scholarly journals Role of respiration in the cardiovascular response to orthostatic and mental stress

2018 ◽  
Vol 314 (6) ◽  
pp. R761-R769 ◽  
Author(s):  
Michal Javorka ◽  
Fatima El-Hamad ◽  
Barbora Czippelova ◽  
Zuzana Turianikova ◽  
Jana Krohova ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Respiratory Sinus Arrhythmia ◽  
Mental Stress ◽  
Blood Pressure Variability ◽  
Mental Arithmetic ◽  
Cardiovascular Response ◽  
Respiratory Response ◽  
Sinus Arrhythmia ◽  
Head Up Tilt

The objective of this study was to determine the response of heart rate and blood pressure variability (respiratory sinus arrhythmia, baroreflex sensitivity) to orthostatic and mental stress, focusing on causality and the mediating effect of respiration. Seventy-seven healthy young volunteers (46 women, 31 men) aged 18.4 ± 2.7 yr underwent an experimental protocol comprising supine rest, 45° head-up tilt, recovery, and a mental arithmetic task. Heart rate variability and blood pressure variability were analyzed in the time and frequency domain and modeled as a multivariate autoregressive process where the respiratory volume signal acted as an external driver. During head-up tilt, tidal volume increased while respiratory rate decreased. During mental stress, breathing rate increased and tidal volume was elevated slightly. Respiratory sinus arrhythmia decreased during both interventions. Baroreflex function was preserved during orthostasis but was decreased during mental stress. While sex differences were not observed during baseline conditions, cardiovascular response to orthostatic stress and respiratory response to mental stress was more prominent in men compared with women. The respiratory response to the mental arithmetic tasks was more prominent in men despite a significantly higher subjectively perceived stress level in women. In conclusion, respiration shows a distinct response to orthostatic versus mental stress, mediating cardiovascular variability; it needs to be considered for correct interpretation of heart rate and blood pressure phenomena.

Incoherent oscillations of respiratory sinus arrhythmia during acute mental stress in humans

2012 ◽  
Vol 302 (1) ◽  
pp. H359-H367 ◽  
Author(s):  
Kyuichi Niizeki ◽  
Tadashi Saitoh
Keyword(s):  
Heart Rate ◽  
Respiratory Sinus Arrhythmia ◽  
Mental Stress ◽  
Phase Synchronization ◽  
Mental Arithmetic ◽  
Recovery Period ◽  
Low Frequency ◽  
Phase Lag ◽  
Arithmetic Task ◽  
Sinus Arrhythmia

Respiratory sinus arrhythmia (RSA) has been widely used as a measure of the cardiac vagal control in response to stress. However, RSA seems not to be a generalized indicator because of its dependency on respiratory parameter and individual variations of RSA amplitude (ARSA). We hypothesized that phase-lag variations between RSA and respiration may serve as a normalized index of the degree of mental stress. Twenty healthy volunteers performed mental arithmetic task (ART) after 5 min of resting control followed by 5 min of recovery. Breathing pattern, beat-to-beat R-R intervals, and blood pressure (BP) were determined using inductance plethysmography, electrocardiography, and a Finapres device, respectively. The analytic signals of breathing and RSA were obtained by Hilbert transform and the degree of phase synchronization (λ) was quantified. With the use of spectral analysis, heart rate variability (HRV) was estimated for the low-frequency (LF) and high-frequency (HF) bands. A steady-state 3-min resting period (REST), the first 3 min (ART1), and the last 3 min (ART2) of the ART period (ranged from 6- to 19 min) and the last 3 min of the recovery period (RCV) were analyzed separately. Heart rate, systolic BP, and breathing frequency (fR) increased and λ, ARSA, and HF power decreased from REST to ART ( P < 0.01). The λ was correlated with normalized ARSA and the HF power. The decrease in λ could not be explained solely by the increase in fR. We conclude that mental stress exerts an influence on RSA oscillations, inducing incoherent phase lag with respect to breathing, in addition to a decrease in RSA.

Reproducibility of heart rate variability, blood pressure variability and baroreceptor sensitivity during rest and head-up tilt

2005 ◽  
Vol 10 (1) ◽  
pp. 19-24 ◽  
Author(s):  
Michael V. H??jgaard ◽  
Niels-Henrik Holstein-Rathlou ◽  
Erik Agner ◽  
J??rgen K. Kanters
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Blood Pressure Variability ◽  
Baroreceptor Sensitivity ◽  
Head Up Tilt

scholarly journals Pulsed Wave Doppler Ultrasound Is Useful to Assess Vasomotor Response in Patients with Multiple System Atrophy and Well Correlated with Tilt Table Study

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Ke-Vin Chang ◽  
Wen-Shiang Chen ◽  
Ruey-Meei Wu ◽  
Ssu-Yuan Chen ◽  
Hsiu-Yu Shen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Correlation Analysis ◽  
Multiple System Atrophy ◽  
Cardiovascular Response ◽  
Vasomotor Response ◽  
Tilt Table ◽  
Hemodynamic Variables ◽  
Pulsed Wave Doppler ◽  
Head Up Tilt

The study aim was to assess sympathetic vasomotor response (SVR) by using pulsed wave Doppler (PWD) ultrasound in patients with multiple system atrophy (MSA) and correlate with the tilt table study. We recruited 18 male patients and 10 healthy men as controls. The SVR of the radial artery was evaluated by PWD, using inspiratory cough as a provocative maneuver. The response to head-up tilt was studied by a tilt table with simultaneous heart rate and blood pressure recording. The hemodynamic variables were compared between groups, and were examined by correlation analysis. Regarding SVR, MSA patients exhibited a prolonged latency and less heart rate acceleration following inspiratory cough. Compared with the tilt table test, the elevation of heart rate upon SVR was positively correlated to the increase of heart rate after head-up tilt. The correlation analysis indicated that the magnitude of blood pressure drop from supine to upright was positively associated with the SVR latency but negatively correlated with the heart rate changes upon SVR. The present study demonstrated that blunted heart rate response might explain MSA's vulnerability to postural challenge. PWD may be used to predict cardiovascular response to orthostatic stress upon head-up tilt in MSA patients.

scholarly journals Relation of body mass index (BMI) with cardiovascular response to head up tilt in healthy subjects

2020 ◽  
Vol 15 (1) ◽  
pp. 6-10
Author(s):  
Sadia Afrin Rimi ◽  
Shamima Sultana ◽  
Iffat Rezwana ◽  
Sultana Ferdousi
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Healthy Subjects ◽  
Cardiovascular Response ◽  
Tilt Test ◽  
Tilt Table ◽  
Chi Square ◽  
Female Head ◽  
Head Up Tilt

Background: Tilt table test is used for the last few decades to detect cause in unexplained syncope. The response to tilting may vary physiologically with obesity. Objective: To assess the relationship of BMI to cardiovascular response to tilting. Methods: This experimental study was conducted from March 2019 to Feb 2020 on 90 healthy subjects with different BMI. Fifty one subjects of both gender with BMI 18.5-24.9 kg/m2 were included in the non-obese group and 39 subjects of both gender with BMI of 25-29.9 kg/m2 were included in overweight group and they were further subdivided into male and female. Head up tilting was done for 10 minutes at 600 by using a motorized tilt table. Systolic blood pressure (SBP), diastolic blood pressure (DBP) were recorded by an automatic sphygmomanometer. Heart rate (HR) and peripheral capillary oxygen saturation (SpO2) were measured by a pulse oximeter. For statistical analysis, Independent sample ‘t’ test, Pearson’s correlation test and Chi square tests were applied. Results: Significantly smaller rise of heart rate was observed in overweight males and greater fall of systolic blood pressure was observed in overweight females. Conclusion: This study concluded that over weight is associated with reduced orthostatic tolerance to head up tilt test in both genders. J Bangladesh Soc Physiol. 2020, June; 15(1): 6-10

scholarly journals A model-based analysis of autonomic nervous function in response to the Valsalva maneuver

2019 ◽  
Vol 127 (5) ◽  
pp. 1386-1402 ◽  
Author(s):  
E. Benjamin Randall ◽  
Anna Billeschou ◽  
Louise S. Brinth ◽  
Jesper Mehlsen ◽  
Mette S. Olufsen
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Respiratory Sinus Arrhythmia ◽  
Valsalva Maneuver ◽  
Patient Specific ◽  
Control Mechanisms ◽  
Sinus Arrhythmia ◽  
Control Subjects ◽  
Model Based ◽  
Model Based Analysis

The Valsalva maneuver (VM) is a diagnostic protocol examining sympathetic and parasympathetic activity in patients with autonomic dysfunction (AD) impacting cardiovascular control. Because direct measurement of these signals is costly and invasive, AD is typically assessed indirectly by analyzing heart rate and blood pressure response patterns. This study introduces a mathematical model that can predict sympathetic and parasympathetic dynamics. Our model-based analysis includes two control mechanisms: respiratory sinus arrhythmia (RSA) and the baroreceptor reflex (baroreflex). The RSA submodel integrates an electrocardiogram-derived respiratory signal with intrathoracic pressure, and the baroreflex submodel differentiates aortic and carotid baroreceptor regions. Patient-specific afferent and efferent signals are determined for 34 control subjects and 5 AD patients, estimating parameters fitting the model output to heart rate data. Results show that inclusion of RSA and distinguishing aortic/carotid regions are necessary to model the heart rate response to the VM. Comparing control subjects to patients shows that RSA and baroreflex responses are significantly diminished. This study compares estimated parameter values from the model-based predictions to indices used in clinical practice. Three indices are computed to determine adrenergic function from the slope of the systolic blood pressure in phase II [ α (a new index)], the baroreceptor sensitivity ( β), and the Valsalva ratio ( γ). Results show that these indices can distinguish between normal and abnormal states, but model-based analysis is needed to differentiate pathological signals. In summary, the model simulates various VM responses and, by combining indices and model predictions, we study the pathologies for 5 AD patients. NEW & NOTEWORTHY We introduce a patient-specific model analyzing heart rate and blood pressure during a Valsalva maneuver (VM). The model predicts autonomic function incorporating the baroreflex and respiratory sinus arrhythmia (RSA) control mechanisms. We introduce a novel index ( α) characterizing sympathetic activity, which can distinguish control and abnormal patients. However, we assert that modeling and parameter estimation are necessary to explain pathologies. Finally, we show that aortic baroreceptors contribute significantly to the VM and RSA affects early VM.

Augmentation of respiratory sinus arrhythmia in response to progressive hypercapnia in conscious dogs

2001 ◽  
Vol 280 (5) ◽  
pp. H2336-H2341 ◽  
Author(s):  
Fumihiko Yasuma ◽  
Jun-Ichiro Hayano
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Arterial Blood Pressure ◽  
Respiratory Sinus Arrhythmia ◽  
Physiological Response ◽  
Minute Ventilation ◽  
Control Level ◽  
Conscious Dogs ◽  
Sinus Arrhythmia ◽  
Arterial Blood

Respiratory sinus arrhythmia (RSA) may serve to enhance pulmonary gas exchange efficiency by matching pulmonary blood flow with lung volume within each respiratory cycle. We examined the hypothesis that RSA is augmented as an active physiological response to hypercapnia. We measured electrocardiograms and arterial blood pressure during progressive hypercapnia in conscious dogs that were prepared with a permanent tracheostomy and an implanted blood pressure telemetry unit. The intensity of RSA was assessed continuously as the amplitude of respiratory fluctuation of heart rate using complex demodulation. In a total of 39 runs of hypercapnia in 3 dogs, RSA increased by 38 and 43% of the control level when minute ventilation reached 10 and 15 l/min, respectively ( P < 0.0001 for both), and heart rate and mean arterial pressure showed no significant change. The increases in RSA were significant even after adjustment for the effects of increased tidal volume, respiratory rate, and respiratory fluctuation of arterial blood pressure ( P < 0.001). These observations indicate that increased RSA during hypercapnia is not the consequence of altered autonomic balance or respiratory patterns and support the hypothesis that RSA is augmented as an active physiological response to hypercapnia.

scholarly journals Anthropometric Determinants of Respiratory Sinus Arrhythmia in Children

2022 ◽  
Vol 19 (1) ◽  
pp. 566
Author(s):  
Paulina Lubocka ◽  
Robert Sabiniewicz ◽  
Klaudia Suligowska ◽  
Tomasz Zdrojewski
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Respiratory Sinus Arrhythmia ◽  
Overweight And Obesity ◽  
Clinical Settings ◽  
Healthy Children ◽  
Resting Heart Rate ◽  
Lower Heart Rate ◽  
Sinus Arrhythmia ◽  
School Aged Children

Background: The study was conducted to investigate the implications of anthropometry in school-aged children on the degree of respiratory sinus arrhythmia observed in clinical settings. Methods: In a cohort study, 626 healthy children (52% male) aged 10.8 ± 0.5 years attending primary school in a single town underwent a 12-lead electrocardiogram coupled with measurements of height, weight and blood pressure. Indices of respiratory sinus arrhythmia (pvRSA, RMSSD, RMSSDc) were derived from semi-automatic measurements of RR intervals. Height, weight, BMI, blood pressure as well as waist and hip circumferences were compared between subjects with rhythmic heart rate and respiratory sinus arrhythmia, and correlations between indices of sinus arrhythmia and anthropometry were investigated. Results: Respiratory sinus arrhythmia was recognized in 43% of the participants. Subjects with sinus arrhythmia had lower heart rate (p < 0.001), weight (p = 0.009), BMI (p = 0.005) and systolic (p = 0.018) and diastolic (p = 0.004) blood pressure. There were important inverse correlations of heart rate and indices of sinus arrhythmia (r = −0.52 for pvRSA and r = −0.58 for RMSSD), but not the anthropometry. Conclusion: Lower prevalence of respiratory sinus arrhythmia among children with overweight and obesity is a result of higher resting heart rate observed in this population.

Autonomic Characteristics Following Surgical Repair of Tetralogy of Fallot Using Heart Rate and Blood Pressure Variability

2001 ◽  
Vol 13 (1) ◽  
pp. 47-59
Author(s):  
Hélène Perrault ◽  
Maria Tzovanis ◽  
Dominique Johnson ◽  
André Davignon ◽  
Claude Chartrand ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Tetralogy Of Fallot ◽  
Blood Pressure Variability ◽  
Surgical Repair ◽  
Vagal Activity ◽  
Sympathetic Response ◽  
Head Up Tilt ◽  
Steady State Cycling ◽  
Vagal Withdrawal

This study compares the autonomic responses of 9 adolescents (mean ± SEM: 17±1 years) successfully operated for tetralogy of Fallot (TOF) in early childhood and 8 age-matched healthy controls (CTRL) using R-R and blood pressure variability. Continuous ECG and BP recordings were obtained during spontaneous and controlled respiration (CR) at 0.20 Hz as well as after an 85° head-up tilt (HUT) and during steady-state cycling at heart rates of 100 and 120 bpm, selected to reflect partial and complete cardiac vagal withdrawal. TOF exhibited total R-R variance and HF power (ms2) lower than CTRL under both spontaneous (938 ± 322 vs. 1,714 ± 296) and CR (1,541 ± 527 vs. 4,725 ± 1,207; p < .05), which may be indicative of a lower cardiac vagal activity. HUT decreased the R-R HF component, which remained lower in TOF than CTRL and increased the diastolic BP LF component in TOF but not in CTRL. Exercise decreased the R-R HF power more in TOF than CTRL. The exaggerated diastolic BP and limited heart rate responses to tilting and the more marked vagal withdrawal at Ex120 in TOF may be suggestive of a disturbance in the cardiac sympathetic response. Further studies are needed to confirm these observations on larger groups of young adults successfully operated for TOF.

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