Autonomic Nervous Function In Patients Research Articles

Effect of cardiac rehabilitation therapy on depressed patients with cardiac insufficiency after cardiac surgery.

This study aims to analyze the effect of cardiac rehabilitation therapy on cardiac autonomic nervous function in patients with cardiac insufficiency complicated with anxiety depression after cardiac operation to provide a reference for clinical practice. A total of 109 patients subject to cardiac operation in our hospital from January 2020 to March 2023 were enrolled as study subjects, including 50 patients who received conventional rehabilitation therapy (control group) and 69 patients who received cardiac rehabilitation therapy (research group). Before and after treatment, the left ventricular ejection fraction (LVEF) and central venous pressure (CVP) were determined, and the level of N-terminal pro-B-type natriuretic peptide (NT-proBNP) was measured. Low frequency/high frequency (LF/HF), standard deviation of normal to normal (SDNN), and root mean of successive square differences (RMSSD) were measured by a multi-lead ECG system. Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI), Activity of daily living (ADL), and Barthel Index (BI) were applied for corresponding investigations, as well as the 6-min walk test (6MWT). After treatment, the research group showed higher LVEF, CVP, LF/HF, SDNN, and RMSSD, and lower NT-proBNP, SAS, and SDS than the control group (P < 0.05). Significantly elevated ADL score, BI, and 6MWT and reduced PSQI were observed in both groups after treatment, with more remarkable changes in the research group (P < 0.05). In conclusion, cardiac rehabilitation therapy effectively improved the cardiac function of patients with cardiac insufficiency complicated with anxiety and depression after the cardiac operation and alleviated their negative emotions.

The Effect of Exercise on Cardiovascular Autonomic Nervous Function in Patients with Diabetes: A Systematic Review.

Diabetic neuropathy, including autonomic neuropathy, is a severe complication in patients with poorly controlled diabetes. Specifically, cardiovascular autonomic neuropathy (CAN) plays a significant prognostic role in cardiovascular morbidity and mortality. Exercise, an essential component of diabetes treatment, may have a therapeutic effect on patients with diabetes complicated by CAN. However, it remains unclear whether exercise has a therapeutic or protective effect in diabetes patients with CAN. The author conducted a systematic search of PubMed/MEDLINE, Embase, and The Cochrane Library, resulting in the identification of eight eligible randomized controlled trials for this review. Exercise, including aerobic exercise combined with resistance training (RT), high-intensity interval training, and progressive RT, has shown a beneficial effect on cardiac autonomic function (CAF) in patients with type 2 diabetes, as measured by heart rate variability, heart rate recovery, and baroreflex sensitivity. However, most studies had low quality. Moreover, there were no relevant studies examining the effect of exercise on CAF in older patients, patients with poorly controlled diabetes, and patients with type 1 diabetes. Exercise has the potential to manage patients with CAN by balancing sympathetic and parasympathetic nervous system functions; however, further studies are warranted in the future.

Analysis of Heart Rate Variability in Obstructive Sleep Apnea Hypoventilation Syndrome

A total of 110 patients with obstructive sleep apnea hypoventilation syndrome were selected from January 2017 to December 2018, including 76 cases of men and 34 females, aged 40-50 y and according to the apnea hyponea index, patients were classified into 3 groups of moderate to moderate and 5 apnea hyponea index 20 was divided into group A (36 cases), the 40 of 20 to apnea hyponea index is divided into group B (45 cases) and apnea hyponea index the 40 of 20 to 40 is divided into group B (45 cases) and apnea hyponea index to 40 is divided into group C (29 cases). In the same period in the health check-up center to extract 40 cases without obstructive sleep apnea hypopnea syndrome, arrhythmia and other medical history of health check-up objects. 24 h Holter-monitoring and polysomography monitoring of 4 groups of people, observed and recorded heart rate variability indicators for each group, including all standard deviations for sinus cardiac arrest, standard deviation per 5 min sinus cardiac interstitial period, the average root mean square of successive differences of the total sinus intercardial period difference is divided by the number of individuals of the sinus cardiac interstitial period of 50 ms the average root mean square of successive differences of the total sinus intercardial period difference is divided by the number of individuals of the sinus cardiac inner struggle period of 50 ms divided by the percentage of the total sinus cardiac inner struggle period (proportion of NN50), low frequency and high frequency. Standard deviation of all sinus beats, standard deviation of the mean value of sinus, root mean square of successive differences, proportion of NN50, low frequency and high frequency were lower than those in the control group (p<0.05) in patients with obstructive sleep apnea hypopnea syndrome. The proportion of NN50 and high frequency in group C were lower than A and B (p<0.05) and the low frequency was higher than the proportion of NN50 and high frequency in group C were lower than A and B (p<0.05) and the low frequency was higher than group A, group B and control group (p<0.05). Holter-monitoring is a non-invasive test, the price is not high and it can be a regular test for testing the autonomic nervous function in patients with obstructive sleep apnea hypopnea syndrome.

Retracted: Acupuncture Enhances Gastrointestinal Motility and Improves Autonomic Nervous Function in Patients with Septic Gastrointestinal Dysfunction

Retracted: Acupuncture Enhances Gastrointestinal Motility and Improves Autonomic Nervous Function in Patients with Septic Gastrointestinal Dysfunction

Research progress of sodium-glucose cotransporter 2 inhibitors and autonomic nervous function in patients with heart failure

Research progress of sodium-glucose cotransporter 2 inhibitors and autonomic nervous function in patients with heart failure

Acupuncture Enhances Gastrointestinal Motility and Improves Autonomic Nervous Function in Patients with Septic Gastrointestinal Dysfunction.

Gastrointestinal dysfunction (GD) is a common complication after endotoxemia, which can further aggravate the progress of infection. Acupuncture uses metal needles of different shapes and techniques to stimulate specific points on the human body, which are effective in treating various diseases, including gastrointestinal diseases. We aimed at exploring the clinical effect of acupuncture on the recovery of visceral sensation, proximal gastric compliance, and autonomic nervous function in patients with septic GD. A total of 73 sepsis with GD patients were selected using modified single section ultrasonography combined with clinical symptoms in the First People's Hospital of Lanzhou City during 2019. The participants were randomly allocated to routine-treatment (control group) and study group receiving acupuncture. The indexes before and after treatment included gastric residue, gastric dilatation, pressure and volume, gastric compliance, autonomic nerve function, APACHE II score, and infection index were measured and compared. Before treatment, there was no significant difference in the basic information of the two groups, including gastric volume and pressure, gastric residue, gastric compliance, autonomic nerve function, and APACHE II score. After treatment, the maximum gastric volume and pressure, gastric residue, and APACHE II score of the two groups were significantly improved (P < 0.05). In addition, the maximum gastric volume and pressure of the study group were significantly higher, while gastric residual, autonomic nerve function, and APACHE II were significantly lower than those of the control group (P < 0.05). However, our results showed that acupuncture did not further reduce inflammatory markers, including white blood cells, C-reactive protein, and procalcitonin. To sum up, on the basis of basic treatment, the application of acupuncture can further improve the clinical symptoms of GD in patients with sepsis, enhance gastrointestinal motility, and improve autonomic nervous function, which is worthy of clinical application and promotion.

Relationship Between the Onset of Ménière's Disease and Sympathetic Hyperactivity.

ObjectiveThe pathogenesis of Ménière's disease is still largely unknown; however, it is known to be strongly associated with stress. Excessive stress can cause hyperactivity of the sympathetic autonomic nervous system. With the aim of understanding changes in sympathetic hyperactivity before and after Ménière's disease, we compared autonomic nervous function in patients in a stable phase of Ménière's disease and that in healthy adults. We also gathered data over about 10 years on autonomic nervous function immediately before a Ménière's attack.Study DesignProspective study.PatientsAutonomic nervous function was analyzed in 129 patients in a stable phase of Ménière's disease 31 healthy adult volunteers. In nine patients, autonomic nervous function was also measured immediately before and after treatment of a vertigo attack.Main Outcome MeasurePower spectrum analysis of heart rate variability (HRV) of EEG/ECG and an infrared electronic pupillometer were used. Sympathetic and parasympathetic nervous function was measured.ResultsThere were no statistically significant differences in autonomic nervous function determined by HRV and electronic pupillometry between patients in a stable phase of Ménière's disease and healthy adults. Sympathetic function as measured by electronic pupillometry parameters VD and T5 showed no difference between the affected and unaffected sides in the baseline data measured in the stable phase (VD: affected side is 31.02 ± 6.16 mm/sec, unaffected side is 29.25 ± 5.73 mm/sec; T5: affected side is 3.37 ± 0.43 msec, unaffected side is 3.25 ± 0.39 msec). In contrast, all nine patients whose HRV data had been obtained just before an attack showed marked suppression of the parasympathetic nervous system and activation of the sympathetic nervous system. Electronic pupillometry also revealed an overactivation of the sympathetic nervous system on the affected side, just before the attacks. Analysis of sequential changes after the onset of an attack revealed that overactivation on the affected side was reduced after treatment, and no difference between affected and unaffected sides was observed 3 days after treatment.ConclusionDetailed analysis of autonomic nervous function showed that immediately before an attack of Ménière's disease, the sympathetic nervous system on the affected side was strongly overactivated.

Autonomic Nervous Function in Patients with Sudden Sensorineural Hearing Loss and Its Association with Prognosis and Disease Severity

Introduction: Vascular disorder is considered one of the main mechanisms of sudden sensorineural hearing loss (SSNHL) due to the anatomy of the inner ear. One factor that can contribute to vascular disorder is impairment in the autonomic nervous system. This study aims to investigate autonomic function in patients with SSNHL and its association with prognosis and disease severity from January 2018 to October 2019. Methods: We conducted a cross-sectional study involving 40 healthy controls and 55 subjects with SSNHL. We compared the autonomic function of controls and patients using heart rate variability (HRV). SSNHL patients were divided into improvement and no-improvement groups and into mild and severe groups according to pure-tone audiometry results. Results: The SSNHL group had significantly decreased total power (TP), low frequency (LF), and high frequency (HF) compared to the control group. However, there were no significant differences between the mild and severe groups. In the no-improvement group, LF was significantly higher and normalized HF was significantly lower than in the improvement group. According to a multiple logistic regression analysis, age and LF were significantly correlated with improvement. Conclusion: This is the first study to evaluate the significance of HRV in patients with SSNHL, according to prognosis and disease severity. Further studies about the relationship between autonomic nervous system and SSNHL with larger sample size and prospective design are needed.

Cardiac autonomic dysfunction in patients with gastroesophageal reflux disease.

To investigate autonomic nervous function in patients with a diagnosis of gastroesophageal reflux disease (GERD). The investigation was performed on 29 patients (14 men), aged 18-80 years (51.14 ± 18.34), who were referred to our Neurocardiology Laboratory at the Clinical and Hospital Center "Bezanijska Kosa" with a diagnosis of GERD. One hundred sixteen healthy volunteers matched in age and sex with the examinees served as the control group. The study protocol included the evaluation of autonomic function and hemodynamic status, short-term heart rate variability (HRV) analysis, 24 h ambulatory ECG monitoring with long-term HRV analysis and 24 h ambulatory blood pressure monitoring. Pathologic results of cardiovascular reflex test were more common among patients with reflux compared to the control group. Severe autonomic dysfunction was detected in 44.4% of patients and in 7.9% of controls (P < 0.001). Parameters of short-term analysis of RR variability, which are the indicators of vagal activity, had lower values in patients with GERD than in the control group. Long-term HRV analysis of time-domain parameters indicated lower values in patients with reflux disease when compared to the control group. Power spectral analysis of long-term HRV revealed lower low- and high-frequency values. Detailed 24 h ambulatory blood pressure analysis showed significantly higher values of systolic blood pressure and pulse pressure in the reflux group than in the control group. Patients with GERD have distortion of sympathetic and parasympathetic components of the autonomic nervous system, but impaired parasympathetic function appears more congruent to GERD.

Cardiac Rehabilitation and Autonomic Function in Patients with Chronic Heart Failure

In patients with heart failure, sympathetic activity is elevated and this imbalance of autonomic function leads to further progression of heart failure. It has been reported that exercise training attenuate sympathetic tone in patients with heart failure. Heart rate variability (HRV) has been a help to noninvasive evaluation of autonomic nervous function in patients with heart failure. However to determine indexes of HRV, 24 hours ambulatory monitoring is usually required. MemCalc system (Reflex-meijinR, Crosswell), is a noninvasive, real-time analysis system that uses the maximum entropy method for spectral analysis.

Skin temperature responses to cold stress in patients with severe motor and intellectual disabilities

Patients with severe motor and intellectual disabilities (SMID) often suffer from autonomic nervous system disturbances. At the same time, the caregivers of patients with SMID face challenges to understand the patients’ chronic health problems effectively by simply observing them. Therefore, recognizing specific symptoms is important to improve support for SMID. We investigated the autonomic nervous function in patients with SMID with skin vasomotor responses to cold stimuli. The relationship of the results of cold stress and autonomic symptoms observed by the main caretakers was also examined. We analyzed 38 patients with SMID. Their hand skin temperature was measured before and after cold stimuli using infrared thermography. A ‘distal-dorsal difference’ (DDD) at baseline, and the recovery rate of the second fingertip and dorsum were calculated. All main caregivers filled out questionnaires evaluating autonomic symptoms. The recovery rate of the second fingertip and dorsum after cold stimuli was lower than 80% in 64% and 60% patients, respectively. The baseline DDD was greater than 1°C in 84% of the patients. A DDD>1°C was associated with a reduced recovery rate. All caregivers recognized some autonomic-related symptoms. Patients with constipation or snoring demonstrated a reduced recovery rate. However, none of the observed symptoms can predict the presence of a reduced rate with cold stimuli in a statistically significant way. This study showed excessive sympathetic nerve activities in patients with SMID. The baseline DDD could be a valuable parameter accessing their microvascular circulation. To improve the life of a person with SMID, accessing autonomic function using a noninvasive method, such as thermography is warranted without directly observed symptoms.

Symptoms, psychosomatic factors and autonomic nervous function in patients of gastroesophageal reflux disease

目的 探讨胃食管反流病(GERD)患者临床症状、心身因素、自主神经功能之间的关系.方法 15例对照者与34例经反流性疾病诊断问卷(RDQ)及经过内镜检查诊断为GERD的患者,均填写Zung自评量表,评分异常的GERD患者为GERD(+)组,评分正常的GERD患者为GERD(-)组,两组同时记录反流症状积分.全部入选者均进行心率变异性检查.检测频域:24 h内平均R-R间期的标准差,5 min平均窦性心率标准差,相邻R-R间期之差的均分根,相邻心搏R-R间期之差大于50 ms的心搏占心搏总数的百分比.时域:低频,高频,低频/高频.结果 GERD组Zung焦虑自评量表平均分、Zung抑郁自评量表平均分明显高于对照组(分别为48±9对38±6,48±11对41±6,均P＜0.05).GERD(+)组Zung分数与症状积分呈正相关,相关系数为0.411和0.483.同时发现非糜烂性反流病组Zung评分异常分布.GERD患者迷走神经张力较对照组增高,GERD(+)组增高更明显.结论 GERD患者尤其是非糜烂性反流病患者反流症状、心身因素、自主神经功能之间互相影响、互为因果,自主神经功能紊乱可能是中间环节.对GERD患者需整体治疗。

Basic Autonomic Nervous Function in Patients with Neurocardiogenic Syncope

Basic autonomic nervous function was evaluated in patients with neurocardiogenic syncope (NCS). Atropine, isoproterenol, propranolol, phenylephrine, and phentolamine were administered successively, and parasympathetic nerve activity and β- (and α-) activity, sensitivity, and secretion of the sympathetic nerve were determined in patients with NCS and control subjects. In patients with NCS, β- and α- sensitivity were higher and β-activity and β- and α-secretion lower than in control subjects.In patients with NCS, the increased basic β-sensitivity may contribute to induce strong cardiac contractions and augment ventricular mechanoreceptor response, and a compensatory state against diminished neuronal sympathetic activity is suggested by the increased α-sensitivity.

Continuous and online analysis of heart rate variability

Spectral analysis of heart rate variability provides a probe to assess the function of the sympathetic and parasympathetic nervous systems. Time-frequency analysis of heart rate variability is useful for investigating autonomic nervous function in patients with syncope or non-sustained ventricular tachycardia, or in anaesthesia, etc. In this paper, we developed an algorithm for continuous and online analysis of heart rate variability. The algorithm was simulated and evaluated in MATLAB, and implemented on the digital signal processor. The electrocardiogram signals from MIT/BIH arrhythmia database and one patient with syncope demonstrate the capability of the proposed method in the continuous and online analysis of heart rate variability.

Autonomic Nervous Function in Patients with Anxiety and Depression(Psychosomatic Medicine for Anxiety and Depression)

Autonomic Nervous Function in Patients with Anxiety and Depression(Psychosomatic Medicine for Anxiety and Depression)

Regulation of QT indices mediated by autonomic nervous function in patients with type 2 diabetes

Both the QT interval and QT dispersion in diabetic patients have been reported to increase with the progression of cardiac autonomic neuropathy and to have a prognostic value. We assessed the cardiac autonomic influences on QT indices using the measurements of baroreflex sensitivity, heart rate variability, and cardiac 123I-metaiodobenzylguanidine scintigraphic findings in patients with type 2 diabetes mellitus. Forty-two consecutive patients with type 2 diabetes (mean±SD: 54±10 years, 22 women and 20 men) were studied. Baroreflex sensitivity negatively correlated with the maximum and minimum QTc intervals as well as QT/QTc dispersion. However, the high-frequency power and the ratio of low-frequency power to high-frequency power of heart rate variability did not correlate with any QT indices. The percent washout rate of 123I-metaiodobenzylguanidine positively correlated with QT/QTc dispersion, but not with maximum and minimum QTc intervals. Our findings suggest that cardiac vagal dysfunction is related to QT interval prolongation while both sympathetic and vagal dysfunctions are related to increased QT dispersion in type 2 diabetic patients. Baroreflex sensitivity and percent washout rate of 123I-metaiodobenzylguanidine may be useful parameters indicating the abnormalities of the cardiac ventricular repolarization in this population.

Factors influencing autonomic nervous function during cold-water immersion test in patients with hand-arm vibration syndrome.

Factors influencing autonomic nervous function in patients with hand-arm vibration syndrome (HAVS) in response to cold-water immersion test with different water temperatures and immersion times were investigated in the summer and winter seasons. Fourteen HAVS patients with vibration-induced white finger (VWF) and 14 healthy control subjects individually age-matched to the patients consented in writing and participated in this study. Patients and controls immersed their left hands in water at 10 degrees C for 10 min and at 15 degrees C for 3 min in summer and in winter in a room with temperature maintained at 21+/-1 degrees C. Electrocardiographic (ECG) data were recorded during the test period and the R-R intervals were analyzed with a fast Fourier transformation (FFT) program. Percentage of very low frequency (VLF%; indicator of both sympathetic and parasympathetic nervous function, and function of rennin-angiotensin system), low frequency (LF%; indicator of both sympathetic and parasympathetic nervous function), high frequency (HF%; indicator of parasympathetic nervous function), and LF/HF ratio (indicator of sympathetic nervous function) were calculated. The results by three-way analysis of variance (ANOVA) were reported elsewhere. In the present study, repeated measures ANOVA was used to re-analyze the factors of data measurement time (time factor) and group (group factor), and their interaction for each test method (water at 10 degrees C for 10-min immersion time; water at 15 degrees C for 3-min immersion time) in summer and winter. The HF% of HAVS patients tended to be lower than that of healthy controls throughout the cold-water immersion tests except for during tests involving water at 10 degrees C for 10-min immersion in summer. The group factor for HF% was statistically significant with an exception during the test involving water at 10 degrees C and 10-min immersion time in summer. The time factor for HF% was statistically significant with an exception during the test involving water at 15 degrees C and 3-min immersion time in winter. The findings of the present study indicated lower cardiac parasympathetic activity in HAVS patients than in healthy controls, especially in winter. The response of the autonomic nervous system to cold stimulation was to some extent more clearly observed during the immersion test with water at 10 degrees C and 10-min immersion time than during the immersion test with water at 15 degrees C and 3-min immersion time. The results revealed by three-way analysis in a previous study were similar to those in the present study with data analysis by repeated measures ANOVA.

Effects of 38&deg;C Bathing for 30min on Hemostatic Function and Autonomic Nervous Function in Patients with Cerebral Infarction

Effects of 38&deg;C Bathing for 30min on Hemostatic Function and Autonomic Nervous Function in Patients with Cerebral Infarction

Autonomic nervous function in patients with Meniere’s disease evaluated by power spectral analysis of heart rate variability

Objective: A hypothesis has been advanced that the autonomic nervous dysfunction (AND) relates to the development of vertigo in Meniere’s disease (MD). We also studied the causal relationship between AND and vertigo in MD. Methods: We evaluated autonomic nervous function in 17 patients with MD (five men and 12 women ranging in age from 16 to 70 years) by classifying them by their stages of attack and interval of vertigo and with power spectral analysis (PSA) of heart rate variability. Fourteen healthy volunteers were also tested as controls. Results: At the interval stage, parasympathetic nervous hypofunction and significant depression of sympathetic response due to postural changes from the supine to the standing position were observed in many of those patients. At the attack stage, sympathetic nervous hypofunction was observed in some of the patients. Conclusion: These findings lead us to the conclusion that AND relates to vertigo in MD as a predisposing factor. However, the question of whether AND relates as a trigger or as a consequence of vertigo in MD has not been adequately solved in this study. We will make further studies on circadian variation of autonomic nervous function.

Saliva in non-insulin-dependent diabetic patients and control subjects: The role of the autonomic nervous system

Objective. The purpose of this investigation was to study the flow rate and organic constituents of whole saliva in relation to autonomic nervous function in patients with non-insulin-dependent diabetes. Study design. We studied the associations of saliva factors and autonomic nervous function in 45 patients with non-insulin-dependent diabetes (mean age, 68 ± 6 years) and 77 control subjects (mean age, 67 ± 5 years). The metabolic evolution was well known over a 10-year period from the time of diagnosis. Resting and paraffin-wax-stimulated whole saliva samples were collected and analyzed. Autonomic nervous function was evaluated by measuring heart rate variation during deep breathing and change in systolic blood pressure during orthostatic testing and by means of power spectral analysis of heart rate variability while standing. The effect of drugs used on saliva was also studied. Results. No difference was seen in flow rate between the patients with diabetes and the control subjects; resting flow rates were 0.3 ± 0.3 ml/min in the patients with diabetes and 0.3 ± 0.2 ml/min in the control subjects, and stimulated flow rates were 1.2 ± 1.4 ml/min in the patients with diabetes and 1.2 ± 0.8 ml/min in the control subjects. The number of drugs used daily correlated with salivary flow rates of the control subjects ( p < 0.001) but not with flow rates of the patients with diabetes. The effect of xerogenic medication on salivary flow rates was stronger in patients with diabetes than in control subjects, however. There were no statistically significant differences between patients with diabetes and control subjects in the organic constituents of saliva. The stimulated saliva secretion was associated with total power ( r s = 0.343; p = 0.035), medium-frequency power ( r s = 0.375; p = 0.020), and high-frequency power ( r s = 0.414; p = 0.010) of heart rate variability in patients with diabetes. Conclusion. Saliva secretion might be more affected by xerogenic drugs and autonomic nervous dysfunction in patients with non-insulin-dependent diabetes than in nondiabetic control subjects.