Cardiovascular Function Tests Research Articles

Single high-dose intravenous injection of Wharton’s jelly-derived mesenchymal stem cell exerts protective effects in a rat model of metabolic syndrome

BackgroundMetabolic syndrome (MetS) is a significant epidemiological problem worldwide. It is a pre-morbid, chronic and low-grade inflammatory disorder that precedes many chronic diseases. Wharton’s jelly-derived mesenchymal stem cells (WJ-MSCs) could be used to treat MetS because they express high regenerative capacity, strong immunomodulatory properties and allogeneic biocompatibility. This study aims to investigate WJ-MSCs as a therapy against MetS in a rat model.MethodsTwenty-four animals were fed with high-fat high-fructose (HFHF) diet ad libitum. After 16 weeks, the animals were randomised into treatment groups (n = 8/group) and received a single intravenous administration of vehicle, that is, 3 × 106 cells/kg or 10 × 106 cells/kg of WJ-MSCs. A healthy animal group (n = 6) fed with a normal diet received the same vehicle as the control (CTRL). All animals were periodically assessed (every 4 weeks) for physical measurements, serum biochemistry, glucose tolerance test, cardiovascular function test and whole-body composition. Post-euthanasia, organs were weighed and processed for histopathology. Serum was collected for C-reactive protein and inflammatory cytokine assay.ResultsThe results between HFHF-treated groups and healthy or HFHF-CTRL did not achieve statistical significance (α = 0.05). The effects of WJ-MSCs were masked by the manifestation of different disease subclusters and continuous supplementation of HFHF diet. Based on secondary analysis, WJ-MSCs had major implications in improving cardiopulmonary morbidities. The lungs, liver and heart show significantly better histopathology in the WJ-MSC-treated groups than in the untreated CTRL group. The cells produced a dose-dependent effect (high dose lasted until week 8) in preventing further metabolic decay in MetS animals.ConclusionsThe establishment of safety and therapeutic proof-of-concept encourages further studies by improving the current therapeutic model.

Predict Sarcopenia Risk in the Elderly by Cardiovascular Function and Heart Rate Variability

Objectives: Preventing and slowing sarcopenia in older people has become an important health issue. Heart rate variability reflects autonomic nervous system balance, and along with cardiovascular function, can indicate potential sarcopenia risk by signaling disruptions in muscle-supporting blood flow and autonomic control. Our objective was to collect simple and non-invasive cardiovascular function measurements and heart rate variability parameters to develop a model for predicting sarcopenia risk. Methods: We conducted a 3-minute cardiovascular function and heart rate variability test and sarcopenia screening (appendicular skeletal muscle index, grip strength, and walking speed) on 418 participants (105 males, 313 females, mean age 73.32±8.81 years) recruited from central Taiwan. Results: Appendicular skeletal muscle index, grip strength, walking speed, cardiovascular function, and heart rate variability had a significant correlation. The key features for predicting sarcopenia risk with logistic regression analysis were age, reflection index, dicrotic elasticity index, and high-frequency power (the overall accuracy was 70.10%; sensitivity was 81.30%; specificity was 54.07%). Conclusions: Simple and non-invasive 3-minute cardiovascular function and heart rate variability test parameters significantly predict sarcopenia risk in older people. This model can be applied to technology devices to detect sarcopenia risk and prevent sarcopenia in older people.

마스크 착용이 학습능력에 미치는 효과

Purpose: The purpose of this study is to investigate the affects of wearing mask on learning ability.
 Methods: A total of 90 college students were included in this study. The participants were divided into three groups: group 1, KF94 mask(n=30); group 2, Dental mask(n=30), and group 3, No mask(n=30). All groups performed cardiovascular function and class concentration test before and after 4 hours of class. All data were analyzed using SPSS window 22.0 version.
 Results: In this study, the difference in cardiovascular function was statistically significant in SpO2 and heart rate(p＜.05). As a result of post-hoc analysis, SpO2 was lower the Dental mask group and the KF mask wearing group than the non-mask wearing group, and lower the KF mask wearing group than the Dental mask group (p<.05). The heart rate was significantly higher in the KF94 mask-wearing group than in the Dental mask-wearing group and the mask-wearing group(p<.05). The difference in class concentration was statistically significant(p＜.05). class concentration was lower the Dental mask group and the KF mask wearing group than the non-mask wearing group, and lower the KF mask wearing group than the Dental mask group(p<.05).
 Conclusion: In order to improve students' concentration in class in the current situation of schools where face-to-face classes are becoming active again, it is suggested to remove the mask or wear a low-resistance mask if there are no individual health problems

Cardiovascular autonomic dysfunction in multiple sclerosis-findings and relationships with clinical outcomes and fatigue severity.

This study evaluates cardiovascular autonomic dysfunction (CAD) in multiple sclerosis (MS) and explores if CAD is related to clinical outcomes and fatigue severity. A total of 53 MS patients (30 relapsing-remitting, RRMS; 23 progressive, PMS) and 30 healthy controls were evaluated. TaskForce® Monitor was used to assess impedance cardiography parameters, heart rate (HRV), and blood pressure (BPV) variability during head-up tilt test (HUTT). Expiration/inspiration (E/I) ratio was assessed in response to a deep breathing test. Fatigue severity was evaluated using Chalder Fatigue Scale (CFQ). Compared to controls, PMS patients were characterized by increased sympathetic-parasympathetic ratio at rest (p < 0.01), decreased resting values of parasympathetic parameters (high-frequency HRV, p < 0.05; E/I ratio, p < 0.001), and index of contractility (p < 0.05), whereas RRMS patients showed reduced E/I ratio (p < 0.01). Compared to RRMS group, PMS patients had higher sympathovagal ratio and lower cardiac inotropy parameters (p < 0.05). No intergroup differences were observed for cardiovascular and autonomic function test parameters after HUTT. PMS and low CFQ physical score were identified as independent predictors of sympathetic hyper-reactivity as measured with HRV. Greater disability and male sex were predictors of diastolic BP increase and reduced cardiac inotropy parameters, and older age was predictor of decreased vagal tone (E/I ratio, high-frequency HRV). Cardiovascular autonomic modulation is altered in MS and highly dependent on disease variant, disability level, fatigue severity, and patients' demographics.

Relationship between Obesity and Sympathetic Nerve Function Status

In order to assess the effect of obesity on sympathetic nervous system a cross-sectional observational study was carried out in the Department of Physiology, Sylhet MAG Osmani Medical College between January 2017 and December 2017. Fifty obese and age-sex matched 50 non-obese subjects were included. Two non-invasive cardiovascular sympathetic function tests like blood pressure response to postural change (orthostatic test) and blood pressure response to sustained handgrip were done to assess sympathetic nerve function status.The fall in systolic blood pressure (SBP) in orthostatic test of obese group (9.02 ± 2.29 mmHg) was significantly higher compared to non-obese group (4.84 ± 0.96) (p&lt;0.001). Increase in diastolic blood pressure (DBP) in handgrip test of obese group (12.36 ± 2.78 mmHg) was significantly lesser than that of non-obese group (20.12 ± 2.64 mmHg) (p&lt;0.001). The results of this study suggested that obese adults have reduced sympathetic activity.

Assessment of cardiovascular sympathetic function tests in premenstrual syndrome patients visiting tertiary care hospital: A case–control study

Background: Premenstrual syndrome (PMS) is a stress-induced disorder and is showing a rising prevalence but its etiopathogenesis is not yet understood. Stress disturbs the balance of the sympathetic and parasympathetic nervous system. Alteration in heart rate and blood pressure is the most important physiological response following stress-induced sympathetic changes. Aims and Objectives: The present study was designed to test the hypothesis of an association between sympathetic functions and PMS and to observe the degree of changes (if any) in these sympathetic functions. The study also aims to provide timely interventions to prevent the development of cardiovascular complications and improve lifestyle. Materials and Methods: A Menstrual Distress Questionnaire was used to evaluate physical, emotional, and behavioral symptoms accompanying the menstrual cycle of the subjects who fulfilled the inclusion criteria. Based on the scores obtained by their questionnaire, subjects with the higher scores formed the PMS group, while the age-matched females with low score served as controls. Cardiovascular sympathetic functions were assessed by standardized, simple, non-invasive tests which included Handgrip test and orthostatic hypotension test. Unpaired Student’s t-test was used for statistical analysis. Results: The results revealed that the sympathetic reactivity is insignificantly higher in PMS group during the follicular phase. During the luteal phase, sympathetic activity is significantly increased. Conclusion: PMS involves psychoneuroendocrinal turmoil, thus early screening of high-risk groups and interventions such as relaxation techniques and lifestyle modification can prevent further cardiovascular complications in patients of high sympathetic responses.

Assessment of parasympathetic cardiovascular activity in primary open-angle glaucoma.

To describe the pattern of quantitative parasympathetic cardiovascular autonomic function among patients with normal-tension glaucoma (NTG) and high-tension primary open-angle glaucoma (HTG) patients. This was cross-sectional study of ninety-two subjects enrolled into three groups: HTG (31 patients), NTG (31 patients) and Control (30 patients). All the participants had anthropometric assessment, ophthalmic examination, baseline cardiovascular examination and the three parasympathetic components of Ewing's battery of autonomic cardiovascular function tests namely heart rate (HR) response to deep breathing, HR response to Valsalva manoeuvre and HR response to standing. The baseline PR intervals were significantly prolonged in HTG (0.18 ± 0.03s) and NTG (0.18 ± 0.04s) groups compared with control (0.15 ± 0.03s) (p = 0.008). The HTG group had a significantly longer mean RR interval (1.09 ± 0.17s) than the NTG group (1.03 ± 0.20s) and control (0.97 ± 0.17s) during the expiratory phase of the HR response to deep breathing test (p = 0.037). The HTG group also had significantly longer mean RR intervals around the 15th beat (p = 0.033) and 30th beats (p = 0.202) post-standing during the HR response to standing test. The HR response to Valsalva manoeuvre test showed a significantly higher mean Valsalva ratio in the NTG group (1.65 ± 0.48) compared to the HTG group (1.45 ± 0.31) and control (1.43 ± 0.25) (p = 0.034). This study demonstrated that normal-tension and high-tension primary open-angle glaucoma have higher parasympathetic cardiovascular activity than normal individuals.

Improved nonclinical safety profile of a novel, highly selective inhibitor of the immunoproteasome subunit LMP7 (M3258)

M3258 is the first selective inhibitor of the immunoproteasome subunit LMP7 (Large multifunctional protease 7) in early clinical development with the potential to improve therapeutic utility in patients of multiple myeloma (MM) or other hematological malignancies. Safety pharmacology studies with M3258 did not reveal any functional impairments of the cardiovascular system in several in vitro tests employing human cardiomyocytes and cardiac ion channels (including hERG), guinea pig heart refractory period and force contraction, and rat aortic contraction as well as in cardiovascular function tests in dogs. Following single dose M3258 administration to rats, no changes were observed on respiratory function by using whole body plethysmography, nor did it change (neuro)behavioral parameters in a battery of tests. Based on pivotal 4-week toxicity studies with daily oral dosing of M3258, the identified key target organs of toxicity were limited to the lympho-hematopoietic system in rats and dogs, and to the intestine with its local lymphoid tissues in dogs only. Importantly, the stomach, nervous system, heart, lungs, and kidneys, that may be part of clinically relevant toxicities as reported for pan-proteasome inhibitors, were spared with M3258. Therefore, it is anticipated that by targeting highly selective and potent inhibition of LMP7, the resulting favorable safety profile of M3258 together with the maintained potent anti-tumor activity as previously reported in mouse MM xenograft models, may translate into an improved benefit-risk profile in MM patients.

Autonomic symptoms, cardiovascular and sudomotor evaluation in de novo type 1 narcolepsy.

To evaluate cardiovascular and sudomotor function during wakefulness and to assess autonomic symptoms in de novo patients with type 1 narcolepsy compared to healthy controls. De novo patients with type 1 narcolepsy (NT1) and healthy controls underwent cardiovascular function tests including head-up tilt test, Valsalva maneuver, deep breathing, hand grip, and cold face, and sudomotor function was assessed through Sudoscan. Autonomic symptoms were investigated using the Scales for Outcomes in Parkinson's Disease-Autonomic Dysfunction (SCOPA-AUT) questionnaire. Twelve de novo patients with NT1 and 14 healthy controls were included. In supine rest condition and at 3min and 10min head-up tilt test, the systolic blood pressure values were significantly higher in the NT1 group than in controls (p < 0.05). A lower Valsalva ratio (p < 0.01), significantly smaller inspiratory-expiratory difference in deep breathing (p < 0.05), and lower delta heart rate in the cold face test (p < 0.01) were also observed in the NT1 group. The mean hand electrochemical skin conductance values were significantly lower (p < 0.05) and the mean SCOPA-AUT total scores were significantly higher in patients with NT1 than in healthy subjects (p < 0.001), with greater involvement of cardiovascular and thermoregulatory items. De novo patients with NT1 exhibit blunted parasympathetic activity during wakefulness, mild sudomotor dysfunction, and a large variety of autonomic symptoms.

Autonomic functions in focal epilepsy: A comparison between lacosamide and carbamazepine monotherapy

ObjectiveSome antiepileptic drugs (AEDs), like sodium channel blockers are significantly associated with autonomic dysfunction in patients with epilepsy. Unlike other sodium-blockers AEDs, lacosamide (LCM) is a third generation AEDs which enhances the slow inactivation of voltage-gated sodium channels. So far, data about LCM on autonomic nervous system are still unknown. This study was designed to investigate cardiovascular autonomic and sudomotor function in patients affected by focal epilepsy on LCM monotherapy, compared to patients treated with carbamazepine (CBZ) monotherapy and healthy subjects. MethodsPatients on LCM underwent autonomic function tests including head up tilt test (HUTT), Valsalva maneuver, deep breathing, hand grip, and cold face. Heart rate variability (HRV) analysis was performed in rest condition and during HUTT. Sudomotor function was assessed through Sudoscan. All results were compared with patients on carbamazepine (CBZ) monotherapy and with healthy subjects. ResultsFourteen patients on LCM monotherapy, 12 patients on CBZ monotherapy and 16 healthy controls were studied. At cardiovascular function tests, delta systolic blood pressure (∆SBP) at 3 min of HUTT and ∆SBP early phase II-late phase II at Valsalva maneuver were significantly lower in CBZ group compared to LCM patients. Spectral analysis of HRV showed no significant differences among LCM, CBZ and control groups. No difference in sudomotor function was found in all three groups. ConclusionsIn conclusion, our findings suggest that LCM and CBZ on monotherapy do not affect autonomic cardiovascular and sudomotor functions compared to controls. Nevertheless, patients on CBZ showed a lower sympathetic reactivity with respect to LCM.

Daytime autonomic activity in idiopathic rapid eye movement sleep behavior disorder: a preliminary study

OjectiveTo investigate cardiovascular and sudomotor autonomic functions in patients with idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD) during wakefulness compared to patients with Parkinson's disease (PD) and healthy subjects. MethodsDrug-naïve iRBD patients, PD patients and healthy controls underwent cardiovascular function tests including head-up tilt test (HUTT), Valsalva maneuver, deep breathing, hand grip, and cold face. Heart rate variability (HRV) analysis was performed in the frequency domain using an autoregressive algorithm in the rest supine condition and during HUTT. Sudomotor function was assessed through Sudoscan. ResultsFourteen iRBD patients, 17 PD patients and 12 healthy controls were included in the study. In the supine resting condition, the baseline values of systolic and diastolic blood pressure and heart rate were comparable in all groups. At Valsalva maneuver, iRBD patients and PD patients showed an overshoot which was significantly lower than controls. In addition, iRBD patients showed a significant reduction of sinus arrhythmia at deep breathing compared to controls. Cardiovascular responses to cold face were similar in the three groups while isometric handgrip was significantly reduced in PD patients with respect to healthy subjects. Spectral analysis of HRV showed no significant differences among iRBD, PD patients and controls in the supine resting condition; whereas during HUTT the low-frequency (LF) component of HRV was significantly higher in controls with respect to iRBD and the high-frequency (HF) component was significantly higher in iRBD patients compared to controls. In addition, a significant increase in the LF/HF ratio in healthy subjects was detected compared to iRBD. Finally, four out of 14 iRBD patients (29%) and nine of 17 PD patients (53%) had a sudomotor dysfunction. ConclusionsOur findings obtained in de novo iRBD and PD patients indicate that some alterations of the autonomic nervous system are shared by both groups of patients, reinforcing the close link between the two pathologies, and show an autonomic fragility during wakefulness in iRBD that mainly arises under stress conditions.

S175. Sleep and autonomic disturbances in fibromyalgia: Cause or consequence?

Fibromyalgia is a major public health problem in all societies with a high impact on health care and total societal costs. Association of sleep and autonomic dysfunctions with fibromyalgia has shown varied results in different studies across the globe. Their extent of association with fibromyalgia and effect on quality of life of patients especially in India is lacking. Present study was done with the objectives to explore the association of autonomic involvement and sleep disturbances in fibromyalgia patients and to see the effect of autonomic changes and sleep disorders on the quality of life of fibromyalgia patients. It was a cross-sectional study enrolling 30 fibromyalgia patients diagnosed by ACR 2010 along with age and gender matched 30 controls. Participants were evaluated for their sleep using Pittsburgh Sleep Quality Index (PSQI) and medical outcomes study sleep scale-R (MOS-12), Quality of life(QOL) by 36 item Short-Form health survey-36v2TM (SF-36V2) and Revised Fibromyalgia Impact Questionnaire (FIQR) (only patients) and autonomic functions by heart rate variability(HRV). Patients also underwent standard autonomic cardiovascular function tests (Ewings battery of test). Ninety percent patients were females. Both groups (patients and control) were comparable in baseline characters and did not differ significantly in their baseline blood pressure and heart rate. Sleep quantity (4.63 h) of patients was far less than controls (6.86 h). Patients scored very poor on all sleep scales and significantly low (p = 0.0001) on all the domains of QOL. There was no difference in HRV of two groups. No difference could be seen between mild FIQR and moderate FIQR group when compared for HRV parameters and other autonomic function tests. Significant correlations were seen between sleep parameters and QOL in patients, both of which became poorer with increasing severity of fibromyalgia. Present study found a strong association between sleep disturbances, poor sleep quality, and poor quality of life in fibromyalgia. Autonomic dysfunctions were absent in mild to moderate grade fibromyalgia patients. Consistently poor and disturbed sleep in FM patients may lead to symptoms of fibromyalgia which together have a deteriorating effect on all the domains of quality of life. Probably, autonomic changes in FMS appear in later stage of disease and may be a consequence rather than cause of disability in FM patients. However, a long-term follow-up study is needed to address these questions as well as to unravel the natural history of FMS.

Does continuous positive airway pressure treatment affect autonomic nervous system in patients with severe obstructive sleep apnea?

ObjectiveThis study is aimed at evaluating whether Continuous Positive Airway Pressure treatment (CPAP) may affect autonomic nervous system (ANS) in male patients with severe obstructive sleep apnea (OSAS). MethodsWe compared autonomic symptoms of de novo severe OSAS patients, OSAS patients on chronic CPAP treatment and healthy controls, using the Scales for Outcome in Parkinson disease-Autonomic (SCOPA-AUT) questionnaire. All groups underwent cardiovascular function tests including head-up tilt test (HUTT), Valsalva maneuver, deep breathing, hand grip and cold face tests. Statistical significance was set at p < 0.05. ResultsTwelve de novo severe OSAS patients, 17 male OSAS on CPAP and 14 controls were studied. The mean SCOPA-AUT total score was significantly higher in de novo OSAS patients compared with controls. Regarding the distinct domains, both de novo OSAS and CPAP group had abnormalities in respect of controls in urinary sphere. In supine rest condition the baseline values of systolic blood pressure were significantly increased in untreated OSAS patients compared with controls, whereas the basal values of diastolic blood pressure were significantly higher in CPAP patients with respect to controls. After ten min of HUTT, diastolic blood pressure changes were significantly higher in controls compared to both OSAS groups. Untreated OSAS patients showed significant different responses at deep breathing compared to controls. Both OSAS groups had a significant reduction of reflex bradycardia at cold face test. ConclusionsOur study shows that both treated and untreated OSAS patients complain of subjective autonomic symptoms like other sleep disorders reinforcing the close relationship between sleep and autonomic activity. Furthermore, cardiovascular reflexes indicate a tendency to hypertension and a reduced sensitivity to stimuli during wakefulness even in OSA patients on CPAP treatment, suggesting potentially permanent autonomic function deficits.

ARM-based Embedded Detection System of Cardiovascular Function Parameters

A cardiovascular function testing system was designed in platform which was built with ARM microprocessor s3c2440 and Linux system, to achieve pulse wave acquisition, feature extraction, index calculation and so on. This article mainly describes the hardware circuit, and describes the touchscreen driver, external ADC driver, and visualization QT-based applications in detail. The system is easy to use, with real-time, low power consumption. Compared with common cardiovascular function test instrument, the results shows that the system can better assess the cardiovascular function, expecially in several key indicators like subendocardial myocardial viability rate and augmentation index, the indicators show good correlations.

Insulin Clearance Is Associated with Hepatic Lipase Activity and Lipid and Adiposity Traits in Mexican Americans.

Reduction in insulin clearance plays an important role in the compensatory response to insulin resistance. Given the importance of this trait to the pathogenesis of diabetes, a deeper understanding of its regulation is warranted. Our goal was to identify metabolic and cardiovascular traits that are independently associated with metabolic clearance rate of insulin (MCRI). We conducted a cross-sectional analysis of metabolic and cardiovascular traits in 765 participants from the Mexican-American Coronary Artery Disease (MACAD) project who had undergone blood sampling, oral glucose tolerance test, euglycemic-hyperinsulinemic clamp, dual-energy X-ray absorptiometry, and carotid ultrasound. We assessed correlations of MCRI with traits from seven domains, including anthropometry, biomarkers, cardiovascular, glucose homeostasis, lipase activity, lipid profile, and liver function tests. We found inverse independent correlations between MCRI and hepatic lipase (P = 0.0004), insulin secretion (P = 0.0002), alanine aminotransferase (P = 0.0045), total fat mass (P = 0.014), and diabetes (P = 0.03). MCRI and apolipoprotein A-I exhibited a positive independent correlation (P = 0.035). These results generate a hypothesis that lipid and adiposity associated traits related to liver function may play a role in insulin clearance.

A case-control study of cardiovascular parasympathetic function tests in offsprings of type 2 diabetes mellitus parents

Background: Type 2 diabetes mellitus (DM) has a strong genetic component. Individuals of a parent with type 2 DM have an increased (40%) risk of diabetes. If both parents have type 2 DM, the risk approaches to 70%. Thus, this study was designed to evaluate cardiovascular parasympathetic functions in offsprings of type 2 diabetic parents. Aims and Objectives: Study was done to compare and observe the degree of changes (if any) in the cardiovascular parasympathetic function tests in the offsprings of diabetic parents (cases) with offsprings of non-diabetic parents (controls) and provides timely lifestyle modifications to prevent the development of diabetes and its complications. Materials and Methods: The cardiovascular parasympathetic function tests were carried out in 50 healthy offsprings of type 2 diabetic parents (study group) and 50 healthy offsprings of non-diabetic parents (control group) in the age range of 18-25 years randomly selected medical and para-medical students. Statistical analysis was done by unpaired Student’s t-test. Results: Study shows decrease in all the three parasympathetic function tests (heart rate variability in response to deep breathing, heart rate variation in response to standing, and valsalva maneuver) in offsprings of type 2 diabetic parents (cases) as compared to non-diabetic parents (controls). However, the results were not statistically significant. Conclusion: Our observations indicate that genetic factors in the form of altered genes could pass from diabetic parents to their offsprings and could manifest as altered response in parasympathetic function tests in healthy offsprings of diabetic parents even before the offsprings developing diabetes.

Comparison of cardiac autonomic neuropathy in asymptomatic T2DM and normal individuals

Introduction: The availability of simple, non-invasive tests for cardiovascular autonomic function has supported an extensive clinical and epidemiologic evolution in the investigation of Cardiac autonomic neuropathy. Such data forms a strong body of evidence in detecting and monitoring impaired autonomic function in patients with diabetes. The proposed study aims at detecting the presence of autonomic neuropathy in an early and possibly stills a reversible phase in Type 2 Diabetes Mellitus (T2DM) individuals in comparison to non T2DM normal individuals. Material and Methods: The cross sectional case control study consisted of 200 subjects, 100 as Cases with T2DM in the age group 35 to 50 years and 100 age and sex matched normal subjects without T2DM as Controls. Resting heart rate, Sinus Arrhythmia and Valsalva Ratio were measured from ECG recorded. Based on these heart rate tests they were grouped into normal, early and definite autonomic neuropathy changes. An informed written consent to participate in the study was taken from the subjects. There was no financial burden on the subjects. The study protocol was approved by the Institutional Ethical Committee. All the quantitative data were summarized and statistically analysed. Results: The basic characteristics with respect to age did not show any significant difference between the T2DM as compared to normals (p

A Multicenter, Randomized, Trial Comparing Urapidil and Nitroglycerin in Multifactor Heart Failure in the Elderly

Multifactor heart failure is a common life-threatening event in elderly patients and often complicated by concomitant hypertension and diabetes mellitus (DM). The aim of this study was to evaluate whether α1-blocker, urapidil, provides additional therapeutic benefits compared to nitroglycerin (NG) in treatment of multifactor heart failure complicated by hypertension and DM in elderly patients. Seventy-two elderly consecutive patients were randomized into 2 groups that received treatment with urapidil or NG. All patients were monitored for blood pressure (BP) and heart rate and received tests for metabolic activity and cardiovascular function. Patients receiving urapidil had significantly lower systolic BP than their counterparts in NG group (P < 0.05). Moreover, patients in urapidil group showed lower N-terminal pro-B-type natriuretic peptide levels but higher ejection fraction (t = 2.206, P < 0.05), cardiac index (t = 3.13, P < 0.05) and left end-diastolic volume (t = -3.104, P < 0.05) compared to NG group. Although both urapidil and NG decreased fasting plasma glucose (FPG) levels, there was no significant difference of FPG levels between these 2 groups. Urapidil demonstrated better efficacy than NG on lowering and stabilizing systolic BP, attenuating cardiac afterload and improving cardiac function. Both NG and urapidil significantly reduced FPG levels in multifactor heart failure patients with DM. Urapidil is a therapeutic option for the multifactor heart failure patients complicated with hypertension and DM.

Research on an anti-motion interference algorithm of blood oxygen saturation based on AC and DC analysis.

There is an urgent need for blood oxygen saturation (SpO2) tests when participants are ambulatory, as in daily activity monitoring, sleep monitoring, or even athletes' cardiovascular function tests. In such situations, measuring equipment needs to be wearable. This restricts the processor volume, and the corresponding algorithm should be microprocessor compatible. This article proposes an anti-motion interference blood oxygen saturation algorithm for the microcontroller based on AC and DC analysis, named de-trended FFT. An experiment was conducted to compare the de-trended FFT algorithm with two other algorithms commonly used in the time and frequency domains. In the experiment, participants' oxygen saturation levels were calculated from Photoplethysmography (PPG) signals that were recorded continuously. Meantime, five types of hand motions were conducted, including hand trembling movements, horizontal hand movements, vertical hand movements, finger tapping, and finger bending, with each state lasting 2 minutes. Results show significant performance of de-trended FFT in SpO2 calculation (P < 0.05), in both accuracy and stability. De-trended FFT stands out in both mean deviation and variance by eliminating trending influence when compared with the other two algorithms. The motion interference's influence on SpO2 calculation mainly comes from the AC component, not the DC.

Chronic dopaminergic treatment in restless legs syndrome: does it affect the autonomic nervous system?

ObjectiveThe link between the autonomic nervous system and restless legs syndrome (RLS) has been recently postulated. Since dopaminergic agents are used as first-line treatment for RLS, the purpose of our study is to verify whether chronic pramipexole treatment could influence the autonomic control of cardiovascular reflexes and heart rate variability (HRV) in RLS during wakefulness. MethodsConsecutive drug naive RLS patients underwent polysomnography (PSG), subjective scales, and cardiovascular function tests including head-up tilt test (HUTT), Valsalva maneuver, deep breathing, handgrip and cold face before and after 3-month pramipexole therapy. HRV analysis was performed in the frequency domain using both autoregressive and fast Fourier transform algorithms in rest supine condition and during HUTT. ResultsTwenty RLS patients reported a significant reduction of RLS symptoms after pramipexole treatment, while PSG did not show significant improvements except for periodic limb movement index. Pramipexole induced a trend to a lower systolic blood pressure and a significant higher variation of systolic and diastolic blood pressure at HUTT. Cardiovascular responses to the other tests were unchanged. No significant differences in HRV spectral analysis between drug naive and treated patients were observed. Moreover, the within-group analysis of HRV between orthostatic and supine position did not show any significant change in sympathetic and parasympathetic components both in the drug naive and pramipexole groups. ConclusionsChronic pramipexole treatment does not seem to affect autonomic balance during wakefulness. Considering that neither PSG data nor autonomic parameters are significantly modified by pramipexole, we hypothesize a non-dopaminergic autonomic dysfunction in RLS.