Significant Increase In Heart Rate Research Articles

Gestationally Administered RAS Modulators Reprogram Endotoxic Cardiovascular and Inflammatory Profiles in Adult Offspring of Preeclamptic Rats

Preeclampsia (PE) adversely programs fetal cardiovascular integrity and amplifies cardiovascular dysfunction induced by endotoxemia in adult offspring of preeclamptic mothers. Here, we asked if such aggravated endotoxic insult could be nullified by modulators of the renin-angiotensin system (RAS). PE was induced by gestational administration of L-NAME, a nitric oxide synthase inhibitor. Adult male offspring of PE mothers treated gestationally with Ang 1-7 (Ang II-derived vasodilator), losartan (AT1 receptor antagonist), pioglitazone (RAS modulator), or combined losartan/pioglitazone, were instrumented with femoral indwelling catheters and challenged intravenously with a 5 mg/kg dose of lipopolysaccharides (LPS, 5 mg/kg). LPS caused significant increases in heart rate and decreases in blood pressure and spectral index of overall heart rate variability. These effects were similarly reduced by all drug therapies. In offspring born to Ang 1-7-treated dams, the spectral index of cardiac sympathovagal balance showed elevated sympathetic dominance in response to LPS. Further, pioglitazone and its combination with losartan were more effective than Ang 1-7 or losartan in depressing the LPS-evoked increases in left ventricular contractility (dP/dtmax). Immunohistochemical studies revealed that Ang1-7, but not losartan/pioglitazone, regimen abolished the exaggerated increases in TLR-4 expression caused by PE/LPS in heart tissues and neuronal circuits of brainstem rostral ventrolateral medulla. By contrast, ACE expression in the same two areas was reduced by losartan/pioglitazone but not Ang 1-7. Together, gestational fetal reprogramming of Ang II (depression) and Ang 1-7 (activation) arms of RAS effectively counterbalance worsened endotoxic cardiovascular and inflammatory profiles in adult offspring of PE rats.

Cardiovascular and cortisol responses to experimentally-induced minority stress.

Lesbian, gay, and bisexual (LGB) individuals who report greater minority stress (e.g., discrimination) are at an elevated risk for multiple health problems. However, few studies have examined physiological mechanisms that might link minority stress to health. This study tested how cardiovascular and cortisol responses to a laboratory-induced social stressor differed when that stressor contained an additional minority stress component. LGB adults (n = 141; 51% male, 49% female) participated in a social stress task in which they were interviewed by a prerecorded confederate. Participants were randomized to receive information that their interviewer held either antigay or progay social/political beliefs. Cardiovascular reactivity and salivary cortisol were assessed at baseline, during the task, and during recovery. All participants experienced significant task-related increases in heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP). However, participants in the antigay condition had greater increases in HR and SBP during the task and smaller decreases in SBP during recovery. Salivary cortisol increased significantly only in the antigay condition. High frequency heart rate variability (hfHRV) was constant throughout the stress task for participants in the progay condition but decreased significantly during the task for participants in the antigay condition. Minority stress has the potential to affect LGB individuals' health through cardiovascular and endocrine mechanisms. Moreover, its physiological signature may differ from other social stress in ways that have implications for health and emotion regulation more broadly. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Cardiovascular response to physical exercise and the risk of Internet addiction in 15-16-year-old adolescents.

Background and aimSubjective symptoms of Internet addiction (IA), such as interpersonal and health-related problems (IH-RP), do not correlate with objective physiological parameters. This study aimed to investigate the cardiovascular reactivity after physical exercise in 15–16-year-old adolescents showing different severities of symptoms of health-related problems due to Internet overuse.MethodsThis study included 20 healthy adolescents (boys, 15–16 years) with different risks of IA (by the Chen internet addiction scale [CIAS]). The physical exercise test was to perform a standing broad jump three times. The arterial blood pressures and heart rates were recorded before, immediately after, and at 4 minutes of rest after exercise.Results and discussionThe total sample of adolescents was divided into two groups, that is, those with IH-RP scores of 12 or less (Group I, n = 12) and those scoring more than 12 points (Group II, n = 8). The diastolic blood pressure significantly increased after exercise in group II, whereas it remained stable in group I. The heart rate in group I tended to increase, but the changes were not statistically significant. Group II adolescents showed significant increases in heart rate, and at rest, this parameter was significantly higher than the baseline value.ConclusionsAdolescents with a risk of IA and severe symptoms of interpersonal and health-related problems had increased sympathetic activity during and after speed-strength physical exercise compared to those without the aforementioned symptoms.

Cardiac output and cerebral blood flow during carotid surgery in regional versus general anesthesia: A prospective randomized controlled study

ObjectiveCarotid endarterectomy (CEA) is a preventive procedure aimed at decreasing the subsequent risk of fatal or disabling stroke in patients with significant carotid stenosis. It is well-known that carotid surgery under ultrasound-guided regional anesthesia (US-RA) causes a significant increase in blood pressure, heart rate and stress hormone levels owing to increased sympathetic activity. However, little is known about the effects on cardiac output (CO), cardiac index (CI), and cerebral blood flow (CBF) under US-RA as compared with general anesthesia (GA). MethodsPatients scheduled for CEA were randomized prospectively to receive US-RA (n = 37) or GA (n = 41). The primary end point was the change in CI after induction of anesthesia and the change from baseline over time at four different times during the entire procedure in the respective randomized US-RA and GA groups. In addition to systolic blood pressure and heart rate, we also recorded peak systolic velocity, end-diastolic velocity, and minimum diastolic velocity as seen from transcranial Doppler ultrasound examination, as well as regional cerebral oxygenation (rSO2) as seen from near-infrared refracted spectroscopy to evaluate cerebral blood flow. ResultsIn the US-RA group, the CI increased after induction of anesthesia (3.7 ± 0.8 L/min/m2) and remained constant until the end of the procedure. In the GA group CI was significantly lower (2.4 ± 0.6 L/min/m2; P < .001). After induction of anesthesia, the rSO2 remained constant in the GA group on both the ipsilateral (63 ± 9 rSO2) and the contralateral (65 ± 7 rSO2) sides; in contrast, it significantly increased in the US-RA group (ipsilateral 72 ± 8 rSO2; P < .001; contralateral 72 ± 6 rSO2; P < .001). The transcranial Doppler ultrasound parameters (peak systolic velocity, end-diastolic velocity, and minimum diastolic velocity) did not differ between the US-RA and the GA group. The clinical outcome was similarly favorable for both groups. ConclusionsCI was maintained near baseline values throughout the procedure during US-RA, whereas a significant decrease in CI values was observed during CEA under GA. Near-infrared refracted spectroscopy values, reflecting blood flow in small vessels, were higher in US-RA patients than in those with GA. These differences did not influence clinical outcome.

Shenxian-Shengmai Oral Liquid Improves Sinoatrial Node Dysfunction through the PKC/NOX-2 Signaling Pathway.

Sick sinus syndrome (SSS) is one of the common causes of cardiac syncope and sudden death; the occurrence of SSS is associated with the accumulation of ROS in the sinoatrial node (SAN). Shenxian-shengmai (SXSM) is a traditional Chinese medicine available as oral liquid that causes a significant increase in heart rate. The objective of this study is to observe the improvement of SXSM on SAN function in SSS mice and explore its potential mechanism. In the current study, SSS was simulated in mice by inducing SAN dysfunction using a micro-osmotic pump to inject angiotensin II (Ang II). The mouse model with SSS was used to determine the effect of SXSM on SAN function and to explore its potential mechanism. Furthermore, the HL-1 cell line, derived from mouse atrial myocytes, was used to simulate SAN pacemaker cells. Our results indicated that SXSM significantly increased the heart rate of SSS mice by reducing the AngII-induced accumulation of ROS in the SAN and by inhibiting the expression of HDAC4, thereby reducing the loss of HCN4, a critical component of the cardiac conduction system. MASSON staining revealed a reduction of SAN damage in SSS mice that were treated with SXSM compared with controls. In vitro experiments showed that AngII treatment caused an upregulation of the PKC/NOX-2 signaling pathway in HL-1 cells which could be prevented by pretreatment with SXSM. The protective effect of SXSM was attenuated upon treatment with the PCK agonist PMA. In conclusion, SXSM reduced the AngII-induced accumulation of ROS in the SAN through the PKC/NOX2 signaling pathway, improving the functioning of the SAN and preventing the decrease of heart rate in SSS mice.

Effect of Light and Noise on Physiological Parameters in a Sample of Preterm Neonates in the Neonatal Intensive Care of Cairo University Teaching Hospital

Background: Some of the neonatal intensive care units (NICUs) partially lack the standard protocols for controlling noise and light. The healthy physical environment of NICUs is crucial for the continued normal development of preterm neonates. The present study aimed to assess the physiological changes (including heart rate, respiratory rate, blood pressure, temperature, and oxygen saturation) induced by noise and ordinary light often existing in NICUs in a sample of preterm neonates admitted to the private ward of NIUCU due to their low-birth weights. Methods: The present study included 100 preterm neonates, 50 neonates were exposed to noise which is often induced in the open ward of NICU, and the other 50 newborns were exposed to cyclical light. Results: During noise exposure, neonates in the private ward displayed a significant increase in heart rate, respiratory rate, as well as systolic and diastolic blood pressure. Moreover, they showed a marked decrease in oxygen saturation in the first and second days in the NICU. Furthermore, the neonates exposed to dim light demonstrated a significant decrease in heart rate, respiratory rate, systolic and diastolic blood pressure, as well as a significant increase in oxygen saturation, compared to those exposed to ordinary light on the first and second days. Nonetheless, body temperature did not show any significant change with noise or light exposure either on the first day or the second one. Conclusion: As evidenced by the obtained results, exposure to excessive light and noise was associated with significant changes in preterm neonates' vital signs. Moreover, the findings highlighted the inadequacy of the current conditions in a sample of Egyptian NICUs for ideal neonatal care. In order to create a favorable environment to help better growth and prevent prematurity complications, it is recommended to devote more assiduous attention to the care conditions of neonates in NICUs in Egypt.Â

Attenuation of pressor response to laryngoscopy and intubation with topical lignocaine 10% spray in the controlled hypertensive patients

Laryngoscopy and tracheal intubation is invariably associated with a reflex sympathetic pressor response resulting in elevated heart rate and blood pressure. There are many studies conducted to attenuate this pressor response, the present study is undertaken to compare efficacy of 10% lignocaine spray with normal saline spray applied before induction in attenuating the pressor response to laryngoscopy and intubation in controlled hypertensive patients. Methods: 60 patients of either sex aged between35-60 years, belonging to ASA I and II undergoing elective surgery requiring general anaesthesia with endotracheal intubation were included. Patients were randomly divided in two groups of 30 patients each. Group I (Study group) received topical lignocaine 10% spray 2 minutes before intravenous induction. Group II (Control group) received topical normal saline 2 minutes before intravenous induction. Results: Showed that the topical lignocaine 10% spray significantly attenuates the rise in mean systolic blood pressure, diastolic blood pressure and heart rate when compared with the baseline as well as the control group. There was a statistically significant (p<0.05) increase in heart rate, systolic and diastolic blood pressure in group II when compared to group I and baseline values. Conclusion: Study concluded that topical lignocaine 10% spray did not completely abolish the rise in heart rate, SBP and DBP but only attenuate it when compared with the baseline or control group.

Sympathetic hyperactivity, hypertension, and tachycardia induced by stimulation of the ponto-medullary junction in humans

ObjectiveThe purpose of this study is to investigate changes in autonomic activities and systemic circulation generated by surgical manipulation or electrical stimulation to the human brain stem. MethodsWe constructed a system that simultaneously recorded microsurgical field videos and heart rate variability (HRV) that represent autonomic activities. In 20 brain stem surgeries recorded, HRV features and sites of surgical manipulation were analyzed in 19 hypertensive epochs, defined as the periods with transient increases in the blood pressure. We analyzed the period during electrical stimulation to the ponto-medullary junction, performed for the purpose of monitoring a cranial nerve function. ResultsIn the hypertensive epoch, HRV analysis showed that sympathetic activity predominated over the parasympathetic activity. The hypertensive epoch was more associated with surgical manipulation of the area in the caudal pons or the rostral medulla oblongata compared to controls. During the period of electrical stimulation, there were significant increases in blood pressures and heart rates, accompanied by sympathetic overdrive. ConclusionsOur results provide physiological evidence that there is an important autonomic center located adjacent to the ponto-medullary junction. SignificanceA large study would reveal a candidate target of neuromodulation for disorders with autonomic imbalances such as drug-resistant hypertension.

The interaction of acute physical fatigue with three traditional functional performance tests and the reactive balance test

ObjectivesTo assess the impact of acute physical fatigue on traditional and neurocognitive functional performance tests in recreational athletes. Designrandomized counterbalanced cross-over study, pre-post design Settinglaboratory ParticipantsTwenty recreational athletes (age = 24 ± 3 years) Main outcome measuresWe evaluated fatigue impairments following a 30 s all-out effort in three traditional and one neurocognitive functional performance test. The traditional functional performance tests encompassed the single leg hop for distance (SLH), countermovement jump (CMJ) and Y-balance test (YBT). The neurocognitive functional performance test encompassed the reactive balance test (RBT). A 30 s modified Wingate was used to induce acute physical fatigue. ResultsAcute physical fatigue was successfully induced as indicated by a significant increase in heart rate, systolic blood pressure, blood lactate levels and rating of perceived exertion (p < 0.001). Acute physical fatigue induced significant decreases in RBT accuracy (p = 0.004) and SLH performance (p < 0.001). YBT, CMJ and RBT visuomotor reaction time remained unaffected by acute physical fatigue. ConclusionsAcute physical fatigue impairs SLH performance and decreases accuracy in the RBT. YBT and CMJ performance remained unaffected by acute physical fatigue. Clinicians should be aware of this divergent neurocognitive functional impairments caused by one all-out effort to allow well-informed selection of functional performance tests.

English

BACKGROUND Present study was undertaken to assess the feasibility of laryngeal mask airway (LMA) supreme and I gel, the second generation supraglottic airway devices in laparoscopic surgeries. METHODS 120 patients with American Society of Anaesthesiologists (ASA) I and II (20 - 50 years) of either sex who underwent laparoscopic surgery under general anaesthesia were randomly divided into three groups. Airway was secured with endotracheal tube (ETT) in group E (N = 40), with LMA supreme in Group S (N = 40) and with I-gel in group I (N = 40). Insertion characteristics of airway device, ease of gastric tube insertion, haemodynamic response and perioperative laryngopharyngeal morbidities were assessed. RESULTS I-gel was easier to insert with higher first attempt success rate (95 %) than LMA Supreme (85 %) and ETT (90 %) but it was statistically insignificant. Heart rate (HR) and mean arterial pressure (MAP) was significantly higher in ETT group at the time of intubation, continued till 5 minutes and also at the time of extubation but statistically significant increase in HR and MAP were noted in group S and I only at the time of device insertion. Gastric tube was easier to insert in group S with shortest insertion time which was statistically significant. Incidence of coughing, dysphonia, dysphagia and sore throat was significantly more in group E. CONCLUSIONS I-gel and LMA Supreme can be used as an alternative to ETT for airway management in adult patients undergoing elective laparoscopic surgeries. KEYWORDS Endotracheal Tube, I-gel, LMA Supreme, Supraglottic Airway Device

Effects of an Innovative Head-Up Tilt Protocol on Blood Pressure and Arterial Stiffness Changes.

The objective of our study was to identify blood pressure (BP) and pulse wave velocity (PWV) changes during orthostatic loading, using a new the head-up tilt test (HUTT), which incorporates the usage of a standardized hydrostatic column height. Methods: 40 healthy subjects 20–32 years performed HUTT, which was standardized to a height of the hydrostatic column at 133 cm. Exposure time was 10 min in each of 3 positions: horizontal supine 1, HUTT, and horizontal supine 2. The individual tilt up angle made it possible to set the standard value of the hydrostatic column. Hemodynamic parameters were recorded beat to beat using “Task Force Monitor 3040 i”, pulse-wave velocity (PWV) was measured with a sphygmograph–sphygmomanometer VaSera VS1500N. Results: Orthostatic loading caused a significant increase in heart rate (HR) and a decrease in stroke volume (SV) (p < 0.05) but no significant reductions in cardiac output, changes in total vascular resistance (TVR), or BP. An analysis of personalized data on systolic blood pressure (SBP) changes in tilt up position as compared to horizontal position (ΔSBP) revealed non-significant changes in this index in 48% of subjects (orthostatic normotension group), in 32% there was a significant decrease in it (orthostatic hypotension group) and in 20% there was a significant increase in it (orthostatic hypertension group). These orthostatic changes were not accompanied by any clinical symptoms and/or syncope. During HUTT, all subjects had in the PWV a significant increase of approximately 27% (p < 0.001). Conclusion: The new test protocol involving HUTT standardized to a height of hydrostatic column at 133 cm causes typical hemodynamics responses during orthostatic loading. Individual analysis of the subjects revealed subclinical orthostatic disorders (OSD) in up to 52% of the test persons. During HUTT, all test subjects showed a significant increase in PWV. The new innovative HUTT protocol can be applied in multi-center studies in healthy subjects to detect preclinical forms of orthostatic disorders under standard gravity load conditions.

Pharmacodynamics of propofol and alfaxalone in rattlesnakes (Crotalus durissus)

To characterise the effect of two common induction agents, propofol and alfaxalone, on mean arterial blood pressure (MAP) and heart rate (HR), we equipped 19 adult South American rattlesnakes (Crotalus durissus) with an indwelling arterial catheter approximately 24 h prior to recording of baseline resting values. Then, seven snakes received alfaxalone (15 mg kg−1) intravascularly (IV) through the catheter, while groups two and three (both n = 6) received propofol (15 mg kg−1 IV). The first two groups were not handled, while the group 3 was manually restrained for 2 min for a mock injection of 0.2 ml saline into the ventral tail vein. Baseline HR was similar in all groups and handling caused a significant tachycardia (p = 0.031) in group three. When given IV to undisturbed animals, both propofol and alfaxalone induced a significant increase in HR (p = 0.0022 and p = 0.0045, respectively) lasting approximately 30 min, but with values only significantly exceeding baseline for the first 5 min for propofol and the first 10 min with alfaxalone. Handling caused a significant increase in MAP (p = 0.0313). Propofol did not affect MAP (p = 0.1064), while alfaxalone caused a marked hypertension (although only significant at 2 min; p = 0.031). Manual restraint significantly increases both HR and MAP, which may lead to a masking of true cardiovascular effects of anaesthetic agents.

Short-Term Effect of Inhaled Salbutamol on Heart Rate in Healthy Volunteers.

ObjectiveTachycardia is a potential side effect of salbutamol inhalation. We aimed to study the short-term effect of salbutamol nebulization on the heart rate of healthy volunteers.Material and methodsA randomized, single-blinded, placebo-controlled, cross-over study was conducted with 30 healthy volunteers divided into two groups of 15 each. One group was nebulized with salbutamol (2.5 mg/2 ml dilution) while the other group was given normal saline (2 ml). Each arm underwent administration of the opposite drug the following week. Baseline readings of heart rate and blood pressure were taken at zero (T0), seven (T7), 15 (T15), and 30 (T30) minutes.ResultsThirty volunteers between the ages of 20 and 25 years were studied. The mean heart rate value was higher for nebulized salbutamol at each point as compared to saline. When nebulized with salbutamol, the heart rate had a significant rise (p= < 0.00001) at 15 minutes as compared to saline nebulization.ConclusionSalbutamol nebulization, even at a low dose, can lead to a significant increase in heart rate when compared to nebulization with normal saline in healthy individuals.

Autonomic Alterations After Pulmonary Vein Isolation in the CIRCA-DOSE (Cryoballoon vs Irrigated Radiofrequency Catheter Ablation) Study.

BackgroundThe natural history of autonomic alterations following catheter ablation of drug‐refractory paroxysmal atrial fibrillation is poorly defined, largely because of the historical reliance on non‐invasive intermittent rhythm monitoring for outcome ascertainment.Methods and ResultsThe study included 346 patients with drug‐refractory paroxysmal atrial fibrillation undergoing pulmonary vein isolation using contemporary advanced‐generation ablation technologies. All patients underwent insertion of a Reveal LINQ (Medtronic) implantable cardiac monitor before ablation. The implantable cardiac monitor continuously recorded physical activity, heart rate variability (measured as the SD of the average normal‐to‐normal), daytime heart rate, and nighttime heart rate. Longitudinal autonomic data in the 2‐month period leading up to the date of ablation were compared with the period from 91 to 365 days following ablation. Following ablation there was a significant decrease in SD of the average normal‐to‐normal (mean difference versus baseline of 19.3 ms; range, 12.9–25.7; P<0.0001), and significant increases in daytime and nighttime heart rates (mean difference versus baseline of 9.6 bpm; range, 7.4–11.8; P<0.0001, and 7.4 bpm; range, 5.4–9.3; P<0.0001, respectively). Patients free of arrhythmia recurrence had significantly faster daytime (11±11 versus 8±12 bpm, P=0.001) and nighttime heart rates (8±9 versus 6±8 bpm, P=0.049), but no difference in SD of the average normal‐to‐normal (P=0.09) compared with those with atrial fibrillation recurrence. Ablation technology and cryoablation duration did not influence these autonomic nervous system effects.ConclusionsPulmonary vein isolation results in significant sustained changes in the heart rate parameters related to autonomic function. These changes are correlated with procedural outcome and are independent of the ablation technology used.RegistrationURL: https://www.clinicaltrials.gov; Unique identifier: NCT01913522.

Effects of Chewing Gum on Nitric Oxide Metabolism, Markers of Cardiovascular Health and Neurocognitive Performance after a Nitrate-Rich Meal

Objectives Cardiovascular and neurocognitive responses to chewing gum have been reported, but the mechanisms are not well understood. Chewing gum after a nitrate-rich meal may upregulate the reduction of oral nitrate to nitrite and increase nitric oxide (NO), a molecule important to cardiovascular and neurocognitive health. We aimed to explore effects of chewing gum after a nitrate-rich meal on nitrate metabolism (through the enterosalivary nitrate-nitrite-NO pathway), endothelial function, blood pressure (BP), neurocognitive performance, mood and anxiety. Methods Twenty healthy men (n = 6) and women (n = 14) with a mean age of 48 years (range: 23–69) were recruited to a randomized controlled cross-over trial. After consumption of a nitrate-rich meal (180 mg of nitrate), we assessed the acute effects of chewing gum, compared to no gum chewing, on (i) salivary nitrate, nitrite and the nitrate reductase ratio (100 x [nitrite]/([nitrate] + [nitrite]); (ii) plasma nitrite, S-nitrosothiols and other nitroso species (RXNO); (iii) endothelial function (measured by flow mediated dilatation); (iv) BP; (v) neurocognitive performance; (vi) mood; and (vii) anxiety. Results Consumption of the nitrate-rich meal resulted in a significant increase in markers of nitrate metabolism. A significantly higher peak flow mediated dilatation was observed with chewing compared to no chewing (baseline adjusted mean difference: 1.10%, 95% CI: 0.06, 2.14; p = 0.038) after the nitrate-rich meal. A significant small increase in systolic BP, diastolic BP and heart rate were observed with chewing compared to no chewing after the nitrate-rich meal. The study did not observe increased oral reduction of nitrate to nitrite and NO, or improvements in neurocognitive performance, mood or anxiety with chewing compared to no chewing. Conclusion Chewing gum after a nitrate-rich meal resulted in an acute improvement in endothelial function and a small increase in BP but did not result in acute effects on neurocognitive function, mood or anxiety.

The endogenous and exogenous brain-derived neurotrophic factor plays pivotal roles in the pathogenesis of stroke onset in high salt-loaded hypertensive rats.

Brain-derived neurotrophic factor (BDNF) is known to have neuroprotective effects on multiple neurovascular diseases especially poststroke recovery. On the other hand, BDNF reported to increase blood pressure (BP) which is one of the major risk factors for stroke onset. To clarify the conflicting effects on stroke onset, we examined the expression of endogenous BDNF in relation to stroke onset. In addition, we explored the effect of exogenous central BDNF against stroke onset and all-cause mortality as the primary endpoint and BP as the secondary object in hypertensive rats with high-salt diet. In experiment 1, male spontaneously hypertensive stroke-prone rats (SHRSP) were fed a 0.3% (n=8) or an 8% (n=22) sodium diet (Na) through 28days. The SHRSP with 8% Na showed significant increase of stroke onset, all-cause mortality, upregulation of reactive astrocytes, and disruption of blood-brain barrier. BDNF in the rats with 8% Na was significantly upregulated and mainly expressed in reactive astrocytes, whereas phosphorylated tropomyosin-related kinase B did not change by the rich BDNF. In experiment 2, male SHRSP were treated with continuous intracerebroventricular injection of 2.1μg/day BDNF (n=10) or the vehicle (Phosphate buffer saline; n=10) and fed an 8% Na through 24days. Exogenous central BDNF induced significant increase of BP and heart rate, and exhibited higher stroke onset and all-cause mortality compared with vehicle group. The present study demonstrated that endogenous BDNF were significantly produced in reactive astrocytes in relation to stroke onset regardless of neuroprotection. In addition, exogenous central BDNF increased BP which might be associated with sympathetic nerve activity and provided unfavorable effects on the prognosis of hypertensive rats. As BDNF is still potentially a good candidate for the treatment of neurovascular diseases, we suggest that hypertensive patients need care for the elevation of BP in the clinical trials of BDNF.

Hemodynamic Changes Associated With Transcervical Laryngeal Injection of Botulinum Toxin

Laryngeal dystonia is a chronic neurologic disorder characterized by intention-induced spasms of the vocal folds driven by aberrant central motor processing. The use of in-office transcervical botulinum toxin injection for the treatment of laryngeal disorders, such as laryngeal dystonia, has been deemed safe and efficacious. There is, however, no available data outlining the hemodynamic changes experienced by patients undergoing this frequently performed procedure. One hundred and one patients diagnosed with laryngeal dystonia were enrolled in this prospective study. These patients underwent transcervical laryngeal botulinum toxin injection to address their dysphonia. Vital signs where acquired prior to, and at the time of injection. Alterations in these parameters were then evaluated for statistical significance. Statistically significant increases in mean heart rate (5.8 ± 10.8 bpm, P < 0.0001), systolic blood pressure and diastolic blood pressure (7.0 ± 9.5 mm Hg, P < 0.0001; 8.7 ± 14.7 mm Hg, P < 0.0001) were discovered. No statistically significant difference in oxygen saturation was noted and no patients in the study faced major adverse outcomes. Though these findings may not have related to clinically significant complication, our study demonstrates the importance of understanding potential stressors in a procedure routinely performed by laryngologists. This may result in more careful patient selection, alterations in procedure, and improved safety by acting in a timely fashion if alarming changes in hemodynamic parameters are noted.

Adverse Cardiovascular Effects of Phenylephrine Eye Drops Combined With Intravenous Atropine.

Background: Phenylephrine and atropine can cause serious adverse effects when applied in combination. We investigated the effect of phenylephrine eye drops combined with intravenous atropine on the cardiovascular system in patients under general anesthesia undergoing intraocular surgery. Methods: The effects of the drugs were observed through clinical study. Thirteen patients undergoing intraocular surgery under general anesthesia were observed in this study; all were injected intravenously with atropine due to the oculocardiac reflex during surgery. To study the combination of drugs, an in vivo study was performed on rats. Seventy-two standard deviation rats that received phenylephrine eye drops and intravenous atropine treatment under general anesthesia were assessed, of which 18 treated with these drugs simultaneously were administered normal saline, neostigmine or esmolol. Blood pressure and heart rate were recorded and analyzed. Findings: The age of the patients ranged from seven to 14 years old with an average age of 10.7 years old, and 11 patients were male. In patients, 5% phenylephrine eye drops combined with intravenous atropine led to a significant heart rate increase and the increase lasted 20 min. The significant increase in diastolic blood pressure and systolic blood pressure lasted for 15 and 25 min, respectively. From five to 25 min after intravenous atropine treatment, the systolic blood pressure and diastolic blood pressure were both more than 20% higher than that at baseline. In rats, the changes in blood pressure and heart rate were independent of the phenylephrine and atropine administration sequence but were related to the administration time interval. The neostigmine group showed a significant decrease in blood pressure after the increase from the administration of phenylephrine and atropine. Interpretation: Phenylephrine eye drops combined with intravenous atropine have obvious cardiovascular effects that can be reversed by neostigmine. This drug combination should be used carefully for ophthalmic surgery, especially in patients with cardio-cerebrovascular diseases.

HEMODYNAMICS AND HEART RATE VARIABILITY UNDER ORTHOSTATIC CHALLENGE TEST IN YOUNG CAUCASIAN MEN: PART 1

Aim: To study hemodynamics and heart rate variability in response to an orthostatic challenge test among young Caucasian men born in the Russian Far North. Methods: Altogether, 172 healthy young men born in the Russian Far North comprised the sample. Cardiohemodynamic parameters in response to an active orthostatic test were studied using "Varicard" device and a tonometer. Results: A significant increase in heart rate, diastolic pressure, blood flow volume per minute, and reduction in systolic flow were observed among residents of the coastal areas as compared to the subjects from the continental areas. Young men of the coastal zone did not show any changes in the total peripheral vascular resistance during the test while the participants of the continental area showed a significant decrease in this indicator, which was most likely a compensatory reaction aimed at maintaining a sufficiently high stroke volume of blood as one of the mechanisms that proved to not allow the development of vasovagal syncope on the background of inadequate activation of the parasympathetic component and a decrease of the sympathetic regulation. It was revealed that the residents of the coastal zone demonstrated more adequate autonomic provision of hemodynamics in response to the orthostatic challenge test by reducing the activity of the parasympathetic link and the relative increase of the sympathetic regulation. The subjects of the intracontinental area tended to develop postural hypotension in response to the test, with a vagotonic type of reactivity and fewer correlations of cardiac hemodynamics with heart rate variability. Conclusion: Our results suggest that young men from the ontinental area develop a negative effect of synergistic amplification of dysregulatory manifestations of hemodynamic changes, autonomous and central contours of autonomic regulation, which can be considered a consequence of the allostatic adaptive tension caused by the particular area of residence.

Effect of short-term variation in air quality index on cardiorespiratory parameters of non-smoking healthy adults during Diwali in Delhi

Background: The adverse impact of air pollution on the human body, particularly on the cardiorespiratory functions, is known and well documented in the past studies. However, limited literature is available on the specific impact of short-term variation in air quality index (AQI) and PM2.5 on the cardiorespiratory functions of young healthy individuals. This is invariably experienced around the festival of Diwali (due to bursting of crackers). This study aims to analyze the adverse impact of such short-term exposure to poor quality air on our cardiorespiratory functions and to suggest specific measures to limit these ill effects. Aim and Objective: This study aims to study the effect of AQI and PM2.5 on pulmonary function test (PFT), heart rate (HR), and blood pressure (BP) in normal non-smoking subjects pre- and post-Diwali. Materials and Methods: This study was done in the Department of Physiology, Maulana Azad Medical College, New Delhi, around the Diwali period in 2019. Subjects were recruited from the general population. This study has been performed on 30 subjects. PFT, HR, and BP measurements of all the subjects were recorded 3 days before Diwali, next day of Diwali, and on the 3rd day of Diwali. AQI and PM2.5 were measured using the System of Air Quality and Weather Forecasting and Research during the above-mentioned 3 specific days. Statistical analysis was done using SPSS-22 statistical software. The two groups were compared using paired Student’s t-test and P < 0.05 will be considered statistically significant. The data were presented as mean ± standard deviation. Results: There was a significant (P < 0.05) decrease in forced expiratory flow at 25 and 75% immediately next day of Diwali. When means of PFT parameters were compared between pre-Diwali and 3rd day of Diwali, all the PFT parameters were significantly decreased. There was a significant increase in HR immediately next day of Diwali. There was a significant increase in HR and systolic BP on the 3rd day of Diwali. Conclusion: Even the short-term exposure of acute surge in AQI and PM2.5 causes adverse effect on cardiorespiratory system of normal healthy adults.