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Applied Psychophysiology and Biofeedback Sep 2023Heart Rate Variability Biofeedback (HRVB) has been widely used to improve cardiovascular health and well-being. HRVB is based on breathing at an individual's resonance... (Review)
Review
Heart Rate Variability Biofeedback (HRVB) has been widely used to improve cardiovascular health and well-being. HRVB is based on breathing at an individual's resonance frequency, which stimulates respiratory sinus arrhythmia (RSA) and the baroreflex. There is, however, no methodological consensus on how to apply HRVB, while details about the protocol used are often not well reported. Thus, the objectives of this systematic review are to describe the different HRVB protocols and detect methodological concerns. PsycINFO, CINALH, Medline and Web of Science were searched between 2000 and April 2021. Data extraction and quality assessment were based on PRISMA guidelines. A total of 143 studies were finally included from any scientific field and any type of sample. Three protocols for HRVB were found: (i) "Optimal RF" (n = 37), each participant breathes at their previously detected RF; (ii) "Individual RF" (n = 48), each participant follows a biofeedback device that shows the optimal breathing rate based on cardiovascular data in real time, and (iii) "Preset-pace RF" (n = 51), all participants breathe at the same rate rate, usually 6 breaths/minute. In addition, we found several methodological differences for applying HRVB in terms of number of weeks, duration of breathing or combination of laboratory and home sessions. Remarkably, almost 2/3 of the studies did not report enough information to replicate the HRVB protocol in terms of breathing duration, inhalation/exhalation ratio, breathing control or body position. Methodological guidelines and a checklist are proposed to enhance the methodological quality of future HRVB studies and increase the information reported.
Topics: Humans; Heart Rate; Biofeedback, Psychology; Exhalation; Respiratory Rate; Respiratory Sinus Arrhythmia
PubMed: 36917418
DOI: 10.1007/s10484-023-09582-6 -
Cureus May 2023Electronic cigarettes may increase the risk of long-term cardiovascular morbidity. To protect the heart, awareness should be raised of the risks and limits of... (Review)
Review
Electronic cigarettes may increase the risk of long-term cardiovascular morbidity. To protect the heart, awareness should be raised of the risks and limits of E-cigarette aerosol exposure. Thus, this systematic review and meta-analysis assessed the cardiovascular risk of e-smoking. This systematic review was conducted by using the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. We searched PubMed, Embase, Scopus, Web of Science, and Science Direct databases in December 2022 to identify studies investigating e-cigarettes' impact on the heart. The study was supported by meta-analysis and qualitative review. Out of the initial 493 papers, only 15 met the inclusion criteria and were included in the study. The cumulative number of participants in the myocardial infarction (MI) group was 85,420, and in the sympathetic groups in whom the systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP), and heart rate (HR) were measured, were 332 cigarette smokers. The control group included the "never use," "non-smokers," and "never smoke." The pooled analysis showed a significant difference between the e-cigarette smokers and the control group regarding the risk of developing MI in former smokers (OR= 0.12; 95% CI: 0.01-1.72, P = 0.12) and never smoked (OR= 0.02; 95% CI: 0.00-0.44, P = 0.01) favoring the control group. The pooled analysis of the included studies showed a significant difference between the e-cigarette smokers with nicotine and the control group regarding the mean difference (MD) of the SBP (MD = 2.89; 95% CI: 1.94-3.84; P < 0.001), the DBP (MD = 3.10; 95% CI: 0.42-5.78; P = 0.02), the MBP (MD = 7.05; 95% CI: 2.70-1.40; P = 0.001), and HF (MD = 3.13; 95% CI: 0.96-5.29; P = 0.005) favoring the control group. We conclude that using e-cigarettes has a detrimental effect on cardiac health. The risk of severe cardiac conditions increases with e-cigarettes. Thus, vaping can do more harm than good. Consequently, the misleading notion that e-cigarettes are less harmful should be challenged.
PubMed: 37366450
DOI: 10.7759/cureus.39528 -
PloS One 2024Cardiovascular diseases (CVD) are the leading causes of morbidity and mortality. Heart rate variability (HRV) represents the modulatory capacity of the autonomous... (Clinical Trial)
Clinical Trial Meta-Analysis
BACKGROUND
Cardiovascular diseases (CVD) are the leading causes of morbidity and mortality. Heart rate variability (HRV) represents the modulatory capacity of the autonomous nervous system and influences mortality. By surveying this meta-analysis, we investigated the impact of physical activity on HRV.
METHODS
Databases, online journal libraries and clinical trial registries were searched for publications of randomized controlled and non-randomized controlled trials concerning adults with coronary artery disease (CAD)/ischemic heart disease (IHD), congestive heart failure (CHF), peripheral arterial disease (PAD) or after acute coronary syndrome (ACS) joining an intervention group with physical activity or a control group with usual care or no intervention. Extracted time-domain and frequency-domain parameter of HRV were analyzed in a meta-analysis using a random effect model. Subgroup analyses concerning intervention type, study design and type of heart disease and sensitivity analysis were performed.
RESULTS
Significant results were obtained for RR-Interval (p = 0.05) and standard deviation of Normal-to-Normal intervals (SDNN) (p = 0.01) for short-term assessment and for the ratio of low-frequency power (LF) to high-frequency power (HF) (p = 0.05) for 24-hour assessment. Subgroup analyses also resulted significant: root-mean-square difference of successive normal R-R intervals (RMSSD) (p = 0.01), SDNN (p = 0.02) and HF (p < 0.01) concerning CHF.
CONCLUSION
We were able to demonstrate the positive impact of physical activity on HRV, especially in patients with CHF. Cardiac rehabilitation exercise programs need to be individualized to identify the most beneficial method of training for improving the prognosis of patients with CVD.
Topics: Adult; Humans; Heart Rate; Coronary Artery Disease; Myocardial Ischemia; Heart Failure; Randomized Controlled Trials as Topic
PubMed: 38578755
DOI: 10.1371/journal.pone.0299793 -
Sensors (Basel, Switzerland) Sep 2022This article presents a systematic review of the literature concerning scientific publications on wrist wearables that can help to identify stress levels. The study is... (Review)
Review
This article presents a systematic review of the literature concerning scientific publications on wrist wearables that can help to identify stress levels. The study is part of a research project aimed at modeling a stress surveillance system and providing coping recommendations. The investigation followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. In total, 38 articles were selected for full reading, and 10 articles were selected owing to their alignment with the study proposal. The types of technologies used in the research stand out amongst our main results after analyzing the articles. It is noteworthy that stress assessments are still based on standardized questionnaires, completed by the participants. The main biomarkers collected by the devices used in the selected works included: heart rate variation, cortisol analysis, skin conductance, body temperature, and blood volume at the wrist. This study concludes that developing a wrist wearable for stress identification using physiological and chemical sensors is challenging but possible and applicable.
Topics: Biomarkers; Heart Rate; Humans; Occupational Stress; Research Design; Wrist
PubMed: 36081096
DOI: 10.3390/s22176633 -
Frontiers in Neuroscience 2019Autonomic dysfunctions may precede the development of cognitive impairment, but the connection between these dimensions is unclear. This systematic review aims to... (Review)
Review
Autonomic dysfunctions may precede the development of cognitive impairment, but the connection between these dimensions is unclear. This systematic review aims to analyze the relationship between heart rate variability (HRV) and cognitive functions. The review process was conducted according to the PRISMA-Statement. Restrictions were made, selecting the studies in English and published in peer-review journals, including at least one cognitive measure and presenting the measurement of HRV. Studies that included participants with medical conditions, dementia, psychiatric disorders, strokes, and traumatic brain injury were excluded. Twenty studies were selected, with a total of 19,431 participants. The results were divided into different cognitive domains determined : global cognitive functioning, attention, processing speed, executive functions, memory, language and visuospatial skills. Both increased sympathetic activity and decreased parasympathetic activity seem to be associated with a worse performance in the cognitive domains considered, in the absence of dementia and severe cardiovascular diseases or other medical and psychiatric diseases. The results highlight the influence of the autonomic nervous system (ANS) in cognitive functioning. However, the marked interest facing toward a specific domain, i.e., the executive functions, and the relatively small number of the studies on this topic do not allow understanding better this relationship. Despite these limits, HRV could be considered a promising early biomarker of cognitive impairment in populations without dementia or stroke. This index should be evaluated within a preventative perspective to minimize the risk of developing cognitive impairment.
PubMed: 31354419
DOI: 10.3389/fnins.2019.00710 -
Medicina (Kaunas, Lithuania) Mar 2020Background and Objectives: Cirrhosis is a liver disease that causes about one million deaths annually worldwide. The estimated cirrhosis prevalence ranges from 4.5-9.5%...
Background and Objectives: Cirrhosis is a liver disease that causes about one million deaths annually worldwide. The estimated cirrhosis prevalence ranges from 4.5-9.5% in the general population. Up to 40% of cirrhotic patients are asymptomatic and may be diagnosed late. Studies have described the importance of the functions of the liver and autonomic nervous system (ANS) and their relationship. There is limited information available on non-alcoholic cirrhosis and heart rate variability (HRV), which is a measure of the ANS. This study aimed to evaluate cardiac autonomic modulation through HRV in non-alcoholic cirrhosis individuals reported in previous observational and clinical trial studies. We performed a systematic review according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement using the Medline, Scopus, and Web of Science electronic databases. Five studies were identified and reviewed. HRV was decreased in patients with non-alcoholic cirrhosis, even in the first stage. HRV could be used as a complementary method to improve both the diagnosis and prognosis of non-alcoholic cirrhosis.
Topics: Autonomic Nervous System; Female; Heart; Heart Rate; Humans; Liver Cirrhosis; Male
PubMed: 32151106
DOI: 10.3390/medicina56030116 -
Resuscitation Plus Dec 2022Positive pressure ventilation via a facemask is critical in neonatal resuscitation, but frequently results in mask leak, obstruction, and inadequate respiratory support.... (Review)
Review
AIM
Positive pressure ventilation via a facemask is critical in neonatal resuscitation, but frequently results in mask leak, obstruction, and inadequate respiratory support. This systematic review aimed to determine whether the display of respiratory function monitoring improved resuscitation or clinical outcomes.
METHODS
Randomized controlled trials comparing outcomes when respiratory function monitoring was displayed versus not displayed for newborns requiring positive pressure ventilation at birth were selected and from databases (last search August 2022), and assessed for risk of bias using Cochrane Risk of Bias Tools for randomized control trials. The study was registered in the Prospective Register of Systematic Reviews. Grading of Recommendations, Assessment, Development and Evaluations was used to assess the certainty of evidence. Treatment recommendations were approved by the Neonatal Life Support Task Force of the International Liaison Committee on Resuscitation. Results reported primary and secondary outcomes and included resuscitation and clinical outcomes.
RESULTS
Of 2294 unique articles assessed for eligibility, three randomized controlled trials were included (observational studies excluded) (n = 443 patients). For predefined resuscitation and clinical outcomes, these studies either did not report the primary outcome (time to heart rate ≥ 100 bpm from birth), had differing reporting methods (achieving desired tidal volumes, significant mask leak) or did not find significant differences (intubation rate, air leaks, death before hospital discharge, severe intraventricular hemorrhage, chronic lung disease). Limitations included limited sample size for critical outcomes, inconsistent definitions amongst studies and unreported long-term outcomes.
CONCLUSION
Although respiratory function monitoring has been utilized in clinical care, there is currently insufficient evidence to suggest its benefit for newborn infants receiving respiratory support for resuscitation at birth.
REGISTRATION
PROSPERO CRD42021278169 (registered November 27, 2021).
FUNDING
The International Liaison Committee on Resuscitation provided support that included access to software platforms and teleconferencing.
PubMed: 36425449
DOI: 10.1016/j.resplu.2022.100327 -
Journal of Translational... 2023In this systematic review, we evaluated the efficacy, mechanisms and safety of three neuromodulation therapies in patients with gastroesophageal reflux disease (GERD),...
BACKGROUND AND OBJECTIVES
In this systematic review, we evaluated the efficacy, mechanisms and safety of three neuromodulation therapies in patients with gastroesophageal reflux disease (GERD), including the effect of neuromodulation therapies on symptoms and key GERD pathophysiologies, lower esophageal sphincter (LES) pressure, esophageal motility, gastric motility, and parasympathetic activity. The first therapy is LES electrical stimulation using an implantable electrical stimulator, the second is transcutaneous electrical acustimulation, and the third is manual acupuncture.
METHODS
A systematic review of literature according to the PRISMA guidelines was performed. Online databases searched include Medline (Ovid), Embase, and PubMed. Studies were assessed for inclusion and exclusion criteria with Covidence, a systematic review software.
RESULTS
The analysis included thirteen clinical studies. Four papers included were registered under two open-label trials on ClinicalTrials.gov for LES electrical stimulation; Five randomized trials with sham-treated controls were analyzed for transcutaneous electrical acustimulation; Four studies, including three involving standard therapy controls and one involving shamtreated controls were included for manual acupuncture. All evaluated studies demonstrated significant beneficial effects on GERD symptoms, using patient-completed questionnaires, objective 24-h measurement of esophageal pH, and patient-reported use of proton pump inhibitors. In evaluating the effect on key GERD pathophysiologies, electrical stimulation significantly increased LES pressure, and transcutaneous electrical acustimulation significantly improved esophageal motility, gastric motility, and parasympathetic activity. None of the evaluated neuromodulation methods produced severe adverse effects.
CONCLUSIONS
Cumulative evidence from the evaluated studies indicates that neuromodulation therapies were effective in treating the GERD symptoms and key underlying GERD pathophysiologies. They are thus valuable options for individualized GERD treatment.
PubMed: 38009094
DOI: No ID Found -
World Journal of Cardiology Jul 2023Time-restricted eating (TRE) is a dietary approach that limits eating to a set number of hours per day. Human studies on the effects of TRE intervention on...
BACKGROUND
Time-restricted eating (TRE) is a dietary approach that limits eating to a set number of hours per day. Human studies on the effects of TRE intervention on cardiometabolic health have been contradictory. Heterogeneity in subjects and TRE interventions have led to inconsistency in results. Furthermore, the impact of the duration of eating/fasting in the TRE approach has yet to be fully explored.
AIM
To analyze the existing literature on the effects of TRE with different eating durations on anthropometrics and cardiometabolic health markers in adults with excessive weight and obesity-related metabolic diseases.
METHODS
We reviewed a series of prominent scientific databases, including Medline, Scopus, Web of Science, Academic Search Complete, and Cochrane Library articles to identify published clinical trials on daily TRE in adults with excessive weight and obesity-related metabolic diseases. Randomized controlled trials were assessed for methodological rigor and risk of bias using version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB-2). Outcomes of interest include body weight, waist circumference, fat mass, lean body mass, fasting glucose, insulin, HbA1c, homeostasis model assessment for insulin resistance (HOMA-IR), lipid profiles, C-reactive protein, blood pressure, and heart rate.
RESULTS
Fifteen studies were included in our systematic review. TRE significantly reduces body weight, waist circumference, fat mass, lean body mass, blood glucose, insulin, and triglyceride. However, no significant changes were observed in HbA1c, HOMA-IR, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, heart rate, systolic and diastolic blood pressure. Furthermore, subgroup analyses based on the duration of the eating window revealed significant variation in the effects of TRE intervention depending on the length of the eating window.
CONCLUSION
TRE is a promising chrononutrition-based dietary approach for improving anthropometric and cardiometabolic health. However, further clinical trials are needed to determine the optimal eating duration in TRE intervention for cardiovascular disease prevention.
PubMed: 37576544
DOI: 10.4330/wjc.v15.i7.354 -
World Journal of Clinical Cases Dec 2023Heart failure (HF), an end-stage manifestation of various cardiac diseases, poses an enormous economic and health burden on society. Vericiguat may be an effective drug...
BACKGROUND
Heart failure (HF), an end-stage manifestation of various cardiac diseases, poses an enormous economic and health burden on society. Vericiguat may be an effective drug in the treatment of HF.
AIM
To explore by meta-analysis the efficacy and safety of Vericiguat in treating chronic heart failure.
METHODS
Databases, including PubMed, EMBASE, Web of Science, and Cochrane Library, were searched to collect all published randomized controlled trials (RCTs) on Vericiguat treatment of chronic heart failure from the earliest electronic records to those published in March 2023. Two investigators independently screened the literature according to inclusion and exclusion criteria, evaluated the quality of the studies, and extracted valid data before conducting a meta-analysis using RevMan5.4.
RESULTS
Four RCTs with 5919 patients were included, and the meta-analysis showed that treatment with 10 mg Vericiguat reduced the incidence of the primary endpoint (a composite of cardiovascular mortality and first heart-failure-related hospitalization) in patients with chronic heart failure compared to placebo [relative risk (RR) = 0.91, 95% confidence interval (CI): 0.85-0.98, = 0.01], and reduced the incidence of heart-failure-related hospitalization (RR = 0.92, 95%CI: 0.84-1.00, = 0.05). However, for the incidence of cardiovascular and all-cause death, there were no significant differences between the Vericiguat and placebo groups. In addition, the two groups did not show significant differences in blood pressure, heart rate, and Kansas Cardiomyopathy Questionnaire physical limitation score. In terms of safety, 10 mg Vericiguat did not increase the risk of adverse effects in patients with chronic heart failure. Vericiguat may increase the risk of symptomatic hypotension (RR = 1.17, 95%CI: 0.98-1.39, = 0.08) and syncope (RR = 1.18, 95%CI: 0.90-1.55, = 0.24), but not significantly.
CONCLUSION
Vericiguat (10 mg) was more effective than placebo in treating patients with chronic heart failure and had a better safety profile.
PubMed: 38130613
DOI: 10.12998/wjcc.v11.i35.8330