scholarly journals Decreased baroreflex sensitivity in acute schizophrenia

2007 ◽  
Vol 102 (3) ◽  
pp. 1051-1056 ◽  
Author(s):  
Karl-Jürgen Bär ◽  
Michael Karl Boettger ◽  
Sandy Berger ◽  
Vico Baier ◽  
Heinrich Sauer ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Baroreflex Sensitivity ◽  
Cardiovascular Regulation ◽  
Left Ventricular ◽  
Vascular Pathology ◽  
Vagal Activity ◽  
Acute Schizophrenia ◽  
Work Index ◽  
The Impact

Decreased vagal activity has been described in acute schizophrenia and might be associated with altered cardiovascular regulation and increased cardiac mortality. The aim of this study was to assess baroreflex sensitivity in the context of psychopathology. Twenty-one acute, psychotic, unmedicated patients with a diagnosis of paranoid schizophrenia were investigated after admission to the hospital. Results were compared with 21 healthy volunteers matched with respect to age and sex. Cardiovascular parameters obtained included measures for heart rate variability, baroreflex sensitivity, as well as cardiac output, left ventricular work index, and total peripheral resistance. All parameters investigated were analyzed using linear and novel nonlinear techniques. Positive and negative symptoms were assessed to estimate the impact of psychopathology on autonomic parameters. Subjects with acute schizophrenia showed reduction of baroreflex sensitivity accompanied by tachycardia and greatly increased left ventricular work index. Nonlinear parameters of baroreflex sensitivity correlated with positive symptoms. For heart rate variability, mainly parameters indicating parasympathetic modulation were decreased. Vascular pathology could be excluded as a confounding factor. These results reflect a dysfunctional cardiovascular regulation in acute schizophrenic patients at rest. The changes are similar to adaptational regulatory processes following stressful mental or physical tasks in healthy subjects. This study suggests that hyperarousal in acute schizophrenia is accompanied by decreased efferent vagal activity, thus increasing the risk for cardiovascular mortality. Future studies are warranted to examine the role of the sympathetic system and possible autonomic differences in hyperarousal induced by anxiety and/or external stressful events.

Baroreflex sensitivity and heart rate variability in conscious rats with myocardial infarction

1997 ◽  
Vol 273 (5) ◽  
pp. H2240-H2247 ◽  
Author(s):  
Carsten Krüger ◽  
Armin Kalenka ◽  
Armin Haunstetter ◽  
Mark Schweizer ◽  
Christoph Maier ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Baroreflex Sensitivity ◽  
Left Ventricular ◽  
Plasma Norepinephrine ◽  
Coronary Artery Ligation ◽  
Sham Operation ◽  
Vagal Activity ◽  
Conscious Rats

The baroreflex sensitivity (BRS) and the heart rate variability (HRV) were studied in conscious rats after myocardial infarction (MI; induced by coronary artery ligation) and after sham operation (SH). BRS was determined by linear regression of R-R interval vs. arterial pressure changes induced by nitroprusside or methoxamine (intravenous bolus). HRV was calculated from 3-min electrocardiogram recordings. Left ventricular end-diastolic pressure and plasma atrial natriuretic peptide were increased after MI; plasma norepinephrine and basal heart rate (HR) remained unchanged. At 3 and 28 days after MI, BRS was reduced as indicated by decreased reflex bradycardia (RB) (MI, 0.66 ± 0.13 and 0.78 ± 0.07 ms/mmHg; SH, 1.27 ± 0.16 and 1.48 ± 0.14 ms/mmHg, respectively; P < 0.05 MI vs. SH). At 56 days after MI, BRS was normalized. RB was unaffected by atropine 3 and 28 days after MI but reduced in all other groups. The increase of basal HR by atropine 3 and 28 days after MI was less than in all other groups. HRV (SD of mean N-N interval, coefficient of variance, low- and high-frequency power; studied at 28 and 56 days) was similar in all groups. It is concluded that BRS is transiently depressed in rats with left ventricular dysfunction after MI probably due to a reduced reflex vagal activity. Even though basal HR and HRV are unchanged after MI, a temporary attenuation of tonic vagal activity is unmasked after autonomic blockade.

scholarly journals Sex differences in baroreflex sensitivity, heart rate variability, and end organ damage in the TGR(mRen2)27 rat

2011 ◽  
Vol 301 (4) ◽  
pp. H1540-H1550 ◽  
Author(s):  
Megan S. Johnson ◽  
Vincent G. DeMarco ◽  
Cheryl M. Heesch ◽  
Adam T. Whaley-Connell ◽  
Rebecca I. Schneider ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Sex Differences ◽  
Baroreflex Sensitivity ◽  
Organ Damage ◽  
Left Ventricular ◽  
Loop Analysis ◽  
Poincaré Plot ◽  
End Organ Damage

The aim of this investigation was to evaluate sex differences in baroreflex and heart rate variability (HRV) dysfunction and indexes of end-organ damage in the TG(mRen2)27 (Ren2) rat, a model of renin overexpression and tissue renin-angiotensin-aldosterone system overactivation. Blood pressure (via telemetric monitoring), blood pressure variability [BPV; SD of systolic blood pressure (SBP)], spontaneous baroreflex sensitivity, HRV [HRV Triangular Index (HRV-TI), standard deviation of the average NN interval (SDNN), low and high frequency power (LF and HF, respectively), and Poincaré plot analysis (SD1, SD2)], and cardiovascular function (pressure-volume loop analysis and proteinuria) were evaluated in male and female 10-wk-old Ren2 and Sprague Dawley rats. The severity of hypertension was greater in Ren2 males (R2-M) than in Ren2 females (R2-F). Increased BPV, suppression of baroreflex gain, decreased HRV, and associated end-organ damage manifested as cardiac dysfunction, myocardial remodeling, elevated proteinuria, and tissue oxidative stress were more pronounced in R2-M compared with R2-F. During the dark cycle, HRV-TI and SDNN were negatively correlated with SBP within R2-M and positively correlated within R2-F; within R2-M, these indexes were also negatively correlated with end-organ damage [left ventricular hypertrophy (LVH)]. Furthermore, within R2-M only, LVH was strongly correlated with indexes of HRV representing predominantly vagal (HF, SD1), but not sympathetic (LF, SD2), variability. These data demonstrated relative protection in females from autonomic dysfunction and end-organ damage associated with elevated blood pressure in the Ren2 model of hypertension.

Impact of maternal obesity on neonatal heart rate and cardiac size

2021 ◽  
pp. fetalneonatal-2021-322860
Author(s):  
Alan M Groves ◽  
Anthony N Price ◽  
Tamarind Russell-Webster ◽  
Simone Jhaveri ◽  
Yang Yang ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Cardiovascular Health ◽  
Maternal Obesity ◽  
Left Ventricular ◽  
Causal Mechanism ◽  
Left Ventricular Volumes ◽  
Healthy Weight ◽  
Systolic Volume ◽  
The Impact

BackgroundMaternal obesity may increase offspring risk of cardiovascular disease. We assessed the impact of maternal obesity on cardiac structure and function in newborns as a marker of fetal cardiac growth.MethodsNeonates born to mothers of healthy weight (body mass index (BMI) 20–25 kg/m2, n=56) and to mothers who were obese (BMI ≥30 kg/m2, n=31) underwent 25-minute continuous ECG recording and non-sedated, free-breathing cardiac MRI within 72 hours of birth.ResultsMean (SD) heart rate during sleep was higher in infants born to mothers who were versus were not obese (123 (12.6) vs 114 (9.8) beats/min, p=0.002). Heart rate variability during sleep was lower in infants born to mothers who were versus were not obese (SD of normal-to-normal R-R interval 34.6 (16.8) vs 43.9 (16.5) ms, p=0.05). Similar heart rate changes were seen during wakefulness. Left ventricular end-diastolic volume (2.35 (0.14) vs 2.54 (0.29) mL/kg, p=0.03) and stroke volume (1.50 (0.09) vs 1.60 (0.14), p=0.04) were decreased in infants born to mothers who were versus were not obese. There were no differences in left ventricular end-systolic volume, ejection fraction, output or myocardial mass between the groups.ConclusionMaternal obesity was associated with increased heart rate, decreased heart rate variability and decreased left ventricular volumes in newborns. If persistent, these changes may provide a causal mechanism for the increased cardiovascular risk in adult offspring of mothers with obesity. In turn, modifying antenatal and perinatal maternal health may have the potential to optimise long-term cardiovascular health in offspring.

scholarly journals Influencing Cardiovascular Outcomes through Heart Rate Variability Modulation: A Systematic Review

Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2198
Author(s):  
Alexandru Burlacu ◽  
Crischentian Brinza ◽  
Iolanda Valentina Popa ◽  
Adrian Covic ◽  
Mariana Floria
Keyword(s):  
Heart Failure ◽  
Coronary Artery Disease ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Coronary Artery ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Inverse Association ◽  
Artery Disease ◽  
The Impact

Psychological stress is a well-established risk factor for cardiovascular disease (CVD). Heart rate variability (HRV)-biofeedback could significantly reduce stress levels and improve autonomic nervous system function and cardiovascular endpoints. We aimed to systematically review the literature to investigate the impact of HRV modulation through HRV-biofeedback on clinical outcomes in patients with CVD. A literature search was performed in the following databases: MEDLINE (PubMed), Embase, and Cochrane from the inception until 1 October 2021. Patients in the HRV-biofeedback group had significantly lower rates of all-cause readmissions than patients who received psychological education (respectively, p = 0.028 and p = 0.001). Heart failure following HRV-biofeedback displayed an inverse association with stress and depression (respectively, p = 0.022 and p = 0.033). When stratified according to left ventricular ejection fraction (LVEF), patients with LVEF ≥ 31% showed improved values of the 6 min walk test after HRV-biofeedback interventions (p = 0.05). A reduction in systolic and diastolic blood pressure associated with HRV-biofeedback was observed (p < 0.01) in pre-hypertensive patients. HRV-biofeedback had beneficial effects on different cardiovascular diseases documented in clinical trials, such as arterial hypertension, heart failure, and coronary artery disease. A standard breathing protocol should be applied in future studies to obtain equivalent results and outcomes. However, data regarding mortality in patients with coronary artery disease are scarce and need further research.

scholarly journals Testing the vagal withdrawal hypothesis during light exercise under autonomic blockade: a heart rate variability study

2018 ◽  
Vol 125 (6) ◽  
pp. 1804-1811 ◽  
Author(s):  
Timothée Fontolliet ◽  
Vincent Pichot ◽  
Aurélien Bringard ◽  
Nazzareno Fagoni ◽  
Alessandra Adami ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Baroreflex Sensitivity ◽  
Total Power ◽  
Vagal Activity ◽  
Arterial Blood ◽  
Exercise Onset ◽  
Autonomic Blockade ◽  
Vagal Withdrawal

We performed the first analysis of heart rate variability (HRV) at rest and during exercise under full autonomic blockade on the same subjects, to test the conjecture that vagal tone withdrawal occurs at exercise onset. We hypothesized that between rest and exercise there would be 1) no differences in total power (PTOT) under parasympathetic blockade, 2) a PTOT fall under β1-sympathetic blockade, and 3) no differences in PTOT under blockade of both autonomic nervous system branches. Seven men [24 (3) yr, mean (SD)] performed 5-min cycling (80 W) supine, preceded by 5-min rest during control and with administration of atropine, metoprolol, and atropine + metoprolol (double blockade). Heart rate and arterial blood pressure were continuously recorded. HRV and blood pressure variability were determined by power spectral analysis, and baroreflex sensitivity was determined by the sequence method. At rest, PTOT and the powers of low- and high-frequency components of HRV (LF and HF, respectively) were dramatically decreased with atropine and double blockade compared with control and metoprolol, with no effects on LF-to-HF ratio and on the normalized LF (LFnu) and HF (HFnu). During exercise, patterns were the same as at rest. Comparing exercise with rest, PTOT varied as hypothesized. For systolic and diastolic blood pressure, resting PTOT was the same in all conditions. During exercise, in all conditions, PTOT was lower than in control. Baroreflex sensitivity decreased under atropine and double blockade at rest and under control and metoprolol during exercise. The results support the hypothesis that vagal suppression determined disappearance of HRV during exercise. NEW & NOTEWORTHY This study provides the first demonstration, by systematic analysis of heart rate variability at rest and during exercise under full autonomic blockade on the same subjects, that suppression of vagal activity is responsible for the disappearance of spontaneous heart rate variability during exercise. This finding supports previous hypotheses on the role of vagal withdrawal in the control of the rapid cardiovascular response at exercise onset.

scholarly journals Heart Rate Variability in Elite Swimmers before, during and after COVID-19 Lockdown: A Brief Report on Time Domain Analysis

2021 ◽  
Vol 11 (17) ◽  
pp. 8106
Author(s):  
Robin Pla ◽  
Laurent Bosquet ◽  
Katie McGibbon ◽  
Iñigo Mujika ◽  
Anaël Aubry
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Time Domain Analysis ◽  
Vagal Activity ◽  
Monday Morning ◽  
Training Volume ◽  
Natural Logarithm ◽  
Elite Swimmers ◽  
Baseline Values ◽  
The Impact

Background: Many athletes worldwide have endured home confinement during the COVID-19 pandemic, and their opportunities to train were strongly limited. This study describes the impact of lockdown on training volume and heart rate variability (HRV) in elite swimmers. Methods: HRV data of seven elite males were collected each Monday morning over 20 weeks, including 8 weeks of lockdown. The training volume was quantified retrospectively. Results: During the lockdown period (weeks 4–11) swimming was not allowed, and the total training volume was reduced by 55.2 ± 7.5% compared to the baseline volume (from 27.2 to 12.2 training hours). This drop was associated with a decrease in vagal activity (a 9.2 ± 5.4% increase in resting HR and a 6.5 ± 3.4% decrease in the natural logarithm of rMSSD from baseline values). After the lockdown (weeks 12–20), the training volume was gradually increased before attaining 68.8% and 88.2% of the baseline training volume at weeks 15 and 17, respectively. Resting HR and Ln rMSSD returned to baseline values four weeks after the lockdown. Conclusions: The lockdown period induced a decreased training volume which was associated with a decrease in vagal activity. However, HRV values returned to the baseline 4 weeks after the resumption of swimming training.

Advanced analysis of spontaneous baroreflex sensitivity, blood pressure and heart rate variability in patients with dilated cardiomyopathy

2002 ◽  
Vol 102 (4) ◽  
pp. 465-473 ◽  
Author(s):  
Hagen MALBERG ◽  
Niels WESSEL ◽  
Annett HASART ◽  
Karl-Josef OSTERZIEL ◽  
Andreas VOSS
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Systolic Blood Pressure ◽  
Dilated Cardiomyopathy ◽  
Healthy Subjects ◽  
Baroreflex Sensitivity ◽  
Left Ventricular ◽  
Sequence Method

Baroreflex sensitivity (BRS) is an important parameter in the classification of patients with reduced left ventricular function. This study aimed at investigating BRS in patients with dilated cardiomyopathy (DCM) and in healthy subjects (controls), as well as comparing the values of BRS parameters with parameters of heart rate variability (HRV) and blood pressure variability (BPV). ECG, continuous blood pressure and respiration curves were recorded for 30min in 27 DCM patients and 27 control subjects. The Dual Sequence Method (DSM) includes the analysis of spontaneous fluctuations in systolic blood pressure and the corresponding beat-to-beat intervals of heart rate to estimate bradycardic, opposite tachycardic and delayed baroreflex fluctuations. The number of systolic blood pressure/beat-to-beat interval fluctuations in DCM patients was reduced in comparison with controls (DCM patients: male, 154.4±93.9ms/mmHg; female, 93.7±40.5ms/mmHg; controls: male, 245.5±112.9ms/mmHg; female, 150.6±55.8ms/mmHg, P < 0.05). The average slope in DCM patients was lower than in controls (DCM, 5.3±1.9ms/mmHg; controls, 8.0±5.4ms/mmHg; P < 0.05). Discriminant function analysis showed that, in the synchronous range of the standard sequence method, the DCM and control groups could be discriminated to only 76% accuracy, whereas the DSM gave an improved accuracy of 84%. The combination of six parameters of HRV, BPV and DSM gives an accuracy of classification of 96%, whereas six parameters of HRV and BPV could separate the two groups to only 88% accuracy. Thus the DSM leads to an improved characterization of autonomous regulation in order to differentiate between DCM patients and healthy subjects. BRS in DCM patients is significantly reduced and apparently less effective.

scholarly journals Vagally mediated heart rate variability in headache patients—a systematic review and meta-analysis

Cephalalgia ◽  
2015 ◽  
Vol 36 (3) ◽  
pp. 265-278 ◽  
Author(s):  
Julian Koenig ◽  
DeWayne P Williams ◽  
Andrew H Kemp ◽  
Julian F Thayer
Keyword(s):  
Systematic Review ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Effect Size ◽  
Meta Analysis ◽  
Medium Effect ◽  
Future Research ◽  
Vagal Activity ◽  
Headache Disorders ◽  
The Impact

Objective Vagal nerve activity—indexed by heart rate variability (HRV)—has been linked to altered pain processing and inflammation, both of which may underpin headache disorders and lead to cardiovascular disease (CVD). Here we examined the evidence for differences in parasympathetic (vagal) activity indexed by time- and frequency-domain measures of HRV in patients with headache disorders compared to healthy controls (HCs). Methods A systematic review and meta-analysis was conducted on studies investigating group differences in vagally mediated HRV (vmHRV) including time- (root-mean-square of successive R-R-interval differences (RMSSD)) and frequency- (high-frequency HRV) domain measures. Studies eligible for inclusion were identified by a systematic search of the literature, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results Seven studies reporting a total of 10 comparisons of patients with headache disorders (HF-HRV n = 67, RMSSD n = 122) and HCs (HF-HRV n = 64, RMSSD n = 125) were eligible for inclusion. Random-effects meta-analysis revealed a significant main effect on RMSSD ( Z = 2.03, p = 0.04; Hedges’ g = −0.63; 95% CI (−1.24, –0.02); k = 6) and similar pooled effect size estimates for HF-HRV when breathing was controlled ( g = −0.30; 95% CI (−0.69; 0.10)) but not when breathing was not controlled ( g = 0.02; 95% CI (−0.69; 0.74)). Controlling for breathing had no effect on RMSSD. Conclusion vmHRV is reduced in patients with headache disorders, findings associated with a medium effect size. Suggestions for future research in this area are provided, emphasizing a need to investigate the impact of headache disorders and commonly comorbid conditions—including mental disorders—as well as the investigation of the risk for CVD in migraine in particular. We further emphasize the need for large-scale studies to investigate HRV as a mechanism mediating the association of migraine and CVD.

Autonomic Dysfunctions in Patients with Anxiety Throughout Therapy

2004 ◽  
Vol 18 (1) ◽  
pp. 27-37 ◽  
Author(s):  
L. Mussgay ◽  
H. Rüddel
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Stroke Volume ◽  
Baroreflex Sensitivity ◽  
Peripheral Resistance ◽  
Cardiovascular Regulation ◽  
Panic Attacks ◽  
General Effect ◽  
Vascular Compliance ◽  
Increased Risk

Abstract Patterns of autonomic cardiovascular regulation were studied in patients with anxiety throughout the course of an intensive inpatient rehabilitation therapy at rest, and in response to an anxiety provocation, in order to measure reactivity changes. Patients had to meet the ICD-10 criteria: F40.0 (agoraphobia), F40.00 (agoraphobia without panic attacks), F40.01 (agoraphobia with panic attacks), or F41 (panic disorder). Thirty-eight patients (13 males, 25 females) were examined after recruitment (T1) and at the end of treatment (T2). Each laboratory session consisted of a resting baseline (5min) and two stress tests of 8min (presentation of word pairs with either neutral or with anxiety-related content). A continuous assessment of ECG, blood pressure, breathing pattern, and thoracic impedance allowed the calculation of heart rate variability (power spectra), baroreflex sensitivity, stroke volume, vascular compliance, and total peripheral resistance. In general, therapy had little impact on the parameters of autonomic cardiovascular regulation, neither on resting level nor on reactivity. Diminished baroreflex sensitivity values in our patients with anxiety were observed; in particular, 15% of the patients had values below 3ms/mmHg, which indicates an increased risk for cardiovascular mortality. Low baroreflex sensitivity in this group goes along with further changes within the cardiovascular system (higher heart rate, diminished heart rate variability, lower stroke volume, higher vascular compliance). This general effect describes altered sympathetic/parasympathetic balance and may be the consequence of illness-related changes in behavior. Our results suggest that a careful cardiovascular examination of patients with anxiety will detect patients with clinically significant cardiovascular alterations. This might lead to a more complex intervention in these patients including, for example, exercise training.

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