Higher Heart Rate Values Research Articles

A Comparative Analysis of Acute Physiological and Perceptual Responses in Whole-Body and Ergometer-Based High-Intensity Interval Training Protocols.

The primary aim of the present investigation was to compare the acute physiological and perceptual responses between two modes of interval training using a randomized crossover design. More specifically, eleven young adult participants (23 ± 4 years, 77 ± 13 kg, 178 ± 7 cm) performed two protocols: one composed of whole-body calisthenics exercises and another on a cycle ergometer. Both protocols encompassed eight 20 s bouts at intensities equivalent to all-out (HIIT-WB) and 170% of the maximal power output (HIIT-C), respectively, interspersed with 10 s of passive rest. The peak and average heart rate, the rating of perceived effort, and blood lactate, creatine kinase, and lactate dehydrogenase concentrations were measured. Aside from blood lactate (HIIT-WB = 9.4 ± 1.8 mmo/L; HIIT-C = 12.5 ± 2.5 mmol/L, p < 0.05) and the rating of perceived exertion (HIIT-WB = 8.8 ± 0.9; HIIT-C = 9.6 ± 0.5, p < 0.05), physiological responses did not significantly differ between protocols (all p > 0.05), with high average heart rate values (HIIT-WB = 86 ± 6% HRmax; HIIT-C = 87 ± 4% HRmax) and a low magnitude of muscle damage, as inferred by CK and LDH concentrations (HIIT-WB = 205.9 ± 56.3 and 203.5 ± 72.4 U/L; HIIT-C = 234.5 ± 77.1 and 155.1 ± 65.3 U/L), respectively. It can be concluded that both protocols elicit vigorous heart rate responses and a low magnitude of muscle damage and, therefore, appear as viable alternatives to improve aerobic fitness. The inclusion of a whole-body HIIT protocol may be an interesting alternative for training prescription in relation to more common interval training protocols.

Hypoxia matters: comparison of external and internal training load markers during an 8-week resistance training program in normoxia, normobaric hypoxia and hypobaric hypoxia

PurposeTo compare external and internal training load markers during resistance training (RT) in normoxia (N), intermittent hypobaric hypoxia (HH), and intermittent normobaric hypoxia (NH).MethodsThirty-three volunteers were assigned an 8-week RT program in either N (690 m, n = 10), HH (2320 m, n = 10), or NH (inspired fraction of oxygen = 15.9%; ~ 2320 m, n = 13). The RT program (3x/week) consisted of six exercises, with three sets of six to 12 repetitions at ~ 70% of one repetition maximum (1RM) with the first session of each week used for analysis. 1RM in back squat and bench press was used to evaluate muscle strength before and after the program. External load was assessed by the volume load relative to body mass (RVL, kg·kg−1). Internal load was assessed by the ratings of perceived exertion (RPE) and heart rate (HR).ResultsSmaller relative improvements were found for the back squat in the N group (11.5 ± 8.8%) when compared to the NH group (22.2 ± 8.2%, P = 0.01) and the HH group (22 ± 8.1%, P = 0.02). All groups showed similar RVL, HR responses and RPE across the program (P˃0.05). However, reduced HR recovery values, calculated as the difference between the highest HR value (HRpeak) and the resting heart rate after a two min rest, were seen in the N and NH groups across the program (P<\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$<$$\\end{document} 0.05).ConclusionIt seems that 8 weeks of intermittent RT in hypoxic environments could maximize time-efficiency when aiming to improve strength levels in back squat without evoking higher levels of physiological stress. Performing RT at hypobaric hypoxia may improve the cardiorespiratory response, which in turn could speed recovery.

Prevalence and prognosis of hyperdynamic left ventricular systolic function in septic patients: a systematic review and meta-analysis

PurposeThe prevalence of hyperdynamic left ventricular (LV) systolic function in septic patients and its impact on mortality remain controversial. In this systematic review and meta-analysis, we investigated the prevalence and association of hyperdynamic LV systolic function with mortality in patients with sepsis.MethodsWe searched MEDLINE, Cochrane Central Register of Controlled Trials, and Embase. Primary outcomes were the prevalence of hyperdynamic LV systolic function in adult septic patients and the associated short-term mortality as compared to normal LV systolic function. Hyperdynamic LV systolic function was defined using LV ejection fraction (LVEF) of 70% as cutoff. Secondary outcomes were heart rate, LV end-diastolic diameter (LVEDD), and E/e’ ratio.ResultsFour studies were included, and the pooled prevalence of hyperdynamic LV systolic function was 18.2% ([95% confidence interval (CI) 12.5, 25.8]; I2 = 7.0%, P < 0.0001). Hyperdynamic LV systolic function was associated with higher mortality: odds ratio of 2.37 [95%CI 1.47, 3.80]; I2 = 79%, P < 0.01. No difference was found in E/e’ (P = 0.43) between normal and hyperdynamic LV systolic function, while higher values of heart rate (mean difference: 6.14 beats/min [95%CI 3.59, 8.69]; I2 = 51%, P < 0.0001) and LVEDD (mean difference: − 0.21 cm [95%CI − 0.33, − 0.09]; I2 = 73%, P < 0.001) were detected in patients with hyperdynamic LV systolic function.ConclusionThe prevalence of hyperdynamic LV systolic function is not negligible in septic patients. Such a finding is associated with significantly higher short-term mortality as compared to normal LV systolic function.

ПРОТЕКТИВНОЕ ВЛИЯНИЕ НООКЛЕРИНА И СЛАВИНОРМА НА КАРДИОРЕСПИРАТОРНЫЕ ФУНКЦИИ КРЫС ПРИ ОХЛАЖДЕНИИ В ВОДЕ

Effects of nooclerin (deanol aceglumate) and slavinorm (vascular polypeptide complex) on the breathing and heart rates were compared in Wistar rats in the course of progressive hypothermia. The animals were immersed in water at 9 ± 0.4 °С. The parameters under study were breathing rate (BR), heart rate (HR), rectal temperature (Тr), esophageal temperature (Tes), and arterial saturation (SpO2). In comparison to controls, at the beginning of hypothermia BR in experimental rats was high at lower Tr values. Nooclerin did not change the trend of HR curve dependence on Tr, whereas slavinorm shifted the trend toward high HR values; besides, it more than doubled life duration before the respiratory arrest. This occurred as a result of rats' transition in the state of cold-hypometabolism when the cardiac activity was maintained by slow breathing. The investigation showed that nooclerin and slavinorm are able to preserve the viability of organisms in hypothermic environment. Both drugs enhance and extend the stage of breathing activation at the beginning of cold immersion in the experimental rats in comparison to their controls. Injection of nooclerin and slavinorm mobilizes the defenses of organism and reduces the pathological effects of deep hypothermia.

Thermoregulatory responses and ingestive behavior of sheep subjected to water restriction and high- and low-energy diets in a semi-arid environment

The aim of the study was to evaluate the effect of water restriction and low- and high-energy diets on sheep's thermoregulatory responses and ingestive behavior. Forty sheep, non-castrated, with an average body weight of 18.85 kg (SD = 2.80 kg) and an average age of 5 months were assigned to a 2 × 2 factorial arrangement, comprising 2 diets (high- and low-energy) and 2 water offers (ad libitum and 50% water restriction), with 10 replicates. Thermoregulatory responses were evaluated in two periods (morning and afternoon). There was an interaction effect of Diet x Water supply x Periods on respiratory rate (P < 0.05). High-energy diets resulted in increased heart rate, idleness, dry matter feeding and rumination efficiency, and water intake. Low-energy diets increased feeding time, rumination time, the number of ruminal cuds, chews per day, total chewing time, neutral detergent fiber intake and rumination efficiency, number of ruminations per day, average duration of rumination, and defecation frequency. Water supply affected heart rate and idleness (P < 0.05). Sheep had higher values of heart rate and rectal and surface temperatures during the afternoon (P < 0.05). Water restriction combined with a low-energy diet and high environmental temperature leads to a reduction in the respiratory rate of Santa Inês crossbred sheep. Regardless of the dietary energy value, water restriction by 50% of the daily requirement of sheep reduces dry matter intake and increases idleness.

Heart Rate Monitoring, Blood Oxygen Levels and Location Determination for Covid 19 Patients Using Internet of Things Technology

The COVID-19 virus is very dangerous. In addition to attacking the lungs, this virus can also attack the heart directly. The relationship between heart health and COVID-19 occurs because blood vessel clots in COVID-19 patients increase the risk of blood vessel disorders and make the heart work harder. Therefore, researchers designed a heart rate monitoring device. This tool serves to maintain heart health and oxygen levels in the patient's blood and can also monitor people under COVID surveillance. The formulation of the problem from this research is how to design an IoT system to monitor COVID-19 patients through heart rate and location and how it performs. The purpose of this study is to analyze the performance of the device and design a tool to measure heart rate and blood oxygen levels through the IoT system and GPS location so that doctors can access heart rate data from any location. This research method uses a Gy-MAX30100 sensor, Wemos, and a GPS module. Of the 2 data samples that have been tested, the highest heart rate value is 78 bpm, the lowest is 76 bpm, and the highest oxygen level is 95 mmHg and the lowest is 93 mmHg. So in conclusion, this tool can make it easier for doctors to get important information about the condition of patients or people under observation that can be accessed by doctors anywhere and anytime via the internet.

Physiological and Energetic Demands During Still-Rings Routines of Elite Artistic Gymnasts.

The aim of the study was to analyze physiological and energetic demands of elite gymnasts during still-rings routines (SRRs). Eleven male gymnasts (mean [SD] 23.6 [3.9]y, 65.9 [5.6]kg, 171.1 [6.7]cm) performed a maximal graded exercise test and an individual SRR, during which respiratory gas and heart rate (HR) were measured using a mobile spiroergometer and a paired HR sensor. Metabolic energy and the energy contribution in terms of aerobic, anaerobic lactic, and anaerobic alactic were determined by oxygen uptake (VO2) during exercise, net lactate production, and the fast component of postexercise VO2 kinetics. Mean routine duration of the SRRs was 48.3 (4.5)seconds. VO2 and HR during SRRs were shown to be 86.9% (5.9%) and 91.0% (3.3%), respectively, of the maximal values measured during the graded exercise test. The anaerobic alactic, aerobic, and anaerobic lactic systems provided 50.9% (6.6%), 28.6% (4.8%), and 20.5% (5.2%), respectively, of the total energy required during SRRs. The energy contribution of the anaerobic lactic system correlated negatively with individual anaerobic threshold (r = -.715) and maximal VO2 (r = -.682). The anaerobic alactic system is the predominant energy source for ATP resynthesis during SRRs. The high relative VO2 and HR values reached during SRRs showthat these routines strongly stress the cardiovascular system.

MULTIPLE RENAL ARTERIES AS A RISK FACTOR FOR SEVERE HYPERTENSION IN YOUNG ADULTS?

Objective: The significance of multiple renal arteries (MRAs) in arterial hypertension (AH) is not fully understood. Lower perfusion pressure due to longer length and narrower caliber of MRAs could cause segmental hyperreninemia sufficient to result in renin-dependent systemic hypertension. Sympathetic renal nerve activity might be affected by hyperreninema as well. The aim of the study was to examine the characteristics of young adult hypertensives in relation to the existence of MRAs that were diagnosed during evaluation for secondary arterial hypertension. Design and method: 32 patients underwent routine evaluation for secondary hypertension and target organ damage. Patients were divided into two groups, one with MRAs and the other without MRAs. Data were presented as mean +standard deviation and compared by the Indipendent-Sample t-test. Results: The mean age was 38 years, and 13 patients were diagnosed with MRAs. There were more men in the MRAs group, otherwise, there were no significant differences in baseline characteristics between the groups (BMI, smoking, family history). None of them were diagnosed with secondary endocrine hypertension or renal artery stenosis. MRAs group showed significantly higher values of office SBP/DBP (p &lt; 0,012) and 24-hour SBP/DBP (p &lt; 0,001), and nonsignificantly higher values of heart rate. Although nonsignificant, direct renin concentrations were slightly higher in the MRAs group, while insulin levels were higher in the non-MRAs group. Dyslipidemia was diagnosed in most patients, without significant differences between groups. Electrocardiographic and echocardiographic changes suggesting hypertensive heart remodeling were found in 55% of patients in MRAs compared to 32% in non-MRAs, there were no significant differences in NTproBNP levels. A nonsignificant reduction in glomerular filtration rate was noticed in the MRAs group, while there were no significant differences in 24-hour albuminuria (p 0,308; p 0,614). Conclusions: The significance of MRAs in arterial hypertension is a matter of debate. In our study of young patients with arterial hypertension and MRAs, we observed features of more severe hypertension with already existing hypertensive target organ damages. Proper medical treatment with antihypertensive agents is crucial. Future studies will answer the question about interventional therapeutic procedures’ role in preventing cardiovascular complications.

Acute Responses in Blood Flow Restriction Low-intensity Aerobic Training: A Meta-analysis.

The purpose was to determine the effect low-intensity training with blood flow restriction (LI-BFR) versus high-intensity aerobic training (HIT) on acute physiological and perceptual responses. The Cumulative Index to Nursing and Allied Health Literature, National Library of Medicine, Scopus, SPORTDiscus and Web of Science databases and the reference list of eligible studies were consulted to identify randomized experimental studies, published until July 4, 2022, that analyzed physiological or perceptual responses between LI-BFR versus HIT in healthy young individuals. Mean difference (MD) and standardized mean difference (SMD) were used as effect estimates and random effects models were applied in all analyses. Twelve studies were included in this review. During exercise sessions, HIT promoted higher values of heart rate (MD=28.9 bpm; p<0.00001; I 2 =79%), oxygen consumption (SMD=4.01; p<0.00001; I 2 =83%), ventilation (MD=48.03 l/min; p=0.0001; I 2 =97%), effort (SMD=1.54; p=0.003; I 2 =90%) and blood lactate (MD=3.85 mmol/L; p=0.002; I 2 =97%). Perception of pain/discomfort was lower in HIT (SMD=-1.71; p=0.04; I 2 =77.5%). In conclusion, LI-BFR promotes less pronounced physiological responses than HIT but with greater perception of pain.

Comparison of General Anaesthesia and Epidural Anaesthesia in Lumbar Microdiscectomies- A Prospective Comparative Study

Introduction: Lumbar Microdiscectomy (LMD) is most commonly performed under General Anaesthesia (GA). Regional techniques are being used more widely now, with Epidural Anaesthesia (EA) being safer than Spinal Anaesthesia (SA). Regional anaesthetic methods are being used increasingly, with EA being less harmful than spinal with respect to cardiac and neurological complications. Aim: To compare the intraoperative and postoperative outcomes of GA and EA in single level lumbar microdiscectomies. Materials and Methods: This prospective comparative study was conducted at a single tertiary care centre between April 2014 to April 2018 and Study was conducted among 40 patients who were posted for single level lumbar microdiscectomies. The patients underwent surgery under group GA and group EA. Intraoperatively, parameters like Heart Rate (HR), Mean Arterial Pressure (MAP), Surgical Onset Time (SOT), Surgical Time (ST), Total Operating room Time (TOT) and postoperatively Visual Analog Scale (VAS) for pain, the Total Analgesic Dose (TAD) of fentanyl, Postoperative Nausea and Vomiting (PONV) and the level of satisfaction with regard to pain relief (4-point Likert scale) for the first 24 hours were compared. The data were analysed using Statistical Package for Social Sciences (SPSS) version 18 software. Mean, percentage, student’s t-test, χ2 test, Mann-whitney test and appropriate statistical tests were used. Results: A total of 40 patients were enrolled in the present study with rather similar demographic characteristics in both groups. The SOT was significantly more in the EA group (24.30±2.958 min) when compared to the GA group (14.05±2.259) minutes. However, the ST and TOT did not show much of a difference. Intraoperatively, group GA showed significantly high HR and MAP values when compared to group EA (p&lt;0.001). Postoperatively, VAS for pain and the TAD of fentanyl were found to be significantly lesser in the EA group, when compared to GA group. The incidence of Postoperative Nausea and Vomiting (PONV) was less in EA group. The level of satisfaction with regard to pain relief at the end of first 24 hours was more among patients in EA group. Conclusion: The present study concludes that, EA may be used as an alternative to GA in single level lumbar microdiscectomies.

Evaluation of the relationship between monocyte to HDL ratio with STEMI, STEMI severity, thrombosis, and early repolarization

Introduction Due to the relationship between high maximum heart rate (MHR) values ​​and the severity of coronary atherosclerosis and cardiac events, as well as standard features and clinical outcomes of early repolarization significant and myocardial infarction with ST-segment elevation, this study investigated the relationship between monocyte to HDL ratio and STEMI, STEMI severity, Thrombosis, and early repolarization were performed. Method This cross-sectional prospective observational study was performed on STEMI patients referred to Imam Khomeini Hospital in Ahvaz in 1399. In this study, STEMI patients and individuals with referred early repolarization patterns are evaluated during the first 12 hours after the onset of pain and used for statistical analysis of SPSS software version 22. Results: In this study, 36 patients have studied with a mean age of 61.6±14.4; 23 patients were male, and the rest were female. The ratio of monocytes to HDL in STEMI patients varied based on the age and sex of the patients. The mean MHR in STEMI patients based on PCI need was 16.4±2.9 in patients in need and 20.5±2.1 in patients who were candidates for CABG. The ratio of monocytes to HDL in STEMI patients varied based on the occurrence and severity of thrombosis.

Electrocardiographic findings in pregnant women in Angola.

BackgroundStudies on the electrocardiogram findings in African pregnant women are limited. There is no information available in the literature on the electrocardiographic parameters of pregnant Angolan women.ObjectivesThe aim of this study was to describe electrocardiographic findings in women with normal pregnancies in Bengo Province, Angola.MethodsThis is a community‐based study with a cross‐sectional design conducted between September 2013 and March 2014 in Bengo. The study involved 114 black pregnant women, compared with a paired control group comprising of 120 black non‐pregnant women, aged 15 to 42 years. A 12‐lead electrocardiogram and a rhythm strip were recorded for all participants.ResultsIn this study, the mean age was 26.2 ± 7.3 years. Comparing pregnant women vs. non‐pregnant, we found the following mean values: Heart rate (83 bpm vs. 74 bpm, p < .001), PR interval (146 ms vs. 151 ms, p = .034), QT interval (360 ms vs. 378 ms, p < .001), QTIc Fridericia (398 ms vs. 403, p = .017), QTIc Framingham (399 ms vs. 404 ms, p = .013) and T‐wave axis (340 vs. 410, p = .001).The main electrocardiographic changes found were: Sinus tachycardia (4.4% vs. 2.5%), T‐wave inversion (14.9% vs. 1.7%), Minor ST segment depression (4.5% vs. 0%) and left ventricular hypertrophy (11.4% vs. 11.7%, p = .726).ConclusionsPregnant Angolan women compared with controls, had several significantly higher values for heart rate, and significantly lower values of systolic blood pressure and diastolic blood pressure, PR interval, QT interval, QTc interval by Fridericia and Framingham and T‐wave axis. Sinus tachycardia, T‐wave inversion, and left ventricular hypertrophy, were the main electrocardiographic changes found.

High-Intensity Interval Exercise Performance in Judo Athletes: Physiological, Perceptual, and Pacing Responses.

This study aimed to verify the behavior of physiological, perceptual, and performance responses during a high-intensity exercise in judo athletes and to identify if this protocol is able to discriminate athletes from different levels (national vs. state). Forty-five male judo athletes participated and were divided into two groups: state (age 24.2 ± 3.7years) and national (22.1 ± 3.3years). Judo athletes performed a judo-specific protocol contained high-intensity intermittent exercise consisted of 12 sets of 20s in all-out intensity. During the protocol, the repetitions and heart rate were assessed over the sets, and at the end of the protocol, the rate of perceived exertion was measured. The results showed that the national group presented higher repetitions (29 ± 4 repetitions) during the high-intensity intermittent exercise compared with state (22 ± 2 repetitions). However, the national group showed a progressive decrease of repetitions up to the middle of the protocol, which coincided with higher values of heart rate compared with state (first and second sets). There was a decrease of repetitions from the first set (p < .001) and similar values of heart rate from the third set in the state. In conclusion, the performance (in repetitions) during the high-intensity intermittent exercise was able to discriminate athletes from different competitive levels. National athletes presented better performance, but worse pacing strategy compared with state.

Physical Fitness Differences, Amenable to Hypoxia-Driven and Sarcopenia Pathophysiology, between Sleep Apnea and COVID-19.

Handgrip strength is an indirect indicator of physical fitness that is used in medical rehabilitation for its potential prognostic value. An increasing number of studies indicate that COVID-19 survivors experience impaired physical fitness for months following hospitalization. The aim of our study was to assess physical fitness indicator differences with another prevalent and hypoxia-driven disease, Obstructive Sleep Apnea Syndrome (OSAS). Our findings showed differences between post-COVID-19 and OSAS groups in cardiovascular responses, with post-COVID-19 patients exhibiting higher values for heart rate and in mean arterial blood pressure. Oxygen saturation (SpO2) was lower in post-COVID-19 patients during a six-minute walking test (6MWT), whereas the ΔSpO2 (the difference between the baseline to end of the 6MWT) was higher compared to OSAS patients. In patients of both groups, statistically significant correlations were detected between handgrip strength and distance during the 6MWT, anthropometric characteristics, and body composition parameters. In our study, COVID-19 survivors demonstrated a long-term reduction in muscle strength compared to OSAS patients. Lower handgrip strength has been independently associated with a prior COVID-19 hospitalization. The differences in muscle strength and oxygenation could be attributed to the abrupt onset of the disorder, which does not allow compensatory mechanisms to act effectively. Targeted rehabilitation focusing on such residual impairments may thus be indispensable within the setting of post-COVID-19 syndrome.

Влияние цикла контрастных температур на организм мужчин трудоспособного возраста с разным типом вегетативной регуляции

The aim of this paper was to study changes in the haemodynamic and psychophysiological parameters of working age men as a result of repeated exposure to contrasting temperatures, depending on the type of autonomic regulation. Materials and methods. The research involved 14 men (aged 34.77 ± 5.66 years; office workers) divided into two groups according to Kérdö index: those with the sympathetic (n = 8) and parasympathetic (n = 6) types of self-regulation. Cold conditioning followed a certain plan of exposure to contrasting temperatures. The haemodynamic and psychophysiological parameters as well as adaptive potential were assessed 20 minutes before and 20 minutes after the exposure (alternating temperature cycles). We examined the following parameters: heart rate, systolic and diastolic blood pressure, pulse and mean arterial pressure, stroke volume, cardiac output, vascular resistance, and adaptive potential according to Baevsky. Integral psychophysiological parameters were determined using the Lüscher express method. Results. Subjects with predominance of sympathetic regulation both before and after the exposure to contrasting temperatures had higher values of heart rate and cardiac output and lower vascular resistance than the parasympathicotonic group. Individuals with predominance of parasympathetic regulation showed decreased cardiac output and a significant increase in vascular resistance after the exposure compared with the initial data. We found statistically significant differences in the integral parameters “heteronomy/autonomy” and “balance of personal traits” between the groups under study before the conditioning procedures. The research indicates that repeated exposure to contrasting temperatures not only affects the haemodynamic parameters, but also changes the psychophysiological parameters, motivated behaviour in particular. For citation: Fisher T.A., Kolyvanova S.S. Effect of Repeated Exposure to Contrasting Temperatures on the Body of Working Age Men with Different Types of Autonomic Regulation. Journal of Medical and Biological Research, 2021, vol. 9, no. 4, pp. 394–404. DOI: 10.37482/2687-1491-Z077

Assessment of Selected Baseline and Post-PCI Electrocardiographic Parameters as Predictors of Left Ventricular Systolic Dysfunction after a First ST-Segment Elevation Myocardial Infarction.

Objective: To assess the performance of ten electrocardiographic (ECG) parameters regarding the prediction of left ventricular systolic dysfunction (LVSD) after a first ST-segment-elevation myocardial infarction (STEMI). Methods: We analyzed 249 patients (74.7% males) treated with primary percutaneous coronary intervention (PCI) included into a single-center cohort study. We sought associations between baseline and post-PCI ECG parameters and the presence of LVSD (defined as left ventricular ejection fraction [LVEF] ≤ 40% on echocardiography) 6 months after STEMI. Results: Patients presenting with LVSD (n = 52) had significantly higher values of heart rate, number of leads with ST-segment elevation and pathological Q-waves, as well as total and maximal ST-segment elevation at baseline and directly after PCI compared with patients without LVSD. They also showed a significantly higher prevalence of anterior STEMI and considerably wider QRS complex after PCI, while QRS duration measurement at baseline showed no significant difference. Additionally, patients presenting with LVSD after 6 months showed markedly more severe ischemia on admission, as assessed with the Sclarovsky-Birnbaum ischemia score, smaller reciprocal ST-segment depression at baseline and less profound ST-segment resolution post PCI. In multivariate regression analysis adjusted for demographic, clinical, biochemical and angiographic variables, anterior location of STEMI (OR 17.78; 95% CI 6.45–48.96; p < 0.001), post-PCI QRS duration (OR 1.56; 95% CI 1.22–2.00; p < 0.001) expressed per increments of 10 ms and impaired post-PCI flow in the infarct-related artery (IRA; TIMI 3 vs. <3; OR 0.14; 95% CI 0.04–0.46; p = 0.001) were identified as independent predictors of LVSD (Nagelkerke’s pseudo R2 for the logistic regression model = 0.462). Similarly, in multiple regression analysis, anterior location of STEMI, wider post-PCI QRS, higher baseline number of pathological Q-waves and a higher baseline Sclarovsky-Birnbaum ischemia score, together with impaired post-PCI flow in the IRA, higher values of body mass index and glucose concentration on admission were independently associated with lower values of LVEF at 6 months (corrected R2 = 0.448; p < 0.00001). Conclusions: According to our study, baseline and post-PCI ECG parameters are of modest value for the prediction of LVSD occurrence 6 months after a first STEMI.

HYPERTENSIVE URGENCY, EMERGENCY AND KIDNEY FUNCTION

Objective: The aim of this study was to determine risk factors for hypertensive crisis development just as an impact of the kidney function on it. Design and method: From January to October 2019, 237 patients (109 males, 128 females) with hypertensive crisis were analyzed at the Emergency department in Clinical Hospital Merkur, Zagreb. We defined the hypertensive crisis as a rapid increase in blood pressure above 180/120mmHg (SBP range 182–260mmHg). Hypertensive crises were divided into two subgroups due to the evidence of end-organ damage. Elementary lab results and pulse wave velocity were checked in all patients. Results: Hypertensive urgency was found in 184 patients (77.64%), emergency in 53 (22.36%). Comparison of these two subgroups showed that patients with an emergency were significantly older (70.51 vs. 64.44 years, p &lt; 0.01), had significantly elevated serum glucose levels (10.04 vs. 6.94mmol/L, p &lt; 0.0001), decreased glomerular filtration rate (CKD-EPI formula 75.96 vs. 59.15 mL/min/1.73m2, p &lt; 0.0001) and high heart rate (mean 96.32 vs. 77.17bpm, p &lt; 0.0001) which showed as the most significant risk factor. Body mass index didn’t show any relevance in the hypertensive crisis development (31.26 vs. 30.58 kg/m2, p = 0.18). Hypertensive emergency incidence increased with a decline in kidney function. Such events developed in 16.94% patients with CKD stage 1, 14.42% in stage 2, 34.61% in stage 3a, 50.00% in stage 3b, 60.00% in stage 4 and 50.00% in stage 5. Within main groups, patients were divided into two groups whether they used antihypertensive medication. A group of 53 patients was without medication (22.36%) of which 13 met criteria for a hypertensive emergency. Pulse wave velocity was much higher in patients with CKD-EPI &lt; 45 ml/min/1.73m2 (13.01 vs. 10.74m/s, p = 0.01). Even though female patients were significantly older (69.02 vs. 62.02years, p &lt; 0.0001), no other differences between genders were found. Conclusions: Age, elevated plasma glucose and a decline in glomerular filtration rate combined with high heart rate values, but gender and body mass index independently are the main factors which are linked to the development of hypertensive emergency.

Peripheral Modulators of the Central Fatigue Development and Their Relationship with Athletic Performance in Jumper Horses.

Simple SummaryPhysical exercise induces various stress responses leading to a disturbance of homeostasis and a number of regulatory systems are called upon to return the body to a new level of equilibrium. The aim of this study was to evaluate the peripheral modulators of serotoninergic function and neurohumoral factors’ changes in athletic horses during an official jumping competition, and to evaluate their relationship with the physical performance of competing horses. The findings obtained in the current survey showed that jumping exercise influenced the levels of tryptophan, leucine, valine, non-esterified fatty acids (NEFAs), dopamine, and prolactin and that these changes are related to the physical performance of competing horses. These findings suggest that the serotoninergic system may be involved in fatigue during jumping exercise.The current study aimed to investigate whether peripheral modulators of serotoninergic function and neurohumoral factors’ changes in athletic horses during an official jumping competition, and to evaluate their relationship with the physical performance of competing horses. From 7 Italian Saddle mares (6–9 years; mean body weight 440 ± 15 kg), performing the same standardized warm-up and jumping course during an official class, heart rate (HR) was monitored throughout the competition. Rectal temperature (RT) measurement, blood lactate and glucose concentration, serum tryptophan, leucine, valine, the tryptophan/branched-chain amino-acids ratio (Try/BCAAs), dopamine, prolactin, and non-esterified fatty acids (NEFAs) were assessed before the exercise event (T0), at the end of the competition stage (5 min ± 10 s following the cessation of the exercise, TPOST5), and 30 min after the end of competition (TPOST30). Highest HR values were recorded during the course and at the outbound (p < 0.0001); blood lactate concentration and RT increased after exercise with respect to the rest condition (p < 0.0001). Lower leucine and valine levels (p < 0.01), and higher tryptophan, Try/BCAAs ratio, and NEFAs values were found at TPOST5 and TPOST30 with respect to T0 (p < 0.0001). A higher prolactin concentration was found at TPOST5 and TPOST30 compared to T0 (p < 0.0001), whereas dopamine showed decreased values after exercise compared to rest (p < 0.0001). Statistically significant correlations among the peripheral indices of serotoninergic function, neurohumoral factors, and athletic performance parameters were found throughout the monitoring period. The findings provide indirect evidence that the serotoninergic system may be involved in fatigue during jumper exercise under a stressful situation, such as competition, in which, in addition to physical effort, athletic horses exhibit more passive behavior.

Secondary risk factors of sudden cardiac death and genes of arterial hypertension

Purpose. To study the influence of polymorphisms of arterial hypertension genes and their various combinations on individual risk factors of sudden cardiac death.&#x0D; Materials and methods. 319 young people from 18 to 24 years of age who are entering military service by conscription were examined. The survey identified 69 individuals with signs of increased risk of sudden cardiac death after being examined for secondary risk factors of sudden cardiac death and taken a blood test to determine the polymorphisms of the genes AGT 521 CT, GNB3 825 CT, CYP11B2 344 CT, NOS3 786 TC.&#x0D; Results. The greatest influence on the severity of secondary risk factors was exerted by the following variants of a combination of gene polymorphisms: AGT 521 CT and NOS3 786 TC in the individuals with a heterozygous risk variant, both genes showed a significant increase in the duration of the corrected QT interval, heart rate, and a decrease in heart rate variability. AGT 521 CT and CYP11B2 344 CT homozygous risk variant of the CYP11B2 344 CT and the heterozygous risk variant AGT 521 CT is associated with a longer duration of the corrected QT interval, and the heterozygous risk variant for both genes is associated with higher heart rate values. AGT 521 CT and GNB3 825 CT combination of a homozygous risk variant of the gene GNB3 825 CT and the heterozygous variant of the gene AGT 521 CT is associated with the greatest effect on a heart rate.&#x0D; Conclusions. The presence of a homozygous risk variant of the gene NOS3 786 TC, a heterozygous risk variant of the gene GNB3 825 CT is prognostically unfavorable for its effect on the severity of secondary risk factors for sudden cardiac death. The combination of the heterozygous variant AGT 521 CT with a heterozygous variant of NOS3 786 TC and a homozygous risk variant by the gene CYP11B2 344 CT and the heterozygous risk variant AGT 521 CT are also the most unfavorable in terms of its effect on secondary risk factors for sudden cardiac death. Secondary risk factors of sudden cardiac death are influenced by both individual polymorphisms of genes of arterial hypertension, and their various combinations.

Abstract 17174: Revisiting the QT Correction Formulas: A Generalized Additive Models for Location, Scale, and Shape Approach

Introduction: Various mathematical equations have been proposed to correct QT interval for heart rate (QTc). However, with most formulas, QTc remains dependent on heart rate (HR) especially at low and high HR values. Hypothesis: A spline correction function would perform better than standard mathematical formulas by allowing the data to determine the form of the relationship. Methods: A series of regression models using the generalized additive models for location, scale, and shape framework was applied to 10,000 completely normal electrocardiogram data from the National Health and Nutrition Examination Surveys II and III. Evaluation of the model’s performance was performed using the R 2 coefficient of determination and the root mean squared of the errors between the predicted and observed QTc. The new regression models were compared to the Bazett’s and Fredericia’s formulas, which are the 2 most widely used formulas in clinical practice. Results: When boxplots of the QTc for each formula are plotted, grouped by HR in intervals of 5 beats/minute, QTc determined by the penalized spline regression was almost heart rate independent for both male and female as the slope of the regression line was almost zero (-0.003 for female and -0.001 for male) (Figure 1 A—B). By contrast, QTc by Bazett had a positive correlation (regression slope of 0.86 for female and 0.89 for male) while Fredericia’s had a negative correlation (regression slope of -0.14 for female and -0.13 for male) with HR (Figure 1C—F). In all 3 formulas, there was no significant difference between male and female. Conclusions: A new QTc formula was developed, which is almost independent of HR thereby providing a more accurate estimate of QTc for clinical management. Automatic QTc calculation and percentiles estimation could easily be incorporated in an online calculator or app for easy integration in everyday clinical practice.