A cross-sectional study of influence of cerebral dominance on cardiovascular responses to autonomic stressor tests in adolescents

Background: Hand preference is perhaps the most obvious behavioral asymmetry observed in humans and is related to cerebral dominance. Animal and human studies have shown that cerebral cortex has a definite role in regulation of cardiovascular autonomic activity. Each hemisphere exhibits differential control over dynamics of heart especially the sympathetic activity is controlled by right hemisphere insula in particular. Hence, the present study was conducted to evaluate influence of cerebral dominance (handedness) on cardiovascular responses such as heart rate (HR) and blood pressure (BP) indices to autonomic stressor tests in the left and right hander adolescents. Aims and Objectives: The aim of the study was to evaluate the differences in cardiovascular responses in the left and right handers to autonomic stressor tests. Materials and Methods: The present cross-sectional study was conducted in 35 right and 35 left hander students of age group 16–20 years. Autonomic stressor tests used in the study were handgrip dynamometry and cold pressor test (CPT). Results: The right and left handers had similar baseline values of BP and HR. All the subjects responded to Autonomic function tests by increased BP and HR from baseline. The absolute BP values and change in BP from baseline were significantly higher in the left than right handers both during and after the tests. HR values showed significant differences in peak values during both the tests. Visual analog score was similar during CPT in both groups. Conclusion: The HR and BP responses to autonomic stressor tests are higher in the left handers than right handers supports the fact that the right hemisphere has more influence on sympathetic activity of heart.

Cardiovascular Responses to Commonly Used Tests In and Outside of the Laboratory Settings

Several tests are available for assessing cardiovascular response to various interventions which may be given in the laboratory, or outside of it in the field. The tests are meant to excite or deactivate cardiovascular and other sensory receptors which signal the central mechanisms. They have been found useful in generating data to study cardiovascular effects on subjects exposed to specialized physical training (e.g., athletes), in the evaluation of people engaged in special occupations such as pilots, astronauts, and other military personnel, and in training undergraduate and postgraduate students. If the response does not fit into the physiological norm, it may reflect a temporary aberration, or a more serious defect in the cardiovascular control mechanism because of disease. Interpretation of data generated may vary between various operators/observers. Here, an attempt has been made to bring out responses of the cardiovascular system to the commonly used tests, and their applicability in clinical situations.

A study of cardiovascular sympathetic function tests during different phases of menstrual cycle in young females

Background:  Menstrual cycle is a regular coordinated physiological change in non-pregnant women. The variation of hormonal concentrations during different phases of the menstrual cycle has a profound influence on autonomic and metabolic activities. The present study was designed to assess the cardiovascular sympathetic functions during different phases of menstrual cycle in normal healthy eumenorrheic females.Methods:  Fifty females in the age group of 18-25 years were selected for the study. Non-invasive cardiovascular sympathetic function tests were performed during different phases of the menstrual cycle using RMS Polyrite D.Results: Results were analyzed using paired ‘t’ test. Resting blood pressure, blood pressure response to isometric handgrip test and cold pressor test were statistically significant higher (p-value <0.05), in the secretory phase as compared to menstrual and proliferative phase. Blood pressure response to orthostatic test was statistically significant between the proliferative and secretory phase and between menstrual and secretory phase (p-value <0.05).Conclusion: Our study shows that sympathetic activity is highest during the secretory phase of the menstrual cycle and lowest in the proliferative phase as compared to the menstrual phase. This higher sympathetic activity may be correlated with higher estrogen and progesterone levels during the secretory phase of the menstrual cycle. The study also emphasizes the complex relationship between ovarian hormones and autonomic regulatory systems.

Comparison of cardiac autonomic response in different ABO blood groups of young adults

Background: ABO blood group has been associated with various disease phenotypes, particularly cardiovascular disease. Abnormal autonomic response also plays a role in cardiac morbidity. Increasing attention is being focused on the role of autonomic nervous system in health and disease. The literature lacks data on the association of blood groups and cardiac autonomic function. The aim of the study was to find out the association between different blood groups and cardiovascular autonomic functions in young adults.Methods: 150 healthy young students of MMU aged 18-25 years, divided into four groups based on ABO blood grouping, determined by agglutination test (group A, group B, group O and group AB). Various autonomic function tests done were lying to standing test, Valsalva maneuver, Hand grip test (HGT) and Cold pressor test (CPT).Results: The mean baseline heart rate was significantly higher in group O as compared to group A. No parasympathetic alteration between different ABO blood groups was seen. Blood pressure response to HGT and CPT was not statistically significant between different blood groups.Conclusions: Present study revealed no alteration in cardiac autonomic function with regards to ABO blood grouping in young adults.

Effect of Body Mass Index on Cardiac Autonomic Functional Status in Healthy Young Adults

Introduction: Autonomic nervous system (ANS) is involvedin energy metabolism and regulation of the cardiovascularsystem. Autonomic dysfunction has been suggested tooccur in obese individuals in both adults and children but acomprehensive study of the autonomic status in young adultsis scant. So aim of the study was to evaluate and comparecardiovascular autonomic functions in young adults on thebasis of BMI.Material and methods: 150 healthy young students of MMUaged 18–25 years, divided into four groups based on BMI asper Asian criteria (underweight, normal weight, overweightand obese). Various autonomic function tests done were Lyingto Standing test, Valsalva manoeuvre, Hand grip test (HGT)and Cold pressor test (CPT).Results: The mean baseline SBP and DBP were significantlyhigher in obese subjects followed by overweight, normalweight and under weight. No parasympathetic alterationbetween different BMI groups was seen. Mean values ofresting SBP and DBP were significantly higher and bloodpressure response to HGT and CPT was significantly lower inobese as compared to normal weight subjects.Conclusion: Our study revealed an altered autonomicfunction in the form of impaired sympathetic activity withno parasympathetic modulation in obese young adults. Soweight reduction and moderate intensity aerobic exerciseprogrammes should be incorporated into daily living, whichmay delay or prevent the onset of hypertension.

Effect of Cold Stress and the Cold Pressor Test on Blood Pressure and Heart Rate

Background: Temperature and other environmental stressors are known to affect blood pressure and heart rate. The cold pressor test is used clinically to evaluate autonomic and left ventricular functions. Aims: This project was done to test the hypothesis that blood pressure and heart rate is altered during the cold pressor test. Methods: Students performed the cold pressor test, to study the change in blood pressure following an environmental stress. 40 medical students from the Ist year MBBS batches were selected and tested for cold pressor test during 1 to 2 min immersion of one hand in ice water. This test used cold as a stressful stimulus. The response of the subject was measured by the change in blood pressure and heart rate after the application of cold stimulus. Results: The study showed that the correlation between Anxiety state scores and cold pressor test response was not significant statistically. The correlation between Anxiety trait scores and cold pressor test response was also not significant statistically. Conclusion: The results indicate that the blood pressure and heart rate increases following an environmental stress. This activity can be easily adapted and students can learn about the test and carry out the test on their classmates.

The combined effect of Suryanamaskar, Pranayama and meditation on hyper-reactors to cold pressure test in young healthy individuals.

Background: To survive in this competitive world, one has to go through a lot of stresses & strains which, in due course of time, reflected in altered physiology of body. One such change is the cardiovascular response to cold stress. Yoga has been reported to be beneficial as a de-stressing technique. Aims & Objective: To investigate whether regular practice of Yoga which includes Suryanamaskar, Pranayama & Meditation for 3 months could reduce the cardio-vascular hyper-reactivity induced by cold stress. Materials and Methods: In the present study, 53 young healthy medical students underwent cold pressor test. 20 turned out to be hyper reactors to this test. These hyper reactors performed Yoga (Suryanamaskar, Pranayama & Meditation) for 3 months and Cold Pressor Test was again performed at the end of this period and cardiovascular hyper-reactivity (parameters are Blood pressure, Pulse rate, and Respiratory rate) before and after yoga compared. Results: Our results showed that 14 out of original 20 hyper reactors (70 %, P<0.001) were converted to hypo reactors. Conclusion: Regular practice of Yoga reduces cardiovascular hyper-reactivity to cold pressor test. If we can spread its benefits and importance to the society we can reduce the risks of many diseases especially those related to stress.

Relationship between autonomic nervous system and early recurrence of atrial fibrillation after radiofrequency catheter ablation / 第二军医大学学报

Objective To investigate the relationship between autonomic nervous reflex and early recurrence of atrial fibrillation after radiofrequency catheter ablation (RFCA) using diving reflex test and cold pressor test. Methods A total of 102 patients with paroxysmal atrial fibrillation were recruited in the present study. All patients underwent diving reflex test and cold pressor test before and after RFCA. The relationship between mean heart rate and early recurrence of atrial fibrillation was observed. Results Circumferential pulmonary vein isolation was successfully achieved in all the 102 patients. The mean heart rate was decreased by diving reflex test and increased by cold pressor test. The diving reflex of the participants was significantly decreased after RFCA (P<0.05), and the cold pressor test results had no noticeable change. The diving reflex in patients with early recurrence of atrial fibrillation was more intensive than those without (P<0.05). Conclusion The parasympathetic activity is decreased in atrial fibrillation patients after RFCA, and the decrease may be related to the early recurrence of atrial fibrillation after RECA.

Salt sensitivity in middle-aged population with normal blood pressure and method for determining salt sensitivity / 第二军医大学学报

Objective To investigate the salt sensitivity of middle-aged population with normal blood pressure, and to observe the consistency of chronic sodium load test and cold pressor test in determining salt sensitivity. Methods Totally 68 middle-aged volunteers with normal blood pressure were divided into salt sensitivity (SS) group and non-salt sensitivity (NSS) group according to the results of chronic sodium load test, and the general data and increase amplitudes of blood pressure were compared between SS and NSS groups. The results of the two tests were compared by Χ2 test of fourfold table. Results According to the results of chronic sodium load test 22 (32. 4%) subjects were included in the SS group and 46 (67. 6%) were included in the NSS group. Compared with NSS group, SS group had a significantly elder age, higher proportion of family hypertension history (P0. 05). Conclusion The rate of salt sensitivity in the present normotensive middle-aged population is 32. 4%. Cold pressor test may be used as a substitute for the chronic sodium load test in determination of salt sensitivity.

Study of Cardiovascular and Pulmonary Responses During Cold Pressor Test (CPT) In Healthy Volunteers.

Acute pain was induced in 35 healthy volunteer males by cold pressor test (CPT) and pulmonary parameters - respiratory rate (RR), tidal volume (TV), inspiratory and expiratory reserve volume (IRV, ERV), inspiratory capacity (IC), vital capacity (VC), forced vital capacity (FVC), FEV1, peak expiratory flow rate and forced expiratory flow rate at 75, 50 and 25% of expired FVC (FEFR 75, 50 and 25%) were measured. Acute pain parameters like pain threshold, tolerance and sensitivity were also recorded. Besides these, the cardiovascular parameters - pulse rate, systolic and diastolic blood pressure, were also measured. Comparisons were made between values recorded before, during and after cold induced pain. There was a significant increase in cardiovascular and pulmonary parameters (RR, TV, IC, IRV, ERV, VC, FVC and FVC1) during the acute pain induced by CPT, reflecting an acute state of responses secondary to sympathetic challenge. The study indicates that alterations in pulmonary and cardiovascular profile form an integral part of multidimensional responses observed during cold induced acute pain.

Autonomic reactivity to cold pressor test in prehypertensive and hypertensive medical students.

Autonomic reactivity to stress has been hypothesized to be a marker for subsequent neurogenic hypertension. Medical training is highly stressful particularly for those who are beginning their medical education. The present study was undertaken to study the autonomic reactivity to cold pressor test in prehypertensive and hypertensive undergraduate medical students. One hundred and seventeen undergraduate medical students between 17-21 years of age got examined for blood pressure and stress level. Twelve Hypertensives and eight prehypertensives selected from the above subjects and twenty normotensives underwent cold pressure test (CPT) to assess autonomic reactivity to laboratory induced stress. 10.25% of the subjects were found to be hypertensive and 6.83% pre hypertensive. On the stress scale 53% had mild stress, 7% showed moderate stress while none had stress as a major problem. There was no correlation between BP and stress score. On CPT, BP increased significantly in all the three groups (hypertensive, prehypertensive and normotensive) but came back to basal levels within 5 minutes indicating normal autonomic response. Rise of BP was higher in hypertensive group as compared to normotensive group. The rise of diastolic and mean BP during CPT was significantly higher in subjects having family history of hypertension. Forty percent of normotensive subjects had more than 20 mm Hg rise in systolic BP on CPT. Adolescents must be routinely screened to detect asymptomatic hypertension. The CPT may identify individuals with an occult physiological abnormality that predisposes them to hypertension in their later life.

Percepção de dor aguda em pacientes com transtorno de pânico / Acute pain perception in panic disorder patients

O presente trabalho investigou experimentalmente os limiares nociceptivos e a percepção subjetiva de dor no transtorno de pânico (TP). Trinta e sete pacientes com TP foram voluntariamente submetidos a um Teste Pressor ao Frio (TPF), em que uma de suas mãos era mergulhada em um banho termostatizado de água fria (7ºC) por um período máximo de três minutos. A latência de retirada da mão da água foi utilizada como um índice de dor aguda, enquanto a experiência subjetiva de dor foi avaliada por meio do Questionário McGill de Dor e de uma escala visual analógica. Os resultados indicaram latências similares de retirada da mão em comparação a 37 sujeitos-controle sadios, mas uma experiência subjetiva de dor significantemente maior nos pacientes com TP. Esse padrão de resultados não apenas confirma a utilidade do teste de pressor ao frio para a indução e estudo experimental da dor aguda em laboratório, mas também sugere uma importante associação entre dor e ansiedade.

The present study experimentally investigated the nociceptive threshold and the subjective pain perception in panic disorder (PD). Thirty seven PD patients were voluntarily submitted to a cold pressor test (CPT) in which one of their hands was dipped into a thermostatized cold water bath (7ºC) for a maximum period of three minutes. Acute pain experience was assessed by measuring the hand retrieval latency, whereas the subjective pain experience was evaluated through McGill Pain Questionnaire and a pain visual analog scale. As compared to 37 healthy control-subjects, results indicated similar hand retrieval latencies but a significantly higher subjective pain experience in PD patients. Such pattern of results not only indicates the usefulness of the cold pressor test to induce and experimentally study pain in laboratory settings, but also suggests an important anxiety-pain association.

¿La prueba del frío podría predecir la aparición de eventos cardiovasculares en pacientes sin enfermedad coronaria demostrada? / Is Cold Pressor Test Useful to Predict Cardiovascular Events in Patients with Not Documented Coronary Artery Disease?

Introducción La disfunción endotelial es la primera alteración conocida que interviene en el desarrollo de la cardiopatía isquémica. La falta de metodologías adecuadamente desarrolladas que permitan reconocer en la etapa preclínica de la enfermedad a los pacientes en riesgo de padecer un evento cardiovascular alertan sobre la necesidad de adoptar métodos adicionales de diagnóstico para su identificación precoz. La función endotelial en las arterias coronarias fue evaluada con perfusión miocárdica SPECT y la prueba del frío. Objetivos Determinar la prevalencia de la prueba del frío en 511 pacientes sin cardiopatía isquémica demostrada, como también de los factores de riesgo coronario asociados en aquellos con resultado positivo y analizar la incidencia de eventos cardiovasculares en un seguimiento de cincuenta meses. Material y métodos En un servicio de medicina nuclear se realizó en 511 pacientes un estudio tomográfico de perfusión miocárdica (SPECT), cuyo resultado ante el ejercicio reveló una captación uniforme del radiotrazador. Ningún paciente tenía antecedentes de revascularización miocárdica ni de infarto previo. Entre los dos y los cinco días posteriores al ingreso en el protocolo se efectuó la prueba del frío. Se considera que ésta es positiva cuando se observa hipocaptación del radioisótopo en algún segmento que no existía en el estudio del esfuerzo y negativo cuando no hay cambios en la captación entre ambos estudios. El seguimiento promedio fue de 24 ± 13 meses, el cual pudo completarse en el 95% de los participantes. Se analizaron los eventos mortalidad cardíaca, infarto de miocardio, accidente cerebrovascular y procedimientos de revascularización. Resultados La edad media fue de 58,7 años con una prevalencia del sexo masculino del 52,6%. Prevalencia de factores de riesgo: diabetes 10,3%, dislipidemia 69,3%, hipertensión arterial 63,4%, obesidad 25,2% y tabaquismo 22,3%. En el 32,4% de los pacientes la prueba fue positiva. El 3,9% no toleró el frío y el 5,3% tuvo reacción vagal. Durante cincuenta meses, la sobrevida libre de eventos fue del 95,6% y del 86,6% en los grupos con prueba del frío negativa y positiva, respectivamente (p < 0,01). Conclusiones La prevalencia de la prueba del frío positiva en pacientes sin cardiopatía isquémica demostrada fue del 32,4%. El sexo masculino y el índice de masa corporal elevado se asociaron con un resultado positivo de la prueba. La prueba del frío positiva identificaría a pacientes que podrían padecer eventos cardiovasculares.

Background Endothelial dysfunction is recognized as the initial step in the development of ischemic heart disease. Yet, the lack of appropriate methods to recognize in the preclinical stage of the disease the patients at risk of cardiovascular events emphasizes the necessity of developing additional diagnostic tools for its early identification. Endothelial function in coronary arteries was evaluated with myocardial perfusion SPECT imaging and cold pressor test. Objective To determine the prevalence of positive cold pressor test in 511 patients with not documented ischemic heart disease, of associated coronary risk factors in those with a positive test, and to analyze the incidence of cardiovascular events after 50-month follow-up. Material and Methods The study was conducted at a department of nuclear medicine. A total of 511 patients underwent myocardial perfusion SPECT imaging; exercise images showed uniform tracer uptake. There were no patients with a history of myocardial revascularization or previous myocardial infarction. Cold pressor test was performed between two and five days after. A positive test was defined by the presence of decreased tracer uptake in any segment that was not present in rest or exercise images; the absence of tracer uptake changes defined a negative test. Mean follow-up was 24±13 months and was achieved in 95% of patients. The incidence of cardiac mortality, myocardial infarction, stroke and revascularization procedures was analyzed. Results Mean age was 58.7 years; 52.6% were men. Prevalence of risk factors: diabetes 10.3%, dyslipemia 69.3%, hypertension 63.4%, obesity 25.2%, and smoking habits 22.3%. The test was positive in 32.4% of patients; 3.9% of patients did not tolerate cold stimulus and 5.3% presented vagal symptoms. Event-free survival at 50 months was 95.6% and 86.6% in patients with negative and positive test, respectively (p<0.01). Conclusions The prevalence of positive cold pressure test in patients with not demonstrated ischemic heart disease was 32.4%. Male gender and body mass index were associated with a positive test. Cold pressure test might identify patients at risk of cardiovascular events.

Family history of hypertension is associated with exaggerated cardiovascular reactivity to mental, but not to physical test.

Aim To investigate whether normotensive young adults with family history of hypertension demonstrate exaggerated cardiovascular responses to both mental and physical stimuli as compared to normotensive young adults without family history of hypertension. Methods Normotensive undergraduate students of normotensive parents (n = 40) and of hypertensive father/ mother/ both (n = 40), aged 20 – 30 years, performed serial subtraction test in a sitting position for three minutes. After taking a rest, subjects performed cold pressor test in ninety seconds. In each test, blood pressure and pulse rate were recorded in pre-test, during test, and post-test using an automated oscillometric device. Changes score rather than absolute scores were analyzed using independent t-test or Mann-Whitney. Results There were no signifi cantly differences in age, body mass index, fasting blood sugar, and plasma creatinine between the two groups. Normotensives of hypertensive parents had signifi cantly higher offi ce systolic blood pressure (108.33+1.6 vs 103.00+1.6 mmHg) and delta change score of cardiovascular reactivity to serial subtraction test (MABP 19.13+1.4 vs 15.5+1.0 mmHg, P= 0.04), but not to cold pressor test (MABP 24.26+1.7 vs 21.74+1.7 mmHg) than those of normotensive parents. Conclusion Normotensive young adults with family history of hypertension demonstrated exaggerated cardiovascular reactivity to mental test but not to physical test. As compared to normotensive young adults without family history of hypertension However, this familial difference in cardiovascular reactivity to mental test is confused with offi ce blood pressure.

Evaluation of Neurophysiological Parameters: Autonomic Status and Acute Pain Perception in Migraneurs.

Introduction: Painful conditions are associated with autonomic dysfunction and altered pain perception. However, data regarding autonomic status in migraineurs is not conclusive and there are few studies regarding acute pain perception in these cases. Aims: This study was conducted to assess various neurophysiological parameters namely autonomic functions using the autonomic function tests and acute pain perception using the cold pressor test in migraneurs. Material and methods: 60 migraineurs and 30 age and gender matched control subjects were included in this study after screening for the exclusion criteria and following a written consent. Diagnosis of migraine was made according to the International Classification of Headache Disorders(ICHD) – 2 Criteria. In the pain free state of the subjects, autonomic function tests including basal heart rate variability, E:I ratio, 30:15 ratio, postural challenge test and sustained handgrip test were carried out together with the cold pressor test. Unpaired t-test was used for analysing the data. Result: Migraineurs showed a trend towards increased parasympathetic tone, as compared to the control subjects, though the p-values were not significant. The pain threshold was lower while the pain tolerance was significantly lower in migraineurs as compared to controls (p= 0.00).Conclusion: In our study we observed an increased vagal tone together with lower values of pain threshold and pain tolerance in migraineurs, indicating that certain neurophysiological parameters are affected in painful conditions like migraine.

Influence of age and gender on cold pressor response in Indian population.

Cold pressor test (CPT) is a simple and well documented laboratory test to evaluate the propensity for hypertension and sympathetic autonomic functions. Role of sex hormones was tested in the present study for the cold pressor response (CPR) in young adults of both sexes and in elderly population. The subjects comprised of young male (n=55), female (n=32) medical students of 17-25 years and elderly males (n=39) and females (n=25) of 50-70 years of age. The CPT was carried out in young and elderly males and females with one minute immersion of one hand in ice cold water (0-4°C). Both in young males and females the absolute rise in SBP and DBP in response to Cold pressor test (CPT) was highly significant, with diastolic percent rise exceeding systolic. In comparison to young males, the females showed greater percent rise in SBP and DBP. Similarly, in elderly groups of both sexes, CPR was associated with significant absolute rise in SBP and DBP with diastolic percent rise more than systolic in males only. Both in young versus elderly males and young versus elderly females comparison yielded comparable percent rise in SBP and DBP. The SBP and DBP percent rise was again comparable between elderly males and females. The greater responsiveness to CPT in young females could be attributed to increased pain sensitivity to cold, and/or genetic and hereditary factors overwhelming the hormonal protection offered by estrogen and nitric oxide (NO).

Application of MWI-a new parameter of wave intensity / 中国医学影像技术

Objective To investigate the feasibility of mean wave intensity (MWI), W1 and W2 in assessing the function of common carotid artery (CCA) before and after cold presser test with wave intensity analysis. Methods Twenty-four healthy subjects were enrolled. The W1, W2, and other parameters of blood flow in resting, before and after cold presser test of CCA, the inner diameter different rate and MWI of blood flow were calculated respectively. The receiver operation characteristic (ROC) curves were drawn, and of the effectiveness of MWI, W1 and W2 was compared. Results The different rate of diameters and W1 decreased significantly when subjects underwent cold presser test (P＜0.05), but MWI and W2 increased significantly (P＜0.05). The area under ROC curves was 0.858, 0.731 and 0.698, corresponding to MWI, W1 and W2 (P＞0.05). Conclusion The function of CCA can be evaluated with MWI calculated from conventional parameters.

Significance of new parameters in evaluation the function of carotid artery / 中华超声影像学杂志

Objective To evaluate the parameters of inner diameter different rate (D%), mean wave intensity(MWl) and diameter-adjusted mean wave intension(DAMWI) in assessing the function of common carotid artery(CCA) by quality intima-media thickness(QIMT) technique. Methods Twenty-four healthy subjects were performed 2D and CDFI examination under the normal quiescent and cold pressor test(CPT) condition respectively. The diastolic and systolic diameters of left-CCA were measured by QIMT respectively. Corresponding the inner diameter different range,rate,MWI and DAMWI were calculated respectively. The curves of their ROC were drawn. Results The different range and rate of diameters were decreased when subjects suffered CPT (P< 0.05) ,but the MWI and DAMWI were increased (P<0. 05). The areas under the ROC curves were 0. 827,0. 821 and 0.728 corresponding DAMWI, MWl and different rate of diameter. There was no significant difference among them(P>0. 05). Conclusions Conclusions The changed rate of diameter can be measured exactly by QIMT. The function of CCA can Be evaluated by MW1 and DAMWI which were calculated by conventional parameters.

Effect of 1 week ‘61-points relaxation training’ on cold pressor test induced stress in premenstrual syndrome.

The present study was conducted on 50 clinically healthy women volunteers who were in their reproductive age group and in their premenstrual period. Thirty women having premenstrual syndrome (PMS) were compared with 20 control women to evaluate 1 week training of 61- points relaxation (61-PR) yogic exercise. In both the groups cold pressor test (CPT) was performed; and systolic blood pressure (SBP; mmHg), diastolic blood pressure (DBP; mmHg) and heart rate (HR/min) were measured. Basal SBP, DBP and HR of women with PMS was significantly higher than the control subjects with P value 1.2E-05, 0.000583 and 0.005707 respectively, suggesting the presence of stress in women with PMS. Immediately after CPT, the said parameters were statistically significantly more raised in PMS group than control group (P = 6.14E-05, 2.78E-06, 0.003799) respectively. Following 1 week of 61-PR training, the control group showed a significant decline in SBP, DBP & HR (P = 0.00769384, 0.00852894, 0.62316217) respectively. However, the PMS group showed a statistically highly significant reduction in SBP, DBP & HR (P = 2.55E-07, 4.35E-07 and 6.4904E-06) respectively immediately after CPT. These results suggest a reduction in sympathetic activity by 61-PR training and it can be used as an effective relaxation tool during premenstrual stress.

Evaluation of Endothelium-dependent Myocardial Perfusion Reserve in Healthy Smokers: Cold Pressor Test using H2 (15) O PET / 대한핵의학회잡지

PURPOSE: Much evidence suggests long-term cigarette smoking alters coronary vascular endothelial response. In this study, we applied nonnegative matrix factorization (NMF), an unsupervised learning algorithm, to CO-less H2 (15) O-PET to investigate coronary endothelial dysfunction caused by smoking noninvasively. MATERIALS AND METHODS: This study enrolled eighteen young male volunteers consisting of 9 smokers (23.8 +/- 1.1 yr; 6.6 +/- 2.5 pack-years) and 9 nonsmokers (23.8 +/- 2.9 yr). They do not have any cardiovascular risk factor or disease history. Myocardial H2 (15) O-PET was performed at rest, during cold (5degrees C) pressor stimulation and during adenosine infusion. Left ventricular blood pool and myocardium were segmented on dynamic PET data by NMF method. Myocardial blood flow (MBF) was calculated from input and tissue functions by a single compartmental model with correction of partial volume and spillover effects. RESULTS: There were no significant difference in resting MBF between the two groups (Smokers: 1.43 0.41 ml/g/min and non-smokers: 1.37 +/- 0.41 ml/g/min; p = NS). during cold pressor stimulation, MBF in smokers was significantly lower than that in non-smokers (1.25 +/- 0.34 ml/g/min vs 1.59 +/- 0.29 ml/g/min ; p=0.019). The difference in the ratio of cold pressor MBF to resting MBF between the two groups was also significant (p=0.024; 90 +/- 24% in smokers and 122 +/- 28% in non-smokers.). During adenosine infusion, however, hyperemic MBF did not differ significantly between smokers and non-smokers (5.81 +/- 1.99 ml/g/min vs 5.11 +/- 1.31 ml/g/min ; p=NS). CONCLUSION: In smokers, MBF during cold pressor stimulation was significantly lower compared with nonsmokers, reflecting smoking-induced endothelial dysfunction. However, there was no significant difference in MBF during adenosine-induced hyperemia between the two groups.