Inflammation and Autonomic Function

Amaro-Leal, Ângela; Carvalho, Mafalda; Rocha, Isabel; Mota-Filipe, Hélder

doi:10.5772/intechopen.79280

Cited by 6 publications

(3 citation statements)

References 106 publications

(168 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The sympathetic and parasympathetic nervous systems are usually balanced for maintaining homeostasis. However, this balance is disrupted in various pathologies, and impaired parasympathetic vagal nerve activity may precede the development of inflammatory disorders ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

Linear and non‑linear indices of vagal nerve in relation to sex and inflammation in patients with Covid‑19

Hunakova,

Sabaka,

Zvarik

et al. 2023

Biomed Rep

View full text Add to dashboard Cite

Hyperinflammation is one of the most important pathophysiological risk factors for poor prognosis in patients with coronavirus disease-2019 (Covid-19). Low vagal neuro-immune modulation can lead into this kind of immune dysregulation. The association between vagal activity, sex and inflammatory markers were investigated in patients with Covid-19. A total of 19 patients with Covid-19 were included in the present study. Vagus nerve activity was indexed by heart rate variability (HRV) derived from electrocardiogram at hospital admission. Linear HRV parameters included the root mean square of successive RR interval differences (RMSSD) and high-frequency HRV (HF-HRV), while non-linear parameters included 2 UV%. Immune/inflammatory parameters included C-reactive protein (CRP), interleukin-6 (IL-6), neutrophil/lymphocyte ratio (NLR), systemic inflammatory index (SII), and procalcitonin (PCT). It has been revealed that both linear HRV indices HF-HRV and RMSSD, are significantly negatively correlated with CRP and IL-6, independent of age. The non-linear index of 2 UV% is significantly negatively correlated with NLR and SII, which reflect subtle changes in the response of immunocompetent cells. Patients that received high-flow nasal oxygen therapy had significantly higher IL-6 and CRP levels and lower levels of HF-HRV and RMSSD. These patients also had a significantly longer length of stay in hospital (LOS) than patients receiving low-flow oxygen therapy. Men had higher plasma PCT levels and longer LOS in hospital than women, and PCT statistically explained (mediated) the association between sex and LOS. The present study showed different correlations of linear and non-linear vagal indexes of HRV and inflammatory markers in patients with Covid-19. Significant sex differences in certain inflammatory markers were also observed, which may very well verify previous findings of poor prognosis in men with Covid-19. HRV reflects a continuous interaction between the sympathetic and parasympathetic autonomic nervous systems, which are affected by mental or physical stress, and certain disease states. The increased sympathetic and decreased parasympathetic vagal tone contribute to a higher risk of diseases associated with inflammation, cardiovascular disease, cancer, pulmonary diseases and other pathologies, including infectious diseases such as Covid-19. The present study showed that higher RMSSD (a marker of vagal activity) in Covid-19 patients is associated with lower levels of inflammatory biomarkers, a lower need for treatment and is negatively correlated with intensive care unit admission, leading to a shorter hospital stay. These findings support the idea that activation of vagus nerve may help certain Covid-19 patients by reducing the cytokine storm and excessive inflammation.

show abstract

Section: Introductionmentioning

confidence: 99%

Linear and non‑linear indices of vagal nerve in relation to sex and inflammation in patients with Covid‑19

Hunakova,

Sabaka,

Zvarik

et al. 2023

Biomed Rep

View full text Add to dashboard Cite

show abstract

“…It has also been linked to many diseases/ conditions viz., rheumatoid arthritis, obesity, sepsis, burn injuries, etc. [8] . These alterations in the sympathetic and parasympathetic nervous system are correlated with higher levels of C-reactive protein (CRP), an inflammatory marker [8] .…”

Section: Introductionmentioning

confidence: 99%

“…[8] . These alterations in the sympathetic and parasympathetic nervous system are correlated with higher levels of C-reactive protein (CRP), an inflammatory marker [8] . Goldstein DS et al, have elucidated biomarkers of extended autonomic system (EAS) activation to correlate with clinical and pathophysiologic data and predict outcome in COVID-19 [9] .…”

Section: Introductionmentioning

confidence: 99%

A Non-Invasive Tool to Quantify Autonomic Dysfunctuion: A Prognostic Indicator in Covid-19

Rajanna

Jayanthi

Swetha

et al. 2021

ijirms

View full text Add to dashboard Cite

Background: The Outbreak of SARS-CoV-2 has caused a major pandemic posing a threat to the millions of lives all over the world. The evidence shows that there is a relation between the autonomic nervous system and coronaviruses and likewise, levels of inflammatory markers - C-reactive protein (CRP) and autonomic dysfunction. Autonomic dysfunction is elicited using heart rate variability which in turn quantified using autonomous regulatory index (ARI). Hence this study was conducted to determine if ARI measured using patented NEUROCOR Precision HRV® Solution instrument could be used as a non-invasive measure of autonomic dysfunction among COVID-19 subjects. Materials & Methods: An exploratory study was conducted among randomly selected 22 COVID-19 male patients aged more than 18 years, admitted to COVID ward, Victoria Hospital, Bengaluru for 5 days, using ANS Recorder, a non-invasive heart rate variability recorder heart rhythm data were collected, one test per day continuously for 5 days and a patented NEUROCOR Precision HRV® Solution, an ANS Analysis Software instrument was used to record, analyze and interpret the heart rate variability in terms of ARI and CRP levels were measured. Data was analyzed using SPSS version 18.0. A P value of < 0.05 was considered statistically significant. Results: The occurrence of autonomic dysfunction in COVID-19 patients using the Patented NEUROCOR Precision HRV® Solution was found to be among 50.0%. The median scores of average ARI indices were significantly lesser among those with higher health risk (28.39) compared to those with lower health risk (65.95) (P<0.05). The Median ARI index showed a weak negative correlation (r = -0.13, P>0.05) with CRP (P>0.05). ARI index showed a significantly excellent predictive ability in detecting the higher health risk with the areas under the curves (AUC) being 0.93 with an optimal cut-off of 40.85 with maximum sensitivity and specificity of 100.0% and 93.0%. Conclusion: Autonomous Regulatory Index (ARI) index with significantly excellent predictive ability in detecting the higher health risk can be used as a non-invasive measure of autonomic dysfunction among COVID-19 subjects.

show abstract