Sequential analysis of heart rate variability, blood pressure variability and baroreflex sensitivity in healthy pregnancy

Garg, Priyanka; Yadav, Kavita; Jaryal, Ashok Kumar; Kachhawa, Garima; Kriplani, Alka; Deepak, Kishore Kumar

doi:10.1007/s10286-020-00667-4

Cited by 29 publications

(28 citation statements)

References 24 publications

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“…Studies by Mathieu Jeanne, Maddalena Ardissino, and Thomas Ledowski have also demonstrated that anesthesia could result in significant reductions of multiple HRV parameters, which is consistent with our findings (Ardissino et al, 2019 ; Jeanne et al, 2009 ; Ledowski et al, 2005 ). Meanwhile, it was clear that the HRV at POD1 and POD2 is significantly reduced, presented as significant reduction of SDNN and SDANN, indicating patients suffering of a significant postoperative stress at POD1 and POD2, and implicating suppression of autonomic nervous system activity (Garg et al, 2020 ; Hattori & Asamoto, 2020 ; Tracy et al, 2016 ). Moreover, the reduction of LF/HF, which was used to evaluate the balance of sympathetic and parasympathetic nervous system (Lopresti, 2020 ), further suggesting that the sympathetic/parasympathetic imbalance occurred during the perioperative period.…”

Section: Discussionmentioning

confidence: 99%

Stress and autonomic nerve dysfunction monitoring in perioperative gastric cancer patients using a smart device

Cheng

Liu

Zhi

et al. 2021

Noninvasive Electrocardiol

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Background Heart rate variability (HRV), a sensitive marker of stress and autonomic nervous disorders, was significantly decreased in cardiovascular disease, inflammation, and surgical injury. However, the effect of radical gastrectomy on HRV parameters needs to be further investigated. Methods A prospective, observational study including 45 consecutive enrolled patients undergoing radical gastrectomy in our enhanced recovery after surgery (ERAS) programs was conducted. Frequency‐ and time‐domain parameters of HRV from 1 day prior to operation to 4 days postoperatively were continuously measured. Meanwhile, plasma cortisol and inflammatory markers were recorded and correlated to HRV parameters. Results Heart rate variability showed a solidly circadian rhythm. Anesthesia severely disturbed HRV parameters, resulting in a reduction of most of the HRV parameters. Frequency‐domain parameter (including VLF) and time‐domain parameters (including the SDNN, SDANN, and triangular index) of HRV demonstrated a significant reduction compared to preoperative values on the postoperative day 1 (Pod1), and these HRV parameters could return to baseline on Pod2 or Pod3, indicating surgical stress and autonomic nerve dysfunction existed in the early postoperative period. Inflammatory biomarkers were significantly elevated on Pod1 and Pod3. Plasma cortisol decreased significantly on Pod1 and Pod3. Both inflammatory biomarkers and plasma cortisol had no significant correlation with HRV parameters. Conclusions Compared with plasma cortisol and inflammation biomarkers, HRV is more sensitive to detect surgical stress and autonomic nervous dysfunction induced by radical gastrectomy in patients with gastric cancer.

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Section: Discussionmentioning

confidence: 99%

Stress and autonomic nerve dysfunction monitoring in perioperative gastric cancer patients using a smart device

Cheng

Liu

Zhi

et al. 2021

Noninvasive Electrocardiol

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“…Pregnancy affects autonomic responses in multiple ways. Various studies have documented various differences, which are further altered by preeclampsia ( Chaswal et al, 2018 ; da Corrêa et al, 2019 ; Garg et al, 2020 ). Autonomic neuropathy is uncommon but can occur in young women.…”

Section: Autonomic Disordersmentioning

confidence: 99%

Neuromuscular disorders in pregnancy

Weimer

2020

Handbook of Clinical Neurology

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Many neuromuscular disorders preexist or occur during pregnancy. In some cases, pregnancy unmasks a latent hereditary disorder. Most available information is based on case reports or series or retrospective clinical experience or patient surveys. Of special interest are pregnancy-induced changes in disease course or severity and likelihood for baseline recovery of function postpartum. Labor and delivery present special challenges in many conditions that affect skeletal but not smooth (uterine) muscle; so labor complications must be anticipated. Anesthesia for cesarean section surgery requires special precautions in many disorders. The types of conditions reviewed are broad and include examples of autoimmune, hereditary, and compressive/mechanical processes. Disorders include carpal tunnel syndrome and other focal neuropathies, Bell palsy, myasthenia gravis, and other neuromuscular junction disorders, acute and chronic inflammatory neuropathy, hereditary and acquired muscle diseases, spinal muscular atrophy, amyotrophic lateral sclerosis, channelopathies, autonomic neuropathy, and dysautonomia. Many commonly used therapies have fetal animal but no proven human toxicity concerns, complicating treatment and risk decisions. Weaning off effective therapeutic agents or preemptive aggressive treatment or surgery prior to planned pregnancy is an option in some conditions.

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“…Owing to the association between pregnancy complications and autonomic dysfunction, tracking autonomic changes throughout pregnancy may allow for detecting deteriorations in maternal health ( Antonazzo et al, 2004 ; Pal et al, 2009 ). However, the normative values of autonomic activity and the trajectory thereof during pregnancy remains insufficiently explored ( Brooks et al, 2020 ; Garg et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

“…However, limited research has longitudinally assessed maternal HRV (mHRV) in healthy pregnancy ( Schlembach et al, 2012 ). Moreover, existing research has offered conflicting results ( Yousif et al, 2019 ; Garg et al, 2020 ; Moors et al, 2020 ). On the one hand, some researchers have found that mHRV – and by proxy, autonomic activity—is unaffected by gestational age (GA) ( Voss et al, 2000 ; Moertl et al, 2009 ).…”

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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Sequential analysis of heart rate variability, blood pressure variability and baroreflex sensitivity in healthy pregnancy

Cited by 29 publications

References 24 publications

Stress and autonomic nerve dysfunction monitoring in perioperative gastric cancer patients using a smart device

Stress and autonomic nerve dysfunction monitoring in perioperative gastric cancer patients using a smart device

Neuromuscular disorders in pregnancy

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

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