Abstract 17343: E-cigarette Aerosol Exposure Acutely Alters Cardiac Conduction and Autonomic Balance and Induces Arrhythmia in Mice

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Alex P Carll ◽  
Meredith D Miles ◽  
Emily ONeill ◽  
Nima Talebi ◽  
Jeff Zurita ◽  
...  
Keyword(s):  
Heart Rate ◽  
Cardiac Arrhythmia ◽  
Cardiac Electrophysiology ◽  
Cardiac Risk ◽  
Cardiac Conduction ◽  
Autonomic Balance ◽  
Cardiac Morbidity ◽  
Aerosol Exposure ◽  
Increase Risk ◽  
Premature Beats

Background: E-cigarette (e-cig) use has rapidly increased, especially among youth. Vaping has been linked to adverse cardiopulmonary effects, but the full extent of effects remains unknown. Several constituents in e-cigs may increase cardiac risk partly by disturbing cardiac electrophysiology and the autonomic nervous system. Hypothesis: E-cig aerosols will differentially induce pro-arrhythmic changes in cardiac conduction and autonomic balance in mice depending on the presence of nicotine and flavors. Methods: Electrocardiograms (ECGs) were collected by telemetry in 5 healthy male mice (C57BL/6) exposed for 6 hours to clean air or e-cig aerosols (9-minute puff sessions every 18 minutes) from JUUL e-liquids (Va. Tobacco, Mango, or Menthol at ≈5% nicotine benzoate), or a nicotine-free mixture of propylene glycol and vegetable glycerin solvents (PG:VG, 30:70 ratio). ECG morphology, heart rate variability (HRV), and arrhythmias were analyzed by mixed models with P < 0.05 (vs. Air) for all effects. Results: PG:VG increased high grade supraventricular block arrhythmias (121±45 events/hour) relative to Air (0±0 events/hour) and decreased heart rate (HR, -25±8 beats/min), whereas aerosols from all nicotine-containing e-liquids increased HR and decreased HRV, suggesting sympatho-excitation. However, these effects were significantly attenuated for Mango relative to Menthol and Va. Tobacco. As well, only PG:VG and Mango increased ventricular premature beats (VPBs, 9.6±3.7 and 5.5±1.2 events/hour, ±SEM) relative to Air (1.1±0.24 events/hour). VPBs correlated with changes in standard deviation of RR and mean HR from pre-exposure (Spearman’s r : 0.51 and -0.27, P < 0.0001). Prolonged repolarization (QTc) correlated with VPBs during exposures to PG:VG ( r = 0.38, P = 0.046), but not nicotine-containing e-liquids ( r = 0.15, P = 0.38). Conclusions: E-cigs may increase risk for cardiac arrhythmia through e-liquid solvents, which when thermally aerosolized generate toxic aldehydes and particulates. Nicotine and flavor chemicals may modify the cardiac and autonomic impacts of e-cigs. Further studies are needed to determine how e-cig aerosols induce cardiac arrhythmia and whether these effects translate to cardiac morbidity and mortality in humans.

Usefulness of cardiac screening in patients with systemic lupus erythematosus and anti-Ro/SSA antibodies

Lupus ◽  
2021 ◽  
pp. 096120332110279
Author(s):  
Roger Villuendas ◽  
Melania Martínez-Morillo ◽  
Gladys Juncà ◽  
Aina Teniente-Serra ◽  
Carles Diez ◽  
...  
Keyword(s):  
Heart Rate ◽  
Lupus Erythematosus ◽  
Holter Monitoring ◽  
Organ Damage ◽  
Cardiac Conduction ◽  
Systemic Lupus ◽  
Cardiac Screening ◽  
Cardiac Evaluation ◽  
Registration Number ◽  
Clinically Significant

Objectives Recent data suggest that some adult patients with autoimmune rheumatic diseases may develop cardiac conduction and repolarization abnormalities mediated by anti-Ro/SSA antibodies. We aim to investigate the utility of a cardiac screening in patients with systemic lupus erythematous (SLE) and anti-Ro/SSA positivity. Methods SLE patients who consecutively attended a Rheumatology clinic during 1 year where evaluated for the presence and levels of anti-Ro/SSA antibodies, and clinical and biological markers of organ damage and disease activity. All participants underwent a cardiovascular anamnesis and physical examination, ECG, echocardiography, and 24-hour Holter. Results Of the 145 recruited patients, 49 (32%) had anti-Ro/SSA positivity. None had any degree of atrioventricular block in the ECG or Holter monitoring. No significant differences were observed between anti-Ro/SSA–positive vs. negative patients in terms of PR, QRS or QTc intervals. No clinically significant arrhythmias were recorded during Holter monitoring and no differences in average heart rate, heart rate variability, or atrial or ventricular ectopy burden were observed. Finally, no differences were found in echocardiographic measurements. Conclusions In this study of SLE patients, anti-Ro/SSA positivity was not associated with significant alterations in ECG, echocardiography, or 24-hour Holter. These findings do not support ordinary cardiac evaluation in these patients. ( Clinicaltrials.gov registration number: NCT02162992).

Effects of physiological aging on cardiac electrophysiology in perfused Fischer 344 rat hearts

1992 ◽  
Vol 262 (1) ◽  
pp. H97-H105 ◽  
Author(s):  
O. Schmidlin ◽  
S. Bharati ◽  
M. Lev ◽  
J. B. Schwartz
Keyword(s):  
Heart Rate ◽  
Age Differences ◽  
Cardiac Electrophysiology ◽  
Histopathological Examination ◽  
Conduction Time ◽  
Fischer 344 Rats ◽  
Aging Effects ◽  
Middle Aged ◽  
Fischer 344 ◽  
Av Conduction

Aging effects on heart rate and atrioventricular (AV) conduction were studied in Langendorff-perfused hearts from 18 mature (4-6 mo), 12 middle-aged (12-14 mo), and 18 senescent (24-26 mo) Fischer 344 rats. Heart rate decreased with increasing age from 218 +/- 18 in mature to 196 +/- 27 (mean +/- SD) beats/min in middle-aged rats to 183 +/- 22 beats/min in senescent rats (analysis of variance, P less than 0.001). Spontaneous AV conduction time increased from 43 +/- 7 to 49 +/- 5 to 62 +/- 9 ms with aging (P less than 0.0001). Paced AV conduction time also lengthened with aging, and AV Wenckebach block cycle length increased from 122 +/- 10 to 133 +/- 9 to 152 +/- 16 ms (P less than 0.005). Intra-atrial conduction time was unaffected by age. Age differences in heart rate and AV conduction responses to isoproterenol (0.5 x 10(-9) to 1 x 10(-7) M) were noted with greater sensitivity at lower doses in hearts from younger rats. In separate experiments, 18 mature and 19 senescent Fischer 344 rats received reserpine (0.25 mg.kg-1.day-1 ip) for 6 days before study. Age differences in heart rate and AV conduction persisted (P less than 0.0001). Histopathological examination of AV nodal and His-bundle tissues in three hearts from each age group showed increased intercellular collagen with advancing age.(ABSTRACT TRUNCATED AT 250 WORDS)

scholarly journals Incidental Cardiac Arrhythmia Identification With Consumer Grade Heart Rate Monitors: A Case Study

2020 ◽  
Vol 52 (7S) ◽  
pp. 201-201
Author(s):  
Neal C. Phifer ◽  
Dale D. Brown ◽  
Kelly R. Laurson ◽  
Skip M. Williams ◽  
Emily Jones ◽  
...  
Keyword(s):  
Heart Rate ◽  
Cardiac Arrhythmia ◽  
Heart Rate Monitors

scholarly journals Shenxian-Shengmai Oral Liquid Improves Sinoatrial Node Dysfunction through the PKC/NOX-2 Signaling Pathway

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Heng Zhang ◽  
Miao Hao ◽  
Lingkang Li ◽  
Keyan Chen ◽  
Jing Qi ◽  
...  
Keyword(s):  
Heart Rate ◽  
Signaling Pathway ◽  
Sinoatrial Node ◽  
Cardiac Conduction ◽  
Potential Mechanism ◽  
Cardiac Syncope ◽  
Common Causes ◽  
Oral Liquid ◽  
Masson Staining

Sick sinus syndrome (SSS) is one of the common causes of cardiac syncope and sudden death; the occurrence of SSS is associated with the accumulation of ROS in the sinoatrial node (SAN). Shenxian-shengmai (SXSM) is a traditional Chinese medicine available as oral liquid that causes a significant increase in heart rate. The objective of this study is to observe the improvement of SXSM on SAN function in SSS mice and explore its potential mechanism. In the current study, SSS was simulated in mice by inducing SAN dysfunction using a micro-osmotic pump to inject angiotensin II (Ang II). The mouse model with SSS was used to determine the effect of SXSM on SAN function and to explore its potential mechanism. Furthermore, the HL-1 cell line, derived from mouse atrial myocytes, was used to simulate SAN pacemaker cells. Our results indicated that SXSM significantly increased the heart rate of SSS mice by reducing the AngII-induced accumulation of ROS in the SAN and by inhibiting the expression of HDAC4, thereby reducing the loss of HCN4, a critical component of the cardiac conduction system. MASSON staining revealed a reduction of SAN damage in SSS mice that were treated with SXSM compared with controls. In vitro experiments showed that AngII treatment caused an upregulation of the PKC/NOX-2 signaling pathway in HL-1 cells which could be prevented by pretreatment with SXSM. The protective effect of SXSM was attenuated upon treatment with the PCK agonist PMA. In conclusion, SXSM reduced the AngII-induced accumulation of ROS in the SAN through the PKC/NOX2 signaling pathway, improving the functioning of the SAN and preventing the decrease of heart rate in SSS mice.

Abstract P483: Healing a Broken Heart Using a Closed-loop, Allostatic, Neurotechnology: A Case Study in a Patient Suffering From Takotsubo Syndrome

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Charles H Tegeler ◽  
Catherine L Tegeler ◽  
Hossam A Shaltout
Keyword(s):  
Heart Rate ◽  
Closed Loop ◽  
Left Ventricular ◽  
Pharmacological Therapy ◽  
Stressful Event ◽  
Takotsubo Syndrome ◽  
Autonomic Balance ◽  
Open Label ◽  
Software Algorithms ◽  
Patient Reported

Background: Stress cardiomyopathy or Takotsubo syndrome (TS) is an acute, reversible disorder of the heart characterized by left ventricular dysfunction, usually triggered by a stressful event. Excessive sympathetic excitation and shift in symapthovagal balance are proposed as mechanisms. High-resolution, relational, resonance-based, electroencephalic mirroring (HIRREM®) is a noninvasive, closed-loop, allostatic, neurotechnology using software algorithms to identify specific brain frequencies, translating them in real time into audible tones, to support self-optimization of brain rhythms and improve autonomic balance. Objective: To evaluate benefits of HIRREM on autonomic function and symptom reduction in a 55 year old female enrolled in an IRB-approved open label feasibility study, after TS diagnosis. Results: The participant received 13 HIRREM sessions over 11 days (9 in office days). Data were collected before, and 21 days after HIRREM completion. Baseline brain patterns had prominent right dominance at temporal lobes (sympathetic pattern), which balanced by the end of the sessions. Cardiovascular autonomic balance also shifted away from sympathetic towards parasympathetic. This was seen as reduced LF/HF ratio (from 1.89 to 0.63), increased heart rate variability (rMSSD from 27 to 40.8 ms), and baroreflex sensitivity (from 11.8 to 24.4 ms/mmHg). Blood pressure dropped from 132/90 to 121/88 with no change in heart rate despite discontinuation of her ACE inhibitor medication due to her BP being “too low.” HIRREM use was also associated with clinically meaningful improvements in multiple symptom inventories including insomnia (ISI) from 15 to 6, depression (CES-D) from 16 to 2, anxiety (GAD-7) from 18 to 2, and perceived stress scale (PSS) from 30 to 14. The patient reported resolution of a feeling of heaviness and discomfort in the chest after starting HIRREM sessions. Conclusion: These data provide the first report of potential cardiovascular benefits of a non- pharmacological therapy to patients suffering from broken heart syndrome.

Dynamics of spectral components of heart rate variability during changes in autonomic balance

1998 ◽  
Vol 275 (1) ◽  
pp. H213-H219 ◽  
Author(s):  
Michael V. Højgaard ◽  
Niels-Henrik Holstein-Rathlou ◽  
Erik Agner ◽  
Jørgen K. Kanters
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Supine Position ◽  
Low Frequency ◽  
Power Spectral Analysis ◽  
Frequency Domain Analysis ◽  
Autonomic Balance ◽  
Power Spectral ◽  
Normalized Units ◽  
Semiquantitative Method

Frequency domain analysis of heart rate variability (HRV) has been proposed as a semiquantitative method for assessing activities in the autonomic nervous system. We examined whether absolute powers, normalized powers, and the low frequency-to-high frequency ratio (LF/HF) derived from the HRV power spectrum could detect shifts in autonomic balance in a setting with low sympathetic nervous tone. Healthy subjects were examined for 3 h in the supine position during 1) control conditions ( n = 12), 2) acute β-blockade ( n = 11), and 3) chronic β-blockade ( n = 10). Heart rate fell during the first 40 min of the control session (72 ± 2 to 64 ± 2 beats/min; P < 0.005) and was even lower during acute and chronic β-blockade (56 ± 2 beats/min; P < 0.005). The powers of all spectral areas rose during the first 60 min in all three settings, more so with β-blockade ( P < 0.05). LF/HF was found to contain the same information as powers expressed in normalized units. LF/HF detected the shift in autonomic balance induced by β-blockade but not the change induced by supine position. In conclusion, none of the investigated measures derived from power spectral analysis comprehensively and consistently described the changes in autonomic balance.

Heart Rate Turbulence after Ventricular and Atrial Premature Beats in Subjects without Structural Heart Disease

2003 ◽  
Vol 14 (5) ◽  
pp. 447-452 ◽  
Author(s):  
Kai S. Lindgren ◽  
Timo H. Mäkikallio ◽  
Tapio Seppänen ◽  
M.J. Pekka Raatikainen ◽  
Agustin Castellanos ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Disease ◽  
Structural Heart Disease ◽  
Heart Rate Turbulence ◽  
Premature Beats
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