BACKGROUND Recent clinical studies have proposed standard deviation of heart rate as a diagnostic tool for the outcome of cardiac infarction. Mathematical analysis of heart rate variability shows that heart rate is influenced by different frequency components derived from different parts of the autonomous nervous system. In the experimental part of this study, we investigated the possibility of calculating a variable describing the parasympathetic branch of the autonomous nervous system exclusively. METHODS AND RESULTS In 60 healthy volunteers, heart rate was measured to 1 millisecond during two different conditions: 5 minutes of rest, and 5 minutes of intermittent handgrip dynamometry; the latter is known to increase sympathetic arousal selectively. Heart rate was found to be lower at rest (65.9 +/- 9.7 beats per minute) than during dynamometry (72.8 +/- 10.4 beats per minute, P < .001). Respiratory sinus arrhythmia (RSA) calculated from the mean absolute differences between successive heart beats showed no significant change (3.01 +/- 1.62 beats per minute at rest versus 2.97 +/- 1.30 beats per minute during dynamometry). In contrast, standard deviation increased from 5.19 +/- 1.98 to 9.22 +/- 3.56 beats per minute (P < .001). CONCLUSIONS It can be concluded from these data as well as from other plots presented in this article that RSA is a measure of the parasympathetic vagal tone, whereas standard deviation is increased by both sympathetic and parasympathetic arousal. Clinical evidence and data from physiological experiments are presented to show that a selective measure of vagal tone like RSA may offer advantages over standard deviation as a prognostic tool in cardiology.

Computer simulation of pulsatile non-Newtonian blood flow has been carried out in different human carotid artery bifurcation models. In the first part of the investigation, two rigid walled models are analysed, differing in the bifurcation angle (wide angle and acute angle bifurcation) and in the shape of both the sinus (narrow and larger sinus width) and the bifurcation region (small and larger rounding of the flow divider), in order to contribute to the study of the geometric factor in atherosclerosis. The results show a significant difference in the wall shear stress and in the flow separation. Flow recirculation in the sinus is much more pronounced in the acute angle carotid. An important factor in flow separation is the sinus width. In the second part of the study, flow velocity and wall shear stress distribution have been analysed in a compliant carotid artery bifurcation model. In the mathematical model, the non-Newtonian flow field and the idealized elastic wall displacement are coupled and calculated iteratively at each time step. Maximum displacement of approximately 6% of the diastolic vessel diameter occurs at the side wall of the bifurcation region. The investigation demonstrates that the wall distensibility alters the flow field and the wall shear stress during the systolic phase. Comparison with corresponding rigid wall results shows that flow separation and wall shear stress are reduced in the distensible wall model.

The flow pattern and the paths of fluid particles in a saccular aneurysm located at the bifurcation of an intracranial arterial segment are investigated with a numerical method. A normal physiological flow pattern was assumed as input to the studied segment. The theoretical study is carried out for two different Reynolds numbers and two different geometries of the aneurysm. The governing equations for incompressible Newtonian fluid flow are solved using the finite element method. The results show the disturbed blood flow in the pathologically altered bifurcation and the flow activity in the aneurysms. It is particularly important that blood particles can circulate in a whirl within the aneurysm for a time which seems long enough to permit the generation of cell aggregates or/and blood clots.

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Isoelectric focusing of purified beta 2-glycoprotein I (beta 2-G-I) revealed five major bands with isoelectric points (pI) between 5.1 and 6.1. Neuraminidase treatment decreased the number of bands to two (pI 8.0 and 8.2). The two asialo subfractions of beta 2-G-I were purified by cation-exchange column chromatography. The more basic isoform II was found to have a higher content of lysine. Western-blot analysis of different plasma samples confirmed the heterogeneity of beta 2-G-I in plasma. Plasma treated with neuraminidase showed two bands irrespective of the number of isoforms as well as of the concentration in native plasma. This led us to the conclusion that human plasma beta 2-G-I consists of two isoproteins that are sialylated to different extents.