Heart rate variability (HRV) is a non-invasive method to measure cardiac autonomic function. Impairments in HRV have been proposed as independent risk factor for increased cardiac mortality and morbidity. Cardio protective phenomenon in females has been hypothesized to be due to differential autonomic tone. Age related loss of vagal control has been reported as predisposing factor for the development of cardiovascular disease. In this study we assessed effect of age and gender on autonomic regulation of heart in healthy volunteers. HRV data of 189 subjects (114 males and 75 females) were analyzed in time and frequency domains using customized program. Artifact free 5 min electrocardiogram segment was used for analysis. It was ensured that none of the subject had medical illness such as diabetes, hypertension, thyroid disorders, cardiac disorders, diseases potentially related with autonomic neuropathy and major psychiatric illness by careful history and clinical examination. HRV recordings were done under standard laboratory condition. On correlation analysis SDNN, RMSSD, total power negatively correlated with age suggesting reduced autonomic regulation of heart with increase in age (SDNN: r = -0.444, p < 0.01; RMSSD: r = -0.552, p < 0.01; total power: r = -0.474, p < 0.01); similarly High frequency power (HF.nu) negatively correlated with age (r = -0.167, p = 0.02), denoting loss of vagal tone with aging. LF/HF ratio correlated positively with age (r = 0.19, p < 0.01) suggesting a relative increase of sympathetic activity with increase in age. On multiple regression analysis to control for effect of age and heart rate while comparing males and females, LF.nu showed significant reduction suggesting lower sympathetic tone in females (β = -6.64; p < 0.01) and HF.nu showed increase at trend level (β = 4.47; p = 0.053). In conclusion, there is overall reduction in autonomic control of heart with increase in the age. Sympathetic tone predominates and vagal tone diminishes with aging process. Females showed greater vagal tone than male. This differential autonomic tone indicate age, gender related predisposition to cardiovascular disease.
Context and Aims:Migraine is an episodic disabling headache requiring long-term management. Migraine management through Yoga therapy would reduce the medication cost with positive health benefits. Yoga has shown to improve the quality of life, reduce the episode of headache and medication. The aim of the present study was to evaluate the efficacy of Yoga as an adjuvant therapy in migraine patients by assessing clinical outcome and autonomic functions tests.Subjects and Methods:Migraine patients were randomly given either conventional care (n = 30) or Yoga with conventional care (n = 30). Yoga group received Yoga practice session for 5 days a week for 6 weeks along with conventional care. Clinical assessment (frequency, intensity of headache and headache impact) and autonomic function test were done at baseline and at the end of the intervention.Results:Yoga with conventional care and convention care groups showed significant improvement in clinical variables, but it was better with Yoga therapy. Improvement in the vagal tone along with reduced sympathetic activity was observed in patients with migraine receiving Yoga as adjuvant therapy.Conclusions:Intervention showed significant clinical improvement in both groups. Headache frequency and intensity were reduced more in Yoga with conventional care than the conventional care group alone. Furthermore, Yoga therapy enhanced the vagal tone and decreased the sympathetic drive, hence improving the cardiac autonomic balance. Thus, Yoga therapy can be effectively incorporated as an adjuvant therapy in migraine patients.
Background and ObjectivesSeveral mechanisms have been proposed for the sudden unexpected death in epilepsy patients, such as cardiac arrhythmias, a decrease in heart rate variability and the use of anti-epileptic drugs (AEDs). Although carbamazepine is commonly used as an AED, the exact working mechanism of this drug as well as its effect on the heart are not completely understood. The aim of this study was to determine whether chronic carbamazepine therapy in patients with focal seizures and impaired awareness has an effect on the electrocardiogram (ECG).Subjects and MethodsThis cross-sectional study included 36 patients with focal seizures and impaired awareness treated for 12–32 months with carbamazepine monotherapy and 38 healthy volunteers. A 5-min modified three-electrode chest lead ECG with lead II configuration was recorded using LabChart 7 ECG software module at 1000-Hz sampling frequency. All data analysis was performed using custom-made Matlab 2015b scripts. ECGs of patients and controls were compared with respect to heart rate, time intervals and measures of short- and long-term variation.ResultsThere were no significant differences in heart rate and ECG time intervals between the patient and control groups. Measures on short- and long-term variability also did not show any significant group differences.ConclusionOur study shows that chronic use of carbamazepine as monotherapy does not have any significant effects on ECG time intervals or measures of short- and long-term variability.
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