Heart rate variability in hypertensive pregnancy disorders: A systematic review

Moors, Suzanne; Staaks, K.J.J.; Westerhuis, Michelle E.M.H.; Dekker, Lukas; Verdurmen, K.M.J.; Oei, S.G.; Laar, Judith O E H van

doi:10.1016/j.preghy.2020.03.003

Cited by 35 publications

(25 citation statements)

References 64 publications

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“…Cardiac function of patients with hypertensive disorder complicating pregnancy (HDCP) was changed with various degrees with the severity of disease. Real-time monitoring of cardiac function was likely to become an effective method of reflecting the severity of disease of patients objectively [ 7 , 8 ]. There were a large number of fundamental research into the changes in cardiac structure and function of hypertension patients during pregnancy, but the reports on whether peripheral elastic blood vessels were abnormal, such as carotid artery, were rare.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Cardiac Function of Pregnant Women with High Blood Pressure during Gestation Period and Coupling of Hearts with Peripheral Vessels by Ultrasonic Cardiogram under Artificial Intelligence Algorithm

Zhang

Liang

Cao

2022

Computational and Mathematical Methods in Medicine

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The research was aimed at analyzing the value of the optimized eXtreme Gradient Boosting (XGBoost) algorithm-based ultrasound cardiogram images in the diagnosis of pregnant hypertension patients. A total of 145 pregnant women (85 cases suffered from hypertension disease during pregnancy and 60 other normal women were healthy) were selected as the reference to the comparison and analysis of ultrasound cardiac function parameter, common carotid artery parameter, and the coupling relationship between hearts and cervical vessels of pregnant hypertension patients. The results demonstrated ultrasound cardiac function parameter of pregnant hypertension patients as follows. The maximum volume of the left atrium (LAVmax) was 35.65 mm, left ventricular end-systolic volume (LVESV) was 31.07 mm, and left ventricular end-diastolic volume (LVEDV) was 88.73 mm. All the above indexes were obviously higher than those of the normal control group ( P < 0.05 ). Besides, intima-media thickness (IMT) of common carotid artery (465.84 μm), pulse wave velocity (PWV) (8.09 m/s), pressure of turning point 1 from isovolumic contraction phase to ejection phase (PT1) (126.5 mmHg), arterial enhancement pressure (AP) (6.14 mmHg), and arterial pressure enhancement index (8.58%) were all significantly higher than those of the normal control group ( P < 0.05 ). In addition, the correlation between the coupling ( E / A ) of hearts and carotid artery of pregnant hypertension patients and PWV was not obvious ( r = − 0.08432 , P > 0.05 ). The results of the research indicated that intima-media inside carotid artery of pregnant hypertension patients thickened obviously, and it became less elastic compared with that of normal healthy pregnant women. What is more, cardiac morphological changes were manifested mainly as the enlargement of the left atrial chamber and the thickening of the interventricular septum. Volume load and blood flow velocity both increased, and left ventricular diastolic function was damaged. XGBoost algorithm-based ultrasound cardiogram images could improve the diagnostic effects of hypertension during pregnancy effectively.

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Section: Introductionmentioning

confidence: 99%

Evaluation of Cardiac Function of Pregnant Women with High Blood Pressure during Gestation Period and Coupling of Hearts with Peripheral Vessels by Ultrasonic Cardiogram under Artificial Intelligence Algorithm

Zhang

Liang

Cao

2022

Computational and Mathematical Methods in Medicine

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“…Maternal pathologies influence the onset of altered neurodevelopment patterns during fetal life, which could lead to actual neurologic disorders during childhood (Faa et al, 2016 ; Vohr et al, 2017 ). In particular, metabolic and cardiovascular pathologies, like obesity, diabetes, hypertension, and preeclampsia, can disrupt vagus nerve development (Brown et al, 2008 ; Russell et al, 2016 ; Moors et al, 2020 ).…”

Section: The Environmental Factors Affecting the Ans Developmentmentioning

confidence: 99%

A Review on the Vagus Nerve and Autonomic Nervous System During Fetal Development: Searching for Critical Windows

Cerritelli¹,

Frasch²,

Antonelli³

et al. 2021

Front. Neurosci.

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The autonomic nervous system (ANS) is one of the main biological systems that regulates the body's physiology. Autonomic nervous system regulatory capacity begins before birth as the sympathetic and parasympathetic activity contributes significantly to the fetus' development. In particular, several studies have shown how vagus nerve is involved in many vital processes during fetal, perinatal, and postnatal life: from the regulation of inflammation through the anti-inflammatory cholinergic pathway, which may affect the functioning of each organ, to the production of hormones involved in bioenergetic metabolism. In addition, the vagus nerve has been recognized as the primary afferent pathway capable of transmitting information to the brain from every organ of the body. Therefore, this hypothesis paper aims to review the development of ANS during fetal and perinatal life, focusing particularly on the vagus nerve, to identify possible “critical windows” that could impact its maturation. These “critical windows” could help clinicians know when to monitor fetuses to effectively assess the developmental status of both ANS and specifically the vagus nerve. In addition, this paper will focus on which factors—i.e., fetal characteristics and behaviors, maternal lifestyle and pathologies, placental health and dysfunction, labor, incubator conditions, and drug exposure—may have an impact on the development of the vagus during the above-mentioned “critical window” and how. This analysis could help clinicians and stakeholders define precise guidelines for improving the management of fetuses and newborns, particularly to reduce the potential adverse environmental impacts on ANS development that may lead to persistent long-term consequences. Since the development of ANS and the vagus influence have been shown to be reflected in cardiac variability, this paper will rely in particular on studies using fetal heart rate variability (fHRV) to monitor the continued growth and health of both animal and human fetuses. In fact, fHRV is a non-invasive marker whose changes have been associated with ANS development, vagal modulation, systemic and neurological inflammatory reactions, and even fetal distress during labor.

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“…The period of pregnancy necessitates major physiological changes to sustain the growing fetus while maintaining maternal health ( Khlybova et al, 2008 ; Moors et al, 2020 ). Some changes are apparent and can be readily monitored, such as the mother’s growing abdomen.…”

Section: Introductionmentioning

confidence: 99%

“…In fact, several pregnancy complications are linked to the insufficient adaptation of the ANS to advancing gestation. Complications such as preeclampsia (a hypertensive disorder of pregnancy) and preterm birth have been associated with dysfunctional maternal autonomic regulation ( Khlybova et al, 2008 ; Yousif et al, 2019 ; Moors et al, 2020 ). These complications are challenging to detect in early gestation when available interventional options (such as aspirin for mitigating preeclampsia) would be most effective ( Cui et al, 2018 ; Shanmugalingam et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Longitudinally Tracking Maternal Autonomic Modulation During Normal Pregnancy With Comprehensive Heart Rate Variability Analyses

et al. 2022

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Changes in the maternal autonomic nervous system are essential in facilitating the physiological changes that pregnancy necessitates. Insufficient autonomic adaptation is linked to complications such as hypertensive diseases of pregnancy. Consequently, tracking autonomic modulation during progressing pregnancy could allow for the early detection of emerging deteriorations in maternal health. Autonomic modulation can be longitudinally and unobtrusively monitored by assessing heart rate variability (HRV). Yet, changes in maternal HRV (mHRV) throughout pregnancy remain poorly understood. In previous studies, mHRV is typically assessed only once per trimester with standard HRV features. However, since gestational changes are complex and dynamic, assessing mHRV comprehensively and more frequently may better showcase the changing autonomic modulation over pregnancy. Subsequently, we longitudinally (median sessions = 8) assess mHRV in 29 healthy pregnancies with features that assess sympathetic and parasympathetic activity, as well as heart rate (HR) complexity, HR responsiveness and HR fragmentation. We find that vagal activity, HR complexity, HR responsiveness, and HR fragmentation significantly decrease. Their associated effect sizes are small, suggesting that the increasing demands of advancing gestation are well tolerated. Furthermore, we find a notable change in autonomic activity during the transition from the second to third trimester, highlighting the dynamic nature of changes in pregnancy. Lastly, while we saw the expected rise in mean HR with gestational age, we also observed increased autonomic deceleration activity, seemingly to counter this rising mean HR. These results are an important step towards gaining insights into gestational physiology as well as tracking maternal health via mHRV.

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Heart rate variability in hypertensive pregnancy disorders: A systematic review

Cited by 35 publications

References 64 publications

Evaluation of Cardiac Function of Pregnant Women with High Blood Pressure during Gestation Period and Coupling of Hearts with Peripheral Vessels by Ultrasonic Cardiogram under Artificial Intelligence Algorithm

Evaluation of Cardiac Function of Pregnant Women with High Blood Pressure during Gestation Period and Coupling of Hearts with Peripheral Vessels by Ultrasonic Cardiogram under Artificial Intelligence Algorithm

A Review on the Vagus Nerve and Autonomic Nervous System During Fetal Development: Searching for Critical Windows

Longitudinally Tracking Maternal Autonomic Modulation During Normal Pregnancy With Comprehensive Heart Rate Variability Analyses

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