Spectral Analysis Of Heart Rate Variability Research Articles

Gastric myoelectric activity during cisplatin-induced acute and delayed emesis reveals a temporal impairment of slow waves in ferrets: effects not reversed by the GLP-1 receptor antagonist, exendin (9-39).

Preclinical studies show that the glucagon-like peptide-1 (GLP-1) receptor antagonist, exendin (9-39), can reduce acute emesis induced by cisplatin. In the present study, we investigate the effect of exendin (9-39) (100 nmol/24 h, i.c.v), on cisplatin (5 mg/kg, i.p.)-induced acute and delayed emesis and changes indicative of ‘nausea’ in ferrets. Cisplatin induced 37.2 ± 2.3 and 59.0 ± 7.7 retches + vomits during the 0-24 (acute) and 24-72 h (delayed) periods, respectively. Cisplatin also increased (P<0.05) the dominant frequency of gastric myoelectric activity from 9.4 ± 0.1 to 10.4 ± 0.41 cpm and decreased the dominant power (DP) during acute emesis; there was a reduction in the % power of normogastria and an increase in the % power of tachygastria; food and water intake was reduced. DP decreased further during delayed emesis, where normogastria predominated. Advanced multifractal detrended fluctuation analysis revealed that the slow wave signal shape became more simplistic during delayed emesis. Cisplatin did not affect blood pressure (BP), but transiently increased heart rate, and decreased heart rate variability (HRV) during acute emesis; HRV spectral analysis indicated a shift to ‘sympathetic dominance’. A hyperthermic response was seen during acute emesis, but hypothermia occurred during delayed emesis and there was also a decrease in HR. Exendin (9-39) did not improve feeding and drinking but reduced cisplatin-induced acute emesis by ~59 % (P<0.05) and antagonised the hypothermic response (P<0.05); systolic, diastolic and mean arterial BP increased during the delayed phase. In conclusion, blocking GLP-1 receptors in the brain reduces cisplatin-induced acute but not delayed emesis. Restoring power and structure to slow waves may represent a novel approach to treat the side effects of chemotherapy.

Esmolol pretreatment attenuates heart rate increase and parasympathetic inhibition during rapid increases in desflurane concentration: A preliminary randomized study.

Background:Rapid increases in desflurane concentration can transiently increase the heart rate (HR). Esmolol possesses a high β1-adrenoceptor selectivity and a short duration of action. This preliminary study aimed at investigating the effects of esmolol on the HR and autonomic modulation during a desflurane-induced HR increase.Methods:American Society of Anesthesiologists physical status I female subjects, aged 20 to 50 years, who were undergoing minor breast surgery were randomly assigned to 2 groups. Rapid increases in desflurane concentration were commenced after induction of anesthesia. Each subject received either i.v. saline (control group) or esmolol 0.5 mg/kg (esmolol group) before desflurane inhalation. Using time-frequency spectral analysis of HR variability, the HR indices were studied at baseline, postinduction, posttreatment, as well as at minimal alveolar concentrations of desflurane reaching 1.0, 1.3, and 1.5. The low frequency (LF) power is influenced by both the sympathetic and parasympathetic activity, whereas the high frequency (HF) power reflects the parasympathetic activity. The LF/HF ratio is thought to reflect either sympathovagal balance or sympathetic modulation.Results:Electrocardiograms for data analysis were obtained from 8 subjects in each group. Rapid increases in desflurane concentration after induction caused a HR increase. Both the corresponding LF and HF powers were low and the LF/HF ratio remained unchanged. This indicates that the desflurane-induced HR increase may be attributed to parasympathetic inhibition and may be independent of sympathetic activation. Esmolol pretreatment effectively attenuated desflurane-induced HR increase. Moreover, subjects receiving esmolol pretreatment had increased LF and HF powers, but did not have changes in their LF/HF ratios, as compared to those without esmolol.Conclusion:Esmolol pretreatment attenuates HR increase and parasympathetic inhibition during rapid increases in desflurane concentration.

Effects of inspiratory muscle training on cardiovascular autonomic control: A systematic review.

To carry out a systematic review to determine if inspiratory muscle training (IMT) promotes changes in cardiovascular autonomic responses in humans. The methodology followed the PRISMA statement for reporting systematic review analysis. MEDLINE, PEDro, SCOPUS and PubMed electronic databases were searched from the inception to March 2017. The quality assessment was performed using a PEDro scale. The articles were included if: (1) primary objective was related to the effects of IMT on the cardiovascular autonomic nervous system, and (2) randomized clinical trials and quasi-experimental studies. Exclusion criteria were reviews, short communications, letters, case studies, guidelines, theses, dissertations, qualitative studies, scientific conference abstracts, studies on animals, non-English language articles and articles addressing other breathing techniques. Outcomes evaluated were measures of cardiovascular autonomic control, represented by heart rate variability (HRV) and blood pressure variability (BPV) indexes. The search identified 729 citations and a total of 6 studies were included. The results demonstrated that IMT performed at low intensities can chronically promote an increase in the parasympathetic modulation and/or reduction of sympathetic cardiac modulation in patients with diabetes, hypertension, chronic heart failure and gastroesophageal reflux, when assessed by HRV spectral analysis. However, there was no study which evaluated the effects of IMT on cardiovascular autonomic control assessed by BPV. IMT can promote benefits for cardiac autonomic control, however the heterogeneity of populations associated with different protocols, few studies reported in the literature and the lack of randomized controlled trials make the effects of IMT on cardiovascular autonomic control inconclusive.

Impaired vagal activity to meal in patients with functional dyspepsia and delayed gastric emptying.

ObjectiveThis study was performed to investigate impaired vagal activity to meal in patients with functional dyspepsia (FD) with delayed gastric emptying (GE).MethodsEighty-five patients were studied. GE parameters, including those in the overall and proximal stomach, were measured by GE functional tests at the Department of Nuclear Medicine. Autonomic nervous function was tested by spectral analysis of heart rate variability (HRV). The vagal activity and sympathetic activity were analyzed by recording the power in the high-frequency component (HF), low-frequency component (LF), and LF/HF ratio.ResultsOverall and proximal GE were delayed in 47.2% and 50.9% of the patients, respectively. Spectral analysis of HRV showed that the HF in patients with delayed proximal GE was significantly lower and that the LF/HF ratio was significantly higher than those in patients with normal proximal GE after a meal.ConclusionDelayed proximal GE might be caused by disrupted sympathovagal balance as a result of decreased vagal activity after a meal. Improvement in vagal activity may constitute an effective treatment method for patients with FD.

PP.03.13] HEART RATE VARIABILITY IN ELDERLY HYPERTENSIVE PATIENTS UNDERGOING CORONARY STENTING ON THE BACKGROUND OF ACUTE CORONARY SYNDROME

Objective: To evaluate heart rate variability (HRV) in elderly patients with systolic-diastolic arterial hypertension (AH) after acute coronary syndrome (ACS), undergone coronary angioplasty and stenting. Design and method: The study included 65 elderly patients (mean age - 68,9 ± 6,3 years, men - 38 (58.5%)) with systolic-diastolic AH 1–3 degree and developed ACS requested a coronary angioplasty and stenting during the first 6 hours after the onset of chest pain. ACS with ST-segment elevation was observed in 35 (53.8%) patients, and ACS without ST elevation - 30 (46.2%). Patients received on the background of the use of anticoagulants and antiplatelet agents also a standard anti-ischemic and antihypertensive therapy. All patients in the hospital stage after coronary stenting performed 24 h ECG monitoring with the assessment of HRV. Results: All patients showed positive dynamics in the form of the disappearance of the chest pain, the most of them reached the target blood pressure values. The time-depend analysis had no differences between patients with ST-segment elevation, and without it, showing a decline of HRV in both groups (65,71% vs 76,67%). In contrast, the spectral analysis of HRV in patients with ST-segment elevation showed a statistically significant effect of the predominance of parasympathetic autonomic nervous system (HF = 40,3 ± 14,0% vs 34,0 ± 14,0%, p = 0.048; LF / HF = 1,1 ± 1,0 c.u.. vs 1,4 ± 1,2, p = 0,048). ACS without ST-segment elevation was accompanied by a significant prevalence of the power of very low frequency waves (VLF = 33,0 ± 16,2% vs 26,3 ± 13,1%, p = 0,032), which indicates to a high role of humoral-metabolic mechanisms of the heart rate regulation. Conclusions: The predominance of low HRV in early hospital period, even during the adequate conservative therapy, was found in elderly patients with systolic-diastolic AH after coronary angioplasty with stenting due to the ACS. ACS without ST-segment elevation was accompanied by a significant predominance of humoral-metabolic effects on HRV, it requires an intensification of the therapy with angiotensin-converting enzyme inhibitors / angiotensin receptor blockers in these patients, which based on blood pressure values.

Autonomic nervous system function in adolescent migraineurs.

Migraine is a common and disabling neurological disorder. Studies on the relationship between migraine and the autonomic nervous system (ANS) have been inconclusive. Moreover, pediatric studies are extremely limited. Therefore, the present study investigated interictal ANS function in adolescent migraineurs. We studied 21 patients with migraine and 26 healthy controls. Beat-to-beat blood pressure (BP) and heart rate (HR) were non-invasively and continuously measured in the supine and standing positions. ANS function was evaluated on power spectral analysis of HR variability and diastolic BP (DBP) variability. Heart rate and systolic BP were not different between the two groups in either the supine or standing position. DBP did not differ between groups in the standing position, but was significantly higher in migraineurs in the supine position. The vasoconstrictor index was significantly higher in migraineurs. High-frequency (HF) RR interval variability (RR-HF) and the ratio of the low-frequency (LF) to HF component of RR interval variability (RR-LF/HF) were not different between the two groups in both positions. The LF component of DBP variability (DBP-LF) in the supine position was significantly lower in migraineurs, while DBP-LF during standing in migraineurs was significantly higher than in controls. Migraineurs have significantly lower sympathetic vasomotor activity in the supine position, while sympathetic vasomotor activity was hyperresponsive during standing.

Vagal activity and oxygen saturation response to hypoxia: Effects of aerobic fitness and rating of hypoxia tolerance

Background: A reduction in the inspired oxygen fraction (FiO2) induces a decline in arterial oxygen saturation (SpO2) and changes of heart rate variability (HRV). It has been shown that SpO2 and HRV responses to similar levels of acute normobaric hypoxia are inter-individual variable. Variable response may be influenced by normoxia reached maximal oxygen uptake (VO2max) value. Objective: The primary aim was to assess HRV and the SpO2 response to hypoxia, and examine the association with normoxic VO2max. Methods: Supine HRV and SpO2 were monitored during normobaric hypoxia (FiO2 = 9.6%) for 10 minutes in 28 subjects, aged 23.7 ± 1.7 years. HRV was evaluated by using both spectral and time domain HRV analysis. Low frequency (LF, 0.05-0.15 Hz) and high frequency (HF, 0.15-0.50 Hz) power together with square root of the mean of the squares of the successive differences (rMSSD) were calculated and transformed by natural logarithm (Ln). Based on the SpO2 in hypoxia, subjects were divided into Resistant (RG, SpO2 ≥ 70.9%, n = 14) and Sensitive (SG, SpO2 < 70.9%, n = 14) groups. Perceived hypoxia tolerance was self-scored on a 4-level scale. Results: VO2max was higher in SG (62.4 ± 7.2 ml ⋅ kg-1 ⋅ min-1) compared with RG (55.5 ± 7.1 ml ⋅ kg-1 ⋅ min-1, p = .017, d = 0.97). A significant relationship (r = -.45, p = .017) between hypoxic-normoxic difference in SpO2 and normoxic VO2max level was found. Vagal activity (Ln rMSSD) was significantly decreased (SG: p < .001, d = 2.64; RG: p < .001, d = 1.22), while sympathetic activity (Ln LF/HF) was relatively increased (p < .001, d = -1.40) in only the SG during hypoxia. Conclusions: Results show that subjects with a higher aerobic capacity exhibited a greater decline in SpO2, accompanied by greater autonomic cardiac disturbances during hypoxia. The SpO2 reduction was associated with perceived hypoxia comfort/discomfort. The hypoxia discomfort state was accompanied by a greater withdrawal in cardiac vagal activity.

Spectral heart rate variability and selected biochemical markers for autonomic activity in rats under pentobarbital anesthesia

Abstract Introduction Autonomic nervous system (ANS) function can be evaluated by analysis of heart rate variability (HRV) and plasma concentration of noradrenaline (NA). Recent studies identified potential, biochemical markers of the ANS activity, including selected co-transmitters, released from either sympathetic (e.g. neuropeptide Y – NPY) or parasympathetic (e.g. vasoactive intestinal peptide – VIP) fibers. Aim The aim of the study was to analyze HRV recordings and to determine plasma level of NA, NPY and VIP in 3–12 months males and females rats under pentobarbital anesthesia. Moreover, our goal was to determine overall and gender-dependent correlation between the HRV indices and abovementioned compounds. Material and methods The experiment included 36 rats with different autonomic tone related to age and gender. Spectral HRV analysis was applied and NA, NPY and VIP were measured by ELISA. Results and discussion Male rats were characterized by significantly higher values of selected HRV indices: total power (TP), very low frequency (VLF) and high frequency (HF) and plasma concentrations of both analyzed neuropeptides comparing to female ones. Similar to the overall assessment, both males and females showed significant correlations between NA and TP, VLF and LF. Moreover, male rats (but not female ones) presented with significant moderate correlations between NPY and LF, VIP and TP, HF and normalized HF (nHF). Conclusions Our preliminary findings imply that NA correlates with global autonomic activity (TP) and with the values of sympathetically-driven components (VLF and LF). Furthermore, VIP seems to correlate with specific measures of parasympathetic drive (HF and nHF), but only in male rats.

Gender Differences in Heart Rate Variability Among Individuals Undergoing Regular Resistance Training Preliminary observations.

Frequency-domain analysis of heart rate variability (HRV) is an effective tool to evaluate autonomic balance. This study aimed to investigate gender differences in HRV among individuals undergoing regular resistance training. This preliminary cross-sectional study was conducted from April to September 2016 in João Pessoa, Paraíba, Brazil. The low-frequency (LF), high-frequency (HF) and LF/HF ratio components of HRV spectral analysis were analysed among 22 men and 27 women undergoing regular resistance training. Among the male participants, the LF component was significantly increased compared to females in both the supine (1,171 ± 192 versus 545 ± 74 ms2; P = 0.0067) and upright (1,824 ± 260 versus 738 ± 133; P = 0.0011) positions. The LF/HF ratio was also significantly increased in both positions among male participants (P <0.0500 each). These preliminary data suggest a possible gender difference in the HRV of individuals undergoing resistance training.

Compression at Myofascial Trigger Point on Chronic Neck Pain Provides Pain Relief through the Prefrontal Cortex and Autonomic Nervous System: A Pilot Study.

Compression at myofascial trigger points (MTrPs), known as “ischemic compression,” has been reported to provide immediate relief of musculoskeletal pain and reduce the sympathetic activity that exacerbates chronic pain. We conducted a pilot study to investigate the possible involvement of the prefrontal cortex in pain relief obtained by MTrP compression in the present study, and analyzed the relationships among prefrontal hemodynamic activity, activity of the autonomic nervous system, and subjective pain in patients with chronic neck pain, with and without MTrP compression. Twenty-one female subjects with chronic neck pain were randomly assigned to two groups: MTrP compression (n = 11) or Non-MTrP compression (n = 10). Compression for 30 s was conducted 4 times. During the experiment, prefrontal hemodynamic activity [changes in Oxy-hemoglobin (Hb), Deoxy-Hb, and Total-Hb concentrations] and autonomic activity based on heart rate variability (HRV) were monitored by using near infrared spectroscopy (NIRS) and electrocardiography (ECG), respectively. The results indicated that MTrP compression significantly reduced subjective pain compared with Non-MTrP compression. The spectral frequency-domain analyses of HRV indicated that a low frequency (LF) component of HRV was decreased, and a high frequency (HF) component of HRV was increased during MTrP compression, while LF/HF ratio was decreased during MTrP compression. In addition, prefrontal hemodynamic activity was significantly decreased during MTrP compression compared with Non-MTrP compression. Furthermore, changes in autonomic activity were significantly correlated with changes in subjective pain and prefrontal hemodynamic activity. Along with previous studies indicating a role for sympathetic activity in the exacerbation of chronic pain, the present results suggest that MTrP compression in the neck region alters the activity of the autonomic nervous system via the prefrontal cortex to reduce subjective pain.

A composite autonomic index as unitary metric for heart rate variability: a proof of concept.

This study addresses whether a unitary cardiac autonomic nervous system index (ANSI), obtained combining multiple metrics from heart rate variability (HRV) into a radar plot could provide an easy appreciation of autonomic performance in a clinical setting. Data are standardized using percentile ranking of autonomic proxies from a relatively large reference population (n = 1593, age 39 ± 13 years). Autonomic indices are obtained from autoregressive spectral analysis of (ECG derived) HRV at rest and during standing up. A reduced ANSI (using RR, RR variance and rest-stand difference of LFnu) is then constructed as a radar plot, quantified according to its combined area and tested against different risk subgroups. With growing risk profile, there is a marked reduction of the rank value of ANSI, quantified individually by the radar plot area. The practical usefulness of the approach was tested in small groups of additional subjects putatively characterized by elevated or poor autonomic performance. Data show that elite endurance athletes are characterized by elevated values of ANSI (80·6 ± 14·9, P < 0·001) while subjects with either Type 1 or Type 2 diabetes show lower values (DM1 = 37·0 ± 18·9 and DM2 = 26·8 ± 23·3, P = 0·002), and patients with coronary artery disease (CAD) represent a nadir (17 ± 20, P < 0·001). This observational study shows the feasibility of testing simpler metrics of cardiac autonomic regulation based on a multivariate unitary index in a preventive setting. This simple approach might foster a wider application of HRV in the clinical arena, and permit an easier appreciation of autonomic performance.

Left Recumbent Position Decreases Heart Rate without Alterations in Cardiac Autonomic Nervous System Activity in Healthy Young Adults.

Some studies have reported that recumbent position may have advantages in patients with heart disease and in pregnancy. However, it remains controversial whether recumbent position affects autonomic nervous system activity and hemodynamics in healthy adults. The aim of this study was to evaluate alterations in heart rate variability (HRV) and hemodynamics in the supine, left recumbent and right recumbent positions in healthy young adults. A total of 80 participants aged 22.8 ± 3.1 years were enrolled in this observational study. Fifty-eight volunteers (29 men and 29 women) maintained the supine position followed by the left and right recumbent positions, while electrocardiographic data were recorded for spectral analysis of HRV to assess cardiac vagal nerve and sympathetic nerve activities. The heart rate (HR) was significantly lower in the left recumbent position than in the other positions. There were no statistically significant differences in HRV among the three positions. Considering the possibility that the echographic procedure affects autonomic nervous system (ANS) activity, the other 22 participants (11 men and 11 women) underwent an echographic evaluation of hemodynamics in the heart and inferior vena cava (IVC) across the three positions. Although a low HR was also observed, there were no statistically significant differences in the IVC or the heart blood volume between the supine and the left recumbent positions. A postural change to the left recumbent position does not affect the cardiac blood circulation or ANS activity, though it does decrease HR in healthy young adults. This finding indicates that the lower HR in the left recumbent position is not attributable to the ANS activity.

The Impact of Menstrual Cycle Phases on Cardiac Autonomic Nervous System Activity: An Observational Study Considering Lifestyle (Diet, Physical Activity, and Sleep) among Female College Students

Studies examining the impact of menstrual cycle phases on the cardiac autonomic nervous system have produced inconsistent results. This study aimed to investigate this relationship, controlling for the confounding effects of diet, physical activity, and sleep, which can be affected by the menstrual cycle. Fifteen female college students with regular menses were enrolled. Data regarding 24-h heart rate variability (HRV), dietary intake, eating behavior, menstrual distress, and sleep and activity parameters were obtained during the follicular and luteal phases. Power spectral analysis of HRV was used to calculate low-frequency (0.04-0.15 Hz, LF), high-frequency (>0.15 Hz, HF), and total spectral power (TP). Cardiac sympathetic and parasympathetic nervous system activity indicators were evaluated as LF/HF and HF/TP, respectively. Intake of protein and fat, as well as total sleep time and number of awakenings, were higher in the luteal phase than in the follicular phase (p<0.05). Tendencies for increased mean activity counts, emotional eating scores, and behavioral change scores in the Menstrual Distress Questionnaire were observed in the luteal phase (p<0.10). Although LF/HF was higher in the luteal phase (p=0.036), the relationship was weakened after controlling for diet, physical activity, and sleep (p=0.113). Our findings suggest that altering sympathetic nervous system activity during the menstrual cycle was not independent from major lifestyle factors (diet, physical activity, and sleep). Menstrual cycle phase and changes of these parameters should be considered when assessing the cardiac autonomic function among menstruating woman.

Autism spectrum disorder is associated with autonomic underarousal.

Autism spectrum disorder (ASD) is a serious neurodevelopmental disorder, associated with autonomic dysregulation. However, the pathomechanism leading to autonomic abnormalities is still unclear. The aim of this study was to assess autonomic nervous system (ANS) activity during baseline in homogenous group of autistic children using electrodermal activity (EDA), as an index of sympathetic activity and short-term heart rate variability (HRV) reflecting predominantly cardiac vagal control. Fifteen ASD boys and 15 healthy age-matched boys at the age of 7-15 years were examined. The continuous EDA and ECG were recorded during resting phase in a supine position. Evaluated parameters: EDA amplitude (microS), RR interval, spectral power, peak frequency and power spectral density in low (LF-HRV: 0.04-0.15 Hz) and high-frequency (HF-HRV: 0.15-0.4 Hz) bands of HRV spectral analysis. In ASD group we found significantly shortened RR intervals (729+/-20 ms vs. 843+/-30 ms, p=0.005), lower mean EDA (0.66+/-0.13 microS vs. 1.66+/-0.42 microS, p=0.033), reduced spectral activity and power spectral density in HF-HRV compared to controls (2.93+/-0.12 ms(2) vs. 3.38+/-0.10 ms(2), p=0.01; 4.12+/-0.10 ms(2)/Hz vs. 4.56+/-0.11 ms(2)/Hz, p=0.008, respectively). We suggest that impairment in resting autonomic regulation associated with ASD could represent an important pathomechanism leading to potential cardiovascular complications in ASD.

Somatic, Endurance Performance and Heart Rate Variability Profiles of Professional Soccer Players Grouped According to Age

This cross-sectional study compared somatic, endurance performance determinants and heart rate variability (HRV) profiles of professional soccer players divided into different age groups: GI (17–19.9 years; n = 23), GII (20–24.9 years; n = 45), GIII (25–29.9 years; n = 30), and GIV (30–39 years; n = 26). Players underwent somatic and HRV assessment and maximal exercise testing. HRV was analyzed by spectral analysis of HRV, and high (HF) and low (LF) frequency power was transformed by a natural logarithm (Ln). Players in GIV (83 ± 7 kg) were heavier (p < 0.05) compared to both GI (73 ± 6 kg), and GII (78 ± 6 kg). Significantly lower maximal oxygen uptake (VO2max, ml•kg-1•min-1) was observed for GIV (56.6 ± 3.8) compared to GI (59.6 ± 3.9), GII (59.4 ± 4.2) and GIV (59.7 ± 4.1). All agegroups, except for GII, demonstrated comparable relative maximal power output (Pmax). For supine HRV, significantly lower Ln HF (ms2) was identified in both GIII (7.1 ± 0.8) and GIV (6.9 ± 1.0) compared to GI (7.9 ± 0.6) and GII (7.7 ± 0.9). In conclusion, soccer players aged >25 years showed negligible differences in Pmax unlike the age group differences demonstrated in VO2max. A shift towards relative sympathetic dominance, particularly due to reduced vagal activity, was apparent after approximately 8 years of competing at the professional level.

An Objective Screening Method for Major Depressive Disorder Using Logistic Regression Analysis of Heart Rate Variability Data Obtained in a Mental Task Paradigm.

Heart rate variability (HRV) has been intensively studied as a promising biological marker of major depressive disorder (MDD). Our previous study confirmed that autonomic activity and reactivity in depression revealed by HRV during rest and mental task (MT) conditions can be used as diagnostic measures and in clinical evaluation. In this study, logistic regression analysis (LRA) was utilized for the classification and prediction of MDD based on HRV data obtained in an MT paradigm. Power spectral analysis of HRV on R-R intervals before, during, and after an MT (random number generation) was performed in 44 drug-naïve patients with MDD and 47 healthy control subjects at Department of Psychiatry in Shizuoka Saiseikai General Hospital. Logit scores of LRA determined by HRV indices and heart rates discriminated patients with MDD from healthy subjects. The high frequency (HF) component of HRV and the ratio of the low frequency (LF) component to the HF component (LF/HF) correspond to parasympathetic and sympathovagal balance, respectively. The LRA achieved a sensitivity and specificity of 80.0 and 79.0%, respectively, at an optimum cutoff logit score (0.28). Misclassifications occurred only when the logit score was close to the cutoff score. Logit scores also correlated significantly with subjective self-rating depression scale scores (p < 0.05). HRV indices recorded during a MT may be an objective tool for screening patients with MDD in psychiatric practice. The proposed method appears promising for not only objective and rapid MDD screening but also evaluation of its severity.

Chronic mercury exposure impairs the sympathovagal control of the rat heart

Mercury is known to cause harmful neural effects affecting the cardiovascular system. Here, we evaluated the chronic effects of low-dose mercury exposure on the autonomic control of the cardiovascular system. Wistar rats were treated for 30days with HgCl2 (1st dose 4.6μg/kg followed by 0.07μg/kg per day, intramuscular) or saline. The femoral artery and vein were then cannulated for evaluation of autonomic control of the hemodynamic function, which was evaluated in awake rats. The following tests were performed: baroreflex sensitivity, Von Bezold-Jarisch reflex, heart rate variability (HRV) and pharmacological blockade with methylatropine and atenolol to test the autonomic tone of the heart. Exposure to HgCl2 for 30days slightly increased the mean arterial pressure and heart rate (HR). There was a significant reduction in the baroreflex gain of animals exposed to HgCl2 . Moreover, haemodynamic responses to the activation of the Von Bezold-Jarisch reflex were also reduced. The changes in the spectral analysis of HRV suggested a shift in the sympathovagal balance toward a sympathetic predominance after mercury exposure, which was confirmed by autonomic pharmacological blockade in the HgCl2 group. This group also exhibited reduced intrinsic HR after the double block suggesting that the pacemaker activity of the sinus node was also affected. These findings suggested that the autonomic modulation of the heart was significantly altered by chronic mercury exposure, thus reinforcing that even at low concentrations such exposure might be associated with increased cardiovascular risk.

Abstract P196: Effects of the Physiological Increase in Angiotensin-converting Enzyme in Acute Myocardial Infarction

The angiotensin converting enzyme (ACE) act in the production of ANG II and degradation of bradykinin. It is believed that higher levels of ACE could modulate susceptibility to coronary occlusion. To investigate this possibility we used adult males mice genetically modified to express different concentrations of ACE similar to that found in humans. Animals (1, 2 or three copies of ACE gene; n = 6 each group) were subjected to acute myocardial infarction (AMI) and evaluated 7 days after. Systolic, diastolic, and mean blood pressure (BP), heart rate, heart rate variability (HRV) were evaluated as well as cardiac function by echocardiography. Regarding hemodynamic data, AMI induced no difference in systolic, diastolic and mean BP of diferente gene copies mice (ACE1: 74.02 ± 3.0; ACE2: 108.65 ± 2.8; ACE3: 102.07 ± 4.1mmHg). Regarding heart rate it was observed a reduction in 3 copies group (ACE1: 654.51 ± 26.34; ACE2: 668.22 ± 10; ACE3: 534.11 ± 33.4 BPM). The heart rate variability evaluated by SDNN (ACE1: 5.16 ± 0.93; ACE2: 5.84 ± 1:32; ACE3: 7.69 ± 1.4 ms), RMSSD (ACE1: 5.91 ± 0.69; ACE2: 5.7 ± 1:14; ACE3: 6.78 ± 1.2ms), and the total variance (ACE1: 30 ± 12.4; ACE2: 37 ± 13.8; ACE3: 69.9 ± 25.6 ms) was higher in the ACE 3 infarcted group. Regarding the spectral analysis of HRV a higher sympathetic modulation (ACE1: 5.14 ± 3; ACE2: 7.2 ± 2.8; ACE3: 12.9 ± 4.1ms 2 ) and a lower parasympathetic modulation (ACE1: 7 ± 2; ACE2: 8.6 ± 3.2; ACE3: 5.5 ± 2.8 ms 2 ) were observed in ACE 3 infarcted mice. The variability of the BP (ACE1: 18.7 ± 6.2; ACE2: 14.85 ± 1.6; ACE3: 13.76 ± 4.2 mmHg 2 ) and the sympathetic modulation component of the vessels were reduced in the ACE 3 AMI group (ACE1: 60.5 ± 6.2; ACE2: 54.6 ± 1.7; ACE3: 53 ± 3.3 mmHg 2 ). Echocardiographic data showed diastolic dysfunction expressed by E / A ratio (ACE1: 3.40 ± 0.67; ACE2: 3:02 ± 1:36; ACE3: 2.0 ± 0.75) and increase in FAC - Fractional Area Change (ACE1: 27.9 ± 4.5; ACE2: 26.4 ± 5.7; ACE3: 33.5 ± 1.3) in the ACE 3 group after AMI. Our data suggest that increasing the number of ACE gene copies may promote autonomic imbalance evidenced by increased sympathetic modulation and the reduction of parasympathetic modulation of the cardiovascular system as well as the impairment of the diastolic function.

C-type natriuretic peptide and natriuretic peptide receptor B signalling inhibits cardiac sympathetic neurotransmission and autonomic function.

AimsB-type natriuretic peptide (BNP)–natriuretic peptide receptor A (NPR-A) receptor signalling inhibits cardiac sympathetic neurotransmission, although C-type natriuretic peptide (CNP) is the predominant neuropeptide of the nervous system with expression in the heart and vasculature. We hypothesized that CNP acts similarly to BNP, and that transgenic rats (TGRs) with neuron-specific overexpression of a dominant negative NPR-B receptor would develop heightened sympathetic drive.Methods and resultsMean arterial pressure and heart rate (HR) were significantly (P < 0.05) elevated in freely moving TGRs (n = 9) compared with Sprague Dawley (SD) controls (n = 10). TGR had impaired left ventricular systolic function and spectral analysis of HR variability suggested a shift towards sympathoexcitation. Immunohistochemistry demonstrated co-staining of NPR-B with tyrosine hydroxylase in stellate ganglia neurons. In SD rats, CNP (250 nM, n = 8) significantly reduced the tachycardia during right stellate ganglion stimulation (1–7 Hz) in vitro whereas the response to bath-applied norepinephrine (NE, 1 μM, n = 6) remained intact. CNP (250 nM, n = 8) significantly reduced the release of 3H-NE in isolated atria and this was prevented by the NPR-B antagonist P19 (250 nM, n = 6). The neuronal Ca2+ current (n = 6) and intracellular Ca2+ transient (n = 9, using fura-2AM) were also reduced by CNP in isolated stellate neurons. Treatment of the TGR (n = 9) with the sympatholytic clonidine (125 µg/kg per day) significantly reduced mean arterial pressure and HR to levels observed in the SD (n = 9).ConclusionC-type natriuretic peptide reduces cardiac sympathetic neurotransmission via a reduction in neuronal calcium signalling and NE release through the NPR-B receptor. Situations impairing CNP–NPR-B signalling lead to hypertension, tachycardia, and impaired left ventricular systolic function secondary to sympatho-excitation.

Pulse transit time and heart rate variability in sleep staging.

This paper presents a new and robust algorithm for detection of sleep stages by using the lead I of the Electrocardiography (ECG) and a fingertip Photoplethysmography (PPG) sensor, validated using multiple overnight PSG recordings consisting of 20 human subjects (9 insomniac and 11 healthy). Heart Rate Variability (HRV) and Pulse Transit Time (PTT) biomarkers which were extracted from ECG and PPG biosignals then employed to extract features. Distance Weighted k-Nearest Neighbours (DWk-NN) was used as classifier to differentiate sleep epochs. The validation of the algorithm was evaluated by Leave-One-Out-Cross-Validation method. The average accuracy of 73.4% with standard deviation of 6.4 was achieved while the algorithm could distinguish stages 2, 3 of non-rapid eye movement sleep by average sensitivity of almost 80%. The lowest mean sensitivity of 53% was for stage 1. These results demonstrate that an algorithm based on PTT and HRV spectral analysis is able to classify and distinguish sleep stages with high accuracy and sensitivity. In addition the proposed algorithm is capable to be improved and implemented as a wearable, comfortable and cheap instrument for sleep screening.