Assessment of Cardiovascular Autonomic Function in Patients with Liver Cirrhosis Using Heart Rate Variability, Blood Pressure Variability and Baroreflex Sensitivity

Abstract Introduction Insomnia is a risk factor for hypertension and cardiovascular events, and this association is strongest for sleep-onset insomnia. However, little is known about insomnia on cardiovascular modulation, especially soon after morning awakening, the peak period of time for cardiovascular incidents. This study explored morning cardiovascular function in individuals with sleep-onset insomnia by analysing heart rate variability, blood pressure variability, and baroreflex sensitivity. Methods Sleep structure of the participants (15 good sleepers and 13 individuals with sleep-onset insomnia) was measured by laboratory polysomnography, followed by continuous recordings of the participant’s blood pressure and heart rate for 10 min in the morning. Results When compared to the good sleepers, the insomnia group showed significant reductions in total sleep time, a longer sleep-onset latency, and reduced sleep efficiency. The sleep structure, including durations of sleep stages, numbers of awakenings and arousal index did not differ between the groups. After morning awakening (averaged time: 12.33 ± 10.48 min), the shorter R-R intervals, lower total power, and lower high-frequency power of heart rate variability were observed among individuals with sleep-onset insomnia, compared with good sleepers. Elevated slopes of systolic and diastolic blood pressure, as well as lower baroreflex sensitivity, were also shown in the insomnia group. Indices of sympathetic activity, including low-frequency percentage of heart rate variability or low-frequency power of blood pressure variability, did not differ between the groups. Conclusion Weak vagal activity and blunted baroreflex sensitivity were evident among sleep-onset insomnia. These findings indicate difficulty in initiating sleep, without significant sleep fragmentation, can independently affect morning cardiovascular function. This study provides a possible link between sleep-onset insomnia and risk of cardiovascular events. Support N/A

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Abstract WP301: Noninvasive Beat-to-Beat Assessment of Blood Pressure Variability, Heart Rate Variability and Baroreflex Sensitivity: Which Parameters Best Predict Clinical Outcome After Acute Ischemic Stroke?

Stroke ◽

10.1161/str.47.suppl_1.wp301 ◽

2016 ◽

Vol 47 (suppl_1) ◽

Author(s):

Li Xiong ◽

Ge Tian ◽

Xiangyan Chen ◽

Howan Leung ◽

Thomas Leung ◽

...

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Heart Rate Variability ◽

Ischemic Stroke ◽

Clinical Outcome ◽

Blood Pressure Variability ◽

Baroreflex Sensitivity ◽

Low Frequency ◽

Prognostic Information ◽

Power Spectral

Background and Objectives: Blood pressure variability (BPV), heart rate variability (HRV) and baroreflex sensitivity (BRS) as measures of autonomic function might provide prognostic information in ischemic stroke. We aimed to study noninvasive beat-to-beat assessment of BPV, HRV and BRS in the acute phase of ischemic stroke to determine whether any of them predicted clinical outcome. Methods & Patients: Consecutive ischemic stroke patients within 7 days of symptom onset were enrolled. The frequency components of BPV and HRV by means of power spectral analysis [very low frequency (VLF; < 0.04 Hz); low frequency (LF; 0.04-0.15 Hz); high frequency (HF; 0.15-0.40 Hz); power spectral density (PSD; <0.40 Hz) and LF/HF ratio] were calculated from 10-minute recordings of beat-to-beat blood pressure and heart rate monitoring. The baroreflex slope and baroreflex effectiveness index (BEI) were determined using the sequence method for BRS. Clinical outcome was assessed at 3 months after stroke onset as good or poor by modified Rankin Scale (mRS) (good outcome, mRS ≤ 2). Results: 82 patients were recruited (mean age, 64.6 ± 9.9 years; 89.3% males). Univariate analysis showed that there were significant differences in National Institutes of Health Stroke Scale (NIHSS) at recruitment, VLF diastolic BPV, VLF, HF and PSD systolic BPV, and down ramp BEI between the good and poor outcome groups (all P < 0.05). After adjusting for NIHSS, multivariate logistic regression showed that only HF systolic BPV (OR 1.320; 95% CI, 1.050-1.659; P=0.017) and down BEI (OR 0.950; 95% CI, 0.912-0.990; P=0.014) were independently correlated with poor functional outcome. Conclusions: Beat-to beat highly variable systolic blood pressure and impaired BRS as evaluated by decreased down BEI are associated with an unfavorable functional outcome after acute ischemic stroke. Important prognostic information can be readily obtained from a short period of noninvasive hemodynamics monitoring in the acute stroke patient.

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Effect of anaesthetic and choice of neuromuscular blocker on vagal control of heart rate under laboratory animal experimental conditions

Laboratory Animals ◽

10.1177/0023677217725365 ◽

2017 ◽

Vol 52 (3) ◽

pp. 280-291

Author(s):

Divya Sarma Kandukuri ◽

Jacqueline K Phillips ◽

Mark Tahmindjis ◽

Cara M Hildreth

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Heart Rate Variability ◽

Laboratory Animal ◽

Baroreflex Sensitivity ◽

Autonomic Function ◽

Neuromuscular Blocking ◽

Neuromuscular Blocking Agents ◽

Isoflurane Anaesthesia ◽

Blocking Agents

Neuromuscular-blocking agents are commonly used in laboratory animal research settings. Due to actions of cholinergic receptors at locations other than the motor end-plate, these agents have a strong propensity to modulate autonomic outflow and may therefore not be desirable in studies examining autonomic function. This study aimed to compare the effect of two non-depolarizing neuromuscular-blocking agents, pancuronium and cisatracurium, on blood pressure, heart rate and non-invasive indices of autonomic function (heart rate variability, systolic blood pressure variability and baroreflex sensitivity) under two different types of anaesthesia in Lewis rats. Pancuronium produced a profound vagolytic response characterized by tachycardia, reduction in heart rate variability and baroreflex sensitivity under urethane anaesthesia, and with minimal effect under isoflurane anaesthesia. Conversely, cisatracurium produced no evidence of vagolytic action under either urethane or isoflurane anaesthesia. Therefore, for studies interested in examining autonomic function, particularly baroreflex or vagal function, neuromuscular blockade would be best achieved using cisatracurium.

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Racial Differences in Blood Pressure Variability, Baroreflex Sensitivity and Heart Rate Variability Following Maximal Exercise

The FASEB Journal ◽

10.1096/fasebj.27.1_supplement.926.2 ◽

2013 ◽

Vol 27 (S1) ◽

Author(s):

Rebecca M Kappus ◽

Sushant M Ranadive ◽

Huimin Yan ◽

Abbi D Lane ◽

Marc D Cook ◽

...

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Heart Rate Variability ◽

Racial Differences ◽

Blood Pressure Variability ◽

Baroreflex Sensitivity ◽

Maximal Exercise

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Anesthesia and autonomic nervous system: is measurement of heart rate variability, blood pressure variability and baroreflex sensitivity useful in anesthesiology specialty?

Korean Journal of Anesthesiology ◽

10.4097/kjae.2008.55.3.265 ◽

2008 ◽

Vol 55 (3) ◽

pp. 265 ◽

Cited By ~ 2

Author(s):

Gyu Sam Hwang

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Heart Rate Variability ◽

Nervous System ◽

Autonomic Nervous System ◽

Blood Pressure Variability ◽

Baroreflex Sensitivity ◽

Autonomic Nervous

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Stroke Outcome Prediction by Blood Pressure Variability, Heart Rate Variability, and Baroreflex Sensitivity

Stroke ◽

10.1161/strokeaha.119.027981 ◽

2020 ◽

Vol 51 (4) ◽

pp. 1317-1320 ◽

Cited By ~ 1

Author(s):

Shujin Tang ◽

Li Xiong ◽

Yuhua Fan ◽

Vincent C.T. Mok ◽

Ka Sing Wong ◽

...

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Heart Rate Variability ◽

Blood Pressure Variability ◽

Baroreflex Sensitivity ◽

Outcome Prediction ◽

Stroke Outcome

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A study of short term heart rate variability in dipping tobacco users

Asian Journal of Medical Sciences ◽

10.3126/ajms.v5i3.9588 ◽

2014 ◽

Vol 5 (3) ◽

pp. 91-94 ◽

Cited By ~ 1

Author(s):

M.I.Glad Mohesh ◽

K Ratchagan ◽

A Sundaramurthy

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Heart Rate Variability ◽

Smokeless Tobacco ◽

Autonomic Function ◽

Statistical Significance ◽

Medical Science ◽

Short Term ◽

Cardiovascular Autonomic Function ◽

Hrv Analysis

Background: WHO (2010) reported the rise in the number of smokeless tobacco users in India. Dipping tobacco is a form of smokeless tobacco being used in these region in various trade names. Nicotine in smoking tobacco is found to alter the cardiovascular autonomic functions. As the expected cardiovascular mortality due to tobacco use across the globe is very high, here we studied the effect of dipping tobacco on cardiovascular autonomic function using the short term heart rate variability (HRV) analysis. Methods: Five minutes Lead II ECG at rest is aquired from male dipping tobacco moderate users (n=30) and age matched controls (n=30). Frequency and time domain parameters were derived and analysed using the Kubios HRV analysis software. Blood pressure changes were also compared. Unpaired ‘t’ test was done using SPSS 17.0 and statistical significance was set at p<0.05. Results: Significant changes in certain parameters indicated that there is a developing set back in the sympathetic control over the heart (LF, 383.8+115.8, 952.8+131.1, p<0.01) and also an established increase in diastolic blood pressure (73.1+2.8, 65.48+1.5, p<0.01). Conclusion: Dipping tobacco a form of smokeless tobacco is equally harmful like any smoked tobacco in altering the cardiovascular autonomic function. Thereby the increase in smokeless tobacco users in India or any country is going to add up more to the mortality rate due to tobacco related diseases in near future as estimated by WHO. An immediate measure to stop the production, sale and use of these smokeless tobacco products could curb this menace. Asian Journal of Medical Science, Volume-5(3) 2014: 91-94 http://dx.doi.org/10.3126/ajms.v5i3.9588

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