Raab C, Koenig J, Kaess M, Borniger JC, Nelson RJ, Hall M, Ditzen B, Thayer JF, Fischer JE. The Heart´s rhythm 'n' blues: Sex differences in circadian variation patterns of vagal activity vary by depressive symptoms in predominantly healthy employees. Chronobiol Int 2018. [PMID: 29543518 DOI: 10.1080/07420528.2018.1439499] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Successful regulation of emotional states is positively associated to mental health, while difficulties in regulating emotions are negatively associated to overall mental health and in particular associated with anxiety or depression symptoms. A key structure associated to socio-emotional regulatory processes is the central autonomic network. Activity in this structure is associated to vagal activity can be indexed noninvasively and simply by measures of peripheral cardiac autonomic modulations such as heart rate variability. Vagal activity exhibits a circadian variation pattern, with a maximum during nighttime. Depression is known to affect chronobiology. Also, depressive symptoms are known to be associated with decreased resting state vagal activity, but studies investigating the association between circadian variation pattern of vagal activity and depressive symptoms are scarce. We aim to examine these patterns in association to symptom severity of depression using chronobiologic methods. METHODS Data from the Manheim Industrial Cohort Studies (MICS) were used. A total of 3,030 predominantly healthy working adults underwent, among others, ambulatory 24-h hear rate-recordings, detailed health examination and online questionnaires and were available for this analysis. The root mean sum of successive differences (RMSSD) was used as an indicator of vagally mediated heart rate variability. Three individual-level cosine function parameters (MESOR, amplitude, acrophase) were estimated to quantify circadian variation pattern. Multivariate linear regression models including important covariates such as age, sex, and lifestyle factors as well as an interaction effect of sex with depressive symptoms were used to estimate the association of circadian variation pattern of vagal activity with depressive symptoms simultaneously. RESULTS The analysis sample consisted of 20.2% females and an average age 41 with standard deviation of 11 years. Nonparametric bivariate analysis revealed significant MESOR and amplitude differences between the 90th percentile split, but not on acrophase. Multivariate linear regression models estimated depressive symptoms to be negatively associated with the 24h mean (MESOR) and oscillation amplitude in men but positively associated in women. This pattern of findings indicates a blunted day-night rhythm of vagal activity in men with greater depressive symptoms as well as a moderation effect of sex in the association of CVP and depressive symptoms. CONCLUSIONS This is the first study investigating circadian variation pattern by mild depressive symptoms in a large, rather healthy occupational sample. Depressive symptoms were associated with decreased circadian variation pattern of vagal activity in men but with increased circadian variation pattern in women. The possible underlying mechanism(s) are discussed using the neurovisceral integration model. These findings may have implications for the knowledge on etiology, diagnosis, course, and treatment of depressive symptoms and thus may be of significant public health relevance.
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Affiliation(s)
- Marc N Jarczok
- a Institute of Medical Psychology, Center for Psychosocial Medicine, Heidelberg University , Heidelberg , Germany.,b Clinic for Psychosomatic Medicine and Psychotherapy , Ulm University Medical Center , Ulm , Germany
| | - Corina Aguilar-Raab
- a Institute of Medical Psychology, Center for Psychosocial Medicine, Heidelberg University , Heidelberg , Germany
| | - Julian Koenig
- c Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry , Center for Psychosocial Medicine, Heidelberg University , Heidelberg , Germany.,d University Hospital of Child and Adolescent Psychiatry and Psychotherapy , University of Bern , Bern , Switzerland
| | - Michael Kaess
- c Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry , Center for Psychosocial Medicine, Heidelberg University , Heidelberg , Germany.,d University Hospital of Child and Adolescent Psychiatry and Psychotherapy , University of Bern , Bern , Switzerland
| | - Jeremy C Borniger
- e Department of Psychiatry & Behavioral Sciences , Stanford University School of Medicine , CA , USA
| | - Randy J Nelson
- f Department of Neuroscience , The Ohio State University Medical Center , Columbus , OH , USA
| | - Martica Hall
- g Department of Psychiatry , University of Pittsburgh , Pittsburgh , PA , USA
| | - Beate Ditzen
- a Institute of Medical Psychology, Center for Psychosocial Medicine, Heidelberg University , Heidelberg , Germany
| | - Julian F Thayer
- h Department of Psychology , The Ohio State University , Columbus , OH , USA
| | - Joachim E Fischer
- i Mannheim Institute of Public Health, Social and Preventive Medicine, Medical School Mannheim, Heidelberg University , Germany
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11
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Wdowczyk J, Makowiec D, Dorniak K, Gruchała M. Visualization of Heart Rate Variability of Long-Term Heart Transplant Patient by Transition Networks: A Case Report. Front Physiol 2016; 7:79. [PMID: 27014081 PMCID: PMC4780201 DOI: 10.3389/fphys.2016.00079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Accepted: 02/17/2016] [Indexed: 12/17/2022] Open
Abstract
We present a heart transplant patient at his 17th year of uncomplicated follow-up. Within a frame of routine check out several tests were performed. With such a long and uneventful follow-up some degree of graft reinnervation could be anticipated. However, the patient's electrocardiogram and exercise parameters seemed largely inconclusive in this regard. The exercise heart rate dynamics were suggestive of only mild, if any parasympathetic reinnervation of the graft with persisting sympathetic activation. On the other hand, traditional heart rate variability (HRV) indices were inadequately high, due to erratic rhythm resulting from interference of the persisting recipient sinus node or non-conducted atrial parasystole. New tools, originated from network representation of time series, by visualization short-term dynamical patterns, provided a method to discern HRV increase due to reinnervation from other reasons.
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Affiliation(s)
- Joanna Wdowczyk
- 1st Chair and Clinic of Cardiology, Medical University of Gdańsk Gdańsk, Poland
| | - Danuta Makowiec
- Institute of Theoretical Physics and Astrophysics, University of Gdańsk Gdańsk, Poland
| | - Karolina Dorniak
- Department of Noninvasive Cardiac Diagnostics, 2nd Chair of Cardiology, Medical University of Gdańsk Gdańsk, Poland
| | - Marcin Gruchała
- 1st Chair and Clinic of Cardiology, Medical University of Gdańsk Gdańsk, Poland
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12
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Jandackova VK, Scholes S, Britton A, Steptoe A. Are Changes in Heart Rate Variability in Middle-Aged and Older People Normative or Caused by Pathological Conditions? Findings From a Large Population-Based Longitudinal Cohort Study. J Am Heart Assoc 2016; 5:JAHA.115.002365. [PMID: 26873682 PMCID: PMC4802439 DOI: 10.1161/jaha.115.002365] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background No study to date has investigated longitudinal trajectories of cardiac autonomic modulation changes with aging; therefore, we lack evidence showing whether these changes occur naturally or are secondary to disease or medication use. This study tested whether heart rate variability (HRV) trajectories from middle to older age are largely normative or caused by pathological changes with aging in a large prospective cohort. We further assessed whether HRV changes were modified by socioeconomic status, ethnicity, or habitual physical activity. Methods and Results This study involved 3176 men and 1238 women initially aged 44 to 69 years (1997–1999) from the UK Whitehall II population‐based cohort. We evaluated time‐ and frequency‐domain HRV measures of short‐term recordings at 3 time points over a 10‐year period. Random mixed models with time‐varying covariates were applied. Cross‐sectionally, HRV measures were lower for men than for women, for participants with cardiometabolic conditions, and for participants reporting use of medications other than beta blockers. Longitudinally, HRV measures decreased significantly with aging in both sexes, with faster decline in younger age groups. HRV trajectories were not explained by increased prevalence of cardiometabolic problems and/or medication use. In women, cardiometabolic problems were associated with faster decline in the standard deviation of all intervals between R waves with normal‐to‐normal conduction, in low‐frequency HRV, and in low‐frequency HRV in normalized units. Socioeconomic status, ethnicity, and habitual physical activity did not have significant effects on HRV trajectories. Conclusions Our investigation showed a general pattern and timing of changes in indices of cardiac autonomic modulation from middle to older age. These changes seem likely to reflect the normal aging process rather than being secondary to cardiometabolic problems and medication use.
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Affiliation(s)
- Vera K Jandackova
- Department of Epidemiology and Public Health, University of Ostrava, Czech Republic Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Shaun Scholes
- Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Annie Britton
- Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Andrew Steptoe
- Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
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Abstract
The purpose of this study was to evaluate cardiac autonomic modulation in university athletes during the post-acute to late phase (mean, 95 days ±63) of injury at rest and during physical exertion. We also sought to evaluate the effect of time since injury and number of injuries on heart rate variability (HRV). We hypothesized that physical exertion would reveal persisting modifications in HRV following a concussion. We included, in a cross-sectional design, athletes who sustained a concussion and matched controls. Concussions were identified by a medical doctor using established criteria. Twelve male concussed and 12 control athletes took part in the study. Control participants were teammates who were chosen to match the concussed athletes with regard to their height, weight, education, and age. The beat-to-beat electrocardiogram intervals of the participants were measured at rest and during physical exertion (isometric hand grip contraction; IHGC), which was sustained for 3 minutes at 30% of the participants' maximum. Linear and nonlinear parameters of HRV were calculated. The ratio between low and high frequency (LF/HF) bands was calculated to assess the sympathovagal balance. During the IHGC, but not at rest, concussed athletes presented significantly lower power in HF bands, leading to a significantly higher LF/HF ratio (p ≤ 0.05). Thus, asymptomatic athletes still may exhibit modifications in cardiac autonomic modulation weeks to months following injury. These modifications may only become apparent during physical exertion. Monitoring HRV may aid diagnosis and provide insight about safe return to play.
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Affiliation(s)
| | - Daniel Curnier
- 1 Department of Kinesiology, Université de Montréal , Montreal, Quebec, Canada .,2 Research Center, CHU Sainte-Justine, Université de Montréal , Montreal, Quebec, Canada
| | - Robert Davis Moore
- 1 Department of Kinesiology, Université de Montréal , Montreal, Quebec, Canada
| | - Dave Ellemberg
- 1 Department of Kinesiology, Université de Montréal , Montreal, Quebec, Canada .,2 Research Center, CHU Sainte-Justine, Université de Montréal , Montreal, Quebec, Canada
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Abstract
Unemployment has consistently been associated with increased risk of cardiovascular disease and premature mortality, and impaired autonomic modulation of the heart might be one mechanism partly explaining this. This study examined whether the possible effect of unemployment on cardiac autonomic modulation is in part mediated by lower psychological well-being. The sample comprised of 15 job-seeking men aged 30-49 years matched with 15 employed men on age, type of job, smoking habits, alcohol intake, frequency of physical activity, and body mass index. Heart rate variability (HRV) during a modified orthostatic test was the measure of cardiac autonomic modulation, and life satisfaction was the measure of psychological well-being. Unemployed men had significantly lower overall HRV (p = .040) than controls. This association was partially mediated through lower general life satisfaction, and in particular, by low financial satisfaction, independently of demographic and/or behavioral factors that influence HRV. These findings suggest that seeking a job is a potential stressor that may reduce overall HRV and contribute towards disturbance of cardiac autonomic modulation in men. Financial difficulties could be one mechanism through which the effects of unemployment are translated into impaired autonomic modulation.
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Affiliation(s)
- V K Jandackova
- a Department of Epidemiology and Public Health , University of Ostrava , Ostrava , Czech Republic
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15
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Shinohara T, Ebata Y, Ayabe R, Fukui A, Okada N, Yufu K, Nakagawa M, Takahashi N. Cardiac autonomic dysfunction in patients with head-up tilt test-induced vasovagal syncope. Pacing Clin Electrophysiol 2014; 37:1694-701. [PMID: 25139789 DOI: 10.1111/pace.12484] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 06/09/2014] [Accepted: 06/11/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND Vasovagal syncope (VVS) is the result of an autonomic reflex that has a final effect of reducing sympathetic drive and increasing vagal activity. However, whether syncopal symptoms are associated with pathological cardiac autonomic modulation is not fully known. We tested the hypothesis that cardiac autonomic function is impaired in patients with VVS. METHODS Eighty-four consecutive patients (59 males; 48.8 ± 20.9 years) with recurrent unexplained syncope were enrolled. The head-up tilt test (HUTT) was positive in 38 patients and negative in 46 patients. Cardiac autonomic function was assessed by baroreflex sensitivity (BRS), heart rate variability, plasma concentrations of norepinephrine, and (123) I-metaiodobenzylguanidine (MIBG) scintigraphy. RESULTS BRS indices were significantly lower in the HUTT-positive group than in the HUTT-negative group (6.1 ± 5.5 mm Hg/s vs 9.8 ± 7.6 mm Hg/s, P = 0.02). With regard to cardiac (123) I-MIBG scintigraphy, the mean heart-to-mediastinum ratio at the delayed phase tended to be lower in HUTT-positive than in HUTT-negative individuals, but this difference was not significant (2.75 ± 0.55 vs 3.02 ± 0.49, P = 0.08).The percent washout rate of (123) I-MIBG was significantly higher in the positive group compared with the negative group (40.7 ± 13.1% vs 31.5 ± 13.3%, P = 0.02). Multivariate logistic analysis revealed that the appearance of HUTT-induced VVS was predicted independently by a high percent washout rate of (123) I-MIBG (odds ratio, 0.954; 95% confidence interval, 0.903-0.998; P = 0.048). CONCLUSIONS Our results suggest that pathological autonomic cardiac modulation may play a role in the appearance of syncope in VVS patients.
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Affiliation(s)
- Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
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Carthy ER, White L, Russell FD, Holmes M, Leicht AS, Brooks PR, Hitchen-Holmes D, Askew CD. Cardiovascular responsiveness to sympathoexcitatory stress in subjects with and without mild hypertension. Clin Physiol Funct Imaging 2014; 35:150-8. [PMID: 24690346 DOI: 10.1111/cpf.12143] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 01/28/2014] [Accepted: 02/17/2014] [Indexed: 11/30/2022]
Abstract
PURPOSE This study compared blood pressure, heart rate variability (HRV) and forearm blood flow, at rest and in response to sympathoexcitatory stressors between normotensive and mildly hypertensive participants. METHODS Participants aged 30-79 years with normal blood pressure (n = 49) or mild hypertension (n = 17), with no history of taking antihypertensive medication, were recruited. Participants completed a cold pressor test (CPT) followed by an ischaemic handgrip test (IHGT). Blood pressure, HRV, forearm blood flow and vascular resistance were measured at rest and in response to each test. RESULTS The CPT and IHGT evoked greater increases in mean arterial blood pressure in hypertensive participants (CPT: 10 ± 2 mmHg, IHGT: 9 ± 1 mmHg) compared with normotensive participants (CPT: 5 ± 1 mmHg, IHGT: 3 ± 1 mmHg; P < 0.05). Resting high frequency power, which is a parameter of HRV associated with parasympathetic cardiac modulation, was lower in hypertensive participants (hypertensive: 31.73 ± 4.07 nu; normotensive: 42.08 ± 2.22 nu; P = 0.026) and was negatively correlated with systolic blood pressure (r = -0.272, P = 0.03) and mean arterial pressure across all participants (r = -0.258, P < 0.05). There were no differences in HRV or forearm blood flow responses to the CPT or IHGT between groups. CONCLUSION This study demonstrated that sympathoexcitatory stress evoked by the CPT and IHGT induces an augmented blood pressure response in individuals with mild hypertension, which supports the notion that autonomic dysfunction is likely to contribute to the pathogenesis of hypertension. It remains to be determined whether the hypertensive response is mediated through alterations in cardiac activity, peripheral vascular resistance or both.
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Affiliation(s)
- Elliott R Carthy
- Inflammation and Healing Research Cluster, School of Health and Sport Sciences, University of the Sunshine Coast, Maroochydore, Qld, Australia
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