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Methodist DeBakey Cardiovascular Journal Apr 2021The surgical treatment of atrial fibrillation (AF) has evolved significantly over the last 20 years and even more so in the last 5 years. There are now many clinically... (Review)
Review
The surgical treatment of atrial fibrillation (AF) has evolved significantly over the last 20 years and even more so in the last 5 years. There are now many clinically successful surgical procedures focused on eliminating AF and AF-related stroke. This review discusses the current types of surgical AF procedures, including minimally invasive and hybrid, and may assist clinicians in understanding the various surgical AF options available to patients today.
Topics: Ablation Techniques; Action Potentials; Anti-Arrhythmia Agents; Atrial Fibrillation; Autonomic Denervation; Autonomic Nervous System; Heart Atria; Heart Rate; Humans; Maze Procedure; Stroke; Treatment Outcome
PubMed: 34104322
DOI: 10.14797/VNDG5944 -
International Journal of... Apr 2021Autonomic nervous system (ANS) activity is a core and central component of emotion and motivated action. The myriad social and cognitive challenges faced by humans...
Autonomic nervous system (ANS) activity is a core and central component of emotion and motivated action. The myriad social and cognitive challenges faced by humans require flexible modulation of ANS activity for different contexts. In this study, simultaneous activity of the parasympathetic and sympathetic nervous system was measured using respiratory sinus arrhythmia (RSA) and pre-ejection period (PEP), respectively. Samples combined four previous studies (N = 325, 63% female, aged 15-55) in which RSA and PEP were collected continuously during a resting baseline and an acute stressor, the Trier Social Stress Task. The concurrent relation between RSA and PEP responses was modelled in order to determine the extent to which SNS and PNS activity is correlated across the task within and between participants, and whether this correlation was moderated by age, race, sex, or baseline RSA and PEP. Overall, RSA and PEP were reciprocally coupled. However, recovery from a stressor was characterized by coactivation. Individuals also vary in the extent to which their SNS and PNS are reciprocally coupled; women, younger adults, and individuals with higher baseline RSA showed more reciprocal coupling than men, older adults, and those with lower baseline RSA, respectively, reflecting greater coordination of physiological responding in the former groups.
Topics: Aged; Autonomic Nervous System; Emotions; Female; Heart Rate; Humans; Male; Parasympathetic Nervous System; Respiratory Sinus Arrhythmia; Sympathetic Nervous System
PubMed: 33561515
DOI: 10.1016/j.ijpsycho.2021.01.015 -
Neuroscience and Biobehavioral Reviews Sep 2020Depression is a well-established stress-related risk factor for several diseases, mainly for those with cardiovascular outcomes. The mechanisms that link depression... (Review)
Review
Depression is a well-established stress-related risk factor for several diseases, mainly for those with cardiovascular outcomes. The mechanisms that link depression disorders with cardiovascular diseases (CVD) include dysfunctions of the autonomic nervous system. Heart rate variability analysis is a widely-used non-invasive method that can simultaneously quantify the activity of the two branches of cardiac autonomic neural control and provide insights about their pathophysiological alterations. Recent scientific literature suggests that sex influences the relationship between depressive symptoms and cardiac autonomic dysfunction. Moreover, a few studies highlight a possible sex paradox: depressed women, despite a greater vagal tone, experience a higher risk of adverse cardiovascular events than depressed men. Although there are striking sex differences in the incidence of depression, scanty data on this topic are available. Lastly, studies on the heart-brain axis bidirectionality and the role of sex are fundamental not only to clarify the biological bases of depression-CVD comorbidity, but also to develop alternative therapies, where vagus nerve appears to be a promising target of non-invasive neuromodulation techniques.
Topics: Autonomic Nervous System; Depression; Female; Heart; Heart Rate; Humans; Male; Vagus Nerve
PubMed: 32598983
DOI: 10.1016/j.neubiorev.2020.06.029 -
Advances in Physiology Education Dec 2017The autonomic nervous system is a powerful regulator of circulatory adjustments to acute hemodynamic stresses. Here we focus on new concepts that emphasize the chronic... (Review)
Review
The autonomic nervous system is a powerful regulator of circulatory adjustments to acute hemodynamic stresses. Here we focus on new concepts that emphasize the chronic influence of the sympathetic and parasympathetic systems on cardiovascular pathology. The autonomic neurohumoral system can dramatically influence morbidity and mortality from cardiovascular disease through newly discovered influences on the innate and adaptive immune systems. Specifically, the end-organ damage in heart failure or hypertension may be worsened or alleviated by pro- or anti-inflammatory pathways of the immune system, respectively, that are activated through neurohumoral transmitters. These concepts provide a major new perspective on potentially life-saving therapeutic interventions in the deadliest of diseases.
Topics: Animals; Autonomic Nervous System; Baroreflex; Cardiovascular Diseases; Cardiovascular System; Cytokines; Hemodynamics; Humans; Immune System; Immunity, Innate; Neurotransmitter Agents; Vagus Nerve
PubMed: 29138216
DOI: 10.1152/advan.00061.2017 -
Regulation of Cardiac Autonomic Nervous System Control across Frailty Statuses: A Systematic Review.Gerontology 2015Frailty is a geriatric syndrome that leads to impairment in interrelated physiological systems and progressive homeostatic dysregulation in physiological systems. (Review)
Review
BACKGROUND
Frailty is a geriatric syndrome that leads to impairment in interrelated physiological systems and progressive homeostatic dysregulation in physiological systems.
OBJECTIVE
The focus of the present systematic review was to study the association between the activity of the cardiac autonomic nervous system (ANS) and frailty.
METHODS
A systematic literature search was conducted in multiple databases: PubMed/MEDLINE, Embase, Cochrane Library, Web of Science, CINAHL, and ClinicalTrials.gov; the last search was performed in March 2015. Inclusion criteria were: (1) that the studied population was classified for frailty according to a standard definition, such as Fried's criteria; (2) that the study had a nonfrail control group, and (3) that heart rate (HR) and/or heart rate variability (HRV) were parameters of interest in the study.
RESULTS
Of the 1,544 articles screened, 54 were selected for full-text review and 6 studies met the inclusion criteria. Assessment of HRV using different standard time domain, frequency domain, and nonlinear domain approaches confirmed the presence of an impaired cardiac ANS function in frail compared to nonfrail participants. Furthermore, HR changes while performing a clinical test (e.g., the seated step test or the lying-to-standing orthostatic test) were decreased in the frail group compared to the nonfrail group.
CONCLUSIONS
The current systematic review provides evidence that the cardiac ANS is impaired in frail compared to nonfrail older adults, as indicated by a reduction in the complexity of HR dynamics, reduced HRV, and reduced HR changes in response to daily activities. Four out of 6 included articles recruited only female participants, and in the other 2 articles the effect of gender on impairment of cardiac ANS was insufficiently investigated. Therefore, further studies are required to study the association between cardiac ANS impairments and frailty in males. Furthermore, HRV was studied only during static postures such as sitting, or without considering the level of activity as a potential confounder. Accordingly, simultaneous measurement of both physiological (i.e., HRV) and kinematic (e.g., using wearable sensor technology) information may provide a better understanding of cardiac ANS impairments with frailty while controlling for activity.
Topics: Aged; Aged, 80 and over; Aging; Autonomic Nervous System; Frail Elderly; Heart Rate; Humans; Posture
PubMed: 26159462
DOI: 10.1159/000431285 -
Psychophysiology Apr 2023The outflow of the autonomic nervous system (ANS) is continuous and dynamic, but its functional organization is not well understood. Whether ANS patterns accompany...
The outflow of the autonomic nervous system (ANS) is continuous and dynamic, but its functional organization is not well understood. Whether ANS patterns accompany emotions, or arise in basal physiology, remain unsettled questions in the field. Here, we searched for brief ANS patterns amidst continuous, multichannel physiological recordings in 45 healthy older adults. Participants completed an emotional reactivity task in which they viewed video clips that elicited a target emotion (awe, sadness, amusement, disgust, or nurturant love); each video clip was preceded by a pre-trial baseline period and followed by a post-trial recovery period. Participants also sat quietly for a separate 2-min resting period to assess basal physiology. Using principal components analysis and unsupervised clustering algorithms to reduce the second-by-second physiological data during the emotional reactivity task, we uncovered five ANS states. Each ANS state was characterized by a unique constellation of patterned physiological changes that differentiated among the trials of the emotional reactivity task. These ANS states emerged and dissipated over time, with each instance lasting several seconds on average. ANS states with similar structures were also detectable in the resting period but were intermittent and of smaller magnitude. Our results offer new insights into the functional organization of the ANS. By assembling short-lived, patterned changes, the ANS is equipped to generate a wide range of physiological states that accompany emotions and that contribute to the architecture of basal physiology.
Topics: Humans; Aged; Autonomic Nervous System; Emotions; Love; Disgust; Sadness
PubMed: 36371680
DOI: 10.1111/psyp.14218 -
Clinical Autonomic Research : Official... Apr 2018A recent developmental study of gene expression by Espinosa-Medina, Brunet and colleagues sparked controversy by asserting a revised nomenclature for divisions of the... (Review)
Review
A recent developmental study of gene expression by Espinosa-Medina, Brunet and colleagues sparked controversy by asserting a revised nomenclature for divisions of the autonomic motor system. Should we re-classify the sacral autonomic outflow as sympathetic, as now suggested, or does it rightly belong to the parasympathetic system, as defined by Langley nearly 100 years ago? Arguments for rejecting Espinosa-Medina, Brunet et al.'s scheme subsequently appeared in e-letters and brief reviews. A more recent commentary in this journal by Brunet and colleagues responded to these criticisms by labeling Langley's scheme as a historical myth perpetuated by ignorance. In reaction to this heated exchange, I now examine both sides to the controversy, together with purported errors by the pioneers in the field. I then explain, once more, why the sacral outflow should remain known as parasympathetic, and outline suggestions for future experimentation to advance the understanding of cellular identity in the autonomic motor system.
Topics: Animals; Autonomic Nervous System; Humans; Neurons; Parasympathetic Nervous System; Sacrum
PubMed: 29453697
DOI: 10.1007/s10286-018-0510-6 -
Developmental Science Sep 2022This study examined autonomic profiles in preschoolers (N = 278, age = 4.7 years) and their relations to self-regulation outcomes concurrently and one year later, in...
This study examined autonomic profiles in preschoolers (N = 278, age = 4.7 years) and their relations to self-regulation outcomes concurrently and one year later, in kindergarten. Children's sympathetic (preejection period [PEP]) and parasympathetic activity (respiratory sinus arrythmia [RSA]) were measured at rest and during cognitive and emotional tasks. Three self-regulatory competencies were assessed: executive functions, emotion regulation and behavioral regulation. Executive functioning was measured at ages 4 and 5 using laboratory tasks designed to assess updating/working memory, inhibitory control, and cognitive flexibility. Emotion regulation was observed during emotionally distressing tasks in the laboratory, both at ages 4 and 5. Behavioral regulation and emotional reactivity were assessed via teacher ratings in kindergarten, at age 5. Latent profile analysis yielded four autonomic profiles: moderate parasympathetic inhibition (45%), reciprocal sympathetic activation (26%), coinhibition (25%), and high sympathetic activation (7%). The reciprocal sympathetic activation group showed better executive functioning in preschool and kindergarten, particularly compared to the high sympathetic activation group. The moderate parasympathetic inhibition group showed lower emotional reactivity and better behavioral regulation in kindergarten, compared to the other three groups. Findings suggest that autonomic profiles meaningfully associate with self-regulation outcomes in early childhood, such that certain profiles relate to better self-regulation than others.
Topics: Autonomic Nervous System; Child; Child, Preschool; Emotions; Executive Function; Humans; Respiratory Sinus Arrhythmia; Self-Control
PubMed: 34962027
DOI: 10.1111/desc.13215 -
Autonomic Neuroscience : Basic &... Nov 2017The autonomic nervous system regulates normal cardiovascular function and plays a critical role in the pathophysiology of cardiovascular disease. Further understanding... (Review)
Review
The autonomic nervous system regulates normal cardiovascular function and plays a critical role in the pathophysiology of cardiovascular disease. Further understanding of the interplay between the autonomic nervous system and cardiovascular system holds promise for the development of neuroscience-based cardiovascular therapeutics. To this end, techniques to image myocardial innervation will help provide a basis for understanding the fundamental underpinnings of cardiac neural control. In this review, we detail the evolution of gross and microscopic anatomical studies for functional mapping of cardiac neuroanatomy.
Topics: Autonomic Nervous System; Cardiovascular Diseases; Heart; Humans; Image Processing, Computer-Assisted; Motor Neurons; Neuroanatomy
PubMed: 28802636
DOI: 10.1016/j.autneu.2017.07.008 -
Autonomic Neuroscience : Basic &... Jan 2015The female reproductive tract undergoes remarkable functional and structural changes associated with cycling, conception and pregnancy, and it is likely advantageous to... (Review)
Review
The female reproductive tract undergoes remarkable functional and structural changes associated with cycling, conception and pregnancy, and it is likely advantageous to both individual and species to alter relationships between reproductive tissues and innervation. For several decades, it has been appreciated that the mammalian uterus undergoes massive sympathetic axon depletion in late pregnancy, possibly representing an adaptation to promote smooth muscle quiescence and sustained blood flow. Innervation to other structures such as cervix and vagina also undergo pregnancy-related changes in innervation that may facilitate parturition. These tissues provide highly tractable models for examining cellular and molecular mechanisms underlying peripheral nervous system plasticity. Studies show that estrogen elicits rapid degeneration of sympathetic terminal axons in myometrium, which regenerate under low-estrogen conditions. Degeneration is mediated by the target tissue: under estrogen's influence, the myometrium produces proteins repulsive to sympathetic axons including BDNF, neurotrimin, semaphorins, and pro-NGF, and extracellular matrix components are remodeled. Interestingly, nerve depletion does not involve diminished levels of classical sympathetic neurotrophins that promote axon growth. Estrogen also affects sympathetic neuron neurotrophin receptor expression in ways that appear to favor pro-degenerative effects of the target tissue. In contrast to the uterus, estrogen depletes vaginal autonomic and nociceptive axons, with the latter driven in part by estrogen-induced suppression of BMP4 synthesis. These findings illustrate that hormonally mediated physiological plasticity is a highly complex phenomenon involving multiple, predominantly repulsive target-derived factors acting in concert to achieve rapid and selective reductions in innervation.
Topics: Animals; Autonomic Nervous System; Estrogens; Female; Genitalia, Female; Humans; Neuronal Plasticity
PubMed: 25530517
DOI: 10.1016/j.autneu.2014.11.009