Cardioautonomic control in healthy singleton and twin pregnancies

Author(s):  
Victoria L. Meah ◽  
Miranda L. Kimber ◽  
Rshmi Khurana ◽  
Rachelle Howse ◽  
Lisa K. Hornberger ◽  
...  

In conjunction with significant cardiovascular adaptation, changes in cardioautonomic balance, specifically greater sympathetic activation and vagal withdrawal, are considered normal adaptations to healthy singleton pregnancy. Cardiovascular adaptation to twin pregnancy is more profound than that of singleton pregnancies; however, the changes in cardioautonomic control during multifetal gestation are unknown. To address this gap, beat-by-beat blood pressure (photoplethysmography) and heart rate (lead II electrocardiogram) were measured continuously in 25 twin pregnancies and 25 singleton pregnancies (matched for age, pre-pregnancy BMI and gestational age) during 10-minutes of rest. Data extracted from a 3- to 5-minute period was used to analyze heart rate variability (HRV), blood pressure variability (BPV), cardiovagal baroreflex gain and cardiac intervals as indicators of cardioautonomic control. Independent t-tests were used to determine statistical differences between groups (α=0.05) and the false rate discovery was determined to adjust for multiple comparisons. Resting heart rate was greater in twin compared to singleton pregnancies (91±10 vs. 81±10 bpm; P=0.001), but blood pressure was not different. Individuals with twin pregnancies had lower HRV, evidenced by lower standard deviation of R-R intervals (32±11 vs. 47±18 ms; P=0.001), total power (1035±810 vs. 1945±1570 ms2; P=0.004) and high frequency power (224±262 vs. 810±806 ms2; P<0.001) compared to singleton pregnancies. There were no differences in cardiac intervals, BPV and cardiovagal baroreflex gain between groups. Our findings suggest that individuals with twin pregnancies have greater sympathetic and lower parasympathetic contributions to heart rate and that cardiac, but not vascular, autonomic control is impacted during twin compared to singleton pregnancy.

1996 ◽  
Vol 271 (2) ◽  
pp. H455-H460 ◽  
Author(s):  
K. P. Davy ◽  
N. L. Miniclier ◽  
J. A. Taylor ◽  
E. T. Stevenson ◽  
D. R. Seals

Coronary heart disease (CHD) and cardiac sudden death (CSD) incidence accelerates after menopause, but the incidence is lower in physically active versus less active women. Low heart rate variability (HRV) is a risk factor for CHD and CSD. The purpose of the present investigation was to test the hypothesis that HRV at rest is greater in physically active compared with less active postmenopausal women. If true, we further hypothesized that the greater HRV in the physically active women would be closely associated with an elevated spontaneous cardiac baroreflex sensitivity (SBRS). HRV (both time and frequency domain measures) and SBRS (sequence method) were measured during 5-min periods of controlled frequency breathing (15 breaths/min) in the supine, sitting, and standing postures in 9 physically active postmenopausal women (age = 53 +/- 1 yr) and 11 age-matched controls (age = 56 +/- 2 yr). Body weight, body mass index, and body fat percentage were lower (P < 0.01) and maximal oxygen uptake was higher (P < 0.01) in the physically active group. The standard deviation of the R-R intervals (time domain measure) was higher in all postures in the active women (P < 0.05) as were the high-frequency, low-frequency, and total power of HRV. SBRS also was higher (P < 0.05) in the physically active women in all postures and accounted for approximately 70% of the variance in the high-frequency power of HRV (P < 0.05). The results of the present investigation indicate that physically active postmenopausal women demonstrate higher levels of HRV compared with age-matched, less active women. Furthermore, SBRS accounted for the majority of the variance in the high-frequency power of HRV, suggesting the possibility of a mechanistic link with cardiac vagal modulation of heart rate. Our findings may provide insight into a possible cardioprotective mechanism in physically active postmenopausal women.


2003 ◽  
Vol 95 (4) ◽  
pp. 1394-1404 ◽  
Author(s):  
Anna Blasi ◽  
Javier Jo ◽  
Edwin Valladares ◽  
Barbara J. Morgan ◽  
James B. Skatrud ◽  
...  

We performed time-varying spectral analyses of heart rate variability (HRV) and blood pressure variability (BPV) recorded from 16 normal humans during acoustically induced arousals from sleep. Time-varying autoregressive modeling was employed to estimate the time courses of high-frequency HRV power, low-frequency HRV power, the ratio between low-frequency and high-frequency HRV power, and low-frequency power of systolic BPV. To delineate the influence of respiration on HRV, we also computed respiratory airflow high-frequency power, the modified ratio of low-frequency to high-frequency HRV power, and the average transfer gain between respiration and heart rate. During cortical arousal, muscle sympathetic nerve activity and heart rate increased and returned rapidly to baseline, but systolic blood pressure, the ratio between low-frequency and high-frequency HRV power, low-frequency HRV power, the modified ratio of low-frequency to high-frequency HRV power, and low-frequency power of systolic BPV displayed increases that remained above baseline up to 40 s after arousal. High-frequency HRV power and airflow high-frequency power showed concommitant decreases to levels below baseline, whereas the average transfer gain between respiration and heart rate remained unchanged. These findings suggest that 1) arousal-induced changes in parasympathetic activity are strongly coupled to respiratory pattern and 2) the sympathoexcitatory cardiovascular effects of arousal are relatively long lasting and may accumulate if repetitive arousals occur in close succession.


2003 ◽  
Vol 105 (5) ◽  
pp. 609-614 ◽  
Author(s):  
Hanna MUSSALO ◽  
Esko VANNINEN ◽  
Risto IKÄHEIMO ◽  
Tomi LAITINEN ◽  
Juha HARTIKAINEN

This study was designed to examine short-term blood pressure variability (BPV) in patients with different severity and forms of chronic medically treated hypertension. Power spectral analysis of BPV was performed from continuous finger blood pressure (Finapres) recordings. Ten patients with renovascular hypertension (RVHT), 34 with severe essential hypertension (SEHT) and 29 with mild essential hypertension (MEHT) as well as healthy age- and sex-matched control subjects were studied. The RVHT group was characterized by reduced low frequency (LF) power of both systolic and diastolic BPV (P=0.004 and P=0.003 respectively) when compared with the control group. There was also a tendency to lower total power of diastolic BPV (P=0.094). On the contrary, the SEHT group had increased total power of diastolic BPV (P=0.044). However, in the SEHT group, we found no differences in the LF and high frequency power of systolic and diastolic BPV when compared with controls. The MEHT group presented with lower LF power of systolic and diastolic BPV (P=0.028 and P=0.003 respectively) and, in addition, high frequency power of diastolic BPV was lower than in the control group (P=0.020). When the hypertensive groups were compared with each other, total power and LF power of diastolic BPV (P=0.043 and P=0.039 respectively) were lower in the RVHT group than in the SEHT group. In addition, total power of diastolic BPV was lower (P=0.030) in the MEHT group than in the SEHT group. No differences were observed in BPV between the RVHT and MEHT groups. The results show that BPV in hypertensive patients groups behaved differently. This suggests that both the aetiology and severity of hypertension have a significant influence on short-term BPV measured in laboratory conditions and that different control mechanisms are operating in these clinically distinctly different hypertension groups.


2021 ◽  
Vol 9 ◽  
Author(s):  
Kamil Javorka ◽  
Katarina Haskova ◽  
Barbora Czippelova ◽  
Mirko Zibolen ◽  
Michal Javorka

Introduction: Cardiovascular system is the vitally important system in the dynamical adaptation process of the newborns to the extrauterine environment. To reliably detect immaturity in the given organ system, it is crucial to study the development of the organ functions in relation to maturation process.Objectives: The objective was to determine the changes in the spontaneous short-term blood pressure variability (BPV) and baroreflex sensitivity (BRS) reflecting various aspects of cardiovascular control during the process of maturation in preterm babies and to separate effects of gestational age and postnatal age.Methods: Thirty-three prematurely born infants without any signs of cardio-respiratory disorders (gestational age: 31.8, range: 27–36 weeks; birth weight: 1,704, range: 820–2,730 grams) were enrolled. Continuous peripheral blood pressure signal was obtained by non-invasive volume-clamp photoplethysmography method during supine rest. The recordings of 250 continuous beat-to-beat blood pressure values were processed by spectral analysis of BPV (assessed measures: total power, low frequency and high frequency powers of systolic BPV) and BRS calculation. For each infant we also assessed systolic, diastolic and mean blood pressures, heart rate and respiratory rate.Results: With the postconceptional age, BPV measures decreased (for total power: Spearman correlation coefficient rs = −0.345, P = 0.049; for low frequency power: rs = −0.365, P = 0.037; for high frequency power rs = −0.349; P = 0.046); and BRS increased significantly (rs = 0.448, P = 0.009). The further analysis demonstrated that these effects were more attributable to gestational age than to postnatal age. BRS correlated negatively with BPV magnitude (rs = −0.479 to −0.592, P = 0.001–0.005). Mean blood pressure and diastolic blood pressure increased during maturation (rs = 0.517 and 0.537, P = 0.002 and 0.001, respectively) while heart rate and respiratory rate decreased (rs = −0.366 and −0.516, P = 0.036 and 0.002, respectively).Conclusion: We conclude that maturation process is accompanied by an increased involvement of baroreflex buffering of spontaneous short-term blood pressure oscillations. Gestational age plays a dominant role not only in BPV changes but also in BRS, mean blood pressure, diastolic blood pressure and heart rate changes.


1987 ◽  
Vol 253 (4) ◽  
pp. H874-H877 ◽  
Author(s):  
D. C. Shannon ◽  
D. W. Carley ◽  
H. Benson

We postulated that measurements of autonomically mediated fluctuations in heart rate might provide a quantitative probe of biological aging. We used power spectrum analysis of instantaneous heart rate while 33 male subjects matched their breathing to a metronome at 15 breaths/min. Measurements were made in supine and standing position. Total power and its two major components, high- and low-frequency power, declined with age in both positions but at different rates. High-frequency power that represents parasympathetically mediated respiratory sinus arrhythmia declined linearly in supine position only in subjects 9-28 yr with a slope of -0.796, which was significantly different from zero at P = 0.0007. The absolute value of high-frequency power in standing position was approximately 60% of that in supine, a difference that was statistically significant (P = 0.01). Low-frequency power that represents beta-adrenergically mediated heart rate fluctuations, especially in standing position, declined linearly to 62 yr of age (P = 0.0001). Mean heart rate increased 17.2 beats/min, and diastolic blood pressure increased 8 mmHg in the entire group in the standing compared with supine position. There were no significant differences in these changes above and below 30 yr of age. We conclude that the influence of the two major mechanisms that modulate heart rate decline at significantly different rates with aging.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Luyi Li ◽  
Dayu Hu ◽  
Wenlou Zhang ◽  
Liyan Cui ◽  
Xu Jia ◽  
...  

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


2003 ◽  
Vol 104 (3) ◽  
pp. 295-302 ◽  
Author(s):  
Mario VAZ ◽  
A.V. BHARATHI ◽  
S. SUCHARITA ◽  
D. NAZARETH

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.


Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Vladimir Shusterman ◽  
Jan Nemec ◽  
Marie Buncova ◽  
Bruce Winter ◽  
Win-Kuang Shen ◽  
...  

Background: The hallmark of Long QT Syndrome (LQTS) is a prolongation of the ventricular electrical action potential caused by mutations involving key cardiac ion channels on the surface membrane of ventricular myocytes. Different mutations are associated with specific modes of arrhythmia initiation and distinct changes in cardiac rhythm prior to these events. We hypothesized that some LQTS-causing mutations might involve the sinus node, leading to aberrations in cardiac rhythm. To test this hypothesis, we examined the features of cardiac rhythm in 23 genotyped patients with LQTS and 14 matched controls (C) using Holter ECG data (6hrs). Methods: QRS-complexes were identified using custom software and verified by an experienced ECG reader; series of sinus beats were extracted and gaps in time series were linearly interpolated. The mean, max, and min heart rate (HR), the time (SD, SDNN, SDANN, RMSSD, pNN50) and frequency-domain (Total (TP), Very low (VLF), Low (LF), High (HF) frequency powers, and LF/HF) indices of heart rate variability (HRV) were calculated in each 5-min interval and over the entire recording. The short-long-short irregularity was examined using the novel multiscale rhythmogenetic analysis (MRA), which quantifies changes in the HRV indices during the transition from one time-scale window to another. Results: The maximum heart rate was slower in LQTS than in C (101±13 and 119±19bpm, p=0.001). The high-frequency power (HF) was lower in LQTS than in C (80±76 and 113±58ms 2 , p<0.05). However, the short-term irregularity (quantified by the difference in RMSSD between the 75ms and 2000ms time scales) was 4 times greater in LQTS compared to C (p=0.003). Inclusion or exclusion of two patents who were on β-blockers did not change the results. Conclusions: LQTS is associated with specific changes in cardiac rhythm, including: diminished acceleration capacity, decreased high-frequency power, and enhanced short-long-short irregularity. This suggests that LQTS involves channel modifications in the sinus node, which might contribute to arrhythmogenesis. Rhythm characterization in genetic sub-types of LQTS might improve arrhythmia risk stratification in this heterogeneous patient population.


Author(s):  
Jean Marie Buregeya ◽  
Philippe Apparicio ◽  
Jérémy Gelb

Exposure to traffic-related air pollution and noise exposure contributes to detrimental effects on cardiac function, but the underlying short-term effects related to their simultaneous personal exposure remain uncertain. The aim is to assess the impact of total inhaled dose of particulate matter and total noise exposure on the variations of electrocardiogram (ECG) parameters between pre-cycling and post-cycling periods. Mid-June 2019, we collected four participants’ personal exposure data related to traffic-related noise and particulate matter (PM2.5 and PM10) as well as ECG parameters. Several Bayesian linear models were built to examine a potential association between air pollutants and noise exposure and ECG parameters: heart rate (HR), standard deviation of the normal-to-normal intervals (SDNN), percentage of successive RR intervals that differ by more than 50 ms (pNN50), root mean square of successive RR interval differences (rMSSD), low-frequency power (LF), high-frequency power (HF), and ratio of low- to high-frequency power (LF/HF). We analyzed in total 255 5-min segments of RR intervals. We observed that per 1 µg increase in cumulative inhaled dose of PM2.5 was associated with 0.48 (95% CI: 0.22; 15.61) increase in variation of the heart rate, while one percent of total noise dose was associated with 0.49 (95% CI: 0.17; 0.83) increase in variation of heart rate between corresponding periods. Personal noise exposure was no longer significant once the PM2.5 was introduced in the whole model, whilst coefficients of the latter that were significant previously remained unchanged. Short-term exposure to traffic-related air and noise pollution did not, however, have an impact on heart rate variability.


2005 ◽  
Vol 33 (01) ◽  
pp. 157-164 ◽  
Author(s):  
Sheng-Teng Huang ◽  
Gau-Yang Chen ◽  
Huey-Ming Lo ◽  
Jaung-Gang Lin ◽  
Yin-Shiung Lee ◽  
...  

Acupuncture at the Neiguan (P6) point has been shown to lessen nausea and vomiting which are related to vagal modulation. This study investigated whether acupuncture at the P6 point could improve vagal modulation by using heart rate variability analysis. We compared the heart rate variability measures of 39 subjects receiving acupuncture at the P6 point, 38 subjects receiving sham acupuncture, and 34 subjects receiving no treatment at all. The normalized high-frequency power was used as the index of vagal modulation, and the low-/high-frequency power ratio was used as the index of sympathovagal balance. The normalized high-frequency power after acupuncture increased significantly from 28.1±12.6 nu (mean±SD) to 30.7±14.1 nu in the P6 acupuncture group, but not in the sham acupuncture (30.6±13.7 nu versus 31.8±13.8 nu) or no-treatment group (30.1±15.0 nu versus 30.1±15.7 nu). In both the P6 and sham acupuncture groups, the mean RR interval (the intervals between consecutive R waves in the electrocardiogram) increased significantly after acupuncture. In the no-treatment group, there was no statistical difference in all heart rate variability measures in the initial and later sessions. In conclusion, acupuncture at the P6 point can increase vagal modulation of the subjects. This result may be helpful in the understanding of the mechanism underlying the effect of acupuncture or acupressure at P6 on the lessening of nausea and vomiting in clinic.


Sign in / Sign up

Export Citation Format

Share Document