Cardiovascular autonomic reflexes in mid‐pregnancy

Ekholm, Eeva; Piha, S. J.; Antila, K.; Erkkola, Risto

doi:10.1111/j.1471-0528.1993.tb15217.x

Cited by 53 publications

(31 citation statements)

References 27 publications

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“…[9] In our study, the maximum rise in DBP during isometric handgrip exercise was significantly less in the second trimester when compared to controls. This is in accordance with many studies [4,8,[10][11][12] which have shown that there is decreased sympathetic activity more in the second trimester, which explains the decreased peripheral vascular resistance in the second trimester is by decreased sympathetic activity. [8] The reduced BP response reported could be due to an antagonistic effect of products of uteroplacental unit such as progesterone or a diminished contractile response of the blood vessels to adrenaline.…”

Section: Discussionsupporting

confidence: 80%

“…[17] In our study of HR response to deep breathing, the ratio of maximum-to-minimum RR-interval during respiratory cycles, that is, the E/I ratio of RR intervals, was found to be significantly less in the second trimester compared to controls. In accordance with our results, many studies [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] showed HR response to deep breathing expressed as deep breathing difference (DBD), a measure of cardiac parasympathetic function was observed to be significantly lower in pregnant women when compared to control group and generally followed a decreasing trend with increase in gestation. [4] This finding was in conformity with observation of Ekholm et al who suggested a multifactorial basis for it.…”

Section: Discussionsupporting

confidence: 78%

“…This may cause supine hypotension syndrome, leading to higher cardiovascular sympathetic activity, which is the main factor responsible for this change. [5] Higher sympathetic activity is noticed in the first trimester. This increased sympathetic activity leads to hypertension in some women during pregnancy called PIH.…”

Section: Introductionmentioning

confidence: 99%

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A comparative study of cardiovascular autonomic function tests between second trimester pregnant women and non-pregnant women

Athani¹,

Kallur²

2018

Natl J Physiol Pharm Pharmacol

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Background: Normal pregnancy has been documented to be accompanied by marked alteration in maternal circulation during the first and second trimesters. For adapting the cardiovascular hemodynamic changes during normal pregnancy, a well-controlled interaction between the sympathetic and parasympathetic system is very essential, failure of which may result in pregnancy-related complications. Aims and Objectives: To evaluate and compare the cardiovascular autonomic function tests (AFTs) between the second trimester pregnant women and controls. Materials and Methods: A cross-sectional study was conducted by random selection of 67 s trimester pregnant women and 67 controls in the age group of 19-29 years. The cardiovascular AFTs were carried out. The statistical analysis was done using unpaired t-test. Results: During isometric handgrip exercise, the maximum rise in diastolic blood pressure (DBP), and during cold pressor test, the maximum rise in systolic BP and maximum rise in DBP were significantly less in the second trimester of pregnancy than controls. There was significantly less increase in 30:15 ratio and E: I ratio of the second trimester pregnant women when compared to controls. Conclusion: The cardiovascular autonomic nervous activity was decreased in the second trimester of pregnancy when compared to controls.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionsupporting

confidence: 78%

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A comparative study of cardiovascular autonomic function tests between second trimester pregnant women and non-pregnant women

Athani¹,

Kallur²

2018

Natl J Physiol Pharm Pharmacol

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“…RSA is substantially reduced during rapid compared to slow breathing (Brown et al, 1993;Grossman et al, 1991). This effect may also be present during pregnancy as high frequency heart rate variability (HRV) is reduced in the second (Ekholm et al, 1993) and third trimester of pregnancy (Eneroth-Grimfors et al, 1994). There is debate, however, as to whether reduced HRV in pregnancy is due to changes in lung volumes or other physiologic changes associated with pregnancy (Ekholm and Erkkola, 1996).…”

Section: Rsa and Body Habitusmentioning

confidence: 99%

Respiratory sinus arrhythmia and diseases of aging: Obesity, diabetes mellitus, and hypertension

Masi

Hawkley

Rickett

et al. 2007

Biological Psychology

111

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Associations between respiratory sinus arrhythmia (RSA) and several chronic diseases, including obesity, diabetes mellitus, and hypertension, have been documented in recent years. Although most evidence suggests reduced RSA is the result of chronic disease rather than the cause, some studies have documented reduced RSA among at-risk individuals prior to disease onset. These results raise the possibility that decreased vagal tone may play a role in the pathogenesis of certain chronic diseases. Presented here is a brief overview of studies which examine the relationship between vagal tone, as measured by RSA and baroreflex gain, and diseases of aging, including obesity, diabetes mellitus, and hypertension. Mechanisms by which vagal tone may be related to disease processes are discussed. In addition, we present results from a population-based study of RSA and hypertension in older adults. Consistent with previous studies, we found an inverse relationship between RSA and age, cigarette use, and diabetes. In logistic regression models which control for age, cigarette use, and diabetes, we found RSA was a significant negative predictor of hypertension. We conclude that the relationship between RSA and hypertension is somewhat independent of the age-related decline in parasympathetic activity.

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“…[3,9] Ekholm et al studies on cardiac autonomic function in human pregnancy have produced conflicting results. Their fi ndings of reduced total power [10,11] and attenuated HR responses to orthostatic tests and the Valsalva maneuver [11] suggest that cardiac parasympathetic modulation is reduced in the resting state during mid pregnancy (22-29 wk of gestation). Studies conducted in early to mid gestation (11-27 wk) [12] were reported reduction in low-frequency HRV during the day and reduction in high-frequency HRV at night.…”

Section: Introductionmentioning

confidence: 99%

A study on cardiac autonomic modulation during pregnancy by non-invasive heart rate variability measurement

Gandhi¹,

Mehta²,

Gokhale³

et al. 2014

Int J Med Public Health

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A study on cardiac autonomic modulation during pregnancy by non-invasive heart rate variability measurement Purpose: Remarkable and uncontrollable changes with modifi cation during pregnancy are connected with the autonomic control and consequently with the heart rate variability (HRV). Heart rate variability is a sum of different mechanisms and if pregnancy is a state of change, these modifi cations could be extracted from HRV analysis. Objective: To assess the effect of pregnancy on heart rate variability among pregnant mothers during fi rst trimester of pregnancy and third trimester of pregnancy. Materials and Methods: HRV was measured for 5 minutes of continuous recording of electrocardiogram (ECG) lead II, using windows based HRV analysis system variowin-HR after obtaining permission from the Institutional Review Board of Government Medical College, Bhavnagar and written consent from 30 pregnant subjects and 30 non-pregnant control subjects at autonomic function lab, Dept of Physiology, Bhavnagar. Result: Frequency domain parameters, very low frequency (VLF), low frequency (LF), high frequency (HF) and HF normalized unit (nu) were signifi cantly decreased and LF (nu) and LF/HF signifi cantly increased in pregnant subject in 3 rd trimester as compared to their 1 st trimester of pregnancy. Time Domain parameters like SDNN, RMSSD, SDSD, NN50 count, pNN50, SD1/SD2, triangular HRV index and average R-R interval were signifi cantly decreased during 3 rd trimester of pregnancy. Conclusion: The inhibition of resting parasympathetic activity or vagal blockage and an increment of the sympathetic modulation during the 3 rd third trimester of gestation in pregnancy as compared to their 1 st trimester and healthy non-pregnant subjects. Sympathovagal imbalance and abnormally low HRV may more pronounce during later stage of normal pregnancy. Key words: Autonomic function test, gestation, heart rate variability, pregnancyOriginal Article INTRODUCTIONThe last three decades have witnessed the recognition of a signifi cant relationship between the autonomic nervous system and cardiovascular mortality, including sudden cardiac death.[1] Heart rate variability (HRV) is a non-invasive, easy and economical technique to assess the status of autonomic nervous regulation of cardio vascular system. Heart with a stable and regular heart beat periodically is now considered as the marker for a poor prognostic for longevity.[2] HRV studies enhance understanding of physiological phenomenon of heart activity especially during pregnancy. The changes in the function of every regulatory system during pregnancy are initiated by ovarian and placental hormones in the fi rst trimester, but may also be modifi ed by placental and fetal endocrine factors as gestational age advances. Pregnancy-induced effects on cardiovascular function are increases in heart rate (HR), stroke volume (SV), and cardiac output. [3,4] These changes result from the interactive effects of a primary reduction in peripheral vascular resistance, [5] cardiac autonomic modulati...

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Cardiovascular autonomic reflexes in mid‐pregnancy

Cited by 53 publications

References 27 publications

A comparative study of cardiovascular autonomic function tests between second trimester pregnant women and non-pregnant women

A comparative study of cardiovascular autonomic function tests between second trimester pregnant women and non-pregnant women

Respiratory sinus arrhythmia and diseases of aging: Obesity, diabetes mellitus, and hypertension

A study on cardiac autonomic modulation during pregnancy by non-invasive heart rate variability measurement

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