Pulse Photoplethysmographic Analysis Estimates the Sympathetic Activity Directed to Heart and Vessels

2015 ◽  
Vol 123 (2) ◽  
pp. 336-345 ◽  
Author(s):  
Riccardo Colombo ◽  
Andrea Marchi ◽  
Beatrice Borghi ◽  
Tommaso Fossali ◽  
Roberto Rech ◽  
...  
Keyword(s):  
Heart Rate ◽  
High Frequency ◽  
Sympathetic Activity ◽  
Baroreflex Sensitivity ◽  
Systolic Arterial Pressure ◽  
Experimental Conditions ◽  
Arterial Pressure Variability ◽  
Head Up Tilt ◽  
Normalized Units ◽  
Good Agreement

Abstract Background: Novel pulse photoplethysmographic–derived indices have been proposed as tools to measure autonomic nervous system (ANS) modulation in anesthetized and awake patients, but nowadays their experimental validation is lacking. The authors aimed to investigate the ability of pulse photoplethysmographic amplitude (PPGA), ANS state (ANSS), and ANSS index (ANSSi) to measure changes of ANS modulation in response to sympathetic stimulation. Methods: Ten awake healthy volunteers underwent two passive head-up tilts at 45° and 90°. The heart rate variability (HRV) and systolic arterial pressure variability were analyzed in the frequency domain as a measure of ANS modulation directed to the heart and the vessels. HRV, baroreflex sensitivity, and pulse photoplethysmographic indices were measured at baseline and after tilt maneuvers. The agreement between HRV-derived indices and pulse photoplethysmographic indices was assessed using Bland–Altman plots. Results: PPGA, ANSS, and ANSSi changed significantly during the study protocol. Head-up tilt decreased PPGA and ANSS and increased ANNSi. There was a good agreement between ANSSi and baroreflex sensitivity explored in the high-frequency band (bias, 0.23; 95% CI, −22.7 to 23.2 normalized units) and between ANSSi and the sympathovagal modulation directed to the heart (bias, 0.96; 95% CI, −8.7 to 10.8 normalized units). Conclusions: In controlled experimental conditions, novel pulse plethysmographic indices seem to estimate the changes of the sympathetic outflow directed to the vessels and the sympathovagal balance modulating heart rate. These indices might be useful in the future to monitor the fluctuation of sympathetic activity in anesthetized patients.

Age dependency of cardiovascular autonomic responses to head-up tilt in healthy subjects

2004 ◽  
Vol 96 (6) ◽  
pp. 2333-2340 ◽  
Author(s):  
Tomi Laitinen ◽  
Leo Niskanen ◽  
Ghislaine Geelen ◽  
Esko Länsimies ◽  
Juha Hartikainen
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
High Frequency ◽  
Healthy Subjects ◽  
Baroreflex Sensitivity ◽  
Low Frequency ◽  
Upright Position ◽  
Vascular Responses ◽  
Autonomic Responses ◽  
Head Up Tilt

In elderly subjects, heart rate responses to postural change are attenuated, whereas their vascular responses are augmented. Altered strategy in maintaining blood pressure homeostasis during upright position may result from various cardiovascular changes, including age-related cardiovascular autonomic dysfunction. This exploratory study was conducted to evaluate impact of age on cardiovascular autonomic responses to head-up tilt (HUT) in healthy subjects covering a wide age range. The study population consisted of 63 healthy, normal-weight, nonsmoking subjects aged 23–77 yr. Five-minute electrocardiogram and finger blood pressure recordings were performed in the supine position and in the upright position 5 min after 70° HUT. Stroke volume was assessed from noninvasive blood pressure signals by the arterial pulse contour method. Heart rate variability (HRV) and systolic blood pressure variability (SBPV) were analyzed by using spectral analysis, and baroreflex sensitivity (BRS) was assessed by using sequence and cross-spectral methods. Cardiovascular autonomic activation during HUT consisted of decreases in HRV and BRS and an increase in SBPV. These changes became attenuated with aging. Age correlated significantly with amplitude of HUT-stimulated response of the high-frequency component ( r = -0.61, P < 0.001) and the ratio of low-frequency to high-frequency power of HRV ( r = -0.31, P < 0.05) and indexes of BRS (local BRS: r = -0.62, P < 0.001; cross-spectral baroreflex sensitivity in the low-frequency range: r = -0.38, P < 0.01). Blood pressure in the upright position was maintained well irrespective of age. However, the HUT-induced increase in heart rate was more pronounced in the younger subjects, whereas the increase in peripheral resistance was predominantly observed in the older subjects. Thus it is likely that whereas the dynamic capacity of cardiac autonomic regulation decreases, vascular responses related to vasoactive mechanisms and vascular sympathetic regulation become augmented with increasing age.

Dose-response relationship of autonomic nervous system responses to individualized training impulse in marathon runners

2009 ◽  
Vol 296 (6) ◽  
pp. H1733-H1740 ◽  
Author(s):  
Vincenzo Manzi ◽  
Carlo Castagna ◽  
Elvira Padua ◽  
Mauro Lombardo ◽  
Stefano D'Ottavio ◽  
...  
Keyword(s):  
Nervous System ◽  
High Frequency ◽  
Baroreflex Sensitivity ◽  
Low Frequency ◽  
Systolic Arterial Pressure ◽  
Training Load ◽  
Recreational Athletes ◽  
Arterial Pressure Variability ◽  
Individualized Training ◽  
Training Impulse

In athletes, exercise training induces autonomic nervous system (ANS) adaptations that could be used to monitor training status. However, the relationship between training and ANS in athletes has been investigated without regard for individual training loads. We tested the hypothesis that in long-distance athletes, changes in ANS parameters are dose-response related to individual volume/intensity training load and could predict athletic performance. A spectral analysis of heart rate (HR), systolic arterial pressure variability, and baroreflex sensitivity by the sequences technique was investigated in eight recreational athletes during a 6-mo training period culminating with a marathon. Individualized training load responses were monitored by a modified training impulse (TRIMPi) method, which was determined in each athlete using the individual HR and lactate profiling determined during a treadmill test. Monthly TRIMPi steadily increased during the training period. All the ANS parameters were significantly and very highly correlated to the dose of exercise with a second-order regression model ( r2 ranged from 0.90 to 0.99; P < 0.001). Variance, high-frequency oscillations of HR variability (HRV), and baroreflex sensitivity resembled a bell-shaped curve with a minimum at the highest TRIMPi, whereas low-frequency oscillations of HR and systolic arterial pressure variability and the low frequency (LF)-to-high frequency ratio resembled an U-shaped curve with a maximum at the highest TRIMPi. The LF component of HRV assessed at the last recording session was significantly and inversely correlated to the time needed to complete the nearing marathon. These results suggest that in recreational athletes, ANS adaptations to exercise training are dose related on an individual basis, showing a progressive shift toward a sympathetic predominance, and that LF oscillations in HRV at peak training load could predict athletic achievement in this athlete population.

scholarly journals Effect of Hypoglycemia on Heart Rate Variability in People with Type 1 Diabetes and Impaired Awareness of Hypoglycemia

2021 ◽  
pp. 193229682110074
Author(s):  
Mats Koeneman ◽  
Marleen Olde Bekkink ◽  
Lian van Meijel ◽  
Sebastian Bredie ◽  
Bastiaan de Galan
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
High Frequency ◽  
Sympathetic Activity ◽  
Elevated Risk ◽  
Wilcoxon Rank Sum Test ◽  
Impaired Awareness ◽  
Induced Changes ◽  
Measurable Change

Background: People with impaired awareness of hypoglycemia (IAH) are at elevated risk of severe, potentially hazardous, hypoglycemia and would benefit from a device alerting to hypoglycemia. Heart rate variability (HRV) changes with hypoglycemia due to sympathetic activity. Since IAH is associated with suppressed sympathetic activity, we investigated whether hypoglycemia elicits a measurable change in HRV in patients with T1D and IAH. Method: Eligible participants underwent a modified hyperinsulinemic euglycemic hypoglycemic clamp (glucose nadir, 43.1 ± 0.90 mg/dl), while HRV was measured by a VitalConnect HealthPatch. Measurements of HRV included Root Mean Square of the Successive Differences (RMSSD) and low to high frequency (LF:HF) ratio. Wilcoxon rank-sum test was used for testing within-subject HRV changes. Results: We included 12 participants (8 female, mean age 57 ± 12 years, mean HbA1c 57 ± 5 mmol/mol (7.4 ± 0.4%)). Symptoms increased from 4.0 (1.5-7.0) at euglycemia to 7.5 (5.0-11.0) during hypoglycemia ( P = .003). In response to hypoglycemia, the LF:HF ratio and RMSSD increased when normalized for data obtained during euglycemia (both P < .01). The LF:HF ratio increased in 6 participants (50%) and declined in one other participant (8%). The RMSSD decreased in 3 (25%) and increased in 4 (33%) participants. In 2 patients, no change in HRV could be detected in response to hypoglycemia. Conclusions: This study reveals that hypoglycemia-induced changes in HRV are retained in the majority of people with T1D and IAH, and that these changes can be detected by a wearable device. Real-time HRV seems usable for detection of hypoglycemia in patients with IAH.

Heart rate variability and baroreflex sensitivity are reduced in chronically undernourished, but otherwise healthy, human subjects

2003 ◽  
Vol 104 (3) ◽  
pp. 295-302 ◽  
Author(s):  
Mario VAZ ◽  
A.V. BHARATHI ◽  
S. SUCHARITA ◽  
D. NAZARETH
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
High Frequency ◽  
Baroreflex Sensitivity ◽  
Human Subjects ◽  
Normal Weight ◽  
Autonomic Nerve ◽  
Total Power ◽  
Healthy Human ◽  
Frequency Power

Alterations in autonomic nerve activity in subjects in a chronically undernourished state have been proposed, but have been inadequately documented. The present study evaluated heart rate and systolic blood pressure variability in the frequency domain in two underweight groups, one of which was undernourished and recruited from the lower socio-economic strata [underweight, undernourished (UW/UN); n = 15], while the other was from a high class of socio-economic background [underweight, well nourished (UW/WN); n = 17], as well as in normal-weight controls [normal weight, well nourished (NW/WN); n = 27]. Baroreflex sensitivity, which is a determinant of heart rate variability, was also assessed. The data indicate that total power (0–0.4Hz), low-frequency power (0.04–0.15Hz) and high-frequency power (0.15–0.4Hz) of RR interval variability were significantly lower in the UW/UN subjects (P<0.05) than in the NW/WN controls when expressed in absolute units, but not when the low- and high-frequency components were normalized for total power. Baroreflex sensitivity was similarly lower in the UW/UN group (P<0.05). Heart rate variability parameters in the UW/WN group were generally between those of the UW/UN and NW/WN groups, but were not statistically different from either. The mechanisms that contribute to the observed differences between undernourished and normal-weight groups, and the implications of these differences, remain to be elucidated.

Comparison of phenylephrine bolus and infusion methods in baroreflex measurements

1990 ◽  
Vol 69 (3) ◽  
pp. 962-967 ◽  
Author(s):  
J. T. Sullebarger ◽  
C. S. Liang ◽  
P. D. Woolf ◽  
A. E. Willick ◽  
J. F. Richeson
Keyword(s):  
Heart Rate ◽  
Arterial Pressure ◽  
Baroreflex Sensitivity ◽  
Heart Rate Response ◽  
Pressor Response ◽  
Plasma Catecholamines ◽  
Systolic Arterial Pressure ◽  
Normal Subjects ◽  
Vagus Nerves ◽  
Baroreflex Control

Phenylephrine (PE) bolus and infusion methods have both been used to measure baroreflex sensitivity in humans. To determine whether the two methods produce the same values of baroreceptor sensitivity, we administered intravenous PE by both bolus injection and graded infusion methods to 17 normal subjects. Baroreflex sensitivity was determined from the slope of the linear relationship between the cardiac cycle length (R-R interval) and systolic arterial pressure. Both methods produced similar peak increases in arterial pressure and reproducible results of baroreflex sensitivity in the same subjects, but baroreflex slopes measured by the infusion method (9.9 +/- 0.7 ms/mmHg) were significantly lower than those measured by the bolus method (22.5 +/- 1.8 ms/mmHg, P less than 0.0001). Pretreatment with atropine abolished the heart rate response to PE given by both methods, whereas plasma catecholamines were affected by neither method of PE administration. Naloxone pretreatment exaggerated the pressor response to PE and increased plasma beta-endorphin response to PE infusion but had no effect on baroreflex sensitivity. Thus our results indicate that 1) activation of the baroreflex by the PE bolus and infusion methods, although reproducible, is not equivalent, 2) baroreflex-induced heart rate response to a gradual increase in pressure is less than that seen with a rapid rise, 3) in both methods, heart rate response is mediated by the vagus nerves, and 4) neither the sympathetic nervous system nor the endogenous opiate system has a significant role in mediating the baroreflex control of heart rate to a hypertensive stimulus in normal subjects.

Influences of neural mechanisms on heart period and arterial pressure variabilities in quadriplegic patients

1994 ◽  
Vol 266 (3) ◽  
pp. H1112-H1120 ◽  
Author(s):  
S. Guzzetti ◽  
C. Cogliati ◽  
C. Broggi ◽  
C. Carozzi ◽  
D. Caldiroli ◽  
...  
Keyword(s):  
Arterial Pressure ◽  
Spectral Component ◽  
Systolic Arterial Pressure ◽  
Neural Mechanisms ◽  
Heart Period ◽  
Recording Session ◽  
Sympathetic Modulation ◽  
Arterial Pressure Variability ◽  
Head Up Tilt ◽  
Vasomotor Activity

The heart period (R-R) variability power spectrum presents two components, at low (LF; approximately 0.10 Hz) and high (approximately 0.25 Hz) frequencies, whose reciprocal powers appear to furnish an index of sympathovagal interaction modulating heart rate. In addition, the LF component of the systolic arterial pressure variability spectrum furnishes a marker of sympathetic modulation of vasomotor activity. The contribution of spinal and supraspinal neural circuits to the genesis of these rhythmic oscillatory components remains largely unsettled. Therefore we performed spectral analysis of R-R and systolic arterial pressure variabilities in 15 chronic neurologically complete quadriplegic patients (QP) and in 15 control subjects during resting conditions, controlled respiration, and head-up tilt. At rest, in seven QP the LF component was undetectable in both cardiovascular variability spectra; in two QP this component was present only in R-R variability spectrum, whereas the remaining six showed a significantly reduced LF in both signals. In QP, the LF component, when present, underwent paradoxical changes with respect to controls, decreasing during tilt and increasing during controlled respiration. In five QP in whom the recording session was repeated after 6 mo, a significant increase in LF was observed in both variability spectra. These data confirm the finding that a disconnection of sympathetic outflow from supraspinal centers can cause the disappearance of the LF spectral component. However, LF presence in some QP supports the hypothesis of a spinal rhythmicity likely to be modulated by the afferent sympathetic activity.

Impaired serotonergic regulation of heart rate may underlie reduced baroreflex sensitivity in an animal model of depression

2008 ◽  
Vol 294 (1) ◽  
pp. H474-H480 ◽  
Author(s):  
Cara M. Hildreth ◽  
James R. Padley ◽  
Paul M. Pilowsky ◽  
Ann K. Goodchild
Keyword(s):  
Heart Rate ◽  
Animal Model ◽  
High Frequency ◽  
Neural Control ◽  
Baroreflex Sensitivity ◽  
Cardiac Risk ◽  
Sprague Dawley ◽  
Animal Model Of Depression ◽  
Spontaneous Baroreflex ◽  
Acute Changes

Serotonin (5-HT) is crucial to normal reflex vagal modulation of heart rate (HR). Reduced baroreflex sensitivity [spontaneous baroreflex sensitivity (sBRS)] and HR variability (HRV) reflect impaired neural, particularly vagal, control of HR and are independently associated with depression. In conscious, telemetered Flinders-Sensitive Line (FSL) rats, a well-validated animal model of depression, we tested the hypothesis that cardiovascular regulatory abnormalities are present and associated with deficient serotonergic control of reflex cardiovagal function. In FSL rats and control Flinders-Resistant (FRL) and Sprague-Dawley (SD) rat strains, diurnal measurements of HR, arterial pressure (AP), activity, sBRS, and HRV were made. All strains had normal and similar diurnal variations in HR, AP, and activity. In FRL rats, HR was elevated, contributing to the reduced HRV and sBRS in this strain. In FSL rats, sBRS and high-frequency power HRV were reduced during the night, indicating reduced reflex cardiovagal activity. The ratio of low- to high-frequency bands of HRV was increased in FSL rats, suggesting a relative predominance of cardiac sympathetic and/or reflex activity compared with FRL and SD rats. These data show that conscious FSL rats have cardiovascular regulatory abnormalities similar to depressed humans. Acute changes in HR, AP, temperature, and sBRS in response to 8-hydroxy-2-(di- n-propylamino)tetralin, a 5-HT1A, 5-HT1B, and 5-HT7 receptor agonist, were also determined. In FSL rats, despite inducing an exaggerated hypothermic effect, 8-hydroxy-2-(di- n-propylamino)tetralin did not decrease HR and AP or improve sBRS, suggesting impaired serotonergic neural control of cardiovagal activity. These data suggest that impaired serotonergic control of cardiac reflex function could be one mechanism linking reduced sBRS to increased cardiac risk in depression.

Effects of high-frequency jet ventilation on arterial baroreflex regulation of heart rate

1987 ◽  
Vol 63 (6) ◽  
pp. 2216-2222 ◽  
Author(s):  
J. J. Rouby ◽  
M. Houissa ◽  
J. F. Brichant ◽  
J. F. Baron ◽  
C. McMillan ◽  
...  
Keyword(s):  
Heart Rate ◽  
Arterial Pressure ◽  
High Frequency ◽  
Airway Pressure ◽  
Systolic Arterial Pressure ◽  
Right Atrial ◽  
Arterial Baroreflex ◽  
Mean Airway Pressure ◽  
Jet Ventilation ◽  
Pulmonary Volume

Fifteen anesthetized mechanically ventilated patients recovering from multiple trauma were studied to compare the effects of high-frequency jet ventilation (HFJV) and continuous positive-pressure ventilation (CPPV) on arterial baroreflex regulation of heart rate. Systolic arterial pressure and right atrial pressure were measured using indwelling catheters. Electrocardiogram (ECG) and mean airway pressure were continuously monitored. Lung volumes were measured using two linear differential transformers mounted on thoracic and abdominal belts. Baroreflex testing was performed by sequential intravenous bolus injections of phenylephrine (200 micrograms) and nitroglycerin (200 micrograms) to raise or lower systolic arterial pressure by 20–30 Torr. Baroreflex regulation of heart rate was expressed as the slope of the regression line between R-R interval of the ECG and systolic arterial pressure. In each mode of ventilation the ventilatory settings were chosen to control mean airway pressure and arterial PCO2 (PaCO2). In HFJV a tidal volume of 159 +/- 61 ml was administered at a frequency of 320 +/- 104 breaths/min, whereas in CPPV a tidal volume of 702 +/- 201 ml was administered at a frequency of 13 +/- 2 breaths/min. Control values of systolic arterial pressure, R-R interval, mean pulmonary volume above apneic functional residual capacity, end-expiratory pulmonary volume, right atrial pressure, mean airway pressure, PaCO2, pH, PaO2, and temperature before injection of phenylephrine or nitroglycerin were comparable in HFJV and CPPV. Baroreflex regulation of heart rate after nitroglycerin injection was significantly higher in HFJV (4.1 +/- 2.8 ms/Torr) than in CPPV (1.96 +/- 1.23 ms/Torr).(ABSTRACT TRUNCATED AT 250 WORDS)

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