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American Journal of Hypertension Jan 2024
Topics: Pregnancy; Female; Humans; Pre-Eclampsia; Arteries; Heart Rate; Hypertension
PubMed: 37738220
DOI: 10.1093/ajh/hpad086 -
JACC. Clinical Electrophysiology Jul 2023Simultaneous activation of the sympathetic and parasympathetic nervous systems is crucial for the initiation of paroxysmal atrial fibrillation (AF). However, unbalanced... (Review)
Review
Simultaneous activation of the sympathetic and parasympathetic nervous systems is crucial for the initiation of paroxysmal atrial fibrillation (AF). However, unbalanced activation of the sympathetic system is characteristic of autonomic remodeling in long-standing persistent AF. Moreover, the adrenergic activation-induced metabolic derangements provide a milieu for acute AF and promote the transition from the paroxysmal to the persistent phase of AF. On the other hand, cholinergic activation ameliorates the maladaptive metabolic remodeling in the face of metabolic challenges. Selective inhibition of the sympathetic system and restoration of the balance of the cholinergic system by neuromodulation is emerging as a novel nonpharmacologic strategy for managing AF. This review explores the link between cardiac autonomic and metabolic remodeling and the potential roles of different autonomic modulation strategies on atrial metabolic aberrations in AF.
Topics: Humans; Atrial Fibrillation; Autonomic Nervous System; Heart Atria; Heart Rate
PubMed: 37086229
DOI: 10.1016/j.jacep.2023.02.019 -
Sensors (Basel, Switzerland) Mar 2024Wearable technology and neuroimaging equipment using photoplethysmography (PPG) have become increasingly popularized in recent years. Several investigations deriving...
Wearable technology and neuroimaging equipment using photoplethysmography (PPG) have become increasingly popularized in recent years. Several investigations deriving pulse rate variability (PRV) from PPG have demonstrated that a slight bias exists compared to concurrent heart rate variability (HRV) estimates. PPG devices commonly sample at ~20-100 Hz, where the minimum sampling frequency to derive valid PRV metrics is unknown. Further, due to different autonomic innervation, it is unknown if PRV metrics are harmonious between the cerebral and peripheral vasculature. Cardiac activity via electrocardiography (ECG) and PPG were obtained concurrently in 54 participants (29 females) in an upright orthostatic position. PPG data were collected at three anatomical locations: left third phalanx, middle cerebral artery, and posterior cerebral artery using a Finapres NOVA device and transcranial Doppler ultrasound. Data were sampled for five minutes at 1000 Hz and downsampled to frequencies ranging from 20 to 500 Hz. HRV (via ECG) and PRV (via PPG) were quantified and compared at 1000 Hz using Bland-Altman plots and coefficient of variation (CoV). A sampling frequency of ~100-200 Hz was required to produce PRV metrics with a bias of less than 2%, while a sampling rate of ~40-50 Hz elicited a bias smaller than 20%. At 1000 Hz, time- and frequency-domain PRV measures were slightly elevated compared to those derived from HRV (mean bias: ~1-8%). In conjunction with previous reports, PRV and HRV were not surrogate biomarkers due to the different nature of the collected waveforms. Nevertheless, PRV estimates displayed greater validity at a lower sampling rate compared to HRV estimates.
Topics: Female; Humans; Heart Rate; Autonomic Nervous System; Benchmarking; Correlation of Data; Electrocardiography
PubMed: 38610260
DOI: 10.3390/s24072048 -
Scientific Reports Nov 2023Associations between cerebrovascular disease and impaired autonomic function and cerebrovascular reactivity have led to increased interest in variability of heart rate...
Associations between cerebrovascular disease and impaired autonomic function and cerebrovascular reactivity have led to increased interest in variability of heart rate (HRV) and blood pressure (BPV) following stroke. In this study, beat-to-beat pulse rate variability (PRV) and BPV were measured in clinically stable stroke patients (6 ischemic, 2 hemorrhagic) at least one year after their last cerebrovascular event. Beat-to-beat blood pressure (BP) measurements were collected from subjects while resting in the sitting position for one hour. Compared with healthy controls, stroke patients exhibited significantly greater time-domain (standard deviation, coefficient of variation, average real variability) and normalized high-frequency BPV (all p < 0.05). Stroke patients also exhibited lower LF:HF ratios than control subjects (p = 0.003). No significant differences were observed in PRV between the two groups, suggesting that BPV may be a more sensitive biomarker of cerebrovascular function in long-term post-stroke patients. Given a paucity of existing literature investigating beat-to-beat BPV in clinically stable post-stroke patients long (> 1 year) after their cerebrovascular events, this pilot study can help inform future studies investigating the mechanisms and effects of BPV in stroke. Elucidating this physiology may facilitate long-term patient monitoring and pharmacological management to mitigate the risk for recurrent stroke.
Topics: Humans; Blood Pressure; Heart Rate; Pilot Projects; Stroke; Monitoring, Physiologic
PubMed: 37935766
DOI: 10.1038/s41598-023-45479-4 -
Journal of Strength and Conditioning... Jul 2023Kayacan, Y, Makaracı, Y, Ucar, C, Amonette, WE, and Yıldız, S. Heart rate variability and cortisol levels before and after a brief anaerobic exercise in handball...
Kayacan, Y, Makaracı, Y, Ucar, C, Amonette, WE, and Yıldız, S. Heart rate variability and cortisol levels before and after a brief anaerobic exercise in handball players. J Strength Cond Res 37(7): 1479-1485, 2023-Evaluating stress in athletes is important for monitoring overall physiologic load and is a core practice for sport performance teams. This study examined relationships between 2 metrics of training stress, heart rate variability (HRV) and cortisol, before and after intense anaerobic power testing. Electrocardiogram recordings and saliva samples were collected before and immediately after a Wingate anaerobic power test (WAnT-30) from professional handball players ( n = 20) and sedentary controls ( n = 18). Between-group differences and correlations were computed to assess study hypotheses. No differences were observed in HRV frequency-dependent parameters between groups, but in athletes, Min. R-R ( p < 0.01) and Avg.R-R ( p = 0.03) before WAnT-30 and the percentage of successive normal cardiac beat intervals greater than 50 milliseconds (i.e., pNN50; p = 0.03) after WAnT-30 were elevated. A high positive correlation was detected between the pretest and post-test cortisol levels in athletes ( p = 0.0001; r = 0.87) but not in sedentary individuals. No correlations were observed between the cortisol levels and WAnT-30 power parameters in either group. Relationships were evident in the standard deviation of RR intervals ( p = 0.02, r = -0.53), square root of the mean squared difference of successive RR intervals ( p = 0.043, r = -0.46), very low frequency ( p = 0.032; r = -0.480), high-frequency ( p = 0.02; r = -0.52) variables, and pretesting cortisol in athletes. These findings suggest that HRV analysis is a valuable tool for examining cardiovascular regulation, independent of cortisol; the data may provide valuable information for performance teams in evaluating acute stress.
Topics: Humans; Heart Rate; Hydrocortisone; Anaerobiosis; Sports; Athletes
PubMed: 36727970
DOI: 10.1519/JSC.0000000000004411 -
Biosensors & Bioelectronics Oct 2023The growing interest in flexible electronics for physiological monitoring, particularly using flexible pressure sensors for cardiovascular pulse waveforms monitoring,... (Review)
Review
The growing interest in flexible electronics for physiological monitoring, particularly using flexible pressure sensors for cardiovascular pulse waveforms monitoring, has potential applications in cuffless blood pressure measurement and early diagnosis of cardiovascular disease. High sensitivity, fast response time, good pressure resolution and a high signal-to-noise ratio are essential for effective pulse waveform detection. This review focuses on flexible capacitive and piezoresistive pressure sensors, which have seen significant enhancements due to their simple operation, superior performance, wide range of materials, and easy fabrication. The comparison of sensing methods for acquiring pulse waveforms from the wrist artery, device integration configurations, high-quality pulse waveforms collection, and performance analysis of capacitive and piezoresistive sensors are discussed. The review also covers the use of machine learning for analyzing pulse waveforms for cardiovascular disease diagnosis and cuff-less blood pressure monitoring. Lastly, it provides perspectives on current challenges and further advancements in the field.
Topics: Humans; Cardiovascular Diseases; Biosensing Techniques; Heart; Heart Rate; Monitoring, Physiologic
PubMed: 37356409
DOI: 10.1016/j.bios.2023.115449 -
Shock (Augusta, Ga.) Jul 2023Objective: Our study aims to evaluate the association between heart rate variability (HRV) and short- and long-term prognosis in patients admitted to intensive care unit...
HEART RATE VARIABILITY PARAMETERS WERE NOT ASSOCIATED WITH 30-DAY ALL-CAUSE MORTALITY IN INTENSIVE CARE UNIT PATIENTS WITH OR WITHOUT ATRIAL FIBRILLATION: A RETROSPECTIVE STUDY OF THE MIMIC-IV DATABASE.
Objective: Our study aims to evaluate the association between heart rate variability (HRV) and short- and long-term prognosis in patients admitted to intensive care unit (ICU). Methods and Results: Adult patients continuously monitored for over 24 h in ICUs from the the American Medical Information Mart for Intensive Care (MIMIC)-IV Waveform Database were recruited in our study. Twenty HRV-related variables (8 time domain, 6 frequency domain, and 6 nonlinear variables) were calculated based on RR intervals. The association between HRV and all-cause mortality was assessed. Ninety-three patients met the inclusion criteria and were classified into atrial fibrillation (AF) and sinus rhythm (SR) groups, which were further divided into 30-day survivor group and nonsurvivor\groups based on their survival status. The 30-day all-cause mortality rates in AF and SR groups were 36.3% and 14.6%, respectively. All the time domain, frequency domain, and nonlinear HRV parameters did not differ significantly between survivors and nonsurvivors with or without AF (all P > 0.05). Presence of renal failure, malignancy, and elevated blood urea nitrogen level were associated with increased 30-day all-cause mortality in SR patients, while presence of sepsis, infection, higher platelet count, and magnesium level were associated with increased 30-day all-cause mortality in AF patients. Conclusions: Heart rate variability variables were not associated with increased 30-day all-cause mortality in ICU patients with or without AF.
Topics: Humans; Atrial Fibrillation; Heart Rate; Retrospective Studies; Critical Care; Intensive Care Units
PubMed: 37219462
DOI: 10.1097/SHK.0000000000002149 -
Annual International Conference of the... Jul 2023Contactless sensors embedded in the ambient environment have broad applications in unobtrusive, long-term health monitoring for preventative and personalized healthcare....
Contactless sensors embedded in the ambient environment have broad applications in unobtrusive, long-term health monitoring for preventative and personalized healthcare. Microwave radar sensors are an attractive candidate for ambient sensing due to their high sensitivity to physiological motions, ability to penetrate through obstacles and privacy-preserving properties, but practical applications in complex real-world environments have been limited because of challenges associated with background clutter and interference. In this work, we propose a thin and soft textile sensor based on microwave metamaterials that can be easily integrated into ordinary furniture for contactless ambient monitoring of multiple cardiovascular signals in a localized manner. Evaluations of our sensor's performance in human subjects show high accuracy of heartbeat and arterial pulse detection, with ≥ 96.5% sensitivity and < 5% mean absolute relative error (MARE) across all subjects. We demonstrate our sensor's utility for cuffless blood pressure monitoring on a human subject over a continuous 10-minute period. Our results highlight the potential of metamaterial textile sensors in ambient health and wellness monitoring applications.Clinical relevance-The contactless metamaterial textile sensors demonstrated in this paper provide unobtrusive, convenient and long-term monitoring of multiple cardiovascular health metrics, including heart rate, pulse rate and cuffless blood pressure, which can facilitate preventative and personalized healthcare.
Topics: Humans; Monitoring, Physiologic; Textiles; Heart Rate; Wearable Electronic Devices; Vital Signs
PubMed: 38082876
DOI: 10.1109/EMBC40787.2023.10340864 -
Journal of Human Hypertension Oct 2023Previous studies have reported a significant relationship between hypertension and nocturia. However, the underlying pathophysiology associated with pulse rate (PR)...
Previous studies have reported a significant relationship between hypertension and nocturia. However, the underlying pathophysiology associated with pulse rate (PR) remains unclear. In the Japan Morning Surge-Home Blood Pressure Study, a self-administered nocturia questionnaire and evening home blood pressure (BP) and PR measurements (taken on a mean of 11.2 days) were performed on 4310 patients with one or more cardiovascular risk factors (mean: 64.9 years old; 47% male). According to the number of nighttime voids, the study population was divided into three groups (no voids: n = 2382; 1 void: n = 847; ≥2 voids per night: n = 1082). In the multinomial logistic regression analysis adjusted for confounders, diuretic use (OR, 1.23; 95%CI, 1.01-1.50; p < 0.05) was significantly associated with one nocturnal void, whereas evening home systolic BP (SBP) (OR per 1 SD, 1.14; 95%CI, 1.05-1.24; p < 0.01) and evening home PR (OR per 1 SD, 1.12; 95%CI: 1.02-1.24; p < 0.05) were significantly associated with multiple nocturnal voids. In the younger group (<65 years), only evening home PR was significantly related to multiple nighttime voids (p < 0.01), whereas in the older group (≥65 years), only evening home SBP was significantly related to multiple nighttime voids (p = 0.02). In this study, both higher evening home PR and higher evening home SBP were associated with multiple nighttime voids, with the former playing a greater role in the younger participants, and the latter more often associating the older group. An age-stratified approach to reduce the burden of BP or PR might be important to improve sleep quality.
Topics: Humans; Male; Middle Aged; Aged; Female; Blood Pressure; Heart Rate; Nocturia; Blood Pressure Monitoring, Ambulatory; Hypertension; Age Factors; Circadian Rhythm
PubMed: 36693950
DOI: 10.1038/s41371-023-00803-3 -
Diabetes & Metabolic Syndrome Jan 2024Heart rate variability (HRV) and resting heart rate (RHR) are usually analyzed and interpreted separately. We aimed to assess the interplay of HRV and RHR on mortality...
AIMS
Heart rate variability (HRV) and resting heart rate (RHR) are usually analyzed and interpreted separately. We aimed to assess the interplay of HRV and RHR on mortality in type 2 diabetes.
METHODS
The study included 7,529 participants from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. HRV metrics included standard deviation of all normal-to-normal intervals (SDNN) and root mean square of successive differences between normal-to-normal intervals (rMSSD). Abnormal values were defined based on <25th percentile for HRV and >75th percentile for RHR. Interactions of HRV status and RHR status were tested on multiplicative and additive scales. Results were validated in a subset of patients with type 2 diabetes (n = 745) from the Multi-Ethnic Study of Atherosclerosis.
RESULTS
Low SDNN was associated with increased all-cause mortality in the high RHR group (HR 1.60; 95% CI 1.29-1.97), but not in the normal RHR group. Compared with those who had neither low SDNN nor high RHR, the presence of either low SDNN or high RHR was not significantly associated with an increased risk of all-cause mortality. In contrast, the combination of low SDNN and high RHR was associated with a significantly increased risk of all-cause mortality (HR 1.68; 95% CI 1.43-1.97). Significant multiplicative and additive interactions were found between HRV status and RHR status on risk of all-cause mortality (all P < 0.05). Similar findings were observed for cardiovascular mortality, in analyses using rMSSD, and in the Multi-Ethnic Study of Atherosclerosis.
CONCLUSIONS
The association between HRV and mortality risk is modified by RHR levels. Furthermore, low HRV and high RHR have interdependent and synergistic associations with mortality risk.
Topics: Humans; Heart Rate; Diabetes Mellitus, Type 2; Heart; Atherosclerosis
PubMed: 38150792
DOI: 10.1016/j.dsx.2023.102930