Early Heart Rate Research Articles

Early heart rate recovery after a 6-min walking test in patients after percutaneous aortic valve implantation coresponds with clinical benefits

Abstract Background Time-appropriate return to a resting heart rate (HR) after cessation of exercise is a marker for predicting outcomes in patients with heart failure (HF). We aimed to evaluate the prognostic value of HR recovery in functional improvement in patients with severe aortic stenosis after percutaneous aortic valve implantation (TAVI). Methods 6 min walk test (6MWT) was performed in 93 individuals before TAVI and in 3 months follow up. The change in walking distance was measured. We analyzed also the differences between baseline HR, HR at the end of the test, and HR at the 1st, 2nd and 3rd minute of recovery. Results After 3 months the distance of 6MWT in TAVI patients improved by 39±63 m and reached a total of 322±117 m. The differences between HR after 2 min of recovery and baseline HR in pre-TAVI after a 6MWT was the only significant predictor of waking distance improvement during follow-up in multiple linear regression model. Conclusions Our study showes that changes of HR recovery after a 6MWT may be a helpful and easy parameter to assess improvement in exercise capacity after TAVI. This simple method can also help to identify patients in whom no significant benefit in functional improvement can be expected despite successful valve implantation.Demographics

Senescent hearts from male Ts65Dn mice exhibit preserved function but altered size and nicotinamide adenine dinucleotide pathway signaling.

Down syndrome (DS) is associated with congenital heart defects at birth, but cardiac function has not been assessed at older ages. We used the Ts65Dn mouse, a model of DS, to quantify heart structure and function with echocardiography in 18-mo male Ts65Dn and wild-type (WT) mice. Heart weight, nicotinamide adenine dinucleotide (NAD) signaling, and mitochondrial (citrate synthase) activity were investigated, as these pathways may be implicated in the cardiac pathology of DS. The left ventricle was smaller in Ts65Dn versus WT, as well as the anterior wall thickness of the left ventricle during both diastole (LVAW_d; mm) and systole (LVAW_s; mm) as assessed by echocardiography. Other functional metrics were similar between groups including left ventricular area end systole (mm2), left ventricular area end diastole (mm2), left ventricular diameter end systole (mm), left ventricular diameter end diastole (mm), isovolumetric relaxation time (ms), mitral valve atrial peak velocity (mm/s), mitral valve early peak velocity (mm/s), ratio of atrial and early peak velocities (E/A), heart rate (beats/min), ejection fraction (%), and fractional shortening (%). Nicotinamide phosphoribosyltransferase (NAMPT) protein expression, NAD concentration, and tissue weight were lower in the left ventricle of Ts65Dn versus WT mice. Sirtuin 3 (SIRT3) protein expression and citrate synthase activity were not different between groups. Although cardiac function was generally preserved in male Ts65Dn, the altered heart size and bioenergetic disturbances may contribute to differences in aging for DS.

Early heart rate variability changes during acute fetal inflammatory response syndrome: An experimental study in a fetal sheep model.

Fetal infection during labor with fetal inflammatory response syndrome (FIRS) is associated with neurodevelopmental disabilities, cerebral palsy, neonatal sepsis, and mortality. Current methods to diagnose FIRS are inadequate. Thus, the study aim was to explore whether fetal heart rate variability (HRV) analysis can be used to detect FIRS. In chronically instrumented near-term fetal sheep, lipopolysaccharide (LPS) was injected intravenously to model FIRS. A control group received saline solution injection. Hemodynamic, blood gas analysis, interleukin-6 (IL-6), and 14 HRV indices were recorded for 6 h. In both groups, comparisons were made between the stability phase and the 6 h following injection (H1-H6, respectively) and between LPS and control groups. Fifteen lambs were instrumented. In the LPS group (n = 8), IL-6 increased significantly after LPS injection (p < 0.001), confirming the FIRS model. Fetal heart rate increased significantly after H5 (p < 0.01). In our FIRS model without shock or cardiovascular decompensation, five HRV measures changed significantly after H2 until H4 in comparison to baseline. Moreover, significant differences between LPS and control groups were observed in HRV measures between H2 and H4. These changes appear to be mediated by an increase of global variability and a loss of signal complexity. As significant HRV changes were detected before FHR increase, these indices may be valuable for early detection of acute FIRS.

91 Early post-resuscitation heart rate and hemodynamics as predictors of survival with a good neurological outcome in a pig model of cardiac arrest

91 Early post-resuscitation heart rate and hemodynamics as predictors of survival with a good neurological outcome in a pig model of cardiac arrest

Early heart rate fluctuation and outcomes in critically ill patients with sepsis: A retrospective cohort study of the MIMIC-IV database

BackgroundHeart rate (HR) abnormalities are common in critically ill patients, but the significance of HR fluctuation in sepsis remains unclear. We aimed to assess the association of HR fluctuation with intensive care unit (ICU) mortality, hospital mortality, and 28-day mortality in patients with sepsis and identify the cutoff value of HR fluctuation associated with the lowest risk of death. MethodsWe conducted a retrospective cohort study using the medical information mart for the intensive care IV database. HR fluctuation, defined as the difference between maximum and minimum HR within the first 24 h of ICU admission, was analyzed for its association with outcomes using restricted cubic spline and multivariable Cox regression models. ResultsAmong 24,419 eligible patients with sepsis, HR fluctuation showed a J-shaped association with ICU mortality, hospital mortality, and 28-day mortality. The high HR fluctuation group (≥ 35 bpm) had a significantly increased risk of ICU mortality ([hazard ratio, 95% confidence interval] 1.12,1.02–1.22, P = 0.013), hospital mortality (1.10,1.02–1.19, P = 0.013), and 28-day mortality (1.11,1.03–1.20, P = 0.007) compared to the control group (HR fluctuation 25–34 bpm). The low HR fluctuation group (< 25 bpm) showed no significant difference in the risk of mortality compared to the control group. ConclusionsOur large-sample study suggests that early high HR fluctuation is indicative of poor prognosis in critically ill patients with sepsis. Early HR fluctuation may serve as a readily available “high-risk alert system” influencing therapeutic decision-making.

Ivabradine monotherapy in pediatric patients with focal atrial tachycardia: a single-center study.

Ivabradine is well-tolerated and may provide early heart rate control in pediatric FAT and can be considered early, especially in the presence of left ventricular dysfunction. Further investigations are deserved to confirm the optimal dose and long-term efficacy in this population. •Focal atrial tachycardia (FAT) is the most common arrhythmia associated with tachycardia-induced cardiomyopathy (TIC) in children, and the efficacy of conventional antiarrhythmic medications in the treatment of FAT is poor. •Ivabradine is currently the only selective hyperpolarization-activated cyclic nucleotide-gated (HCN) inhibitor, which can effectively low HR without negative effect on blood pressure or inotropy. • Ivabradine (0.1-0.2 mg/kg every 12 h) can effectively suppress focal atrial tachycardia in 50% of pediatric patients. •Ivabradine provides early control of heart rate and hemodynamic stabilization in children with severe left ventricular dysfunction due to atrial tachycardia within 48 h.

Early Heart Rate Recovery after a 6-min Walking Test Predicts Clinical Benefits in Patients after Percutaneous Aortic Valve Implantation.

It was hypothesized that the time-appropriate return to a resting heart rate (HR) after cessation of exercise could be a marker for predicting outcomes in patients with heart failure (HF). We aimed to evaluate the prognostic value of HR recovery in functional improvement among adults with severe aortic stenosis undergoing percutaneous aortic valve implantation (TAVI). We performed a 6 min walk test (6MWT) in 93 individuals before TAVI and 3 months after the procedure. The change in walking distance was calculated. During the pre-TAVI 6MWT, we analyzed the differences between baseline HR, HR at the end of the test, and HR at the 1st, 2nd, and 3rd minute of recovery. After 3 months, 6MWT distances improved by 39 ± 63 m and reached a total of 322 ± 117 m. Multiple linear regression proved the differences between HR after 2 min of recovery and baseline HR in pre-TAVI after a 6MWT was the only significant predictor of waking distance improvement during follow-up. Our study suggests that analysis of HR recovery after a 6MWT may be a helpful and easy parameter to assess improvements in exercise capacity after TAVI. This simple method can help to identify patients in whom no significant benefit in functional improvement can be expected despite successful valve implantation.

Initial Heart Rate Predicts Functional Independence in Patients With Spinal Cord Injury Requiring Surgery: A Registry-Based Study in a Mature Trauma System Over the Past 10Years.

Retrospective Cohort Study. To determine the ability of early vital sign abnormalities to predict functional independence in patients with SCI that required surgery. A retrospective analysis of data extracted from the Pennsylvania Trauma Outcome Study database. Inclusion criteria were patients >18years with a diagnosis of SCI who required urgent spine surgery in Pennsylvania from 1/1/2010-12/31/2020 and had complete records available. A total of 644 patients met the inclusion criteria. The mean age was 47.1 ± 14.9years old and the mean injury severity score (ISS) was 22.3 ± 12.7 with the SCI occurring in the cervical, thoracic, and lumbar spine in 61.8%, 19.6% and 18.0%, respectively. Multivariable logistic regression analyses for predictors of functional independence at discharge showed that higher HR at the scene (OR 1.016, 95% CI 1.006-1.027, P = .002) and lower ISS score (OR .894, 95% CI .870-.920, P < .001) were significant predictors of functional independence. Similarly, higher admission HR (OR 1.015, 95% CI 1.004-1.027, P = .008) and lower ISS score (OR .880, 95% CI 0.864-.914, P < .001) were significant predictors of functional independence. Peak Youden indices showed that patients with HR at scene >70 and admission HR ≥83 were more likely to achieve functional independence. Early heart rate is a strong predictor of functional independence in patients with SCI. HR at scene >70 and admission HR ≥83 is associated with improved outcomes, suggesting lack of neurogenic shock.

Use of Swedish smokeless tobacco during pregnancy: A systematic review of pregnancy and early life health risk.

Smokeless tobacco is a heterogeneous product group with diverse composition and prevalence globally. Tobacco use during pregnancy is concerning due to the risk of adverse pregnancy outcomes and effects on child health. Nicotine may mediate several of these effects. This systematic review measured health outcomes from Swedish smokeless tobacco (snus) use during pregnancy. Literature search was conducted by an information specialist in May 2022. We included human studies of snus use during pregnancy compared with no tobacco use, assessed risk of bias, conducted a meta-analysis and assessed confidence in effect-estimates using Gradingof Recommendations, Assessment, Development and Evaluations (GRADE). We included 18 cohort studies (42 to 1 006 398 participants). Snus use during pregnancy probably (moderate confidence in risk estimates) increase the risk of neonatal apnea, adjusted odds ratio 95% confidence interval [aOR (95% CI)] 1.96 (1.30 to 2.96). Snus use during pregnancy possibly (low confidence in risk estimates) increase the risk of stillbirths aOR 1.43 (1.02 to 1.99), extremely premature births aOR 1.69 (1.17 to 2.45), moderately premature birth aOR 1.26 (1.15 to 1.38), SGA aOR 1.26 (1.09 to 1.46), reduced birth weight mean difference of 72.47 g (110.58 g to 34.35 g reduction) and oral cleft malformations aOR 1.48 (1.00 to 2.21). It is uncertain (low confidence in risk estimates, CI crossing 1) whether snus use during pregnancy affects risk of preeclampsia aOR 1.11 (0.97 to 1.28), antenatal bleeding aOR 1.15 (0.92 to 1.44) and very premature birth aOR 1.26 (0.95 to 1.66). Risk of early neonatal mortality and altered heart rate variability is uncertain, very low confidence. Snus using mothers had increased prevalence of caesarean sections, low confidence. This systematic review reveals that use of smokeless tobacco (snus) during pregnancy may adversely impact the developing child.

Sleep duration and disturbance are associated with orthostatic heart rate recovery: Findings from the Irish Longitudinal Study on Ageing

ObjectiveTo examine a novel measurement of autonomic innervation, the early heart rate response to orthostasis, in relation to sleep duration and disturbance (actigraphy-based and self-reported) in healthy older adults. DesignCross-sectional analyses of a nationally representative prospective cohort study, the Irish Longitudinal Study on Ageing (TILDA). ParticipantsNine hundred sixty community-dwelling adults aged 50 and over (mean age 65.6 ± 8.1; 53% women). MeasurementOrthostatic heart rate response was measured during an active stand test. Beat-to-beat heart rate was monitored over 3 minutes using noninvasive digital photoplethysmography. Mean values at each 10-second time point after standing were generated and differences from baseline at each time point were used for analysis. Actigraphy-based sleep measures were extracted from wrist-worn GENEactiv devices; self-reported sleep measures using interview questions. ResultsLinear mixed-effects regression analyses, with inclusion of a large number of confounders, show that self-reported sleep duration and actigraphy-based sleep duration and disturbance were associated with altered orthostatic heart rate response, particularly within the first 20 seconds poststanding. Self-reported short sleep (β = -0.06; 95% confidence interval [CI]: -0.11, -0.01) and long sleep (β = -0.15; 95% CI: -0.24, -0.05) and actigraphy-based short sleep (β = -0.08; 95% CI: -0.14, -0.01) were characterized by a smaller increase at 10 seconds (p < .01). Actigraphy-based short sleep (β = 0.15; 95% CI: 0.08, 0.22) and sleep disturbance (β = 0.04; 95% CI: 0.02, 0.06) were associated with a slower return toward baseline at 20 seconds (p < .001). ConclusionsOur findings suggest sympathetic dysregulation, impaired vagal reactivation, and/or decreased baroreceptor sensitivity in the presence of shortened or disturbed sleep.

No Association of Early Postoperative Heart Rate With Outcomes After Coronary Artery Bypass Grafting.

Elevated perioperative heart rate potentially causes perioperative myocardial injury because of imbalance in oxygen supply and demand. However, large multicenter studies evaluating early postoperative heart rate and major adverse cardiac and cerebrovascular events (MACCEs) are lacking. To assess the associations of 4 postoperative heart rate assessment methods with in-hospital MACCEs after elective coronary artery bypass grafting (CABG). Using data from the eICU Collaborative Research Database in the United States from 2014 to 2015, the study evaluated postoperative heart rate measured during hospitalization within 24 hours after intensive care unit admission. Four heart rate assessment methods were evaluated: maximum heart rate, duration above heart rate 100/min, area above heart rate 100/min, and time-weighted average heart rate. The outcome was in-hospital MACCEs, defined as a composite of in-hospital death, myocardial infarction, angina, arrhythmia, heart failure, stroke, cardiac arrest, or repeat revascularization. Among 2585 patients, the crude rate of in-hospital MACCEs was 6.2%. In multivariable logistic regression analysis, the adjusted odds ratios (95% CI) for in-hospital MAC-CEs assessed by maximum heart rate in each heart rate category (beats per minute: >100-110, >110-120, >120-130, and >130) were 1.43 (0.95-2.15), 0.98 (0.56-1.64), 1.47 (0.76-2.69), and 1.71 (0.80-3.35), respectively. Similarly, none of the other 3 methods were associated with MACCEs. More research is needed to assess the usefulness of heart rate measurement in patients after CABG.

Role of Triarchic Traits in Relations of Early Resting Heart Rate With Antisocial Behavior and Broad Psychopathology Dimensions in Later Life

Low resting heart rate (HR) is a known risk indicator for the development of antisocial behavior (ASB) and other clinical problems. Stimulation seeking and fearlessness have been explored as factors underlying the HR/ASB relationship, but these have often been conflated, which has complicated interpretation. We examined HR’s associations with ASB and other outcomes in terms of biobehavioral traits described by the triarchic model of psychopathy using data ( N = 710) from a longitudinal study of ASB risk. Low resting HR in childhood was related to adult ASB, and covariance between ASB and traits of disinhibition and boldness largely accounted for this association. In addition, low childhood HR was related to greater externalizing problems and fewer internalizing problems in adulthood; disinhibition accounted for the former association, and boldness accounted for the latter. Findings indicate a role for both disinhibition and boldness in associations between early HR and later clinical outcomes and have implications for theory and practice.

The Influence of EGCG on the Pharmacokinetics and Pharmacodynamics of Bisoprolol and a New Method for Simultaneous Determination of EGCG and Bisoprolol in Rat Plasma.

Background and AimResearch has shown that green tea catechins may influence the activity of drug metabolizing enzymes and drug transporters. We examined whether epigallocatechin-3-gallate (EGCG) affected the pharmacokinetics and pharmacodynamics of bisoprolol in rats.MethodsA sensitive, specific liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was established for the quantitative determination of EGCG and bisoprolol. The pharmacokinetic parameters of EGCG and bisoprolol in Sprague-Dawley (SD) rats were analyzed using non-compartmental methods with the aid of the computer program WinNolin. Blood pressure (BP) of spontaneously hypertensive rats (SHRs) was monitored by the tail-cuff method. Bisoprolol was given as single doses of 10 mg/kg with or without EGCG 100 mg/kg by gavage or by intravenous injection.ResultsIntake of EGCG with bisoprolol by gavage significantly reduced the Cmax (mean Cmax from 2012.31 to 942.26 ng/mL, P < 0.05) and increased the Tmax (mean Tmax from 0.5 to 0.83 h, P < 0.01) for bisoprolol. After intravenous injection, EGCG significantly increased the apparent volume of distribution of bisoprolol (mean Vz/F from 1629.62 to 2473.27 mL/Kg, P < 0.05) and tended to increase the clearance. The absolute bioavailability of bisoprolol was reduced from 92.04 to 66.05% in rats when bisoprolol was administered with EGCG. Heart rate reduction was less in SHRs when EGCG was given by gavage with bisoprolol whereas BP reduction occurred more rapidly.ConclusionThis study showed that the simultaneous administration of EGCG by gavage at a dose of 100 mg/kg was associated with decreased Cmax and increased Tmax of bisoprolol, and the Vz/F of bisoprolol was increased when administered with EGCG by intravenous injection in SD rats. Moreover, the early heart rate reduction with bisoprolol was attenuated and BP reduction occurred earlier when EGCG was given with bisoprolol by gavage in SHRs.

Longitudinal association of early childhood lead exposure and adolescent heart rate variability: influence of parental education

Lead exposure has been shown to dysregulate physiological stress responses. However, few studies have investigated the effect of lead exposure on later heart rate variability (HRV), an indicator of a stress response, in large samples of children. Furthermore, the interaction between social environmental factors and lead exposure in childhood, which commonly co-occur, remains understudied. This study examined relationships between childhood lead exposure and early adolescent physiological stress responses at different levels of parental education. Participants were 406 children from Jintan, China. Blood lead levels (BLLs) and parental education data were collected at 3–5 years of age, and HRV outcomes assessed at 12 years via frequency domain measures (LF/HF ratio) collected during an induced stress test. Results show a significant interaction between parental education and BLLs at 3–5 years. This relationship was found to be most consistent for the interaction between BLLs and mother’s years of education for both the planning (β = 0.12, p = 0.046) and speaking (β = 0.11, p = 0.043) phase of the stress task, suggesting that increasing years of mother’s education may enhance the deleterious influence of lead exposure on the HRV frequency measure, LF/HF ratio. This research highlights the complexity in lead exposure induced outcomes.

When Nothing Goes Right: Risk Factors and Biomarkers of Right Heart Failure after Left Ventricular Assist Device Implantation.

Right heart failure (RHF) is a severe complication after left ventricular assist device (LVAD) implantation. The aim of this study was to analyze the incidence, risk factors, and biomarkers for late RHF including the possible superiority of the device and implantation method. This retrospective, single-center study included patients who underwent LVAD implantation between 2014 and 2018. Primary outcome was freedom from RHF over one-year after LVAD implantation; secondary outcomes included pre- and postoperative risk factors and biomarkers for RHF. Of the 145 consecutive patients (HeartMate 3/HVAD: n = 70/75; female: 13.8%), thirty-one patients (21.4%) suffered RHF after a mean LVAD support of median (IQR) 105 (118) days. LVAD implantation method (less invasive: 46.7% vs. 35.1%, p = 0.29) did not differ significantly in patients with or without RHF, whereas the incidence of RHF was lower in HeartMate 3 vs. HVAD patients (12.9% vs. 29.3%, p = 0.016). Multivariate Cox proportional hazard analysis identified HVAD (HR 4.61, 95% CI 1.12–18.98; p = 0.03), early post-op heart rate (HR 0.96, 95% CI 0.93–0.99; p = 0.02), and central venous pressure (CVP) (HR 1.21, 95% CI 1.05–1.39; p = 0.01) as independent risk factors for RHF, but no association of RHF with increased all-cause mortality (HR 1.00, 95% CI 0.99–1.01; p = 0.50) was found. To conclude, HVAD use, lower heart rate, and higher CVP early post-op were independent risk factors for RHF following LVAD implantation.

Early childhood lead exposure and adolescent heart rate variability: A longitudinal cohort study

Lead is a known neurotoxicant with many detrimental health effects, including neurocognitive deficits and cardiovascular and metabolic disorders. However, few studies have tested the association between lead exposure and the physiological stress response, which in and of itself may act as a precursor to and/or underlying mechanism of detrimental health outcomes. The purpose of this study was to examine the influence of early childhood and early adolescent low-level lead exposure on early adolescent heart rate variability, a widely-used measure of physiological stress. Participants were 408 children from Jintan, China for whom blood lead levels were measured between 3 and 5 years (early childhood) and again at 12 years (early adolescence). Heart rate variability was assessed at 12 years while participants underwent an induced stress task utilizing the ratio of low to high frequency (LF/HF) ECG measures. Mean blood lead levels in the cohort were 6.63 mcg/dl and 3.10 mcg/dl at 3–5 years and 12 years, respectively. Blood lead levels at 3–5 years of age (β 0.06, p = 0.027), but not at age 12 (β −0.05, p = 0.465), were significantly associated with LF/HF measures while controlling for multiple sociodemographic variables, potentially reflecting a dysregulated stress response with a shift towards sympathetic dominance. These findings suggest that early childhood lead exposure may have a detrimental influence on early adolescent autonomic responses to acute stress, which holds implications for cardiovascular health and overall growth and development.

Multichannel EEG abnormalities during the first 6\u2009hours in infants with mild hypoxic\u2013ischaemic encephalopathy

BackgroundInfants with mild HIE are at risk of significant disability at follow-up. In the pre-therapeutic hypothermia (TH) era, electroencephalography (EEG) within 6 hours of birth was most predictive of outcome. This study aims to identify and describe features of early EEG and heart rate variability (HRV) (<6 hours of age) in infants with mild HIE compared to healthy term infants.MethodsInfants >36 weeks with mild HIE, not undergoing TH, with EEG before 6 hours of age were identified from 4 prospective cohort studies conducted in the Cork University Maternity Services, Ireland (2003–2019). Control infants were taken from a contemporaneous study examining brain activity in healthy term infants. EEGs were qualitatively analysed by two neonatal neurophysiologists and quantitatively assessed using multiple features of amplitude, spectral shape and inter-hemispheric connectivity. Quantitative features of HRV were assessed in both the groups.ResultsFifty-eight infants with mild HIE and sixteen healthy term infants were included. Seventy-two percent of infants with mild HIE had at least one abnormal EEG feature on qualitative analysis and quantitative EEG analysis revealed significant differences in spectral features between the two groups. HRV analysis did not differentiate between the groups.ConclusionsQualitative and quantitative analysis of the EEG before 6 hours of age identified abnormal EEG features in mild HIE, which could aid in the objective identification of cases for future TH trials in mild HIE.ImpactInfants with mild HIE currently do not meet selection criteria for TH yet may be at risk of significant disability at follow-up.In the pre-TH era, EEG within 6 hours of birth was most predictive of outcome; however, TH has delayed this predictive value.72% of infants with mild HIE had at least one abnormal EEG feature in the first 6 hours on qualitative assessment.Quantitative EEG analysis revealed significant differences in spectral features between infants with mild HIE and healthy term infants.Quantitative EEG features may aid in the objective identification of cases for future TH trials in mild HIE.

Monitoring and Analysis of Early Heart Structure of Fetus in Gynecology and Obstetrics Based on Ultrasound Image

As the core organ of cardiovascular system, fetal heart plays a very important role. With the development of pregnancy, the early fetal heart rate tends to mature, and the corresponding cardiac function tends to mature and stable. But the fetal heart is very fragile during pregnancy. Various diseases during pregnancy directly lead to fetal heart growth restriction, and even lead to fetal heart function damage. Ultrasound image diagnosis is one of the most important diagnostic methods in medical imaging. It is of great significance to detect the early heart structure of the fetus in gynecology and obstetrics. It can detect the early fetal heart in real time and noninvasively. However, the traditional ultrasonic image detection has many disadvantages in the process of application, such as many noise points, low performance of processing algorithm, which to some extent affects the detection performance of ultrasonic image detection in the detection of fetal heart structure in gynecology and obstetrics. Based on the above problems, this paper proposes an adaptive detection algorithm of superimposed moving image based on ultrasonic image detection, which can accurately extract and analyze fetal heart region when the signal-to-noise ratio of ultrasonic image sequence is low. The average anisotropy algorithm is also proposed innovatively in this paper. In order to predict the structure of fetal heart more accurately, the active heart model combining fetal heart structure and motion information is considered in the actual analysis process. Experiments show that the accuracy error of the algorithm is less than 11 pixels.

Heart rate response to orthostatic challenge in patients with dementia with Lewy bodies and Alzheimer's disease.

To elucidate the differences in autonomic dysfunction between dementia with Lewy bodies (DLB) and Alzheimer's disease using a simple and convenient method, we investigated the heart rate response to orthostatic challenge. Ninety-seven people participated in this cross-sectional study, and data from 26 DLB patients, 29 Alzheimer's disease patients, and 25 healthy elderly individuals were analysed. Participants underwent postural changes, including 5 min in a supine position, 1 min in a sitting position, and 3 min in an orthostatic position. Their heart rates were continuously recorded. Two heart rate variables were analysed as main outcomes: (i) the difference between heart rate in the sitting position and the peak heart rate within 15 s of orthostasis, defined as the 'early heart rate increase'; and (ii) the difference between the peak heart rate and the negative peak heart rate after this, defined as 'early heart rate recovery.' An early heart rate increase has been considered to reflect parasympathetic and sympathetic functions. Early heart rate recovery is considered to reflect parasympathetic function. We also investigated the frequency domains of resting heart rate variability. A significant difference was observed across the three groups in early heart rate increase, and that of the DLB group was lower than that of the healthy control group. Early heart rate recovery also differed significantly across the three groups, and that of the DLB group was less than that of the healthy control group. In addition, the power of the low-frequency component, which represents both sympathetic and parasympathetic activity, was significantly decreased in the DLB group compared to the Alzheimer's disease group. Impaired heart rate response to standing was detected in patients with DLB. Electrocardiogram is a convenient, non-invasive method that might be useful as a subsidiary marker for DLB diagnosis and differentiation from Alzheimer's disease.

Impact of Overweight in Mens with Family History of Hypertension: Early Heart Rate Variability and Oxidative Stress Disarrangements.

Aim To evaluate cardiovascular, autonomic, and oxidative stress markers in eutrophic and overweight offspring of hypertensive parents comparing them to eutrophic and overweight offspring of normotensive parents. Methods We conducted a cross-sectional study. We selected 71 male and sedentary subjects, divided into 4 groups: eutrophic group with a negative family history of hypertension (EH-, n = 18) or positive family history of hypertension (EH+, n = 17), overweight group with a negative family history of hypertension (OH-, n = 19) or a positive family history of hypertension (OH+, n = 17), and aged between 18 and 35 years. Results Blood glucose was higher in the OH+ group when compared to other groups. Diastolic blood pressure was increased in OH- and OH+ groups when compared to eutrophic groups. Regarding the HRV, the LF abs was higher in OH- and OH+ groups when compared to the EH- group. LF/HF values were higher in EH+ and OH+ groups when compared to the EH- and OH- groups. As to oxidative stress and the metabolism of nitric oxide, we observed an increase in hydrogen peroxide and nitrite levels in the OH+ group, and in the NADPH oxidase in OH- and OH+ groups when compared to the other groups. Conclusion Our findings demonstrate that the overweight group with a family history of hypertension presented all the dysfunctions observed in isolation from these risk factors. We observed an exacerbation of cardiac sympathetic modulation and early prooxidants increase, which may be associated with target organ damage and cardiovascular risk in this population.