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Cool dialysate has variable impact on hemodynamic stability and dialysis adequacy. Hemodynamic stability and dialysis adequacy are crucial indicators for better life expectancy and cardiovascular mortality. This research aims to evaluate the impact of cool dialysate temperature (35.5°C) compared to standard dialysate temperature (37°C) on blood pressures, pulse rate, and dialysis adequacy (Urea reduction ratio and online Kt/V) in a cross over design. Material and Methods. Consenting ESRD patients on maintenance haemodialysis (HD) with minimum 3 months dialysis vintage and functioning permanent vascular access are included for the study. Each participant had two sessions of HD at 37°C followed by two sessions at 35.5° C on a Fresenius 4008S HD machine. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and Pulse rate are measured pre-HD, every hourly and post dialysis. Pre-HD Blood urea nitrogen (BUN) and post-HD BUN are measured, and Urea reduction rate was calculated for each HD session. Kt/V was calculated by ionic conductance by HD machine for each session. Results. 25 patients (5 females and 20 males) were enrolled. The mean age was 54 ± 9.58 years. Dialysis vintage was 21.48 ± 6.9 months for study participants 10 patients (40%) were diabetic nephropathy, 9 patients (36%) were presumed chronic glomerulonephritis, 2 patients (8%) were lupus nephritis and 4 patients (16%) were chronic interstitial nephritis. There was statistically no difference between pre-HD BUN (p = 0.330), post-HD BUN (p = 0.776), URR (p = 0.718) and Kt/V (p = 0.534) among the dialysis sessions done at 37°C and 35.5°C. SBP variability in the low temperature (35.5°C) group at 4th hour and post dialysis assumed statistical significance with p = 0.05 and p = 0.025 respectively. DBP variability in the low temperature (35.5°C) group at 3rd hour, 4th hour and post-dialysis demonstrated statistical significance with p = 0.027, p = 0.36 and p = 0.016 respectively. Pulse rate variability was more in the low temperature (35.5°C) group at 3rd hour and 4th hour which showed statistical significance with p = 0.037 and p = 0.05 respectively. Conclusion. Cool dialysate is non inferior to standard dialysate temperature in terms of dialysis adequacy and is associated with less variability in diastolic blood pressure, systolic blood pressure and more pulse rate variability thereby contributing to better hemodynamic stability.
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Estudios Cruzados , Hemodinámica , Fallo Renal Crónico , Diálisis Renal , Humanos , Femenino , Masculino , Diálisis Renal/métodos , Persona de Mediana Edad , Fallo Renal Crónico/terapia , Fallo Renal Crónico/fisiopatología , Presión Sanguínea , Soluciones para Diálisis/química , Soluciones para Hemodiálisis/química , Temperatura , Frecuencia Cardíaca , Anciano , Frío , Nitrógeno de la Urea SanguíneaRESUMEN
Introduction: during laparoscopic surgery, carbon dioxide (CO2) insufflation to create pneumoperitoneum increases blood pressure, heart rate and systemic vascular resistance. The purpose of our study was to investigate the efficacy of magnesium sulfate in preventing adverse hemodynamic reactions associated with pneumoperitoneum in patients undergoing laparoscopic cholecystectomy. Methods: we conducted a prospective, randomized, double-blind, controlled clinical study of patients scheduled for laparoscopic cholecystectomy and divided into two equal groups: the Mg2+ group received slow intravenous magnesium sulfate 50 mg/kg injection prior to pneumoperitoneum insufflation while the S group received the same volume of 0.9 % saline. Our primary endpoint was intraoperative changes in systolic blood pressure (SBP) related to pneumoperitoneum, in particular at 1 minute after insufflation. The secondary endpoints were the haemodynamic effects of pneumoperitoneum in terms of systolic blood pressure (SP), diastolic blood pressure (DP), mean arterial pressure (MAP) and heart rate (HR) from 2 minutes after insufflation to extubation and postoperatively, and the presence of possible adverse reactions related to the administration of magnesium sulphate. Results: we included 70 patients divided into two groups of 35. SP was significantly higher in the S group at insufflation (T0), 3 min, 4 min and 5 min post-operative, and at 60 min after surgery. HR was significantly higher in patients in the S group compared to the Mg2+ group at 7 min and 8 min after insufflation. No significant differences in DP and MAP measurements were observed between the 2 groups. No adverse reactions related to magnesium administration were reported. Conclusion: magnesium sulfate administered prior to pneumoperitoneum insufflation provided improved intraoperative hemodynamic stability during laparoscopic surgery.
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Presión Sanguínea , Colecistectomía Laparoscópica , Frecuencia Cardíaca , Hemodinámica , Sulfato de Magnesio , Neumoperitoneo Artificial , Humanos , Sulfato de Magnesio/administración & dosificación , Sulfato de Magnesio/farmacología , Estudios Prospectivos , Femenino , Masculino , Método Doble Ciego , Colecistectomía Laparoscópica/métodos , Colecistectomía Laparoscópica/efectos adversos , Neumoperitoneo Artificial/efectos adversos , Neumoperitoneo Artificial/métodos , Hemodinámica/efectos de los fármacos , Persona de Mediana Edad , Adulto , Presión Sanguínea/efectos de los fármacos , Frecuencia Cardíaca/efectos de los fármacos , Dióxido de Carbono/administración & dosificación , Adulto Joven , Insuflación/métodosRESUMEN
OBJECTIVES: The aim of this study is to analyse the adaptations of the autonomic nervous system after a musculoskeletal injury, obtained by measuring heart rate variability in athletes. It was hypothesized that there is an alteration in heart rate variability after a musculoskeletal injury. STUDY DESIGN: Cohort study. SUBJECTS: 15 semi-professional soccer players from three football teams, aged between 21 and 33 (mean age: 29.4 ± 3.31 years), with a recent musculoskeletal injury. METHODS: Heart rate variability was collected using the Polar m200 and the chest strap H10 in two moments: within 72 h after the injury and between 5 and 7 days after full return-to-play. RESULTS: Results show differences between T1 and T2 (p ≤ 0.05) in low-frequency power (n.u.) (p = 0.001) and high-frequency power (n.u.) (p = 0.001), in low-frequency/high-frequency ratio (p = 0.001) and in high-frequency power (ms2) (p = 0.017) measures. No statistical differences were found in low-frequency power (ms2) (p = 0.233). The low frequency power (n.u.) was significantly lower after injury compared with LF power (n.u.) values after full return-to-play. In high-frequency power there was a significant difference between both moments with high values after injury. CONCLUSIONS: The use of heart rate variability therefore seems to be promising to detect an imbalance in the autonomic nervous system and help clinical departments to identify a possible non-traumatic musculoskeletal injury. Further research should be performed considering a wide range of musculoskeletal injuries and to establish baseline values of the athletes.
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Sistema Nervioso Autónomo , Frecuencia Cardíaca , Fútbol , Humanos , Fútbol/lesiones , Frecuencia Cardíaca/fisiología , Adulto , Masculino , Adulto Joven , Sistema Nervioso Autónomo/fisiopatología , Estudios de Cohortes , Traumatismos en Atletas/fisiopatología , Atletas , Sistema Musculoesquelético/lesiones , Sistema Musculoesquelético/fisiopatologíaRESUMEN
BACKGROUND: Heart rate variability (HRV) has been reported to be associated with cardiovascular diseases (CVD), while few studies focused on the instantaneous heart rate (IHR). This study aimed to establish models to predict the occurrence of cardiovascular events based on the IHR sequence. METHODS: A total of 2977 participants with useful electrocardiogram (ECG) data and free of CVD events at baseline from the Sleep Heart Health Study (SHHS) database were included in this retrospective cohort study. All IHR indicators were measured during the awake period before sleep. The logistic regression, random forest, and XGBoost methods were used to develop the predictive models. The model performance was quantified by calculating the area under the curve (AUC). RESULTS: Of theses 2977 participants, 1460 (49.04%) participants had CVD events during the 15-year follow-up. Higher standard deviation of IHR (SDHR) (OR=0.906; 95% CI, 0.832-0.986), coefficient of variation of IHR (CVHR) (OR=0.910; 95% CI, 0.835-0.990), power in low frequency (LF) (OR=0.896; 95% CI, 0.822-0.975), power in high frequency (HF) (OR=0.872; 95% CI, 0.796-0.955), and total power (TP) (OR=0.887; 95% CI, 0.813-0.967) were associated with the lower risk of CVD events, while ratio of semi-minor axis and semi-major axis in Poincare plot (SDratio) (OR=1.105; 95% CI, 1.012-1.206) was related to the higher risk of CVD events. The AUCs of the logistic regression, random forest, and the XGBoost models were 0.734 (95% CI, 0.701-0.767), 0.794 (95% CI, 0.764-0.823) and 0.828 (95% CI, 0.801-0.855) in the testing set, respectively. CONCLUSIONS: IHR sequences were important predictors of cardiovascular events. The IHR indicators should be paid more attention to in future clinical researches on CVD.
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Enfermedades Cardiovasculares , Electrocardiografía , Frecuencia Cardíaca , Humanos , Masculino , Femenino , Enfermedades Cardiovasculares/epidemiología , Frecuencia Cardíaca/fisiología , Persona de Mediana Edad , Estudios Retrospectivos , Vigilia/fisiología , Adulto , Sueño/fisiología , Anciano , Estudios de CohortesRESUMEN
Motor imagery (MI) is the mental representation of a movement without its execution. It activates internal representations of the movement without external stimulus through different memory-related processes. Although acute stress is frequent in the population and affects supraspinal structures essential for memory functionality, it is still unknown how that stress affects MI capacity and temporal congruence (TC) between execution and movement imagination. This study aimed to discover how acute stress may influence MI capacity and TC in the subscales of internal and external visual imagery and kinesthetic imagery. A double-blind, randomized trial was conducted. Sixty-two young, healthy subjects (mean age = 20.65 [2.54]; 39 females and 23 males) unfamiliar with the assessment and uses of MI were recruited. Participants were assigned by stratified randomization to the stress group or the control group. Stress was induced by the Maastricht Acute Stress Test (MAST), while the control group performed the MAST control protocol. MI capacity and TC were assessed before (t1) and after (t2) MAST stress or control using the Movement Imagery Questionnaire-3 (MIQ-3). Electrodermal activity and heart rate variability were further recorded as control variables to assess stress induction. Thirty subjects in the stress group and 26 subjects in the control group were analyzed. No significant group differences were observed when comparing MI capacity or TC in any subscales. These findings suggest that acute stress does not significantly affect MI capacity or TC in young, healthy, non-experienced MI subjects. MI could thus be a relevant helpful technique in stressful situations.
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Frecuencia Cardíaca , Imaginación , Estrés Psicológico , Humanos , Femenino , Masculino , Adulto Joven , Método Doble Ciego , Imaginación/fisiología , Frecuencia Cardíaca/fisiología , Movimiento/fisiología , Respuesta Galvánica de la Piel/fisiología , Adulto , Adolescente , Cinestesia/fisiología , Encuestas y CuestionariosRESUMEN
Horse's stress responses have been reported during road transport in temperate but not tropical environments. Therefore, this study measured cortisol levels, heart rate (HR), and heart rate variability (HRV) in horses during medium-distance road transport with different truck conditions in a tropical environment. Six horses were repeatedly transported in either air-conditioned trucks with full (ATF) or space (ATS) loads or non-air-conditioned trucks with full (N-ATF) and space (N-ATS) loads. Blood cortisol was determined beforehand and 5, 30, and 90 minutes post-transport. HR and HRV were assessed pre-transport and at 15-minute intervals until 90 minutes post-transport. Cortisol levels increased significantly in N-ATS horses (but non-significantly in ATF, ATS, and N-ATF horses) at 5 minutes post-transport and returned to baseline by 30 minutes post-transport. Predominant parasympathetic nervous system (PNS) activity was observed during the first few hours and returned to baseline until the destination was reached. A recurrent, increased PNS activity was detected post-transport. Interaction effects of air condition-by-loading condition-by-time, air condition-by-time, and separate effects of air condition and time were observed on HR and various HRV variables during transport. A transient increase in beat-to-beat intervals, coinciding with decreased HR, was observed in ATF horses. The PNS index increased, corresponding to a decreased sympathetic nervous system index, in ATS horses during transport. We suggest that medium-distance road transport causes no stress for transport-experienced horses in a tropical environment. Air and loading conditions impacted hormonal and autonomic modulation, causing different responses in horses transported in differently conditioned trucks.
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Sistema Nervioso Autónomo , Frecuencia Cardíaca , Hidrocortisona , Transportes , Clima Tropical , Animales , Caballos/fisiología , Frecuencia Cardíaca/fisiología , Hidrocortisona/sangre , Hidrocortisona/metabolismo , Sistema Nervioso Autónomo/fisiología , Masculino , Estrés Fisiológico/fisiología , Vehículos a Motor , FemeninoRESUMEN
BACKGROUND: To analyze the effects of different anesthesia depths on perioperative heart rate variability and hemodynamics in middle-aged and elderly patients undergoing general anesthesia, and to provide a basis for clinical application. METHODS: A total of 111 patients with gastric cancer who were treated with epidural anesthesia combined with general anesthesia were selected as the study subjects, and the patients were randomly divided into group A, group B and group C. The bispectral index (BIS) was maintained by adjusting the infusion speed of anesthetics, the BIS of group A was maintained at 50 ~ 59, the BIS of group B was maintained at 40 ~ 49, and the BIS of group C was maintained at 30 ~ 39. The high-frequency power (HFP), low-frequency power (LFP), total power (TP), mean arterial pressure (MAP), heart rate (HR), diastolic blood pressure (DBP), and systolic blood pressure (SBP) were measured before anesthesia induction (T1), immediately after intubation (T2), 3 min after intubation (T3), and 6 min after extubation (T4). The cognitive function of the patients was evaluated before and 48 h after surgery. RESULTS: The HFP, LFP/HFP, TP, HR, DBP and SBP between the three groups at T1 ~ T3 are significantly difference from each other (P < 0.05). There were significant differences in spontaneous breathing recovery time, eye opening time and extubation time among group A, B and C groups, and group B had the lowest spontaneous breathing recovery time, eye opening time and extubation time (P < 0.05). There was no significant difference in the incidence of adverse reactions during anesthesia between the three groups. The cognitive function score of group B was significantly higher than that of group A and group C (P < 0.05). CONCLUSIONS: BIS maintenance of 40 ~ 49 has little effect on perioperative heart rate variability and hemodynamics in middle-aged and elderly patients undergoing general anesthesia, which is helpful for postoperative recovery.
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Anestesia General , Frecuencia Cardíaca , Hemodinámica , Humanos , Anestesia General/métodos , Frecuencia Cardíaca/efectos de los fármacos , Frecuencia Cardíaca/fisiología , Femenino , Masculino , Persona de Mediana Edad , Anciano , Hemodinámica/efectos de los fármacos , Hemodinámica/fisiología , Neoplasias Gástricas/cirugía , Anestesia Epidural/métodos , Presión Sanguínea/efectos de los fármacos , Presión Sanguínea/fisiología , Periodo PerioperatorioRESUMEN
BACKGROUND: The primary objective of anesthesiologists during the induction of anaesthesia is to mitigate the operative stress response resulting from endotracheal intubation. In this prospective, randomized controlled trial, our aim was to assess the feasibility and efficacy of employing Index of Consciousness (IoC, IoC1 and IoC2) monitoring in predicting and mitigating circulatory stress induced by endotracheal intubation for laparoscopic cholecystectomy patients under general anesthesia (GA). METHODS: We enrolled one hundred and twenty patients scheduled for laparoscopic cholecystectomy under GA and randomly allocated them to two groups: IoC monitoring guidance (Group T, n = 60) and bispectral index (BIS) monitoring guidance (Group C, n = 60). The primary endpoints included the heart rate (HR) and mean arterial pressure (MAP) of the patients, as well as the rate of change (ROC) at specific time points during the endotracheal intubation period. Secondary outcomes encompassed the systemic vascular resistance index (SVRI), cardiac output index (CI), stroke volume index (SVI), ROC at specific time points, the incidence of adverse events (AEs), and the induction dosage of remifentanil and propofol during the endotracheal intubation period in both groups. RESULTS: The mean (SD) HR at 1 min after intubation under IoC monitoring guidance was significantly lower than that under BIS monitoring guidance (76 (16) beats/min vs. 82 (16) beats/min, P = 0.049, respectively). Similarly, the mean (SD) MAP at 1 min after intubation under IoC monitoring guidance was lower than that under BIS monitoring guidance (90 (20) mmHg vs. 98 (19) mmHg, P = 0.031, respectively). At each time point from 1 to 5 min after intubation, the number of cases with HR ROC of less than 10% in Group T was significantly higher than in Group C (P < 0.05). Furthermore, between 1 and 3 min and at 5 min post-intubation, the number of cases with HR ROC between 20 to 30% or 40% in Group T was significantly lower than that in Group C (P < 0.05). At 1 min post-intubation, the number of cases with MAP ROC of less than 10% in Group T was significantly higher than that in Group C (P < 0.05), and the number of cases with MAP ROC between 10 to 20% in Group T was significantly lower than that in Group C (P < 0.01). Patients in Group T exhibited superior hemodynamic stability during the peri-endotracheal intubation period compared to those in Group C. There were no significant differences in the frequencies of AEs between the two groups (P > 0.05). CONCLUSION: This promising monitoring technique has the potential to predict the circulatory stress response, thereby reducing the incidence of adverse reactions during the peri-endotracheal intubation period. This technology holds promise for optimizing anesthesia management. TRAIL REGISTRATION: Chinese Clinical Trail Registry Identifier: ChiCTR2300070237 (20/04/2022).
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Anestesia General , Monitores de Conciencia , Frecuencia Cardíaca , Intubación Intratraqueal , Monitoreo Intraoperatorio , Humanos , Anestesia General/métodos , Intubación Intratraqueal/métodos , Masculino , Femenino , Estudios Prospectivos , Persona de Mediana Edad , Adulto , Monitoreo Intraoperatorio/métodos , Frecuencia Cardíaca/fisiología , Colecistectomía Laparoscópica/métodos , Estado de Conciencia/efectos de los fármacos , Estrés Fisiológico , Presión Arterial , Propofol/administración & dosificaciónRESUMEN
BACKGROUND: Supraventricular extra beats (SVEB) are frequently observed in athletes but data on significance, prognostic role and correlation with cardiac remodeling are contrasting. It is uncertain whether SVEB may indicate the development of more complex arrhythmias and the need for closer monitoring is undetermined. The aim was to assess the prevalence and clinical significance of BESV in Olympic athletes of different sporting disciplines, evaluating potential correlations with cardiac remodeling and clinical features. METHODS: We enrolled athletes who participated at 2012-2022 Olympic Games, submitted to physical examination, blood tests, echocardiography and exercise tests, categorized into power, skills, endurance and mixed disciplines. RESULTS: We studied 1492 elite athletes: 56% male individuals, mean age 25.8â±â5.1âyears; 29.5% practiced power, 12.3% skills, 21% endurance and 37.2% mixed disciplines. At exercise-stress tests, 6.2% had SVEB, mostly single beats. SVEB were not influenced by anthropometrics or blood test results. They were more common in male individuals (77.4 vs. 54.6%, Pâ<â0.0001) and older athletes (27.1â±â5.7 vs. 25.7â±â5.1, Pâ=â0.01). In male athletes with SVEB, higher left atrial volumes were observed (24.2â±â7.3 vs. 22.2â±â7.1âml/m2, Pâ=â0.03). No differences were found in terms of sporting discipline: despite larger left atrial dimensions in aerobic disciplines, SVEB rates were similar in different sporting disciplines (6.1% endurance, 6.3% mixed, 5.2% power and 8.7% skills; Pâ=â0.435). CONCLUSION: SVEB were more common in older, male athletes and associated with higher left atrial volume (especially in male individuals) regardless of sport practiced. Athletes with greater left atrial volume and SVEB are supposed to have higher risk, in middle age, of developing more complex arrhythmias.
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Atletas , Humanos , Masculino , Adulto , Atletas/estadística & datos numéricos , Adulto Joven , Femenino , Prevalencia , Deportes/fisiología , Deportes/estadística & datos numéricos , Remodelación Ventricular , Complejos Atriales Prematuros/fisiopatología , Complejos Atriales Prematuros/diagnóstico , Complejos Atriales Prematuros/epidemiología , Factores de Riesgo , Ecocardiografía , Frecuencia Cardíaca , Prueba de Esfuerzo , Estudios Transversales , Resistencia Física/fisiologíaRESUMEN
Atrial fibrillation (AF) is a life-threatening heart condition, and its early detection and treatment have garnered significant attention from physicians in recent years. Traditional methods of detecting AF heavily rely on doctor's diagnosis based on electrocardiograms (ECGs), but prolonged analysis of ECG signals is very time-consuming. This paper designs an AF detection model based on the Inception module, constructing multi-branch detection channels to process raw ECG signals, gradient signals, and frequency signals during AF. The model efficiently extracted QRS complex and RR interval features using gradient signals, extracted P-wave and f-wave features using frequency signals, and used raw signals to supplement missing information. The multi-scale convolutional kernels in the Inception module provided various receptive fields and performed comprehensive analysis of the multi-branch results, enabling early AF detection. Compared to current machine learning algorithms that use only RR interval and heart rate variability features, the proposed algorithm additionally employed frequency features, making fuller use of the information within the signals. For deep learning methods using raw and frequency signals, this paper introduced an enhanced method for the QRS complex, allowing the network to extract features more effectively. By using a multi-branch input mode, the model comprehensively considered irregular RR intervals and P-wave and f-wave features in AF. Testing on the MIT-BIH AF database showed that the inter-patient detection accuracy was 96.89%, sensitivity was 97.72%, and specificity was 95.88%. The proposed model demonstrates excellent performance and can achieve automatic AF detection.
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Algoritmos , Fibrilación Atrial , Electrocardiografía , Redes Neurales de la Computación , Procesamiento de Señales Asistido por Computador , Fibrilación Atrial/diagnóstico , Fibrilación Atrial/fisiopatología , Humanos , Electrocardiografía/métodos , Aprendizaje Automático , Frecuencia Cardíaca , Aprendizaje ProfundoRESUMEN
Sudden cardiac arrest (SCA) is a lethal cardiac arrhythmia that poses a serious threat to human life and health. However, clinical records of sudden cardiac death (SCD) electrocardiogram (ECG) data are extremely limited. This paper proposes an early prediction and classification algorithm for SCA based on deep transfer learning. With limited ECG data, it extracts heart rate variability features before the onset of SCA and utilizes a lightweight convolutional neural network model for pre-training and fine-tuning in two stages of deep transfer learning. This achieves early classification, recognition and prediction of high-risk ECG signals for SCA by neural network models. Based on 16 788 30-second heart rate feature segments from 20 SCA patients and 18 sinus rhythm patients in the international publicly available ECG database, the algorithm performance evaluation through ten-fold cross-validation shows that the average accuracy (Acc), sensitivity (Sen), and specificity (Spe) for predicting the onset of SCA in the 30 minutes prior to the event are 91.79%, 87.00%, and 96.63%, respectively. The average estimation accuracy for different patients reaches 96.58%. Compared to traditional machine learning algorithms reported in existing literatures, the method proposed in this paper helps address the requirement of large training datasets for deep learning models and enables early and accurate detection and identification of high-risk ECG signs before the onset of SCA.
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Algoritmos , Muerte Súbita Cardíaca , Electrocardiografía , Redes Neurales de la Computación , Humanos , Electrocardiografía/métodos , Muerte Súbita Cardíaca/prevención & control , Frecuencia Cardíaca , Sensibilidad y Especificidad , Aprendizaje Profundo , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/fisiopatología , Procesamiento de Señales Asistido por ComputadorRESUMEN
Previous studies report contradicting age-related neurovascular coupling (NVC). Few studies assess postural effects, but less investigate relationships between age and NVC within different postures. Therefore, this study investigated the effect of age on NVC in different postures with varying cognitive stimuli. Beat-to-beat blood pressure, heart rate and end-tidal carbon dioxide were assessed alongside middle and posterior cerebral artery velocities (MCAv and PCAv, respectively) using transcranial Doppler ultrasonography in 78 participants (31 young-, 23 middle- and 24 older-aged) with visuospatial (VST) and attention tasks (AT) in various postures at two timepoints (T2 and T3). Between-group significance testing utilized one-way analysis-of-variance (ANOVA) (Tukey post-hoc). Mixed three-way/one-way ANOVAs explored task, posture, and age interactions. Significant effects of posture on NVC were driven by a 3.8% increase from seated to supine. For AT, mean supine %MCAv increase was greatest in younger (5.44%) versus middle (0.12%) and older-age (0.09%) at T3 (p = 0.005). For VST, mean supine %PCAv increase was greatest at T2 and T3 in middle (10.99%/10.12%) and older-age (17.36%/17.26%) versus younger (9.44%/8.89%) (p = 0.004/p = 0.002). We identified significant age-related NVC effects with VST-induced hyperactivation. This may reflect age-related compensatory processes in supine. Further work is required, using complex stimuli while standing/walking, examining NVC, aging and falls.
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Envejecimiento , Acoplamiento Neurovascular , Postura , Humanos , Masculino , Femenino , Acoplamiento Neurovascular/fisiología , Adulto , Persona de Mediana Edad , Anciano , Postura/fisiología , Envejecimiento/fisiología , Adulto Joven , Atención/fisiología , Ultrasonografía Doppler Transcraneal/métodos , Presión Sanguínea/fisiología , Circulación Cerebrovascular/fisiología , Velocidad del Flujo Sanguíneo/fisiología , Frecuencia Cardíaca/fisiología , Arteria Cerebral Media/fisiología , Arteria Cerebral Media/diagnóstico por imagenRESUMEN
The use of wearable sensors to monitor vital signs is increasingly important in assessing individual health. However, their accuracy often falls short of that of dedicated medical devices, limiting their usefulness in a clinical setting. This study introduces a new Bayesian filtering (BF) algorithm that is designed to learn the statistical characteristics of signal and noise, allowing for optimal smoothing. The algorithm is able to adapt to changes in the signal-to-noise ratio (SNR) over time, improving performance through windowed analysis and Bayesian criterion-based smoothing. By evaluating the algorithm on heart-rate (HR) data collected from Garmin Vivoactive 4 smartwatches worn by individuals with amyotrophic lateral sclerosis and multiple sclerosis, it is demonstrated that BF provides superior SNR tracking and smoothing compared with non-adaptive methods. The results show that BF accurately captures SNR variability, reducing the root mean square error from 2.84 bpm to 1.21 bpm and the mean absolute relative error from 3.46% to 1.36%. These findings highlight the potential of BF as a preprocessing tool to enhance signal quality from wearable sensors, particularly in HR data, thereby expanding their applications in clinical and research settings.
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Algoritmos , Teorema de Bayes , Frecuencia Cardíaca , Relación Señal-Ruido , Dispositivos Electrónicos Vestibles , Humanos , Frecuencia Cardíaca/fisiología , Masculino , Femenino , Procesamiento de Señales Asistido por ComputadorRESUMEN
S-Limonene (s-Lim) is a monocyclic monoterpene found in a variety of plants and has been shown to present antioxidant and cardioprotective activity in experimental models of myocardial infarction. The aim of this study was to evaluate the potential mechanism by which s-Lim exerts its antiarrhythmic effect, focusing on the blockade of ß-adrenoceptor (ß-AR) and its effects on various in vivo and in vitro parameters, including electrocardiogram (ECG) measurements, left ventricular developed pressure (LVDP), the ß-adrenergic pathway, sarcomeric shortening and L-type calcium current (ICa,L). In isolated hearts, 10 µM of s-Lim did not alter the ECG profile or LVPD. s-Lim increased the heart rate corrected QT interval (QTc) (10.8%) at 50 µM and reduced heart rate at the concentrations of 30 (12.4%) and 50 µM (16.6%). s-Lim (10 µM) also inhibited the adrenergic response evoked by isoproterenol (ISO) (1 µM) reducing the increased of heart rate, LVDP and ECG changes. In ventricular cardiomyocyte, s-Lim antagonized the effect of dobutamine by preventing the increase of sarcomeric shortening, demonstrating a similar effect to atenolol (blocker ß1-AR). In vivo, s-Lim antagonized the effect of ISO (agonists ß1-AR), presenting a similar effect to propranolol (a non-selective blocker ß-AR). In ventricular cardiomyocyte, s-Lim did not alter the voltage dependence for ICa,L activation or the ICa,L density. In addition, s-Lim did not affect changes in the ECG effect mediated by 5 µM forskolin (an activator of adenylate cyclase). In an in vivo caffeine/ISO-induced arrhythmia model, s-Lim (1 mg/kg) presented antiarrhythmic action verified by a reduced arrhythmia score, heart rate, and occurrence of ventricular premature beats and inappropriate sinus tachycardia. These findings indicate that the antiarrhythmic activity of s-Lim is related to blockade of ß-AR in the heart.
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Antiarrítmicos , Limoneno , Ratas Wistar , Receptores Adrenérgicos beta , Transducción de Señal , Animales , Ratas , Antiarrítmicos/farmacología , Masculino , Receptores Adrenérgicos beta/metabolismo , Limoneno/farmacología , Transducción de Señal/efectos de los fármacos , Terpenos/farmacología , Corazón/efectos de los fármacos , Frecuencia Cardíaca/efectos de los fármacos , Ciclohexenos/farmacología , Arritmias Cardíacas/tratamiento farmacológico , Arritmias Cardíacas/metabolismo , Arritmias Cardíacas/inducido químicamente , Arritmias Cardíacas/fisiopatología , Isoproterenol/farmacología , Miocitos Cardíacos/efectos de los fármacos , Miocitos Cardíacos/metabolismoRESUMEN
Standard cardiopulmonary exercise testing (CPET) produces a rich dataset but its current analysis is often limited to a few derived variables such as maximal or peak oxygen uptake (VÌO2). We tested whether breath-by-breath CPET data could be used to determine sample entropy (SampEn) in 81 healthy children and adolescents (age 7-18 years old, equal sex distribution). To overcome challenges of the relatively small time-series CPET data size and its nonstationarity, we developed a Python algorithm for short-duration physiological signals. Comparing pre- and post-ventilatory threshold (VT1) CPET phases, we found: (1) SampEn decreased by 9.46% for VÌO2 and 5.01% for VÌCO2 (p < 0.05), in the younger, early-pubertal participants; and (2) HR SampEn fell substantially by 70.8% in the younger and 77.5% in the older participants (p < 0.001). Across all ages, females exhibited greater HR SampEn than males during both pre- and post VT1 CPET phases by 14.10% and 23.79%, respectively, p < 0.01. In females, late-pubertal had 17.6% lower HR SampEn compared to early-pubertal participants (p < 0.05). Breath-by-breath gas exchange and HR data from CPET are amenable to SampEn analysis that leads to novel insight into physiological responses to work intensity, and sex and maturational effects.
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Prueba de Esfuerzo , Frecuencia Cardíaca , Intercambio Gaseoso Pulmonar , Humanos , Niño , Masculino , Adolescente , Femenino , Prueba de Esfuerzo/métodos , Prueba de Esfuerzo/normas , Intercambio Gaseoso Pulmonar/fisiología , Frecuencia Cardíaca/fisiología , Consumo de Oxígeno/fisiología , EntropíaRESUMEN
Purpose: Pilot study to evaluate the safety and effectiveness of stellate ganglion blocks in the treatment of symptoms related to long COVID infection. Materials and Methods: A total of 17 patients who underwent stellate ganglion block for the treatment of their long COVID symptoms were included. COMPASS-31, GAD-7, PCL-5, and Fatigue Severity Score (FSS) pre and post intervention surveys and data on baseline heartrate and post- block heart rate recorded in the EMR. Results: A total of 94% of patients reported moderate-to-severe autonomic dysfunction pre-procedure as measured by COMPASS-31. All patients reported some degree of symptomatic improvement from the block. Specifically, patients had significantly lower FSS scores (P = 0.002) and heart rate post-procedure (P = 0.008). Although the decrease in PCL-5 scores after the procedure was clinically meaningful, this change was not statistically significant (P = 0.159). No significant difference was found in pre and post procedure GAD-7 scores (P = 0.101). Conclusions: Stellate ganglion block is a safe, low-risk, minimally invasive, and effective procedure in the treatment of symptoms for long COVID. It should be evaluated as an adjunctive treatment of select patients in this population.
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Bloqueo Nervioso Autónomo , COVID-19 , Ganglio Estrellado , Humanos , Proyectos Piloto , Ganglio Estrellado/efectos de los fármacos , Masculino , Femenino , Bloqueo Nervioso Autónomo/métodos , Persona de Mediana Edad , Anciano , Resultado del Tratamiento , Adulto , Síndrome Post Agudo de COVID-19 , Frecuencia Cardíaca/fisiologíaRESUMEN
BACKGROUND: Sepsis is associated with a high incidence and mortality and poses a significant challenge to the treatment. Although esmolol has shown promise in sepsis treatment, its efficacy and safety remain contentious. This meta-analysis aims to clarify the role of esmolol in sepsis management. METHODS: PubMed, Embase, Web of Science, Cochrane library, clinicaltrials.gov and the Chinese Clinical Trial Registry were searched and references of relevant reviews and meta-analysis were also screened for appropriate studies. Keywords and free words of 'sepsis', 'esmolol' and 'randomized controlled trials' were used for search. Meta-analysis was performed using RevMan 5.3 software. RESULTS: Fifteen studies involving 1100 patients were included. Compared with the control group, patients receiving esmolol exhibited significantly decreased 28-day mortality (RR, 0.69; 95% CI, 0.60 to 0.81; P < 0.0001), heart rate (HR) (SMD, -1.15; 95% CI, -1.34 to -0.96; P < 0.0001), cardiac troponin I levels (cTnI) (SMD, -0.88; 95% CI, -1.13 to -0.64; P < 0.0001), length of intensive care unit (ICU) stay (SMD, -0.46; 95% CI, -0.62 to -0.3; P < 0.0001) and duration of mechanical ventilation (SMD, -0.28; 95% CI, -0.48 to -0.09; P = 0.004) and significantly increased central venous oxygen saturation (ScvO2) (SMD, 0.66; 95% CI, 0.44 to 0.88; P < 0.0001).While, esmolol had no significant influence on norepinephrine dosage (SMD, 0.08; 95% CI, -0.13 to 0.29; P = 0.46), mean arterial pressure (MAP) (SMD, 0.17; 95% CI, -0.07 to 0.4; P = 0.16), central venous pressure (CVP) (SMD, 0.16; 95% CI, -0.04 to 0.35; P = 0.11) and left ventricular ejection fraction (LVEF) (SMD, 0.21; 95% CI, -2.9 to 0.7; P = 0.41). CONCLUSION: Esmolol reduces 28-day mortality, length of ICU stay and duration of mechanical ventilation in sepsis patients. Furthermore, esmolol improves oxygen metabolism, mitigates myocardial injury and decreases heart rate without significantly affecting hemodynamic parameters. TRIAL REGISTRATION: This study was registered on the PROSPERO website (registration number: CRD42023484884).
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Antagonistas de Receptores Adrenérgicos beta 1 , Propanolaminas , Sepsis , Humanos , Antagonistas de Receptores Adrenérgicos beta 1/uso terapéutico , Frecuencia Cardíaca/efectos de los fármacos , Frecuencia Cardíaca/fisiología , Tiempo de Internación , Propanolaminas/uso terapéutico , Ensayos Clínicos Controlados Aleatorios como Asunto/métodos , Sepsis/tratamiento farmacológicoRESUMEN
Systemic arterial hypertension is accompanied by autonomic impairments that, if not contained, promotes cardiac functional and morphological damages. Pyridostigmine bromide (PYR) treatment results in positive effects on autonomic control and beneficial cardiac remodeling. These findings were also observed after aerobic physical training (APT). However, little is known about PYR effects on left ventricular contractility, mainly when it is combined with APT. We aimed to investigate the effects of chronic acetylcholinesterase inhibition on cardiac autonomic tone balance, coronary bed reactivity, and left ventricular contractility in spontaneously hypertensive rats (SHR) submitted to APT. Male SHR (18 weeks) were divided into two groups (N = 16): untrained and submitted to APT for 14 weeks (18th to 32nd week). Half of each group was treated with PYR (15 mg/kg/day) for two weeks (31st to 32nd week). The experimental protocol consisted of recording hemodynamic parameters, double autonomic blockade with atropine and propranolol, and assessment of coronary bed reactivity and ventricular contractility in isolated hearts using the Langendorff technique. PYR and APT reduced blood pressure, heart rate, and sympathetic influence on the heart. The Langendorff technique showed that APT increased coronary perfusion pressure and left ventricle contractility in response to coronary flow and ß-agonist administration. However, treatment with PYR annulled the effects of APT. In conclusion, although chronic treatment with PYR reduces cardiac sympathetic tonic influence, it does not favor coronary bed reactivity and cardiac contractility gains. PYR treatment in the trained SHR group nullified the coronary vascular reactivity and cardiac contractility gains.
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Inhibidores de la Colinesterasa , Hipertensión , Contracción Miocárdica , Condicionamiento Físico Animal , Bromuro de Piridostigmina , Ratas Endogámicas SHR , Animales , Inhibidores de la Colinesterasa/farmacología , Masculino , Ratas , Contracción Miocárdica/efectos de los fármacos , Hipertensión/tratamiento farmacológico , Hipertensión/fisiopatología , Bromuro de Piridostigmina/farmacología , Presión Sanguínea/efectos de los fármacos , Frecuencia Cardíaca/efectos de los fármacos , Hemodinámica/efectos de los fármacos , Vasos Coronarios/efectos de los fármacos , Vasos Coronarios/fisiopatología , Función Ventricular Izquierda/efectos de los fármacos , Acetilcolinesterasa/metabolismoRESUMEN
(1) Background: This study utilized a 24-week intervention incorporating heart rate sensors for real-time monitoring of intervention training, aiming to comprehensively assess the effects of Tai Chi on vascular endothelial function, atherosclerosis progression, and lipid metabolism. The insights gained may inform personalized non-pharmacological interventions to enhance the management of cardiovascular health in this population to provide sustainable benefits and improve quality of life. (2) Methods: Forty postmenopausal middle-aged and elderly women were randomly assigned to an exercise or control group. The exercise group underwent a 24-week Tai Chi (BaFa WuBu) training intervention with real-time heart rate monitoring using Polar sensors. Pre- and post-intervention assessments included body composition, blood pressure, vascularity, and blood parameters measured with the Inbody 720, Vascular Endothelial Function Detector, and Arteriosclerosis. Data were analyzed using SPSS 26.0 and mixed-design ANOVA to assess the effects of time, group, and their interactions on study outcomes. (3) Results: After training through 24 weeks of Tai Chi (BaFa WuBu) intervention, compared with the control group, systolic blood pressure in the exercise group was significantly lower (p < 0.05), and the difference between left and right arm pulse pressure, left and right ankle mean arterial pressure, left and right side baPWV, left and right side ABI, TC, TG, LDL, and blood pressure viscosity were all very significantly lower (p < 0.01), and the diastolic blood pressure was significantly higher (p < 0.05). Compared with baseline values in the exercise group, systolic blood pressure, right and left arm pulse pressure difference, right and left ankle mean arterial pressure, right and left side baPWV, right and left side ABI, TC, TG, LDL, and blood pressure viscosity decreased very significantly (p < 0.01) and diastolic blood pressure and FMD increased very significantly (p < 0.01) in the exercise group after the intervention. (4) Conclusions: In our study, a 24-week Tai Chi (BaFa WuBu) program significantly improved vascular health in middle-aged and older postmenopausal women. This simplified Tai Chi form is gentle and effective, ideal for older adults. Regular practice led to reduced vascular obstruction, improved lipid metabolism, and enhanced vascular endothelial function, crucial for preventing vascular diseases. The real-time heart rate sensors used were pivotal, enabling precise monitoring and adjustment of exercise intensity, thereby enhancing the study's scientific rigor and supporting Tai Chi (BaFa WuBu) as a beneficial therapeutic exercise.
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Presión Sanguínea , Frecuencia Cardíaca , Posmenopausia , Taichi Chuan , Humanos , Taichi Chuan/métodos , Femenino , Persona de Mediana Edad , Posmenopausia/fisiología , Anciano , Frecuencia Cardíaca/fisiología , Presión Sanguínea/fisiología , Ejercicio Físico/fisiología , Calidad de VidaRESUMEN
Background: Type 1 diabetes is a chronic autoimmune disease associated with insulin-producing beta cell destruction, declining insulin secretion, and elevated blood glucose. Physical activity improves glycaemic control and cardiovascular health. This study explores acute effects of maximal exhaustion induced by a cardiopulmonary exercise on macro- and microvascular parameters in type 1 diabetes. Methodology: Twenty-five participants with type 1 diabetes (14 males, 11 females), aged 41.4 ± 11.87 years, BMI 23.7 ± 3.08, completed a repeated-measure study. Measurements pre-, post-, 30- and 60-minutes post-exhaustion involved a maximal incremental cardio-pulmonary exercise test. Macro- and microvascular parameters were assessed using VICORDER® and retinal blood vessel image analysis. Repeated measures ANOVA in SPSS (Version 27.0) analysed data. Results: Post-exercise, heart rate increased (p<.001), and diastolic blood pressure decreased (p=.023). Diabetes duration correlated with pulse wave velocity (r=0.418, p=.047), diastolic blood pressure (r=0.470, p=.023), and central retinal arteriolar equivalent (r=0.492, p=.023). Conclusion: In type 1 diabetes, cardiopulmonary exercise-induced exhaustion elevates heart rate and reduces diastolic blood pressure. Future research should explore extended, rigorous physical activity protocols for greater cardiovascular risk reduction.