Effect of fingolimod on cardiac autonomic regulation in patients with multiple sclerosis

2015 ◽  
Vol 22 (8) ◽  
pp. 1080-1085 ◽  
Author(s):  
Sakari Simula ◽  
Tomi Laitinen ◽  
Tiina M Laitinen ◽  
Tuula Tarkiainen ◽  
Päivi Hartikainen ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
High Frequency ◽  
Frequency Ratio ◽  
Low Frequency ◽  
Autonomic Regulation ◽  
Rr Interval ◽  
Cardiac Autonomic Regulation ◽  
Multiple Sclerosis Patients

Background: Fingolimod modulates sphingosine-1-phosphate receptors that are also found in cardiovascular tissue. Objective: To investigate the effects of fingolimod on cardiac autonomic regulation prospectively. Methods: Twenty-seven relapsing–remitting multiple sclerosis patients underwent 24-hour electrocardiogram recording before, at the first day of fingolimod treatment (1d) and after three months of continuous dosing (3mo). The time interval between two consecutive R-peaks (RR-interval) was measured. Cardiac autonomic regulation was assessed by the various parameters of heart rate variability. Parasympathetic stimulation prolongs the RR-interval and increases heart rate variability while the effects of sympathetic stimulation are mainly the opposite. The low frequency/high frequency ratio reflects sympathovagal balance. Results: From baseline to 1d, a prolongation of the RR-interval ( P<0.001), an increase in the values of various heart rate variability parameters ( P<0.05 to P<0.001) and a decrease in the low frequency/high frequency ratio ( P<0.05) were demonstrated. At 3mo, although the RR-interval remained longer ( P<0.01), the values of various heart rate variability parameters were lower ( P<0.01 to P<0.001) as compared to baseline. At 3mo, the low frequency/high frequency ratio ( P<0.05) was higher in men than in women although no such difference was found at baseline or at 1d. Conclusions: After an initial increase in parasympathetic regulation, continuous fingolimod dosing shifts cardiac autonomic regulation towards sympathetic predominance, especially in men. Careful follow-up of fingolimod-treated relapsing–remitting multiple sclerosis patients is warranted as sympathetic predominance associates generally with impaired outcome. ClinicalTrials.cov: NCT01704183

scholarly journals Binary symbolic dynamics analysis to detect stress-associated changes of nonstationary heart rate variability

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Conrad Spellenberg ◽  
Peter Heusser ◽  
Arndt Büssing ◽  
Andreas Savelsbergh ◽  
Dirk Cysarz
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Psychological Stress ◽  
Symbolic Dynamics ◽  
Acute Stress ◽  
Stress Test ◽  
Autonomic Regulation ◽  
Rr Interval ◽  
Cardiac Autonomic Regulation ◽  
Acute Psychological Stress

Abstract Psychological stress may have harmful physiological effects and result in deteriorating health. Acute psychological stress acts also on cardiac autonomic regulation and may lead to nonstationarities in the interbeat interval series. We address the requirement of stationary RR interval series to calculate frequency domain parameters of heart rate variability (HRV) and use binary symbolic dynamics derived from RR interval differences to overcome this obstacle. 24 healthy subjects (12 female, 20–35 years) completed the following procedure: waiting period, Trier Social Stress Test to induce acute psychological stress, recovery period. An electrocardiogram was recorded throughout the procedure and HRV parameters were calculated for nine 5-min periods. Nonstationarities in RR interval series were present in all periods. During acute stress the average RR interval and SDNN decreased compared to rest before and after the stress test. Neither low frequency oscillations (LF), high frequency oscillations (HF) nor LF/HF could unambiguously reflect changes during acute stress in comparison to rest. Pattern categories derived from binary symbolic dynamics clearly identified acute stress and accompanying alterations of cardiac autonomic regulation. Methods based on RR interval differences like binary symbolic dynamics should be preferred to overcome issues related to nonstationarities.

scholarly journals Potential value of the low frequency/high frequency ratio of heart rate variability to guide atrial fibrillation ablation procedures

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
JM Gregoire ◽  
C Gilon ◽  
J Hellinckx ◽  
S Carlier ◽  
H Bersini
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
High Frequency ◽  
Frequency Ratio ◽  
Low Frequency ◽  
Progressive Increase ◽  
Added Value ◽  
Clinical Criteria ◽  
Ganglionated Plexi

Abstract Funding Acknowledgements Type of funding sources: None. Background. The  differentiation  between  vagally  and  non-vagally mediated  atrial fibrillation (AF)  could be useful  to decide  adding  ganglionated  plexi  ablation  (GPA)  to  pulmonary vein isolation (PVI)  in  patients with vagally mediated  AF  onset. The role of the autonomic nervous system in triggering paroxysmal AF can be analyzed through heart rate variability (HRV) parameters. The low frequency/high frequency ratio (LF/HF) is used as an index of sympatho-vagal interaction. Based on clinical criteria, values of LF/HF &lt;1.5 are considered to reflect an increase of vagal modulation.  Purpose Identify  patients with paroxysmal AF who may benefit from GPA in addition to PVI, based on analysis of HRV parameters Material and methods From our database of unselected Holter recordings containing paroxysmal AF episodes, 199 analyzable AF onsets were labelled. We analyzed HRV frequential parameters by segments every 300 RR intervals to identify adrenergic and vagal onsets of AF episodes. We categorized AF onsets, depending of their respective values of LF/HF. We also checked the relationship of these parameters to heart rate (HR). We followed the evolution of the mean normalized values of LF/HF from the beginning of the recordings to the AF onsets (see figure). Results We found a progressive increase of LF/HF  in normalized units  (mean [95% confidence interval]) from  2.44  [2.12-2.76]  to 3.12  [2.85-3.39]  in the adrenergic group  (n = 113)  and a  progressive decrease of LF/HF from  1.51 [1.28-1.75]  to 1.02 [0.95-1.09]  in the  vagal group (n = 86). Differences between adrenergic and vagal AF were highly significant using Mann-Whitney test (p &lt; 0.001). A given patient shows the same type of AF in 80% of cases.  We found no correlation between frequential parameters and HR. Conclusions Our data show  potential  added value of  frequential  HRV  analysis  to  guide additional ganglionated  plexi ablation  to PVI. This  remains  to be demonstrated in a prospective study. The ratio LF/HF should be  considered  to optimize the decision-making process for  the ablation procedure. Abstract Figure. Frequential HRV parameters before AF

scholarly journals Maternal, fetal and neonatal heart rate and heart rate variability in Holstein cattle

2019 ◽  
Vol 39 (4) ◽  
pp. 286-291
Author(s):  
Dario A.C. Quevedo ◽  
Maria Lucia G. Lourenço ◽  
Carmen D. Bolaños ◽  
Angélica Alfonso ◽  
Carla M.V. Ulian ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Frequency Domain ◽  
High Frequency ◽  
Low Frequency ◽  
Perinatal Period ◽  
Rr Interval ◽  
Neonatal Heart ◽  
Neonatal Heart Rate ◽  
The Time Domain

ABSTRACT: The aim of this study was to describe the normal values for maternal, fetal and neonatal heart rate (HR) and heart rate variability (HRV) indexes in the time domain (standard deviation of beat-to-beat interval - SDNN; root mean square of successive beat-to-beat differences - RMSSD) and the frequency domain (low frequency - LF; high frequency - HF; relationship between low and high frequency - LF/HF) in 23 Holstein cows, 23 fetuses and 18 neonates during the perinatal period. HR and HRV were calculated by fetomaternal electrocardiography (ECG). Fetomaternal measurements were taken six times prepartum (between days 234 and 279 of pregnancy) and measurements were taken in neonates six times after calving (after birth and five times weekly). HR, time and frequency domain were analyzed. No significant changes in maternal, fetal beat-to-beat interval (RR interval) or HR were found. In maternal variables, SDNN decreased significantly from 38.08±2.6ms (day 14 before calving) to 23.7±2.5ms (day 1 after calving) (p<0.05), but the RMSSD did not change significantly. HR and RR interval of calf differed statistically from the day before delivery (163±7.5bpm; 381±24.2ms) to the day after calving (131±5bpm; 472±16.2ms). Time variables (SDNN and RMSSD) and the frequency-domain variables (LF and HF) were significantly different (p<0.05) between fetal and neonatal stages. Reductions in the values of SDNN and RMSSD can reflect a sympathetic dominance. After calving, the increase in HF and decrease in LF variables can indicate activation of the vagal nerve followed by heart and respiratory modulation.

scholarly journals The Influence ofNrf2on Cardiac Responses to Environmental Stressors

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Reuben Howden ◽  
Eva Gougian ◽  
Marcus Lawrence ◽  
Samantha Cividanes ◽  
Wesley Gladwell ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
High Frequency ◽  
Low Frequency ◽  
Therapeutic Strategies ◽  
Environmental Stressors ◽  
Total Power ◽  
Airborne Pollutants ◽  
Cardiac Responses

Nrf2protects the lung from adverse responses to oxidants, including 100% oxygen (hyperoxia) and airborne pollutants like particulate matter (PM) exposure, but the role ofNrf2on heart rate (HR) and heart rate variability (HRV) responses is not known. We hypothesized that genetic disruption ofNrf2would exacerbate murine HR and HRV responses to severe hyperoxia or moderate PM exposures.Nrf2-/-andNrf2+/+mice were instrumented for continuous ECG recording to calculate HR and HRV (low frequency (LF), high frequency (HF), and total power (TP)). Mice were then either exposed to hyperoxia for up to 72 hrs or aspirated with ultrafine PM (UF-PM). Compared to respective controls, UF-PM induced significantly greater effects on HR (P<0.001) and HF HRV (P<0.001) inNrf2-/-mice compared toNrf2+/+mice.Nrf2-/-mice tolerated hyperoxia significantly less thanNrf2+/+mice (~22 hrs;P<0.001). Reductions in HR, LF, HF, and TP HRV were also significantly greater inNrf2-/-compared toNrf2+/+mice (P<0.01). Results demonstrate thatNrf2deletion increases susceptibility to change in HR and HRV responses to environmental stressors and suggest potential therapeutic strategies to prevent cardiovascular alterations.

scholarly journals Effect of Acupuncture on Heart Rate Variability: A Systematic Review

2014 ◽  
Vol 2014 ◽  
pp. 1-19 ◽  
Author(s):  
Joanne W. Y. Chung ◽  
Vincent C. M. Yan ◽  
Hongwei Zhang
Keyword(s):  
Systematic Review ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
High Frequency ◽  
Healthy Subjects ◽  
Keyword Search ◽  
Data Extraction ◽  
Meta Analysis ◽  
Low Frequency ◽  
Control Group

Aim.To summarize all relevant trials and critically evaluate the effect of acupuncture on heart rate variability (HRV).Method.This was a systematic review with meta-analysis. Keyword search was conducted in 7 databases for randomized controlled trials (RCTs). Data extraction and risk of bias were done.Results.Fourteen included studies showed a decreasing effect of acupuncture on low frequency (LF) and low frequency to high frequency ratio (LF/HF ratio) of HRV for nonhealthy subjects and on normalized low frequency (LF norm) for healthy subjects. The overall effect was in favour of the sham/control group for high frequency (HF) in nonhealthy subjects and for normalized high frequency (HF norm) in healthy subjects. Significant decreasing effect on HF and LF/HF ratio of HRV when acupuncture was performed on ST36 among healthy subjects and PC6 among both healthy and nonhealthy subjects, respectively.Discussion.This study partially supports the possible effect of acupuncture in modulating the LF of HRV in both healthy and nonhealthy subjects, while previous review reported that acupuncture did not have any convincing effect on HRV in healthy subjects. More published work is needed in this area to determine if HRV can be an indicator of the therapeutic effect of acupuncture.

Modulation of Neurocardiac Function by Oesophageal Stimulation in Humans

1997 ◽  
Vol 92 (2) ◽  
pp. 167-174 ◽  
Author(s):  
Gervais Tougas ◽  
Markad Kamath ◽  
Geena Watteel ◽  
Debbie Fitzpatrick ◽  
Ernest L. Fallen ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Power Spectrum ◽  
High Frequency ◽  
Low Frequency ◽  
Sensory Stimulation ◽  
Sensory Stimuli ◽  
Autonomic Reflexes ◽  
Low Frequency Power ◽  
Beat Heart

1. The heart and the oesophagus have similar sensory pathways, and sensations originating from the oesophagus are often difficult to differentiate from those of cardiac origin. We hypothesized that oesophageal sensory stimuli could alter neurocardiac function through autonomic reflexes elicited by these oesophageal stimuli. In the present study, we examined the neurocardiac response to oesophageal stimulation and the effects of electrical and mechanical oesophageal stimulation on the power spectrum of beat-to-beat heart rate variability in male volunteers. 2. In 14 healthy volunteers, beat-to-beat heart rate variability was compared at rest and during oesophageal stimulation, using either electrical (200 μs, 16 mA, 0.2 Hz) or mechanical (0.5 s, 14 ml, 0.2 Hz) stimuli. The power spectrum of beat-to-beat heart rate variability was obtained and its low- and high-frequency components were determined. 3. Distal oesophageal stimulation decreased heart rate slightly (both electrical and mechanical) (P < 0.005), and markedly altered heart rate variability (P < 0.001). Both electrical and mechanical oesophageal stimulation increased the absolute and normalized area of the high-frequency band within the power spectrum (P < 0.001), while simultaneously decreasing the low-frequency power (P < 0.005). 4. In humans, oesophageal stimulation, whether electrical or mechanical, appears to amplify respiratory-driven cardiac vagoafferent modulation while decreasing sympathetic modulation. The technique provides access to vagoafferent fibres and thus may yield useful information on the autonomic effects of visceral or oesophageal sensory stimulation.

scholarly journals Analysis of heart rate variability in corn snakes (Pantherophis guttatus)

2021 ◽  
Vol 10 (11) ◽  
pp. e294101119781
Author(s):  
Antonio Gomes da Silva Neto ◽  
Daniel Souza Ferreira Magalhães ◽  
Raduan Hage ◽  
Laurita dos Santos ◽  
José Carlos Cogo
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Low Frequency ◽  
Autonomic Nervous ◽  
Rr Interval ◽  
Diagnosis And Prognosis ◽  
Frequency Domains ◽  
The Time Domain

The assessment of heart rate variability (HRV) by linear methods in conjunction with Poincaré plots can be useful for evaluating cardiac regulation by the autonomic nervous system and for the diagnosis and prognosis of heart disease in snakes. In this report, we describe an analysis of HRV in conscious adult corn snakes Pantherophis guttatus (P. guttatus).  The electrocardiogram (ECG) parameters were determined in adult corn snakes (8 females, 13 males) and used for HRV analysis, and the RR interval was analyzed by linear methods in the time and frequency domains. There was no sex-related difference in heart rate. However, significant differences were seen in the duration of the P, PR, and T waves and QRS complex; there was no difference in the QT interval. The values for the RR interval varied by 15.3% and 18.8% in male and female snakes, respectively, and there was considerable variation in the values for the high and low frequency domains. The changes in the time domain were attributed to regulation by the parasympathetic branch of the autonomic nervous system, in agreement with variations in the high and low frequency domains. The values for standard deviations 1 and 2 in Poincaré plots, as well as the values of the frequency domain, provide useful parameters for future studies of cardiac function in P. guttatus.

Mind–body interactive qigong improves physical and mental aspects of quality of life in inpatients with stroke: A randomized control study

2019 ◽  
Vol 18 (8) ◽  
pp. 658-666 ◽  
Author(s):  
Ching-Hsiang Chen ◽  
Kuo-Sheng Hung ◽  
Yu-Chu Chung ◽  
Mei-Ling Yeh
Keyword(s):  
Quality Of Life ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
High Frequency ◽  
Standard Care ◽  
Low Frequency ◽  
Control Group ◽  
Subacute Stroke ◽  
Interactive Exercise

Background: Stroke, a medical condition that causes physical disability and mental health problems, impacts negatively on quality of life. Post-stroke rehabilitation is critical to restoring quality of life in these patients. Objectives: This study was designed to evaluate the effect of a mind–body interactive qigong intervention on the physical and mental aspects of quality of life, considering bio-physiological and mental covariates in subacute stroke inpatients. Methods: A randomized controlled trial with repeated measures design was used. A total of 68 participants were recruited from the medical and rehabilitation wards at a teaching hospital in northern Taiwan and then randomly assigned either to the Chan-Chuang qigong group, which received standard care plus a 10-day mind–body interactive exercise program, or to the control group, which received standard care only. Data were collected using the National Institutes of Health Stroke Scale, Hospital Anxiety and Depression Scale, Short Form-12, stroke-related neurologic deficit, muscular strength, heart rate variability and fatigue at three time points: pre-intervention, halfway through the intervention (day 5) and on the final day of the intervention (day 10). Results: The results of the mixed-effect model analysis showed that the qigong group had a significantly higher quality of life score at day 10 ( p<0.05) than the control group. Among the covariates, neurologic deficit ( p=0.04), muscle strength ( p=0.04), low frequency to high frequency ratio ( p=0.02) and anxiety ( p=0.04) were significantly associated with changes in quality of life. Conversely, heart rate, heart rate variability (standard deviation of normal-to-normal intervals, low frequency and high frequency), fatigue and depression were not significantly associated with change in quality of life ( p >0.05). Conclusions: This study supports the potential benefits of a 10-day mind–body interactive exercise (Chan-Chuang qigong) program for subacute stroke inpatients and provides information that may be useful in planning adjunctive rehabilitative care for stroke inpatients.

Elevated heart rate variability in physically active postmenopausal women: a cardioprotective effect?

1996 ◽  
Vol 271 (2) ◽  
pp. H455-H460 ◽  
Author(s):  
K. P. Davy ◽  
N. L. Miniclier ◽  
J. A. Taylor ◽  
E. T. Stevenson ◽  
D. R. Seals
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Postmenopausal Women ◽  
High Frequency ◽  
Low Frequency ◽  
Total Power ◽  
High Frequency Power ◽  
Fat Percentage ◽  
Physically Active ◽  
Frequency Power

Coronary heart disease (CHD) and cardiac sudden death (CSD) incidence accelerates after menopause, but the incidence is lower in physically active versus less active women. Low heart rate variability (HRV) is a risk factor for CHD and CSD. The purpose of the present investigation was to test the hypothesis that HRV at rest is greater in physically active compared with less active postmenopausal women. If true, we further hypothesized that the greater HRV in the physically active women would be closely associated with an elevated spontaneous cardiac baroreflex sensitivity (SBRS). HRV (both time and frequency domain measures) and SBRS (sequence method) were measured during 5-min periods of controlled frequency breathing (15 breaths/min) in the supine, sitting, and standing postures in 9 physically active postmenopausal women (age = 53 +/- 1 yr) and 11 age-matched controls (age = 56 +/- 2 yr). Body weight, body mass index, and body fat percentage were lower (P < 0.01) and maximal oxygen uptake was higher (P < 0.01) in the physically active group. The standard deviation of the R-R intervals (time domain measure) was higher in all postures in the active women (P < 0.05) as were the high-frequency, low-frequency, and total power of HRV. SBRS also was higher (P < 0.05) in the physically active women in all postures and accounted for approximately 70% of the variance in the high-frequency power of HRV (P < 0.05). The results of the present investigation indicate that physically active postmenopausal women demonstrate higher levels of HRV compared with age-matched, less active women. Furthermore, SBRS accounted for the majority of the variance in the high-frequency power of HRV, suggesting the possibility of a mechanistic link with cardiac vagal modulation of heart rate. Our findings may provide insight into a possible cardioprotective mechanism in physically active postmenopausal women.

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