The Adapted Autonomic Profile (Aap) Home-Based Test for the Evaluation of Neuro-Cardiovascular Autonomic Dysfunction

Sivan, Manoj; Corrado, Joanna

doi:10.20944/preprints202206.0325.v1

Cited by 3 publications

(4 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Narrow Pulse Pressure (38) has previously been reported as low in long covid patients during a NLT, (34) consistent with our findings, supporting the role of dysautonomia and possible cerebral hypoperfusion (34) and providing an area for further research.…”

Section: Discussionsupporting

confidence: 91%

Prevalence of orthostatic intolerance in Long Covid clinic patients: A multicentre observational study

Lee,

Greenwood,

Master

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

PurposeOrthostatic intolerance (OI), including postural orthostatic tachycardia syndrome (PoTS) and orthostatic hypotension (OH), are often reported in long covid, but published studies are small with inconsistent results. We sought to estimate the prevalence of objective OI in patients attending long covid clinics and healthy volunteers and associations with symptoms and comorbidities.MethodsParticipants were recruited from 8 UK long covid clinics, and healthy volunteers from general population. All undertook standardised National Aeronautics and Space Administration Lean Test (NLT). Participants’ history of typical OI symptoms (e.g. dizziness, palpitations) prior to and during the NLT were recorded.Results277 long covid patients and 50 frequency-matched healthy volunteers were tested. Healthy volunteers had no history of OI symptoms or PoTS, 10% had asymptomatic OH. 130 (47%) long covid patients had previous history of OI symptoms and 144 (52%) developed symptoms during the NLT. 41 (15%) had an abnormal NLT, 20 (7%) met criteria for PoTS and 21 (8%) had OH. Of patients with an abnormal NLT, 45% had no prior symptoms of OI. Relaxing the diagnostic thresholds for PoTS from two consecutive to one reading, resulted in 11% of long covid participants meeting criteria for PoTS, but not in healthy volunteers.ConclusionMore than half of long covid patients experienced OI symptoms during NLT and more than one in ten patients met the criteria for either PoTS or OH, half of whom did not report previous typical OI symptoms. We recommend all patients attending long covid clinics are offered an NLT and appropriate management commenced.Trial registration numbersNCT05057260, ISRCTN15022307

show abstract

Section: Discussionsupporting

confidence: 91%

Prevalence of orthostatic intolerance in Long Covid clinic patients: A multicentre observational study

Lee,

Greenwood,

Master

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…Omron M2 blood pressure monitor (endorsed by the British Hypertension Society) will be used to conduct NASA Lean test (NLT) in clinic and the adapted Autonomic Profile (aAP). 26…”

Section: Methodsmentioning

confidence: 99%

“…Adapted Autonomic Profile (aAP): This is an autonomic profile test developed by St Mary’s Hospital and the National Hospital for Neurology and Neurosurgery and later adapted for domiciliary use during the COVID-19 pandemic. 26 Participants are asked to monitor their heart rate and blood pressure on lying, and at 3 minutes of standing at various intervals over 24 hours, including after waking, after eating breakfast/ lunch/ dinner, before and after 5 minutes of exercise, and before bed. Abnormal results are calculated using the same criteria for heart rate and blood pressure differences as the NLT (HR increase > 30/min or BP drop >20 mm Hg).…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

HEART rate variability biofeedback for LOng Covid symptoms (HEARTLOC): protocol for a feasibility study

Corrado

Halpin

Preston

et al. 2022

Preprint

View full text Add to dashboard Cite

IntroductionLong covid (LC), also known as Post-COVID-19 syndrome, refers to symptoms persisting 12 weeks after COVID-19 infection. It affects up to 1 in 7 people contracting the illness and causes a wide range of symptoms, including fatigue, breathlessness, palpitations, dizziness, pain and brain fog. Many of these symptoms can be linked to dysautonomia or dysregulation of the autonomic nervous system after SARS-CoV2 infection. This study aims to test the feasibility and estimate the efficacy, of the Heart Rate Variability Biofeedback (HRV-B) technique via a standardised slow diaphragmatic breathing programme in individuals with LC.Methods and Analysis30 adult LC patients with symptoms of palpitations or dizziness and an abnormal NASA Lean Test (NLT) will be selected from a specialist Long COVID rehabilitation service. They will undergo a 4-week HRV-B intervention using a Polar chest strap device linked to the Elite HRV phone application while undertaking the breathing exercise technique for two 10-min periods every day for at least 5 days a week. Quantitative data will be gathered during the study period using: HRV data from the chest strap and wrist-worn Fitbit, the modified COVID-19 Yorkshire Rehabilitation Scale (C19-YRSm), composite autonomic symptom score (COMPASS 31), World Health Organisation Disability Assessment Schedule (WHODAS 2.0) and EQ-5D-5L health related quality of life measures. Qualitative feedback on user experience and feasibility of using the technology in a home setting will also be gathered. Standard statistical tests for correlation and significant difference will be used to analyse the quantitate data.Ethics and DisseminationThe study has received ethical approval from Health Research Authority (HRA) Leicester South Research Ethics Committee (21/EM/0271). Dissemination plans include academic and lay publications.Study RegistrationClinicaltrials.gov No: NCT05228665Strengths and limitations of the studyTo our knowledge, this is the first study of HRVB in long covid and will provide new information regarding the feasibility of the technology-based intervention in this condition.The estimation of efficacy will determine the scope and sample size for a larger controlled trial in the condition that currently has no definitive treatmentsThe study will provide preliminary evidence on the correlation between long covid symptoms and dysautonomia.The limitation of this study is the small sample size of 30 participants which might not give an accurate estimate of efficacy.HRV-B is a technology-based intervention, therefore its take-up could be limited in those with a lack of experience in using digital technology in daily life, particularly those from less privileged backgrounds.

show abstract

Orthostatic tachycardia after covid-19

Espinosa-González

Master

Gall

et al. 2023

BMJ

View full text Add to dashboard Cite

The Adapted Autonomic Profile (Aap) Home-Based Test for the Evaluation of Neuro-Cardiovascular Autonomic Dysfunction

Cited by 3 publications

References 6 publications

Prevalence of orthostatic intolerance in Long Covid clinic patients: A multicentre observational study

Prevalence of orthostatic intolerance in Long Covid clinic patients: A multicentre observational study

HEART rate variability biofeedback for LOng Covid symptoms (HEARTLOC): protocol for a feasibility study

Orthostatic tachycardia after covid-19

Contact Info

Product

Resources

About