Influence Of Autonomic Nervous System Research Articles

Influence of autonomic nervous system tone on the content of unsaturated fatty acids in blood lipids in goats

The relevance of this study lies in the need to determine the role of the autonomic nervous system in the metabolism of unsaturated fatty acids, especially essential ones, in the body of goats, which will improve the understanding of individual metabolic characteristics in these animals. The use of established blood markers will make it possible to analyse the state of lipid metabolism in the body of goats and ensure an increase in the effectiveness of methods of its correction. The purpose of this study was to determine the specific features of the autonomic nervous system influence on the relative content of unsaturated fatty acids in goat plasma lipids. The experiment involved goats of the Zaanenska breed, of which, using electrocardiographic analysis according to the Baevsky method and depending on the tone of the autonomic nervous system, three experimental groups were formed: normotonics, sympathotonics, and vagotonics. The method of gas-liquid chromatography was used to determine the percentage of unsaturated fatty acids in goat plasma lipids. Thus, in goats with sympathotonics, which have a predominance of sympathetic nervous system activity, a high percentage of the following lipids in blood plasma was noted: linolenic (P < 0.01), cis-4, 7, 10, 13, 16, 19-docosahexaenoic (P < 0.05), docosahexapentaenoic (P < 0.001), and arachidonic acids (P < 0.001) compared to normotonics. These animals also had a lower content of palmitoleic (P < 0.05) and oleic acids (P < 0.01) in plasma lipids against the background of normotonics. In vagotonic goats, in which the influence of the parasympathetic nervous system predominates, the relative content of cis-4, 7, 10, 13, 16, 19-docosahexaenoic (P < 0.05), linoleic (P < 0.001) and arachidonic acids (P < 0.001) and high cis11-eicosenoic acid (P < 0.01) in blood plasma lipids was found to be low compared to normotonic goats. The established features suggest a substantial influence of the tone of the autonomic nervous system on the quantitative redistribution of unsaturated fatty acids in the composition of goat blood plasma lipids and the need to consider them when analysing the state of the corresponding metabolism in the body, which will substantially improve not only the effectiveness of scientific research, but also its reliability

The Influence of Autonomic Nervous System during Resting State on the Peripheral Pulse Wave Velocity in Young Adult Males

Abstract Background: The association between the activity of autonomic nervous systems (ANS) and pulse wave velocity (PWV) was commonly deduced after adjusting for confounding factors. The relationship between the ANS and PWV was either maintained, but attenuated, or no longer statistically connected after controlling for confounding variables. Research in young healthy individuals showed that the ANS does not control aortic stiffness (indexed by PWV) in a pressure-independent manner. Therefore, the role of the ANS in controlling PWV is debatable. Objectives: The objective of this study was to examine the possibility that ANS directly affects PWV independent of blood pressure (BP) and heart rate (HR). Subjects and Methods: Thirty-four healthy male volunteers (19 years old) were recruited. Stable brachial systolic BP (SBP)/diastolic BP (DBP) and HR were measured in semi-supine position after a 15-min rest. During the last 5 min, fingertip digital pulse wave (DPW) and lead II electrocardiogram (ECG) signals were recorded. The pulse transit time, and consequently PWV, was calculated by measuring the duration between the ECG R wave climax and a reference point on the DPW in the same cardiac cycle. The ANS activity was assessed by calculating the HR variability (HRV) indices obtained from the ECG record of 5-min R-R intervals (RRIs). Results: HRV indices low-frequency (LF)/high-frequency (HF) (LF band power measured in the 0.04–0.15 Hz)/the HF band power measured in the 0.15–0.4 Hz band) and SD2/SD1 ratios (SD1 and SD2 represent the dispersion along the minor and major axis of the fitted ellipse of the Poincaré plot) (sympathovagal balance) were significantly and positively correlated with PWV. In addition, the standard deviation of RRI, or normal-to-normal “NN” (SDNN) interval, after excluding ectopic beats, the square root of the mean squared differences of successive NN intervals (RMSSD) were significantly and negatively correlated with the PWV. No correlation was obtained between PWV and HR, SBP, or DBP. Conclusion: Peripheral PWV during rest or inactivity is affected directly by the sympathovagal balance independent of BP.

ECG Multi-Emotion Recognition Based on Heart Rate Variability Signal Features Mining.

Heart rate variability (HRV) serves as a significant physiological measure that mirrors the regulatory capacity of the cardiac autonomic nervous system. It not only indicates the extent of the autonomic nervous system's influence on heart function but also unveils the connection between emotions and psychological disorders. Currently, in the field of emotion recognition using HRV, most methods focus on feature extraction through the comprehensive analysis of signal characteristics; however, these methods lack in-depth analysis of the local features in the HRV signal and cannot fully utilize the information of the HRV signal. Therefore, we propose the HRV Emotion Recognition (HER) method, utilizing the amplitude level quantization (ALQ) technique for feature extraction. First, we employ the emotion quantification analysis (EQA) technique to impartially assess the semantic resemblance of emotions within the domain of emotional arousal. Then, we use the ALQ method to extract rich local information features by analyzing the local information in each frequency range of the HRV signal. Finally, the extracted features are classified using a logistic regression (LR) classification algorithm, which can achieve efficient and accurate emotion recognition. According to the experiment findings, the approach surpasses existing techniques in emotion recognition accuracy, achieving an average accuracy rate of 84.3%. Therefore, the HER method proposed in this paper can effectively utilize the local features in HRV signals to achieve efficient and accurate emotion recognition. This will provide strong support for emotion research in psychology, medicine, and other fields.

Continuous heart rate variability monitoring of freely moving chicken through a wearable electrocardiography recording system

Identification and quantification of stress and stress inducing factors are important components of animal welfare assessment and essential parts of poultry management. Measurement of the autonomic nervous system's influence on cardiac function using heart rate and heart rate variability (HR/HRV) indices can provide a non-invasive assessment of the welfare status of an animal. This paper presents a preliminary study showing the feasibility of continuous long-term measurement of HR/HRV indices in freely moving chicken. We developed and evaluated an electrocardiography (ECG) based HR/HRV recording system that can be used as a poultry wearable backpack for research studies. The backpack system was first validated against a commercial ECG amplifier, and the corresponding estimations of HR values matched well with each other. Then, an in vivo proof-of-concept experiment was conducted on floor-reared chickens to collect ECG data for 2 weeks. The extracted HR/HRV values show strong alignment with circadian patterns and well-defined sleep cycles. Wearable devices, like the backpack ECG system used in this study, may be best suited for application in freely moving poultry to get an insight into circadian abnormalities and sleep quality for stress and welfare management.

A direct effect of the autonomic nervous system on somatic stem cell proliferation?

Regulation of somatic stem cell proliferation is critical for the maintenance of tissue and organ function throughout the body. Modulators of this process include nutrients and peptides, but the role of an autonomic neural influence on stem cell proliferation has been neglected. This article describes the literature in support of autonomic nervous system (ANS) influence on somatic stem cells, with emphasis on intestinal epithelial stem cells (IESCs) as a representative somatic stem cell. Based on the current available data, models for the direct influence of both branches of the ANS (the sympathetic and parasympathetic nervous systems) on IESCs are outlined. Finally, the prospect of treatments derived from ANS influence on somatic stem cells is explored.

Evidence for a direct effect of the autonomic nervous system on intestinal epithelial stem cell proliferation.

The sympathetic (SNS) and parasympathetic (PNS) branches of the autonomic nervous system have been implicated in the modulation of the renewal of many tissues, including the intestinal epithelium. However, it is not known whether these mechanisms are direct, requiring an interaction between autonomic neurotransmitters and receptors on proliferating epithelial cells. To evaluate the existence of a molecular framework for a direct effect of the SNS or PNS on intestinal epithelial renewal, we measured gene expression for the main autonomic neurotransmitter receptors in this tissue. We separately evaluated intestinal epithelial regions comprised of the stem, progenitor, and mature cells, which allowed us to investigate the distinct contributions of each cell population to this proposed autonomic effect. Notably, we found that the stem cells expressed the receptors for the SNS‐associated alpha2A adrenoreceptor and the PNS‐associated muscarinic acetylcholine receptors (M1 and M3). In a separate experiment, we found that the application of norepinephrine or acetylcholine decreases the expression of cyclin D1, a gene necessary for cell cycle progression, in intestinal epithelial organoids compared with controls (P < 0.05). Together, these results provide evidence of a direct mechanism for the autonomic nervous system influence on intestinal epithelial stem cell proliferation.

Oscillatory behavior of P wave duration and PR interval in experimental congestive heart failure: a preliminary study

Objective: The relationship between the autonomic nervous system (ANS) modulation of the sinus node and heart rate variability has been extensively investigated. The current study sought to evaluate, in an animal experimental model of pacing-induced tachycardia congestive heart failure (CHF), a possible ANS influence on the P wave duration and PR interval oscillations. Approach: Short-term (5 min) time and frequency domain analysis has been obtained in six dogs for the following electrocardiographic intervals: P wave duration (P), from the onset to peak of P wave (Pp), from the onset of P wave to the q onset (PR) and from the end of P wave to the onset of q wave (PeR). Direct vagal nerve activity (VNA), stellate ganglion nerve activity (SGNA) and electrocardiogram (ECG) intervals have been evaluated contextually by implantation of three bipolar recording leads. Main results: At the baseline, multiple regression analysis pointed out that VNA was strongly positively associated with the standard deviation of PP and PeR intervals (r2:0.997, p < 0.05). The same variable was also positively associated with high-frequency (HF) of P expressed in normalized units, of Pp, and of PeR (b: 0.001) (r2: 0.993; p < 0.05). During CHF, most of the time and frequency domain variability significantly decreased from 20% to 50% in comparison to the baseline values (p < 0.05) and SGNA correlated inversely with the low frequency (LF) obtained from PeR (p < 0.05) and PR (p < 0.05) (r2:0.899, p < 0.05). LF components, expressed in absolute and normalized power, obtained from all studied intervals, were reduced significantly during CHF. Any difference between the RR and PP spectral components was observed. Significance: The data showed a significant relationship between ANS and atrial ECG variables, independent of the cycle duration. In particular, the oscillations were vagal mediated at the baseline, while sympathetic mediated during CHF. Whereas P wave variability might have a clinical utility in CHF management, it needs to be addressed in specific studies.

The influence of autonomic nervous system and elastic properties of the aortic wall on arterial hypertension progression in patients after surgical correction of coarctation of the aorta

&lt;p&gt;&lt;strong&gt;Aim:&lt;/strong&gt; To assess sensitivity of the baroreceptors and elastic properties of the aortic wall in patients who underwent surgical correction of coarctation of the aorta.&lt;br /&gt;&lt;strong&gt;Methods:&lt;/strong&gt; In this prospective cohort study focus was placed on the evaluation of baroreceptors function and elastic properties of the aorta in 26 young patients who underwent surgical repair of coarctation of the aorta by using end-to-end extended anastomosis (Group I). The evaluation data obtained was then compared with that of the control group consisting of 26 healthy children without any congenital heart defects (Group II).&lt;br /&gt;&lt;strong&gt;Results:&lt;/strong&gt; Follow-up period was 25 (21;30) months. The spontaneous sensitivity of baroreceptors varied between the groups and was significantly higher in Group I 11.6 (10.5;12.6) versus 8.8 (8.1;9.9) in Group II, p=0.01. The velocity of pulsatile blood flow was higher in Group I 7.7 (5.8;9) (m/s) -1 versus 5.9 (4.8;7.1) (m/s) -1 in Group II, with a statistically significant difference between them (p = 0.003). The elastic properties of the aortic wall in Group I also considerably differed from those in the control group.&lt;br /&gt;&lt;strong&gt;Conclusion:&lt;/strong&gt; A high baroreceptors sensitivity and aortic wall stiffness in patients after surgical repair of coarctation of the aorta are direct predictors of arterial hypertension progression. However, it is important to assess the influence of the stroke volume on the rate of arterial hypertension incidence in patients who underwent surgical repair of coarctation of the aorta.&lt;/p&gt;

Authors' reply to “The influence of autonomic nervous system on the conduction system and heart muscle. Do different inhaled bronchodilators cause different tachyarrhythmias?”

Authors' reply to “The influence of autonomic nervous system on the conduction system and heart muscle. Do different inhaled bronchodilators cause different tachyarrhythmias?”

The influence of autonomic nervous system on the conduction system and heart muscle. Do different inhaled bronchodilators cause different tachyarrhythmias?

The influence of autonomic nervous system on the conduction system and heart muscle. Do different inhaled bronchodilators cause different tachyarrhythmias?

Isolated heart models: cardiovascular system studies and technological advances.

Isolated heart model is a relevant tool for cardiovascular system studies. It represents a highly reproducible model for studying broad spectrum of biochemical, physiological, morphological, and pharmaceutical parameters, including analysis of intrinsic heart mechanics, metabolism, and coronary vascular response. Results obtained in this model are under no influence of other organ systems, plasma concentration of hormones or ions and influence of autonomic nervous system. The review describes various isolated heart models, the modes of heart perfusion, and advantages and limitations of various experimental setups. It reports the improvements of perfusion setup according to Langendorff introduced by the authors.

Influence of autonomic nervous system in muscle activity of individual with sequelae af ter stroke.

Introduction: The stroke is a lesion of the Central Nervous System inducing spasticity, caused by a lesion of the upper motor neuron. The presence of spasticity limits the patient in achieving the necessary adjustments for the execution of required functional movements, causing limitations in daily life activities, interfering in our quality of life. Objective: To analyze the influence of the Autonomic Nervous System (ANS) in spastic patient consequential of stroke and decrease spasticity resulting of stimulus in the ANS. Method: It is a case study, where the spasticity was analyzed by means of Electromyography record (RMS), Ashowrth Scale modified and goniometry. The intervention consisted in 10 visits by performing Parasympathetic Laringe-Faringe Maneuvers, Plantar Arch and inhibition of Gastrocnemius. Results: The ANS has influence on the muscular activity, seen that there was a reduction of spasticity with decrease of the RMS values, increase in the amplitude of movement quantified by degrees and by means of the Modified Ashworth Scale. Conclusion: However, the mobilization of the autonomic nervous system through parasympathetic maneuvers are effective in decreasing spasticity due to stroke.

Hypertension and Autonomic Control

Arterial hypertension is considered one of the most important public health problems and had their development, progression and complications associated with the autonomic nervous system (ANS). In this context, the present systematic review aim at gathering recent studies (2003-2013) that addressed the relation between ANS and hypertension, in order to update the knowledge in the last 10 years. Searches were made onMedLine / PubMed, PEDro, SciELO, IBECS, COCHRAINE and LILACS databases using the intersection between the keywords hypertension, autonomic nervous system, sympathetic nervous system , parasympathetic nervous system and heart rate variability”. A total of 17 articles were included and main findings of this review indicating the acute influence of the ANS in different types of hypertension characterized by a reduction of the overall heart rate variability (HRV) and a reduction in the parasympathetic component of ANS evaluated by linear indexes. In addition, the behavior of the sympathetic component could present an increase or a reduction according to the study design. Thus further studies to assess the influence of chronic influence of ANS on hypertension as well as investigations by nonlinear HRV indexes are needed.

CLASSICAL CARDIOVASCULAR AUTONOMIC FUNCTION TESTS IN SCHOOL CHILDREN OF URBAN POPULATION: A NORMATIVE STUDY

Almost all organs systems in the body are under the influence of autonomic nervous system (ANS) for maintaining homeostatic regulatory functions. Many of the present lifestyle related disorders like hypertension and obesity have their primary pathology in the homeostatic derangements. Childhood overweight and high blood pressure increase the risk of subsequent obesity and hypertension in adulthood. To the best of our knowledge there is no sufficient qualitative and quantitative data in childhood which restricts the use of this tool in scientific medical practice and in understanding the occurrence of these systemic diseases in near future. The plan of our study is to assess the classical cardiovascular autonomic functions tests in school children and to generate normative data to validate the subtle variations present in childhood for an earlier intervention.

Differential effects of selective versus nonselective alpha adrenergic receptor blockade on cardiovascular (CV) parameters and heart rate variability (HRV) in rats

HRV analysis is an important noninvasive tool for investigating autonomic nervous system influence on the heart. The objective of the study was to compare CV profiles of doxazosin (selective á1 blocker) at 10 mg/kg, p.o. and phentolamine (non selective á blocker) at 20 and 100 mg/kg. p.o. in conscious rats using telemetry and subsequent HRV analysis, in addition plasma norepinephrine (NE) was also measured. Doxazosin caused a sustained decrease in blood pressure (BP): maximum change −12 mmHg occurred at 8–16 hours post dose (hpd), induced reflex tachycardia (65 bpm) and increased plasma NE levels by 3 fold. HRV analysis revealed no change in high (HF) and low (LF) frequency power compared to vehicle. Phentolamine decreased BP: maximum changes of −9.2 mmHg (20 mg/kg) and −29.1 mmHg (100 mg/kg) occurred at 0–2 hpd with reflex tachycardia (71 and 111 bpm respectively), reduced body temperature and increased NE 10 fold compared to vehicle. HRV analysis revealed a significantly reduced LF/HF ratio with a significant increase in HF but no change in LF at 0–2 hpd. 22 hpd there were no changes in any parameters measured, suggesting the changes observed were treatment‐mediated. It is hypothesized that the increased parasympathetic tone (HF) with phentolamine could be compensatory in response to reflex tachycardia and immediate NE release. In conclusion, doxazosin and phentolamine show differential effects on HRV and CV parameters

Adaptive neuro fuzzy selection of heart rate variability parameters affected by autonomic nervous system

Heart rate variability (HRV) parameters can be used as specific indicator of autonomic nervous system (ANS) behavior. ANS, with its main two branches, sympathetic and parasympathetic, may be considered as a coordinated neuronal network which controls heart rate continually. Many parameters define heart rate variability in different domains such as time, frequency or nonlinear. An excessively high computational complexity can occur when developing models for medical applications when the best set of inputs to use is not known. To build a model that can predict a specific process output, it is desirable to select a subset of variables that are truly relevant or the most influential to this output. This procedure is typically called variable selection, and it corresponds to finding a subset of the full set of recorded variables that exhibits good predictive abilities. In this study an architecture for modeling complex systems in function approximation and regression was used, based on using adaptive neuro-fuzzy inference system (ANFIS). Variable searching using the ANFIS network was performed to determine how the ANS branches affect the most relevant HRV parameters. The method utilized may work as a basis for examination of ANS influence on HRV activity.

Complex Fractionated Electrograms in the Right Atrial Free Wall and the Superior/Posterior Wall of the Left Atrium Are Affected by Activity of the Autonomic Nervous System

Complex fractionated atrial electrograms (CFAEs) are supposed to be related to structural and electrical remodeling. Animal studies suggest a role of the autonomic nervous system (ANS). However, this has never been studied in humans. The goal of this study was to investigate the influence of ANS on CFAEs in patients with idiopathic atrial fibrillation (AF). Thirty-six patients (28 men, 55 ± 9 years) were included before undergoing catheter ablation. In the 24 hours preceding the procedure, 20 patients were in AF (group 1) and 16 were in sinus rhythm (SR, group 2). With 2 decapolar catheters, 1 in the right atrium (RA) and 1 in the left atrium (LA), 20 unipolar electrograms were simultaneously recorded during a 100-second AF-period (in group 2 after induction of AF). After atropine and metoprolol administration, a second 100-second AF-period was recorded 30 minutes later. Five patients of group 2 served as controls and did not receive atropine and metoprolol prior to the second recording. CFAEs were assessed and the prevalence of CFAEs was expressed as percentage of the recording time. The prevalence of CFAEs was greater in group 1 than in group 2 in both RA and LA (P = 0.026, P < 0.001, respectively). Atropine and metoprolol significantly reduced CFAEs in group 1 (P < 0.001) and prevented the time-dependent increase of CFAEs in group 2. The prevalence of CFAEs is greater in long-lasting AF episodes. Atropine and metoprolol administration reduces CFAEs in both atria. Thus, CFAEs are at least partly influenced by the ANS.

EFFICACY AND SAFETY OF BISOPROLOL IN YOUNG MEN WITH ARTERIAL HYPERTENSION AND OBESITY

Aim. To evaluate effect of bisoprolol on circadian blood pressure (BP) profile, autonomic cardiovascular regulation, lipid and carbohydrate metabolism in young patients with arterial hypertension (HT) and obesity. Materials and methods. 36 men aged 18 to 35 years with HT 1-2 degrees, obesity 1-2 degrees and signs of sympathetic over activity were examined. In addition to standard clinical examination assessment of heart rate variability (HRV) during orthostatic test with spectral analysis, ambulatory BP monitoring, evaluation of lipid profile, oral glucose tolerance test, determination of immunoreactive insulin, insulin resistance index and functional activity of beta-cells were performed. Anthropometric measurements included body mass index and waist circumference. Bisoprolol in the initial dose of 5 mg QD orally for 12 weeks was assigned to all patients. After 12 weeks of bisoprolol treatment repeated examination was performed. Results. Significant changes in HRV after 12 weeks of treatment with bisoprolol was found. Parasympathetic influence of autonomic nervous system increased during orthostatic test. Contribution of the slow and very slow waves, which reflect sympathetic and neurohumoral activity , reduced. Total spectral power was significantly increased. Initial tachycardia reduced. Target BP values were achieved after 12 weeks of treatment with bisoprolol 5 mg QD. Increase in a number of dippers and decrease in a number of nondippers in terms of both systolic and diastolic BP was observed. Heart rate and HRV was significantly decreased. No adverse events in terms of lipid or carbohydrate metabolism were found during treatment with bisoprolol. Conclusion. Bisoprolol 12 week treatment resulted in sympathetic activity decrease and parasympathetic activity increase, achievement of BP target levels, improvement of BP circadian profile. Bisoprolol therapy in dose of 5 mg/day demonstrated metabolic neutrality in patients with risk factors of cardiovascular diseases and type 2 diabetes.

Effects of normal blood pressure, prehypertension, and hypertension on autonomic nervous system function

BackgroundAutonomic nervous system plays an important role in blood pressure (BP) regulation, and large proportion of patients with hypertension have increased sympathetic and decreased parasympathetic activity. Heart rate recovery (HRR) is a simple non-invasive measurement for investigating autonomic nervous system influence on the cardiovascular system; however, this methodology has not been used to evaluate autonomic nervous system in subjects with prehypertension (PHT). Accordingly, the present study was designed to evaluate HRR in subjects with PHT. Methods and resultsWe measured HRR of 91 subjects with PHT, 44 patients with hypertension, and 53 normotensive healthy volunteers. HRR was significantly lower in the HT and PHT groups as compared to the control group (24.4±5.7, 26.0±8.4, 30.0±8.7; hypertension, PHT, and control groups, respectively), but it did not significantly differ between HT and PHT groups. HRR was significantly and inversely correlated with age, systolic and diastolic BP, fasting and postprandial glucose level, waist circumference, total cholesterol, LDL cholesterol and non-HDL cholesterol, whereas exercise duration and METs were positively correlated with HRR. In multivariable analysis, we found that systolic BP, postprandial glucose level and exercise duration were independent predictors of lower HRR. ConclusionsHRR, a non-invasive measurement analyzing the dysfunction in autonomic nervous system, was reduced in subjects with PHT as compared to normotensives, and the subjects with PHT had HRR as lower as patients with HT did. Our findings are supportive for the hypothesis that autonomic dysregulation is present in an early stage of essential hypertension.

The p75 neurotrophin receptor, semaphorins, and sympathetic traffic in the heart

the sympathetic and parasympathetic branches of the autonomic nervous system control cardiac function through the coordinated activity generated by neurons within the intracardiac autonomic ganglia and central nervous system (3). Activation of the sympathetic efferent projections to the heart increases heart rate, modifies the pattern and conduction velocity of the impulse through the heart, and augments both atrial and ventricular contractility while hastening myocardial relaxation. In the vasculature, the sympathetic nervous system (SNS) reduces venous capacitance and constricts resistance vessels, increasing blood pressure. Conversely, the parasympathetic nervous system (PSNS) decreases heart rate and cardiac impulse conduction. More recent evidence has suggested that the PSNS may also affect ventricular function, indirectly by countering β-adrenergic action or directly via inhibition of L-type Ca2+ channels (34). A transient imbalance between these two branches can lead to increased heart rate and blood pressure when cardiac output is increased. When subnormal cardiac PSNS activity concomitant with sympathetic hyperactivation persists, such as after myocardial infarction, this disequilibrium may increase the risk for cardiac adverse events, including arrhythmias, hypertension, cardiac hypertrophy, and, ultimately, heart failure. This condition is called “autonomic neural remodeling” and can greatly contribute to the induction of ventricular fibrillation, thus increasing the patient's susceptibility to sudden cardiac death (41, 47). It is plausible that neurotrophic factors, target organ-secreted proteins essential for the development and differentiation of neurons, are involved in the remarkable neuroplasticity exhibited by the SNS in the adult life, including autonomic remodeling after infarction and/or in the onset and progression of congestive heart failure (17, 30, 32).