Effects of moxibustion of "biaoben acupoint combination" on heart rate variability, atrial natriuretic peptide in the model rats of IBS-D complicated with anxiety / 中国针灸

OBJECTIVE@#To compare the effects on the heart rate variability (HRV) and the expression of the atrial natriuretic peptide (ANP) in the model rats of irritable bowel syndrome with predominant diarrhea (IBS-D) rats complicated with anxiety between moxibustion of "biaoben acupoint combination" and that of "conventional acupoint combination".@*METHODS@#Of 50 healthy SPF female SD rats, aged 3 months, 8 rats were selected randomly as a blank group, and the rest rats were prepared to be the model of IBS-D complicated with anxiety. Twenty-four rats after successfully modeled were randomized into a model group, a conventional acupoint combination group (convention group) and a biaoben acupoint combination group (biaoben group), 8 rats in each one. In the convention group, moxibustion was delivered at "Tianshu" (ST 25), "Zusanli"(ST 36) and "Shangjuxu"(ST 37); and in the biaoben group, moxibustion was applied to "Neiguan" (PC 6), "Zusanli" (ST 36), and "Guanyuan" (CV 4). One session of moxibustion took 20 min, once daily, for 14 days in total. Before and after intervention, the body mass and fecal moisture content were compared in the rats of each group; using abdominal wall withdrawal reflex, the visceral hypersensitivity was evaluated; with elevated plus maze (EPM) and light-dark box (LDB), the anxiety conditions were assessed. After intervention, HRV was compared among groups, the ultrastructure of intestinal mucosa was observed under the transmission electron microscope in the rats of each group, and ANP expression in the myocardial tissue was detected using Western blot method and immunofluorescence.@*RESULTS@#Before the intervention, compared with the blank group, the body mass and visceral pain threshold of rats were reduced in the model group, the convention group and the biaoben group (P<0.05), fecal moisture content and AWR scores (at the dilatation pressure of 40, 60 and 80 mm Hg, 1 mm Hg ≈ 0.133 kPa) were elevated (P<0.05); and time in the open arm, the open arm entry number and the total movement distance (EPM), the time spent in the light compartment, the number of dark to light transitions and the total transition distance (LDB) were decreased (P<0.05). After the intervention, compared with the blank group, in the model group, the body mass, visceral pain threshold, standard diviation of NN intervals (SDNN) and root mean square of successive RR interval differences (RMSSD) were dropped (P<0.05), fecal moisture content, AWR scores (the dilation pressures of 40, 60 and 80 mm Hg), LF/HF and ANP expression were increased (P<0.05), the time in open arm, the open arm entry number and the total movement distance (EPM), the time spent in the light compartment, the number of dark to light transitions and the total transition distance (LDB) were decreased (P<0.05). When compared with the model group, in the convention group and the biaoben group, the body mass, visceral pain threshold, SDNN and RMSSD were increased (P<0.05), fecal moisture content, AWR scores (the dilation pressures of 60 and 80 mm Hg), LF/HF and ANP expression were dropped (P<0.05), the time in open arm, the open arm entry number and the total movement distance (EPM), the time spent in the light compartment, the number of dark to light transitions and the total transition distance (LDB) were increased (P<0.05). In the biaoben group, compared with the convention group, the body mass, visceral pain threshold, SDNN and RMSSD were elevated (P<0.05), fecal moisture content, AWR score (the dilation pressure of 80 mm Hg), LF/HF and ANP expression were decreased (P<0.05), the time in open arm, the open arm entry number and the total movement distance (EPM), the time spent in the light compartment, the number of dark to light transitions and the total transition distance (LDB) were increased (P<0.05). The epithelial cells of the intestinal mucosa showed a normal morphology in the blank group, the tight junction of the cells was disrupted and the junction was loose in the model group; the tight junction was imperfect in the convention group, but it was intact in the biaoben group.@*CONCLUSION@#Compared with the conventional acupoint combination, moxibustion of biaoben acupoint combination is more effective on the symptoms of IBS-D complicated with anxiety in the model rats. The effect mechanism may be related to attenuating anxiety-like negative emotions, positively regulating HRV, stabilizing IBS-D intestinal mucosal barrier and down-regulating the expression of ANP in myocardium.

6-hydroxydopamine and ovariectomy has no effect on heart rate variability parameters of females

OBJECTIVES: In addition to the classic motor symptoms of Parkinson's disease (PD), patients also present with non-motor symptoms, such as autonomic dysfunction, which is present in almost 90% of patients with PD, affecting the quality of life and mortality. Regarding sex differences in prevalence and presentation, there is increasing concern about how sex affects autonomic dysfunction. However, there are no previous data on autonomic cardiac function in females after 6-hydroxydopamine (6-OHDA) striatal injection. METHODS: Wistar female rats were ovariectomized. After 20 days, the animals received bilateral injections of 6-OHDA (total dose per animal: 48 µg) or a vehicle solution in the striatum. Thirty days after 6-OHDA injection, subcutaneous electrodes were implanted for electrocardiogram (ECG) recording. Ten days after electrode implantation, ECG signals were recorded. Analyses of heart rate variability (HRV) parameters were performed, and the 6-OHDA lesion was confirmed by analyzing the number of tyrosine hydroxylase-positive neurons in the substantia nigra pars compacta (SNpc). RESULTS: A high dose of 6-OHDA did not affect HRV of females, independent of ovariectomy. As expected, ovariectomy did not affect HRV or lesions in the SNpc after 6-OHDA injection. CONCLUSIONS: We suggest that females with 6-OHDA present with cardioprotection, independent of ovarian hormones, which could be related to female vagal predominance.

Determination of maximum noise level in an ECG channel under SURE Wavelet filtering for HRV extraction

Abstract Heart Rate Variability (HRV) is the measure of variation between R-R interbeats, it has been demonstrated to be a good representation of physiological features, especially to the alterations in the Autonomic Nervous System (ANS). Considering the values that compose a HRV distribution are extracted from electrocardiography (ECG), many of the electrical disturbances that affect ECG-based diagnosis can also interfere with the results of the HRV analysis. This paper uses a 30-minute portion of a healthy patient (no arrhythmias detected or annotated) from the MIT-BIH ECG database to analyze the effectiveness of the SURE Wavelet denoising method for extracting the HRV from a progressively noisier ECG channel. Results show that the minimum SNR for reliable HRV extraction under these conditions is approximately 5dB and outlines the exponential behavior of HRV extraction for escalating noise levels in the ECG signal.

Autonomic Dysregulation And Low Heart Rate Variability In Spinal Cord Injury (SCI): A Marker For Depression

Background: Spinal cord injury (SCI) results in physical, autonomic, and psychological consequences. Depression is among one the most common psychological effects of SCI, with an incidence of 22%. Depression is associated with reduced heart rate variability (HRV), but it remains unclear if autonomic dysregulation possesses depression risk in SCI. Thus, this study aims to explore the association between HRV and depression in SCI. Methodology: Ninety-one spinal cord injured patients (eighty-eight males and three female) representing three levels of severity of injury (cervical, high thoracic, and low thoracic) were recruited. Basal/resting HRV was assessed using 1000Hz Polar Heart rate monitor RS800 CX and Kubios HRV software. PHQ-9 assessed the depression; a cut of 10 was used to divide the sample into patients with probable Major Depressive Disorder (MDD) and non-MDD. Results: Non-parametric tests for between-group comparisons showed a significant difference in HRV variables (p<0.05) between the probable MDD and non-MDD SCI. Significant differences in HRV were observed between the low and high thoracic (p<0.05) and low thoracic and cervical group (p<0.05), suggesting that the functioning of the autonomic nervous system might differ with level of SCI. Conclusion: Depression in SCI has been associated with injury-related factors; we use the neurovisceral theory to explain the role of the autonomic nervous system in depression in SCI.

Evaluation of Heart Rate Variability in Critically-ill Neonates

Aims: The objective of this work was to evaluate heart rate variability (HRV) in critically-ill neonates admitted to NICU, to detect the effect of different causes of critical illness on cardiac autonomic function and outcome of these neonates.Study Design:Case-control study.Place and Duration of Study:Neonatal Intensive Care Unit (NICU) of Pediatric Department, Tanta University Hospital, in the period from January 2018 to May 2019.Methodology:We included 30 neonates who were critically-ill according to Score for Neonatal Acute Physiology with Perinatal Extension II (SNAPPE-II score) as cases Group. Fifteen healthy full term neonates, matched for age and sex, were enrolled as a control group. 24-hour Holter monitoring was performed with recording and interpretation of ECG data for every neonate in the study, including analysis of HRV.Results:There was significant increase of mean HR in critically-ill neonates as compared to control group. There was significant decrease of all HRV parameters (SDNN, SDANN, SDNNI, RMSSDand PNN50) in critically-ill neonates as compared to control group (P< 0.05). Significant negative correlations between SNAPPE-II score and HRV parameters (SDNN, SDANN, SDNNI, RMSSD, PNN50) in critically-ill neonates were present, whereas there was non-significant positive correlation between SNAPPE-II score and mean heart rate.Conclusion:HRV parameters decreased significantly in critically-ill neonates admitted to NICU, denoting severe cardiac autonomic dysfunction in these sick newborn infants. HRV strongly correlated to severity (SNAPPE-II score) and outcome, with strong relation to mortality of these critically-ill neonates

Análisis de parámetros en señales electrocardiográficas de pacientes con Chagas y de variables del dominio del tiempo de la HRV usando polígrafo de alta resolución / Analysis of parameters in electrocardiographic signals of patients with Chagas and time domain variables of the HRV using high resolution polygraph / Análise de parâmetros em sinais eletrocardiográficos de pacientes com variáveis Chagas e de domínio do tempo da VFC utilizando polígrafo de alta resolução

Resumen Este trabajo presenta los resultados obtenidos de un estudio sobre el análisis de parámetros electrocardiográficos en registros de pacientes seropositivos a la enfermedad de Chagas del Departamento del Meta y medición de las variables en el dominio de tiempo de la variabilidad de la frecuencia cardiaca (HRV) y su comparación con registros de población de control. Se obtuvieron un total de 38 registros de 10 minutos en su gran mayoría (57,9%) con un polígrafo de alta resolución entre ambas poblaciones, creándose una base de datos anotada de éstos registros. El presente estudio, permitió encontrar diferencias significativas de parámetros electrocardiográficos para el intervalo QTc entre los grupos, que podría ser consecuencia de alteración de la condución cardiaca que se traduce en un mayor incremento del QTc, así como de afectación de las variables del dominio de tiempo de la Variabilidad de la Frecuencia Cardiaca (HRV), como la SDRR y SEHR, que resultan en valores más bajos para los pacientes seropositivos a enfermedad de Chagas. Se concluye que variables de los registros ECG y de la HRV, presentan alteración en pacientes con enfermedad de Chagas , que podrían ser utilizados como alertas tempranas de la enfermedad no diagnosticada serológicamente.

Abstract This paper presents the results obtained from a study on the analysis of electrocardiographic parameters in records of patients seropositive to Chagas disease of the Department of Meta and measurement of the variables in the time domain of heart rate variability (HRV) and its comparison with population control records. A total of 38 10-minute records were obtained in the vast majority (57,9%) with a high resolution polygraph between both populations, creating an annotated database of these records. The present study allowed us to find significant differences in electrocardiographic parameters for the QTc interval between the groups, which could be a consequence of an alteration of the cardiac conduction that translates into a greater increase in the QTc, as well as the affectation of the time domain variables of Heart Rate Variability (HRV), such as the SDRR and SEHR, which result in lower values ​​for HRV-positive patients with Chagas disease. It is concluded that variables from the ECG and HRV registries present an alteration in patients with Chagas disease, which could be used as early warnings of the serologically undiagnosed disease.

Resumo Este artigo apresenta os resultados obtidos em um estudo sobre a análise de parâmetros eletrocardiográficos em prontuários de pacientes soropositivos para a doença de Chagas do Departamento de Meta e mensuração das variáveis ​​no domínio do tempo da variabilidade da freqüência cardíaca (VFC) e sua comparação com os registros de controle populacional. Um total de 38 registros de 10 minutos foi obtido na grande maioria (57,9%) com um polígrafo de alta resolução entre as duas populações, criando um banco de dados anotado desses registros. O presente estudo permitiu encontrar diferenças significativas nos parâmetros eletrocardiográficos para o intervalo QTc entre os grupos, o que pode ser consequência de uma alteração da condução cardíaca que se traduz em maior aumento no QTc, bem como no comprometimento das variáveis ​​no domínio do tempo Variabilidade da Frequência Cardíaca (VFC), como o SDRR e o SEHR, que resultam em valores mais baixos para pacientes HIV positivos com doença de Chagas. Concluise que as variáveis ​​dos registros de ECG e HRV apresentam alteração nos pacientes com doença de Chagas, que pode ser utilizada como alerta precoce da doença sorologicamente não diagnosticada.

A Comparative Study Of Heart Rate Variability In Middle Aged Obese Male And Non Obese Male

Objectives: Obesity is on the rise in our country once viewed as a sign of prosperity it is a contributing factor to diseases. The purpose of this study is to see whether obesity has an effect on the heart rate of the subject by comparing and possibly contrasting the heart rate variability in obese and non-obese males.Materials and methods: Out of 100 participants, 50 healthy male obese (BMI >25kg/m2) individuals and 50 healthy male non-obese individuals (BMI <25kg/m2) of age group 35yrs-55yrs were taken from the general population. The ECG was recorded and HRV were derived from it. Results were compared by using independent ‘t’ test and Pearson’s correlation test was done for BMI and HRV. P < 0.05 was considered as significant.Results: HRV parameters and heart rate between the two groups LF, HF and HFnu, was found to be significantly reduced and LFnu and LF/HF was found to be significantly higher in obese persons. The correlation of BMI with the parameters such as ratio of LF/HF, normalised units of LF and HF revealed a significantly negative relation with HFnu. A positive relationship was also observed between LFnu and LF/HF ratio. However, it was statistically not significant.Conclusion: The middle aged obese males had reduced parasympathetic activity associated with elevated sympathovagal modulation. This altered balance of the autonomic nervous system increases the risk of cardiovascular disorders.

Presence of age- and sex-related differences in heart rate variability despite the maintenance of a suitable level of accelerometer-based physical activity

There is currently a lack of information adjacent on the influence of sex and age in heart rate variability (HRV), adjusted according to accelerometer-based physical activity (PADL). We hypothesized that the effect of sex and age on the HRV should be reduced or absent in individuals with a suitable PADL level. We aim to evaluate the influence of sex and age on HRV, adjusted for the confounding effects of the PADL level. A total of 485 age-stratified subjects (18-39, 40-59, and ≥60 years) underwent HRV analyses at rest and 7-day assessments of accelerometer-based PADL. Multivariate analyses of covariance were done using log-transformed HRV indices as outcomes, age and sex as fixed factors, and PADL, cardiovascular risk, fat body mass, and heart rate (HR) at rest as covariates. Despite the adjustment for directly measured PADL, women had better indices of vagal tone, whereas men had higher sympathetic influence. Also, compared to middle-aged and older adults, younger individuals (ages 18-39 years) presented better HRV. Multiple regression analyses confirmed that age and sex were the main predictors of HRV indices, even after adjusting for PADL directly assessed by triaxial accelerometer and HR. We also observed that the correlation between some HRV indexes and the different indexes of physical activity directly evaluated was significant, but not very consistent. Thus, HRV indices are influenced by age and sex, regardless of accelerometer-based physical activity. Interventions with physical activity and exercise aimed at improving the autonomic modulation of asymptomatic adults should take such differences into account.

Analysis of risk factors of decreased heart rate variability in patients with type 2 diabetes mellitus / 上海交通大学学报（医学版）

Objective • To analyze the related risk factors of decreased heart rate variability (HRV) in type 2 diabetes mellitus (T2DM) patients. Methods • A total of 210 cases with T2DM in Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine from Jan. 2013 to Dec. 2014 were divided into two groups by the levels of urinary albumin creatinine ratio (UACR) and serum triacylglycerol (TAG), and with/without hypertension, respectively. By comparing the differences of clinical characteristics, HRV parameters and other general clinical data between the two groups, the correlations between HRV indexes and their risk factors were explored. Results • The average heart rate of the whole day was higher, and SDNN [normal RR intervals of sinus beats (NN intervals) standard deviation] was lower in the high UACR group than those in the normal UACR group (both P<0.05). The average heart rate of the whole day was higher, while SDNN and pNN50 (percentage of total heart beats with adjacent NN intervals greater than 50 ms) were lower in the hypertriglyceridemia group than those in the normal TAG group (all P<0.05). Minimum frequency domain power hour was lower in the hypertension group than that in the normotension group (P<0.05). Regression analysis showed that the linear correlativity between TAG and SDNN was very prominent (P<0.05), as well as between the diastolic blood pressure (DBP) and the average heart rate of the whole day, SDNN, frequency domain power 24 hours and minimum frequency domain power hour (all P<0.05). Similarly, the age was linearly correlated significantly with the average heart rate of the whole day, SDNN, SDANN (the standard deviation of the mean NN intervals every 5 min), frequency domain power 24 hours, minimum frequency domain power hour and maximum frequency domain power hour (all P<0.05). Conclusion • Age, TAG level and hypertension are the risk factors of decreased HRV in T2DM patients. Thus, early detection of the decrease of HRV in these patients can prevent the cardiovascular events of T2DM.

Influence of expiratory positive airway pressure on cardiac autonomic modulation at rest and in submaximal exercise in COPD patients

The aim of this study was to evaluate the effect of expiratory positive airway pressure (EPAP) on heart rate variability (HRV) indices at rest and during 6-min walk test (6MWT) in chronic obstructive pulmonary disease (COPD) patients. Fifteen moderate to severe COPD patients were randomized and evaluated with and without (Non-EPAP) a 5 cmH2O EPAP device. Respiratory rate (RR) was collected at rest (5 min), during the 6MWT (5 min), and at recovery (5 min). Indices of HRV were computed in the time domain, in the frequency domain, and nonlinear analysis. For EPAP and Non-EPAP during the 6MWT, we found an increased mean heart rate (HR) (P=0.001; P=0.001) while mean RR (P=0.001; P=0.015) and RR tri index decreased (P=0.006; P=0.028). Peripheral oxygen saturation (P=0.019) increased at rest only in the EPAP group. In EPAP, correlations were found between forced expiratory volume in 1 s (FEV1) and low frequency (LF) sympathetic tonus (P=0.05; r=-0.49), FEV1 and high frequency (HF) parasympathetic tonus at rest (P=0.05; r=0.49), lactate at rest and LF during the 6MWT (P=0.02; r=-0.57), and lactate at rest and HF during 6MWT (P=0.02; r=0.56). Through a linear regression model, we found that lactate at rest explained 27% of the alterations of LF during 6MWT. The use of 5 cmH2O EPAP improved autonomic cardiac modulation and its complexity at rest in COPD patients. Although it did not influence the performance of the 6MWT, the EPAP device caused alterations in resting lactate concentration with an effect on sympatho-vagal control during the test.

Design of ECG Monitoring Analyzer Based on MicrocontrollerCC2530 / 中国医疗器械杂志

<p><b>OBJECTIVE</b>A remote wireless electrocardiogram (ECG) monitoring system is designed by using the CC2530 micro-controller as the device core.</p><p><b>METHODS</b>Acquisition, conversion and data processing for ECG signals are realized on CC2530 micro-controllers. And the ECG data is transmitted to the coordinator by using ZigBee. It realizes the real-time monitoring of ECG signals and heart rate variability (HRV) data.</p><p><b>RESULTS</b>The test results show that the maximum error of the designed ECG monitoring analyzer is 3 beats per minute and the average error is 1.6 beats per minute, which can meet the requirement of pharmaceutical industry standards of the People's Republic of China.</p><p><b>CONCLUSIONS</b>The ECG monitoring analyzer has good portability, high measurement precision and good practical application values.</p>

Differences of acupuncture and moxibustion on heart rate variability in-deficiency syndrome:a randomized controlled trial / 中国针灸

<p><b>OBJECTIVE</b>To observe the improvement of acupuncture and moxibustion on symptoms of-deficiency syndrome as well as their differences on the parameters of heart rate variability (HRV).</p><p><b>METHODS</b>Thirty patients with-deficiency syndrome and 15 healthy volunteers were recruited. Thirty patients with-deficiency syndrome were randomly assigned into an acupuncture group and a moxibustion group, 15 cases in each one. Fifteen healthy volunteers were allocated as a healthy control group. Patients in the acupuncture group and healthy control group were treated with acupuncture while patients in the moxibustion group were treated with moxibustion. Guanyuan (CV 4) and Zusanli (ST 36) were chosen for treatment, once every other day, for totally 10 times. All the patients were evaluated with-deficiency assessment scale (QDAS) and HRV parameters before treatment, after 4th treatment and after all treatment. The correlation was analyzed between QDAS and HRV parameters, and HRV parameters were compared among the three groups before treatment, after 4th treatment and after all treatment.</p><p><b>RESULTS</b>Compared before treatment, the scores of QDAS were decreased in the acupuncture group and the moxibustion group after 4th treatment and after all treatment (all<0.05); after all treatment the score of QDAS in the moxibustion group was lower than that in the acupuncture group (<0.05). The HRV parameters of-deficiency syndrome were significantly lower than those of healthy volunteers with higher correlation with QDAS. Compared before treatment, the mean heart rate was decreased after treatment (<0.05), while total HRV and low frequency were increased in the moxibustion group (both<0.05). The mean heart rate in the healthy control group was increased after treatment (<0.05). The differences of HRV parameters before and after treatment were not significant in the acupuncture group (all>0.05).</p><p><b>CONCLUSIONS</b>Total HRV can reflect the severity of-deficiency syndrome. Both acupuncture and moxibustion can improve symptoms of-deficiency patients, which is superior in moxibustion. The possible mechanism is likely to be related with improved sustainable activation of autonomic nervous system.</p>

The responses of subjective feeling, task performance ability, cortisol and HRV for the various types of floor impact sound: a pilot study

BACKGROUND: Recently, noise coming from the neighborhood via floor wall has become a great social problem. The noise between the floors can be a cause of physical and psychological problems, and the different types of floor impact sound (FIS) may have the different effects on the human's body and mind. The purpose of this study is to assess the responses of subjective feeling, task performance ability, cortisol and HRV for the various types of floor impact. METHODS: Ten men and 5 women were enrolled in our study, and the English listening test was performed under the twelve different types of FIS, which were made by the combinations of bang machine (B), tapping machine (T), impact ball (I) and sound-proof mattress (M). The 15 subjects were exposed to each FIS for about 3 min, and the subjective annoyance, performance ability (English listening test), cortisol level of urine/saliva and heart rate variability (HRV) were examined. The sound pressure level (SPL) and frequency of FIS were analyzed. Repeated-measures ANOVA, paired t-test, Wilcoxon signed rank test were performed for data analysis. RESULTS: The SPL of tapping machine (T) was reduced with the soundproof mattress (M) by 3.9–7.3 dBA. Impact ball (I) was higher than other FIS in low frequency (31.5–125 Hz) by 10 dBA, and tapping machine (T) was higher than other FIS in high frequency (2–4 k Hz) by 10 dBA. The subjective annoyance is highest in the combination of bang machine and tapping machine (BT), and next in the tapping machine (T). The English listening score was also lowest in the BT, and next in T. The difference of salivary cortisol levels between various types of FIS was significant (p = 0.003). The change of HRV parameters by the change of FIS types was significant in some parameters, which were total power (TP) (p = 0.004), low frequency (LF) (p = 0.002) and high frequency (HF) (p = 0.011). CONCLUSIONS: These results suggest that the human's subjective and objective responses were different according to FIS types and those combinations.

Assessment Of Examination Stress And HRV in Adolescents.

Objective.The present study was designed to define and evaluate examination stress among ,adolescents in the age group of 12–18 years in relation to heart rate variability (HRV), an index of sympathovagal interplay, one of the sensitive neurophysiological axes to be influenced initially, when an individual is exposed to any stressor.Methods. Hari’s stress inventory for students was used to qualify examination stress was collected on 69 healthy school students, free from any acute or chronic ailment, one month and seven days before the start of final examinations along with acquisition of short – term HRV to profile the sympathovagal interplay, a sensitive index of both physical and mental stress. Results. The stress inventory depicted that the sample population was under an enhanced mental stress 7 days before the examination as compared to that observed 1 month before the ratios of HRV 1month and 7 days before the final examination. Significant appreciable difference could also be appreciated in the values of SDANN in time domain and amplitude of the waveforms in HF, LF on the frequency domain of HRV.Conclusion. An enhanced sympathetic outflow as discerned through increase in LF/HF ratio and LF power with a concomitant decrease in HF power along with significant decrease in SDANN values profiling a decreased vagal outflow of the student population denotes an autonomic neurophysiological status that needs a specialist attention in terms of proper and adequate guidance and counselling.

Assessment of Cardiovascular Autonomic Functions and Baroreceptor Reactivity in Women with Premenstrual Syndrome.

Objectives: The study was conducted to assess the autonomic status of women with mild PMS using shortterm heart rate variability (HRV) analysis and conventional autonomic function tests (CAFT). Methods: Sixty females in the age group 17-25 years with mild premenstrual syndrome were identified using a self-report questionnaire, the shortened premenstrual assessment form. HRV and CAFTs were recorded 1- 5 days prior and 8-10 days after menstruation. Results: The subjects showed a significant increase in HR and SBP in luteal phase. In HRV, an increase in mean HR and LF-HF ratio were seen in the luteal phase whereas an increase in the NN50, RMSSD and pNN50, HF, HF(nu) and TP were seen in the follicular phase. In CAFT, no change in HRB, 30:15 and E/ I ratios but increase in ?DBP(ihg) in the luteal phase was seen. Conclusion: The increase in HR and SBP in the luteal phase could be because increased water and salt retention due to the ovarian steroids. A decrease in HRV, increase in ?DBPihg with no change in 30:15 ratio in the luteal phase could be attributed to delayed withdrawal of ovarian hormones in the luteal phase.

Spectral Heart Rate Variability During Late Gestation In Moderately Anaemic Pregnancy.

Abstracts: Backround: Third trimester of pregnancy is associated with profound adaptive autonomic cardiovascular changes. Anaemia in pregnancy, which is a common problem in India, is known to put pregnant female at higher cardiovascular risk. The aim of this study is to measure & compare the cardiovascular autonomic balance in normal pregnancy i.e. control group (Hb ≥ 11.0 g/dl) & pregnancy with moderate anaemia i.e. case group (Hb = 7.0 to 9.9 g/dl). Methodology: Spectral HRV was measured in supine position using digital polyrite and kubios HRV analysis software. Parameters LF(for sympathetic and parasympathetic modulation) , HF(for vagal modulation) in absolute power (ms 2 ) and normalised units (n.u.) and LF/HF ratio for sympathovagal balance were measured and analysed using SPSS 16.0 software. Results: A significantly high LF power(p<0.001) ,low HF power(p<0.001) and high LF/HF ratio (p<0.001) were observed during late gestation period in moderately anaemic pregnant females compared with healthy pregnant females. Conclusion: Third trimester of pregnancy with moderate anaemia has an elevated sympathetic activity and reduced parasympathetic activity characterised by compensatory rise in cardiac output mainly because of rise in stroke volume. Spectral HRV is a better test to diagnose above change than mere measuring heart rate and blood pressure.

Non-linear Analysis of Heart Rate Variability Improves Differential Diagnosis between Parkinson Disease and Multiple System Atrophy.

Aims: Parkinson's disease (PD) and multiple system atrophy (MSA) are neurodegenerative disorders characterized by motor "parkinsonian" symptoms and non-motor symptoms related to autonomic nervous system (ANS) dysfunction. The latter can be quantified with the analysis of Heart Rate Variability (HRVa) and of its complexity. In this study nonlinear (NL) HRV complexity parameters were calculated to assess their predictive accuracy as markers of “disease” useful for early differentiation between PD and MSA in parkinsonian syndromes of uncertain diagnosis. Study Design: Observational study. Place and Duration of Study: Clinical Physiology-Biomagnetism Center, Policlinico A. Gemelli, Rome Italy. Patients enrolled from January 2010 to October 2013. Methodology: 51 patients [25 with “certain” diagnosis of PD, 9 with a “highly probable” diagnosis of MSA and 17 with parkinsonian syndromes of uncertain neurological definition (6 with “undefined parkinsonism” and 11 with “suspected MSA”)] and 40 age-matched healthy control subjects were studied. Short-term NL HRVa was performed during daily activity and during REM/NREM sleep from 24 h ECG recordings. Discriminant analysis (DA) was used to identify which NL HRV parameters (or their combination) were efficient to differentiate between PD and MSA in cases of uncertain diagnosis. Results: Compared with healthy controls, most NL HRV parameters were significantly altered in patients (p<0.05), during both active and passive awakeness and during sleep. Most evident HRV abnormalities were found during active awakeness in MSA. DA of recurrence plot parameters provided the best predictive accuracy (76.5%) for the classification of parkinsonian patients with uncertain diagnosis. Conclusion: NL HRVa is efficient in differentiating MSA from PD and may improve earlier diagnosis in patients with parkinsonian symptoms of uncertain nature, useful to address second level diagnostic steps and to guide more individualized drug treatment.

Study of Abnormal Heart Rate Variability and Its Acupuncture Intervention in Anxiety Disorder / 上海针灸杂志

Heart rate variability (HRV) is a reliable, innocuous and sensitive new index to measure cardiac autonomic nervous function. Anxiety disorder is often accompanied by autonomic nerve dysfunction and its main sign is abnormal HRV. Acupuncture can affect HRV indices, correct abnormal HRV and improve cardiac autonomic nerve dysfunction to relieve anxiety. This article sorts out and analyzes recent years’ studies on abnormal HRV in anxiety disorder, the effect of acupuncture on HRV and acupuncture regulation of abnormal HRV in anxiety disorder to provide a therapeutic basis for clinical acupuncture intervention in abnormal HRV in anxiety disorder.

Autonomic Dysfunction in Major Depressive Disorder.

Background: Cardiovascular (CV) morbidity is a major problem in patients suffering from depression as greater CV mortality is found in cardiac patients with depression. Objective: To assess cardiac autonomic nerve activity by power spectral analysis of heart rate variability in patients with Major Depressive disorder. Methods: This case control study was conducted in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka during 2011. Sixty patients of both sexes with Major Depressive disorder (MDD) aged 20-50 years were enrolled. The patients were selected from the Department of Psychiatry in Bangabandhu Sheik Mujib Medical University (BSMMU). Thirty drug naive MDD patients and thirty medicated MDD patients were compared with 30 healthy control and also between them. The HRV parameters were recorded by 4 active channels, RMS Polyrite-D. For statistical analysis independent sample t-test test was used. Results: LF norm and LF/HF were significantly higher and Total power, HF power, HF norm were significantly lower in both drug naive and medicated MDD patients in comparison with those of healthy control. Conclusion: Autonomic nerve dysfunction involved both the drug naive and medicated MDD patients which was associated with higher sympathetic activity and reduced vagal modulation of the heart and sympathovagal imbalance. Antidepressent drug treatment did not have any effect on autonomic dysfunction.

Effect of Deep Relaxation on Heart Rate Variability in Sedentary Females.

Background: Lower heart rate variability (HRV) in sedentary people is associated with higher risk of coronary heart diseases. Deep Relaxation Technique (DRT) generate higher HRV which reduces the risk of coronary heart disease. Objective: To assess HRV after practicing DRT to find out it’s effect on cardiac autonomic nerve function in sedentary subjects. Methods: This study with intervention by DRT was carried out in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University from July 2012 to June 2013 on 30 apparently healthy sedentary females aged 25-35 years practicing DRT for 3 months. 30 apparently healthy sedentary females who had no experience of relaxation technique constituted control. All subjects were sedentary housewives. The study subjects were participants in a private yoga center in Dhaka. HRV was assessed by RMS polynte D and frequency domain parameters were analysed. Statistical analysis was done by Independent Sample t-test. Results: Total power (p<0.001), HF power (p<0.01), HF norm (p<0.05) were significantly higher and LF power (p<0.001), LF norm (p<0.05), LF/HF (p<0.01) were significantly lower in the relaxation group than those of non relaxation group. Conclusion: Cardiac autonomic nerve function was improved by practice of DRT with parasympathetic dominance in sedentary females.