Spectral Analysis of Systolic Blood Pressure and Heart Rate after Heart Transplantation in Children

1995 ◽  
Vol 88 (1) ◽  
pp. 95-102 ◽  
Author(s):  
Isabelle Constant ◽  
Arlette Girard ◽  
Jérôme Le Bidois ◽  
Elizabeth Villain ◽  
Dominique Laude ◽  
...  

1. The aim of the study was to examine the short-term variability in blood pressure and heart rate in 19 children who had received heart transplants and in eight normal control children. 2. Blood pressure was determined by a finger arterial pressure device. We examined the power spectra for heart rate and systolic blood pressure in the supine and tilted positions. In addition, we studied the acute changes in blood pressure and heart rate during active standing. 3. In the transplanted children we could distinguish two groups (groups A and B) in whom heart rate variability differed, although in both it was greatly reduced compared with controls (group C). In group A there were no significant fluctuations in the mid-frequency range for heart rate. The gain of the relationship between systolic blood pressure and heart rate was very low and there were virtually no heart rate changes associated with passive tilting. 4. By contrast, in group B transplant patients the heart rate variability, as assessed by standard deviation, was about half that of normal controls. The power spectra attenuation was greater in the high-frequency than in the mid-frequency bands. On passive tilting the latter became enhanced, but not the high-frequency variability. On active standing the tachycardic response was about half that of controls. The findings suggest some reinnervation involving cardiac sympathetic fibres to a greater degree than the fast-responding vagal fibres. 5. In both groups A and B the drop in systolic blood pressure observed early in active standing was about 4–6 times as great as in controls. One possible mechanism could be the loss of cardiac afferents. 6. Time since operation was a critical factor for reinnervation, since all subjects from group B were transplanted more than 44 months prior to the recording. 7. We conclude that in a proportion of children who have received heart transplantation there is a delayed reinnervation of the heart, which probably involves sympathetic effectors rather than the vagus.

1994 ◽  
Vol 87 (2) ◽  
pp. 225-230 ◽  
Author(s):  
Pekka Koskinen ◽  
Juha Virolainen ◽  
Markku Kupari

1. The acute effects of a moderate dose of ethanol (1 g/kg body weight) on heart rate and blood pressure variability and baroreflex sensitivity were studied in 12 healthy male subjects in a juice-controlled experiment. Electrocardiographic and finger blood pressure data were recorded and stored in a minicomputer during 5 min of controlled breathing (15 cycles/min) and during deep breathing (5 s inpiration, 5 s expiration, four cycles) before drinking and hourly thereafter for 3 h. 2. Mean breath alcohol concentration rose to 18.9 mg/100 ml. In the time domain analysis, the root mean square difference of successive R-R interval decreased significantly with ethanol as compared with the juice experiment. The difference remained statistically significant even after adjustment for the shorter R-R interval after alcohol. In the frequency domain analysis the high-frequency (0.15-0.5 Hz) spectral power showed a significant decrease after alcohol intake. Also, the index of sensitivity of the baro-receptor reflex (square root of R-R interval power/systolic blood pressure power) decreased significantly in the high-frequency component. Ethanol did not change finger systolic blood pressure, and power spectral analysis did not show significant variability in blood pressure. 3. These data indicate that acute intake of moderate amounts of alcohol causes a significant decrease in heart rate variability owing to diminished vagal modulation of the heart rate.


Author(s):  
Rishman Tandi ◽  
Tanvi Kumar ◽  
Amritpal Singh Kahlon ◽  
Aaftab Sethi

Introduction: Acute coronary syndrome remains as one of the most important causes for morbidity and mortality in developed countries. Therefore, evidence-based management strategy is required to offset the loss of health during an acute coronary syndrome. An effective approach includes both medical and surgical methods. This study was conducted to evaluate the medical method of management. Objective: To study blood pressure and heart rate variability after administration of Ivabradine or metoprolol in cases with acute coronary syndrome. Materials and methods: The study was a Prospective single center observational study conducted in patients attending Cardiology Intensive Care Unit in Nayyar Heart and Superspecialty Hospital, a tertiary care centre located in an urban area. All patients with Acute coronary syndrome admitted to the emergency or cardiac care unit were analysed with ECG as a preliminary diagnostic test and confirmed with troponin markers. They were either given Ivabradine or Metoprolol. Baseline evaluation and follow up was done and necessary data was collected and analysed.   Results: 100 patients were included in the study out of which 50 were given Metoprolol (Group A) and 50 were given Ivabradine (Group B). Themean age of studied cases was found to be 66.54 years in group A and 68.69 years in group B. It was observed that there was a fall in heart rate by 26.8 beats per minute with beta blocker and 24.4 beats per minute with Ivabradine. In case of blood pressure measurement, in patients with beta blocker administration, there was a fall of 25 mm Hg in systolic blood pressure and 17 mm Hg in diastolic blood pressure However, with Ivabradine there was only a fall of 8mm Hg in systolic Blood pressure and 6 mm Hg in diastolic blood pressure. Conclusion: Although Metoprolol is the drug of choice to decrease heart rate and blood pressure in acute coronary syndrome, Ivabradine is being increasingly used in cases where beta blockers are contraindicated as it has similar efficacy in lowering heart rate without compromising contractility of cardiac muscle, thereby maintaining LVEF and blood pressure. Keywords: Acute coronary syndrome, Beta Blockers, Metoprolol, Ivabradine.


Author(s):  
Ranjita Acharya ◽  
Shakti Bedanta Mishra ◽  
Arun Rath ◽  
Bhabani Sankara Pati ◽  
Kalyani Bala Nayak

Objective: Labetalol is a non-selective beta blocker which is used for the treatment of hypertension. Its role in controlling the hemodynamic response to tracheal intubation is established. This comparative controlled study was carried out to verify its effects on time to onset of action of rocuronium in comparison to esmolol.Methods: We randomized patients into two groups. Group A receiving injection labetalol 0.25 mg/kg diluted to 10 ml with 0.9% saline and Group B receiving 0.5 mg/kg of esmolol in 10 ml 0.9% saline before surgery. The time to onset of action of rocuronium, systolic blood pressure, and heart rate were recorded. The adverse reactions were observed in the post-operative period.Results: A total of 60 patients were randomized into two groups. At the time of intubation, the systolic blood pressure and heart rate were similar between the two groups. The onset of action of rocuronium was decreased significantly in the labetalol group.Conclusion: Labetalol attenuates the hemodynamic response to tracheal intubation both during intubation. It also slightly decreases the time to onset of action of rocuronium.


2017 ◽  
Vol 40 (2) ◽  
pp. 77-88 ◽  
Author(s):  
Kurt A. Spurgin ◽  
Anthony Kaprelian ◽  
Roberto Gutierrez ◽  
Vidyasagar Jha ◽  
Christopher G. Wilson ◽  
...  

1997 ◽  
Vol 92 (6) ◽  
pp. 543-550 ◽  
Author(s):  
Gary C. Butler ◽  
Shin-Ichi Ando ◽  
John S. Floras

1. There is a substantial non-harmonic or fractal component to the variability of both heart rate and blood pressure in normal subjects. Heart rate is the more complex of these two signals, with respect to the slope, β, of the 1/fβ relationship. In congestive heart failure, heart rate spectral power is attenuated, but the fractal and harmonic components of heart rate and systolic blood pressure variability have not been characterized. 2. Two groups, each comprising 20 men, were studied during 15 min of supine rest and spontaneous respiration: one with functional class II—IV heart failure (age 52 ± 2 years; mean ± SEM) and a second group of healthy men (age 46 ± 2 years). 3. Total spectral power for heart rate was significantly reduced in heart failure (P < 0.02), whereas total spectral power for systolic blood pressure was similar in the two groups. In both heart failure and normal subjects, 65–80% of total spectral power in these two signals displayed fractal characteristics. 4. In heart failure, the slope of the 1/fβ relationship for heart rate was significantly steeper than in normal subjects (1.40 ± 0.08 compared with 1.14 ± 0.05; P < 0.05), indicating reduced complexity of the fractal component of heart rate variability. There was no significant difference in the 1/fβ slope for systolic blood pressure variability between these two groups, but the blood pressure signals were less complex than heart rate variations in both heart failure (2.31 ± 0.15; P < 0.006) and normal subjects (2.47 ± 0.15; P < 0.0001). 5. Parasympathetic nervous system activity, as estimated from heart rate variability was reduced (P < 0.01) in patients with heart failure, whereas trends towards increased sympathetic nervous system activity and decreased non-harmonic power were not significant. 6. The non-harmonic components of cardiac frequency are reduced in heart failure. Non-harmonic power is not attenuated, but the complexity of the heart rate signal is less than in subjects with normal ventricular function. A reduction in parasympathetic modulation appears to contribute to this loss of complexity of heart rate. Consequently, the heart rate signal comes to resemble that of blood pressure. In contrast, the variability and complexity of the systolic blood pressure signal is similar in heart failure and normal subjects. This reduced complexity of heart rate variability may have adverse implications for patients with heart failure.


2011 ◽  
Vol 26 (S2) ◽  
pp. 147-147
Author(s):  
T. Diveky ◽  
D. Kamaradova ◽  
A. Grambal ◽  
K. Latalova ◽  
J. Prasko ◽  
...  

The aim of our study is to measure very low frequency band (VLF), low frequency band (LF) and high frequency band (HF) components of R-R interval during orthostatic experiment in panic disorder patients before and after treatment.MethodsWe assessed heart rate variability in 19 patients with panic disorder before and after 6-weeks treatment with antidepressants combined with CBT and 18 healthy controls. They were regularly assessed on the CGI, BAI and BDI. Heart rate variability was assessed during 5 min standing, 5 min supine and 5 min standing positions before and after the treatment. Power spectra were computed using a fast Fourier transformation for very low frequency - VLF (0.0033 - 0.04 Hz), low-frequency - LF (0.04-0.15 Hz) and high frequency - HF (0.15-0.40 Hz) powers.Results19 panic disorder patients entered a 6-week open-label treatment study with combination of SSRI and cognitive behavioral therapy. A combination of CBT and pharmacotherapy proved to be the effective treatment of patients. They significantly improved in all rating scales. There were highly statistical significant differences between panic patients and control group in all components of power spectral analysis in 2nd and in two component of 3rd (LF and HF in standing) positions. There was also statistically significant difference between these two groups in LF/HF ratio in supine position (2nd). During therapy there was tendency to increasing values in all three positions in components of HRV power spectra, but there was only statistically significant increasing in HF1 component.Supported by project IGA MZ ČR NS 10301-3/2009


2011 ◽  
Vol 103 (2) ◽  
pp. 188-196 ◽  
Author(s):  
Rosangela Poletto ◽  
Andrew M. Janczak ◽  
Ruth M. Marchant-Forde ◽  
Jeremy N. Marchant-Forde ◽  
Donald L. Matthews ◽  
...  

Author(s):  
Б.И. Кузник ◽  
Ю.Н. Смоляков ◽  
Е.С. Гусева ◽  
С.О. Давыдов ◽  
И.В. Файн

Цель исследования - выявление взаимосвязи между показателями вариабельности сердечного ритма (ВСР), кровяным давлением и гемодинамическими функциями у женщин, страдающих гипертонической болезнью (ГБ) и находящихся на медикаментозной терапии (ГБ-1), либо в дополнение к этому, проходящих регулярные курсы кинезитерапии (ГБ-2). Методика. Наблюдения проведены на 72 женщинах, страдающих артериальной гипертензией II стадии. В группу ГБ-1 вошли 37 женщин с ГБ, находящихся на медикаментозной терапии, в группу ГБ-2 - 35 женщин с ГБ, которые, помимо медикаментозной терапии, регулярно проходили на протяжении 2-3 лет по 3-4 полуторамесячных курса кинезитерапии (управляемые умеренные физические нагрузки). Для изучения гемодинамики был использован датчик динамического рассеяния света (miniature Dynamic Light Scattering - mDLS) от Elfi-Tech (Rehovot, Israel), измеряющий сигналы, инициированные кожным кровотоком, и использующий методику разложения сигнала на частотные компоненты, связанные с разными гемодинамическими источниками. Из пульсовой компоненты mDLS сигнала извлекалась информация о вариабельности RR-интервалов и рассчитывались индикаторы вариабельности сердечного ритма. Введен показатель «гемодинамический индекс» (Hemodynamic Index - HI). Зависимость HI от скорости сдвига интерпретируется путем сопоставления каждой полосе частот определенной скорости сдвига (HI1 - низкочастотный, HI2 - промежуточный, HI3 - высокочастотный). Использованы следующие относительные (RHI, Relative Hemodynamic Index) и осцилляторные (OHI, Oscillatory Hemodynamic Indexes) гемодинамические индексы: нейрологический (NEUR), Майера (MAYER), дыхательный (RESP) и пульсовой (PULSE). ВСР показатели включали: HR (Heart Rate), PWR (Power) - общую мощность колебаний, LF (Low Frequency), HF (High Frequency), SDNN (Standard Deviation of the Normal-to-Normal), RMSSD (Root Mean Square of the Successive Differences), а также индексы: CVI (Cardiac Vagal Index) и CSI (Cardiac Sympathetic Index). Результаты. У женщин, находящихся исключительно на медикаментозной терапии (ГБ-1), выявляются отрицательные взаимосвязи LF и LF/HF с систолическим, средним и пульсовым давлением. При ГБ-2 проявляются отрицательные связи PWR, LF, HF с пульсовым давлением. При ГБ-1 обнаружены положительные взаимосвязи между HR и гемодинамическими индексами HI1, RHI2 и отрицательная взаимосвязь с RHI3, а также между RMSSD и RHI3 и между HF и HI1/HI3. У пациенток ГБ-2 обнаружена отрицательная корреляция SDNN и RHI1, а также PWR и RHI1; положительные взаимосвязи между PWR и HI2, HI3, RHI2, HF и RHI3 и LF/HF с HI1/HI3; отрицательные связи HF c HI1/HI3 и с RHI1, а также между LF/HF и RHI3, CSI и RHI3. У больных ГБ-1 имеются прямые связи между SDNN, PWR, LF, HF, CVI и NEUR_HI1, что свидетельствует о действии этих факторов на эндотелиальный кровоток (HI1). В группе ГБ-2 установлено наличие лишь положительных связей между LF, HF и NEUR_HI3. У больных ГБ-1 на уровень АД влияют все без исключения осцилляторные ритмы, которые могут оказывать как отрицательное (с MAYER_HI1, PULSE_HI2), так и положительное (MAYER_HI2, RESP_HI3) влияние. У больных ГБ-2 взаимосвязи АД с осцилляторными индексами не обнаружены. Заключение. Уменьшение в группе ГБ-2 по сравнению с больными группы ГБ-1 числа факторов, влияющих на АД и гемодинамику, носит более совершенный и благоприятный характер, что и обеспечивает более быструю и устойчивую нормализацию артериального давления. Aim. To study the relationship between heart rate variability (HRV), blood pressure and hemodynamic functions in women with essential hypertension (EH) receiving a drug therapy alone (EH-1) or in combination with regular courses of kinesitherapy (EH-2). Methods. The study included 72 women with EH. The EH-1 group consisted of 37 women with stage II arterial hypertension. The EH-2 group consisted of 35 women with stage II arterial hypertension who underwent 3-4 1.5-month courses of kinesitherapy (controlled moderate physical activity) on a regular basis for 2-3 years. Hemodynamics was studied with a miniature Dynamic Light Scattering (mDLS) sensor from Elfi-Tech (Rehovot, Israel), which measures signals initiated by the skin blood flow by decomposing the signal into frequency components associated with different hemodynamic sources. Information on the RR interval variability was extracted from the pulse component of mDLS signal, and indicators of heart rate variability were calculated. A Hemodynamic Index (HI) was introduced. The HI dependence on shear rate was interpreted by matching each frequency band with a specific shear rate (HI1, low-frequency; HI2, intermediate; HI3, high-frequency). The following relative (RHI, Relative Hemodynamic Index) and oscillatory (OHI, Oscillatory Hemodynamic Indexes) indexes were used: neurological (NEUR), Mayer (MAYER), respiratory (RESP), and pulse (PULSE) ones. The HRV indexes included HR (Heart Rate), PWR (Power, total oscillation power), LF (Low Frequency), HF (High Frequency), SDNN (Standard Deviation of the Normal-to-Normal), RMSSD (Root Mean Square of the Successive Differences). CVI (Cardiac Vagal Index), and CSI (Cardiac Sympathetic Index). Results. In women who were on drug therapy alone (EH-1), negative relationships were found for LF and LF/HF with systolic, mean and pulse pressure. For EH-2, PWR, LF, and HF negatively correlated with pulse pressure. For EH-1, HR positively correlated with the hemodynamic indices HI1 and RHI2 and negatively correlated with RHI3; RMSSD negatively correlated with RHI3; and HF negatively correlated with HI1/HI3. For patients with EH-2, negative correlations were observed for SDNN and RHI1, PWR and RHI1; positive correlations were found between PWR and HI2; HI3, RHI2, HF and RHI3; and between LF/HF and HI1/HI3. HF negatively correlated with HI1/HI3 and with RHI1. LF/HF negatively correlated with RHI3, and CSI negatively correlated with RHI3. In patients with EH-1, SDNN, PWR, LF, HF, CVI, and NEUR_HI1 were directly related, which indicated an effect of these factors on the endothelial blood flow (HI1). In the EH-2 group, only positive correlations were found between LF, HF, and NEUR_HI3. In EH-1 patients, all oscillatory rhythms influenced BP; this influence could be both negative (for MAYER_HI1, PULSE_HI2) and positive (for MAYER_HI2, RESP_HI3). In EH-2 patients, no relationship was found between blood pressure and oscillatory indices. Conclusion. The smaller number of factors influencing blood pressure and hemodynamics in the EH-2 group compared to the EH-1 group was more beneficial and favorable, which ensured faster and steadier normalization of blood pressure.


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