Abnormal passive head-up tilt test in subjects with symptoms of anxiety power spectral analysis study of heart rate and blood pressure

Piccirillo, Gianfranco; Santagada, Elvira; Bucca, Carmela; Viola, Emanuela; Cacciafesta, Mauro; Marigliano, Vincenzo

doi:10.1016/s0167-5273(97)00088-0

Cited by 78 publications

(78 citation statements)

References 41 publications

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“…On the other hand, GH is known to stimulate slow-wave sleep (24), and a transient surge in GH levels related to the nighttime dose of PYD is another possibility. The observed improvement in anxiety is consistent with many reports of reduced heart rate variability in anxiety disorders (39,40) and the ability of PYD to improve heart rate variability (28,41). There is some preliminary evidence that increasing heart rate variability through biofeedback benefits some clinical features of FM (42).…”

Section: Discussionsupporting

confidence: 88%

A six‐month randomized controlled trial of exercise and pyridostigmine in the treatment of fibromyalgia

Jones¹,

Burckhardt²,

Deodhar³

et al. 2008

Arthritis & Rheumatism

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Objective. A subset of fibromyalgia (FM) patients have a dysfunctional hypothalamic-pituitary-insulinlike growth factor 1 (IGF-1) axis, as evidenced by low serum levels of IGF-1 and a reduced growth hormone (GH) response to physiologic stimuli. There is evidence that pyridostigmine (PYD) improves the acute response of GH to exercise in FM patients. The purpose of this study was to evaluate the clinical effectiveness of 6 months of PYD and group exercise on FM symptoms.Methods. FM patients were randomized to 1 of the following 4 groups: PYD plus exercise, PYD plus diet recall but no exercise, placebo plus exercise, and placebo plus diet recall but no exercise. The primary outcome measures were the visual analog scale (VAS) score for pain, tender point count, and total myalgic score. Secondary outcome measures were the total score on the Fibromyalgia Impact Questionnaire (FIQ) and FIQ VAS scores for individual symptoms (fatigue, poor sleep, stiffness, and anxiety), as well as quality of life (QOL) and physical fitness (lower body strength/ endurance, upper and lower body flexibility, balance, and time on the treadmill).Results. A total of 165 FM patients completed baseline measurements; 154 (93.3%) completed the study. The combination of PYD and exercise did not improve pain scores. PYD groups showed a significant improvement in sleep and anxiety in those who completed the study and in QOL in those who complied with the therapeutic regimen as compared with the placebo groups. Compared with the nonexercise groups, the 2 exercise groups demonstrated improvement in fatigue and fitness. PYD was generally well tolerated.Conclusion. Neither the combination of PYD plus supervised exercise nor either treatment alone yielded improvement in most FM symptoms. However, PYD did improve anxiety and sleep, and exercise improved fatigue and fitness. We speculate that PYD may have improved vagal tone, thus benefiting sleep and anxiety; this notion warrants further study.

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Section: Discussionsupporting

confidence: 88%

A six‐month randomized controlled trial of exercise and pyridostigmine in the treatment of fibromyalgia

Jones¹,

Burckhardt²,

Deodhar³

et al. 2008

Arthritis & Rheumatism

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“…Anxious symptomatology is associated with reduced heart rate variability 25,26 and reduction in vagal control of the heart. 27,28 Several studies have found that reduction in the vagal control of heart rate is associated with increased cardiac mortality.…”

mentioning

confidence: 99%

Sustained Anxiety and 4-Year Progression of Carotid Atherosclerosis

Paterniti

Zureik

Ducimetière

et al. 2001

ATVB

111

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Abstract-Several studies have shown that anxiety disorders are associated with a higher risk of coronary artery disease.However, the relationship between anxiety disorders and atherosclerosis has been studied to a lesser extent. The goal of this study was to examine whether high and stable trait anxiety was associated with the progression of atherosclerosis.The study group consisted of 726 subjects (297 men and 429 women), aged 59 to 71 years, recruited from the electoral rolls of the city of Nantes. The subjects had no history of coronary artery disease at baseline evaluation and or at the 2-year follow-up. Two follow-up examinations were conducted 2 and 4 years after the baseline evaluation. Trait anxiety was evaluated by means of the French translation of the Spielberger Inventory (a 20-item trait inventory, form X-2). The "sustained anxiety" group consisted of men and women with the highest Spielberger Inventory scores at baseline and at the 2-year follow-up examination. Each ultrasound examination included measurement of intima-media thickness and the sites of plaque in the extracranial carotid arteries. Men with sustained anxiety showed a higher 4-year increase of common carotid intima-media thickness than did men without sustained anxiety (adjusted means 0.08 versus 0.04 mm, respectively; Pϭ0.05) and a higher risk of 4-year plaque occurrence (adjusted OR 3.5, 95% CI 1.4 to 8.5). Among women, sustained anxiety was associated with a higher 4-year increase of common carotid intima-media thickness (0.07 versus 0.04 for women with versus women without sustained anxiety, respectively; Pϭ0.07). These results suggest that chronically high levels of anxiety may contribute to accelerating the evolution of carotid atherosclerosis.

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“…10 It has been proven a long back that anxiety is associated with a raise in both HR and cardiac output (CO). 11,12,20 Fell et al suggested that anxiety and stress-induced adrenaline release may account for the preoperative increase in HR and CO. 21 Anxiety causes increase in catecholamine levels through sympathetic surge. Catecholamines affect CO by increasing contractility and HR.…”

Section: Discussionmentioning

confidence: 99%

“…5,8 But some recent studies have come with different results. 9,10 Anxiety and acute mental stress are associated with increased heart rate (HR) and cardiac output 11,12 and studies have shown that increased cardiac output increases the propofol requirements. [13][14][15][16] Hence hemodynamic status during induction of anesthesia may modify propofol Effect of pre-anesthetic anxiety and heart rate on propofol dose requirement for induction: A correlation study requirements.…”

Section: Introductionmentioning

confidence: 99%

Effect of pre-anesthetic anxiety and heart rate on propofol dose requirement for induction: A correlation study

Hazra

Das

et al. 2017

Asian J Med Sci

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Background: Though anxiety is associated with increase in heart rate and cardiac output, there is conflicting reports regarding its effect on propofol induction dose. Aims and Objectives: The aim of the study was to delineate the correlation between pre-anesthetic anxiety and heart rate on propofol requirement for induction. Materials and Methods: Total 42 patients of ASA (American Society of Anesthesiologists) physical status I and II, 13 male and 29 female, aged between 18 to 50 years and scheduled for elective surgery under general anesthesia, were enrolled in this study. Trait anxiety in the waiting room and state anxiety both in the waiting room and operating room were assessed using Spielberger's revised State-Trait Anxiety Inventory (STAI) scale. After heart rate (HR) recording, anesthesia was induced with 200 ml/hr 1% propofol infusion till loss of verbal contact. Results: Pre-anesthetic trait anxiety and HR had strong positive correlation with propofol requirement (ρ>0.6, P<0.05) while state anxiety had not. But pre-anesthetic state anxiety measured just before induction is strongly associated with increase in HR (ρ>0.6, P<0.05).Conclusion: Pre-operative anxiety should be considered and the dose of propofol should be titrated for induction accordingly. Further, larger trials with more sophisticated monitoring are needed to confirm our findings.

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Abnormal passive head-up tilt test in subjects with symptoms of anxiety power spectral analysis study of heart rate and blood pressure

Cited by 78 publications

References 41 publications

A six‐month randomized controlled trial of exercise and pyridostigmine in the treatment of fibromyalgia

A six‐month randomized controlled trial of exercise and pyridostigmine in the treatment of fibromyalgia

Sustained Anxiety and 4-Year Progression of Carotid Atherosclerosis

Effect of pre-anesthetic anxiety and heart rate on propofol dose requirement for induction: A correlation study

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