scholarly journals Rescue Operations Lead to Increased Cardiovascular Stress in HEMS Crew Members: A Prospective Pilot Study of a German HEMS Cohort

2021 ◽  
Vol 10 (8) ◽  
pp. 1602
Author(s):  
Markus Strauss ◽  
Janosch Dahmen ◽  
Sophia Hutter ◽  
Marko Brade ◽  
Roman Leischik
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cardiovascular System ◽  
Helicopter Emergency Medical Service ◽  
Stress Profile ◽  
Maximal Heart Rate ◽  
Cardiac Events ◽  
Rescue Operation ◽  
Cardiovascular Stress ◽  
The Difference

Helicopter emergency medical service (HEMS) is an essential part of prehospital emergency medicine. The working conditions lead to high physical stress, especially in rescue operations. The study aimed to determine the cardiovascular stress profile during rescue situations in HEMS crew members. Twenty-one HEMS crew members (male n = 20) participated in the prospective study. Heart rate, blood pressure and long-term ECG measurements were recorded during the whole operation day. The changes of measurements during rescue operation (52 operations in total) were compared to these of standby time. Rescue operations lead to increased load on the cardiovascular system, as expressed by significantly higher blood pressure, heart rate values and rate of cardiac events compared to standby time. Of special note, the difference in systolic blood pressure mean was 7.4 ± 9.0 mmHg (CI [5.1; 9.7], p < 0.001). Maximal heart rate was on average 33.7 bpm higher during rescue operation than in the standby time (CI [26.2; 40.8], p < 0.001). Cardiac events occurred significantly more frequently during the period of rescue operation than in standby time hours (p = 0.02). The results reported a significant load on the cardiovascular system during rescue operations in HEMS crew members. Therefore, it is necessary to carry out a risk stratification of the HEMS crew members to prevent cardiovascular risk and events.

Rescue operations lead to increased cardiovascular stress in HEMS Crew Members - A prospective pilot study of a German HEMS cohort

2020 ◽  
Author(s):  
Markus Strauss ◽  
Janosch Dahmen ◽  
Sophia Hutter ◽  
Marko Brade ◽  
Roman Leischik
Keyword(s):  
Blood Pressure ◽  
Cardiovascular System ◽  
Significant Risk ◽  
Stress Profile ◽  
Cardiac Events ◽  
Rescue Operation ◽  
Rescue Service ◽  
Cardiovascular Stress ◽  
Prehospital Emergency ◽  
The Difference

Abstract BackgroundHelicopter emergency medical service (HEMS) is an important part of prehospital emergency medicine. The working conditions lead to high physical stress, especially in rescue operations. To date, little is known about the cardiovascular stress of HEMS crew members in the rescue service. Examinations of professional groups in public security have shown a significant risk in these. The present study aims to determine the cardiovascular stress profile during rescue situations in HEMS crew members.MethodsA total number of 21 (male n=20) HEMS crew members (11 emergency physicians and 10 paramedics) participated in the prospective study. Heart rate (HR), blood pressure (BP) and long-term ECG measurements were recorded at the whole operation day. The changes of measurements during rescue operation (in total 52 operations) were compared to these of standby time.ResultsRescue operations lead to increased load on the cardiovascular system. Expression of this is significantly higher BP, HR values and rate of cardiac events compared to standby time. Significantly higher of both, mean and maximal, diastolic and systolic blood pressure were measured on duty. Especially the difference in BP sys mean is 7.4 ± 9.0 mmHg (7.4, CI [5.1; 9.7], p <0.001). HR minimal, mean and maximal were also significantly higher during rescue operations. HR max was 33.7 bpm higher on average than in the standby time (CI [26.2; 40.8], p <0.001). Cardiac events occurred significantly more frequently during the period of rescue operation than in standby time hours (time volume of 1 hour, p = 0.02).ConclusionsThe results show a significant load on the cardiovascular system during rescue operations in HEMS crew members. This is expressed in a higher occurrence of extrasystoles, HR and BP values during rescue operation than on standby time. Therefore, it is important to carry out a risk stratification of the personnel deployed in the HEMS crew members to prevent cardiovascular risk and events.

The Effects of a Caffeine Placebo and Experimenter Expectation on Blood Pressure, Heart Rate, Well-Being, and Cognitive Performance

2001 ◽  
Vol 6 (1) ◽  
pp. 15-25 ◽  
Author(s):  
Harald Walach ◽  
Stefan Schmidt ◽  
Yvonne-Michelle Bihr ◽  
Susanne Wiesch
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cognitive Task ◽  
Well Being ◽  
Control Group ◽  
Double Blind ◽  
Main Effect ◽  
The Difference ◽  
Being There ◽  
To Receive

We studied the effect of experimenter expectations and different instructions in a balanced placebo design. 157 subjects were randomized into a 2 × 4 factorial design. Two experimenters were led to expect placebos either to produce physiological effects or not (pro- vs. antiplacebo). All subjects except a control group received a caffeine placebo. They were either made to expect coffee, no coffee, or were in a double-blind condition. Dependent measures were blood pressure, heart rate, well-being, and a cognitive task. There was one main effect on the instruction factor (p = 0.03) with the group “told no caffeine” reporting significantly better well-being. There was one main effect on the experimenter factor with subjects instructed by experimenter “proplacebo” having higher systolic blood pressure (p = 0.008). There was one interaction with subjects instructed by experimenter “proplacebo” to receive coffee doing worse in the cognitive task than the rest. Subjects instructed by experimenter “antiplacebo” were significantly less likely to believe the experimental instruction, and that mostly if they had been instructed to receive coffee. Contrary to the literature we could not show an effect of instruction, but there was an effect of experimenters. It is likely, however, that these experimenter effects were not due to experimental manipulations, but to the difference in personalities.

Bifurcation in a Simple Model of the Cardiovascular System

2000 ◽  
Vol 39 (02) ◽  
pp. 118-121 ◽  
Author(s):  
S. Akselrod ◽  
S. Eyal
Keyword(s):  
Nonlinear Dynamics ◽  
Blood Pressure ◽  
Heart Rate ◽  
Fixed Point ◽  
Cardiovascular System ◽  
Modified Model ◽  
Mayer Waves ◽  
Sustained Oscillations ◽  
Human Cardiovascular System ◽  
Physiological Values

Abstract:A simple nonlinear beat-to-beat model of the human cardiovascular system has been studied. The model, introduced by DeBoer et al. was a simplified linearized version. We present a modified model which allows to investigate the nonlinear dynamics of the cardiovascular system. We found that an increase in the -sympathetic gain, via a Hopf bifurcation, leads to sustained oscillations both in heart rate and blood pressure variables at about 0.1 Hz (Mayer waves). Similar oscillations were observed when increasing the -sympathetic gain or decreasing the vagal gain. Further changes of the gains, even beyond reasonable physiological values, did not reveal another bifurcation. The dynamics observed were thus either fixed point or limit cycle. Introducing respiration into the model showed entrainment between the respiration frequency and the Mayer waves.

Cardiovascular Responses to Muscle Stretching: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Ewan Thomas ◽  
Marianna Bellafiore ◽  
Ambra Gentile ◽  
Antonio Paoli ◽  
Antonio Palma ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cardiovascular System ◽  
Vascular Function ◽  
Meta Analysis ◽  
Random Effect ◽  
Cardiovascular Responses ◽  
Qualitative Description ◽  
Cross Sectional ◽  
Quantitative Synthesis

AbstractThe aim of this study will be to review the current body of literature to understand the effects of stretching on the responses of the cardiovascular system. A literature search was performed using the following databases: Scopus, NLM Pubmed and ScienceDirect. Studies regarding the effects of stretching on responses of the cardiovascular system were investigated. Outcomes regarded heart rate(HR), blood pressure, pulse wave velocity (PWV of which baPWV for brachial-ankle and cfPWV for carotid-femoral waveforms), heart rate variability and endothelial vascular function. Subsequently, the effects of each outcome were quantitatively synthetized using meta-analytic synthesis with random-effect models. A total of 16 studies were considered eligible and included in the quantitative synthesis. Groups were also stratified according to cross-sectional or longitudinal stretching interventions. Quality assessment through the NHLBI tools observed a “fair-to-good” quality of the studies. The meta-analytic synthesis showed a significant effect of d=0.38 concerning HR, d=2.04 regarding baPWV and d=0.46 for cfPWV. Stretching significantly reduces arterial stiffness and HR. The qualitative description of the studies was also supported by the meta-analytic synthesis. No adverse effects were reported, after stretching, in patients affected by cardiovascular disease on blood pressure. There is a lack of studies regarding vascular adaptations to stretching.

Abstract P319: Association of Heart Rate Reserve with Incidence of Hypertension in Men

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Vivek K Prasad ◽  
Gregory A Hand ◽  
Mei Sui ◽  
Duck C Lee ◽  
Deepika Shrestha ◽  
...  
Keyword(s):  
Heart Rate ◽  
Exercise Test ◽  
Heavy Drinking ◽  
Risk Groups ◽  
Hazard Ratio ◽  
Maximal Heart Rate ◽  
Heart Rate Reserve ◽  
Incident Hypertension ◽  
The Difference ◽  
Design And Methods

Abstract Objectives— We examined the association between heart rate reserve (HRR) and incident hypertension in men in the Aerobics Center Longitudinal Study. Research design and Methods— A total of 10418 healthy normotensive men, who did not have an abnormal electrocardiogram or a history of heart attack, stroke, cancer, or diabetes, performed a maximal treadmill exercise test and were followed for the incidence of hypertension. HRR was defined as the difference between maximal heart rate during exercise test and resting heart rate. Results— During a mean follow-up of 6 years, there were 2831 cases of incident hypertension. Compared with men in the reference category (the lowest quartile of HRR), the risk of incident hypertension was significantly lower in the highest quartile of HRR with a hazard ratio 0.67 (95% CI: 0.60-0.75) when adjusted for age and baseline examination year. Further adjustment for smoking, heavy drinking, body mass index (BMI), resting systolic and diastolic blood pressure, cholesterol, blood glucose and cardio respiratory fitness, resulted a hazard ratio of 0.84 (95% CI:0.74-0.95). This result was almost similar when we stratified them into younger and older men with hazard ratio of 0.77(95% CI: 0.62-0.98) and 0.78 (95% CI: 0.66-0.90) respectively. We also found a significant lower hypertension risk associated with higher HRR among high risk groups such as overweight, low fitness, or prehypertension with hazard ratio of 0.82(95% CI:0.70-0.97), 0.80(95% CI:0.67-0.96), 0.76(95% CI:0.64-0.88) respectively. Conclusion— Risk of Incident hypertension was significantly lower in men with higher HRR. High HRR was also associated with lower risk of developing hypertension irrespective of age and status of risk factors such as high BMI, low fitness and prehypertension. Therefore, HRR may be considered as a reliable exercise parameter for predicting the risk of incident hypertension.

scholarly journals Autonomic cardiovascular response during and after a graded exercise test in concussed athletes and healthy controls

2021 ◽  
Vol 5 ◽  
pp. 205970022110448
Author(s):  
Alessandra Ventura ◽  
Fausto Romano ◽  
Mario Bizzini ◽  
Antonella Palla ◽  
Nina Feddermann
Keyword(s):  
Heart Rate ◽  
Cardiovascular System ◽  
Exercise Test ◽  
Cardiovascular Response ◽  
Heart Rate Recovery ◽  
Exercise Intolerance ◽  
Maximal Heart Rate ◽  
Healthy Controls ◽  
Graded Exercise Test ◽  
Graded Exercise

Objective Dysfunction of the autonomic cardiovascular system after a concussion is known to cause exercise intolerance due to symptoms exacerbation. The aim of this study was to compare athletes with symptoms of a sport-related concussion and healthy controls with regard to their heart rate during a graded exercise test and their heart rate recovery during the 5 min cool-down after the graded exercise test. Methods Sport-related concussion patients ( N = 61; 31% female) and controls ( N = 16; 50% female) participated in a graded exercise test on a cycle ergometer followed by 5 min active cool-down. Based on the results of graded exercise tests they were divided into four groups: (1) patients who reached the symptom threshold and had to stop the graded exercise test (symptom threshold; N = 39; 33.3% female), (2) patients with symptoms who finished the graded exercise test (S; N = 16; 25% female), (3) patients without symptoms (NS; N = 6; 33.3% female), (4) controls ( N = 16; 50% female). Main outcome measures Heart rate, severity of headache and dizziness during graded exercise test, heart rate recovery (median (heart rate recoveries/maximal heart rate) ± median absolute deviation (MAD)) 30, 60 and 300 s after the start of cool-down. Results Heart rate recovery at 30 s was significantly slower in symptom (0.95 ± 0.01) compared to all other groups ( p < 0.002; symptom threshold: 0.92 ± 0.02, NS: 0.91 ± 0.02, controls: 0.93 ± 0.02). Heart rate recovery at 60 s was significantly slower in symptom (0.90 ± 0.02) compared to the symptom threshold and controls ( p < 0.041; 0.86 ± 0.03, 0.85 ± 0.04). Heart rate recovery at 300 s was significantly slower in symptom threshold (0.72 ± 0.05) compared to controls ( p = 0.003; 0.66 ± 0.02). Conclusions Heart rate measurements in athletes with symptoms of sport-related concussion should be continued during cool-down after the graded exercise test, as dysfunction of the autonomic cardiovascular system might manifest also during cool-down.

scholarly journals Rhythmic Breath Holding and Its Effect on Arterial Blood Pressure and Its Correlation With Blood Gases

2020 ◽  
Author(s):  
Bharti Bhandari ◽  
Manisha Mavai ◽  
Yogendra Raj Singh ◽  
Bharati Mehta ◽  
Omlata Bhagat
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cardiovascular System ◽  
Arterial Blood Pressure ◽  
Blood Gases ◽  
Total Power ◽  
Breath Holding ◽  
Single Episode ◽  
Arterial Blood ◽  
Maximum Inspiration

A single episode of breath-holding (BH) is known to elevate the blood pressure, and regular breathing exercise lowers the blood pressure. This prompted us to investigate how a series of BH epochs would affect the cardiovascular system. To observe arterial blood pressure (ABP) and heart rate (HR) changes associated with a series of “BH epochs” following maximum inspiration and maximum expiration and find the underlying mechanisms for the change by autonomic activity. Thirty-five healthy young adults were instructed to hold their breath repetitively, for 5 minutes, in two patterns, one following maximum inspiration and other following maximum expiration. ABP and ECG (for Heart Rate Variability) were continuously recorded at rest and during both the maneuvers. Capillary blood gases (BG) were zanalyzed at baseline and at the breakpoint of the last epoch of BH. ABP rose significantly at the breakpoint during both the maneuvers. No change in HR was observed. There was significant fall in PO2 from 94.7 (4.1) mmHg at baseline to 79.1 (9.0) mmHg during inspiratory and 76.90 (12.1) mmHg during expiratory BH. Similarly, SPO2 decreased from 96.3 (1.9) % at baseline to 95.4 (1.5) % and 94.5 (2.7) % during inspiratory and expiratory BH, respectively. Rise in PCO2 from 39.5(3.1) mmHg at baseline to 42.9 (2.7) mmHg and 42.1 (2.8) mmHg during inspiratory and expiratory BH respectively was observed. There was no significant correlation between blood gases and arterial blood pressure. Among HRV parameters, a significant decrease in SDNN, RMSSD, HFnu, total power and SD1/SD2 and the significant increase in LFnu, LF/HF and SD2 were observed during both BH patterns. Rhythmic BH patterns affect the cardiovascular system in similar way as a single episode of BH. Sympathetic overactivity could be the postulated mechanism for the same. © 2019 Tehran University of Medical Sciences. All rights reserved. Acta Med Iran 2019;57(8):492-498.

scholarly journals Predictors of the development of cardiac arrhythmias in women after induction of superovulation in vitro fertilization

2020 ◽  
Vol 10 (5) ◽  
pp. 57-65
Author(s):  
Victoria V. Vakareva ◽  
Marina V. Avdeeva ◽  
Larisa V. Scheglova ◽  
Sergey A. Bondarev ◽  
Pavel B. Voronkov
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cardiovascular System ◽  
Functional State ◽  
Blood Pressure Monitoring ◽  
Myocardial Oxygen Demand ◽  
Heart Rate Variability Analysis ◽  
Supraventricular Arrhythmias ◽  
Rate Profile

The article presents the results of a clinical and instrumental examination of 80 healthy women (average age 32,313,57 years) in order to assess the heart rhythm disturbances after induction of superovulation duringin vitrofertilization. All women were examined twice before and after induction of superovulation during extracorporeal fertilization. Clinical and instrumental examination included: electrocardiography at rest; echocardiography; 24-hour ECG monitoring with heart rate variability analysis; 24-hour blood pressure monitoring. Induction of superovulation is associated with a significant increase in mean daily HR max (р0,01), and consequently with an increase in myocardial oxygen demand. It has been established that induction of superovulation contributes to the development of supraventricular arrhythmias (р0,01) and an increase in episodes of apnea/hypnea (р0,01). Regression analysis revealed predictors of supraventricular arrhythmias after induction of superovulation, including adverse circadian heart rate profile, adverse circadian blood pressure profile, impaired autonomic regulation of heart activity (р0,01). It was shown that the appearance of rhythm disturbances is associated with both the initial functional state of the cardiovascular system and its response to the induction of superovulation. It was established a correlation between the estradiol concentration and the increase of daily average heart rate after induction of superovulation (r=0,30,р0,05), apnea/hypnea index after induction of superovulation (r=0,34,р0,05). Conclusion. Superovulation induction may exacerbate existing chronic cardiovascular diseases. Due to the adverse effect of superovulation induction on the daily heart rate profile, women need to evaluate the functional state of the cardiovascular system duringinvitrofertilization planning. This will prepare the woman for the upcoming procedure and avoid adverse reactions from the cardiovascular system in response to stimulation of superovulationin vitrofertilization.

scholarly journals Cardiac parameters during the estrous cycle of canine bitches

2017 ◽  
Vol 37 (3) ◽  
pp. 295-299 ◽  
Author(s):  
Rute C.A. de Souza ◽  
Regiane Peres ◽  
Marlos G. Sousa ◽  
Aparecido A. Camacho
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Nervous System ◽  
Estrous Cycle ◽  
Cardiac Rhythm ◽  
Gradual Increase ◽  
Maximal Heart Rate ◽  
Group I ◽  
Mean Heart Rate ◽  
Prospective Investigation

ABSTRACT: The cardiovascular parameters of canine bitches were assessed during the estrous cycle. A total of eleven mongrel female dogs were enrolled in a longitudinal prospective investigation. Six animals were bred during the study and were assigned into group I, in which evaluations were performed during proestrus, estrus, gestational diestrus and anestrus. The five remaining bitches were not bred and underwent evaluations during proestrus, estrus, nongestational diestrus and anestrus. The holter data showed a gradual increase in the minimum and mean heart rate along pregnancy, as well as a reduction during anestrus, which differed significantly among the distinct periods. The values for maximal heart rate documented during pregnancy were significantly lower than those recorded during anestrus, and a variation in the heart rate circadian rhythm was also found, as demonstrated by decreases at night and rises during the day. Cardiac rhythm had a similar performance in both pregnancy and anestrus. Likewise, the blood pressure, electrocardiography, and echocardiography data did not vary during the estrous cycle. The results support the role played by the autonomic nervous system during these two distinct periods in order to attain a heart rate that provides the blood needed by the female’s body during the various stages of the reproductive cycle. Further studies are needed to better clarify the cardiovascular compensatory neuroendocrine events that accompany gestation in this species.

scholarly journals Maximal Heart Rate for Swimmers

Sports ◽  
2019 ◽  
Vol 7 (11) ◽  
pp. 235 ◽  
Author(s):  
Bjørn Harald Olstad ◽  
Veronica Bjørlykke ◽  
Daniela Schäfer Olstad
Keyword(s):  
Body Mass Index ◽  
Heart Rate ◽  
Step Test ◽  
Maximal Heart Rate ◽  
Test Protocol ◽  
Front Crawl ◽  
Running Training ◽  
Elite Swimmers ◽  
Rate Test ◽  
The Difference

The main purpose of this study was to identify whether a different protocol to achieve maximal heart rate should be used in sprinters when compared to middle-distance swimmers. As incorporating running training into swim training is gaining increased popularity, a secondary aim was to determine the difference in maximal heart rate between front crawl swimming and running among elite swimmers. Twelve elite swimmers (4 female and 8 male, 7 sprinters and 5 middle-distance, age 18.8 years and body mass index 22.9 kg/m2) swam three different maximal heart rate protocols using a 50 m, 100 m and 200 m step-test protocol followed by a maximal heart rate test in running. There were no differences in maximal heart rate between sprinters and middle-distance swimmers in each of the swimming protocols or between land and water (all p ≥ 0.05). There were no significant differences in maximal heart rate beats-per-minute (bpm) between the 200 m (mean ± SD; 192.0 ± 6.9 bpm), 100 m (190.8 ± 8.3 bpm) or 50 m protocol (191.9 ± 8.4 bpm). Maximal heart rate was 6.7 ± 5.3 bpm lower for swimming compared to running (199.9 ± 8.9 bpm for running; p = 0.015). We conclude that all reported step-test protocols were suitable for achieving maximal heart rate during front crawl swimming and suggest that no separate protocol is needed for swimmers specialized on sprint or middle-distance. Further, we suggest conducting sport-specific maximal heart rate tests for different sports that are targeted to improve the aerobic capacity among the elite swimmers of today.

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