Chemoreceptor dependence of very low frequency rhythms in advanced chronic heart failure

1997 ◽  
Vol 272 (1) ◽  
pp. H438-H447 ◽  
Author(s):  
P. Ponikowski ◽  
T. P. Chua ◽  
M. Piepoli ◽  
A. A. Amadi ◽  
D. Harrington ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Heart Rate ◽  
Chronic Heart Failure ◽  
Low Frequency ◽  
Peripheral Chemoreceptor ◽  
Very Low Frequency ◽  
Oscillatory Power ◽  
Male Patients ◽  
Frequency Power

Factors responsible for very low frequency oscillations (VLF; cycle > 30 s) in the cardiovascular system remain obscure. We tested the hypothesis that increased peripheral chemosensitivity is important in the pathogenesis of VLF oscillations in patients with chronic heart failure (CHF). Fourteen male patients with stable, moderate to severe CHF (age 60 +/- 1.1 yr, ejection fraction 23 +/- 11%) and reproducible VLF oscillations in heart rate underwent a protocol consisting of three consecutive 20-min phases during which they breathed air, hyperoxia (O2 via mask, 60% O2 concn), and air again. Autoregressive spectral analysis of R-R intervals, blood pressure, and respiration was used to quantify total oscillatory power (TP), VLF, low (0.04-0.15 Hz)- and high (0.15-0.40Hz)-frequency power, and the coherence between these signals. Peripheral chemosensitivity was studied by assessing the ventilatory response to hypoxia using transient inhalations of pure N2. Discrete VLF rhythms were seen in R-R intervals in all 14 patients, in blood pressure in 7 of 14, and in respiration in 8 of 14 patients. A significant coherence (> 0.5) between heart rate and systolic blood pressure within the VLF band with mean phase value of -140 degrees, suggesting an antibaroreflex relationship, was seen in six subjects. Transient hyperoxia abolished the VLF oscillations in most subjects (12 of 14 in R-R intervals) and decreased R-R variability power within the VLF band. This response significantly correlated with peripheral chemoreceptor sensitivity (r = 0.77, P = 0.014). This study suggests that in CHF, enhanced peripheral chemoreceptor activity may facilitate slow oscillations in the cardiorespiratory signals.

Reproducibility of Heart Rate Variability Measures in Patients with Chronic Heart Failure

1996 ◽  
Vol 91 (4) ◽  
pp. 391-398 ◽  
Author(s):  
Piotr Ponikowski ◽  
Massimo Piepoli ◽  
Aham A. Amadi ◽  
Tuan Peng Chua ◽  
Derek Harrington ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Chronic Heart Failure ◽  
Time Domain ◽  
Low Frequency ◽  
Variation Coefficient ◽  
Very Low Frequency ◽  
Low Frequency Power ◽  
Frequency Power

1. In patients with chronic heart failure, heart rate variability is reduced with relative preservation of very-low-frequency power (< 0.04 Hz). Heart rate variability has been measured without acceptable information on its stability and the optimal recording periods for enhancing this reproducibility. 2. To this aim and to establish the optimal length of recording for the evaluation of the very-low-frequency power, we analysed 40, 20, 10 and 5 min ECG recordings obtained on two separate occasions in 16 patients with chronic heart failure. The repeatability coefficient and the variation coefficient were calculated for the heart rate variability parameters, in the time-domain (mean RR, SDRR and pNN50), and in the frequency-domain: very low frequency (< 0.04 Hz), low frequency (0.04–0.15 Hz), high frequency (0.15–0.40 Hz), total power (0–0.5 Hz). 3. Mean RR remained virtually identical over time (variation coefficient 8%). The reproducibility of time-domain (variation coefficient 25–139%) and of spectral measures (variation coefficient 45–111%) was very low. The stability of the heart rate variability parameters was only apparently improved after square root and after log transformation. 4. Very-low-frequency values derived from 5 and 10 min intervals were significantly lower than those calculated from 40 and 20 min intervals (P < 0.005). Discrete very-low-frequency peaks were detected in 11 out of 16 patients on the first 40, 20 and 10 min recording, but only in seven out of 16 when 5 min segments were analysed. 5. The reproducibility of both time or frequency-domain measures of heart rate variability in patients with chronic heart failure may vary significantly. Square root or log-transformed parameters may be considered rather than absolute units in studies assessing the influence of management on heart rate variability profile. Recordings of at least 20 min in stable, controlled conditions are to be recommended to optimize signal acquisition in patients with chronic heart failure, if very-low-frequency power in particular is to be studied.

Very-low-frequency oscillations in heart rate and blood pressure in periodic breathing: role of the cardiovascular limb of the hypoxic chemoreflex

2000 ◽  
Vol 99 (2) ◽  
pp. 125-132 ◽  
Author(s):  
Darrel P. FRANCIS ◽  
L. Ceri DAVIES ◽  
Keith WILLSON ◽  
Piotr PONIKOWSKI ◽  
Andrew J. S. COATS ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Heart Rate ◽  
Chronic Heart Failure ◽  
Spectral Power ◽  
Low Frequency ◽  
Periodic Breathing ◽  
Free Breathing ◽  
Very Low Frequency ◽  
Rr Interval

In chronic heart failure, very-low-frequency (VLF) oscillations (0.01–0.04 Hz) in heart rate and blood pressure may be related to periodic breathing, although the mechanism has not been fully characterized. Groups of ten patients with chronic heart failure and ten healthy controls performed voluntary periodic breathing with computer guidance, while ventilation, oxygen saturation, non-invasive blood pressure and RR interval were measured. In air, voluntary periodic breathing induced periodic desaturation and prominent VLF oscillations when compared with free breathing in both patients [RR interval spectral power from 179 to 358 ms2 (P < 0.05); systolic blood pressure (SBP) spectral power from 3.44 to 6.25 mmHg2 (P < 0.05)] and controls [RR spectral power from 1040 to 2307 ms2 (P < 0.05); SBP spectral power from 3.40 to 9.38 mmHg2 (P < 0.05)]. The peak in RR interval occurred 16–26 s before that in SBP, an anti-baroreflex pattern. When the patients followed an identical breathing pattern in hyperoxic conditions to prevent desaturation, the VLF RR interval spectral power was 50% lower (179.0±51.7 ms2; P < 0.01) and the VLF SBP spectral power was 44% lower (3.51±0.77 mmHg2; P < 0.01); similar effects were seen in controls (VLF RR power 20% lower, at 1847±899 ms2, P < 0.05; VLF SBP power 61% lower, at 3.68±0.92 mmHg2, P = 0.01). Low- and high-frequency spectral powers were not significantly affected. Thus periodic breathing causes oxygen-sensitive (and by implication chemoreflex-related) anti-baroreflex VLF oscillations in RR interval and blood pressure in both patients with chronic heart failure and normal controls.

Very-low-frequency oscillations in heart rate and blood pressure in periodic breathing: role of the cardiovascular limb of the hypoxic chemoreflex

2000 ◽  
Vol 99 (2) ◽  
pp. 125 ◽  
Author(s):  
Darrel P. FRANCIS ◽  
L. Ceri DAVIES ◽  
Keith WILLSON ◽  
Piotr PONIKOWSKI ◽  
Andrew J.S. COATS ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Low Frequency ◽  
Periodic Breathing ◽  
Very Low Frequency ◽  
Low Frequency Oscillations

scholarly journals Cooling-Evoked Hemodynamic Perturbations Facilitate Sympathetic Activity with Subsequent Myogenic Vascular Oscillations via Alpha2-Adrenergic Receptors

2017 ◽  
pp. 449-457 ◽  
Author(s):  
Y.-H. LIN ◽  
Y.-P. LIU ◽  
Y.-C. LIN ◽  
P.-L. LEE ◽  
C.-S. TUNG
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Pressor Response ◽  
Low Frequency ◽  
Power Spectral Analysis ◽  
Sprague Dawley ◽  
Cold Stimulation ◽  
Very Low Frequency ◽  
Power Spectral ◽  
Sprague Dawley Rats

This study extends our previous work by examining the effects of alpha2-adrenoceptors under cold stimulation involving the increase of myogenic vascular oscillations as increases of very-low-frequency and low-frequency of the blood pressure variability. Forty-eight adult male Sprague-Dawley rats were randomly divided into four groups: vehicle; yohimbine; hexamethonium+yohimbine; guanethidine+yohimbine. Systolic blood pressure, heart rate, power spectral analysis of spontaneous blood pressure and heart rate variability and spectral coherence at very-low-frequency (0.02 to 0.2 Hz), low-frequency (0.2 to 0.6 Hz), and high-frequency (0.6 to 3.0 Hz) regions were monitored using telemetry. Key findings are as follows: 1) Cooling-induced pressor response was attenuated by yohimbine and further attenuated by hexamethonium+yohimbine and guanethidine+yohimbine, 2) Cooling-induced tachycardia response of yohimbine was attenuated by hexame-thonium+yohimbine and guanethidine+yohimbine, 3) Different patterns of power spectrum reaction and coherence value compared hexamethonium+yohimbine and guanethi-dine+yohimbine to yohimbine alone under cold stimulation. The results suggest that sympathetic activation of the postsynaptic alpha2-adrenoceptors causes vasoconstriction and heightening myogenic vascular oscillations, in turn, may increase blood flow to prevent tissue damage under stressful cooling challenge.

scholarly journals The use of a new type of heart rate-controlled training system HeartGo for patients with chronic Heart failure on the pedelec.

2020 ◽  
Author(s):  
Erik B Friedrich ◽  
Guenter Hennersdorf ◽  
Herbert Loellgen ◽  
Helmut Roeder ◽  
Wolfgang Baltes ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Heart Rate ◽  
Pilot Study ◽  
Chronic Heart Failure ◽  
Ejection Fraction ◽  
Clinical Data ◽  
Health Benefits ◽  
Left Ventricular Ejection ◽  
Rate Controlled

Summary: Background: The study "HI-Herz.BIKE Saar" (August 2017 - September 2019) examined health benefits and training effects of e-bikes (pedelecs) in patients with moderate chronic heart failure (CHF) from ambulatory heart groups. Method: The presented study is explicitly marked as a pilot study. 10 subjects with CHF NYHA stage II-III and a left ventricular ejection fraction (LVEF) of <=50% were selected. In our study, we are the first to employ the novel HeartGo system which allows for heart rate controlled training on pedelecs via a smartphone app. Training groups were accompanied during bike rides by a medical doctor and a paramedic. No cardiac complications occurred. Every six months, training sessions increased in duration, distance, and target frequency. Parameters measured were frequency behaviour, pedaling and motor load on the pedelec as well as clinical data such as ejection fraction, the biomarker NT-pro BNP, risk factors, arterial blood pressure and ergometric courses. Results: Power tolerance increased by almost 2.5 times, while a discrete decrease of the resting heart rate by 3.7% was observed and pedaling power improved accordingly. Clinical data show significant increases in well-being determined by questionnaire, in ergometric power by 45%, and in the LVEF by 29%. This was paralleld by a significant decrease in the NT-pro BNP value by 27% and in systolic blood pressure by 11%. Body Mass Index (BMI) remained constant at 27 and cholesterol levels showed no significant changes. Conclusions: Pedaling according to this pilot study with its methodological limitations of low numbers was safe and accompanied by significant health benefits in patient with CHF. Moreover, subjects were enthusiastic and satisfied with this form of training. Therefore, pedelec training using the HeartGo system could be a helpful tool in the training process of heart group participants with stable CHF. The results of this pilot study with its methodological weaknesses should be verified in a larger follow-up study. Key words: Pedelec, e-bike, heart rate control, heart failure, physical activity

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