Cardiac baroreflex hysteresis is one of the determinants of the heart period variability asymmetry

Maria, Beatrice De; Bari, Vlasta; Cairo, Beatrice; Vaini, Emanuele; Abreu, Raphael Martins de; Perseguini, Natália Maria; Milan‐Mattos, Juliana Cristina; Rehder-Santos, Patrícia; Minatel, Vinícius; Catai, Aparecida Maria; Vecchia, Laura Adelaide Dalla; Porta, Alberto

doi:10.1152/ajpregu.00112.2019

Cited by 22 publications

(27 citation statements)

References 79 publications

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“…Factors beyond direct action of autonomic nervous system influence on decelerations and accelerations (Piskorski and Guzik, 2012) such as the mechanical effects of intrathoracic pressure fluctuation related to inspiration and expiration (Klintworth et al, 2012), impact of hormones, and O 2 , electrolytes, H + as well as asymmetrical characteristic of the conduction of depolarization wave between atria and ventricles (Camm et al, 1996;Berntson et al, 1997;Guzik et al, 2011). Moreover, five-irreversible dynamics (Casali et al, 2008) as well as time irreversibility of beat-to-beat HRV and BPV were changed in response to orthostatic stress (Chladekova et al, 2012). De Maria et al (2019 have suggested that HRA is determined by cardiac baroreflex hysteresis.…”

Section: Discussionmentioning

confidence: 99%

“…Previous attempts have been made to estimate the change in HRA during orthostasis in past. De Maria et al (2019) investigated HRA at rest in supine position and during active standing. Casali et al (2008) showed that the cardiovascular response to the vertical position in the form of changes in HRA is different for tilt and standing (the asymmetry between accelerations and decelerations in heart rate appears to be more meaningful in tilt that in standing).…”

Section: Introductionmentioning

confidence: 99%

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Heart Rate Asymmetry Analysis During Head-Up Tilt Test in Healthy Men

et al. 2021

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The purpose of this study is to assess the cardiovascular system response to orthostatic stress in a group of 133 healthy men using heart rate asymmetry (HRA) methods. HRA is a feature of variability in human heart rate which is dependent upon external and internal body conditions. The initial phases of head-up tilt test (HUTT), namely, supine and tilt, were chosen as the external body affecting factors. Various calculation methods of HRA, such as Porta’s index (PI), Guzik’s index (GI), and its variance based components, were used to assess the heart rate variability (HRV) and its asymmetry. We compared 5-min ECG recordings from both supine and tilt phases of HUT test. Short-term HRA was observed in 54.1% of men in supine phase and 65.4% of men in tilt phase. The study revealed significant increase of GI (from 0.50 to 0.52, p < 0.001) in the tilt phase as well as significant changes in HRV descriptors between HUTT phases. Our results showed that the variability of human heart rate and its asymmetry are sensitive to orthostatic stress. The study of short-term HRA is a potential additional tool to increase sensitivity in conditions where HUTT is a diagnostic tool, such as vasovagal syncope.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Heart Rate Asymmetry Analysis During Head-Up Tilt Test in Healthy Men

et al. 2021

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“…This observation is somehow opposite to what expected during the physiological ageing process, which is characterised by a progressive increase of the sympathetic tone and a decrease of the vagal one. [29][30][31] This apparent discrepancy could just reflect the effect of the reduced amount of physical exercise weekly in a group of athletes used to train much more and to have high cardiac sympathetic modulation at rest. If so, a regular and strenuous endurance exercise practiced at the time of the first study 11 likely elicited a transient increase of cardiac sympathetic drive, 32 that is, reversible by the modification of training intensity, that did not represent a risk factor for the development of echocardiographic abnormalities or cardiovascular disease.…”

Section: Cardiac Risk Factors and Preventionmentioning

confidence: 99%

Ten-year follow-up of cardiac function and neural regulation in a group of amateur half-marathon runners

et al. 2021

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ObjectiveIn the last years, a debate exists about type, intensity and frequency of physical exercise that is really indicated to protect healthy subjects from cardiovascular disease. Regular physical training has been associated with an improved cardiovascular risk profile, but it has also been demonstrated that strenuous and uncontrolled physical exercise could be dangerous, in terms of increased cardiovascular morbidity and mortality. In the present study, we evaluated a group of 35 amateur half-marathon runners, who were likewise studied 10 years before (B). The results of B suggested that an increased cardiac sympathetic modulation could potentially represent a negative prognostic factor. The aim of this follow-up was to assess the medium–long-term effects of moderate to vigorous physical training on the cardiovascular neural control, cardiac function and occurrence of cardiovascular diseases.MethodsEach enrolled subject underwent: (1) an interview and physical examination to ascertain the presence of cardiovascular disease; (2) standing test to evaluate the cardiovascular neural control by means of heart rate variability (HRV), arterial blood pressure (AP) variability and baroreflex sensitivity (BRS); (3) transthoracic echocardiography to evaluate cardiac function.ResultsAt 10-year follow-up (FU), in this group of middle-aged athletes the occurrence of cardiovascular diseases was low, not unlike that of the overall population. The results of HRV analysis showed a decreased sympathetic and increased vagal modulation directed to the heart, compared with B. In addition, HRV, AP variability and BRS indices showed a physiological response to active standing. Finally, athletes had normal echocardiographic measures.ConclusionWe conclude that in our group of athletes a regular moderate–vigorous physical training through the 10 years was quite beneficial as the prevalence of sympathetic cardiac modulation observed at B was not accompanied by increased cardiovascular risk, on the contrary a slight prevalence of vagal indices was observed at FU.

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“…The development of nonlinear dynamics appears to be favored by an enhancement of the vagal control [9][10][11][12] and by a weakened action of the cardiac baroreflex [13]. Also the different response of regulatory mechanisms to positive or negative SAP variations and circuits imposing a certain degree of cardiorespiratory phase coupling might play an important role in producing nonlinear RR variability patterns [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the impact of surgical aortic valve replacement on short-term cardiovascular and cerebrovascular controls through spontaneous variability analysis

et al. 2020

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We assessed the effect of surgical aortic valve replacement (SAVR) on cardiovascular and cerebrovascular controls via spontaneous variability analyses of heart period, approximated as the temporal distance between two consecutive R-wave peaks on the electrocardiogram (RR), systolic, diastolic and mean arterial pressure (SAP, DAP and MAP) and mean cerebral blood flow (MCBF). Powers in specific frequency bands, complexity, presence of nonlinear dynamics and markers of cardiac baroreflex and cerebral autoregulation were calculated. Variability series were acquired before (PRE) and after (POST) SAVR in 11 patients (age: 76±5 yrs, 7 males) at supine resting and during active standing. Parametric spectral analysis was performed based on the autoregressive model. Complexity was assessed via a local nonlinear prediction approach exploiting the k-nearest-neighbor strategy. The presence of nonlinear dynamics was checked by comparing the complexity marker computed over the original series with the distribution of the same index assessed over a set of surrogates preserving distribution and power spectral density of the original series. Cardiac baroreflex and cerebral autoregulation were estimated by assessing the transfer function from SAP to RR and from MAP to MCBF and squared coherence function via the bivariate autoregressive approach. We found that: i) orthostatic challenge had no effect on cardiovascular and cerebrovascular control markers in PRE; ii) RR variance was significantly reduced in POST; iii) complexity of SAP, DAP and MAP variabilities increased in POST with a greater likelihood of observing nonlinear dynamics over SAP compared to PRE at supine resting; iv) the amplitude of MCBF variations and MCBF complexity in POST remained similar to PRE; v) cardiac baroreflex sensitivity decreased in POST, while cerebrovascular autoregulation was preserved. SAVR induces important changes of cardiac and vascular autonomic controls and baroreflex regulation in patients exhibiting poor reactivity of cardiovascular regulatory mechanisms, while cerebrovascular autoregulation seems to be less affected.

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Cardiac baroreflex hysteresis is one of the determinants of the heart period variability asymmetry

Cited by 22 publications

References 79 publications

Heart Rate Asymmetry Analysis During Head-Up Tilt Test in Healthy Men

Heart Rate Asymmetry Analysis During Head-Up Tilt Test in Healthy Men

Ten-year follow-up of cardiac function and neural regulation in a group of amateur half-marathon runners

Evaluation of the impact of surgical aortic valve replacement on short-term cardiovascular and cerebrovascular controls through spontaneous variability analysis

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