Cardiac Autonomic Dysfunction and Risk of Sudden Unexpected Death in Epilepsy

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000011998
Author(s):  
William Szurhaj ◽  
Alexandre Leclancher ◽  
Anca Nica ◽  
Bertille Périn ◽  
Philippe Derambure ◽  
...  
Keyword(s):  
Heart Rate ◽  
Age At Onset ◽  
Sudden Unexpected Death ◽  
Autonomic Response ◽  
Control Group ◽  
Sympathetic Stimulation ◽  
Unexpected Death ◽  
Cardiac Autonomic Dysfunction ◽  
Patients At Risk ◽  
And Control

Objective:We aimed to test whether patients who died from sudden unexpected death in epilepsy (SUDEP) had an abnormal cardiac autonomic response to sympathetic stimulation by hyperventilation.Methods:We conducted a retrospective, observational, case-control study of a group of patients who died from SUDEP and controls who were matched with the patients for epilepsy type, drug resistance, sex, age at electroencephalogram recording, age at onset of epilepsy, and duration of epilepsy. We analyzed the heart rate (HR) and heart rate variability (HRV) at rest, during and after hyperventilation performed during the patient’s last electroencephalogram recording before SUDEP. In each group, changes over time in HRV indexes were analyzed using linear mixed models.Results:Twenty patients were included in each group. In the control group, the HR increased and the RMSSD decreased during the hyperventilation and then returned to the baseline values. In the SUDEP group, however, the HR and RMSSD did not change significantly during or after hyperventilation. A difference in HR between the end of the hyperventilation and 4 min after its end discriminated well between SUDEP patients and control patients (AUC: 0.870; sensitivity: 85%; specificity: 75%).Conclusion:Most of patients with subsequent SUDEP have an abnormal cardiac autonomic response to sympathetic stimulation through hyperventilation. An index reflecting the change in heart rate upon hyperventilation (dHRh) might be predictive of the risk of SUDEP and could be used to select patients at risk of SUDEP for inclusion in trials assessing protective measures.

scholarly journals Cardiac Parasympathetic Withdrawal and Sympathetic Activity: Effect of Heat Exposure on Heart Rate Variability

2021 ◽  
Vol 18 (11) ◽  
pp. 5934
Author(s):  
Oriol Abellán-Aynés ◽  
Pedro Manonelles ◽  
Fernando Alacid
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Environmental Conditions ◽  
Sympathetic Activity ◽  
Heat Exposure ◽  
Repeated Measurements ◽  
Control Group ◽  
Poincaré Plot ◽  
Activity Effect ◽  
And Control

(1) Background: Research on heart rate variability has increased in recent years and the temperature has not been controlled in some studies assessing repeated measurements. This study aimed to analyze how heart rate variability may change based on environmental temperature during measurement depending on parasympathetic and sympathetic activity variations. (2) Methods: A total of 22 volunteers participated in this study divided into an experimental (n = 12) and control group (n = 10). Each participant was assessed randomly under two different environmental conditions for the experimental group (19 °C and 35 °C) and two identical environmental conditions for the control group (19 °C). During the procedure, heart rate variability measurements were carried out for 10 min. (3) Results: Significantly changes were observed for time and frequency domains as well as Poincaré plot variables after heat exposure (p < 0.05). These findings were not observed in the control group, whose conditions between measurements did not change. (4) Conclusions: The reduction of heart rate variability due to exposure to hot conditions appears to be produced mostly by a parasympathetic withdrawal rather than a sympathetic activation. Therefore, if consecutive measurements have to be carried out, these should always be done under the same temperature conditions.

A SCIENTIFIC STUDY ON LOW AND MODERATE LEVEL OF INTENSE CIRCUIT TRAINING ON SELECTED PHYSIOLOGICAL PARAMETER AMONG ELITE FEMALE ATHLETES

2021 ◽  
pp. 62-63
Author(s):  
S. Shanthi
Keyword(s):  
Heart Rate ◽  
Female Athletes ◽  
Physiological Parameter ◽  
Control Group ◽  
Criterion Variable ◽  
Circuit Training ◽  
Post Test ◽  
Medium Level ◽  
And Control ◽  
Experimental Group

The purpose of the present study was to investigate the effect of a scientic study on low and medium level of intense circuit training on selected physiological parameter among elite female athletes. To achieve the purpose of the study thirty female athletes were selected from Erode District, Tamilnadu, India during the year 2021. The subject’s age ranges from 21 to 25 years. The selected subjects were divided into two equal groups consists of 15 subjects each namely experimental group and control group. The experimental group underwent a combined low and medium level of intensity circuit training programme for eight weeks. The control group was not taking part in any training during the course of the study. Resting heart rate was taken as criterion variable in this study. The selected subjects were tested on resting heart rate was measured through heart rate monitor. Pre-test was taken before the training period and post- test was measured immediately after the eight week training period. Statistical technique‘t’ ratio was used to analyse the means of the pre-test and post test data of experimental group and control group. The results revealed that there was a signicant difference found on the criterion variable. The difference is found due to combined low and medium level of intensity circuit training given to the experimental group on heart rate when compared to control group.

Increased heart rate accelerates norepinephrine washout from normal myocardium

1987 ◽  
Vol 253 (6) ◽  
pp. H1581-H1585 ◽  
Author(s):  
R. J. Henning ◽  
J. Cheng ◽  
A. M. Bhat ◽  
M. N. Levy
Keyword(s):  
Heart Rate ◽  
Ventricular Myocardium ◽  
Neuronal Uptake ◽  
Control Group ◽  
Inotropic Response ◽  
Sympathetic Stimulation ◽  
Uptake Mechanism ◽  
The Mean ◽  
Time Required ◽  
Experimental Group

We determined whether a change in heart rate affected the decay of the ventricular inotropic response to sympathetic stimulation in an experimental group and in a control group of anesthetized dogs. We induced complete heart block in each animal and paced the ventricles at rates of 90, 120, and 150 min-1 during two observation periods. In the experimental group, desipramine hydrochloride was given during the second period to block the neuronal uptake mechanism. The control animals did not receive desipramine during either period. The time required for the ventricular inotropic response to decay by 50% after cessation of a 2-min train of sympathetic stimulation was used as an index of the rate of norepinephrine washout from the myocardial interstitium. As we increased the pacing rate over the range of 90-150 min-1 in the experimental group, the mean decay half times (+/- SE) decreased by 36 +/- 4% (P less than 0.001) before desipramine and by 26 +/- 6% (P less than 0.001) in the presence of desipramine. These decrements in the decay half times were not significantly different from each other. The mean decay half times decreased by 36 +/- 4% (P less than 0.001) in the control dogs; the effects did not change appreciably from the first to the second observation period. We conclude that an increase in pacing frequency facilitates the washout of norepinephrine from the ventricular myocardium; this facilitation is equally pronounced regardless of whether the neuronal uptake mechanism is intact or suppressed.

scholarly journals Possible Use of Blood Tryptophan Metabolites as Biomarkers for Coronary Heart Disease in Sudden Unexpected Death

Metabolites ◽  
2019 ◽  
Vol 10 (1) ◽  
pp. 6 ◽  
Author(s):  
Kobchai Santisukwongchote ◽  
Yutti Amornlertwatana ◽  
Thanapat Sastraruji ◽  
Churdsak Jaikang
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Picolinic Acid ◽  
Sudden Unexpected Death ◽  
Control Group ◽  
Xanthurenic Acid ◽  
Unexpected Death ◽  
Tryptophan Metabolites ◽  
Hydroxyindoleacetic Acid ◽  
The Relationship

Coronary heart disease (CHD) is the major cause of death in sudden unexpected death (SUD) cases. Tryptophan (TRP) and its metabolites are correlated with the CHD patient but less studies in the SUD. The aim of this study was to evaluate the relationship of TRP and its metabolites with the CHD in the SUD cases. Blood samples and heart tissues were collected from CHD subjects (n = 31) and the control group (n = 72). Levels of kynurenine (KYN), kynurenic acid (KYA), xanthurenic acid (XAN), 3-hydroxyanthranillic acid (HAA), quinolinic acid (QA), picolinic acid (PA) and 5-hydroxyindoleacetic acid (HIAA) were determined by HPLC-DAD. A severity of heart occlusion was categorized into four groups, and the relationship was measured with the TRP metabolites. The HIAA and The KYN levels significantly differed (p < 0.01) between the CHD group and the control group. Lower levels of QA/XAN, PA/KA, HAA/XAN, KYN/XAN and KYN/TRP were found in the CHD group. However, PA/HAA, PA/HIAA, PA/KYN and XAN/KA values in the CHD group were higher than the control group (p < 0.05). This study revealed that the values of PA/KA and PA/HAA provided better choices for a CHD biomarker in postmortem bodies.

Do alterations in inter-ictal heart rate variability predict sudden unexpected death in epilepsy?

2009 ◽  
Vol 87 (2-3) ◽  
pp. 277-280 ◽  
Author(s):  
R. Surges ◽  
C. Henneberger ◽  
P. Adjei ◽  
C.A. Scott ◽  
J.W. Sander ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Sudden Unexpected Death ◽  
Unexpected Death

scholarly journals Health status in patients at risk of inherited arrhythmias and sudden unexpected death compared to the general population

2010 ◽  
Vol 11 (1) ◽  
Author(s):  
Anniken Hamang ◽  
Geir Egil Eide ◽  
Karin Nordin ◽  
Berit Rokne ◽  
Cathrine Bjorvatn ◽  
...  
Keyword(s):  
At Risk ◽  
Health Status ◽  
General Population ◽  
Sudden Unexpected Death ◽  
Unexpected Death ◽  
Patients At Risk ◽  
Inherited Arrhythmias

scholarly journals Efectos del entrenamiento cardiovagal en la respuesta autonómica en personas con sobrepeso (Effects of cardiovagal training on autonomic response in overweight people)

Retos ◽  
2019 ◽  
pp. 118-122
Author(s):  
Alexis Espinoza-Salinas ◽  
Jose González-Jurado ◽  
Arnaldo Burdiles-Alvarez ◽  
Giovanny Arenas-Sanchez ◽  
Marcelo Bobadilla
Keyword(s):  
Metabolic Disorders ◽  
Intervention Group ◽  
Autonomic Response ◽  
Control Group ◽  
Overweight People ◽  
Autonomic Changes ◽  
Increased Risk ◽  
Health Institutions ◽  
And Control ◽  
Los Grupos

La asociación entre la obesidad y un mayor riesgo de morbimortalidad cardiometabólica es un hecho, pero las alteraciones metabólicas provocan cambios autonómicos que no siempre son detectados en una institución de salud. Objetivo: Evidenciar el efecto de un protocolo interválico de alta intensidad sobre la actividad cardiovagal en personas con sobrepeso, evaluando por medio de la variabilidad de la frecuencia cardiaca. Método: Colaboraron 20 personas con sobrepeso, sin otros antecedentes mórbidos. Su edad fue de 24,6 ± 2,17 años; índice de masa corporal (IMC) de 27,11 ± 1,38 kg•m-2; presión arterial sistólica y diastólica de 126,4 ± 2,49 y de 86,1 ± 1,85 mmHg, respectivamente. El muestreo fue realizado por conveniencia. Se distribuyeron aleatoriamente en Grupo de intervención (GI, n=10) y Grupo de Control (GC, n=10). Resultados: Se registraron diferencias significativas entre los grupos, en los tiempos donde los valores de inicio son menores que a la sexta semana (F: 120,412; G.L.=1; 7; p= 0,003). Además, existe diferencia estadística entre el valor SD1 del GC > GE (F: 6,700; G.L.=1; 7; p= 0,036) y solamente en el GI, entre la 1 semana > 6 semana (EMMEANS =10,400; p=0,001). Conclusión: En seis semanas de intervención, con un protocolo de activación vagal, aumentó la modulación parasimpática en reposo en personas con sobrepeso.Summary. The association between obesity and an increased risk of cardiometabolic morbidity and mortality is a fact, but most of the time there are metabolic disorders that cause autonomic changes not always detected by health institutions. Objective: To demonstrate the effect of a high intensity and short duration interval protocol on cardiovagal activity in overweight people through the evaluation of heart rate variability. Method: a total of 20 overweight people without other morbid backgrounds collaborated in the study. Their age was 24.6 ± 2.17 years old; body mass index (BMI) of 27.11 ± 1.38 kg • m-2; systolic and diastolic blood pressure of 126.4 ± 2.49 and 86.1 ± 1.85 mmHg, respectively. Sampling was done by convenience. They were randomly distributed in Intervention Group (GI, n = 10) and Control Group (GC, n = 10). Results: Significant differences were registered between the groups, the starting values being lower than after sixth week (F: 120,412; G.L. = 1; 7; p = 0,003). In addition, there is a statistical difference between the SD1 value of the GC> GE (F: 6,700; GL = 1; 7; p = 0.036) and only in the GI, between 1 week> 6 weeks (EMMEANS = 10,400; p = 0.001). Conclusion: After the six-week intervention with a vagal activation protocol, parasympathetic modulation at rest increased in overweight people.

scholarly journals Meta-analysis of trimetazidine treatment for cardiomyopathy

2018 ◽  
Vol 38 (3) ◽  
Author(s):  
Qian Fan ◽  
Zhaozhuo Niu ◽  
Liqing Ma
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Publication Bias ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Cochrane Library ◽  
Control Group ◽  
Ventricular Ejection Fraction ◽  
And Control

To explore the effect of trimetazidine (TMZ) in cardiomyopathy treatment. Literatures, related with TMZ treatment for cardiomyopathy, were retrieved between 1990 and February 2018 in the Pubmed, Embase, and Cochrane Library systems. Cardiopulmonary exercise testing [resting heart rate (RHR), peak heart rate (PHR), peak systolic blood pressure (PSBP), and resting systolic blood pressure (RSBP)] and echocardiographic results [left ventricular ejection fraction (LVEF), left ventricular end-systolic volume (LVESV), left ventricular end-diastolic volume (LVEDV), systolic wall thickening score index (SWTSI), left ventricular end-systolic diameter (LVESD), and left ventricular end-diastolic diameter (LVEDD)] were merged to detect the publication bias. Total 898 patients with cardiomyopathy were divided into two groups: TMZ-treated group (n=456) and control group (n=442). There was no difference in the improvement of cardiomyopathy between the TMZ and control group. No publication bias was shown for PHR (t= 0.9791, P=0.5067). There were significant differences in LVEF, LVESV, SWTSI, LVESD, and LVEDD between the TMZ group and the control group. TMZ-treatment significantly increased the level of LVEF (95% confidence interval (CI): 5.46–7.84, P<0.001), and reduced the level of LVESV (95% CI: −18.73 to −7.77, P<0.001), SWTSI (95% CI: −0.47 to −0.15, Z = −3.85, P=0.001), LVESD (95% CI: −1.09 to −0.08, P<0.001), and LVEDD (95% CI: −0.55 to −0.26, P=0.023). There was no publication bias except for LVEDV (t = 2.5456, P=0.0438). TMZ is effective for cardiomyopathy treatment and worth to popularize in clinic.

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