Altered heart rate variability in angiotensin II–mediated hypertension is associated with impaired autonomic nervous system signaling and intrinsic sinoatrial node dysfunction

Dorey, Tristan W.; Moghtadaei, Motahareh; Rose, Robert A.

doi:10.1016/j.hrthm.2020.03.014

Cited by 21 publications

(16 citation statements)

References 26 publications

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“…Interestingly, almost no age- or BP-related changes under stress conditions could be found, which suggests impaired ANS reactivity. Our results are in agreement with previous findings of reduced HRV in subjects with elevated BP ( Fonkoue et al, 2018 ; Grandemange et al, 2019 ; Dorey et al, 2020 ).…”

Section: Discussionsupporting

confidence: 94%

Heart Rate Variability Changes in Patients With Major Depressive Disorder: Related to Confounding Factors, Not to Symptom Severity?

2021

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BackgroundThe aim of this study was to assess the electrophysiological and other influencing factors correlating with symptom severity in patients with major depressive disorder (MDD) under three different conditions: baseline, stress exposure, and relaxation following stress exposure.MethodsSymptom severity was assessed using the Beck Depression Inventory (BDI-II) in 89 inpatients (37 women; mean age 51 years) with MDD. Resting heart rate (RHR), heart rate variability (HRV), respiration rate (RR), skin conductance (SC), and skin temperature (ST) were recorded at baseline for 300 s, under stress exposure for 60 s, and under self-induced relaxation for 300 s. Age, nicotine consumption, body mass index, and blood pressure were evaluated as influencing factors.ResultsThe mean BDI-II mean score was 29.7 points. Disease severity correlated positively with SC elevation under stress exposure and with a lower RR in the relaxed state, but no association was found between HRV and symptom severity. Age and higher blood pressure were both associated with lower HRV and higher RHR.ConclusionThe results indicate that, in patients with MDD, changes in the autonomic nervous system (ANS) are complex; and the assessment of ANS reactivity to stressors is useful. Elevated blood pressure might be underdiagnosed, although it is already relevant in patients with MDD in their early 50s.

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Section: Discussionsupporting

confidence: 94%

Heart Rate Variability Changes in Patients With Major Depressive Disorder: Related to Confounding Factors, Not to Symptom Severity?

2021

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“…We have previously shown that HR can decrease with age in normotensive rodents ( Zubcevic et al, 2009 ). Thus, attenuation of these time-dependent changes in HF IBI and HR in the Ang II group suggests deregulation of cardiac parasympathetic drive after Ang II infusion, as it has previously been reported ( Miller and Arnold, 2019 ; Dorey et al, 2020 ; Sharma et al, 2021 ). However, this effect of Ang II on HF IBI was not significantly affected by ICV NaHS co-treatments, suggesting lesser effects of central infusion of NaHS on parasympathetic control of BP in our study.…”

Section: Discussionsupporting

confidence: 75%

Central Administration of Hydrogen Sulfide Donor NaHS Reduces Iba1-Positive Cells in the PVN and Attenuates Rodent Angiotensin II Hypertension

et al. 2021

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Hydrogen sulfide (H2S) is a gaseous signaling molecule with neuromodulatory, anti-inflammatory, and anti-hypertensive effects. Here, we investigate whether chronic intracerebroventricular (ICV) infusion of sodium hydrosulfide (NaHS), an H2S donor, can alleviate angiotensin II (Ang II)–induced hypertension (HTN), improve autonomic function, and impact microglia in the paraventricular nucleus (PVN) of the hypothalamus, a brain region associated with autonomic control of blood pressure (BP) and neuroinflammation in HTN. Chronic delivery of Ang II (200 ng/kg/min, subcutaneous) for 4 weeks produced a typical increase in BP and sympathetic drive and elevated the number of ionized calcium binding adaptor molecule 1–positive (Iba1+) cells in the PVN of male, Sprague–Dawley rats. ICV co-infusion of NaHS (at 30 and/or 60 nmol/h) significantly attenuated these effects of Ang II. Ang II also increased the abundance of cecal Deltaproteobacteria and Desulfovibrionales, among others, which was prevented by ICV NaHS co-infusion at 30 and 60 nmol/h. We observed no differences in circulating H2S between the groups. Our results suggest that central H2S may alleviate rodent HTN independently from circulating H2S via effects on autonomic nervous system and PVN microglia.

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“…HRV was assessed using time and frequency domain analysis in accordance with the European task force HRV guidelines 23 and as described elsewhere. 24,25 Briefly, ECG filtering and R-wave detection was performed using LabChart (ADInstruments, V8, Colorado Springs, CO, USA). The RR interval time series were obtained over 4-5-minute segments during supine rest and UDS at baseline and post-treatment.…”

Section: Methodsmentioning

confidence: 99%

“…27 The same segments were subsequently used for frequency domain analysis using Welch’s method with 50% windowing. 24,25 The periodogram of each segment was then calculated using the Fourier transformation. Total power of each periodogram was measured as a total index of HRV, which is determined by the integral over the entire frequency range.…”

Section: Methodsmentioning

confidence: 99%

Reduced Reflex Autonomic Responses following Intradetrusor OnabotulinumtoxinA Injections: A pre/post study in Individuals with Cervical and Upper Thoracic Spinal Cord Injury

Walter

Krassioukov

2021

Preprint

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Importance: Urodynamic studies (UDS) can provoke autonomic dysreflexia (AD) in individuals with spinal cord injury (SCI) at and above the sixth thoracic (T6) spinal segment potentially leading to profound vagally mediated heart rate reductions. Intradetrusor onabotulinumtoxinA injections have been shown to reduce AD events during UDS in this cohort but evidence is lacking whether this treatment can improve reflex autonomic responses. Objective: To assess the effects of intradetrusor onabotulinumtoxinA injections on heart rate variability (HRV) responses to UDS in individuals, 18-65 years of age, with chronic (>1-year) SCI at or above T6 with confirmed neurogenic detrusor overactivity and AD during UDS. Design, Setting, and Participants: This cohort study used participants from our recent prospective phase IV clinical trial. Individuals were screened at an academic medical centre between November 2014 and December 2019. After enrollment, participants underwent UDS prior to (i.e., baseline) and one month after intradetrusor onabotulinumtoxinA injections (post-treatment). Interventions: OnabotulinumtoxinA (200 U) was injected into the detrusor muscle at 20 sites (10 U/site). Main Outcomes and Measures: Continuous electrocardiogram (ECG) and blood pressure (BP) recordings were used to assess RR-interval, time and frequency domain metrics of HRV (a surrogate marker of autonomic nervous system activity), and AD pre- and post-intervention. Results: A total of 19 participants with SCI (5 women; mean [SD] age 42 [8.3] years) with complete ECG and BP data sets were suitable for autonomic analysis. During baseline UDS, an increase in RR-interval (adjusted mean difference, -0.08; 95% CI, -0.14 to -0.03; P=0.002) as well as time and frequency domain metrics of HRV were detected. Vagally mediated increases in high frequency (HF) power during UDS were larger in participants with cervical SCI compared to upper thoracic SCI (adjusted mean difference, 20.3; 95% CI, 3.3 to 37.2; P=0.013). Intradetrusor onabotulinumtoxinA injections significantly reduced time domain metrics of HRV and HF power (adjusted mean difference, 9.1; 95% CI, 3.1 to 15.1, P<0.01) responses to UDS across all participants. Conclusions and Relevance: Changes in HRV during UDS could be a potential indicator of improved autonomic cardiovascular function following interventions such as intradetrusor onabotulinumtoxinA injections.

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Altered heart rate variability in angiotensin II–mediated hypertension is associated with impaired autonomic nervous system signaling and intrinsic sinoatrial node dysfunction

Cited by 21 publications

References 26 publications

Heart Rate Variability Changes in Patients With Major Depressive Disorder: Related to Confounding Factors, Not to Symptom Severity?

Heart Rate Variability Changes in Patients With Major Depressive Disorder: Related to Confounding Factors, Not to Symptom Severity?

Central Administration of Hydrogen Sulfide Donor NaHS Reduces Iba1-Positive Cells in the PVN and Attenuates Rodent Angiotensin II Hypertension

Reduced Reflex Autonomic Responses following Intradetrusor OnabotulinumtoxinA Injections: A pre/post study in Individuals with Cervical and Upper Thoracic Spinal Cord Injury

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