A Case Report on Heart Rate Variability Biofeedback and Postconcussion Syndrome: Healing the Autonomic Nervous System

Postconcussion syndrome is a devastating condition of the mind, body, and even personality. Mounting research demonstrates that heart rate variability biofeedback can help the concussed individual in three critical ways: (a) eliciting high amplitude oscillations in cardiovascular functions and thereby strengthening self-regulatory control mechanisms; (b) restoring autonomic balance; and (c) increasing the afferent impulse stream from the baroreceptors to restore balance between inhibitory and excitatory processes in the brain.

Urocortin Role in Ischemia Cardioprotection and the Adverse Cardiac Remodeling

Despite the considerable progress in strategies of myocardial protection, ischemic heart diseases (IHD) and consequent heart failure (HF) remain the main cause of mortality worldwide. Several procedures are used routinely to guarantee the prompt and successful reestablishment of blood flow to preserve the myocardial viability of infarcted hearts from ischemia injuries. However, ischemic heart reperfusion/revascularization triggers additional damages that occur when oxygen-rich blood re-enters the vulnerable myocardial tissue, which is a phenomenon known as ischemia and reperfusion (I/R) syndrome. Complications of I/R injuries provoke the adverse cardiac remodeling, involving inflammation, mishandling of Ca2+ homeostasis, apoptotic genes activation, cardiac myocytes loss, etc., which often progress toward HF. Therefore, there is an urgent need to develop new cardioprotective therapies for IHD and HF. Compelling evidence from animal studies and pilot clinical trials in HF patients suggest that urocortin (Ucn) isoforms, which are peptides associated with stress and belonging to the corticotropin releasing factor family, have promising potential to improve cardiovascular functions by targeting many signaling pathways at different molecular levels. This review highlights the current knowledge on the role of urocortin isoforms in cardioprotection, focusing on its acute and long-term effects.

Neonatal adjustments in respiratory and pulse rates in tropical breeds of buck-kids and doelings

Background The transition to pulmonary respiration and the termination of foetal cardiovascular shunts is expected to commence immediately after birth. Subsequently, alveolar ventilation and tissue perfusion must be established, despite the challenge of extra-uterine environmental conditions, which could be quite demanding, even to the adult animals. The current study evaluated neonatal adjustment and diurnally induced changes in respiratory and pulse rates in kids of Red Sokoto, Sahel and West African Dwarf (WAD) goats in a tropical climate. Results Morning and afternoon respiratory rates started decreasing (P < 0.05) in the second week of birth. The pulse rate in the morning hours rose (P < 0.05) on Day 1 with no significant fluctuation subsequently, while the pattern in the afternoon hours showed a progressive decrease (P < 0.05) after birth. Apart from the day of birth, respiratory rate on other days increased significantly from morning to afternoon hours. The afternoon pulse rate was higher (P < 0.05) on the day of birth, but lower (P < 0.05) on Day 2 as compared to the morning values; and no diurnal difference was observed in subsequent days. The WAD goats had significantly higher respiratory and pulse rates than Red Sokoto and Sahel kids, especially in the afternoon hours. Similarly, the values were higher (P < 0.05) in doelings than buck-kids during the morning hours. The correlation between respiratory and pulse rates was positive (P < 0.05) and the strength of the association increased with age. Conclusion It was concluded that the afternoon rise in ambient temperature induced the establishment of a clear diurnal variation in respiratory rate 24 h postnatal, while the diurnal variation in pulse rate was weak and irregular. The tropical climate may be quite challenging to the attainment of physiological stability in respiratory and cardiovascular functions of neonatal goat kids, especially during the hot season.

Angiopoietin-like protein 3, 4 and 8 are linked to cardiovascular function in naïve sub-clinical and overt hypothyroid patients receiving levothyroxine therapy

Objective: Angiopoietin-like protein (ANGPTL) 3,4,8 are upcoming cardiovascular biomarkers. Experimental studies showed thyroid hormones altered their levels. We assessed: ANGPTL3,4,8 as predictor of cardiovascular functions among naïve-subclinical and naïve-overt hypothyroidism [SCH and OH]; and altered ANGPTL levels with levothyroxine replacement (LT4) and their association with improved cardiovascular risk factors and cardiovascular function. Design and Methods: Prospective follow-up study assessed ANGPTL3,4,8 levels, vascular status (flow mediated dilation% of brachial artery (FMD%), carotid intima media thickness (CIMT), aortic stiffness index (ASI)), left ventricle (LV) parameters (ejection fraction (EF), myocardial performance index (MPI), LV mass), well-known cardiovascular risk factors and HOMA-IR, at two time points: among naïve -SCH, naïve-OH and healthy subjects groups; and at six months after achieved euthyroid state with LT4 with calculating their increased or decreased delta changes (∆↑ or ∆↓) in longitudinal arm among LT4- hypothyroid groups. Results: Significantly elevated ANGPTL3,4 and 8 among hypothyroid groups than healthy subjects were reduced with LT4. Multivariate analysis revealed ANGPTLs as independent predictors of cardiovascular functions and the contributors for ANGPTL levels: ANGPTL3,4 for impaired FMD% and ANGPTL8 for LVmass among naïve-SCH; ANGPTL3 for EF% and ANGPTL8 for CIMT in naïve-OH; ∆↓ ANGPTL3 for ∆↓ ASI meanwhile ∆↑ freeT4 for ∆↓ ANGPTL3, ∆↓ fasting glucose, ∆↓ triglyceride and ∆↓ thyroid peroxidase antibody for ∆↓ ANGPTL4 among LT4-SCH. ∆↓ ANGPTL4 for ∆↓ MPI and ∆↓ LVmass meanwhile ∆↓ TSH and ∆↓ triglyceride for ∆↓ ntributors for ANGPTL level: ANGPTL3,4 for impaired FMD% and ANGPTL8 for LVmass among naïve-SCH; ANGPTL3 for EF% and g LT4-OH. Conclusion: Elevated ANGPTL3,4,8 levels are differentially independent predictors of endothelial and cardiac function and reduced with LT4 in SCH and OH.

Seasonal Effects of High-Altitude Forest Travel on Cardiovascular Function: An Overlooked Cardiovascular Risk of Forest Activity

Cardiovascular physiological responses involving hypoxemia in low temperature environments at high altitude have yet to be adequately investigated. This study aims to demonstrate the health effects of hypoxemia and temperature changes in cardiovascular functions (CVFs) by comparing intra-individual differences as participants ascend from low (298 m, 21.9 °C) to high altitude (2729 m, 9.5 °C). CVFs were assessed by measuring the arterial pressure waveform according to cuff sphygmomanometer of an oscillometric blood pressure (BP) device. The mean ages of participants in winter and summer were 43.6 and 41.2 years, respectively. The intra-individual brachial systolic, diastolic BP, heart rate, and cardiac output of participants significantly increased, as participants climbed uphill from low to high altitude forest. Following the altitude increase from 298 m to 2729 m, with the atmosphere gradually reducing by 0.24 atm, the measured average SpO2 of participants showed a significant reduction from 98.1% to 81.2%. Using mixed effects model, it is evident that in winter, the differences in altitude affects CVFs by significantly increases the systolic BP, heart rate, left ventricular dP/dt max and cardiac output. This study provides evidence that cardiovascular workload increased significantly among acute high-altitude travelers as they ascend from low to high altitude, particularly in winter.

Role of the Melanocortin System in the Central Regulation of Cardiovascular Functions

Increasing evidence indicates that the melanocortin system is not only a central player in energy homeostasis, food intake and glucose level regulation, but also in the modulation of cardiovascular functions, such as blood pressure and heart rate. The melanocortins, and in particular α- and γ-MSH, have been shown to exert their cardiovascular activity both at the central nervous system level and in the periphery (e.g., in the adrenal gland), binding their receptors MC3R and MC4R and influencing the activity of the sympathetic nervous system. In addition, some studies have shown that the activation of MC3R and MC4R by their endogenous ligands is able to improve the outcome of cardiovascular diseases, such as myocardial and cerebral ischemia. In this brief review, we will discuss the current knowledge of how the melanocortin system influences essential cardiovascular functions, such as blood pressure and heart rate, and its protective role in ischemic events, with a particular focus on the central regulation of such mechanisms.

Effect of yoga on cardiovascular functions and psychological aspects of people on public service-related work: an exploratory study

Objectives Yoga is increasingly being introduced in workplace settings to improve health and well-being. However, there is a lack of studies reporting the effect of yoga in people on public service-related work, who are at high risk for various health-related problems. Thus, the objective of this study was to find the effect of yoga on cardiovascular functions and psychological (stress, anxiety, and depression) aspects of people on public service-related work. Methods A single-group pre-test and post-test experimental study design was adopted. Eighty-two participants aged 41.52 ± 7.44 years who are working in the Tamil Nadu Public Service Commission were undergone 1-h of yoga (under the supervision of a yoga & naturopathy doctor) a day, 5-days a week for a period of 1-month at their office. Cardiovascular functions such as systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse rate (PR) were measured using an automatic BP monitor. Psychological variables such as stress, anxiety, and depression were measured using Depression Anxiety and Stress Scales (DASS) before and after the intervention. Results Results of this study showed a significant reduction in body mass index, SBP, DBP, PR, mean arterial pressure, rate pressure product, and double product. Though results showed insignificant (just missed the statistical significance [p=0.056]) reduction in anxiety, it showed clinical improvement (i.e. the mean anxiety score has reduced from moderate category to mild category). However, there is neither statistically significant nor clinical difference in stress and depression. None of the participants reported any untoward events during the study period. Conclusions Results suggest that yoga might improve the cardiovascular functions and anxiety of people in public service-related work. However, no such significant improvement was noted in their stress and depression levels. However, a randomized controlled trial is required to warrant the results of this study.