Total Power Of Heart Rate Variability Research Articles

Differences in the cardiovascular hemodynamic response between the Valsalva and Reverse Valsalva Maneuvers in healthy subjects.

The Valsalva Maneuver (VM) is the first-line treatment for paroxysmal supraventricular tachycardia, but a recent, novel, and efficient tool to restore sinus rhythm has been described, i.e., the Reverse Valsalva (RV). This study aims to compare changes in cardiovascular hemodynamics and autonomic system activity (ANS) based on heart rate variability (HRV) analysis during both maneuvers. Fifteen healthy participants performed the VM and RV maneuvers three times in a sitting position for durations of 15 s and 10 s, respectively. Blood pressure (BP) and heart rate (HR) were continuously monitored before, during and after the tests. Autonomic system activity was evaluated using frequency-domain analysis of HRV. The decrease in HR from baseline to the lowest values, expressed as a ratio, was similar during both maneuvers (0.81 during the RV vs. 0.79 during the VM, p = 0.27). However, the final lowest HR in response to the RV was higher than that in response to the VM, 70/min vs. 59/min (p <0.001). The activation of the autonomic nervous system during the most bradycardic phase of the RV (phase II) and VM (phase IV) showed that the total power of HRV was less prominent during the RV than during the VM (p <0.012), with similar levels of parasympathetic activation. Our results showed less HR slowdown during the RV than during the VM. The changes in HRV parameters during both procedures in particular phases of the RV and VM suggest that the autonomic nervous system is activated alternately, so these tests can be used complementarily in a clinical setting with different results.

Cardiac Autonomic Activity, Personality Traits, and Academic Performance in First-Year Medical Students: A Gender-Specific Relation.

Background It is not always the sincere or hardworking or intelligent student that gets the highest grades. Exploring unknown dimensions that may distinguish academic performance in adolescents/youth migrating from a high school study environment to that of a professional school and in a learning environment without parental supervision for the first time remains important. We hypothesized that cardiac autonomic activity influenced by cognitive domain factors and emotions would predict academic success in them. Further, we investigated which of their personality traits related to academic performance. Exploratory gender-based analysis was included. Methods A prospective cohort study measured first-year medical students' resting heart rate, heart rate variability (HRV), and personality traits (from the self-reported NEO Five-Factor Inventory-3). Spearman's correlation coefficient tested the correlation between the year-end final aggregate marks and assessed parameters, including subgroup analysis based on gender. Regression analyses of variables with academic marks were performed in the entire cohort. Results The aggregate marks of 81 volunteering students (Mage = 18.7, SD = 0.8 years; 42 females, 39 males) as a cohort did not correlate with their resting heart rate or HRV indices. Subgroup analysis revealed a positive correlation between marks and high-frequency power (r = 0.33, p= 0.03) and total power (r = 0.37, p= 0.02) of HRV in females. The marks positively correlated with the personality conscientiousness score (r = 0.32, p= 0.04) and extraversion score (r = 0.34, p= 0.03) in females.Multivariable regression analysis in the entire cohort revealed no significant interactions. Conclusion Academic performance was significantly related to cardiac autonomic modulation and personality traits of conscientiousness and extraversion in female but not male first-year medical students. These resultsindicate a gender-specific difference in the relation between scholastic performance and HRV in adolescents/youth transiting from high school to professional schools and entering a study environment without parental supervision for the first time. Further our data expands the knowledge base of educational psychology among them.

Coping und vegetative Reaktivität bei Aderhautmelanomen

Summary Background We aimed to assess coping and vegetative reactivity in uveal melanoma (UM) patients compared to controls with benign nevi of the uvea. Material and methods In total, 20 patients with recently diagnosed uveal melanoma were recruited and matched for age and gender to 20 controls with benign nevi of the uvea. Heart rate variability (HRV) and blood pressure variability (BPV) were monitored throughout an initial period of rest (POR1), a mental stress test (DT), and another period of rest (POR2). Coping strategies were assessed for both groups using a stress-coping questionnaire. Results The LF/HF ratio (low-/high-frequency component of total spectral power) of HRV showed decreasing values in the UM group and increasing values in controls throughout the measurement sequence (p = 0.025). Diastolic BPV revealed declining values of the low-frequency component in normalized units (LFnu) between POR1 and DT in UM patients compared to rising values between POR1 and DT in controls (p = 0.006). There were no intergroup differences in coping strategies (p &gt; 0.05). Conclusions Coping mechanisms are unaltered in patients with uveal melanoma compared to controls, but vegetative reactivity may show a different pattern once patients are diagnosed.

Overnight Heart Rate Variability During Sleep Disturbance In Peri- And Postmenopausal Women

ABSTRACT Objectives Disturbed sleep, common during the climacteric, is associated with increased sympathetic activity, a cardiovascular risk factor. We evaluated sleep disturbance effect on autonomic nervous function in climacteric women Methods Seventeen perimenopausal and 18 postmenopausal women underwent a sleep study protocol: an adaptation night, a reference night, and a sleep disturbance night, with a hand loosely tied to the bed to allow blood sampling. This procedure was repeated after six months of menopausal hormone therapy (MHT) or placebo. Sleep disturbance and MHT effects on overnight heart rate variability (HRV) were analyzed. Results At baseline, sleep disturbance increased vagal HRV in postmenopausal women, but no changes were seen in perimenopausal women. At six months, sleep disturbance increased total HRV power in the perimenopausal placebo group, and increased nonlinear vagal HRV in the postmenopausal placebo group, but no other changes were seen. MHT did not have any effects on HRV, neither at perimenopause nor at postmenopause. Conclusions External sleep disturbance had only minor effects on HRV across menopause. MHT had no detectable HRV effects.

Inflammation and decreased cardiovagal modulation are linked to stress and depression at 36th week of pregnancy in gestational diabetes mellitus

Stress and depression have been reported in gestational diabetes mellitus (GDM). Though inflammation and oxidative stress are associated with depression, there are no reports of link of cardiometabolic risks (CMR) to stress and depression in GDM. Normal pregnant women (control group, n = 164) and women with GDM (study group, n = 176) at 36th week of gestation were recruited for the study. Blood pressure (BP), body composition, heart rate variability (HRV), glycated hemoglobin (HbA1C), markers of insulin resistance, oxidative stress, inflammation and endothelial dysfunction, were assessed. Perceived stress score (PSS), quality of life (QoL) scale, Indian diabetic risk score (IDRS) and Edinburg postnatal depression score (EPDS) were assessed. Association of potential contributors to PSS and EDPS were assessed by correlation and regression analyses. There was significant increase in PSS, EPDS, IDRS scores, HbA1C, malondialdehyde (MDA) (oxidative stress marker) and high-sensitive C-reactive protein and interleukin-6 (inflammatory markers), and significant decrease in total power (TP) of HRV (marker of cardiovagal modulation), QoL and nitric oxide (endothelial dysfunction marker) in study group compared to control group. Though many cardiometabolic risk parameters were correlated with PSS and EPDS, the significant independent association was observed for TP, HbA1C, MDA and interleukin-6. However, interleukin-6 had maximum contribution to PSS (β = 0.550, p < 0.001) and EPDS (β = 0.393, p < 0.001) as demonstrated by multiple regression analysis. Inflammation, oxidative stress, glycation status and decreased cardiovagal modulation are associated with stress and depression at 36th week of gestation in GDM.

Continuous perioperative heart rate variability monitoring in video-assisted thoracoscopic surgery lobectomy—a pilot study

Heart rate variability (HRV) is a measure of cardiac autonomic modulation and is potentially related to hypotension, postoperative atrial fibrillation, and orthostatic intolerance. However, there is a lack of knowledge on which specific time points and indices to measure. To improve future study design, there is a need for procedure-specific studies in an enhanced recovery after surgery (ERAS) video-assisted thoracic surgery (VATS) lobectomy setting, and for continuous measurement of perioperative HRV. HRV was measured continuously from 2 days before until 9 days after VATS lobectomy in 28 patients. After VATS lobectomy, with median length of stay = 4 days, the standard deviation between normal-to-normal beats and the total power of HRV were reduced for 8 days during the night and day times, while low-to-high frequency variation and detrended fluctuation analysis were stable. This is the first detailed study to show that HRV measures of total variability were reduced following ERAS VATS lobectomy, while other measures were more stable. Further, preoperative HRV measures showed circadian variation. The patch was well tolerated among participants, but actions should be taken to ensure proper mounting of the measuring device. These results demonstrate a valid design platform for future HRV studies in relation to postoperative outcomes.

Time-course of heart rate variability after total hip arthroplasty

Heart rate variability (HRV) is a measure of the autonomic nervous system function and possibly related to postoperative outcome. Despite several HRV studies in different surgical settings, optimal indices and timepoints for measuring have not been adequately determined. Consequently, there is a need for detailed descriptive procedure-specific studies on the time-course of perioperative HRV within a modern fast-track surgical setting. We measured HRV continuously in 24 patients from 4 days before until 9 days after total hip arthroplasty (THA). Statistical methods included mainly ANOVA and t-tests or Kruskal–Wallis and pairwise Wilcoxon test. Patients completed the Orthostatic Discriminant and Severity Scale five times during the study describing autonomic nervous system dysfunction. Standard deviation between normal-to-normal beats and the total power of HRV were reduced for at least 9 days following THA, with a trend towards increased HRV leading up to the day of surgery. The balance between low- and high-frequency power of HRV was reduced in the postoperative evenings. There was increased orthostatic intolerance symptoms on the first postoperative day, with symptoms of pain, fatigue and weakness decreasing after the first postoperative day. Median hospital stay was 1 day. We provide the first detailed description of perioperative time-course of HRV and orthostatic symptoms in fast-track THA, showing reduced HRV after surgery for at least a week, and that HRV changes are sensitive to time of day and timing before and after surgery. These results are helpful in designing future HRV studies in perioperative risk assessment and outcome.

Abstract 10683: Alternations in Autonomic Function During Pulmonary Vein Isolation Without Targeting Ganglionated Plexi Ablation in Patients With Atrial Fibrillation

Introduction: Abnormal autonomic innervation in the left atrium was reported to be related to developing/sustaining atrial fibrillation (AF). Autonomic denervation by radiofrequency catheter ablation (RFCA), evaluated by heart rate variability (HRV), is associated with a lower recurrence rate of AF. Ganglionated Plexi (GP) has been regarded as a target of autonomic denervation during the RFCA; however, the degree by which autonomic function is altered during the RFCA procedure remains unclear. Hypothesis:We tested the hypothesis that autonomic function is altered consistently during the ablation procedure without targeting GP. Method: Thirteen patients with paroxysmal AF who underwent pulmonary vein isolation (PVI) via RFCA were included (Age, 64.3 ± 1.9; Male/Female, 10/3). PVI was performed in the order prescribed (left superior, left inferior, right superior, and right inferior PV). HRV was assessed prior to, during each PV ablation, and post-ablation. Results: A vagal response (significant bradycardia) during the procedure was observed in three patients. The parameter of para-sympathetic nerve activity (para-SNA) (e.g., RMSSD, 38.7 ± 7.8 vs. 26.6 ± 6.0 ms, P &lt; 0.05), and total power of HRV (1861 ± 831 vs. 1105 ± 584 ms, P &lt; 0.05) were decreased by the procedure. While the balance of SNA to para-SNA (ratio of low to high frequency, LF/HF) was unchanged, which may indicate both SNA and para-SNA denervation. Using a linear mixed effect model, the effect of the “period” (i.e., pre, each PV, post) on the reduction in para-SNA parameter (HF) or total power of HRV was significant (both, P &lt; 0.05). The reduction was consistent in each PV, and post-hoc analysis (Bonferroni) showed significant differences only between baseline and post-RFCA in these parameters (P &lt; 0.05). Even in the patients without significant bradycardia response, the reduction in HRV parameter was significant in the linear mixed effect model (e.g., the effect of the “period” on RMSSD, P &lt; 0.05). Conclusion: We found that the PVI by RFA, without targeting GP, modified autonomic function, even in the patients who did not develop vagal responses. The HRV change was consistent during each PV isolation, which may suggest the non-necessity of GP ablation for autonomic modification by the ablation.

Effect of Lesion of Central Amygdala on Heart Rate Variability in Albino Wistar Rats

Background and Aim: Heart rate variability (HRV) reflects the pre-frontal cortex (PFC) and amygdalar connections. HRV is also influenced by emotions, which is controlled by limbic system. Thus, amygdala-limbic connection is suggested to be the major integrator of HRV and the alterations in the regulation lead to cardiometabolic risks. The present study was conducted to assess the central amygdala in the heart rate variability in albino Wistar rats. Methods: A total of 8 albino Wistar rats were taken for the study. Stereotaxic procedure was performed and lesion was made into the central amygdalar nuclei bilaterally. HRV was assessed before and after lesion of central amygdala. Results: Following lesion of central amygdala, there was decrease in total power (TP), high frequency (HF), and other time domain indices of HRV, while there was increase in low frequency (LF) and LF-HF ratio. Conclusion: Lesion of central amygdala decreased TP indicating the crucial role of central amygdala in the control of HRV. The control of central amygdala on sympathovagal balance is profound.

Cardiovascular response to whole-body cold exposure in humans with different initial autonomic tone

Relevance. Cold exposure increases sympathetic activity and blood pressure. It can also promote intensification of hypertension symptoms and its progress in winter. However, the mechanisms of this phenomenon are poorly understood.Intention: To determine the dynamics of cardiovascular parameters in young people with different initial autonomic regulation of heart rate during experimental general cold exposure.Methodology. 30 healthy male volunteers aged 18–20 years were examined. In accordance with the initial type of autonomic regulation of the heart rate, all subjects were divided into 3 groups as follows: predominance of vagotonia (Group I, n = 9), optimal autonomic regulation – normotonia (Group II, n = 14), predominance of sympathicotonia (Group III, n = 7). The experiment included three stages: rest at a temperature (+20 0C); exposure to cold (–20 0C) for 10 minutes; warming the body (+20 0C). The heart rate variability (HRV) was recorded during each stage of the study using a portable complex “Varicard 2.8” (Russia). At the same time, blood pressure and temperature in the ear canal were recorded.Results and Discussion. Moderate short-term general air cooling causes generally the same type of temporary reactions of central hemodynamics (increase in blood pressure) and indicators of the total HRV power with an increase in parasympathetic activity. Baseline and dynamic values of heart rate and stress index in Group III were significantly higher than in Groups I and II. During body cooling, the stress index in individuals from Group III was 4 times lower, and in individuals from Group I was 1.5 times lower than before cooling. In Group I, baroreflex was less pronounced (slightly decreased heart rate and HRV) along with a significant increase in blood pressure, thus suggesting a high risk of cold-associated vessel injuries. In Groups II and III, a baroreflex was maintained (significant decrease in heart rate and SI) in response to an increase in blood pressure.Conclusion. Apparently, an increase in blood pressure during moderate exposure to cold does not disturb the protective mechanisms of the cardiovascular system in healthy residents of the North with normotonia and predomination of sympathicotonia. At the same time, a week baroreflex in Northerners with vagotonia can be considered at risk for developing cold arterial hypertension.

Effects of yoga on cardiometabolic risks and fetomaternal outcomes are associated with serum nitric oxide in gestational hypertension: a randomized control trial

Gestational hypertension (GH) is associated with adverse cardiometabolic and pregnancy outcomes. Though yoga is known to be beneficial in pregnancy, the effects of yoga rendered for twenty weeks starting from 16th week of gestation in pregnant women having risk of GH on the incidence of hypertension, cardiometabolic risks and fetomaternal outcomes have not been studied. A randomized control trial was conducted on 234 pregnant women having risk of GH receiving standard antenatal care (Control group, n = 113), and receiving standard care + yoga (Study group, n = 121). Interventions were given for twenty weeks starting at 16th week of gestation. Baroreflex sensitivity (BRS), heart rate variability (HRV), insulin resistance, lipid-risk factors, and markers of inflammation, oxidative stress and vascular endothelial dysfunction (VED) were assessed before and after intervention. Incidence of new-onset hypertension, level of cardiometabolic risks at 36th week, and fetomaternal-neonatal outcomes in the perinatal period, were noted. The link of hypertension, pregnancy outcomes and cardiometabolic risks with nitric oxide (NO), the marker of VED was assessed by analysis of covariance, Pearson’s correlations, and multilinear and logistic regressions. In study group, 6.61% women developed hypertension compared to 38.1% in the control group following 20-week intervention and there was significant decrease in risk of developing GH (RR, 2.65; CI 1.42–4.95). There was less-painful delivery, decreased duration of labor, increased neonatal birthweight and Apgar score in study group. Increase in total power of HRV (β = 0.187, p = 0.024), BRS (β = 0.305, p < 0.001), and decrease in interleukin-6 (β = − 0.194, p = 0.022) had significant association with increased NO. Twenty weeks of practice of yoga during pregnancy decreases the incidence of hypertension, improves fetomaternal outcomes, and reduces cardiometabolic risks in pregnant women having risk of GH. Decreased blood pressure, increased HRV, BRS and birth weight and decreased inflammation were associated with improved endothelial function.Trial registration: Clinical Trials Registry of India (CTRI), registration number: CTRI/2017/11/010608, on 23.11.2017.

Реакция сердечно- сосудистой системы на скоростно-силовую нагрузку в условиях холода у юношей на возрастных этапах 14–15 и 15–16 лет

The purpose of this study was to determine the reactivity of the cardiovascular system after a speed-strength exercise in cold conditions using short-term biofeedback (BF) training to increase total heart rate variability (HRV) in adolescents aged 14–15 years and the following year, when they turned 15–16. Materials and methods. Healthy male adolescents were examined twice with an interval of 1 year (14–15 years old and 15–16 years old). Blood pressure (BP) and HRV were recorded before and immediately after a thrice-repeated standing long jump in the open air (t = –1…–10 °C) as well as during the recovery period. In the recovery period, the experimental group underwent BF training (3 min) using Varikard equipment (Ramena, Russia) to increase the total HRV power; the control group stayed at rest. Results. In adolescents aged 14–15 years after exercise in cold conditions total HRV and sympathetic activity remained stable (p &gt; 0.05); during the recovery period, a pronounced decrease in systolic BP and preservation of vagal activity were detected in the BF group, in contrast to the control. Adolescents aged 15–16 after exercise had a more pronounced rise in sympathetic activity compared with those aged 14–15 years (p &lt; 0.05); in the BF group, the decrease in total HRV power was less pronounced than in the control, with vagal activity preserved. Thus, in 15–16-year-old adolescents after a speed-strength exercise in the cold sympathetic activity and a decrease in total HRV were more pronounced than in those aged 14–15 years. During the recovery period, a short-term BF training (3 min) aimed to increase total HRV power contributes to preserving vagal activity in adolescents at both age stages.

General non-specific effects of balneofactors of Truskavets’ spa on parameters of neuroendocrine regulation, metabolism, immunity and microbiota in patients with chronic pyelonephritis and cholecystitis

Background. Earlier in experiments on rats, it was shown that drinking mineral water, regardless of their mineralization and chemical composition, have similar (nonspecific) course effects on a number of parameters of metabolism and neuroendocrine-immune complex. The aim of this study is to identify such parameters in patients of Truskavets’ spa who received complex drinking balneotherapy. Materials and Methods. The object of clinical-physiological observation were 34 men aged 23-70 years, who underwent rehabilitation treatment of chronic cholecystitis and pyelonephritis in remission. The examination was performed twice, before and after a 7-10-day course of balneotherapy. All patients received bioactive water Naftussya, therewith, 11 men additionally drank sulfate-chloride sodium-magnesium water "Khrystyna" (5 g/L), and the other 11 men - water "Myroslava" with a similar chemical composition, but twice the mineralization. The object of the study were the parameters of the electroencephalogram, heart rate variability (HRV), hormones, metabolism, immunity, microbiota and cholekinetics. Results. The complex balneotherapy by interval use of Naftussya water with sulfate-chloride sodium-magnesium mineral waters causes similar significant changes in the constellation of 10 EEGs, 10 metabolic, 10 microbiota and 4 immune parameters as well as total power and entropy of HRV, calcitonin and testosterone plasma levels and cholecystokinetics activity index. Conclusion. Balneofactors of Truskavets’ spa causes non-specific modulating effects on parameters of neuroendocrine regulation, metabolism, immunity, microbiota and cholekinetics in patients with chronic pyelonephritis and cholecystitis.

The influence of external stressors on physiological testing: Implication for return-to-play protocols.

External stressors such as alcohol, caffeine, and vigorous exercise are known to alter cellular homeostasis, affecting the autonomic nervous system (ANS) and overall physiological function. However, little direct evidence exists quantifying the impact of these external stressors on physiological testing. We assessed the impact of the above-listed stressors on spontaneous baroreflex sensitivity (BRS), heart rate variability (HRV), heart rate asymmetry (HRA), and systolic blood pressure variability (BPV). Seventeen male university varsity American-style football athletes completed two identical assessments on separate days, once presenting with one or more stressors (recent intake of caffeine, alcohol, or exercise participation; contraindicated assessment) and another with no stressors present (repeat assessment). Both assessments were conducted within one week and at the same time of day. The testing protocol consisted of 5-min of rest followed by 5-min of a squat-stand maneuver (0.05 Hz). Continuous beat-to-beat blood pressure and electrocardiogram measurements were collected and allowed for calculations of BRS, HRV, HRA, and BPV. Significant decreases (p < 0.05) in HRV and HRA metrics (SDNN, SD2, SDNNd, SDNNa, SD2a, SD2d), HRV total power, and BRS-up sequence were found during the contraindicated assessment in comparison to the repeat assessment. When assessing those with exercise as their only stressor, high-frequency HRV and BRS-pooled were significantly decreased and increased, respectively, during the contraindicated assessment. Pre-season physiological baseline testing in sport is becoming increasingly prevalent and thus must consider external stressors to ascertain accurate and reliable data. This data confirms the need for stringent and standardized guidelines for pre-participation baseline physiological testing.

Assessment of Cardiovascular Risk in People Living with Epilepsy

Background and Aim: Increase prevalence of cardiovascular morbidity and mortality has been reported in people living with epilepsy (PWE) compared to the general population. This study was done to assess the cardiovascular risk of PWE using Heart rate variability (HRV) and Blood Pressure variability (BPV) techniques. Methods: Twenty-seven patients with epilepsy and thirty age and gender-matched healthy individuals were included in the study and control group, respectively. Basal cardiovascular parameters (heart rate-HR, systolic blood pressure- SBP, diastolic blood pressure-DBP), HRV indices, and BPV parameters were recorded and compared between the study and control group individuals. In addition, the association of the Total Power (TP) of HRV with other study parameters was assessed by Pearson correlation coefficient test. Results: Cardiovascular parameters such as HR, SBP, DBP, rate pressure product, cardiac output and total peripheral resistance were significantly high in PWE compared to healthy individuals. Baroreflex sensitivity (BRS) and HRV parameters indicative of cardiac parasympathetic drive (TP, SDNN, RMSSD, and pNN50) were significantly low in these individuals. While a significant negative correlation was observed between TP, BHR and DBP, a significant positive correlation was observed between TP and BRS. Conclusion: Cardiac sympathovagal imbalance characterized by increased sympathetic and decreased parasympathetic activity was evident in PWE. These changes in the autonomic nervous system could predispose them to increased risk of cardiovascular morbidity.

Effects of 12 Weeks Practice of Yoga on Heart Rate Variability in Males with Type 2 Diabetes Receiving Oral Antidiabetic Drugs: A Randomized Control Trial.

Objective: To investigate the effects of 12 weeks practice of a structured yoga module on heart rate variability (HRV) and cardiometabolic risks in patients with type 2 diabetes (T2D) receiving similar kind of oral antidiabetic drugs (OAD) with yoga therapy and without yoga therapy, matched for all the known confounders. Design: Parallel design interventional (randomized control trial) study. Subjects: Eighty treatment-naive males with T2D were randomized into control group (n = 40) and study group (n = 40). Intervention: Study group participants received a structured yoga therapy that included asana and pranayama practice for 12 weeks in addition to OAD, whereas control group participants received OAD alone. Outcome measures: Before and after intervention, BP parameters, rate pressure product (RPP) as the marker of myocardial stress, total power (TP) of HRV, low-frequency to high-frequency (LF-HF) ratio of HRV, homeostatic model of insulin resistance (HOMA-IR), lipid profile and lipid risk factors, malondialdehyde (MDA), and high-sensitive C-reactive protein (hsCRP) were measured. TP of HRV was defined as the primary outcome. Association of TP (the marker of HRV) and LF-HF ratio (the marker of sympathovagal balance) with cardiometabolic parameters was assessed by correlation and regression analyses. Results: After 12 weeks yoga therapy, there was significant reduction in cardiometabolic risks (TP of HRV, RPP, lipid risks factors, levels of MDA, and hsCRP) in study group subjects compared with control subjects that did not receive yoga therapy. All cardiometabolic risk factors were significantly correlated with TP in study group, having maximum significance with homeostatic model of insulin secretion (r = 0.502, p ≤ 0.001). Multiple regression analysis demonstrated the independent contribution of decrease in RPP, HOMA-IR, hsCRP, and MDA to increased TP and decreased LF-HF ratio in T2D patients after yoga therapy. Conclusion: From the results of this study, the authors conclude that 12 weeks practice of a structured yoga module improves TP of HRV, sympathovagal balance, and metabolic functions, and reduce cardiovascular (CV) risks in patients with diabetes who received routine antidiabetic medicines along with yoga therapy, compared with the patients with diabetes who received antidiabetic medicines alone. The reduction in cardiometabolic risks in these patients is linked to the improvement in TP of HRV. Future studies should also include a control group with rapid walking or a similar exercise program of equal time to the yoga intervention group to discern whether it is in fact yoga that is leading to these results and not simply increased CV activity. Clinical Trial Registry of India (No. CTRI/2021/06/034074).

Low-Intensity Laser Therapy As a Method to Reduce Stress Responses after Septoplasty.

The aim of the study was to evaluate the effectiveness of the use of photobiomodulation therapy (PBMT) to minimize acute pain in the early postoperative period in patients after septoplasty. In total, 62patients underwent septoplasty under general anesthesia (40 men and 22 women, 18-44 years old) followed by nasal tamponade. Patients of the 1st group did not undergo PBMT, and patients of the 2nd group received PBMT 3, 6, and 24 h after septoplasty (infrared pulsed laser radiation, λ = 0.890 μm, P = 10 W, 2min in the projection of the wings of the nose). After 48 h, after the removal of tampons, intranasal PBMT with a nozzle in the red range, with λ = 0.63 μm, P = 8 mW, 2 min. ULF, HF, LF, and total power of heart rate variability (HRV), pain syndrome was assessed. ULF, LF, HF, total HRV power were significantly lower in group 2, compared to group 1. In the period from 6 to 24 h after septoplasty, patients of group 1 experienced higher pain than patients with PBMT (p < 0.001). The use of PBMT after septoplasty against the background of nasal tamponade helps to reduce the severity of pain syndrome and the inflammatory response to surgical stress and, consequently, leads to less pronounced changes in the autonomic nervous system in response to surgical stress.

Changes in the Time-Domain of Heart Rate Variability and Corticosterone after Surgical Trauma to the Nasal Septum in Rats.

The aim of the work was to study changes in the time range of heart rate variability (HRV) against the background of changes in the concentration of corticosterone in blood plasma in rats after surgical trauma to the nasal septum. Septoplasty was simulated in 30 mature male Wistar rats weighing 210-290 g. ECG was recorded with subsequent analysis of the time domain of HRV, as well as blood sampling to estimate changes in the concentration of corticosterone in the blood plasma was performed. As a result, SDNN significantly increased in comparison with the control on days 2 and 3 (p < 0.001) but decreased on days 4-5 (p < 0.001) and 6 (p < 0.01). rMSSD changed in waves with two irregular peaks on days 1 and 6. SDNN/rMSSD, in comparison with the 1st day of the postoperative period, increased on the 2nd day, continued to increase (p<0.05), and then began to decrease on day 4 (p < 0.01). The total HRV power of was low throughout the postoperative period (p < 0.001), except for day 3, when it was equal to the control data. The increase in the total power index fell on day 3 after the operation (p <0.01), after which its decline was observed again. The concentration of corticosterone in the blood plasma in rats was significantly higher than before (p < 0.001). On postoperative day 2 to 4, its plateau was determined. Simulation of septoplasty leads to changes in the time range of HRV, an increase in the concentration of corticosterone in the blood plasma in rats with its maximum at the time of surgery and 24 h later, and the formation of a "plateau" on postoperative days 2 to 4, which coincides with the changes in HRV.

Effects of bilateral lung transplantation on cardiac autonomic modulation and cardiorespiratory coupling: a prospective study

BackgroundAlthough cardiac autonomic modulation has been studied in several respiratory diseases, the evidence is limited on lung transplantation, particularly on its acute and chronic effects. Thus, we aimed to evaluate cardiac autonomic modulation before and after bilateral lung transplantation (BLT) through a prospective study on patients enrolled while awaiting transplant.MethodsTwenty-two patients on the waiting list for lung transplantation (11 women, age 33 [24–51] years) were enrolled in a prospective study at Ospedale Maggiore Policlinico Hospital in Milan, Italy. To evaluate cardiac autonomic modulation, ten minutes ECG and respiration were recorded at different time points before (T0) and 15 days (T1) and 6 months (T2) after bilateral lung transplantation. As to the analysis of cardiac autonomic modulation, heart rate variability (HRV) was assessed using spectral and symbolic analysis. Entropy-derived measures were used to evaluate complexity of cardiac autonomic modulation. Comparisons of autonomic indices at different time points were performed.ResultsBLT reduced HRV total power, HRV complexity and vagal modulation, while it increased sympathetic modulation in the acute phase (T1) compared to baseline (T0). The HRV alterations remained stable after 6 months (T2).ConclusionBLT reduced global variability and complexity of cardiac autonomic modulation in acute phases, and these alterations remain stable after 6 months from surgery. After BLT, a sympathetic predominance and a vagal withdrawal could be a characteristic autonomic pattern in this population.

Response of the Cardiac Autonomic Control to Exposure to Nanoparticles and Noise: A Cross-Sectional Study of Airport Ground Staff.

Airport activity causes the emission of particulate matter and noise, two environmental contaminants and potential health hazards, particularly for the personnel operating nearby taxiways. We explored the association between exposure to fine/ultrafine particles (UFPs) and noise with heart rate variability (HRV), an early indicator of cardiovascular autonomic response, among a sample of airport ground staff. Between May and June 2018, thirty-four male operators (mean age = 43 years and SD = 6.7) underwent personal monitoring of exposure to nanoparticles and noise, and HRV during their work activity. We conducted univariate and multivariate analysis to test the effect of UFP and noise exposure HRV. Total Lung Deposition Surface Area (LDSA) was significantly associated with a decrease in HRV Total Power and Triangular index (β = −0.038 p = 0.016 and β = −7.8 × 10−5, p = 0.042, respectively). Noise peak level showed an opposite effect, which was significant for Total Power (β = 153.03, p = 0.027), and for Triangular index (β = 0.362, p = 0.035). Further investigation is warranted to clarify the effect of the concurrent exposure to UFPs and noise on early changes of cardiac autonomic regulation.