Changes In Heart Rate Variability Research Articles

Heart rate variability in schizophrenia: A comparative analysis before and after electroconvulsive therapy

AbstractAimThe aim of this study was to investigate autonomic nervous system imbalance in schizophrenia by comparing heart rate variability (HRV) between patients with schizophrenia and healthy controls, and to assess changes in HRV in patients before and after electroconvulsive therapy (ECT).MethodsHRV was compared between patients with schizophrenia (n = 17) and age‐ and gender‐matched healthy controls (n = 34). Changes in HRV were also assessed in patients pre‐ and post‐ECT. Additionally, the relationship between HRV and Positive and Negative Symptom Scale (PANSS) scores in patients with schizophrenia was investigated.ResultsPatients with schizophrenia showed significantly lower high‐frequency (HF) and low‐frequency (LF) power compared with healthy controls, with a trend towards a higher LF/HF ratio. Following ECT, HF power increased significantly while the LF/HF ratio decreased significantly, resulting in no significant differences between patients and controls for these HRV parameters. The associations between HRV and symptoms observed before ECT were largely diminished after ECT, with only changes in the LF component correlating with changes in PANSS scores.ConclusionFollowing ECT, we observed a shift in autonomic balance from sympathetic dominance towards increased parasympathetic activity and a state more closely resembling that in healthy controls.

Features of Changes in Heart Rate Variability among Medical Students during the Education Process

Background: We investigated the changes of Heart Rate Variability (HRV) parameters, which reflect the state of the regulatory mechanisms of cardiovascular system, among medical students during routine academic period and examination session. Methods: The study was conducted in Jan-Feb 2024, at the IHSM in Bishkek, Kyrgyz Republic, among the healthy 70 students (mean age 19.71 ± 1.54 years) from India and Pakistan. For each student, two ECG recordings were performed: one 3 weeks before the exam and one 10-15 minutes after exam. Results: The results of study demonstrated that after the exam, students presented significantly higher HR, AMo, SI, VLF, LF and lower SDNN, TP, HF compared before the exam (P<0.05). Distribution of students showed that on a routine academic period 53% of students belonged to sympathotonic, 14% to vagotonic and 33% to normotonic. During the examination period the number of sympathotonic increased to 74%, but the number of vagotonic and normotonic decreased to 4% and 22% respectively. Conclusion: Each type revealed an individual reaction to exam stress: in the group of vagotonic there was a slight activation of the SNS; in sympathotonic students there was a tension of regulatory mechanisms, leading to depletion of adaptive mechanisms; in the group of normotonic there was a shift in the vegetative balance towards the sympathetic link of ANS.

Preterm Brain Injury: Mechanisms and Challenges.

Preterm fetuses and newborns have a high risk of neural injury and impaired neural maturation, leading to neurodevelopmental disability. Developing effective treatments is rather challenging, as preterm brain injury may occur at any time during pregnancy and postnatally, and many cases involve multiple pathogenic factors. This review examines research on how the preterm fetus responds to hypoxia-ischemia and how brain injury evolves after hypoxia-ischemia, offering windows of opportunity for treatment and insights into the mechanisms of injury during key phases. We highlight research showing that preterm fetuses can survive hypoxia-ischemia and continue development in utero with evolving brain injury. Early detection of fetal brain injury would provide an opportunity for treatments to reduce adverse neurodevelopmental outcomes, including cerebral palsy. However, this requires that we can detect injury using noninvasive methods. We discuss how circadian changes in fetal heart rate variability may offer utility as a biomarker for detecting injury and phases of injury.

Changes in heart rate variability and subclinical heart failure with preserved left ventricular ejection fraction in workers of the main professions at the coal industry

Introduction. The high prevalence of diseases of the circulatory system necessitates their detection and prevention at an early stage, especially in regions with high industrial potential. The occurrence of subclinical heart failure depends on a cascade of processes that are already occurring in the body and may eventually manifest themselves in clinically pronounced diseases. One of the possible mechanisms of its development is a violation of the balance of the autonomic nervous system with a violation of adaptive capabilities to the labour process, characterized by severe physical overloads among miners. The study aims to evaluate changes in heart rate variability in workers of the main professions at the coal industry with signs of heart failure with a preserved left ventricular ejection fraction. Materials and methods. The study included 78 employees of the main professions at the coal industry. Specialists performed ultrasound examination of the heart according to generally accepted methods with the study of longitudinal deformation of the myocardium. The concentration of NT-proBNP in the blood serum was determined by solid-phase enzyme immunoassay. The authors also conducted an analysis of heart rate variability, determined temporal, spectral and linear parameters. Results. Specialists revealed a decrease in longitudinal myocardial deformation in 38.5% of the examined patients, signs of diastolic dysfunction in 41%; in these groups, a tendency to increase the concentration of NT-proBNP was revealed. In the examined miners with heart failure with preserved ejection fraction, they revealed a significant decrease in the SDNN index and an increase in IC values. The increase in DFA and LF/HF indicators reflects a vegetative imbalance towards sympathetic activation observed in all surveyed miners. Limitations. This study is limited to a sample of employees of the main professions of the coal industry undergoing periodic medical examination at the Research Institute of Complex Problems of Hygiene and Occupational Diseases. Conclusion. The revealed relationship between indicators of heart failure and heart rate variability (SDNN, LF/HF, DFA and IC) in miners allows us to identify a group of people at greatest risk of adverse outcomes. Ethics. The study was conducted in compliance with the standards of the Bioethical Committee of the Research Institute of Complex Problems of Hygiene and Occupational Diseases, established in accordance with the Helsinki Declaration of the World Medical Association "Ethical Principles of Conducting medical Research with human participation as a subject" as amended in 2013 and the "Rules of Good Clinical Practice" approved by Order No. 200n of the Ministry of Health of the Russian Federation dated 04/01/2016. The subjects signed an informed consent to participate in the study.

Changes in Negative Emotions Across Five Weeks of HRV Biofeedback Intervention were Mediated by Changes in Resting Heart Rate Variability.

Resting heart rate variability (HRV) is typically higher in those with better emotional well-being. In the current study, we examined whether changes in resting HRV mediated changes in negative emotions during a 7-week clinical trial of HRV biofeedback. Younger and older adults were randomly assigned to one of two daily biofeedback practices for 5weeks: (1) engage in slow-paced breathing to increase the amplitude of oscillations in heart rate at their breathing frequency (Osc+); or (2) engage in self-selected strategies to decrease heart rate oscillations (Osc-). We assessed negative emotion using the State Anxiety Inventory (SAI) and Profile of Mood States (POMS). Resting HRV at pre-intervention was significantly higher among those with lower negative emotion scores. Those participants showing greater increases in resting HRV showed greater decreases in negative emotion. In a mediation model with all participants, resting HRV changes significantly mediated the relationship between training performance (i.e., heart rate oscillation during practice sessions) and changes in negative emotion. However, additional analyses revealed this mediation effect was significantly moderated by condition and was only significant in the Osc+ condition. Thus, resting HRV changes mediated how biofeedback to increase amplitude of heart rate oscillations reduced negative emotion.

Dynamics of Respiratory Rate and Heart Rate Variability when Performing a Cognitive Task of Two Levels of Complexity

The study examined heart rate variability (HRV) and respiratory rate during a cognitive task (reading) at two difficulty levels. Time, frequency and nonlinear analysis of HRV was used. It has been shown that both some indicators of HRV (HR, SDNN, RMSSD, SD2, SD2/SD1) and respiratory rate change with increasing mental load, however, they do not separately demonstrate significant differences at all three stages of the study. Therefore, for the first time for cognitive studies, an integral indicator was used that links the parameters of the heart with respiration – the physiological cost of activity (PhysCost), which was previously used in work with athletes when they performed physical exercises to failure. Changes in the PhysCost showed that differences between a simple and a complex task are observed at all stages of the study. Thus, it has been established that the difference in the functional state of a person in the process of performing a continuous task of two levels of complexity is most reliably revealed when using an integrative indicator connecting the activity of the respiratory system and the circulatory system.

Continuous heart monitoring to evaluate treatment effects in pulmonary hypertension

Abstract Background The treatment of pulmonary hypertension (PH) has improved rapidly in recent years, and there is increasing evidence to support the role of early intervention. However, studies demonstrate that timely intervention is often still lagging which affects clinical outcomes in patients with PH. Purpose To assess treatment effects after escalation of specific PH treatments using continuous heart monitoring via a Reveal LINQ loop recorder. Methods The patients change in heart rate variability (HRV), heart rate (HR), and physical activity were assessed before and after treatment escalation. Treatment escalation was defined as an additional PAH drug, pulmonary endarterectomy (PEA), percutaneous balloon angioplasty (PBA), or bilateral lung transplantation (BLTX). Results In this prospective study, 41 patients (27 with PAH and 14 with chronic thromboembolic pulmonary hypertension) were enrolled. Among them, 15 patients (36.6%) underwent PH treatment escalation. Prior to escalation, patients were monitored for a median of 100 (range: 68–100) days and after therapy escalation for a median duration of 165 (range: 89–308) days. In the escalation group, a significant increase in HRV (Figure), physical activity indexed by daytime HR was observed, while a significant decrease was seen in nighttime HR assessed at baseline and after treatment escalation. These changes were found both in the PAH and CTEPH group. In parallel a significant improvement in WHO functional class, 6-minute walking distance, and N-terminal pro-b-type natriuretic peptide (NT-proBNP) was observed. Conclusions This is the first study to demonstrate a direct association between specific PH therapies and changes in HRV, HR nighttime and physical activity in patients with PAH and CTEPH. Continuous monitoring allows for an early intervention with supplementary treatment for PH. This is especially relevant considering the increasing availability of wearables that allow for a convenient measurement of relevant prognostic parameters in PH.

Mindfulness Exercises Reduce Acute Physiologic Stress Among Female Clinicians.

Approximately 50% of clinicians experience excessive emotional, physical, and mental stress, with repercussions across the entire medical system. Mindfulness exercises may mitigate this excessive stress. Heart rate variability (HRV) is an objective stress measure that can quantify which mindfulness exercises provide the greatest stress reduction. To define the impact of specific mindfulness exercises on HRV, a surrogate for physiologic stress, and the relationship between physiologic (HRV) and subjective stress measured by the State-Trait Anxiety Inventory during a one-day mindfulness workshop. This was a prospective observational pilot study performed at a quaternary children's hospital with diverse subspecialists of pediatric nurses, nurse practitioners, and physicians. Our primary outcome measure was change in HRV from baseline during three mindfulness exercises. The grounding, deep breathing, and body scan exercises all produced statistically significant changes in HRV among our 13 female participants. The body scan exercise produced statistically significant changes in all studied HRV parameters compared with baseline. We observed significant increases in Root Mean Square of Successive Differences between normal heartbeats (p = 0.026), high frequency (p ≤ 0.001), and the parasympathetic nervous system index (p ≤ 0.001) reflecting increased parasympathetic tone (e.g., relaxation), whereas sd 2/sd 1 ratio (p ≤ 0.001) and the stress index (p = 0.004) were decreased reflecting sympathetic withdrawal (e.g., decreased stress). Subjective stress decreased after 1-day mindfulness training (44.6 to 27.2) (p < 0.001). Individuals with the largest decrease in subjective stress also had the most improvement in HRV during the body scan exercise. Clinician stress levels (HRV) improved after participating in grounding, deep breathing, and body scan meditations, which may highlight their importance as stress reduction tools for clinicians. Monitoring of HRV during mindfulness exercises may provide deeper understanding of which specific exercises produce the greatest physiologic stress reduction for individual participants and the trend of these changes over time.

Effect of Lead, Cadmium, and Their Combination on the Heart Rate Regulation in Nonlinear Rats.

We studied heart rate variability (HRV) and the concentrations of heavy metals in the heart tissue after 14-fold peroral administration of heavy metal salts: lead acetate (50 mg/kg), cadmium chloride (5 mg/kg), and their combination. After administration of lead, its concentration in the myocardium exceeded the control values by 1.2 times or did not change in case of combination with cadmium; after administration of cadmium, its concentration in the myocardium exceeded the control value by 6.1 times or by 2 times after combined administration. After lead administration, a moderate increase in HR, low values of stress and centralization indices, and an increase in the power in all ranges of the HRV spectrum were recorded. After cadmium intoxication, a tendency to a decrease in heart rhythm variability, a moderate increase in HR, stress and centralization indices, and an increase in the contribution of VLF waves in the HRV spectrum were observed. After combined administration, a pronounced increase in HR and stress index and a moderate increase in the centralization of heart rhythm control were recorded, which was similar to changes in HRV observed after administration of cadmium alone. In the experiment, the concentration of cadmium in the myocardium increased to a much greater extent than the concentration of lead. After lead administration, the autonomous type of regulation persisted and parasympathetic influences increased. Cadmium apparently acts as a stress factor and increases the role of sympathoadrenal influences and central ergotropic structures in the heart rhythm regulation.

The consequences of cardiac autonomic nervous system modulation during pulmonary vein isolation: A review.

Pulmonary vein isolation (PVI) is a well-established treatment modality for atrial fibrillation (AF). Apart from the desired effect regarding the arrhythmic substrate within the left atrium, PVI commonly leads to modulation of the intrinsic cardiac autonomic nervous system (ICANS). Using the available literature, this article presents the anatomy of ICANS and describes methods of assessing its function, mainly focusing on heart rate (HR) variability metrics. Then, we summarize the modern pathophysiological outlooks on the onset and recurrence of AF and explain how the arrhythmia and the activation of ICANS are intertwined. Further, the article discusses the extent, dynamics and persistence of ICANS modulation during PVI, accounting for various modalities and procedural strategies. Both the potential benefits and pitfalls of such modulation are explored, considering AF recurrence, HR and HR variability changes, as well as the unclear effect on ventricular arrhythmias and nerve remodeling. Finally, the article aims to outline further directions of research necessary to improve our understanding of ICANS and its modulation.

Age-Related Changes in Heart Rate Variability from the Neonatal Period to Adulthood.

The aim of the study was to reveal the patterns of the age-related dynamics of the frequency-dependent regulation of heart rate variability (HRV) based on the analysis of Holter ECG recordings from healthy subjects of four age groups: neonates, one-year-old infants, adolescents, and adults. A wide spectral composition of HRV is shown, consisting of nine Hilbert-Huang modes in the frequency range from 0.0001 to 2 Hz. A decrease in the central frequencies of all modes is shown in the postnatal period with a plateau in adolescence. A rapid progression of systemic humoral regulation of HRV, characterized by a consolidated increase in the amplitudes of the corresponding modes with a plateau in adolescence, is demonstrated. The dome-shaped character of age-related changes in amplitude of modes associated with autonomic control with a maximum in adolescence is shown. The results obtained quantitatively demonstrate age-related consolidated changes in HRV parameters from neonates to adulthood.

Using heart rate variability to predict neurological outcomes in preterm infants: a scoping review.

Infants born preterm are at higher risk of neurological complications, including intraventricular haemorrhage and white matter injury. After discharge, these infants may experience adverse neurodevelopmental outcomes and exhibit lower educational attainment. Early detection of brain injury and accurate prediction of neurodevelopmental impairment would allow early intervention and support. Heart rate variability (HRV) describes the variation of time intervals between each subsequent heartbeat. HRV is controlled by the autonomic nervous system, which may be affected by hypoxia and compromised blood flow. While HRV has primarily been investigated in neonatal sepsis, the association between HRV, brain injury and neurodevelopmental outcomes in preterm infants is less established. The present scoping review examines the utility of HRV monitoring for predicting short-term and long-term neurological outcomes in preterm infants. Following systematic search of Medline, Embase, Web of Science and the Cochrane Library, 15 studies were included. Nine studies examined the relationship between HRV and brain injury, with all but two showed an association. Eight studies examined the relationship between HRV and long-term outcomes and all eight found an association. This scoping review suggests that decreased HRV in the neonatal period is associated with short- and long-term neurodevelopmental outcomes in preterm infants. IMPACT: Changes in heart rate variability correlate with the occurrence of intraventricular haemorrhage in preterm infants. A decrease in heart rate variability may precede the development of intraventricular haemorrhage. Alterations in heart rate variability correlate with long-term neurodevelopmental outcomes. Significant variability exists in metrics used in assessing heart rate variability.

Feet-heating and Calf-heating have Opposing Effects on Glucose Tolerance and Heart Rate Variability: A Randomized, Controlled, Crossover Trial.

Heat exposure's effect on glucose tolerance depending on the amount of body exposure, likely relating to autonomic nervous system balance. We assessed how partial-body heat exposure at two different levels of the lower extremities would affect glucose tolerance and autonomic nervous system balance measured via heart rate variability. We hypothesized feet-heating would improve glucose tolerance without affecting heart rate variability while calf-heating would worsen glucose tolerance and decrease heart rate variability compared to a thermoneutral control condition. In a randomized, controlled, crossover trial, healthy participants' (N=31, 23(3)years, 45% male) glucose tolerance was measured in A)thermoneutral; B)feet-heating; and C)calf-heating conditions. Every 30 minutes for 2 hours, blood glucose, heart rate, heart rate variability, tympanic temperature, thermal comfort scores, and blood pressure were measured. There were significant interactions between condition and time for blood glucose (F(4.6,72.6)=2.6,p=.036), heart rate (F(3.4,54.5)=3.5,p=.017), heart rate variability (F(4.3,63.2)=7.5,p<.0001), tympanic temperature (F(8,268)=2.4,p=.014), and thermal comfort scores (F(8,248)=22.1,p<.0001). Calf-heating increased 90-minute glucose (+12(95%CI: 3 to 21)mg/dL,p=.013) and decreased heart rate variability throughout (mean decrease: 13-22%,p<.007), while feet-heating lowered 90-minute glucose (-7(95%CI:-16 to +1)mg/dL,p=.090) without affecting heart rate variability (p=.14-.99). Blood pressure and body temperature were similar between conditions, but heart rate and thermal comfort scores increased with heating. Calf-heating worsens, while feet-heating may improve, glucose tolerance. Changes in heart rate variability coincide with changes in glucose tolerance despite unchanged body temperature. Whether heart rate variability can be used to monitor autonomic nervous system balance during heating to the effect on acute glycemic indices should be further explored.

A Bayesian analysis of heart rate variability changes over acute episodes of bipolar disorder

Bipolar disorder (BD) involves autonomic nervous system dysfunction, detectable through heart rate variability (HRV). HRV is a promising biomarker, but its dynamics during acute mania or depression episodes are poorly understood. Using a Bayesian approach, we developed a probabilistic model of HRV changes in BD, measured by the natural logarithm of the Root Mean Square of Successive RR interval Differences (lnRMSSD). Patients were assessed three to four times from episode onset to euthymia. Unlike previous studies, which used only two assessments, our model allowed for more accurate tracking of changes. Results showed strong evidence for a positive lnRMSSD change during symptom resolution (95.175% probability of positive direction), though the sample size limited the precision of this effect (95% Highest Density Interval [−0.0366, 0.4706], with a Region of Practical Equivalence: [-0.05; 0.05]). Episode polarity did not significantly influence lnRMSSD changes.

Lifelong longitudinal assessment of the contribution of multi-fractal fluctuations to heart rate and heart rate variability in aging mice: role of the sinoatrial node and autonomic nervous system.

Aging is a major risk factor for sinoatrial node (SAN) dysfunction, which can impair heart rate (HR) control and heart rate variability (HRV). HR and HRV are determined by intrinsic SAN function and its regulation by the autonomic nervous system (ANS). The purpose of this study wasto use multi-scale multi-fractal detrended fluctuation analysis (MSMFDFA; a complexity-based approach to analyze multi-fractal dynamics) to longitudinally assess changes in multi-fractal HRV properties and SAN function in ECG time series recorded repeatedly across the full adult lifespan in mice. ECGs were recorded in anesthetized mice in baseline conditions and after autonomic nervous system blockade every three months beginning at 6months of age until the end of life. MSMFDFA was used to assess HRV and SAN function every three months between 6 and 27months of age. Intrinsic HR (i.e. HR during ANS blockade) remained relatively stable until 15months of age, and then progressively declined until study endpoint at 27months of age. MSMFDFA revealed sudden and rapid changes in multi-fractal properties of the ECG RR interval time series in aging mice. In particular, multi-fractal spectrum width (MFSW, a measure of multi-fractality) was relatively stable between 6months and 15months of age and then progressively increased at 27months of age. These changes in MFSW were evident in baseline conditions and during ANS blockade. Thus,intrinsic SAN function declines progressively during aging and is manifested by age-associated changes in multi-fractal HRV across the lifespan in mice, which can be accurately quantified by MSMFDFA.

Long-Term Differences in AutonomicAlterations After Cryoballoonvs Radiofrequency AtrialFibrillation Ablation.

The long-term natural history of autonomic alterations following catheter ablation of drug-refractory paroxysmal atrial fibrillation is poorly defined. The authors sought to define the long-term impact of thermal catheter ablation on the cardiac autonomic system. The study included 346 patients with drug-refractory paroxysmal atrial fibrillation undergoing pulmonary vein isolation using thermal ablation energy (radiofrequency or cryoballoon ablation). All patients underwent insertion of a Reveal LINQ implantable cardiac monitor prior to ablation. The implantable cardiac monitor continuously recorded physical activity, heart rate variability (HRV) (measured as the standard deviation of the average normal-to-normal), daytime heart rate, and nighttime heart rate (NHR). Longitudinal autonomic data in the 2-month period prior to the date of ablation were compared with the 3 years following ablation. Following ablation, there was a significant decrease in HRV (10-20ms; P< 0.0001) and significant increases in daytime heart rate and NHR (10 beats/min [P< 0.0001] and 7 beats/min [P< 0.0001], respectively). Changes in autonomic parameters were greatest in the first 3months following ablation but remained significantly different from baseline for 36months following ablation. Greater changes in NHR and HRV were associated with improved freedom from recurrent arrhythmia. The type of thermal ablation energy had no influence on the heart rate and autonomic parameters. Pulmonary vein isolation using thermal ablation energy results in significant sustained changes in the heart rate parameters related to autonomic function. These changes are independent of the ablation technology employed and are associated with procedural success. (Cryoballoon vs Irrigated Radiofrequency Catheter Ablation: Double Short vs Standard Exposure Duration [CIRCA-DOSE]; NCT01913522).

Examining the applicability of virtual battle space for stress management training in military personnel-A validation study.

Military personnel are often exposed to high levels of both physical and psychological challenges in their work environment and therefore it is important to be trained on how to handle stressful situations. The primary aim of this study was to examine whether military-specific virtual battle space (VBS) scenarios could elicit a physiological and subjective stress response in healthy military personnel, as compared to that of a virtual reality height exposure (VR-HE) stress task that has shown to reliably increase stress levels. Twenty participants engaged in two VBS scenarios and the VR-HE during separate sessions, while measurements of heart rate (HR), heart rate variability (HRV), respiration rate, and subjective stress levels were collected. Contrary to our initial expectations, analysis revealed that neither of the VBS scenarios induced a significant stress response, as indicated by stable HR, HRV, and low subjective stress levels. However, the VR-HE task did elicit a significant physiological stress response, evidenced by increased HR and HRV changes, aligning with previous research findings. Moreover, no discernible alterations were detected in cognitive performance subsequent to these stressors. These results suggest that the current VBS scenarios, despite their potential, may not be effective for stress-related training activities within military settings. The absence of a significant stress response in the VBS conditions points to the need for more immersive and engaging scenarios. By integrating interactive and demanding elements, as well as physical feedback systems and real-time communication, VBS training might better mimic real-world stressors and improve stress resilience in military personnel. The findings of this study have broader implications for stress research and training, suggesting the need for scenario design improvements in virtual training environments to effectively induce stress and improve stress management across various high-stress professions.

A maternal diet high in carbohydrates causes bradyarrhythmias and changes in heart rate variability in the offspring sex-dependent in mice

BackgroundMaternal obesity prepregnancy, as well as gestational overweight produced by high-sucrose diet, could be evolved to the cardiometabolic diseases in offspring during adulthood. Until then, the cardiometabolic diseases were ignored that have been presented or inherited in the offspring for overnutrition were ignored, depend on gender. We proposed that maternal prepregnancy obesity in CD1 mice, as well as gestational overweight produced by a high sucrose diet, develop to cardiometabolic disease in offspring and even if gender. For detection of the cardiometabolic diseases in a Murine model with a high sucrose diet (HSD), the time series formed by the RR intervals taken from lead I of the ECG has used the corresponding Poincare plot. The heart rate variability was characterized by the standard deviation of width and length SD1, SD2 respectively of the Poincare plot and the SD1/SD2 correlation index in addition was calculated between to gender and body weight.ResultsA maternal diet was based high sucrose diet and produced overweight on progeny in both sexes, but the cardiac arrhythmias depended on gender. Other results were due to the chronic effect of high sucrose diet in offspring with this intrauterine ambiance that contributes to changes in HRV, arrhythmias, and sinus pauses, also these phenomena were observed just in the male mice offspring with high sucrose diet during adulthood.ConclusionsWe propose, that the arrhythmias originated from fetal programming due to the maternal diet in mice model and produced alterations in the offspring female more than in the male, probably due to hormones.

How does fetal inflammatory response syndrome change fetalresponse to hypoxia? An experimental study in a fetal sheep model.

Fetal inflammatory response syndrome associated with acidosis during labor is a high-risk situation for the fetus. This study evaluated hemodynamic, gasometric, and heart rate variability changes during acute fetal inflammatory response syndrome associated with hypoxia, compared with isolated hypoxia. Acute fetal inflammatory response syndrome was obtained via anintravenously injection of lipopolysaccharide derived from Escherichia coli. Hypoxia was induced by repeated umbilical cord occlusions during three phases: mild, moderate, and severe umbilical cord occlusions. Two groups were created with chronically instrumented near-term fetal sheep: one group with isolated hypoxia, the other with hypoxia and fetal inflammatory response syndrome. Hemodynamic, gas parameters, and fetal heart rate variability were compared between the groups. The hypoxia and fetal inflammatory response syndrome group had a higher mortality rate (n = 4/9) compared with the hypoxia group (n = 0/9). Gasometric state was altered earlier in case of lipopolysaccharide injection (pH = 7.22 (7.12-7.24) vs 7.28 (7.23-7.34) p = 0.01; lactate = 10.3 mmol/L (9.4-11.0) vs 6.0 mmol/L (4.1-8.2) p < 0.001 after mild occlusions). After mild occlusions, the hypoxia and fetal inflammatory response syndrome group had higher values on seven heart rate variability parameters compared with the hypoxia group. After moderate occlusions, two parameters remained significantly higher. During fetal inflammatory response syndrome, fetal adaptation to hypoxia is impaired. In case of fetal infection, acidosis during labor is likely to become severe more rapidly, requiring closer fetal monitoring during labor.

Comparing E-Cigarettes and Traditional Cigarettes in Relation to Myocardial Infarction, Arrhythmias, and Sudden Cardiac Death: A Systematic Review and Meta-Analysis.

The use of electronic cigarettes (e-cigarettes) as a perceived safer alternative to traditional cigarettes has grown rapidly. However, the cardiovascular risks associated with e-cigarettes compared to regular cigarettes remain unclear. To systematically review and compare the cardiovascular outcomes of e-cigarette use versus traditional cigarette use, focusing on the risks of myocardial infarction, arrhythmias, and sudden death. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Peer-reviewed studies published in English were included if they reported cardiovascular outcomes related to e-cigarette or traditional cigarette use. A total of 20 studies were included, covering observational and interventional studies focusing on heart rate variability, myocardial infarction, arrhythmias, and sudden cardiac events. The quality of the evidence was assessed using the GRADE criteria, and data were extracted and analyzed based on the PICOS (Population, Interventions, Comparisons, Outcomes, and Study designs) framework. The systematic review found that both e-cigarettes and traditional cigarettes pose significant cardiovascular risks, with traditional cigarettes linked to a higher incidence of myocardial infarction, arrhythmias, and sudden cardiac death. E-cigarette users also face increased risks of arrhythmias and myocardial infarction compared to non-smokers, primarily due to the constituents of aerosolized e-liquid, including nicotine and flavorings, which contribute to adverse cardiac effects. Regular e-cigarette use, particularly in combination with traditional cigarette use, was associated with a heightened risk of myocardial infarction. Studies also reported heart function abnormalities, such as systolic and diastolic dysfunction, and reduced ejection fractions. Additionally, changes in heart rate variability, heart rate, and blood pressure were observed, indicating both acute and chronic effects of e-cigarettes on cardiovascular autonomic regulation. While e-cigarettes may present a lower cardiovascular risk compared to traditional cigarettes, they are not without harm. Both products are linked to increased risks of myocardial infarction and arrhythmias, though traditional cigarettes pose a higher overall threat. Given the limitations in the current evidence base, particularly concerning the long-term effects of e-cigarette use, further research is needed to clarify these cardiovascular risks and inform public health guidelines.