Pre-ejection Period Research Articles

Sympathetic arousal during the processing of dysphoric affect by youths at high and low familial risk for depression.

Youths at high risk for depression have been shown to have problems in repairing their own sad mood. Given that sympathetic arousal has been implicated both in the experience and regulation of affect, an atypical pattern of arousal may be one of the factors that contribute to mood repair problems. In the current study, we measured sympathetic arousal of never-depressed youths at high (n=56) and low (n=67) familial risk for depression during sad mood induction and instructed mood repair. Sympathetic arousal was indexed by skin conductance level (SCL) and cardiac pre-ejection period (PEP); mood repair outcome was indexed by self-rated affect. High-risk youths demonstrated increased SCL during sadness induction, which persisted during mood repair; low-risk youths evidenced increased SCL only during mood repair. Shortened PEP was evident only among high-risk youths and only during mood repair. Furthermore, shortened PEP during mood induction predicted less successful mood repair in the low-risk but not in the high-risk group. The findings suggest that: (a) depression-prone youths differ from control peers in patterns of sympathetic responses to emotional stimuli, which may impair their ability to relieve sadness, and (b) activation patterns differ across subsystems (SCL vs. PEP) of sympathetic activity, in conjunction with depression risk status.

Harnessing the Manifold Structure of Cardiomechanical Signals for Physiological Monitoring During Hemorrhage.

Local oscillation of the chest wall in response to events during the cardiac cycle may be captured using a sensing modality called seismocardiography (SCG), which is commonly used to infer cardiac time intervals (CTIs) such as the pre-ejection period (PEP). An important factor impeding the ubiquitous application of SCG for cardiac monitoring is that morphological variability of the signals makes consistent inference of CTIs a difficult task in the time-domain. The goal of this work is therefore to enable SCG-based physiological monitoring during trauma-induced hemorrhage using signal dynamics rather than morphological features. We introduce and explore the observation that SCG signals follow a consistent low-dimensional manifold structure during periods of changing PEP induced in a porcine model of trauma injury. Furthermore, we show that the distance traveled along this manifold correlates strongly to changes in PEP ( ∆PEP). ∆PEP estimation during hemorrhage was achieved with a median R2 of 92.5% using a rapid manifold approximation method, comparable to an ISOMAP reference standard, which achieved an R2 of 95.3%. Rapidly approximating the manifold structure of SCG signals allows for physiological inference abstracted from the time-domain, laying the groundwork for robust, morphology-independent processing methods. Ultimately, this work represents an important advancement in SCG processing, enabling future clinical tools for trauma injury management.

Mortality salience, effort, and cardiovascular response to a bar-press challenge: Remarkably nuanced effects of a death prime on heart performance.

We presented participants with a bar-pressing challenge relevant to their identity after having exposed them to a prime that made their mortality more or less salient. For some participants, difficulty was low; for others, it was high; for the rest, it was unfixed. As expected, heart pre-ejection period responses-reflecting heart contraction force-were (a) stronger under high-salience conditions when difficulty was high and unfixed, but (b) low regardless of salience when difficulty was low. Findings bear out conceptually and extend results from a previous experiment. In doing so, they add substantively to a new line of support for terror management theory and document the predictive utility of a proposed blended analysis of associated effort processes. The blended analysis speaks to the way in which motives to manage existential terror should convert into active goal striving and to the impact that existential threat might have on aspects of autonomic arousal.

Effects of Therapeutic Intervention on Parentally Bereaved Children's Emotion Reactivity and Regulation 15Years Later.

The Family Bereavement Program (FBP) is a family-based intervention for parentally bereaved children and surviving caregivers. Results are reported of a randomized controlled trial, examining intervention effects on emotional reactivity and regulation of young adults who participated in the program 15years earlier. Participants (N = 152) completed four emotion challenge tasks: reactivity to negative images, detached reappraisal while viewing negative images, positive reappraisal while viewing negative images, and reengagement with positive images. Outcomes included cardiac interbeat interval (IBI), pre-ejection period (PEP), and respiratory sinus arrhythmia (RSA) as well as self-reported emotional experience and regulation effectiveness. Direct intervention effects and effects mediated through improved parenting were estimated. Several significant effects were observed in primary analyses; however, none remained significant after correction for familywise Type I error. Parentingmediated FBP effects on IBI during negative reactivity (b = 15.04), and on RSA during positive reengagement (b = 0.35); the latter effect was accounted for by changes in breathing. Intervention condition was a direct predictor of self-reported detached reappraisal effectiveness (b = 1.00). Intervention and gender interacted in predicting self-reported negative emotion during the negative reactivity (b = 1.04) and positive reappraisal tasks (b = 1.31) such that intervention-conditionmen reported more negative emotions during those tasks. Although these findings should be considered preliminary given the limited power of the corrected statistical tests, they suggest long-term effects of family intervention following the death of a parent on offspring's emotional reactivity and regulation ability that should be pursued further in future research.

Distribution, Stability, and Continuity of Autonomic Nervous System Responsivity at 18- and 36-Months of Age.

Cardiac autonomic nervous system (ANS) measures, respiratory sinus arrhythmia (RSA) and preejection period (PEP), are valid and reliable indicators of children's sensitivity to their environment; however, there are few studies of ANS measures in children less than three years of age. This study's aim was to summarize the distributions, stability, and continuity of RSA and PEP measures during resting, challenge, and reactivity for children at 18- and 36-months. This was a cohort study of racially- and ethnically-diverse, low-income children who completed a developmentally challenging protocol while we simultaneously assessed their RSA and PEP at 18-months (N = 134) and 36-months (N = 102). The ANS resting, challenge, and reactivity measures at 18- and 36-months of age were normally distributed. The RSA resting (r = 0.29), RSA challenge (r = 0.44), PEP resting (r = 0.55) and PEP challenge (r = 0.58) measures were moderately stable but RSA (r = 0.01) and PEP reactivity (r = 0.02) were not stable from 18- to 36-months of age. There was no continuity in the ANS measures from 18- to 36-months of age with statistically significant changes in sample means for all of the ANS measures. These developmental changes in ANS are shown at the sample level but there are individual differences in ANS responses from 18- to 36-months that may be affected by adversity or protective factors experienced early in life.

A latent change score approach to understanding dynamic autonomic coordination.

Children's self-regulation is a core adaptive system in child development. Physiological indices of regulation, particularly the autonomic nervous system (ANS), have garnered increased attention as an informative level of analysis in regulation research. Cardiography supports the simultaneous examination of both ANS branches via measures of pre-ejection period (PEP) and respiratory sinus arrhythmia (RSA) as indicators of sympathetic and parasympathetic activity, respectively. However, despite their heavily intertwined functions, research examining autonomic coordination across sympathetic and parasympathetic systems is scarce. Moreover, extant efforts have favored static, mean level reactivity analyses, despite the dynamic nature of ANS regulation and the availability of analytic tools that can model these processes across time. This study drew on a sample of 198 six-year-old children from a diverse community sample (49.5% female, 43.9% Latinx) to examine dynamic autonomic coordination using bivariate latent change score modeling to evaluate bidirectional influences of sympathetic and parasympathetic activity over the course of a challenging puzzle completion task. Results indicated that children evidenced reciprocal sympathetic activation (i.e., PEP attenuation and RSA withdrawal) across the challenge task, and these regulatory responses were characterized by a temporally leading influence of PEP on lagging changes in RSA. The current findings contribute to our understanding of children's autonomic coordination while illustrating a novel analytic technique to advance ongoing efforts to understand the etiology and developmental significance of children's physiological self-regulation.

Cross system autonomic balance and regulation: Associations with depression and anxiety symptoms.

The autonomic nervous system (ANS) has demonstrated utility for identifying alterations in emotion processing associated with common psychopathology, including depression and anxiety. To date though the majority of this ANS research has several limitations. Most studies have examined parasympathetic and sympathetic branches separately, requiring activity in the other branch be inferred. This is problematic as each branch may function independently. Composite indices such as cardiac autonomic balance (CAB) and cardiac autonomic regulation (CAR) which examine the relative input between respiratory sinus arrhythmia (RSA) and pre-ejection period (PEP) should provide more comprehensive measures of autonomic functioning and thus stronger predictors of psychopathology. However, the sympathetic branch is driven by multiple neurotransmitter systems, thus PEP does not necessarily reflect overall SNS arousal. We propose two new metrics for assessing ANS functioning associated with psychopathology: parasympathetic effects on cardiac control (RSA) relative to sympathetic effects on the eccrine system (electrodermal activity, EDA), which we term cross-system autonomic balance (CSAB) and regulation (CSAR). Eighty-five women (18-37) completed a baseline physiological assessment with parasympathetic (RSA) and sympathetic indices (PEP, EDA), along with self-reported depressive and anxiety symptoms. Lower CSAB, indicating sympathetic dominance driven by cholinergic neurotransmission, was associated with higher depressive and anxiety symptoms. Lower CAB indicating sympathetic dominance driven by beta-adrenergic neurotransmission was associated specifically with depressive symptoms. CSAB was a more robust index than RSA. Results support the utility of assessing multiple composite ANS indices for identifying physiological substrates of alterations in emotion regulation associated with internalizing disorders.

Features of autonomic cardiovascular control during cognition in major depressive disorder.

Previous research has suggested reduced parasympathetic cardiac regulation during cognitive activity in major depressive disorder (MDD). However, little is known about possible abnormalities in sympathetic control and cardiovascular reactivity. This study aimed to provide a comprehensive analysis of autonomic cardiovascular control in the context of executive functions in MDD. Thirty six MDD patients and 39 healthy controls participated. Parameters of sympathetic (pre-ejection period, PEP) and parasympathetic control (high and low frequency heart rate variability, HF HRV, LF HRV; and baroreflex sensitivity, BRS) as well as RR interval were obtained at rest and during performance of executive function tasks (number-letter task, n-back task, continuous performance test, and Stroop task). Patients, as compared to controls, exhibited lower HF HRV and LF HRV during task execution and smaller shortenings in PEP and RR interval between baseline and tasks. They displayed longer reaction times during all conditions of the tasks and more omission errors and false alarms on the continuous performance test. In the total sample, on-task HF HRV, LF HRV and BRS, and reactivity in HF HRV, LF HRV, and PEP, were positively associated with task performance. As performance reduction arose independent of executive function load of the tasks, the behavioral results reflect impairments in attention and processing speed rather than executive dysfunctions in MDD. Abnormalities in cardiovascular control during cognition in MDD appear to involve both divisions of the autonomic nervous system. Low tonic parasympathetic control and blunted sympathetic reactivity imply reduced physiological adjustment resources and, by extension, provide suboptimal conditions for cognitive performance.

An Experimental Laboratory Examination of the Psychological and Physiological Effects of Civic Empowerment: A Novel Methodological Approach

Civic engagement can be empowering and might promote well-being, especially for individuals from marginalized backgrounds. This study uses a novel experimental approach to simulate civic engagement in a laboratory study and to test whether this approach engenders civic empowerment and buffers psychological and physiological reactivity to stress and social rejection. Young adults, primarily experiencing low socioeconomic status ( N = 128), were randomly assigned to deliver a speech about a civic or a neutral issue. Giving a civic speech leads to higher feelings of empowerment compared with giving a neutral speech. Delivering the civic speech buffers sympathetic nervous system reactivity to stress (measured through the pre-ejection period) and leads to higher identification with social class background. This is one of the first studies to use an experimental approach and psychophysiological methods to examine the effects of civic empowerment on civic, psychosocial, and physiological reactivity outcomes.

Resting high frequency heart rate variability and PTSD symptomatology in Veterans: Effects of respiration, role in elevated heart rate, and extension to spouses

Heart rate variability (HRV) associated with parasympathetic activity (i.e., cardiac vagal tone) is reduced in posttraumatic stress disorder (PTSD), but possible confounding effects of respiration have not been studied sufficiently. Further, reduced parasympathetic inhibition might contribute to elevated heart rate (HR) in PTSD. Finally, reduced HRV in PTSD might extend to intimate partners, given their chronic stress exposure. In 65 couples (male Veterans, female partners), elevated PTSD symptomatology (n = 32; 28 met full DSM IV criteria, 4 fell slightly short) was documented by structured interview and self-reports. Baseline HR, high-frequency HRV (HF-HRV), cardiac pre-ejection period (PEP), and respiration rate and depth were measured via impedance cardiography. Veterans with PTSD symptoms displayed reduced lnHF-HRV, even when adjusting for respiration, but their partners did not. In mediational analyses, elevated resting HR in PTSD was accounted for by lnHF-HRV but not PEP. Results strengthen evidence regarding HF-HRV and elevated HR in PTSD.

Cardiac Function Monitoring for Patients Undergoing Cancer Treatments Using Wearable Seismocardiography: A Proof-of-Concept Study.

Advances in cancer therapeutics have dramatically improved the survival rate and quality of life in patients affected by various cancers, but have been accompanied by treatment-related cardiotoxicity, e.g. left ventricular (LV) dysfunction and/or overt heart failure (HF). Cardiologists thus need to assess cancer treatment-related cardiotoxic risks and have close followups for cancer survivors and patients undergoing cancer treatments using serial echocardiography exams and cardiovascular biomarkers testing. Unfortunately, the cost-prohibitive nature of echocardiography has made these routine follow-ups difficult and not accessible to the growing number of cancer survivors and patients undergoing cancer treatments. There is thus a need to develop a wearable system that can yield similar information at a minimal cost and can be used for remote monitoring of these patients. In this proof-of-concept study, we have investigated the use of wearable seismocardiography (SCG) to monitor LV function non-invasively for patients undergoing cancer treatment. A total of 12 subjects (six with normal LV relaxation, five with impaired relaxation and one with pseudo-normal relaxation) underwent routine echocardiography followed by a standard six-minute walk test. Wearable SCG and electrocardiogram signals were collected during the six-minute walk test and, later, the signal features were compared between subjects with normal and impaired LV relaxation. Pre-ejection period (PEP) from SCG decreased significantly (p < 0.05) during exercise for the subjects with impaired relaxation compared to the subjects with normal relaxation, and changes in PEP/LV ejection time (LVET) were also significantly different between these two groups (p < 0.05). These results suggest that wearable SCG may enable monitoring of patients undergoing cancer treatments by assessing cardiotoxicity.

Risk Taking by Adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD): a Behavioral and Psychophysiological Investigation of Peer Influence

Adolescents with ADHD demonstrate increased risk-taking behavior (RTB) like substance abuse and dangerous traffic conduct. RTB in adolescence is more likely under peer influence. The current investigation (1) tests the hypothesis that adolescents with ADHD are particularly susceptible to such influence and (2) tests whether groups differed in autonomic reactivity to peer influence. Adolescent boys between 12 and 19 years with (n = 81) and without (n = 99) ADHD performed the Balloon Analogue Risk Task twice. In the peer condition, a highly credible virtual peer manipulation that encouraged risk taking was added, in the solo condition this was absent. Autonomic reactivity was indexed by heart rate (HR), pre-ejection period (PEP) and respiratory sinus arrhythmia (RSA). All adolescents engaged in more risk taking in the peer condition relative to solo condition. Autonomic differences between groups were only found on PEP: a stronger sympathetic response to peer influence was observed in typically developing adolescents relative to adolescents with ADHD. Increased physiological stress (as indexed by PEP) in the peer relative to the solo condition predicted peer-induced risk taking in all adolescents. We conclude that susceptibility to peer influence is not exaggerated in ADHD but rather reflects a general tendency of adolescents. As adolescents experiencing peer influence as stressful are most susceptible to peer influence, we suggest that increasing resistance to peer influence may be an important treatment aim for these adolescents specifically.

Acute psychological stress, autonomic function, and arterial stiffness among women

This study aimed to investigate the effect of acute psychological stress on autonomic function and arterial stiffness, and to test a mediating role of changes in autonomic function between acute stress and arterial stiffness. Eighty-five healthy female adults were randomized into either an experimental or control group. The Trier Social Stress Test (TSST) was used to induce acute psychological stress. Autonomic function (measured by pre-ejection period [PEP] from cardiac impedance and high frequency [HF] of heart rate variability [HRV]) and arterial stiffness (measured by carotid and femoral pulse wave velocity [cfPWV] and augmentation index [AIx]) were assessed before and after the TSST. The mean age of the participants was 28.78 (±9.84) years old. Experimental group participants had a significant increase in cfPWV (p = .025) and AIx (p = .017) following the stressor, compared with those in the control group, after controlling for age, body mass index, and systolic blood pressure. However, no significant group differences were observed in changes in PEP (p = .181) and HF (p = .058). Changes in PEP and HF were neither associated with changes in cfPWV (p = .975 and p = .654, respectively), nor in AIx (p = .376 and p = .323, respectively). The results suggest that even a brief period of mild to moderate stress, which does not cause sustainable changes in autonomic function, may still exert significant adverse effects on arterial stiffness. The changes in arterial stiffness were not related to changes in autonomic function. Future experimental studies with several measurement points are recommended to identify distinct effects of stress on autonomic function and arterial stiffness.

The autonomic correlates of dysphoric rumination and post-rumination savoring

Trait dysphoric rumination is a transdiagnostic factor associated with depression and anxiety that has also been linked with blunted respiratory sinus arrhythmia (RSA), an index of reduced emotion regulation capacity. However, the autonomic correlates of state dysphoric rumination remain unclear. We examined the physiological correlates of state dysphoric rumination and the potential repairing effects of savoring on autonomic functioning. To provide a comprehensive assessment of autonomic correlates, we examined changes in parasympathetic (RSA) and sympathetic (cardiac pre-ejection period, PEP; and electrodermal activity, EDA) arousal independently, as well as autonomic coordination among indices. Eighty-two women (ages 18–25) completed laboratory physiological assessments, including rumination and savoring tasks, and self-report measures of trait rumination. Dysphoric rumination was associated with sympathetic activation (i.e., decreases in PEP, increases in EDA), and subsequent savoring following a recovery period also corresponded with decreases in PEP. Trait rumination did not predict autonomic changes during state rumination. However, higher trait rumination was associated with greater sympathetic coordination (PEP-EDA correspondence) during savoring. In summary, dysphoric rumination co-occurred with sympathetic activation, and subsequent savoring successfully recruited sympathetic activity (PEP) redirected on positive moods and events. Results also emphasize the utility of examining sympathetic and parasympathetic indices, and coordination among autonomic indices to delineate autonomic activity associated with emotion regulation strategies.

Lay theory of generalized prejudice moderates cardiovascular stress responses to racism for White women

Research on stigma by prejudice transfer has demonstrated that White women anticipate sexism when interacting with a racist individual due to a belief that prejudices stem from an underlying ideology of group inequality. The present research proposes that individuals’ lay theory of generalized prejudice (LTGP) varies across individuals and examines cardiovascular stress responses (high frequency heart rate variability [HF-HRV] and preejection period [PEP]). White women who held a lay theory of generalized prejudice and were evaluated by a White man with negative attitudes towards Black Americans demonstrated greater cardiovascular reactivity (decreases in parasympathetic activity [Studies 1 and 2] and shortened PEP [Study 2] from baseline to evaluation) than White women being evaluated by a neutral evaluator or who did not hold a lay theory of generalized prejudice. The present studies are the first to demonstrate cardiovascular stress responses to stigma by prejudice transfer and to highlight LTGP as a key individual difference in stigma by prejudice transfer.

Autonomic nervous system activity predicts increasing serum cytokines in children

Systemic inflammation is associated with increased risk for prevalent and costly diseases, and animal models implicate the autonomic nervous system in the control of inflammatory processes. In humans, research on autonomic-immune connections has been much more limited, and has focused on single branch autonomic measures (i.e., either parasympathetic or sympathetic). The current study utilized cardiac autonomic balance (CAB), derived from dual-branch cardiac autonomic recordings, to test the relation between resting autonomic function and inflammatory reactivity to challenge in children. MethodsParticipants included 96 children (51 boys, 45 girls) ages 9–11 years (mean age = 9.93 years, SD = 0.57 years). CAB values were calculated from standardized measures of parasympathetic and sympathetic activity, namely resting respiratory sinus arrhythmia and pre-ejection period data, respectively. Children provided two blood samples, one before and one following exposure to an acute social stressor or control condition. Serum was assayed for four cytokines that orchestrate inflammation: interleukin-6 (IL6), interleukin-8 (IL8), interleukin-10 (IL10), and tumor necrosis factor-alpha (TNFa). ResultsWe discovered large individual differences in inflammatory marker production across children, and no average main effect of stress condition. CAB significantly predicted these individual differences, such that children lower on CAB showed increasing serum cytokines from time 1 to time 2. In contrast, children with greater CAB tended to show declining inflammatory markers across the session. DiscussionLow cardiac autonomic balance (i.e., the combination of low parasympathetic and high sympathetic activity) may be a useful marker of proinflammatory tendencies in children, suggesting novel paths for early risk detection and intervention.

P1729HEMODYNAMIC AND AUTONOMIC PERFORMANCE IN CHRONIC DIALYSIS AND RENAL TRANSPLANT PATIENTS. IS THERE AN IMPROVEMENT?

Abstract Background and Aims Chronic kidney disease (CKD) is a major public health problem, with high prevalence worldwide. It’s associated with high morbidity and mortality, especially in the advanced stage when substitution therapies are needed. It’s well established that Ps with end-stage kidney disease have increased mortality due to an elevated incidence of cardiovascular diseases (CVD). The best treatment for this population it’s definitely the kidney transplant (KT), mostly because it improves the quality of life and reduces global and CV mortality compared with Ps treated with chronic dialysis (Dx). There is not a convincing explanation about the physiological mechanisms involved in this improvement. Impedance cardiography (IC) it’s a well established, validated method to asses hemodynamics parameters. Study and describe the differences between hemodynamic and autonomic profiles between KT and Dx Ps using IC. Method We studied 331 Ps as part of a cardiovascular evaluation program in Ps with ESKD which is being carried out in our institution (CEMIC, Buenos Aires). Of these, 190 were on Dx and 141 on KT. Non-invasive hemodynamic assessment was performed using IC (Z Logic- Exxer SA) in supine and standing position, taking into account the following variables: heart rate (HR), thoracic fluid content (TFC), stroke volume (SV), systemic vascular resistance index (SVRI), arterial compliance index (ACI), and pre-ejection period (PEP). Ps in the Dx group were studied on the interdialytic day. We evaluated the autonomic profile by studying the variability of HR (Kubios Finland) for three minutes, with measurements of the spectral components, high frequency (HF), low frequency (LF), total power (totpowar) and the ratio LF/HF. We compared absolute supine variables and then the differences between supine and standing positions. Exclusions criteria: less than six months of KT or Dx; incomplete basic hemodynamic study or lack of data; amputation; previous KT. Results We included 107 Ps of Dx and 118 of KT. No significant differences were detected in terms of age, sex, diabetes, and antihypertensive treatment. Ps on Dx had more prevalence of hypertension and CVD. Those in KT group had a median time of 72,5 months of transplantation and 46 months of prior dialysis time, with a media of eGFR (CKD-Epi) of 56 ml/min/1,72 m2. Ps on Dx had a median of 22 months on substitution treatment. The hemodynamic evaluation showed that KT Ps had lower HR (p=o,oo1), higher ACI (p=0,002) and PEP (p=0,05), and a tendency of higher SV (p=0,07). The autonomic evaluation showed no significant differences between the two groups, though the totpowar had a tendency to be higher in the KT group with a median of 367(200-625) compared with 248 (103-465) in the Dx group (p=0,07). The changes in the variables during the standing position evidenced that Ps on Dx had a lower elevation of HR (p=0,04) and SVRI (p&amp;lt;0,001). We assessed the prevalence of orthostatic hypotension defined as a reduction of the SBP in 20 mmHg and/or the DBP in 10 mmHg after standing up. The Dx group had a prevalence of 30% and the KT group of 20%, but the difference was not significant. Conclusion Ps with KT seems to have a better hemodynamic profile than those on Dx, mainly, a better vascular response with a more physiological- compensatory elevation of HR and VSRI when they stand up. Although the autonomic activity showed no significant statistical difference, the total power, an expression of the whole autonomic activity, showed us a clear tendency in favor of KT, which needs to be confirmed with a larger size sample.

Harsh parenting and youth systemic inflammation: Modulation by the autonomic nervous system.

The present study aimed to test the role of the autonomic nervous system (ANS) in modulating the impact of family stress induced by harsh parenting on youths' inflammation. First, we examined the direct effect of severity of adverse parenting behaviors on two serum biomarkers of systemic inflammation (C-reactive protein and interleukin-6) among youth. Second, we tested the moderating role of ANS reactivity in response to laboratory-induced stress in the association between harsh parenting and inflammation among these youth. The sample included 101 low-income children (75.2% African American) between 9 and 12 years of age (Mage = 10.9; SDage = 1.2) who participated in a conflict task with their primary caregiver in a laboratory setting. Heart rate variability reactivity (HRV-R), skin conductance level reactivity (SCL-R), and preejection period reactivity (PEPr-R) were used to index parasympathetic and sympathetic nervous system reactivity. Markers of low-grade inflammation (C-reactive protein and interleukin-6) were obtained from serum. After adjusting for confounding variables, ANS activity moderated the associations between family stress and systemic inflammation. Specifically, elevated HRV-R buffered the effect of family stress on youths' inflammation, whereas elevated PEPr-R and SCL-R exacerbated the effect. These findings show that self-regulatory capacity and threat sensitivity, as indicated by ANS function, may have an impact on the associations between family stress and systemic inflammation. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Creative Flow and Physiologic States in Dancers During Performance.

Pre-professional and professional dancers (n = 60) participated in this ambulatory psychophysiology study that investigated performance flow and heart rate and autonomic nervous system (ANS) function during three time periods: baseline rest, performance, and post-performance rest. To gather these results, the psychophysiology laboratory traveled to the concert hall to collect data on dancers. The self-report Flow State Scale (FSS) measured global flow, challenge–skill balance, sense of control, and autotelic experiences; it addresses important features of the creative experience of performing artists. These data were collected immediately following the performance. The flow measures were compared with physiologic responses to performance [heart rate, pre-ejection period (PEP), root mean square differences of successive R-R (heartbeat) intervals (RMSSD), cardiac autonomic balance, and cardiac autonomic regulation]. The regression analyses indicated that greater sympathetic nervous system (SNS) activation with performance (PEP change from base to performance) explained 8.8% of the variance in sense of control, whereas less cardiac autonomic regulation explained 13.8% of the variance in autotelic experiences. The sample was then divided into high and low flow groupings and four autonomic groups. During performance, the high autotelic group and high sense of control group had a higher distribution of dancers with co-inhibition of both ANS branches than had the low autotelic and sense of control groups who employed more co-activation of both ANS branches (chi-square analyses). These novel findings add to the growing information about the interaction of both branches of the ANS during creative performance flow states.

Wearable Cardiorespiratory Monitoring Employing a Multimodal Digital Patch Stethoscope: Estimation of ECG, PEP, LVETand Respiration Using a 55 mm Single-Lead ECG and Phonocardiogram.

Cardiovascular diseases are the main cause of death worldwide, with sleep disordered breathing being a further aggravating factor. Respiratory illnesses are the third leading cause of death amongst the noncommunicable diseases. The current COVID-19 pandemic, however, also highlights the impact of communicable respiratory syndromes. In the clinical routine, prolonged postanesthetic respiratory instability worsens the patient outcome. Even though early and continuous, long-term cardiorespiratory monitoring has been proposed or even proven to be beneficial in several situations, implementations thereof are sparse. We employed our recently presented, multimodal patch stethoscope to estimate Einthoven electrocardiogram (ECG) Lead I and II from a single 55 mm ECG lead. Using the stethoscope and ECG subsystems, the pre-ejection period (PEP) and left ventricular ejection time (LVET) were estimated. ECG-derived respiration techniques were used in conjunction with a novel, phonocardiogram-derived respiration approach to extract respiratory parameters. Medical-grade references were the SOMNOmedics SOMNO HDTM and Osypka ICON-CoreTM. In a study including 10 healthy subjects, we analyzed the performances in the supine, lateral, and prone position. Einthoven I and II estimations yielded correlations exceeding 0.97. LVET and PEP estimation errors were 10% and 21%, respectively. Respiratory rates were estimated with mean absolute errors below 1.2 bpm, and the respiratory signal yielded a correlation of 0.66. We conclude that the estimation of ECG, PEP, LVET, and respiratory parameters is feasible using a wearable, multimodal acquisition device and encourage further research in multimodal signal fusion for respiratory signal estimation.