Sympathovagal imbalance in hyperthyroidism

2001 ◽  
Vol 281 (1) ◽  
pp. E190-E195 ◽  
Author(s):  
J. Burggraaf ◽  
J. H. M. Tulen ◽  
S. Lalezari ◽  
R. C. Schoemaker ◽  
P. H. E. M. De Meyer ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
High Frequency ◽  
Spectral Power ◽  
Systemic Exposure ◽  
Urinary Catecholamine ◽  
Catecholamine Excretion ◽  
Euthyroid State ◽  
Sympathovagal Imbalance ◽  
Hyperthyroid Patients

We assessed sympathovagal balance in thyrotoxicosis. Fourteen patients with Graves' hyperthyroidism were studied before and after 7 days of treatment with propranolol (40 mg 3 times a day) and in the euthyroid state. Data were compared with those obtained in a group of age-, sex-, and weight-matched controls. Autonomic inputs to the heart were assessed by power spectral analysis of heart rate variability. Systemic exposure to sympathetic neurohormones was estimated on the basis of 24-h urinary catecholamine excretion. The spectral power in the high-frequency domain was considerably reduced in hyperthyroid patients, indicating diminished vagal inputs to the heart. Increased heart rate and mid-frequency/high-frequency power ratio in the presence of reduced total spectral power and increased urinary catecholamine excretion strongly suggest enhanced sympathetic inputs in thyrotoxicosis. All abnormal features of autonomic balance were completely restored to normal in the euthyroid state. β-Adrenoceptor antagonism reduced heart rate in hyperthyroid patients but did not significantly affect heart rate variability or catecholamine excretion. This is in keeping with the concept of a joint disruption of sympathetic and vagal inputs to the heart underlying changes in heart rate variability. Thus thyrotoxicosis is characterized by profound sympathovagal imbalance, brought about by increased sympathetic activity in the presence of diminished vagal tone.

Evaluation of cardiac autonomic function using heart rate variability in children with acute carbon monoxide poisoning

2017 ◽  
Vol 27 (9) ◽  
pp. 1662-1669 ◽  
Author(s):  
Cagdas Vural ◽  
Ener Cagri Dinleyici ◽  
Pelin Kosger ◽  
Ozge Bolluk ◽  
Zubeyir Kilic ◽  
...  
Keyword(s):  
Heart Rate ◽  
Carbon Monoxide ◽  
Heart Rate Variability ◽  
High Frequency ◽  
Autonomic Function ◽  
Spectral Power ◽  
Carbon Monoxide Poisoning ◽  
Low Frequency ◽  
Qt Dispersion ◽  
Cardiac Autonomic Function

AbstractIntroductionCarbon monoxide poisoning may cause myocardial toxicity and cardiac autonomic dysfunction, which may contribute to the development of life-threatening arrhythmias. We investigated the potential association between acute carbon monoxide exposure and cardiac autonomic function measured by heart rate variability.MethodThe present study included 40 children aged 1–17 years who were admitted to the Pediatric Intensive Care Unit with acute carbon monoxide poisoning and 40 healthy age- and sex-matched controls. Carboxyhaemoglobin and cardiac enzymes were measured at admission. Electrocardiography was performed on admission and discharge, and 24-hour Holter electrocardiography was digitally recorded. Heart rate variability was analysed at both time points – 24-hour recordings – and frequency domains – from the first 5 minutes of intensive care unit admission.ResultsTime domain and frequency indices such as high-frequency spectral power and low-frequency spectral power were similar between patient and control groups (p>0.05). The ratio of low-frequency spectral power to high-frequency spectral power was significantly lower in the carbon monoxide poisoning group (p<0.001) and was negatively correlated with carboxyhaemoglobin levels (r=−0.351, p<0.05). The mean heart rate, QT dispersion, corrected QT dispersion, and P dispersion values were higher in the carbon monoxide poisoning group (p<0.05) on admission. The QT dispersion and corrected QT dispersion remained longer in the carbon monoxide poisoning group compared with controls on discharge (p<0.05).ConclusionThe frequency domain indices, especially the ratio of low-frequency spectral power to high-frequency spectral power, are useful for the evaluation of the cardiac autonomic function. The decreased low-frequency spectral power-to-high-frequency spectral power ratio reflects a balance of the autonomic nervous system, which shifted to parasympathetic components.

Sympathetic and parasympathetic indicators of heart rate control at altitude studied by spectral analysis

1994 ◽  
Vol 77 (6) ◽  
pp. 2537-2542 ◽  
Author(s):  
R. L. Hughson ◽  
Y. Yamamoto ◽  
R. E. McCullough ◽  
J. R. Sutton ◽  
J. T. Reeves
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Spectral Analysis ◽  
Placebo Group ◽  
High Frequency ◽  
Spectral Power ◽  
Adaptive Responses ◽  
Propranolol Group ◽  
Total Spectral Power ◽  
Receptor Number

The adaptive responses of the cardiovascular system to altitude appear to be dominated by increased sympathetic neural activity. We investigated the combined roles of the sympathetic and parasympathetic nervous systems (SNS and PNS, respectively) in the early (days 4–5) and subsequent (days 11–12) phases of acclimatization on Pike's Peak, CO (4,300 m), by spectral analysis of heart rate variability. Male subjects were randomly assigned to groups receiving oral propranolol (240 mg/day; n = 6) or a matched placebo (n = 3). On ascent to altitude, the high-frequency, fractal, and total spectral powers were reduced in the placebo group during days 4–5 and 11–12. At altitude during days 4–5, all three placebo group subjects increased SNS and decreased PNS activities compared with at sea level, and during days 11–12 SNS decreased and PNS increased compared with days 4–5. Relative to the placebo group, propranolol caused lengthening of the R-R interval; increases in high-frequency power, total spectral power, and the PNS indicator; and a decrease in the SNS indicator. Total spectral power tended to decrease at altitude, but there were no effects of altitude on PNS and SNS indicators in the propranolol group. The data from the placebo and propranolol groups suggest that both the PNS and SNS are involved in the elevated heart rate during the early phase of altitude acclimatization. Changes in heart rate variability during days 11–12 at altitude must be considered in light of the possible reductions in sympathetic receptor number noted in previous studies.

Acute Alcohol Intake Decreases Short-Term Heart Rate Variability in Healthy Subjects

1994 ◽  
Vol 87 (2) ◽  
pp. 225-230 ◽  
Author(s):  
Pekka Koskinen ◽  
Juha Virolainen ◽  
Markku Kupari
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Systolic Blood Pressure ◽  
High Frequency ◽  
Alcohol Intake ◽  
Spectral Power ◽  
Domain Analysis ◽  
Alcohol Concentration ◽  
High Frequency Component

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.

scholarly journals Comparative study of heart rate variability in normotensive young adults with family history of hypertension

2021 ◽  
Vol 9 (2) ◽  
pp. 371
Author(s):  
Ovais K. Wadoo ◽  
Sheikh I. Sayeed ◽  
Mariya R. Tramboo
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
High Frequency ◽  
Low Frequency ◽  
Vascular Diseases ◽  
Test Group ◽  
Time Domain Analysis ◽  
Domain Analysis ◽  
Control Group ◽  
Sympathovagal Imbalance

Background: Hypertension is a risk factor for the development of cardiovascular and cerebro-vascular diseases. Autonomic nervous system plays a crucial role in the development of hypertension. The integrity of autonomic modulation of heart rate is evaluated by analysing heart rate variability (HRV), which refers to oscillations in the intervals between consecutive heartbeats or R-R intervals. The present study was designed to analyse the indices of heart rate variability in the offsprings of hypertensive parents and off springs of normotensive parents to understand if there is any autonomic imbalance between the two groups.  Methods: The study was conducted in the Department of Physiology, Government Medical College, Srinagar. The test group consisted of 30 healthy normotensive subjects studying in 1st year of MBBS with hypertensive parents and the control group consisted of healthy normotensive of 1st year of MBBS with both parents normotensive. In time domain analysis the standard deviation of all normal-to-normal intervals {SDNN(ms)} was taken as index of overall HRV. Frequency domain analysis was done with respect to low frequency (LF) analysis and high frequency (HF) analysis. Low and high frequency power were expressed in normalized units.Results: The SDNN was reduced in cases but was not statistically significant. RMSSD was also reduced in cases though not statistically significant. LFnu was found to be significantly higher in cases. The HFnu was significantly reduced in cases. LF/HF ratio was found to be higher in cases and the difference was statistically significant.  Conclusions: Our study reveals that incidence of prehypertension and the risk of cardiovascular dysfunction in relation to sympathovagal imbalance is more in the off springs of hypertensive parents than in the off springs of normotensive parents. Sympathovagal imbalance in the form of increased sympathetic drive and decreased parasympathetic drive can lead to prehypertension in these genetically predisposed individuals.  

scholarly journals Gender-Related Differences in Heart Rate Variability of Epileptic Patients

2016 ◽  
Vol 12 (1) ◽  
pp. 117-125
Author(s):  
Soroor Behbahani ◽  
Nader Jafarnia Dabanloo ◽  
Ali Motie Nasrabadi ◽  
Antonio Dourado
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
High Frequency ◽  
Spectral Power ◽  
Low Frequency ◽  
Female Group ◽  
Sudden Increase ◽  
Unexpected Death ◽  
Epileptic Patients ◽  
Hrv Analysis

Recently, heart rate variability (HRV) analysis has been used as an indicator of epileptic seizures. As women have a lower sudden, unexpected death in epilepsy risk and greater longevity than men, the authors postulated that there are significant gender-related differences in heart rate dynamics of epileptic patients. The authors analyzed HRV during 5-minute segments of continuous electrocardiogram recording of age-matched populations. The middle-aged epileptic patients included males ( n = 12) and females ( n = 12), ranging from 41 to 65 years of age. Relatively high- (0.15 Hz-0.40 Hz) and low-frequency (0.01 Hz-0.15 Hz) components of HRV were computed using spectral analysis. Poincaré parameters of each heart rate time series were considered as nonlinear features. The mean heart rate markedly differed between gender groups including both right- and left-sided seizures. High-frequency heart rate power and the low-frequency/high-frequency ratio increased in the pre-ictal phase of both male and female groups ( p < .01), but men showed more increase especially in right-sided seizures. The standard deviation ratio, SD2/ SD1, of pre-ictal phase was greater in males than females ( p < .01). High-frequency spectral power and parasympathetic activity were higher in the female group with both right- and left-sided seizures. Men showed a sudden increase in sympathetic activity in the pre-ictal phase, which might increase the risk of cardiovascular disease in comparison to women. These complementary findings indicate the need to account for gender, as well as localization in HRV analysis.

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.

scholarly journals Effect of short-term exposure to particulate air pollution on heart rate variability in normal-weight and obese adults

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Luyi Li ◽  
Dayu Hu ◽  
Wenlou Zhang ◽  
Liyan Cui ◽  
Xu Jia ◽  
...  
Keyword(s):  
Heart Rate ◽  
Air Pollution ◽  
Heart Rate Variability ◽  
High Frequency ◽  
Normal Weight ◽  
High Frequency Power ◽  
Short Term ◽  
Particulate Air Pollution ◽  
Short Term Exposure ◽  
Frequency Power

Abstract Background The adverse effects of particulate air pollution on heart rate variability (HRV) have been reported. However, it remains unclear whether they differ by the weight status as well as between wake and sleep. Methods A repeated-measure study was conducted in 97 young adults in Beijing, China, and they were classified by body mass index (BMI) as normal-weight (BMI, 18.5–24.0 kg/m2) and obese (BMI ≥ 28.0 kg/m2) groups. Personal exposures to fine particulate matter (PM2.5) and black carbon (BC) were measured with portable exposure monitors, and the ambient PM2.5/BC concentrations were obtained from the fixed monitoring sites near the subjects’ residences. HRV and heart rate (HR) were monitored by 24-h Holter electrocardiography. The study period was divided into waking and sleeping hours according to time-activity diaries. Linear mixed-effects models were used to investigate the effects of PM2.5/BC on HRV and HR in both groups during wake and sleep. Results The effects of short-term exposure to PM2.5/BC on HRV were more pronounced among obese participants. In the normal-weight group, the positive association between personal PM2.5/BC exposure and high-frequency power (HF) as well as the ratio of low-frequency power to high-frequency power (LF/HF) was observed during wakefulness. In the obese group, personal PM2.5/BC exposure was negatively associated with HF but positively associated with LF/HF during wakefulness, whereas it was negatively correlated to total power and standard deviation of all NN intervals (SDNN) during sleep. An interquartile range (IQR) increase in BC at 2-h moving average was associated with 37.64% (95% confidence interval [CI]: 25.03, 51.51%) increases in LF/HF during wakefulness and associated with 6.28% (95% CI: − 17.26, 6.15%) decreases in SDNN during sleep in obese individuals, and the interaction terms between BC and obesity in LF/HF and SDNN were both statistically significant (p <  0.05). The results also suggested that the effects of PM2.5/BC exposure on several HRV indices and HR differed in magnitude or direction between wake and sleep. Conclusions Short-term exposure to PM2.5/BC is associated with HRV and HR, especially in obese individuals. The circadian rhythm of HRV should be considered in future studies when HRV is applied. Graphical abstract

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.

scholarly journals The Influence ofNrf2on Cardiac Responses to Environmental Stressors

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Reuben Howden ◽  
Eva Gougian ◽  
Marcus Lawrence ◽  
Samantha Cividanes ◽  
Wesley Gladwell ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
High Frequency ◽  
Low Frequency ◽  
Therapeutic Strategies ◽  
Environmental Stressors ◽  
Total Power ◽  
Airborne Pollutants ◽  
Cardiac Responses

Nrf2protects the lung from adverse responses to oxidants, including 100% oxygen (hyperoxia) and airborne pollutants like particulate matter (PM) exposure, but the role ofNrf2on heart rate (HR) and heart rate variability (HRV) responses is not known. We hypothesized that genetic disruption ofNrf2would exacerbate murine HR and HRV responses to severe hyperoxia or moderate PM exposures.Nrf2-/-andNrf2+/+mice were instrumented for continuous ECG recording to calculate HR and HRV (low frequency (LF), high frequency (HF), and total power (TP)). Mice were then either exposed to hyperoxia for up to 72 hrs or aspirated with ultrafine PM (UF-PM). Compared to respective controls, UF-PM induced significantly greater effects on HR (P<0.001) and HF HRV (P<0.001) inNrf2-/-mice compared toNrf2+/+mice.Nrf2-/-mice tolerated hyperoxia significantly less thanNrf2+/+mice (~22 hrs;P<0.001). Reductions in HR, LF, HF, and TP HRV were also significantly greater inNrf2-/-compared toNrf2+/+mice (P<0.01). Results demonstrate thatNrf2deletion increases susceptibility to change in HR and HRV responses to environmental stressors and suggest potential therapeutic strategies to prevent cardiovascular alterations.

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