Volume Pulse Amplitude Research Articles

Empatica E4 Assessment of Child Physiological Measures of Listening Effort During Remote and In-Person Communication.

Telepractice is a growing service model that delivers aural rehabilitation to deaf and hard-of hearing children via telecommunications technology. Despite known benefits of telepractice, this delivery approach may increase patients' listening effort (LE) characterized as an allocation of cognitive resources toward an auditory task. The study tested techniques for collecting physiological measures of LE in normal-hearing (NH) children during remote (referred to as tele-) and in-person communication using the wearable Empatica E4 wristband. Participants were 10 children (age range: 9-12 years old) who came to two tele- and two in-person weekly sessions, order counterbalanced. During each session, the children heard a short passage read by the clinical provider, completed an auditory passage comprehension task, and self-rated their effort as a part of the larger study. Measures of electrodermal activity and blood volume pulse amplitude were collected from the child E4 wristband. No differences in child subjective, physiological measures of LE or passage comprehension scores were found between in-person sessions and telesessions. However, an effect of treatment duration on subjective and physiological measures of LE was identified. Children self-reported a significant increase in LE over time. However, their physiological measures demonstrated a trend indicating a decrease in LE. A significant association between subjective measures and the passage comprehension task was found suggesting that those children who reported more effort demonstrated a higher proportion of correct responses. The study demonstrated the feasibility of collection of physiological measures of LE in NH children during remote and in-person communication using the E4 wristband. The results suggest that measures of LE are multidimensional and may reflect different sources of, or cognitive responses to, increased listening demand. https://doi.org/10.23641/asha.27122064.

Building blocks of suspense: subjective and physiological effects of narrative content and film music

The current study explores the role of narrative content and non-diegetic music, as well as their interplay in the creation of film suspense. In a between-subjects design, three audience groups watched either the full version (audio–video) of a suspenseful short movie (Love Field) or a video-only version or listened to the audio track only. Audience responses were assessed with a combination of continuous response measurement (CRM) and psychophysiological measures, comprising heart rate (i.e., inter-beat interval, IBI), pulse volume amplitude (PVA), and skin conductance level (SCL). Frame-by-frame content coding was performed to identify distinct plot segments and musical moods (tense vs. relaxing) and mark the critical visual and auditory events that directed the audience’s inferences about the nature of the plot and elicited specific outcome expectations. Results showed that continuous self-report data and objective physiological measures were largely dissociated, suggesting different processing modalities. Tense music alone induced feelings of suspense (CRM) even in the absence of any clues about the story content. Overall, the audio-only version led to the highest arousal levels, as indicated by SCL and PVA, while the video-only version led to the lowest arousal levels. IBI data revealed short-term heart rate deceleration responses to salient narrative clues that could be interpreted in terms of heightened attention and cognitive resource allocation. Results are discussed in light of a multidimensional framework of tension and suspense and a terminological differentiation of both concepts.

Emotional Effects in Object Recognition by the Visually Impaired People in Grocery Shopping.

To date, neuroscientific literature on consumption patterns of specific categories of consumers, such as people with disability, is still scarce. This study explored the implicit emotional consumer experience of visually impaired (VI) consumers in-store. A group of VI and a control group explored three different product shelves and manipulated target products during a real supermarket shopping experience. Autonomic (SCL, skin conductance level; SCR, skin conductance response; HR, heart rate; PVA, pulse volume amplitude; BVP, blood volume pulse), behavioural and self-report data were collected in relation to three phases of the in-store shopping experience: (i) identification of a product (recognition accuracy, ACC, and reaction times, RTs); (ii) style of product purchase (predominant sense used for shelf exploration, store spatial representation, and ability to orientate themselves); (iii) consumers experience itself, underlying their emotional experience. In the VI group, higher levels of disorientation, difficulty in finding products, and repeating the route independently were discovered. ACC and RTs also varied by product type. VI also showed significantly higher PVA values compared to the control. For some specific categories (pasta category), PVA correlates negatively with time to recognition and positively with simplicity in finding products in the entire sample. In conclusion, VI emotional and cognitive experience of grocery shopping as stressful and frustrating and has a greater cognitive investment, which is mirrored by the activation of a larger autonomic response compared to the control group. Nevertheless, VI ability to search and recognise a specific product is not so different from people without visual impairment.

Temporal effects of two interferential current applications on peripheral circulation in children with hemiplegic cerebral palsy

ObjectivesTo determine the short-term effects of sympathetic and peripheral stimulation of interferential current (IFC) on blood flow (BF) in children with hemiplegic cerebral palsy (CP). MethodsThirty children with hemiplegic CP, ranging from 8 to 12 years old, were randomly divided into three groups (10 children/group). The first group received sympathetic stimulation of IFC, the second group received peripheral stimulation of IFC, and the third group (control) received placebo peripheral stimulation of IFC. A frequency of 80–100 Hz at an intensity of 10–20 mA was applied for 20 min. Blood volume pulse (BVP) amplitude was measured before IFC application using a plethysmography sensor at the big toe immediately after and 15 min poststimulation. The data were statistically analyzed and compared. ResultsThere were statistically significant differences in BVP amplitude among the three time intervals in both the sympathetic and peripheral groups (P < 0.05) with no difference in the control group (P = 0.995). There was a significant increase in BVP amplitude immediately after stimulation compared with before stimulation in both the sympathetic and peripheral groups (P = 0.0001). However, differences between the sympathetic and peripheral groups at the three measured periods were statistically nonsignificant (P > 0.05). ConclusionBoth IFC applications had a proper effect on improving BF in children with hemiplegic CP with no difference in efficacy between sympathetic and peripheral stimulation.

Heart Rate Variability biofeedback therapy for children and adolescents with chronic pain: A pilot study

PurposeAs a brief, noninvasive, cost-effective, and technology-driven therapy, biofeedback is a promising and welcomed clinical intervention for children and adolescents with pediatric chronic pain conditions. The aim of this pilot study was to explore the application of a brief Heart Rate Variability (HRV) biofeedback intervention supplemented by at-home breathing practice as a tool for reducing symptomatology associated with chronic pain in a pediatric urban hospital setting. Design and methodsTwenty-one participants aged 10–17 years (M = 14.05, SD = 1.91; 76% female) and their caregivers completed the study. Participants were randomized to either 1) receive immediate biofeedback treatment including at-home breathing practice or 2) to be placed on a 4-week waitlist and then enrolled in the biofeedback treatment. Study outcomes included self-reported pain intensity, health-related quality of life (HRQOL), and anxiety sensitivity. HRV data were obtained from biofeedback sessions. Results: Following biofeedback treatment, participants achieved significant reductions in self-reported pain intensity, higher levels of self-reported school functioning, and increased HRV, as measured by Blood Volume Pulse (BVP) amplitude. Participants in the waitlist group experienced an increase in pain intensity during the waitlist period. ConclusionFurther research is needed to understand the mechanisms underlying HRV biofeedback and its treatment of pediatric chronic pain. Practice implicationsNurses are ideal practitioners for biofeedback given their training in physiology and background in healthcare and should be encouraged to explore training in this area. Suggested biofeedback-related apps and mobile devices to share with patients at bedside are provided.

Differences in the Course of Physiological Functions and in Subjective Evaluations in Connection With Listening to the Sound of a Chainsaw and to the Sounds of a Forest.

We explored differences in the course of physiological functions and in the subjective evaluations in response to listening to a 7-min recording of the sound of a chainsaw and to the sounds of a forest. A Biofeedback 2000x-pert apparatus was used for continual recording of the following physiological functions in 50 examined persons: abdominal and thoracic respiration and their amplitude and frequency, electrodermal activity (skin conductance level), finger skin temperature, heart rate (pulse, blood volume pulse and blood volume pulse amplitude) and heart rate variability (HRV). The group of 25 subjects listening to the sound of a chainsaw exhibited significantly lower values of blood volume pulse amplitude, lower values in peak alpha frequency HRV and higher values in peak high-frequency HRV. In the time interval from 80 s to 209 s, in which the two groups showed the greatest differences, lower values of blood volume pulse were also recorded while listening to the sound of a chainsaw. Listening to the sound of a chainsaw is associated with a greater feeling of fatigue and higher tension, while listening to the sounds of a forest is even considered to elicit feelings of improved learning abilities. The assumption that listening to the sound of a chainsaw results in higher defense arousal was confirmed. The greater variability which is exhibited by a majority of physiological functions while listening to the forest sounds may also be an innovative finding. It seems that there are two types of arousal (sympathetic and parasympathetic) following from correlations between physiological functions and subjective assessment. Low values of blood volume pulse amplitude are especially important from the health perspective. They correspond to the amount of vasoconstriction which occurs in the endothelial dysfunction related to increased mortality, incidence of myocardial infarction, leg atherosclerosis and topically to COVID-19.

Air Cuff Transducer Design for Occlusion-Based Hemodynamic Measurements—An Experimental and Simulation Study

In standard clinical practice, cuff devices are widely used for non-invasive blood pressure measurements (NIBP). However, cuff-based NIBP is prone to large errors especially in cases of hypo- and hypertension. In addition to this, the cuff measurement principle allows for estimation of a number of other hemodynamic parameters (e. g. cardiac output, arterial stiffness, augmentation index) by means of analysis of the pulse waveform and/or pulse amplitude recorded in the cuff pressure. However, in standard practice, the cuff is still only used for the measurement of BP.A key reason for the observed measurement errors and the limited set of extracted parameters lies in our poor understanding of the cuff device as a transducer; the cuff pressure response to arm volume pulsations (the cuff transfer function <i>TF</i>_cuff) depends on a large number of factors. It is not yet clear to what extent the cuff contributes to the NIBP error, or if the cuff in its current format is reliable for measurement of arterial pulse waveform/amplitude. In this study, we investigate the isolated cuff in order to gain a better understanding of the main sources of measurement errors. By using an experimental setup which measures the cuff response to mechanically simulated arm pulsations, we find that the cuff can explain part of the NIBP errors in cases of hypotension. Also, we find that pulse waveforms can be estimated using a standard cuff; however, measurement of the pulse volume amplitude is unfeasible. We demonstrate that the observed inaccuracies can be eliminated by usage of a calibrator device which obtains real-time information on <i>TF</i>_cuff. These findings will enable further investigation of the effects related to the pulse travel along the compressed limb and the interaction between cuff, arm tissue, distal arm hemodynamics and arterial walls for the development of improved occlusion-based measurement strategies.

Interoceptive attentiveness and autonomic reactivity in pain observation

Aim: This study explores interoceptive attentiveness (IA) influence on autonomic reactivity related to pain and self-regulation during situations evoking physiological mirroring for pain. Methods: 20 participants observed face/hand, painful/non-painful stimuli in an individual versus social condition while the autonomic response was measured [Electrodermal activity, Pulse Volume Amplitude (PVA), and Heart Rate (HR)] was measured. The sample was divided into experimental (EXP) subjects, required to focus on their interoceptive correlates while observing the stimuli, and the control (CNT) group. HR inter-beat interval (IBI), and HR Variability (HRV) were calculated. Results: Results showed high accuracy to painful and non-painful stimuli recognition. Regarding autonomic indices, higher PVA values were detected for hand painful versus non-painful stimuli, whereas for the EXP group a significant activation of IBI was found for face painful vs non-painful stimuli. Conclusion: In the context of observation of pain in others, PVA and IBI could be respectively markers of mirroring mechanisms and autonomic self-regulation mediated by IA.

The Winner Doesn’t Take It All: Analyzing Audience Responses to an Inspirational Sports Narrative

Applying a dual-process rationale, this study explored the cognitive and affective mechanisms involved in the processing of hedonic versus eudaimonic film clips and their putatively distinct inspirational effects. The two types of narratives were operationalized in terms of complete and incomplete goal satisfaction in the film endings. Participants either watched the final boxing match from &lt;em&gt;Rocky&lt;/em&gt;, where the protagonist loses the fight, but achieves self-mastery and finds love (eudaimonic narrative) or from &lt;em&gt;Rocky II&lt;/em&gt;, where he wins against his opponent (hedonic narrative). A combination of continuous measures of how pleasant participants felt (slider ratings) and psychophysiological measures (heart rate, galvanic skin response [GSR], pulse volume amplitude [PVA]) indicating cognitive load and arousal was used to track the audience responses while watching a compilation of the same intro and the different fight versions. Results revealed that arousal was more strongly associated with participants’ affective scores during the hedonic (winning) version than during the eudaimonic (losing) one. Furthermore, participants experience more positive affect and arousal after watching the protagonist win the match compared to those that watched him lose. Lastly, participants in the eudaimonic condition were more likely to be inspired to exercise afterward. Implications of our results are discussed.

325 Stress-Induced Physiological Profiles Among Different Phenotype Insomniacs

Abstract Introduction Stress reactivity and autonomic nervous system (ANS) dysregulation have been suggested to be the pathophysiology of insomnia. Based on the finding PSG-measured short sleep duration was associated with higher morbidity of metabolic and cardiovascular disease. Vgontzas and Fernandez-Mandoza (2013) proposed that objective sleep duration is a biomarker for insomnia phenotypes. The phenotype with short objective sleep duration is associated with increased stress-related physiological hyperarousal. The present study aims to test this hypothesis by comparing the stress-induced cardiovascular reactivity between insomnia patients with short and long objective sleep durations. Methods 27 insomnia patients (age mean 34.48 ±12.87, Male: Female= 6:21) without comorbidity of psychiatric, medical or sleep disorders participated in this study. They went through one night of 8-hour PSG recording and were divided into two groups by their total sleep time with a cutoff of 6 hours. Nine participants were in short sleep duration group and 18 in longer sleep duration group. Psychophysiological reactivity profile, as recorded with EKG, skin conductance (SC), body temperature (BT), blood volume pulse (BVP), respiration rate (RR), was measured under three conditions: baseline resting state, arithmetic word problems solving, and recovery resting state. Results Both groups showed similar stress physiological response with increased heart rate (HR) and SC, nearly equivalent BT and BVP, and decreased RR when solving arithmetic problems, and opposite reaction during recovery resting state. Mann-Whitney U test comparing the changes from baseline resting state on all the psychophysiological measures between two phenotypes of insomnia showed no significant differences: stress-induced heart-rate (U=106, p=.119.) recovery heart-rate (U=44, p=.095), stress-induced skin conductance (U=104.5, p=.132),recovery skin conductance (U=51.5, p=.198), stress-induced body temperature (U=79, p=.897),recovery body temperature (U=60.5, p=.418), stress-induced blood volume pulse amplitude (U=77, p=1.0), and recovery blood volume pulse amplitude (U=69, p=.735), stress-induced respiration rate (U=76, p =.696), and recovery respiration rate (U=85, p=.658). Conclusion Our results indicate that the insomnia phenotypes with short and long objective sleep duration are not different in their stress-induced physiological responses. Future studies are needed to confirm these results and to explore other mechanisms for the increased metabolic and cardiovascular disease risk in insomnia patients with short objective sleep duration. Support (if any):

Paint it green: A neuroscientific approach to hotel sustainability and ecological tourism

Hoteliers and companies are asked to optimize their budgets and, at the same time, gifting unforgettable experiences to customers who are freely able to express their feedbacks, readable by thousands of potential guests. In addition, the rise of corporate social responsibility (CSR), sustainability, environmental and social issues leads to the necessity to investigate more systematically new business models that respond to these emerging concerns. In order to investigate the impact of sustainability in tourism marketing, a multimethod neuroscientific approach was used to record individuals’ neural activity (electroencephalography, EEG) and autonomic system responses during the exploration of four different environments of a green hotel adopting a sustainability approach. EEG findings showed an increase of beta and theta frequency band activity during individuals’ environments exploration, underlying the presence of cognitive and emotional elaboration processes. Moreover, from autonomic activity, an increase of pulse volume amplitude (PVA) and heart rate (HR) response emerged during the exploration of hotel environments, highlighting emotional engagement and positive emotional response. This research, therefore, contributes to show how responsiveness to sustainability concept within consumer services can improve individuals’ experience enjoyment and customers' well-being condition.

Acoustic Measures of Voice and Physiologic Measures of Autonomic Arousal During Speech as a Function of Cognitive Load in Older Adults

The purpose of this study was to determine the relationships among cognitive loading, autonomic arousal, and acoustic measures of voice in healthy older adults. Prospective and observational. Twelve healthy older adults (six females) produced a sentence containing an embedded Stroop task in each of two cognitive load conditions: congruent and incongruent. Three physiologic measures of autonomic arousal (pulse volume amplitude, pulse period, and skin conductance response amplitude) and four acoustic measures of voice (cepstral peak prominence, low-to-high spectral energy ratio, fundamental frequency, and sound pressure level) were analyzed in each cognitive load condition. A logistic regression model was used to predict the cognitive load condition using participant as a categorical predictor and the four acoustic measures and three autonomic measures as continuous predictors. Skin conductance response amplitude and pulse volume amplitude were both predictive of cognitive load; however, no acoustic measures of voice were statistically significant predictors of cognitive load for older adults. These findings support the idea that increased cognitive load is associated with increased autonomic nervous system activity in older adults. The lack of changes in acoustic measures of voice with increased cognitive load may result from age-related changes in vocal quality and speech subsystems.

Background soundscapes influence the perception of ice-cream as indexed by electrophysiological measures.

Listening to specific soundscapes can influence multisensory flavour perception. In the present study, changes in people's perception of the flavour of ice-cream were tracked over time as they listened to a café soundscape, and when this soundscape was overlaid with either bird, machine, or forest soundscapes. In addition, emotions and electrophysiological measures were recorded in order to help understand any changes in taste/flavour perception. The results of Temporal Dominance of Sensation (TDS) analysis revealed that cocoa was dominant early in the consumption episode while listening to the control café soundscape. Sweetness and creaminess were dominant at the start of the consumption episode while listening to the café-forest soundscape. Creaminess was dominant at the start of the consumption episode while listening to the café-bird soundscape. Bitterness was perceived at the end of the consumption period while listening to the café control and café-machine soundscapes. These findings demonstrate the crossmodal influence of audition on perception in the chemical senses. As expected, negative emotions were significantly higher when listening to the machine soundscape, while positive emotions were significantly higher when listening to café-forest and café-bird soundscapes. Evaluating ice-cream while listening to the café-machine soundscape evoked negative emotions associated with bitterness and creaminess, that were also associated with increased heart rate (HR) and respiration rate (RESP). When listening to the café-forest soundscape, ice-cream was associated with sweetness, and positive emotions (e.g., love, satisfaction, happiness, amusement and enjoyment). This might have led to increased blood volume pulse (BVP) amplitude, which is itself indicative of a relaxed state. Enhancing eating experiences by means of atmospheric soundscapes that are designed specifically to accentuate specific aspects of multisensory taste/flavour perception is currently an area of interest in the food sciences literature and will likely lead to future commercial applications.

Does noise sensitivity or attentional capacity predict cardiovascular responses to distracting sound?

Workplace noise may cause stress that has long-term implications for health. Employees in open-plan offices typically identify intermittently occurring background sounds as significant sources of stress, possibly because they distract attention away from intended tasks. Thus, individual differences in attention and noise sensitivity may explain individual differences in physiological responses to workplace noise. In previous research [Oliver, et al., in 176th Meeting of the Acoustical Society of America (2018)], we reported results from a preliminary analysis of 19 participants’ affective and electrodermal responses to working in background noise that included intermittent environmental sounds. Electrodermal responses were used as a measure of distraction because they constitute a primary component of the physiological orienting response, a multi-component response reflecting exogenous capture of attention. Our results suggested that individuals who are more sensitive to noise experienced greater frustration with the primary task, but there was no relationship between frustration and distraction as indexed by electrodermal responses. Here, we present additional analyses of an expanded dataset, focusing on attentional and cardiovascular measures (heart rate and pulse volume amplitude) previously linked to cognitive demand and noise annoyance (Francis et al., 2016) and relate these results to an overall characterization of the auditory orienting response.

Contribution of systemic vascular reactivity to variability in pulse volume amplitude response during reactive hyperemia.

The aim of the present study was to investigate why the magnitude of reactive hyperemia (RH) observed by pulse volume amplitude (PVA) after arm occlusion differs greatly among study subjects. Healthy subjects (n = 12) in the age range of 22-30years participated in this study. Vascular reactivity was assessed by measuring the changes in finger PVA simultaneously in the test (occluded arm) and control arm (contralateral non-occluded arm) using two separate Photoplethysmographic sensors. Short-term HRV was computed from simultaneously acquired lead II ECG signal to monitor the changes in cardiac sympathetic nervous activity. The observed coefficient of variation for inter-subject variability in PVA response in test arm during second minute of RH was 115.3%. In the control arm, significantly reduced PVA was observed during the period of occlusion as well as RH. This observation was corroborated by simultaneously acquired short-term HRV which showed a significant rise in total power (p value < 0.005) and low-frequency (LF) power (p value < 0.05) during release of occlusion when compared to the baseline. A significant positive correlation (Spearman r = 0.33; p = 0.02) was observed between % change in PVA in the control arm and in the test arm for first 3min of RH. Sympathetic activation possibly plays an important role in mediating the inter-subject variability of vascular responses during reactive hyperemia which warrants simultaneous recording of both the test and the control arm responses during RH to accurately assess endothelial function.

Emotional and electrophysiological measures correlate to flavour perception in the presence of music

Research into the influence of auditory cues upon food perception has increased in the past decade. Mechanisms evoked to explain crossmodal interactions between the auditory and gustatory senses include attentional, emotional, and affective mediators. In this study, the Temporal Dominance of Sensations (TDS) method was utilised to document the changes in taste and flavour of chocolate gelato while participants listened to music. After each TDS trial, the participants rated their emotions using intensity scales. Additionally, electrophysiological measures including heart rate, respiration rate, and skin conductance were obtained. As anticipated, listening to liked music evoked positive emotions (enjoyment, happiness, love, and satisfaction), while disliked music elicited negative emotions (disappointment, and disgust). No significant difference in terms of respiration parameters were observed while listening to music differing in liking. When compared to neutral and liked music, listening to disliked music exhibited the greatest change in skin conductance. Additionally, neutrally liked music significantly decreased blood volume pulse amplitude, while listening to liked music significantly increased heart rate. Partial Least Square Regression (PLSR) analysis was employed to explore associations between electrophysiological and sensory measures. Skin conductance and cardiovascular measures were both linked to the perception of gelato. Partial Least Square Path Modelling (PLS-PM) was also utilised to investigate the relationships between the electrophysiological measures, subjective ratings of emotion, and perception. The PLS-PM model showed that changes in cardiac and skin conductance measures were correlated with subjectively-rated emotions. Furthermore, these self-reported emotions evoked by music were significantly correlated with flavour.

Endothelial Vasodilation After a High-Volume Training Load and Tapered Training in Collegiate Female Swimmers

Weihl, FM and Van Guilder, GP. Endothelial vasodilation after a high-volume training load and tapered training in collegiate female swimmers. J Strength Cond Res 35(3): 811-818, 2021-High-volume endurance training loads have been linked to adverse remodeling of the heart and large arteries; yet, data on the vascular endothelial function are unclear. Moreover, although collegiate-level endurance athletes often perform high-volumes of vigorous endurance training and resistance training as part of their strength and conditioning programs, it is unknown whether they also experience vascular abnormalities, particularly changes in endothelial function. The aim of this study was to verify the impact of a high-volume training load phase followed by low-volume tapered training on endothelial vasodilator function in National Collegiate Athletic Association (NCAA) Division I competitive female swimmers. Microvascular endothelial vasodilation was assessed by pulse arterial tonometry that provides a reactive hyperemia index in 10 female NCAA Division 1 swimmers after 4 weeks of a high-volume training load, and subsequently, after 3 weeks of low-volume tapered training as part of preparation for annual conference championships. The reactive hyperemia index was calculated as the ratio of the pulse volume amplitude after 5 minutes of left-arm brachial artery ischemia to the baseline amplitude, divided by same ratio in the contralateral arm. The high-volume training load included a 4-week block of dual-day sessions (120 minutes per practice) consisting of vigorous intensity endurance and high-intensity interval/sprint swim training, coupled with 5K running, resistance training, and Olympic weightlifting. Tapered training consisted of 3 weeks of 3-5 swims per week at ∼50% V̇o2max for 60 minutes per practice (∼4,000 minutes per practice). The reactive hyperemia index (1.73 ± 0.50) was low in athletes after the high-volume training load with 8 athletes demonstrating endothelial dysfunction. However, after tapered training, the reactive hyperemia index was ∼33% higher (2.29 ± 0.43; 95% confidence interval [CI]: 1.98-2.60, p = 0.0223 vs. the high-volume training load). Effect size, as expressed by the partial eta2 (0.46) and Cohen's dz (1.1923; 95% CI: 0.1687-2.4643) with tapered training, was large. These results demonstrate distinct differences in endothelial vasodilation after 4 weeks of a high-volume training load compared with a 3-week taper in NCAA Division I female swimmers.

Reactive Hyperemia is Decreased in Black Subjects with Heart Failure Despite Equal Prescription of Guideline-Directed Medical Therapy

Background Impaired vascular function in Black Americans contributes to a higher risk of heart failure compared to other race/ethnicities. Augmentation of digital pulse volume amplitude (PVA) in response to hyperemia is a novel measure of microvascular function that is partially nitric oxide dependent, and is related to adverse cardiovascular events. We sought to examine augmentation of digital PVA in blacks and whites with heart failure to determine if guideline-directed medical therapy (GDMT) ameliorates racial differences in vascular function. Methods We assessed vascular function in 139 subjects with heart failure with reduced ejection fraction. Using digital pulse amplitude tonometry (EndoPAT), we estimated the reactive hyperemia index (RHI). Generalized linear models were used to determine if race was predictive of the RHI after adjustment for age, sex, blood pressure, diabetes, body mass index, lipid profile, serum creatinine, and number of vasodilator drugs as GDMT. Results Compared with whites, blacks were younger (51 ± 4 vs. 59 ± 11 years, P Figure ). Conclusion Black race is associated with impaired microvascular vasodilatory function, despite equal prescription of GDMT. Whether the vascular impairment seen in Blacks is associated with increased risk for adverse clinical outcomes in HF warrants further investigation.

Correlation Between Resting Testosterone/Cortisol Ratio and Sound-Induced Vasoconstriction at Fingertip in Men.

A sound-induced sympathetic tone has been used as an index for orienting responses to auditory stimuli. The resting testosterone/cortisol ratio is a biomarker of social aggression that drives an approaching behavior in response to environmental stimuli, and a higher testosterone level and a lower cortisol level can facilitate the sympathetic response to environmental stimuli. Therefore, it is possible that the testosterone/cortisol ratio is correlated with the sound-induced sympathetic tone. The current study investigated the relationship between the resting testosterone/cortisol ratio and vasoconstriction induced by listening to sound stimuli. Twenty healthy males aged 29.0 ± 0.53 years (mean ± S.E.M) participated in the study. They came to the laboratory for 3 days and listened to one of three types of sound stimuli for 1 min on each day. Saliva samples were collected for an analysis of salivary testosterone and cortisol levels on the day of each experiment. After the collecting the saliva sample, we measured the blood volume pulse (BVP) amplitude at a fingertip. Since vasoconstriction is mediated by the activation of the sympathetic nerves, the strength of the reduction in BVP amplitude at a fingertip was called the BVP response (finger BVPR). No difference was observed between the sound-induced finger BVPR for the three types of sound stimuli (p = 0.779). The correlation coefficient between the sound-induced finger BVPR and the salivary testosterone/cortisol ratio within participants was significantly different from no correlation (p = 0.011) and there was a trend toward a significance in the correlation between the sound-induced finger BVPR and the salivary testosterone/cortisol ratio between participants (r = 0.39, p = 0.088). These results suggest that the testosterone/cortisol ratio affects the difference in the sound-evoked sympathetic response.

The More Vivid the Imagination the Better: The Role of the Vividness of Imagination in Vasoconstriction Training and Vasodilatation Training

Blood volume pulse biofeedback represents an effective non-pharmacological treatment for migraine. However, the underlying mechanisms of blood volume pulse biofeedback are still unclear. This study investigated the influence of vividness of imagination, private body consciousness, perfectionism, and general self-efficacy on physiological (blood volume pulse amplitude) and psychological (session performance rated by participants and by trainers) success. Changes in skin conductance and skin temperature indicating habituation to training context were examined. Forty-five healthy male participants were randomized to four sessions of vasoconstriction training or vasodilatation training. Hierarchical linear models were estimated. Results showed significant changes of session performance rated by participants (UC = 0.62, p < .05), by trainers (UC = 0.52, p < .001), and skin temperature (UC = 0.01, p < .001) over time. A change of blood volume pulse amplitude could not be observed (UC = -0.01, p = .65). Vividness of imagination was highly important for both psychological achievement ratings (UC participants = 1.3, p < .001; UC trainers = 0.29, p < .01). Relations between skin temperature and general self-efficacy or personal standards were small (UC self-efficacy = 0.002, p < .10; UC personal standards = 0.002, p < .05). A time × group interaction regarding trainers' achievement ratings indicated a specific judgement effect. In conclusion, biofeedback trainers should pay attention to their beliefs and participants' vividness of imagination.