Active Orthostatic Test Research Articles

Особенности вегетативной регуляции ритма сердца у пациентов с гипертонической болезнью после ишемического инсульта

INTRODUCTION. A decrease in heart rate variability indicates a violation of the autonomic control of cardiac activity, which is one of the reasons for the poor prognosis in this category of patients. Until now, the problem of the effectiveness and safety of correction of high blood pressure during the acute period of ischemic stroke remains a subject of debate. AIM. To determine clinical, autonomic and hemodynamic changes at rest and during an active orthostatic test to assess the functional state and adaptive capabilities of the cardiovascular system and identify risk factors for the unfavorable course of arterial hypertension in patients with hypertension in the acute period of ischemic stroke. MATERIAL AND METHODS. 78 patients with hypertension who were treated in a therapeutic hospital were examined. The first group consisted of 40 people with hypertension complicated by ischemic stroke, the second group included 38 people with uncomplicated hypertension. The patient's condition was assessed using the NIHSS scale and the Rankin scale. data from electrocardiography, duplex scanning of blood vessels, computed tomography of the brain, transthoracic ECHO-CG, portable monitor VNS-Micro and Poly-Spectrum SM from Neurosoft. The study of heart rate variability was carried out in patients with stroke upon admission, on days 5-10 and before discharge from the hospital (days 15-21). With the Revermead mobility index, more than 7 patients underwent an active orthostatic test with parallel ECG recording, measurement of blood pressure and heart rate at rest and when moving to a vertical position. RESULTS AND DISCUSSION. Patients with insufficient recovery of neurological functions on days 5-7 of stroke demonstrate the development of hypotension during an orthostatic test. An active orthostatic test on days 15-21 of stroke is successfully performed by patients with increased tone of the sympathetic nervous system. Patients with good recovery of neurological functions at discharge have normal autonomic reactivity and an adequate response of the sympathetic division of the autonomic nervous system to standing. CONCLUSION. Young men with hypertension should be closely monitored by physicians and receive primary stroke prevention. To increase tolerance to physical activity in patients who did not complete an active orthotest on days 5-7 of a stroke, daily passive verticalization is necessary. KEYWORDS: ischemic stroke, active orthotest, heart rate variability, hypertension, verticalization

Cardiohemodynamic responses and heart rate variability following an active orthostatic test among male residents of the North with different NOS3 (rs2070744) genotypes

AIM: This study explored associations between the -786TC (rs2070744) genetic polymorphism of the NOS3 gene and the main indices of systemic hemodynamics and heart rate variability following an active orthostatic test in men living in the North. MATERIAL AND METHODS: Eighty-three healthy men aged 33.5±1.5 yеаrs on average, who were permanent residents of the Magadan Region, comprised the sample. The participants underwent both resting and active orthostatic testing modes. Cardiovascular system variables were recorded using an automatic tonometer. Hemodynamic indices were then calculated. Short-term heart rate variability in frequency and spectral areas was simultaneously measured using the Varikard hardsoft complex unit. Genotyping was conducted using polymerase chain reaction. The sample was then divided into two groups: Group 1 consisted of homozygotes with the TT genotype (n=34), while Group 2 comprised carriers of the NOS3*C allele variant (genotypes TC+CC) associated with reduced nitric oxide production (n=49). RESULTS: By examining the complex vasomotor, chrono- and inotropic reactions of hemodynamic and heart rate variables during the active orthostatic test, we were able to discern unique patterns in the response of the two groups under study. Men in Group 1 demonstrated an elevated cardiac output response during orthostatic changes, while maintaining consistent vascular resistance values. This was accompanied by a shift towards sympathetic autonomic activity and an increase in the very low-frequency component of heart rate variability. In Group 2, individuals with sympathetic insufficiency and increased vascular resistance during the orthostatic test showed a 35% increase in the low-frequency component of the cardiac rhythm reflecting the importance of this indicator as a stimulator of blood pressure rhythm fluctuations mediated by baroreflex mechanisms. CONCLUSION: Our findings suggest that men lacking the NOS3*С allele variant in their genotype demonstrate more favorable responses to the active orthostatic test. This may reflect higher level of cardiovascular functional reserves. The 786TC (rs2070744) polymorphism of the NOS3 gene can be considered as a marker of cardiohemodynamic status and autonomic regulations during functional exercise, such as an active orthostatic test.

ПРОГНОЗИРОВАНИЕ РАЗВИТИЯ АРТЕРИАЛЬНОЙ ГИПЕРТЕНЗИИ У МОЛОДЫХ МУЖЧИН С ВЫСОКИМ НОРМАЛЬНЫМ АРТЕРИАЛЬНЫМ ДАВЛЕНИЕМ

High normal blood pressure (HNBP) is known to be associated with an increased risk of arterial hypertension (AH) development. The purpose of the study is to identify predictors of the development of AH in young men with HNBP, to assess their prognostic significance. Materials and methods. From a sample of 50 men aged 18-29 years with registered HNBP, groups were formed: group 1 – 18 patients with AH diagnosed within 10 years, group 2 – 32 patients in whom AH was not diagnosed. Cardiovascular risk factors, indicators of 24-hour blood pressure monitoring, bicycle ergometry, heart rate variability (HRV) during an active orthostatic test, echocardiography, and pulse wave velocity were analyzed. Results. Predictors of the development of AH in young men with HNBP are HRV indicators during active orthostatic test (ΔSDNN, ΔHF) and bicycle ergometry indicators (heart rate (HR) at the end of the physical load, diastolic BP (DBP) at the end of the recovery period). Conclusions. Predictors of the development of AH in young men with HNBP are ΔSDNN and ΔHF during active orthostatic test, HR in peak physical load and the level of DBP in the recovery period of bicycle ergometry (sensitivity – 88.89%, specificity – 93.75%, accuracy – 92.0%). The resulting prognostic model can be used as a method for determining the individual risk of AH development.

Синкопальные состояния у военнослужащих: клинико-диагностическое сопоставление, оказание медицинской помощи в многопрофильном лечебном учреждении

The article provides general information about clinical manifestations, modern approaches to the diagnosis and interpretation of clinical and instrumental methods in patients with various types of syncopal conditions, as well as provides own data from the analysis of medical care for this category of patients in the conditions of 432 main military clinical medical center. The emphasis is placed on the possibilities of diagnosis after the initial examination, the expediency of using simple and affordable diagnostic techniques (active orthostatic test, vegetative Kerdo index, scale for detecting permanent autonomic dysfunction), treatment tactics, prevention of possible complications, and solving expert issues.

Arterial oscillography as an indicator of adaptation of the cardiovascular system during active orthostatic test

The article is devoted to the study of an effective means of early diagnosis of premorbid conditions, control of the effectiveness of treatment results, physical exercises and sports, namely the orthostatic test, as well as registration methods that make it possible to assess the state of the cardiovascular system and the functional reserves of blood circulation regulation mechanisms. The orthostatic test is the simplest and most accessible method, which makes it possible to assess the state of the cardiovascular system and the functional reserves of blood circulation regulation mechanisms. 21 people aged 18-22 years without health complaints were examined. Arterial oscillograms were recorded during blood pressure measurement with an electronic tonometer in the supine position and after standing up. For the morphological analysis of the arterial oscillogram, the Oranta-AO Software Complex (PC) developed by the authors was used. The type of arterial oscillogram, the level of health, and the adaptation capabilities of the subjects were evaluated. Orthoprobe is accompanied by an increase in blood pressure and heart rate, which indicates its stimulating effect on the state of the sympathetic link of the autonomic nervous system. According to the results of the arterial oscillogram in the supine position, only 33% of the examined were excellent and good. After standing up, the quality of the arterial oscillogram improved in 47% of the examinees, which indicates the functional nature of disorders caused by the lability of the autonomic nervous system and the positive effect of the orthoprobe on the pulsatility of blood vessels.
 Deterioration refers to a decrease in the functional capacity of the cardiovascular system and its regulatory mechanisms. The use of PC Oranta-AO enables the doctor (as well as the patient) in offline or online mode, immediately after measuring blood pressure, to obtain conclusions about the state of the cardiovascular system and its regulatory mechanisms.

Evaluation of autonomic disorders in miners with vibration disease

Introduction. Autonomic disorders in the form of autonomic neuropathy develop in vibration disease already at the early stages. As the disease progresses, the compensatory mechanisms of autonomic regulation are depleted, which leads to a worse prognosis for life and an increased risk of sudden cardiac death in patients with a severe degree of autonomic neuropathy. 
 The aim of the study was to evaluate the severity of autonomic disorders and the preservation of compensatory reserves of autonomic regulation in patients with vibration disease. 
 Materials and methods. One hundred thirty six miners with a proven diagnosis of vibration disease and 60 apparently healthy men of similar age without complaints and who had never worked under the conditions of exposure to industrial vibration were examined. Heart rate variability was analyzed at rest and during an active orthostatic test.
 Results. A decrease in the spectral parameters of heart rate variability in the patients with vibration disease was revealed. In a subgroup of the patients with an initially low level of very low frequency oscillations (less than 30 ms2/Hz), a decrease in the non-linear entropy index (less than 180) was determined; when performing an active orthostatic test, the power of very low frequency spectrum oscillations in the patients of this subgroup decreased by more than 50% of the initial values. In all patients with vibration disease under orthostatic load, a decrease in the oscillations of high and low frequencies of the spectrum of heart rate variability was revealed, whereas in the control group, the low frequency oscillation power remained at the initial level.
 Limitations. The study was limited to the evaluation of spectral and non-linear indices of heart rate variability in 136 miners with vibration disease. 
 Conclusion. The criteria for a severe course of autonomic neuropathy in the patients with vibration disease were identified: an initial decrease in the power of very low frequency oscillations and a non-linear entropy index of heart rate variability, as well as a decrease in the power of very low frequency oscillations by more than 50% during an orthostatic test. According to these criteria, in 40.4% of the miners with vibration disease, pronounced violations of the autonomic support with a lack of compensatory mechanisms of autonomic regulation were found to be detected.

Overweight and dysregulation of the autonomic nervous system in young persons

Background. More than 1 billion people worldwide are obese, and this number is growing. Obesity at an early age is accompanied by impaired carbohydrate tolerance and the development of type 2 diabetes, lipid metabolism pathology, obstructive apnea, hypercoagulability, chronic inflammation and the development of insulin resistance in the future. In modern literature, there is no single point of view regarding the role of the autonomic nervous system in the coordination of hormonal, nervous and metabolic factors in the body.Aim. The article presents the results of studying the functional state of the sympathetic and parasympathetic parts of the autonomic nervous system in overweight persons and presents an assessment of the central hemodynamic parameter depending on the type of autonomic reactivity of the cardiovascular system.Methods. The study involved measuring systolic and diastolic blood pressure, heart rate, and anthropometric measurements for calculating the corresponding indices. An active orthostatic test to determine the functional state of reflex mechanisms for regulating hemodynamics. Statistical methods were used for data analysis.Results. Based on anthropometric indicators and calculated indices, boys and girls with overweight differed from the control group in abdominal and total distribution of fat. However, there were no differences in terms of vegetative tone (sympathicotonic, vagotonic, eutonic). The distribution of eutonic and vagotonic types of the autonomic nervous system and sympathicotonia was similar in both groups. Most overweight individuals had insufficient reactivity of the parasympathetic autonomic nervous system. Paradoxical reactivity in both groups was observed with the same frequency. In the group of people with paradoxical autonomic reactivity among overweight people, a significantly lower increase in heart rate was found than in the control group. In persons with overweight and increased autonomic reactivity, minute blood volume and pulse pressure increased 1.5-fold, there was a tendency to increase stroke volume and inotropic function of the heart. The increase in this characteristic indicated a hyperkinetic type of hemodynamics in overweight persons in the group with normal autonomic reactivity. In groups with paradoxical and increased autonomic reactivity of the cardiovascular system, a normokinetic type of hemodynamics was observed.Conclusions. Signs of altered autonomic reactivity found in most overweight individuals indicate dysfunction of the parasympathetic autonomic nervous system and possible dysfunction of nonspecific regulatory (limbic-reticular) parts of the brain.

Heart rate variability is a marker of the risk of maladaptation of students of various educational institutions

A comparative analysis of the level of adaptive capabilities of cadet corps and secondary school students based on the study of heart rate variability. Materials and methods: Cadets (n = 64) and schoolchildren (n = 86) aged 1012 years took part in the study; spectral parameters of the heart rate were evaluated at rest and under conditions of an active orthostatic test. Results: It was found that the severity of the HF component of the heart rate decreases with age in cadets, which indicates a decrease in the effects of the parasympathetic system, (40.2 8.7) % at 10 years and (25.1 3.6) % at 12 years; р = 0.024. At the age of 12, the values of LF (р = 0.034), LF/HF (р = 0.031) and SI (р = 0.041) in cadets are higher than in schoolchildren, and HF (р = 0.022) are lower. During the active orthostatic test, the cadets showed a decrease in K30:15, as well as an increase in LF (р = 0.035), LF/HF (р = 0.041) and TI (р = 0.038), which demonstrates the predominance of the central contour of regulation. Conclusions: 1) spectral analysis of the heart rate indicates a marked increase in the stress of adaptive mechanisms with age in the cadets of the Cossack corps, which reflects increased physical, intellectual and psycho-emotional stress compared with schoolchildren; 2) spectral characteristics of heart rate variability can be used as sensitive markers of stress of physiological systems and a decrease in adaptive reserves.

СРАВНЕНИЕ ПОКАЗАТЕЛЕЙ ФИЗИЧЕСКОГО РАЗВИТИЯ И ФИЗИЧЕСКОЙ ПОДГОТОВЛЕННОСТИ ПЕРВОКУРСНИКОВ С РАЗНЫМ СОСТОЯНИЕМ ЗДОРОВЬЯ, ПЕРЕНЕСШИХ COVID-19

To study the "post-covid syndrome," as a natural consequence of the pathological course of the new coronavirus infection "covid-19," data from a retrospective analysis of the incidence and testing of motor abilities of freshmen in 2022 are presented. The incidence rate of covid-19 among 2022 freshmen was significantly higher than among 2021 freshmen and had two peaks in October 2021 and February 2022. The ratio of girls who had been ill and did not have covid-19 was significantly higher than in the group of boys. Among young men who had recovered from covid-19, 14.86% belonged to a special medical group, while among those who were not sick, only 4.27% belonged to a special medical group. In the group of girls who had had covid-19, 17.45% belonged to the special medical group, and 11.42% among those who were not sick. Among young men who had been ill and did not have covid-19, 68.92 and 68.29% of freshmen, respectively, had a normal level of body mass index (BMI); 13.51 and 14.63% − reduced BMI values, and 16.22 and 13.42% − high BMI values. Among girls, 64.98 and 69.84% of freshmen were characterized by normal BMI values; 21.52 and 19, 34% − reduced values, and 13.08 and 8.86% − high BMI. Comparison of physical fitness indicators of freshmen who had been ill and did not have covid-19 were performed in subgroups with comparable BMI values. In the group of boys and girls with normal body mass index values, there were no significant differences in physical development and physical fitness among students who had been ill and did not have covid-19. In boys and girls with an insufficient body mass index who had recovered from covid-19, the indicators of active orthostatic test were significantly worse than in those who were not sick. In boys with excessive BMI who have had covid-19, the indicators of the hand dynamometry index and resistance to hypoxia were significantly lower than among non-sick fellow students.

Features of autonomic regulation of heart rate in patients with takotsubo syndrome

BACKGROUND: The pathophysiological mechanisms underlying takotsubo syndrome are still being actively investigated, but it is generally accepted that sympathetic nervous system hyperactivity is of key importance. The method for assessing heart rate variability allows to study the vegetative status of a patient, however, there are few scientific works on this topic at present, and the results obtained are ambiguous.
 AIM: To study heart rate variability in patients with takotsubo syndrome in acute and late periods of the disease at rest, when performing vegetative tests (the deep-breath test, active orthostatic test), as well as before and after mental stress tests and to compare the data obtained with the results of the examination of the control group.
 MATERIALS AND METHODS: The study included patients with takotsubo syndrome (n = 48), including 43 (89.6%) women; the average age of the patients was 63.3 13.5 years, and healthy volunteers of the same sex and age (control group, n = 40). All the subjects with takotsubo syndrome in the acute (first 714 days from the onset of the disease) and in the long-term periods of the disease (after 1 year and 2 years) and the ones in the control group underwent cardiorhythmography at rest to assess the heart rate variability after mental stress tests and against the background of vegetative tests.
 RESULTS: According to the cardiorhythmography at rest, in 47 (97.9%) patients with takotsubo syndrome, the influence of sympathetic nervous system on the heart rate prevailed, which persisted in the long-term period of the disease. The vegetative tests revealed a paradoxical reaction of the sympathetic nervous system and reduced activity of the parasympathetic nervous system in the acute and late periods of takotsubo syndrome, compared with the control group. In the acute and long-term periods in the patients with takotsubo syndrome after mental stress tests, in comparison with control group, there was no increase in parasympathetic nervous system activity.
 CONCLUSIONS: According to the study findings, the patients with takotsubo syndrome revealed autonomic dysfunction in the form of an excessive increase in the activity of the sympathetic nervous system both before the onset of the disease, and in the acute and long-term periods as well as a decrease in vagal tone, which was reflected in the suppressed response of the parasympathetic nervous system to the deep-breath test and mental stress tests.

PHYSICAL THERAPY OF PREGNANT WOMEN WITH PRIMARY MANIFESTATIONS OF VARICOSE DISEASE OF THE LOWER EXTREMITIES

As a result of the generalization of clinical experience, it has been proved that varicose disease of the lower extremities of pregnant women is defined as a polyetiological disease of the venous system.
 The high pathological incidence of varicose veins among pregnant women is caused by a number of factors. The consequence of such changes may be stagnation in the venous bed of the lower extremities. Therefore, women who have a history of primary manifestations of varicose veins of the lower extremities often have got problems during pregnancy and the postpartum period in the form of complications of symptoms leading to thrombophlebitis (inflammation of superficial veins).
 Timely started and implemented physical therapy allows relieving or completely eliminating the above symptoms of the disease of pregnant women, significantly improves the properties of blood circulation and the condition of the inner walls of vessels.
 The aim of the study is to assess the functional state of the body of women in the second and third trimester of pregnancy with primary manifestations of varicose veins of the lower extremities and the effectiveness of the physical therapy program.
 Methods and materials. 19 pregnant women with varicose veins, aged 22 to 29 years, from the second to third trimester of pregnancy participated in the study. Two groups were formed: the main number of 10 women (implemented measures of the developed physical therapy program, which included kinesiotherapy, therapeutic and electrophoresis) and a comparison group – 9 women (implemented standard physical therapy technique).
 The following methods were used during the research: 1) anthropometric examination; 2) physiological monitoring of functional indicators of the state of the cardiovascular system of women (pulsometry and tonometry with systematic registration of the indicators of systolic and diastolic blood pressure, heart rate; 3) functional diagnostics (active orthostatic test, spirometry); 4) clinical somatoscopy with participation; 5) assessment of the quality of life.
 Conclusions. In the process of different periods of pregnancy, the examined patients were diagnosed with primary varicose veins of the lower extremities. Pregnant women with varicose veins had an intensive increase of body weight in the last trimester of pregnancy.
 The inconsistency of the actual blood pressure indicators towards hypertension compared to the physiological norms was revealed. After the implementation of the developed physical therapy program, the following dynamics of changes were exposed: the average value of systolic and diastolic pressure and heart rate indicators of the main group decreased in contrast to the comparison group (p>0.05). Among the women of the main group, the vital capacity of the lungs increased by 7.56%. The normalization of the regulation and type of reaction of the orthostatic test with a change of body position from horizontal to vertical was observed among pregnant women of the main group (-20.56%) in contrast to the examined comparison group (p>0.05).
 The assessment based on the data of the CIVIQ questionnaire showed a probable improvement of all components of the quality of life of the respondents of the main group (indicator of the category of pain and complaints regarding the physical condition) of pregnant women. Thus, the obtained results make it possible to ascertain the effectiveness of the developed physical therapy program.

Функциональное состояние педагогов северного университета при переходе к дистанционному формату работы

The purpose of this paper was to perform a comprehensive study of the functional state of male and female teachers of a northern university during the quarantine due to the coronavirus pandemic, when they had to switch from on-campus to distance teaching. Materials and Methods. The study involved 56 teachers (36 men and 20 women) from Surgut State Pedagogical University, who were examined before and after the switch to distance teaching. The functional state of the central nervous system (CNS) was evaluated according to the data of simple visual-motor reaction. The state of autonomic regulation was characterized based on the dynamics of heart rate variability at rest and during active orthostatic test. Peripheral systolic and diastolic blood pressure and central systolic aortic pressure were measured. The psychophysiological state was analysed using the Maslach Burnout Inventory and Eysenck’s “Self-assessment of anxiety, frustration, aggressiveness and rigidity”. The quality of life was evaluated using the Short Form (36) Health Survey. Results. During on-campus teaching, female university teachers showed more pronounced impairments of autonomic regulation and functional state of the CNS compared to their male colleagues. In addition, women experienced professional burnout more often, while an increase in central and peripheral blood pressure was less common among them. After the transition from on-campus to distance teaching during the COVID-19 quarantine, functional disorders of autonomic hear rate regulation and haemodynamics were more pronounced in men than in women. Women under the same conditions had greater impairments of the functional state of the CNS, while demonstrating improvements in the psychophysiological state. Thus, the research found that changes in the form of teaching produce different effects on the functional state of male and female university teachers.

ВАРИАБЕЛЬНОСТЬ СЕРДЕЧНОГО РИТМА И ГИПОФИЗАРНО-НАДПОЧЕЧНИКОВАЯ ФУНКЦИЯ У ПАЦИЕНТОВ С ПСОРИАЗОМ

The study of heart rate variability and the function of the pituitary-adrenal axis was carried out in 91 patients with various forms of psoriasis. The tension of the regulatory systems of the heart rhythm and disorders of the autonomic nervous system observed in conditions of an active orthostatic test were established. Impairment of the autonomic nervous system was associated with high glucocorticoid and mineralocorticoid activity of the adrenal glands. The difference in the heart rate, pituitary and adrenal hormones was revealed in patients with streptococcus-associated psoriasis and psoriasis without streptococcal association.

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Post-COVID Syndrome: A Common Neuroimmune Ground?

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating chronic disease of unknown etiology, sharing a similar clinical presentation with the increasingly recognized post-COVID syndrome. We performed the first cross-sectional study of ME/CFS in a community population in Russia. Then we described and compared some clinical and pathophysiological characteristics of ME/CFS and post-COVID syndrome as neuroimmune disorders. Of the cohort of 76 individuals who suggested themselves as suffering from ME/CFS, 56 were diagnosed with ME/CFS by clinicians according to ≥1 of the four most commonly used case definitions. Of the cohort of 14 individuals with post-COVID-19 syndrome, 14 met the diagnostic criteria for ME/CFS. The severity of anxiety/depressive symptoms did not correlate with the severity of fatigue either in ME/CFS or in post-COVID ME/CFS. Still, a positive correlation was found between the severity of fatigue and 20 other symptoms of ME/CFS related to the domains of "post-exertional exhaustion", "immune dysfunction", "sleep disturbances", "dysfunction of the autonomic nervous system", "neurological sensory/motor disorders" and "pain syndromes". Immunological abnormalities were identified in 12/12 patients with ME/CFS according to the results of laboratory testing. The prevalence of postural orthostatic tachycardia assessed in the active orthostatic test amounted to 37.5% in ME/CFS and 75.0% in post-COVID ME/CFS (the latter was higher than in healthy controls, p = 0.02). There was a more pronounced increase in heart rate starting from the 6th minute of the test in post-COVID ME/CFS compared with the control group. Assessment of the functional characteristics of microcirculation by laser doppler flowmetry revealed obvious and very similar changes in ME/CFS and post-COVID ME/CFS compared to the healthy controls. The identified laser doppler flowmetry pattern corresponded to the hyperemic form of microcirculation disorders usually observed in acute inflammatory response or in case of systemic vasoconstriction failure.

Оценка функциональных резервов организма первокурсников северного педагогического вуза по результатам ортостатической пробы

The success of adaptation to the standard minimum load (using orthostatic test as an example) is primarily determined by the ability of the regulatory systems to restructure the activity of the cardiovascular system without involving the central regulatory circuit. Evaluation of the body’s functional reserves can provide the basis for characterization of its adaptive capabilities as a whole. The aim of this study was to assess the body’s functional reserves in first-year students of a pedagogical university in northern Russia according to the results of an orthostatic test. Materials and methods. A total of 135 first-year students of Surgut State Pedagogical University were examined, their mean age being 18.3 ± 0.33 years. Cardiointervalography (VNS-spektr device, Neurosoft, Russia) was used to assess heart rate variability at rest and during an active orthostatic test. Results. Total power, as well as absolute low frequency and very low frequency power decreased during the orthostatic test in both groups. It was found that 23 % of male and 16 % of female students had a reduced reaction to the orthostatic test. High level of adaptation reserves was observed in 30 % of first-year students. At the same time, we identified groups with a low level of adaptation reserves (8.8 % of male and 2 % of female students). The research established that the level of the body’s functional reserves in young women was higher than that in young men. In addition, female students showed a bigger contribution of the central circuit to heart rate regulation. Young men demonstrated high parasympathetic reactivity and a greater contribution of subcortical centres to heart rate regulation, compared to young women.

STATE OF REGULATORY MECHANISMS AND VASCULAR PARAMETERS OF FIRST YEAR STUDENTS OF NORTHERN UNIVERSITY WITH DIFFERENT LEVEL OF ADAPTATION RESERVES

The study of the autonomic nervous system parameters and assessment of the adaptive reserves of the students’ organism allows to determine the key markers of changes in the functioning of the cardiovascular system at the prenosological level.
 Objective. To estimate regulatory mechanisms and state of vascular system of 1st year students depending on the level of adaptive reserves.
 Materials and methods. The total number of 245 freshmen of Surgut State Pedagogical University was examined: 18.3±0.33 years old on average. Heart rate variability at rest and during orthostatic test were measured by cardiointervalography (“VNS-spectrum”, Neurosoft company). We used hardware-software complex “Angioscan-01P” to assess the state of vascular bed. Statistical processing of the obtained data was performed using Statistica 10.0 program.
 Results. The results showed that during the active orthostatic test the number of intersex differences in the comparison groups significantly decreased in comparison with the background recording. The parameters describing the state of the vascular bed were the following: central pressure value, vascular age and stress level depending on the level of adaptive reserves.
 Conclusion. The adaptation reserves of the organism of 1st year students of the Northern HEI determine the regulatory features of male and female students as well as the value of vascular tone and the age of the vascular system.

Influencing factors and hemodynamic study of initial and sustained orthostatic hypotension in middle-aged and elderly patients.

Orthostatic hypotension (OH) is a common autonomic disorder. This study aimed to investigate the influencing factors and hemodynamic mechanisms of initial and sustained OH in middle-aged and elderly patients. The authors analyzed the clinical characteristics and hemodynamic variables of patients aged ≥ 50years according to the various forms of OH, diagnosed by an active orthostatic test using the CNAP monitor. The study included 473 participants; 119 (25.2%) patients had initial (54, 45.4%) or sustained (65, 54.6%) OH. Age, comorbidities, or medications did not differ significantly between the initial OH and non-OH groups. Sustained OH was associated with age and diabetes (p =.003 and p =.015, respectively). Hemodynamic analysis revealed higher cardiac output (CO) in the sustained OH group within 15 s than in the non-OH and initial OH groups (both p <.001); no difference in CO was observed between the initial OH and non-OH groups. The systemic vascular resistance (SVR) in both initial OH and sustained OH groups within 15 s was lower than that in the non-OH group (both p <.001). No differences in SVR at 3min were observed between the initial OH and non-OH groups. The SVR at 3min in the sustained OH group was significantly lower than in non-OH and initial OH groups (both p <.001). Age and diabetes emerged as the independent risk factors associated with sustained OH. Initial OH is associated with a mismatch of increase in CO and decrease in SVR. Sustained OH is mainly associated with sustained inadequate adjustment in SVR.

Preoperative state of autonomic regulation in patients with adolescent idiopathic scoliosis

Objective. To analyze the state of autonomic regulation of the heart rate in patients with adolescent idiopathic scoliosis before the upcoming surgical treatment of spinal deformity.Material and Methods. The study included 30 patients with adolescent idiopathic scoliosis who were admitted for surgical treatment from January to April 2021. There were 28 female and 2 male patients. The heart rate variability (HRV) registration was carried out on the VNS-micro vegetotester, with Poly-Spectrum.NET software, Neurosoft (Russia). The study was conducted for 5 minutes in the supine position and for 5 minutes after the active orthostatic test. Temporal and spectral indicators of heart rate were analyzed.Results. When analyzing HRV at rest, an increase in the temporal indicators of the heart rate and the power of high-frequency wave oscillations was recorded, which indicates both an increased activity of autonomic regulation in general and the predominance of the regulatory influence o of the parasympathetic division of the autonomic nervous system. A decrease in all spectral components during an active orthostatic test and an increase in stress index values by 3.5 times indicate a significant stress of regulatory systems.Conclusion. Analysis of HRV in patients with adolescent idiopathic scoliosis at rest revealed increased autonomic activity with a predominant effect of the parasympathetic division of the autonomic nervous system. The state of exercise-induced energy deficit, registered after an active orthostatic test, indicates a significant preoperative stress of the regulatory systems and refers this category of patients to a group of increased risk of complications associated with hemodynamic instability.

Gastrocnemius Muscle Contraction and Its Role in Orthostatic Anti-Gravity Adjustment – The Effects of Body Mass Index

BACKGROUND: Obesity is a global concern with severe detrimental health and economic effect. Body mass index (BMI) is an inexpensive, non-invasive indicator for different diseases, and associated with abnormal weight. AIM: The aim of the study was to investigate the relationship between BMI and the contraction of gastrocnemius muscle (GM) and its possible role in peripheral muscle pump activity and pathogenesis of orthostatic intolerance. METHODS: One hundred and four volunteers (63 women and 41 men, mean age 39 ± 14 years) were divided into three subgroups according to their BMI values (with normal weight, overweight, and obesity). Changes in the transverse diameter and pennation angle of GM at rest and during maximal active plantar flexion (MAPF) were measured with multimodal ultrasound imaging. An active orthostatic test was performed and changes in systemic blood pressure and heart rate in supine position and active standing on the 1st, 5th, and 10th min were monitored. The results were statistically processed with alternative, variational, and correlational analysis. RESULTS: Patients with abnormal BMI were significantly older and had higher anthropometrical parameters compared to the subgroup with normal weight. They showed a significantly larger diameter and pennation angles at rest and during maximal active plantar flexion of GM bilaterally, which was more pronounced for the dominant right leg. However, the amount of changes in the GM diameter and pennation angles was similar in the different subgroups. CONCLUSION: The study showed that BMI affects predominantly the initial values of GM parameters at rest and MAPF without influence on its antigravity contractility associated with active straightening.

Impact of Diabetes Type 2 in Adults on Autonomic Modulation at Rest and in Response to the Active Orthostatic Test

Background: Cardiovascular autonomic neuropathy Is one of the most common complications ofDiabetes Mellitus Type 2(DM2). Heart rate variability (HRV} Is a noninvasive measure of cardiacautonomicmodulation. Reduced HRVIs an Independent cardiovascula rrisk factor and has beenproposed as amarker of increased risk of mortality.Very few studies have measured ChangesinHRV in DM2 in India.Objectives: To analyze the autonomic modulation responses In DM2 patients by means of HRVindices.Methodology: Across-sectional study of 20 Type 2 Diabetic mellitus from age groups 30-S0 years and age and gender matchenon-diabetic subjects as controls. Subjects satisfying inclusion and exclusion criteria and gave written informed consent were randomly invited to takepartin the study. Initial assessment was done for HTN, hyperlipidemia, smoking, cardiovasculardisease, familyH/o DM2, FBS &gt;130 mg/di, Body mass index (BMI) &gt;25 kg/m,DM2, duration of disease, andHeart rate.Bloodpressure: measure dmercury sphygmomanometer aftera5-minrest. ElectrocardiogramwasrecordedusingPower Lab• (ADlnstruments). The time domain, frequencydomainvariables,and nonli near parameters was meas ured from ECGusing Lab Chart• software.Results and Conclusion : Time domain Variablesnamely AverageRR, SDRR,SDARR,rMSSDandPNNS0(%) and Frequency domain Variables; High frequency (HF) power, Low frequency(LF) power and Very Lowfrequency (LF)power Non-Linear Variables; S01and SD2 werereuced in patients with diabetes Mellitus compared to normal control but was not statisticallysignificant. One of the reasons couldbesmallsamplesize. Study should be repeated in largesample size.