scholarly journals Transfer Information Assessment in Diagnosis of Vasovagal Syncope Using Transfer Entropy

Entropy ◽  
2019 ◽  
Vol 21 (4) ◽  
pp. 347
Author(s):  
Katarzyna Buszko ◽  
Agnieszka Piątkowska ◽  
Edward Koźluk ◽  
Tomasz Fabiszak ◽  
Grzegorz Opolski
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Information Transfer ◽  
Vasovagal Syncope ◽  
Upright Position ◽  
Transfer Entropy ◽  
Tilt Test ◽  
Study Group ◽  
Head Up Tilt ◽  
Passive Phase

The paper presents an application of Transfer Entropy (TE) to the analysis of information transfer between biosignals (heart rate expressed as R-R intervals (RRI), blood pressure (sBP, dBP) and stroke volume (SV)) measured during head up tilt testing (HUTT) in patients with suspected vasovagal syndrome. The study group comprised of 80 patients who were divided into two groups: the HUTT(+) group consisting of 57 patients who developed syncope during the passive phase of the test and HUTT(−) group consisting of 23 patients who had a negative result of the passive phase and experienced syncope after provocation with nitroglycerin. In both groups the information transfer depends on the phase of the tilt test. In supine position the highest transfer occurred between driver RRI and other components. In upright position it is the driver sBP that plays the crucial role. The pre-syncope phase features the highest information transfer from driver SV to blood pressure components. In each group the comparisons of TE between different phases of HUT test showed significant differences for RRI and SV as drivers.

scholarly journals Predictive Value of Blood Pressure, Heart Rate, and Blood Pressure/Heart Rate Ratio in a Chinese Subpopulation with Vasovagal Syncope

2020 ◽  
Author(s):  
Dengfeng Geng
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Vasovagal Syncope ◽  
Cost Effective ◽  
Tilt Test ◽  
Clinical Settings ◽  
Mixed Response ◽  
Head Up Tilt ◽  
Head Up Tilt Test ◽  
Mixed Pattern

Objective: The head-up tilt test (HUTT) is widely used but is time-consuming and not cost-effective to evaluate patients with vasovagal syncope (VVS). The present study aims to verify the hypothesis that ambulatory blood pressure (BP) monitoring (ABPM) and the simplistic tilt test may be potential alternatives to the HUTT.Methods: The study consecutively enrolled 360 patients who underwent the HUTT to evaluate VVS. BP), heart rate(HR), and BP/HR ratios derived from ABPM and the simplistic tilt test were evaluated to predict the presence, pattern, and stage of syncope during the HUTT.Results: Mixed response was the commonest pattern, and syncope occurred frequently with infusion of isoproterenol at a rate of 3 μg/min. During the simplistic tilt test, the cardioinhibitory group had higher tilted BP/HR ratios than the vasodepressor group, while the vasodepressor group had a faster tilted HR and a larger HR difference than the cardioinhibitory group. The higher the BP/HR ratio in the titled position, the higher the isoproterenol dosage needed to induce a positive response. During ABPM, BP/HR ratios were significantly higher in the cardioinhibitory group than in the vasodepressor group. The higher the ABPM-derived BP, the higher the dosage of isoproterenol needed to induce syncope. There were significant correlations in BP/HR ratios between ABPM and the supine position in the vasodepressor group, while significant correlation was found only for the diastolic BP/HR ratio between ABPM and the tilted position in the cardioinhibitory group. The mixed pattern shared correlative features of the other two patterns.Conclusion: ABPM and the simplistic tilt test might be used as promising alternatives to the HUTT in VVS evaluation in clinical settings.

Age dependency of cardiovascular autonomic responses to head-up tilt in healthy subjects

2004 ◽  
Vol 96 (6) ◽  
pp. 2333-2340 ◽  
Author(s):  
Tomi Laitinen ◽  
Leo Niskanen ◽  
Ghislaine Geelen ◽  
Esko Länsimies ◽  
Juha Hartikainen
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
High Frequency ◽  
Healthy Subjects ◽  
Baroreflex Sensitivity ◽  
Low Frequency ◽  
Upright Position ◽  
Vascular Responses ◽  
Autonomic Responses ◽  
Head Up Tilt

In elderly subjects, heart rate responses to postural change are attenuated, whereas their vascular responses are augmented. Altered strategy in maintaining blood pressure homeostasis during upright position may result from various cardiovascular changes, including age-related cardiovascular autonomic dysfunction. This exploratory study was conducted to evaluate impact of age on cardiovascular autonomic responses to head-up tilt (HUT) in healthy subjects covering a wide age range. The study population consisted of 63 healthy, normal-weight, nonsmoking subjects aged 23–77 yr. Five-minute electrocardiogram and finger blood pressure recordings were performed in the supine position and in the upright position 5 min after 70° HUT. Stroke volume was assessed from noninvasive blood pressure signals by the arterial pulse contour method. Heart rate variability (HRV) and systolic blood pressure variability (SBPV) were analyzed by using spectral analysis, and baroreflex sensitivity (BRS) was assessed by using sequence and cross-spectral methods. Cardiovascular autonomic activation during HUT consisted of decreases in HRV and BRS and an increase in SBPV. These changes became attenuated with aging. Age correlated significantly with amplitude of HUT-stimulated response of the high-frequency component ( r = -0.61, P < 0.001) and the ratio of low-frequency to high-frequency power of HRV ( r = -0.31, P < 0.05) and indexes of BRS (local BRS: r = -0.62, P < 0.001; cross-spectral baroreflex sensitivity in the low-frequency range: r = -0.38, P < 0.01). Blood pressure in the upright position was maintained well irrespective of age. However, the HUT-induced increase in heart rate was more pronounced in the younger subjects, whereas the increase in peripheral resistance was predominantly observed in the older subjects. Thus it is likely that whereas the dynamic capacity of cardiac autonomic regulation decreases, vascular responses related to vasoactive mechanisms and vascular sympathetic regulation become augmented with increasing age.

scholarly journals Relation of body mass index (BMI) with cardiovascular response to head up tilt in healthy subjects

2020 ◽  
Vol 15 (1) ◽  
pp. 6-10
Author(s):  
Sadia Afrin Rimi ◽  
Shamima Sultana ◽  
Iffat Rezwana ◽  
Sultana Ferdousi
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Healthy Subjects ◽  
Cardiovascular Response ◽  
Tilt Test ◽  
Tilt Table ◽  
Chi Square ◽  
Female Head ◽  
Head Up Tilt

Background: Tilt table test is used for the last few decades to detect cause in unexplained syncope. The response to tilting may vary physiologically with obesity. Objective: To assess the relationship of BMI to cardiovascular response to tilting. Methods: This experimental study was conducted from March 2019 to Feb 2020 on 90 healthy subjects with different BMI. Fifty one subjects of both gender with BMI 18.5-24.9 kg/m2 were included in the non-obese group and 39 subjects of both gender with BMI of 25-29.9 kg/m2 were included in overweight group and they were further subdivided into male and female. Head up tilting was done for 10 minutes at 600 by using a motorized tilt table. Systolic blood pressure (SBP), diastolic blood pressure (DBP) were recorded by an automatic sphygmomanometer. Heart rate (HR) and peripheral capillary oxygen saturation (SpO2) were measured by a pulse oximeter. For statistical analysis, Independent sample ‘t’ test, Pearson’s correlation test and Chi square tests were applied. Results: Significantly smaller rise of heart rate was observed in overweight males and greater fall of systolic blood pressure was observed in overweight females. Conclusion: This study concluded that over weight is associated with reduced orthostatic tolerance to head up tilt test in both genders. J Bangladesh Soc Physiol. 2020, June; 15(1): 6-10

Continuous assessment of hemodynamic control by complex demodulation of cardiovascular variability

1993 ◽  
Vol 264 (4) ◽  
pp. H1229-H1238 ◽  
Author(s):  
J. Hayano ◽  
J. A. Taylor ◽  
A. Yamada ◽  
S. Mukai ◽  
R. Hori ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Dynamic Responses ◽  
Time Dependent ◽  
Frequency Resolution ◽  
Tilt Test ◽  
Continuous Assessment ◽  
Cardiovascular Variability ◽  
Complex Demodulation ◽  
Head Up Tilt

Usefulness of complex demodulation (CDM) in assessing the frequency components of cardiovascular variability was assessed and, subsequently, this technique was utilized to determine the time-dependent responses of the low-frequency (LF) and high-frequency (HF) amplitudes of heart rate and blood pressure variabilities during postural tilt. CDM provides the time-dependent changes in amplitude of a particular frequency component on a continuous basis. Analysis of simulated data showed that CDM has sufficient frequency resolution to separately measure LF and HF amplitudes with a time resolution < 15 s and that CDM is robust to alterations in the frequency of the components. Analysis of actual data during postural tilt test in 23 young healthy subjects demonstrated that the HF amplitude of heart rate, an index of cardiac parasympathetic tone, rapidly decayed with head-up tilt (P < 0.01) and increased quickly showing an overshoot with tilt back to the supine position (P < 0.01). The LF amplitude of blood pressure, an index of vasomotor sympathetic activity, showed marked rhythmic fluctuation at an interval of 48-100 s during head-up tilt (P < 0.01), synchronizing with similar fluctuation in the LF amplitude of heart rate (P < 0.01). These results suggest that CDM can be used to provide a continuous assessment of cardiovascular variability components and that the dynamic responses of autonomic circulatory control to upright posture result in a phasic modulation of LF amplitude.

Abnormal passive head-up tilt test in subjects with symptoms of anxiety power spectral analysis study of heart rate and blood pressure

1997 ◽  
Vol 60 (2) ◽  
pp. 121-131 ◽  
Author(s):  
Gianfranco Piccirillo ◽  
Santagada Elvira ◽  
Carmela Bucca ◽  
Emanuela Viola ◽  
Mauro Cacciafesta ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Spectral Analysis ◽  
Power Spectral Analysis ◽  
Tilt Test ◽  
Analysis Study ◽  
Power Spectral ◽  
Head Up Tilt ◽  
Head Up Tilt Test

scholarly journals Mathematical modeling of the cardiovascular autonomic control in healthy subjects during a passive head-up tilt test

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yurii M. Ishbulatov ◽  
Anatoly S. Karavaev ◽  
Anton R. Kiselev ◽  
Margarita A. Simonyan ◽  
Mikhail D. Prokhorov ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cardiovascular System ◽  
Healthy Subjects ◽  
Low Frequency ◽  
Tilt Test ◽  
Peripheral Vascular ◽  
Control Loops ◽  
Head Up Tilt ◽  
Head Up Tilt Test

Abstract A mathematical model is proposed for the autonomic control of cardiovascular system, which takes into account two separated self-exciting sympathetic control loops of heart rate and peripheral vascular tone. The control loops are represented by self-exciting time-delay systems and their tone depends on activity of the aortic, carotid, and lower-body baroreceptors. The model is used to study the dynamics of the adaptive processes that manifest in a healthy cardiovascular system during the passive head-up tilt test. Computer simulation provides continuous observation of the dynamics of the indexes and variables that cannot be measured in the direct experiment, including the noradrenaline concentration in vessel wall and heart muscle, tone of the sympathetic and parasympathetic control, peripheral vascular resistance, and blood pressure. In the supine and upright positions, we estimated the spectral characteristics of the model variables, especially in the low-frequency band, and the original index of total percent of phase synchronization between the low-frequency oscillations in heart rate and blood pressure signals. The model demonstrates good quantitative agreement with the dynamics of the experimentally observed indexes of cardiovascular system that were averaged for 50 healthy subjects.

Body Position Influences Cardiovascular Disgust Reactivity

2015 ◽  
Vol 29 (2) ◽  
pp. 73-79 ◽  
Author(s):  
Anne Schienle ◽  
Sonja Übel ◽  
Andreas Rössler ◽  
Andreas Schwerdtfeger ◽  
Helmut Karl Lackner
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Body Position ◽  
Vasovagal Syncope ◽  
Upright Position ◽  
Compensatory Mechanism ◽  
Tilt Table ◽  
Increased Risk ◽  
Disgust Proneness

It has been suggested that elevated trait disgust constitutes a vulnerability factor for fainting episodes. We tested the hypothesis that disgust-prone individuals are susceptible to vasovagal syncope by means of a tilt table experiment, during which 30 women were presented with disgusting pictures in a supine and a 70° upright position. The results showed that relative to disgust elicitation in the supine position, tilting reduced diastolic blood pressure during disgust elicitation, which could indicate increased risk for presyncope. Moreover, self-reported disgust proneness was positively correlated with heart rate during disgust induction in the tilted position. This association may point to a compensatory mechanism that aims at stabilizing mean arterial pressure. Disgust-prone individuals possibly utilized this mechanism more extensively to prevent fainting. Future investigations with a longer duration should follow up on this finding and compare the onset of presyncope between high and low disgust-prone individuals.

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