State Of Autonomic Nervous System Research Articles

Listening to music before tooth extraction attenuates sympathetic nervous system activity: A randomized control trial

AbstractAimThe effect of listening to music before tooth extraction on the autonomic nervous system and psychological state remains unclear. This prospective study explored the hypothesis that playing music before the extraction of an impacted mandibular third molar would stabilize patients' autonomic nervous system activity and circulatory dynamics.MethodsThirty‐six patients were randomized into two groups: control and music. Patients in the music group listened to music before tooth extraction. Heart rate variability and circulatory dynamics were recorded during the procedure. The Modified Dental Anxiety Scale and State Trait Anxiety Inventory scale scores were recorded before the procedure, and the latter was used to assess postoperative anxiety scores.ResultsSympathetic nervous activity significantly increased in the control group during the administration of local anesthesia, bone removal, and extraction (p < 0.01), although this increase was lower in the music group during the administration of local anesthesia and extraction (p < 0.05). In the music group, the postoperative anxiety score was significantly lower than the preoperative score (p < 0.05).ConclusionPlaying music preoperatively may help reduce sympathetic nerve activity during the administration of local anesthesia and tooth extraction.

Perspectives on applying immuno-autonomics to rheumatoid arthritis: results from an online rheumatologist survey

The term “immuno-autonomics” has been coined to describe an emerging field evaluating the interaction between stress, autonomic nervous system (ANS), and inflammation. The field remains largely unknown among practicing rheumatologists. Our objective was to evaluate the perspectives of rheumatologists regarding the role of stress in the activity and management of rheumatoid arthritis (RA). A 31-item survey was conducted with 231 rheumatologists. Rheumatologists were asked to assess the role of stress in rheumatoid arthritis (RA) disease activity and were provided with information regarding immuno-autonomics. They were asked to consider how immuno-autonomics resonated with their patient management needs. The majority of rheumatologists are eager to better understand non-response, believe that stress biology and ANS dysfunction interfere with disease activity, and embrace the theory that measurement of ANS via next-generation HRV may be able to evaluate autonomic dysfunction and the biology of stress. Rheumatologists are open to the idea that quantitative measurement of ANS function using next-generation HRV can be a helpful tool to RA practice. The majority agree that ANS state influences RA disease control and that quantitative measures of ANS state are helpful to RA practice. Rheumatologists also agree that patients with poor ANS function may be at risk for not responding adequately to conventional, biologic, or targeted synthetic DMARDs. Almost all would use an in-office test to quantitatively measure ANS using next-generation HRV. This study shows that rheumatologists are open to embracing evaluation of ANS function as a possible tool in the management and treatment of RA.

Relationship Between Body Composition Components and Functional State of the Autonomic Nervous System in Primary School Children with Overweight

Objective: Obesity and overweight in children is a socio-economic and medical problem around the world. [1] Target organs for the influence of excess fat are the heart, blood vessels, kidneys, liver and others. Therefore, more and more scientists and health professionals try to detect, prevent and control childhood obesity. [2] Methods: 72 children aged 10-11 years were examined by body composition parameters using the bioimpedance method on Tanita BC-601 analyzer scales. Heart rate variability and autonomic nervous system status were assessed using a “CardioLab” electrocardiograph. Results: Both BMI and total body fat, visceral fat and fat free mass were statistically significantly correlated with the activity of the sympathetic and parasympathetic systems. As the total fat content of the body increased, the total power of the regulatory systems decreased. Visceral fat content was statistically significantly affected by both ANS systems, but there was a stronger association between visceral fat and the sympathetic nervous system. Conclusion: The data obtained can serve as an impetus for the identification of children with autonomic dysfunction and overweight to develop corrective and preventive programs for the prevention of CVD by normalizing the body composition. Keywords: fat content, heart rate variability, obesity, BMI.

Динаміка біохімічних параметрів і функціонального стану вегетативної нервової системи у хворих на гострий гепатит B із хронічним уживанням алкоголю в гепатотоксичних дозах

В роботі показано, що у хворих на гострий гепатит В із хронічним уживанням алкоголю в гепатотоксичних дозах відбуваються більш виражені функціональні порушення стану вегетативної нервової системи з розвитком вегетативного дисбалансу у бік ваготонії, які зберігаються і в періоді реконвалесценції.

Effectiveness of pupillography for assessing the state of autonomic nervous system and the choice of treatment for accommodative disorders in children

AbstractPurposeFor the first time, the values of indices of accommodation, direct and friendly pupillary reactions were determined – the maximal (Smax) and minimal (Smin) area of the healthy children aged 6 to 18 years depending on their age and tone of the autonomic nervous system (2016).Methods269 healthy children, 130 children with spasm of accommodation and 79 children with accommodation weakness were obsovered. We used the computer pupillography OК‐2 for registration of direct, consensual and accommodative convergent‐pupillary reaction.ResultsDifference between Smax values in children with accommodation spasm (23.94 ± SD 5.5 mm2, DI 95% 22.8–25.0) and with accommodation weakness (49.3 ± SD13.8 mm2, DI 95% 47.1–51.6) was revealed, that can be considered as a criterion for choosing the type of treatment. In accommodation spasm, the pupil area (Smax) in the range 22.8–25.0 mm2 and the general vagotonia (according to the Kerdo index) treatment by mydriatics should be appointed. In weak accommodation, Smax in the range of 47.1–51.6 mm2 and general sympathotonia, transcranial electrical stimulation and phosphenelectrostimulation are indicated. Phosphenelectrostimulation (FES) and ETRANS had unidirectional influence – an increase in the uncorrected visual acuity at a distance of 33% and 49% respectively, an improvement in accommodation reserves of 2.8–4.1 D in patients with accommodative dysfunctions.ConclusionsThe mechanisms of action of electrostimulation, where one of the key roles is the improvement of conduction of nerve fibers. In accommodation spasm and the general vagotonia treatment by mydriatics should be appointed.

Дифференциальная диагностика эссенциальной артериальной гипертензии и нейроциркуляторной астении по гипертензивному типу

Neurocirculatory asthenia (NCA) of the hypertensive type (synonyms: vegetative-vascular dystonia of the hypertensive type, neurocirculatory dystonia (NCD) or hypertensive type of vegetative-vascular dysfunction) is one of the three main forms of NCA. This type includes vegetovascular disorders of the sympathetic part of the autonomic nervous system (ANS). First of all, it is characterized by an increase in systolic blood pressure (BP). Vegetative-vascular disorders syndrome with an inadequate BP response of blood pressure to any stimuli is typical for NCA. Hypertension is a chronic disease, the main manifestation of which is the syndrome of high blood pressure, which is not associated with the presence of pathological processes in which the increase in blood pressure is due to known causes (symptomatic arterial hypertension). When making an expert decision, it is necessary to use methods of non-invasive evaluation of the ANS state: the Kerdo index, the cold test, the ocular reflex (Dagnini–Aschner), the solar reflex (Toma–Ru), and the Vane– Solovyova tables.

NEUROLOGICAL AND PSYCHOEMOTIONAL STATE OF THE POPULATION OF THE DONETSK REGION AND THE INFLUENCE OF "V-OMEGA-3" ON IT

Relevance. The armed conflict is taking place on the territory of the Donetsk region. Such eco-crisis conditions may have an additional negative impact on the nervous system and psychoemotional state of the population. It is important to take fat-soluble vitamins which simultaneously have antioxidant properties during ecological problems.
 Objective: to assess the neurological and psychoemotional state of the population of the Donetsk region before and after taking "V-Omega-3".
 Materials and methods. The study involved 105 apparently healthy persons aged 21-56 years, living in the cities of Kramatorsk and Mariupol. The participants of the main group (n = 45) took the food dietary supplement product "V-Omega-3" for 21 days, and the participants of the control group (n = 60) did not take any drugs. The neurological state of all individuals was examined twice - at the beginning of the experiment and after 21 days, that is, after the course of taking the product by the main group. The neurological exam was organized into the following categories: cranial nerves, reflexes, sensory system, in conducting coordination tests. The tone in autonomic nervous system (ANS) was assessed using the Wayne Scale. Psychoemotional state was assessed according to “Hospital Anxiety and Depression Scale” (HADS).
 Results. The mild organic and functional neurological microsymptoms were found in all 105 apparently healthy persons. After taking the "V-Omega-3", the main group showed objective and subjective improvement of health. The neurological status of the main group showed positive dynamics, such as: normalization of tendon reflexes by 50%, normalization of oculomotor disorders in the form of weak convergence and accommodation - by 46%, coordination of movements improved by 60%, metacarpal joint tremor decreased by 36%; cerebral asthenia syndrome - by 45%, astheno-neurotic syndrome - by 5%, while no positive changes were observed in the control group. At the beginning of the experiment, in the main group, sympathicotonia prevailed in 21 people, vagotonia in 9, and mixed tonus in 15. After treatment, normalization of the ANS parameters was noted: a decrease of the level of sympathicotonia and parasympathicotonia. Sub-clinical anxiety (8-10 points) was found in 19 people and no significant symptoms (3-7 points) in 26 people when assessing emotional state and well-being using the HADS scale before treatment. After treatment, there was an improvement in the emotional state (absence of significant symptoms of 0-7 points) in 8 people, i.e. subclinical anxiety decreased by 18%.
 Conclusions. The drug "V-Omega-3" has a positive effect on the state of the autonomic nervous system and psychoemotional state, which is manifested by a decrease in headache, dizziness, asthenia, normalization of reflexes, reduction of oculomotor disorders, improved coordination, disappearance of hand tremor, reducing of the cerebroasthenic syndrome and emotional lability.

Особенности вегетативного портрета детей с хроническим лямблиозом

Актуальность. Актуальность исследования связана с широтой распространения лямблиоза. Комплекс патогенетических факторов приводит к нарушению вегетативной регуляции нервной системы. До настоящего времени неизученным остается вопрос о взаимосвязи лямблиоза и особенностей вегетативного состояния. В связи с изложенным целью нашего исследования стало изучение состояния вегетативной нервной системы у больных хроническим лямблиозом. Материалы и методы. Для достижения поставленной цели было обследовано 187 детей в возрасте от 7 до 18 лет с хроническим течением лямблиоза, а также 92 ребенка того же возраста без данной паразитарной инвазии. Исследование вегетативных функций проводили путем определения вегетативного тонуса (вычислялся индекс Кердо, коэффициент Хильдебранта), вегетативной реактивности (исследовались проба Даньини — Ашнера и рефлекс Чермака — Геринга), а также вегетативного обеспечения деятельности (при помощи ортоклиностатической пробы). Результаты. Исследование показало значимое снижение показателей вегетативного тонуса, свидетельствующее о ваготонической направленности вегетативных процессов, увеличение значений вегетативной реактивности, что отражает ваготонический характер вегетативного реагирования, и дисбаланс показателей вегетативного обеспечения деятельности, отражающий недостаточность обеспечения. Выявленные изменения наблюдались у большинства детей с хроническим лямблиозом. Ваготонический тонус наиболее часто сочетался с избыточной вегетативной реактивностью, а недостаточное вегетативное обеспечение деятельности наблюдалось на фоне ваготонического и нормотонического вегетативного тонуса. Выводы. Изменения функционального состояния вегетативной нервной системы у детей с хроническим лямблиозом необходимо учитывать при планировании терапевтических мероприятий.

Assessing Correlation between Heart Rate Variability Markers Based on Laguerre Expansion and Direct Measures of Sympathetic Activity during Incremental Head-up Tilt.

Traditional frequency domain analysis of heart period (HP) variability allows the estimation of the parasympathetic modulation directed to the heart but the sympathetic one remains largely unknown. Recently, sympathetic and parasympathetic activity indexes (SAI and PAI) have been proposed to address this issue. SAI and PAI were derived from HP variability via the application of an orthonormal Laguerre expansion allowing the separation of HP variations driven by sympathetic and parasympathetic outflows. In this study, SAI and PAI were validated against tonic and variability measures of muscle sympathetic nerve activity (MSNA) and more traditional markers derived from HP variability. Indexes were calculated in 12 healthy subjects (9 females, age from 20 to 36 years, median 22.5 years) undergoing incremental head-up tilt. Results showed that traditional HP and MSNA variability markers as well as SAI and PAI were modified in proportion to the magnitude of the postural challenge. However, SAI was not correlated with any MSNA markers and PAI was not linked to respiratory sinus arrhythmia. SAI and PAI can capture modifications of cardiac control induced by the orthostatic challenge but they might be weak surrogates of vagal and sympathetic activities and/or modulations.Clinical Relevance- SAI and PAI markers are useful to characterize cardiac control but poorly linked with autonomic nervous system state.

Correlation of peripheral pulse wave features and pulse rate variability parameters with hospitalization of COVID-19 patients – the scientific aspect of a tele-pulse oximetry project study design

Abstract Introduction The Operational Group, leading the fight against COVID-19 in Hungary, has approved a pilot program, in December 2020, to monitor high risk COVID-19 patients in 40 family practices. The main goal of this project is to connect family physicians to their COVID-19 patients through a telemedicine system, in order to ensure patients' security and support for personalized telemedical-care and on-time hospitalization of the patients. 200 special pulse-oximeters were distributed and are continuously rotated among patients with acute phase of infection. Every patient is required to install a smartphone application on their phones to capture and transfer the oxygen saturation (SpO2), heart rate and raw pulse wave data. The peripheral pulse wave is used for calculating more than 30, cardiovascular and autonomic nervous system parameters by a proprietary algorithm. Most of these parameters are well described in the medical literature but not used for decision support in this project. Research question Do remote pulse wave analysis parameters have a predictive value on hospitalization above SpO2 recordings in COVID-19 patients? Methods Retrospective observational cohort study. The data analysis will be performed on the pulsewave database collected during the above mentioned project and correlated with endpoints. The parameters are measured with a special pulse oximeter; transferred, stored, processed and calculated by a remote patient monitor platform. The information about primary and secondary endpoints will be collected from the primary care physician of the patient. Study population Patients with diagnosed SARS-CoV-2 infection who have been monitored with a certain remote patient monitor system between November 2020 and September 2021. Expected number of participants: 100–150 patients. Primary endpoint Hospitalization due to acute COVID-19 infection Secondary endpoints Death connected to SARS-CoV-2 infection, presence of long-COVID symptoms during the monitoring period- maximum one month after the start of the infection Expected outcome According to literature data pulse wave features show correlation with cardiovascular status of the patient, while pulse rate variability parameters can be descriptive of the autonomic nervous system status of the subject. These parameters are described to possibly alter during and after an acute SARS-CoV-2 infection. To our knowledge there was no similar telemedical pulsewave data collection and analysis relation to COVID-19 before. However this is an easy to use methodology to explore more details about the patient's status. In this research we aim to explore these parameter's clinical utility in COVID-19 patients. Results will help to determine if pulse wave analysis and pulse rate variability parameters can be used as indicators of higher risk of hospitalization in COVID-19 patients. Funding Acknowledgement Type of funding sources: Private company. Main funding source(s): E-Med4All Europe Kft., Budapest, Hungary

Ефективність застосування Ноофену в комплексі лікування гастроезофагеальної рефлюксної хвороби в дітей шкільного віку

Нами обстежені 40 дітей віком 10–18 років із діагнозом гастроезофагеальної рефлюксної хвороби (ГЕРХ). За даними опитування за А.М. Вейном, в усіх дітей були прояви вегетативної дисфункції. Діти були розподілені на 2 групи. Контрольну групу становили 20 дітей, які одержували лікування за стандартною схемою. Основну групу — 20 дітей, які, крім стандартної терапії, отримували гідрохлорид бета-феніл-гамма-аміномасляну кислоту — фенібут (Ноофен®, Olain Farma, Латвія) у дозі 250 мг 2 рази на добу протягом 21 дня. Через 1 місяць після початку лікування проводилась оцінка його ефективності. Клінічна оцінка динаміки вегетативного статусу школярів із ГЕРХ дозволяє стверджувати, що включення в комплекс терапії цієї патології препарату Ноофен забезпечує добрий вегетостабілізуючий ефект, що проявляється відновленням вегетативного балансу в дітей.

Динаміка показників нейровегетативної регуляції в дітей із рекурентними захворюваннями респіраторного тракту і зниженим функціональним резервом міокарда після реабілітаційної програми

Актуальність. Останнім часом проблеми з рівнем дитячого здоров’я викликають побоювання з боку як медичної, так і педагогічної громадськості. Інтенсивна програма шкільної освіти, високе інфекційне навантаження на організм молодшого школяра і підвищений інтерес до засобів масової електронної комунікації — все це призводить до напруження функціонування вегетативної нервової системи (ВНС) і, як результат, зниження функціонального резерву міокарда. У зв’язку з цим було запропоновано проведення оздоровчих літніх заходів, метою яких було надати відновлюваний вплив на функціонування ВНС і стан функціонального резерву міокарда молодшого школяра. Мета роботи: проаналізувати клінічну ефективність реабілітаційної програми в дітей із рекурентними захворюваннями респіраторного тракту і зниженим функціональним резервом міокарда. Матеріали та методи. 30 дітям раннього шкільного віку проведена протягом 1 літнього місяця реабілітаційна програма. Здійснена оцінка клінічної ефективності реабілітаційної програми за даними стану ВНС, показників активності регуляторних систем (ПАРС), рівнів концентрації нейротрансмітерів у сироватці крові. Проведено оцінку функціонального резерву міокарда. Результати. За підсумками реабілітаційної програми отримані вірогідні результати поліпшення функціонування ВНС: знизилися прояви симпатикотонії і зменшилася реєстрація порушеного ПАРС і зривів процесів адаптації (p < 0,05). Звертають на себе увагу статистично значуще зниження сироваткової концентрації субстанції Р і кінцевих стабільних метаболітів NO (KCM NO) і підвищення сироваткової концентрації вазоактивного інтестинального пептиду. Дана позитивна динаміка супроводжувалася значним зниженням реєстрації симпатикотонії, ригідного ритму, порушеного ПАРС, зриву процесів адаптації (p < 0,05). Проведена річна реабілітаційна програма привела до поліпшення результатів проби Руф’є на 4 бали порівняно з показниками наприкінці навчального року. Висновки. Здійснення реабілітаційної програми в дітей із рекурентними захворюваннями респіраторного тракту і зниженим функціональним резервом міокарда поліпшило показники функціонального стану ВНС і ПАРС. Поліпшення функціонального стану ВНС і ПАРС супроводжувалося: зниженням рівня концентрації субстанції Р, КСМ NO в сироватці крові та підвищенням вазоактивного інтестинального пептиду. Проведення оздоровчого курсу в дітей із рекурентними гострими респіраторними захворюваннями та зниженим функціональним резервом міокарда дозволило знизити показник проби Руф’є на 4 бали, що свідчить про підвищення функціонального резерву міокарда.

Analysis of Heart Rate Variability and Implication of Different Factors on Heart Rate Variability.

BackgroundThe heart is the central organ of the circulatory system, which maintains the flow of blood along with the transport of nutrients to different cells and tissues. A well-functioning cardiac state is a complicated mode of changeability. A healthy heart is not only about oscillation, as the rhythmometer is not the same in every circumstance. Heart rate shows variations so that it can be regulated according to psychophysiological conditions to maintain the effect of the internal-external stimulus.ObjectiveThe main objective of this review is to provide a piece of all-inclusive information about heart rate variability (HRV) and different variables affecting HRV. The direct interconnection so that HRV can be used in clinical practices.MethodsThis review article contains a detailed survey of literature about HRV available in different online sources such as; Google Scholar, Science Direct, PubMed, and Web of Science, etc. In this review, the authors have focused on the role of the autonomic nervous system in the regulation of HRV and the role of various factors affecting HRV.ResultsThe variation in the time between two heartbeats is termed as HRV. It is one of the indicators of many pathological conditions related to cardiovascular health. It provided reliable information about the interaction of the sympathetic and parasympathetic nervous systems. The analysis of the variation of heart rate is a well-known non-invasive technique to identify the functioning of the autonomic nervous system. The autonomic nervous system (ANS) depends on the sympathetic and parasympathetic nervous system for transferring information. The cardio-accelerating center, lungs, and non-striated muscles are innervated by cardiac sympathetic nerves. This division of ANS latches upon the heart accordingly via the cervicothoracic ganglion and vagus nerve. It is found that cardiac normal variability depends upon this stimulation towards the sinoatrial node (pacemaker), which can be evaluated by analyzing the HRV. In human-based studies, it has been found that a low level of HRV is one of the main causes of death rate among adults. Hence, HRV helps in identifying the risk of cardiac diseases and the state of ANS.ConclusionThe heart plays a vital role in the human body and the well-functioning of the cardiac system is the need for a healthy life. The heart contains its nervous system termed as neurocardio system in which ANS plays a key role in which the sympathetic and parasympathetic systems interplay to regulate HRV. High HRV is associated with healthy condition, while low HRV is associated with pathological conditions. The HRV is influenced by various variables such as; pathological, physiological, psychological, environmental factors, lifestyle factors, and genetic factors, etc.

Social skills and psychopathology are associated with autonomic function in children: a cross-sectional observational study.

In recent years, the increase of psychopathological disorders in the population has become a health emergency, leading to a great effort to understand psychological vulnerability mechanisms. In this scenario, the role of the autonomic nervous system (ANS) has become increasingly important. This study investigated the association between ANS, social skills, and psychopathological functioning in children. As an ANS status proxy, we measured heart rate variability (HRV). Infants admitted to the neonatal intensive care unit of the University Hospital of Padova because of preterm birth or neonatal hypoxic-ischemic encephalopathy were sequentially recruited from January 2011 to June 2013 and followed long-term up to school age in this cross-sectional observational study. We recorded 5 minutes of HRV immediately before measuring performance in social abilities tasks (affect recognition and theory of mind, NEPSY-II) in 50 children (mean age 7.4 ± 1.4 years) with and without risk factors for developing neuropsychiatric disorders due to pre-/perinatal insults without major sequelae. Children also completed extensive cognitive, neuropsychological, and psychosocial assessment. Parents were assessed with psychopathological interviews and a questionnaire (CBCL 6-18). Analysis in a robust Bayesian framework was used to unearth dependencies between HRV, social skills, and psychopathological functioning. Social task scores were associated with HRV components, with high frequency the most consistent. HRV bands were also associated with the psychopathological questionnaire. Only normalized HRV high frequency was able to distinguish impaired children in the affect recognition task. Our data suggest that ANS may be implicated in social cognition both in typical and atypical developmental conditions and that HRV has cross-disease sensitivity. We suggest that HRV parameters may reflect a neurobiological vulnerability to psychopathology. The study was approved by the Ethics Committee of the University Hospital of Padova (Comitato Etico per la Sperimentazione, Azienda Opedaliera di Padova, approval No. 1693P).

PECULIARITIES OF AUTONOMIC NERVOUS SYSTEM STATE IN YOUNG PATIENTS WITH NEUROLOGICAL MANIFESTATIONS OF LUMBAR SPINE OSTEOCHONDROSIS

Lower back pain is the most common cause forcing adults to seek for medical assistance; it is associated with severe functional disorders and burdens on patients themselves and health care system that require in-depth study of its causes, management, and prevention. The aim of this research is to investigate the peculiarities of autonomic nervous system status depending on indices (rates) of anxiety and depression in patients under 45 years with lower back pain and to develop more effective treatment. We examined 104 male patients with neurological manifestations of the lumbar spine osteochondrosis without obesity, somatic and cardiovascular pathology (average age was 34,05±5,7 years) and 25 practically healthy volunteers (the mean age constituted 35,04±3,6). All patients were shared into two groups. The 1st group consisted of 50 patients with radiculopathy caused by herniation of intervertebral discs, whereas the 2nd group involved 54 patients who suffered from radicular signs of lumbar spine osteochondrosis. The patients underwent clinical (somatic) and neurological examinations, thorough assessment of the autonomic nervous system, psychological states by Hospital Anxiety and Depression Scale (HADS) in addition. We have revealed that the muscular-tonic disorders with myofascial syndrome occurred in all patients. We also found a reliable increase in the expression of vegetative complaints and symptoms in comparison with the control group. Analysis of anxiety and depression indices by HADS has reflected that average anxiety level in control group amounted to 8.33±1.24 scores and the depression level made up 0,8±1,06 scores; in the patients with vertebrogenic radiculopathy, the average anxiety level constituted 9.78±1.58 scores and the depression level was assessed as 4.1±2.13 scores. The patients suffering from reflexogenic lower back pain had the anxiety level, which equalled 8.01±1.16 scores and the depression level of 1.53±1.5 scores. Severe muscular-tonic signs and the development of vegetative dystonia syndrome in association with subclinical increasing levels of anxiety in spite of unchanged depression rates have been found as key features of neurological manifestations of the lumbar spine osteochondrosis in young male patients.

Sinus node dysfunction in patients with long-standing persistent atrial fibrillation: Clinical and laboratory parallels

Introduction. This article provides an overview of the problem of sinus node dysfunction after surgical treatment for longstanding persistent atrial fibrillation and the methods for diagnosing the initial states of cardiac activity and conduction. Purpose. To identify predictors of initial sinus node dysfunction in patients with long-standing persistent atrial fibrillation. Material and Methods: The study comprised a total of 65 patients with long-standing persistent atrial fibrillation complicating mitral valve disease. The state of autonomic nervous system was analyzed in patients with long-standing persistent atrial fibrillation. The associations between the analyzed data and electrophysiological parameters were investigated. Results . The study allowed to identify the cutoff points for the contents of neurohumoral factors in the coronary circulation in patients with intact sinus node function and sinus node dysfunction. Prognostic criteria for the development of bradyarrhythmias in the postoperative period requiring pacemaker implantation were proposed and introduced into clinical practice.

Entropy Analysis of COVID-19 Cardiovascular Signals.

The world has faced a coronavirus outbreak, which, in addition to lung complications, has caused other serious problems, including cardiovascular. There is still no explanation for the mechanisms of coronavirus that trigger dysfunction of the cardiac autonomic nervous system (ANS). We believe that the complex mechanisms that change the status of ANS could only be solved by advanced multidimensional analysis of many variables, obtained both from the original cardiovascular signals and from laboratory analysis and detailed patient history. The aim of this paper is to analyze different measures of entropy as potential dimensions of the multidimensional space of cardiovascular data. The measures were applied to heart rate and systolic blood pressure signals collected from 116 patients with COVID-19 and 77 healthy controls. Methods that indicate a statistically significant difference between patients with different levels of infection and healthy controls will be used for further multivariate research. As a result, it was shown that a statistically significant difference between healthy controls and patients with COVID-19 was shown by sample entropy applied to integrated transformed probability signals, common symbolic dynamics entropy, and copula parameters. Statistical significance between serious and mild patients with COVID-19 can only be achieved by cross-entropies of heart rate signals and systolic pressure. This result contributes to the hypothesis that the severity of COVID-19 disease is associated with ANS disorder and encourages further research.

Skeletal muscle status, autonomic balance and short-term results of cardiac surgery

Purpose — To study the association between the status of lower extremities’ skeletal muscles and autonomic balance with the short-term results of cardiac surgery patients. Methods — 64 patients (57 men, median age 63 years) who underwent non-urgent cardiac surgery at the Research Institute for Complex Issues of Cardiovascular Diseases clinic from March 2015 to March 2016 were included in the study. Patients with exacerbation of underlying disease were excluded from the study. Additionally, muscle status of the patients was assessed using static-dynamic tests on a multifunctional training apparatus, and the autonomic nervous system (ANS) state was evaluated using the ORTOexpert program during an active orthostatic test. 9 patients developed complications in the postoperative period; groups with the postoperative complications present and absent were compared according to the studied preoperative indicators. Results — The following indicators were revealed more often prior to the surgery in the group with the postoperative complications: cardiac arrhythmias (p=0.023), aortic valve regurgitation (p=0.002), left ventricle aneurysm (p=0.007), carotid stenosis (p=0.036), decreased muscle strength of the upper and lower extremities (p=0.047 and p=0.046), sympathetic activation (LF/HF ratio p=0.028), and ANS stress in response to the test. Conclusion — Low status of skeletal muscles (upper and lower extremities) and ANS sympathetic activation and the overstrain of its adaptive mechanisms were associated with development of postoperative complications after cardiac surgery, along with severity of the underlying cardiac pathology, risk and duration of the surgery.

Neuromodulating Influence of Two Electroacupuncture Treatments on Heart Rate Variability, Stress, and Vagal Activity.

Introduction: Although the clinical use of electro-acupuncture is widespread, the neuromodulating influence of various applied frequencies is not well established. Objectives: Heart rate variability (HRV), stress and parasympathetic recovery are closely related to health, longevity and vitality in humans. This study was undertaken to determine the influence of different electro-therapy frequencies on various autonomic nervous system markers when applied to a Battlefield Acupuncture Protocol (BFA). Design: A detailed comparison of autonomic nervous system (ANS) response to low frequency (LF) 2.5 Hz electro-acupuncture and mid-frequency (MF) 15 Hz electro-acupuncture applied by point stimulation to acupuncture points was undertaken on 2 groups of 12 patients. Interventions: Both LFEA and MFEA were applied to Battlefield Acupuncture protocol, consisting of five (5) key acupuncture ear (auricular) points that isolate the autonomic nervous system (ANS) and central nervous system's role in the chronic/acute pain cycle. Evaluations entailed an advanced status of autonomic nervous system (ANS) function through Electro-Cardiogram (ECG) baseline markers reflecting: sympathetic stress (SI); parasympathetic vagal tone (high frequency [HF]) and heart rate variability (HRV = total power). All were repeated subsequent to electro-therapy using 2 separate electro-modalities of low-frequency (2.5 Hz) electro-acupuncture (LFEA) and Mid-Frequency (15 Hz) electro-acupuncture (MFEA). All 24 patients received one (1) elector-acupuncture session. Results: The autonomic nervous system response to LFEA (2.5 Hz) reflected a statistically significant pre-post improvement in three of the markers collected: heart rate variability (HRV) improved by 61% [p = 0.002]; sympathetic stress (SI) reduced 42% [p = 0.002]; and parasympathetic vagal tone (HF) increased 56% [p = 0.017]. In contrast, MFEA (15 Hz) showed positive but non-significant changes in outcomes in all nervous system markers. Conclusions: The autonomic nervous system response with LFEA showed a measurable reduction in sympathetic stress with subsequent improvement in vagal tone, and HRV. This positive sympathetic nervous system deactivation from LFEA application shown in this study could have a major impact on other pathologies related to human health and longevity. Further cohort studies are warranted to determine the validity of these outcomes.

RELATIONSHIP BETWEEN THE CARDIOVASCULAR SYSTEM AND THE AUTONOMIC NERVOUS SYSTEM DURING THE PHYSICAL LOAD IN PERSONS WITH DIFFERENT BODY MASS

The rapid increase in the number of overweight and obese individuals poses a significant threat to the health of the world's population of all ages. Obesity is able to induce a condition of chronic low-intensity inflammation underlying the number of diseases, and, in particular, the diseases of the cardiovascular system. The aim of the study was to determine the relationship between the response of the cardiovascular system and the state of autonomic nervous system to graduated physical exercises in young adults with normal body weight and overweight. Anthropometric measurements of 84 individuals of both sexes aged 18-25 years were carried out. According to the body mass index (BMI), the following groups were defined: control group of 22 individuals (BMI 18,50-24,99 kg/m2), group with overweight individuals (n=20) of both sexes (BMI 25,00-29,99 kg/m2). The condition of the cardio-vascular system was evaluated by heart rate, systolic and diastolic blood pressure; the status of autonomic nervous system was assessed by the Kerdo index. Indicators were evaluated before and immediately after the graduated exercise test. Data obtained were processed statistically. According to the results of the study, the normotоnic type by its response to the physical exercise was found out in both study groups, but the overweight individuals of both sexes demonstrated the cardiovascular indicators were significantly higher compared to the control group. Having finished the physical exercise tests, overweight men and women showed marked sympathicotonia (≥ + 31). The Kerdo᾿s index in 29,65% of male and in 19,01% of female individuals was higher than in the individuals with normal body mass (p <0.05). It can be concluded that the dominance of sympathetic influences is characteristic for overweight individuals after physical activity. Correlation between anthropometric, cardiovascular and Kerdo᾿s index immediately following the physical exertion in overweight individuals indicate impaired autonomic nervous system balance restoration.