scholarly journals Novel method to assess intrinsic heart rate recovery in ambulatory ECG recordings tracks cardioprotective effects of chronic autonomic regulation therapy in patients enrolled in the ANTHEM-HF study

2017 ◽  
Vol 22 (5) ◽  
pp. e12436 ◽  
Author(s):  
Gerrard M. Carlson ◽  
Imad Libbus ◽  
Badri Amurthur ◽  
Bruce H. KenKnight ◽  
Richard L. Verrier
2017 ◽  
Vol 30 (6) ◽  
pp. 629-633 ◽  
Author(s):  
Tatjana Jezdimirovic ◽  
Valdemar Stajer ◽  
Sasa Semeredi ◽  
Julio Calleja-Gonzalez ◽  
Sergej M. Ostojic

AbstractBackground:A correlation between adiposity and post-exercise autonomic regulation has been established in overweight and obese children. However, little information exists about this link in non-obese youth. The main purpose of this cross-sectional study was to describe the relationship between body fat percentage (BFP) and heart rate recovery after exercise [post-exercise heart rate (PEHR)], a marker of autonomic regulation, in normal-weight children and adolescents.Methods:We evaluated the body composition of 183 children and adolescents (age 15.0±2.3 years; 132 boys and 51 girls) who performed a maximal graded exercise test on a treadmill, with the heart rate monitored during and immediately after exercise.Results:A strong positive trend was observed in the association between BFP and PEHR (r=0.14; p=0.06). Hierarchical multiple regression revealed that our model explained 18.3% of the variance in PEHR (p=0.00), yet BFP accounted for only 0.9% of the variability in PEHR (p=0.16). The evaluation of the contribution of each independent variable revealed that only two variables made a unique statistically significant contribution to our model (p<0.01), with age contributing 38.7% to our model (p=0.00) while gender accounted for an additional 25.5% (p=0.01). Neither BFP (14.4%; p=0.16) nor cardiorespiratory endurance (5.0%, p=0.60) made a significant unique contribution to the model.Conclusions:Body fatness seems to poorly predict PEHR in our sample of non-obese children and adolescents, while non-modifiable variables (age and gender) were demonstrated as strong predictors of heart rate recovery. The low amount of body fat reported in non-obese young participants was perhaps too small to cause disturbances in autonomic nervous system regulation.


Author(s):  
Bruce D. Nearing ◽  
Imad Libbus ◽  
Gerrard M. Carlson ◽  
Badri Amurthur ◽  
Bruce H. KenKnight ◽  
...  

Abstract Purpose Disturbed autonomic function is implicated in high mortality rates in heart failure patients. High-intensity vagus nerve stimulation therapy was shown to improve intrinsic heart rate recovery and left ventricular ejection fraction over a period of 1 year. Whether these beneficial effects are sustained across multiple years and are related to improved baroreceptor response was unknown. Methods All patients (n = 21) enrolled in the ANTHEM-HF clinical trial (NCT01823887, registered 4/3/2013) with 24 h ambulatory electrocardiograms at all time points and 54 normal subjects (PhysioNet database) were included. Intrinsic heart rate recovery, based on ~ 2000 spontaneous daily activity-induced heart rate acceleration/deceleration events per patient, was analyzed at screening and after 12, 24, and 36 months of chronic vagus nerve stimulation therapy (10 or 5 Hz, 250 μs pulse width, 18% duty cycle, maximum tolerable current amplitude). Results In response to chronic high-intensity vagus nerve stimulation (≥ 2.0 mA), intrinsic heart rate recovery (all time points, p < 0.0001), heart rate turbulence slope, an indicator of baroreceptor reflex gain (all, p ≤ 0.02), and left ventricular ejection fraction (all, p ≤ 0.04) were improved over screening at 12, 24, and 36 months. Intrinsic heart rate recovery and heart rate turbulence slope were inversely correlated at both screening (r = 0.67, p < 0.002) and 36 months (r = 0.78, p < 0.005). Conclusion This non-randomized study provides evidence of an association between improvement in intrinsic heart rate recovery and left ventricular ejection fraction during high-intensity vagus nerve stimulation for a period of ≥ 3 years. Correlated favorable effects on heart rate turbulence slope implicate enhanced baroreceptor function in response to chronic, continuously cyclic vagus nerve stimulation as a physiologic mechanism.


2019 ◽  
Vol 96 (6) ◽  
pp. 556-561 ◽  
Author(s):  
Irina G. Kretova ◽  
O. A. Vedyasova ◽  
M. V. Komarova ◽  
O. I. Shiryaeva

Introduction. Currently, there is a deterioration trend in the health of the younger generation, in particular, an increasing number of persons with functional disorders of the cardiovascular system. Regarding this it is important to develop an comprehensive approach to the study of the circulatory indices in the young age with informative clinical diagnostic techniques and new ways to analyze the data. Material and methods. Heart rate variability (HRV) indices in 200 students at rest and during exercise were studied. For a more complete assessment of the functional reserves of cardiovascular system after the load the index of the normal heart rhythm restoration (SDNN) was calculated. Moreover, we built logistic models and curves of the operating characteristics. Results. At rest, no significant differences in indices of both HRV and autonomic regulation of heart rate have been identified between boys and girls aged of 16-18 years. Students of the different gender, aged of 19-22 years showed significant differences in spectral parameters of HRV, there was noted the dominance of the sympathetic component of heart rate regulation in boys and parasympathetic - in girls. In terms of physical activity in undergraduate students there is observed mainly the activation of vagal influences on the heart, in senior students the vegetative balance shifted to the direction of the increased activity of mechanisms of the sympathetic regulation. The revealed decrease of NHRR reflects the low level of the reserve capacity of the cardiovascular system in 41% out of observed students. Part of students with an increased probability of the reduction of functional cardiac disorders accounted for 42% of boys and 39% of girls among students aged 16-18 years and 36% of boys and 44% of girls among students aged of 19-22 years. Conclusion. There is a change in the nature of autonomous regulation of heart rate in students of different gender and ages from 16-18 to 19-22 years. The optimal cardiac response to stress test is observed at low baseline values of heart rate and the prevalence of the parasympathetic part of the autonomic regulation of the heart rate at rest. To assess the functional reserve of the cardiovascular system in HRV indices we recommend the calculation of NHRR and the analysis of the SDNN coefficient for the effective prediction of heart rate recovery rate after exercise testing.


Cardiology ◽  
2009 ◽  
Vol 114 (1) ◽  
pp. 50-55 ◽  
Author(s):  
Uğur Kocabaş ◽  
Ergün Barış Kaya ◽  
Kudret Aytemir ◽  
Hikmet Yorgun ◽  
Alper Kepez ◽  
...  

2018 ◽  
Vol 1 (80) ◽  
Author(s):  
Audrius Gocentas ◽  
Anatoli Landõr ◽  
Aleksandras Kriščiūnas

Research background and hypothesis. Replete schedule of competitions and intense training are features of contemporary team sports. Athletes, especially the most involved ones, may not have enough time to recover. As a consequence, aggregated fatigue can manifest in some undesirable form and affect athlete’s performance and health.Research aim. The aim of this study was to evaluate the changes in heart rate recovery (HRR) and investigate possible relations with sport-specifi c measures of effi cacy in professional basketball players during competition season.Research methods. Eight male high-level basketball players (mean ± SD, body mass, 97.3 ± 11.33 kg; height 2.02 ± 0.067 m, and age 23 ± 3.12 years) were investigated. The same basketball specifi c exercise was replicated several times from September till April during the practice sessions in order to assess the personal trends of HRR. Heart rate monitoring was performed using POLAR TEAM SYSTEM. Investigated athletes were ranked retrospectively according to the total amount of minutes played and the coeffi cients of effi cacy. Research results. There were signifi cant differences in the trends of HRR between the investigated players. The most effective players showed decreasing trends of HRR in all cases of ranking.Discussion and conclusions. Research fi ndings have shown that the quality of heart rate recovery differs between basketball players of the same team and could be associated with sport-specifi c effi cacy and competition playing time.Keywords: adaptation, autonomic control, monitoring training.


Author(s):  
A.M. Satarkulova

The assessment and dynamic control over students’ status is a very important task. It allows timely detection of prenosological status prior to pathology and health maintenance in students. The objective of the paper is to assess the adaptive abilities of the body, to analyze changes in heart rate variability indicators in students with various types of autonomic regulation, to identify prenosological status and precursory pathological symptoms. Materials and Methods. The study enrolled 302 students from India, aged 21.54±1.43. Programming complex «Psychophysiologist» was used to register the main HRV parameters within 5 minutes. Health status was evaluated according to the index of functional changes and the scale of functional states. Results. N.I. Shlyk (2009) distinguished two groups of students with different types of autonomic regulation: type 1 (53 %) with moderate and type 2 (5 %) with marked characteristics of central regulation profile, type 3 (35 %) with moderate and type 4 (7 %) with marked characteristics of autonomous regulation profile. Main parameters of HRV and adaptation potential were defined for each student.All the parameters characterized functional and health status. Conclusions. It was shown that 82 % of trial subjects (type 1), 53 % (type 2), 94 % (type 3) and 95 % (type 4) demonstrated satisfactory adaptation and their physiological processes were at an optimal level. 18 % of students (type 1) demonstrated reduced adaptive abilities of the body. Moreover, they were under moderate stress. 47 % of subjects (type 2) were also under a significant stress, which was proven by excessively high SI, low SDNN and TP, and an increased index of functional changes. 5 % of students (type 4) revealed dysfunctional characteristics in the heart rhythm, peculiar to pathology. Keywords: foreign students, heart rate variability, types of autonomic regulation, adaptation potential, functional status. Оценка состояния студентов и динамический контроль за ним является важной задачей, поскольку позволяет своевременно выявлять у студентов донозологические состояния, предшествующие патологии, и способствовать сохранению здоровья. Цель. Оценка адаптивных возможностей организма, анализ изменений показателей вариабельности сердечного ритма у студентов с различными типами вегетативной регуляции, выявление донозологических состояний и ранних признаков патологии. Материалы и методы. В исследовании участвовало 302 студента в возрасте 21,54+1,43 года из Индии. Регистрировались основные параметры ВСР в течение 5 мин с использованием программно-аппаратного комплекса «Психофизиолог». Состояние и уровень здоровья оценивались по индексу функциональных изменений и шкале функциональных состояний. Результаты. По способу, предложенному Н.И. Шлык, выделены группы студентов с различными типами вегетативной регуляции: I (53 %) и II типы (5 %) – с умеренным и выраженным преобладанием центрального контура регуляции соответственно, III (35 %) и IV типы (7 %) – с умеренным и выраженным преобладанием автономного контура регуляции соответственно. У каждого из студентов определены основные параметры ВСР и адаптационного потенциала, характеризующие функциональное состояние и уровень здоровья. Выводы. Показано, что для 82 % обследуемых с I типом, 53 % со II типом, 94 % c III типом и 95 % с IV типом регуляции характерно состояние удовлетворительной адаптации, физиологические процессы сохраняются на оптимальном уровне. В группе студентов I типа у 18 % студентов адаптивные возможности организма снижены, выявлено состояние умеренного напряжения. У 47 % обследуемых II типа также зафиксировано состояние резко выраженного напряжения, индикатором которого является чрезмерно высокое значение SI, низкие величины SDNN и ТP, повышенное значение индекса функциональных изменений. В группе студентов с IV типом у 5 % учащихсяв регуляции ритма сердца выявлены дисфункциональные признаки, характерные для патологии. Ключевые слова: иностранные студенты, вариабельность сердечного ритма, типы вегетативной регуляции, адаптационный потенциал, функциональное состояние.


Author(s):  
Emi Yuda ◽  
Yutaka Yoshida ◽  
Kento Yamamoto ◽  
Junichiro Hayano

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