Cardiac Autonomic Nervous Function Research Articles

Frequency Domain Parameters of Heart Rate Variability in Patients with Gastro-Oesophageal Reflux Disease

Background: Gastro-oesophageal reflux disease (GERD) has been associated with autonomicnervous dysfunction along with reduced Heart Rate Variability.Objective: To observe cardiac autonomic nerve function status by heart rate variability analysis inpatients with Gastro-oesophageal reflux disease (GERD).Methods: This cross-sectional study was carried out in the Department of Physiology, SirSalimullah Medical College (SSMC), Dhaka from 1st January, 2017 to 31st December, 2017.Forthis, total 30 male and female diagnosed GERD patients from the Out Patient Department(OPD) of Gastroenterology, BSMMU aged 20-35 years were included in the study group. LowFrequency norm (LF norm),High Frequency norm (HF norm) and LF/HF ratio of HRV parameterswere recorded. Thirty age and BMI matched healthy subject also included as control. For statisticalanalysis, unpaired t-test was done as applicable.Results: The mean LF norm was 72.10±13.97 n.u. and the mean LF/HF was 3.34±1.14. Whichwere significantly (p<0.001) higher in GERD patients in comparison to that of healthy subjects.Which indicate sympathetic overactivity in GERD patients. However, the mean HF norm was24.54±10.56 n.u. Which was significantly (p<0.001) lower in GERD patients as compared to that of apparently healthy subjects. Which indicate decreased parasympathetic activity in GERDpatients.Conclusion: Parasympathetic hypofunction and sympathetic over activity were found in GERDpatients.

Evaluation of heart rate variability at 1-month after pulsed field ablation of atrial fibrillation and comparison with radiofrequency ablation

Abstract Background Pulsed Field Ablation (PFA) of atrial fibrillation (AF) is a nonthermal novel ablative modality in which high-voltage electric pulses are delivered to generate a high myocardial tissue-specific cellular death, with negligible consequences on surrounding structures including ganglionated plexi. The impairment of the cardiac autonomic ganglia after AF ablation with radiofrequency (RF) has been associated with an increase in mean heart rate (HR) and a reduction in heart rate variability (HRV) and might influence the long-term success of AF ablation. Little data is available on the effect of PFA on cardiac autonomic nervous function. Purpose The aim of this study is to investigate whether PFA ablation could lead to different values of HR and HRV compared to RF at 1-month post-ablation 24-hour Holter monitoring. Methods Between January to September 2023, we included consecutive patients undergoing AF ablation with PFA. According to our clinical practice, all patients performed a routine 24-hour Holter monitoring at 1-month post-ablation. Consecutive AF patients treated with RF were used as controls. Patients in treatment with antiarrhythmics or with documented recurrences of AF at 1-month post-ablation Holter monitoring were excluded. Results 22 consecutive PFA patients were compared to 22 consecutive RF controls. There were no differences in demographic, clinical and echocardiographic data between the 2 groups (Table 1). At 1-month post-ablation Holter monitoring (Table 2), PFA patients had significant higher values of VarIndex (2.18±0.9 vs 1.47±0.7, p=0.01), ASDNN/5min (52.37±15.93 vs 37.17±12.96, p<0.01), SDANN/5min (116.50±27.97 vs 96.03±28.38, p=0.04), and SD (128.95±31.31 vs 106.30±29.56, p=0.04). There was no difference in minimum HR (47.00±6.59 vs 50.29±10.25, p=0.21), mean HR (67.77±6.63 vs 69.24±9.71, p=0.56), and maximal HR (115.41±18.12 vs 110.81±16.44, p=0.39). Conclusions PFA leads to higher values of HRV parameters (i.e., VarIndex, ASDNN/5min, SDANN/5min, and SD) at 1-month post-ablation compared to RF. These data suggest a higher preservation of cardiac autonomic function with PFA, in contrast to RF. Whether the preservation of cardiac autonomic function with PFA might lead to higher rate of long-term AF recurrences remains to be determined.Table 1Table 2

Effect of listening music (Rabindra Sangeet) on autonomic dysfunction in patients with generalized anxiety disorder: A power spectral analysis of heart rate variability

Background: Power spectral analysis of heart rate variability (HRV) is a complex method for assessing cardiac autonomic nerve function (CANF) in generalized anxiety disorder (GAD) patients which is a common mental disorder in the world. Recently, music therapy is used as an adjunct to pharmacotherapy in clinical psychiatry for GAD. Objective: To observe the effect of music therapy on CANF by power spectral analysis of HRV in GAD patients was designed. Methods: This prospective non randomized intervention study was done in 2019 on 60 newly diagnosed GAD patients aged 20- 40 years, both male and female. Among them 30 patients were under music therapy with listening of Raga Bhairabi based Rabindra sangeet for 3 months and 30 patients were without music therapy for three months. Age, sex and BMI matched healthy control were also enrolled. HRV of all GAD patients and control were recorded at baseline and after three months of follow up. HRV were recorded by Power Lab 8/35. For statistical analysis Bonferroni’s Post Hoc test and paired sample‘t’ test were done. Results: Total power, LF power, HF power, LF n.u, HF n.u and LF/HF and were significantly lower in all GAD patients compared to healthy control at baseline. After 3 months of music therapy, significant increment of Total power, HF power, HF n.u and significant decrement of LF n.u and LF/HF occurred whereas no change of these except HF n.u were noted in patients without music after 3 months. Moreover, after three months of music therapy, Total power, HF n.u, and LF/HF were almost same to control. Conclusion: So this study concluded that music therapy improve autonomic dysfunction in GAD patients and can be used as an adjunct to pharmacotherapy in clinical psychiatry for good cardiac health in GAD patients. J Bangladesh Soc Physiol 2022;17(2): 91-100

Regulation of exercise on heart rate variability in perimenopausal and postmenopausal women.

Heart rate variability (HRV) is a non-invasive quantitative measure of cardiac autonomic nervous activity. Due to the increase of age and the decrease of estrogen level in perimenopausal and postmenopausal women, the cardiac autonomic nervous function is abnormal, increasing the risk of cardiovascular disease. Proper exercise can increase estrogen levels, improve cardiovascular health, regulate cardiac autonomic nervous activity, and reduce the risk of cardiovascular disease. Low-moderate intensity aerobic exercise, resistance exercise, aerobic combined resistance exercise and mind-body exercise have positive effects on HRV in perimenopausal and postmenopausal women. Therefore, summarizing the effects of different exercise modes on HRV in perimenopausal and postmenopausal women, as well as the mechanism of exercise training improvement on HRV, so as to adopt better exercise strategies to improve HRV of perimenopausal and postmenopausal women, and thus reduce the risk of cardiovascular diseases and improve the health level and quality of life of perimenopausal and postmenopausal women.

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.

Retracted: Postoperative Curative Effect of Cardiac Surgery Diagnosed by Compressed Sensing Algorithm-Based E-Health CT Image Information and Effect of Baduanjin Exercise on Cardiac Autonomic Nerve Function of Patients.

[This retracts the article DOI: 10.1155/2022/4670003.].

Effect of Slow Breathing Exercise on Time Domain Heart Rate Variability in Transfusion Dependent Thalassemic Patients

Time domain measure of heart rate variability (HRV) is a newersystem to seek out any alteration in cardiacautonomic nerve function (CANF) in transfusion dependent thalassemic (TDT) patients. Slow breathing exercise(SBE) plays important role in improvement of HRV in health and various diseases.This research aims to observe theeffect of slow breathing exercise (SBE) on time domain measures of HRV in TDT patients. This prospectiveinterventional study was done in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University(BSMMU), Dhaka in 2018 on 60 male TDT patients aged 15-30 years. Thirty patients received conventionaltreatment and 30 patients performed slow breathing exercise along with the conventional treatment for 3 months. Ageand sex matched healthy control were taken to compare. All subjects were followed up at baseline and after 3 months.Time domain HRV parameters were recorded by Power Lab 8/35. For statistical analysis paired sample 't' test andindependent sample 't' test were done. Mean RR interval, Mean SD, RMSSD and pRR50% were found significantlylower in TDT patients compared to healthy control at baseline and on the other hand mean heart rate was significantlyhigher in this group of patients. After 3 months of slow breathing exercise, significant decrement of mean heart rateand significant increment of others parameters occurred with trend of improvement in cardiac autonomic nervefunction in TDT patients. In conclusion slow breathing exercise may improve cardiac autonomic nerve function andsympathovagal balance in transfusion dependent thalassemic patients. Bangabandhu Sheikh Mujib Med. Coll. J. 2022;1(2):65-69

PS-BPC10-4: THE CLINICOPATHOLOGICAL FINDINGS IN NON-DIABETIC CKD PATIENTS WITH CARDIOVASCULAR AUTONOMIC NEUROPATHY

Background: Cardiovascular autonomic neuropathy (CAN) is common as the process of kidney injury. Coefficient of variation of R-R interval (CVR-R) is one of the most convenient, noninvasive tests of heart rate variability, and is widely used to assess cardiac autonomic nerve function. However, the clinical and pathological findings in non-diabetic CKD patients with CAN has not been fully elucidated. This current study investigated the characteristics of non-diabetic CKD patients with CAN diagnosed by CVR-R. Method: Subjects who underwent percutaneous kidney biopsy and performed CVR-R test at the Jikei University School of Medicine Hospital, Tokyo, Japan were retrospectively examined. Patients with arrhythmia, diabetes, and post transplantation were excluded. CAN was defined using the reference values of CVR-R based on age and sex. The proportion of glomerulosclerosis (GS) and interstitial fibrosis/tubular atrophy (IF/TA) were assessed. The severity of arteriosclerosis was determined by the extent of thickening of the intima: grade0 = intimal thickening&lt; thickness of media grade1 = intimal thickening&gt; thickness of media. Results: Ninety subjects were identified (Age 45.7 ± 14.9 (mean ± SD) years old; Male 56%; heart rate 69 ± 11 /min; eGFR 60.0 ± 29.5 mL/min/1.73m2; 24h-urinary protein excretion 0.55 [0.24–1.30] (median [IQR]) g/day; CVR-R rest 3.7 ± 1.7%; GS 11.6 [3.6–24.8] %, IFTA 20 [10–30] %.) Eleven patients were diagnosed as CAN, with nephrosclerosis [n = 4], acute tubulointerstitial nephritis [n = 2], IgA nephropathy [n = 1], IgA vasculitis [n = 1], membranous nephropathy [n = 1], lupus nephritis [n = 1], and focal segmental glomerular sclerosis [n = 1]. Patients with CAN had a higher triglyceride (P = 0.030) and higher IF/TA(P = 0.005) than those without CAN. The severity of arteriosclerosis increased in patients with CAN. (P = 0.017) Conclusion: These results indicated that that arteriosclerosis and IF/TA were associated with CAN in non-diabetic CKD patients.

Effect of physical exercise on non-linear parameters of heart rate variability in Chronic Obstructive Pulmonary Disease

Background: Chronic Obstructive Pulmonary Disease (COPD) is associated with autonomic nerve dysfunction. Nonlinear methods of heart rate variability (HRV) analysis have been gaining interest as a method of detecting changes in cardiac autonomic nerve function. Regular practice of physical exercise may cause improvement of this impaired autonomic nerve function. Objectives: To assess the effect of physical exercise on nonlinear measures of HRV analysis in male patients with COPD. Methods: This prospective interventional study was carried out in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka in 2018 on 60 diagnosed male COPD patients aged 40-75 years with disease duration of at least 5 years selected from the Department of Respiratory Medicine, BSMMU, Dhaka. Thirty patients underwent physical exercise (walking for 30 minute and pursed lip and diaphragmatic breathing 10 minuts)for 3 months in addition to standard treatment. Thirty (30) patients received only standard treatment for 3 months. For comparison, 30 age matched apparently healthy males were also enrolled. HRV data of all patients were recorded before and after 3 months of follow up. HRV data of healthy controls were recorded once at baseline. For assessing autonomic dysfunction, nonlinear parameters of HRV were recorded by Power Lab 8/35. For statistical analysis, paired sample t-test and independent sample t-test were done as applicable. Results: SD1, SD2 and SD1/ SD2 were found significantly lower in COPD patients compared to healthy controls at baseline. After 3 months of physical exercise, significant increment of these parameters occurred with a trend of improvement in cardiac autonomic nerve function in these patients. Conclusion: This study concluded that physical exercise can improve cardiac autonomic nerve dysfunction function in COPD patients. J Bangladesh Soc Physiol. 2022, June; 17(1): 6-13

Effect of slow breathing exercise on heart rate variability in tension-type headache female patients: A time domain analysis

Background: Tension-type headache (TTH), the most frequently occurring primary headache is associated with autonomic dysfunction. Time domain analysis of heart rate variability (HRV) is a popular tool to detect changes in cardiac autonomic nerve function (CANF) in TTH patients. Slow breathing exercise (SBE) can significantly improve HRV in patients with cardiovascular disorders. Objective: To observe the effect of SBE on HRV by time domain analysis in TTH female patients. Methods: This quasi-experimental study was conducted from March 2021 to February 2022 in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka on 60 female TTH patients aged 20-45 years. Thirty patients performed SBE every morning and evening for 30 minutes in addition to receiving conventional treatment and 30 patients continued only conventional treatment without any exercise for 90 days. Thirty age, sex and BMI matched apparently healthy control were enrolled who did not perform SBE or any other exercise. All subjects were assessed at baseline and also after 90 days. Time domain HRV parameters were recorded by Power Lab 8/35 AD Instruments, Australia. One way ANOVA followed by post-hoc test and Paired sample t-test were performed for statistical analysis and p&lt;0.05 was considered as statistical significance. Results: Mean heart rate (HR) was significantly higher (p&lt;0.001) and SDRR (Standard deviation of all RR interval); CVRR (Coefficient variation of RR interval); SDSD (Standard deviation of successive RR interval differences between adjacent RR intervals); RMSSD (Square root of mean of squared differences of successive RR interval) and pRR50% (Proportion of RR interval with duration &gt; 50ms) were significantly lower (p&lt;0.001) in TTH female patients compared to control at baseline. Significant decrement of mean HR (p&lt;0.001) and increment of all other time domain parameters (p&lt;0.001) was observed after 90 days of SBE. Again, significantly decreased SDRR, CVRR, SDSD, RMSSD and pRR50% (p&lt;0.001, p&lt;0.01) was observed in the patients who did not perform SBE. Conclusion: SBE may effectively improve cardiac autonomic dysfunction in TTH female patients. J Bangladesh Soc Physiol. 2022, June; 17(1): 56-63

ARNI effects in HFrEF. Risk reduction beyond LVEF

Abstract Background The imbalance of cardiac autonomic nervous system function plays an important role in heart failure associated mortality. ARNI has demonstrated a paramount effect in reducing risk of death and hospitalization for worsening of heart failure. However, its exact mechanism of action remains only partly understood. We sought to prospectively compare heart rate variability as a noninvasive measure of cardiac autonomic nervous system function. Methods The study design was prospective sequential observational. Patients served as their own internal control. Patients with heart failure with reduced ejection fraction (HFrEF) receiving optimal medical therapy who were scheduled for a switch to ARNI therapy underwent echocardiography and a standardized 30-minute 12-lead Holter ECG recording before starting ARNI therapy. A monitoring of the parameters was performed 3 months after the start of therapy. Physicians were instructed to increase ARNI dose to the highest tolerated or maximum dose. Besides left ventricular ejection fraction (LVEF) we assessed heart rate (HR), standard deviation of normal-to-normal intervals (SDNN) and mean square of differences between consecutive R-R intervals (RMSSD). Results We recruited 55 patients and baseline characteristics were as follows: age 65±12 years, male sex 78%, NT-proBNP 4989±809 pg/ml, LVEF 28±6%, HR 75±9 bpm, SDNN 43±2 ms, RMSSD 19±2 ms. All patients received beta-blocker therapy and the dosage was similar at baseline and follow-up. After 3 months of ARNI therapy, heart rate showed a significant reduction of 7% (74±14 bpm vs. 69±11 min, P=0.005). SDNN increased by 49% (43±2 ms vs. 64±4 ms, P&amp;lt;0.001) and RMSSD by 42% (19±2 ms vs. 27±3 ms, P=0.01). These results were accompanied by increased LVEF (28±6% vs. 38±10%, P&amp;lt;0.001) and reduced plasma NT-proBNP levels (4989±809 pg/ml vs. 2602±87 pg/ml, P&amp;lt;0.04). NYHA Class of affected patients changed from III to II. Conclusion After changing from ACE/AT1-I to ARNI, significant improvement of autonomic cardiac nervous system function could be observed. ARNI apparently activates the parasympathetic nervous system as suggested by decreased HR and increased SDNN and RMSSD. Therefore, part of its cardioprotective and beneficial effects may relate to the restoration of autonomic cardiac nervous system function. Potential beneficial effects regarding incidence of sudden cardiac arrest may relate to these observations. Funding Acknowledgement Type of funding sources: None.

The benefits of Heart Rate Variability (HRV) in the assessment of health and exercise performance

The purpose of this brief report is to stimulate further interest and to raise awareness in relation to the usefulness of assessing cardiac autonomic nerve function using heart rate variability (HRV). The paper outlines the mechanisms associated with HRV and the relationships between HRV, health, and athletic performance. The paper then summarizes the potential benefits of HRV in the assessment of health and exercise adaptations. The paper also provides suggestions about the practical implications of HRV measurement during data collection. We hope that the content provides useful information for the application of HRV for health evaluation and training adaptations. In addition, we hope the paper will provide a better understanding of how HRV measurements can be interpreted and used. Finally, the paper provides practical applications that are effective in the assessment of health and athletic training program outcomes.

Time Domain Measures of Heart Rate Variability to Assess Cardiac Autonomic Nerve Function in Adult Bangladeshi Male and Female

Background: Heart rate variability (HRV) has been considered as an indicator of autonomic nerve function status.Objective:To find out the reference values of heart rate variability by time domain measures of HRV inadult Bangladeshi population of both sexes.Methods:This cross-sectional, analytical study was conducted between July 2012 and June 2013. A total of 180 subjects were selected through the Department of Physiology, Dhaka Medical College Dhaka, Bangladesh, with the age ranging from 18 to 60 years. All the study subjects were divided into 3 different groups: group A (18-30 years), group B (31-45 years) and group C (46-60 years). Each group had 60 subjects: 30 males and 30 females. The experimentation of HRV parameters and recording of data were done using RMS Polyrite D (version 2.4) in Autonomic Nerve Function Test Laboratory of the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Mean systolic and diastolic blood pressure, heart rate along with R-R interval between successive QRS complexes, standard deviation of NN interval (SDNN), RMSSD (square root of mean squared differences between adjacent NN intervals) were observed and analyzed.Results: Systolic and diastolic blood pressure and RMSSD were significantly higher in males than that of females in all three groups (P&lt;0.001). However, no differences were observed in mean heart rate, R-R interval, and SDNN between males and females in any group.Conclusion: Our data suggest that males have higher cardiac sympathetic activities, while females show higher cardiac parasympathetic activities in different age groups in terms of heart rate and blood pressure regulation. The difference of blood pressure is statistically significant; however, the difference of mean heart rate is not statistically significant.International Journal of Human and Health Sciences Vol. 06 No. 04 Oct’22 Page: 393-397

Slow Breathing Exercise Improves Cardiac Autonomic Dysfunction in Male Patients with Transfusion Dependent Thalassemia: A Power Spectral Analysis of Heart Rate Variability

Background and Aim: Iron overload induced cardiac autonomic dysfunction is a major contributor to fatal arrhythmia and cardiac morbidity and mortality in transfusion-dependent thalassemia (TDT) patients. Slow breathing exercise (SBE) increases cardiac parasympathetic activity in health and disease. This study aimed to assess the effect of slow breathing exercise (SBE) on frequency domain measures of heart rate variability in TDT patients. Methods: This prospective interventional study was done on 60 diagnosed male TDT patients aged 15-30 years. They were subdivided into 30 patients with conventional treatment only and 30 patients performed SBE for consecutive 3 months along with the conventional treatment. Age and gender matched healthy control were also studied without SBE. HRV parameters were recorded by Power Lab 8/35. For statistical analysis paired t test and independent sample t test were done as applicable. Results: Total power (TP), High frequency power (HF), HFnu and Low frequency power (LF) were found significantly lower but LFnu and LF/HF were found significantly higher in TDT patients compared to healthy control at baseline. After 3 months of SBE, significant increment of TP, HF and HFnu and significant decrement of LF, LFnu and LF/HF occurred with trend of improvement in cardiac autonomic nerve function in TDT patients. No significant change in these parameters was found in patients without SBE after 3 months of follow-up. Conclusion: SBE can improve cardiac autonomic dysfunction by restoring cardiac vagal activity and reducing sympathetic activity with shifting of autonomic balance to parasympathetic predominance in TDT patients.

Associations of forest negative air ions exposure with cardiac autonomic nervous function and the related metabolic linkages: A repeated-measure panel study

Forest environment has many health benefits, and negative air ions (NAI) is one of the major forest environmental factors. Many studies have explored the effect of forest environment on cardiac autonomic nervous function, while forest NAI in the among function and the underlying mechanism still remain unclear. To explore the associations and molecular linkages between short-term exposure to forest NAI and heart rate variability (HRV), a repeated-measure panel study was conducted among 31 healthy adults. Participants were randomly selected to stay in a forest park for 3 days and 2 nights. Individual exposures including NAI were monitored simultaneously and HRV indices were measured repeatedly at the follow-up period. Urine samples were collected for non-targeted metabolomics analysis. Mixed-effect models were adopted to evaluate associations among NAI, HRV indices and metabolites. The median of NAI concentration was 68.11 (138.20) cm−3 during the study period. Short-term exposure to forest NAI was associated with the ameliorative HRV indices, especially the excitatory parasympathetic nerve. For instance, per interquartile range increase of 5-min moving average of NAI was associated with 9.99 % (95%CI: 8.95 %, 11.03 %) increase of power in high frequency. Eight metabolites were associated with NAI exposure. The down-regulated tyrosine metabolism was firstly observed, followed by other amino acid metabolic alterations. The NAI-related metabolic changes reflect the reduction of inflammation and oxidative stress. HRV indices were associated with 25 metabolites, mainly including arginine, proline and histidine metabolism. Short-term exposure to forest NAI is beneficial to HRV, especially to the parasympathetic nerve activity, by successively disturbing different metabolic pathways which mainly reflect the increased anti-inflammation and the reduced inflammation. The results will provide epidemiological evidences for developing forest therapy and improving cardiac autonomic nervous function.

Impact of Short-Term Heart Rate Variability in Patients with STEMI Treated by Delayed versus Immediate Stent in Primary Percutaneous Coronary Intervention: A Prospective Cohort Study.

Objective Patients with ST-segment elevated myocardial infarction (STEMI) have been treated with the delayed stent strategy to reduce the occurrence of postoperative no-reflow and improve the recovery of postoperative cardiac function. However, the effects of electrocardiac activity and autonomic nerve function after primary percutaneous coronary intervention (pPCI) have been rarely reported. The purpose of this study was to investigate the effects of short-term heart rate variability (HRV) in patients with STEMI treated by immediate stent (IS) and delayed stent (DS) strategy. Methods A total of 178 patients with STEMI were divided into 124 cases (69.66%) in the IS group and 54 cases (30.34%) in the DS group from July 2019 to September 2021. The mean heart rate, premature ventricular contraction (PVC), left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVED), and HRV indexes were compared between the two groups. Results In terms of cardiac electrical stability, the number of PVCs, the percentage of PVCs, and the number of paired PVCs in the DS group were lower than those in the IS group. In terms of HRV, high frequency (HF) and standard deviation of all NN (SDNN) intervals were higher in the patients with DS strategy than IS strategy. There were no significant differences in the LVED and LVEF between the two groups. Conclusion Compared to the IS strategy, the DS strategy in pPCI in patients with STEMI has advantages in postoperative cardiac electrical stability and short-term cardiac autonomic nerve function, with no difference in postoperative short-term cardiac function.

Assessment of Exhaustive Exercise under Internet of Things Exercise Monitoring System and Mechanism Analysis of Cardiovascular Endothelial Cell Apoptosis Induced by Oxidative Stress

To investigate the effect of high-intensity exhaustive exercise on body and the molecular mechanism of oxidative stress regulating apoptosis of cardiovascular endothelial cells (CVECs), 70 college students who took an aerobics course were recruited as the research subjects, all of which were divided into the high-intensity group (35 students) and the moderate-intensity group (35 students). The Internet of Things- (IoT-) based human exercise information monitoring system was employed to collect the electrocardiogram, serum indexes, and oxidative stress indexes of the two groups of subjects after exercise. Moreover, 30 clean male SD rats were divided into exhaustive exercise group ( n = 10 ), routine exercise group ( n = 10 ), and blank control group ( n = 10 ) using treadmill exercise as stress source, and various physiological indexes of the three groups were compared. In human experiments, the time-domain indexes of heart rate variability (HRV), 50 ms in the total number of sinus heartbeats (PNN50), the standard deviation of all NN intervals (SDNN), standard deviation of mean NN interval (SDANN), standard deviation of difference between adjacent NN intervals (SDSD), root mean square (RMSSD) in the high intensity group were lower than those in the moderate intensity group ( P &lt; 0.05 ). The levels of T-sensitive troponin I (Tnl-ultra), cortisol (COR), high-sensitive troponin T (TnT-hs), high-sensitive C-reactive protein (hs-CRP), and human heart-type fatty acid binding protein (HUMAN H-FABP) in high intensity group were higher than those in moderate intensity group ( P &lt; 0.05 ). Experiments on animals found that SOD content and mRNA expression of fork-head box 03A (FOX03A) and silencing-information regulator 1 (Sirtl) in serum of rats in exhaustion exercise group were lower than those in the routine exercise group and blank control group, while lactate dehydrogenase (LDH) and malondialdehyde (MDA) contents were opposite ( P &lt; 0.05 ). In short, strenuous exercise made the body in the state of acute stress, leading to the disturbance of cardiac autonomic nervous function and sympathetic nervous function, and increasing the risk of malignant arrhythmia. Oxidative stress induced by exhaustive exercise may promote the apoptosis of CVECs by reducing the expression of Sirtl and FOX03A and locating FOX03A to the nucleus.

Cardiac autonomic nerve function in polycystic ovary syndrome is not related to oxidative stress: A Poincaré analysis of heart rate variability

Background: Polycystic ovary syndrome (PCOS) is a well recognized reproductive hormone disorder. It is often associated with dysautonomia and increased oxidative stress Objective: To assess the relationship between cardiac autonomic nerve function (CANF) and oxidative stress in patients with PCOS. Methods: This cross sectional study enrolled 30 newly diagnosed PCOS patients 20-35 years of age and 30 apparently healthy, regularly menstruating women of similar age and BMI. The patients were enrolled from outpatient Department of Endocrinology, BSMMU, Dhaka. CANF was assessed by poincare analysis of RR interval, a non linear method of Heart Rate Variability (HRV) analysis. HRV data of all subjects were recorded by a digital data acquisition device, Power lab 8/35, AD instruments, Australia, with lab chart software analysis. Oxidative stress was assessed by plasma catalase and plasma Malondialdehyde (MDA) levels. For statistical analysis unpaired “t” test and Pearson’s correlation test were used. Results: In this study, resting pulse rate, systolic blood pressure(SBP), diastolic blood pressure(DBP) were significantly higher (p&lt;0.001, p&lt;0.01, p&lt;0.01 respectively) and standard deviation of the short term RR interval variability (SD1), ratio of short term and long term variability (SD1/SD2) ratio were significantly lower (p&lt;0.001) in PCOS than those of healthy controls. In addition, plasma catalase levels was significantly lower (p&lt;0.01) and plasma MDA levels was significantly higher (p&lt;0.001) in PCOS patients compared to controls. On correlation analysis, SD1 showed negative correlation with plasma catalase and plasma MDA levels (p&gt;0.05) in PCOS patients. In addition SD1/SD2 ratio showed positive correlation with plasma catalase and negative correlation with plasma MDA levels (p&gt;0.05) in these group of patients. But all these correlations were statistically not significant. Conclusion: The present study reveals association of autonomic dysfunction and higher oxidative stress with PCOS but it failed to show evidence for any interrelationship between them. J Bngladesh Soc Physiol 2021;16(1): 88-94

Postoperative Curative Effect of Cardiac Surgery Diagnosed by Compressed Sensing Algorithm-Based E-Health CT Image Information and Effect of Baduanjin Exercise on Cardiac Autonomic Nerve Function of Patients.

This research was aimed at exploring the effect of CT images reconstructed by optimized compressed sensing algorithm on postoperative diagnosis of patients with hypertensive heart disease and the influence of Baduanjin on cardiac autonomic nerve function. Based on the compressed sensing algorithm, the maximum likelihood expectation maximization algorithm was introduced to optimize it, and the optimization algorithm was established. The optimized algorithm and filtered back projection algorithm (FBP) were compared regarding the root mean squared error (RMSE), peak signal-to-noise ratio (PSNR), and structural similar image metric (SSIM). A total of 126 patients with hypertensive heart disease who underwent CT examination in the hospital were selected as study subjects. According to whether Baduanjin intervention was adopted, patients were divided into observation group (conventional treatment +Baduanjin) and control group (conventional treatment), with 63 patients in each group. The effect of CT examination on postoperative diagnosis was analyzed. Systolic blood pressure (SBP), diastolic blood pressure (DBP), differential pressure (DP), respiratory rate and heart rate (HR), very low-frequency (VLF) power, low-frequency (LF) power, high-frequency (HF) power, total power (TP) of HR variability, and changes in LF/HF of patients before and after treatment were compared. The RMSE of the compressed sensing optimization algorithm (3.28 ± 0.36) was significantly lower than that of the FBP algorithm (9.25 ± 1.03) (P < 0.05). The SSIM and PNSR of the compressed sensing optimization algorithm were (0.87 ± 0.10) and (21.22 ± 1.60) dB, respectively. The SSIM was significantly higher than the FBP algorithm (P < 0.01), and the PNSR was also higher than the FBP algorithm (P < 0.05). The detection rate of CT for pleural effusion was 16 cases (25.40%) higher than 5 cases (7.94%) with TTE (P < 0.01). After treatment, SBP, DBP, HR, LF, VLF, LF/HF, and DP values in the observation group were lower than those in the control group (P < 0.05), and TP and HF were higher than those in the control group (P < 0.05). It suggested that a novel algorithm was established based on compressed sensing algorithm to improve image quality. CT image had important guiding significance for postoperative diagnosis of heart. Baduanjin intervention could improve the integrated function of patient's autonomic nervous system and the regulation ability of the vagus nerve.

Effects of Alzheimer's disease of varying severity on cardiac and autonomic function.

Alzheimer’s disease (AD) is one of the most common neurodegenerative diseases in the elderly. The aim of this study was to explore the effects of AD on cardiac function and autonomic nervous function, and the feasibility of electrocardiogram (ECG) in monitoring the development of AD. APP/PS1 double transgenic mice were used in the Morris water maze (MWM) experiment to evaluate the changes of cognitive ability of AD mice, then the non-invasive ECG acquisition system was used and the changes of ECG intervals and heart rate variability (HRV) were analyzed. AD mice already had cognitive dysfunction at the age of 5 months, reaching the level of mild dementia, and the degree of dementia increased with the course of disease. There were no significant changes in ECG intervals in the AD group at each month. The mean square of successive RR interval differences, percentage of intervals >6 ms different from preceding interval, and normalized high frequency power component in the AD group were decreased and low-to-high frequency power ratio and normalized low frequency power component were increased. Combined with the results of the MWM, it was shown that the regulation mechanism of sympathetic and parasympathetic nerves in mice was already imbalanced in early stage AD, which was manifested as the increase of excessive activity of sympathetic nerves and the inhibition of parasympathetic activities. Therefore, ECG-based analysis of HRV may become a means of daily monitoring of AD and provide an auxiliary basis for clinical diagnosis.