Evaluation of cardiac autonomic function using heart rate variability in children with acute carbon monoxide poisoning

Vural, Cagdas; Dinleyici, Ener Çağrı; Köşger, Pelin; Bolluk, Özge; Kılıç, Zübeyir; Uçar, Birsen

doi:10.1017/s1047951117000944

Cited by 5 publications

(4 citation statements)

References 40 publications

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“…In these cases, the levels of LF/HF declined with the increase in the CO concentration. These results are consistent with the studies showing a decline in the levels of LF/HF with exposure to acute CO concentrations [23]. In a previous study, showed that, while an increase in the concentrations of dust contributes to increased levels of LF/HF, an increase in CO levels caused a decrease in the levels of LF/HF [24].…”

Section: Introductionsupporting

confidence: 92%

“…These intervening factors may possibly reverse the negative relationship between low concentrations of CO and LF/HF. In other words, while an increase in CO concentration is associated with decreased LF/HF, other air pollutants and noise may increase the LF/HF ratio, as demonstrated in a recent study by Tang et al [23]. However, despite the dominant effect of NO 2 , this study aims to highlight the uniqueness of the behavior of CO.…”

mentioning

confidence: 83%

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The Relationship between City Size and Carbon Monoxide (CO) Concentration and Their Effect on Heart Rate Variability (HRV)

Saadi

Tirosh

Schnell

2021

IJERPH

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Generally, larger cities are characterized by traffic congestion, which is associated with higher concentrations of pollution, including Carbon Monoxide (CO) pollution. However, this convention requires empirical support on the basis of accurate and reliable measurements. In addition, the assessment of the effect of CO on the autonomic nervous system (ANS), as measured by heart rate variability (HRV), has yielded conflicting results. A majority of the (few) studies on the topic have shown that increases in CO concentration of up to about 10 parts per million (ppm) are associated with a decrease in stress and risk to health in subjects. Beyond the hypothesis postulating city size as a determinant of increased CO concentration, the hypothesis proposing a causal link between CO concentration and HRV balance also requires empirical support. This article compares CO concentrations in a large metropolis with those in a small town, analyzing the relationship between CO and the HRV responses of young women in terms of city size. Four different types of environments were compared, taking into account mediating variables. The study participants spent 35 min in selected environments (a city center, a residential environment, a park, and a home) wearing Polar devices to measure HRV, and portable devices to measure noise thermal load and CO. The average concentrations of CO in each environment were calculated, along with the time distribution of the CO concentration, and the regression slopes between the concentrations of CO and the ANS balance, as measured by the low frequency power/high frequency power ratio (LF/HF) expressed as an HRV index. The results show that, regardless of size, the cities measured were all characterized by low levels of CO, far below the maximal accepted threshold standards, and that urban residents were exposed to these concentrations for less than half of the daytime hours. Furthermore, in contrast to the common view, larger cities do not necessarily accumulate higher concentrations of CO compared to small cities, regardless of the level of transport congestion. This study confirms the findings of the majority of the other studies on the subject, which showed a decrease in stress (as measured by HRV) as a result of an increase in CO concentrations below 7 ppm. Finally, following the assessment of the differential contribution attributed to the different environmental factors, it appears that noise, thermal load, and congestion all contribute more to a higher level of HRV balance than CO. This finding highlights the importance of a multivariable approach to the study, and a remediation of the effect of environmental factors on stress in urban environments.

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Section: Introductionsupporting

confidence: 92%

mentioning

confidence: 83%

The Relationship between City Size and Carbon Monoxide (CO) Concentration and Their Effect on Heart Rate Variability (HRV)

Saadi

Tirosh

Schnell

2021

IJERPH

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“…The record of electrocardiograms ranged from 5 min, 7 min, 15 min, 16 min, 30 min, 35 min, and 36 min to 24 h (ambulatory) in our included studies. However, a 5-min recording of electrocardiograms is recommended as longer recordings may be affected by emotions or physical activity [ 53 ]. The 24 h mean O 3 concentration was the most commonly used; however, there were studies with O 3 exposure periods of 1 h, 2 h, 4 h, 12 h, 24 h, 72 h and 120 h. Various mean period of O 3 concentrations and ECG recording lengths do not produce the same effect estimates on HRV indicators, which may also explain the heterogeneity observed in the associations of O 3 exposure with RMMSD, LF, and HF [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Association between Short-Term Exposure to Ozone and Heart Rate Variability: A Systematic Review and Meta-Analysis

Zong

Zhang

et al. 2022

IJERPH

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At present, ambient air pollution poses a significant threat to patients with cardiovascular disease (CVD). The heart rate variability (HRV) is a marker of the cardiac autonomic nervous system, and it is related to air pollution and cardiovascular disease. There is, however, considerable disagreement in the literature regarding the association between ozone (O3) and HRV. To further investigate the effects of short-term exposure to O3 on HRV, we conducted the first meta-analysis of relevant studies. The percentage change of HRV indicator(s) is the effect estimate extracted for the quantitative analysis in this study. In our meta-analysis, per 10 ppb increase in O3 was significantly associated with decreases in the time-domain measurements, for standard deviation of the normal-to-normal (NN) interval (SDNN) −1.11% (95%CI: −1.35%, −0.87%) and for root mean square of successive differences (RMSSD) −3.26% (95%CI: −5.42%, −1.09%); in the frequency-domain measurements, for high frequency (HF) −3.01% (95%CI: −4.66%, −1.35%) and for low frequency (LF) −2.14% (95%CI: −3.83%, −0.45%). This study showed short-term exposure to O3 was associated with reduced HRV indicators in adults, which suggested that the cardiac autonomic nervous system might be affected after O3 exposure, contributing to the association between O3 exposure and CVD risk.

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“…Apart from the case reports, the scarce literature on the acute effects of individual constituents of cigarette smoking on human in vivo ECG has mainly investigated nicotine and carbon monoxide. Acute carbon monoxide intoxication in children impaired ventricular repolarization with higher mean heart rate, QT dispersion, QTc dispersion, P dispersion, Tp-Te, QTc durations, Tp-Te dispersion, and Tp-Te/QT ratio compared to controls [230,231]. However, it increased heart rate, ST-T wave changes, QTc dispersion, and TpTe dispersion in adults [232,233].…”

Section: Acute Exposure To Smoking (Nicotine and Non-nicotine Constitmentioning

confidence: 96%

The effects of nicotine and cigarette smoking on cardiac electrophysiology.

Irfan¹

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collaboration, and contribution to projects related to this dissertation. This work would not have been possible without the administrative and financial support of Marshall University's Departments of Cardiology and Clinical Translational Services. I am especially grateful to research coordinators, Melissa Marcum and Scott Wiley, for their perseverance and unwavering commitment to this research study. I am greatly indebted to, and honored by, the encouragement and guidance from Dr. Christian Mueller, who introduced me to cardiovascular research and helped take the first steps of my scientific pursuits. Lastly, I thank my dear family, especially my mother, father, brother, sister, and wife for their enduring love, support, and sacrifice.

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Evaluation of cardiac autonomic function using heart rate variability in children with acute carbon monoxide poisoning

Cited by 5 publications

References 40 publications

The Relationship between City Size and Carbon Monoxide (CO) Concentration and Their Effect on Heart Rate Variability (HRV)

The Relationship between City Size and Carbon Monoxide (CO) Concentration and Their Effect on Heart Rate Variability (HRV)

Association between Short-Term Exposure to Ozone and Heart Rate Variability: A Systematic Review and Meta-Analysis

The effects of nicotine and cigarette smoking on cardiac electrophysiology.

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