Association between autonomic control indexes and mortality in subjects admitted to intensive care unit

Abstract

This study checks whether autonomic markers derived from spontaneous fluctuations of heart period (HP) and systolic arterial pressure (SAP) and from their interactions with spontaneous or mechanical respiration (R) are associated with mortality in patients admitted to intensive care unit (ICU). Three-hundred consecutive HP, SAP and R values were recorded during the first day in ICU in 123 patients. Population was divided into survivors (SURVs, n = 83) and non-survivors (NonSURVs, n = 40) according to the outcome. SURVs and NonSURVs were aged- and gender-matched. All subjects underwent modified head-up tilt (MHUT) by tilting the bed back rest segment to 60°. Autonomic control indexes were computed using time-domain, spectral, cross-spectral, complexity, symbolic and causality techniques via univariate, bivariate and conditional approaches. SAP indexes derived from time-domain, model-free complexity and symbolic approaches were associated with the endpoint, while none of HP variability markers was. The association was more powerful during MHUT. Linear cross-spectral and causality indexes were useless to separate SURVs from NonSURVs, while nonlinear bivariate symbolic markers were successful. When indexes were combined with clinical scores, only SAP variance provided complementary information. Cardiovascular control variability indexes, especially when derived after an autonomic challenge such as MHUT, can improve mortality risk stratification in ICU.

Birth weight and heart rate autonomic recovery following exercise in healthy term-born adults

“…We reveal important results to the clinical research community, since cardiovascular disorders are projected to be one of the key public health challenges globally in the twenty-first century 46 . Moreover, impaired autonomic function is consistent with significantly higher rates of cardiovascular disease and mortality 47 , 48 . Our results advocate that young healthy young women born term with BW below 3200 g may be at a slightly increased risk of developing cardiovascular disease compared to those with BW > 3200 g. Thus, we reinforce the importance of preventive measures for children with BW < 3200 g during their whole lifetime.…”

Impact of Supratentorial Cerebral Hemorrhage on the Complexity of Heart Rate Variability in Acute Stroke

“…Interestingly, we recently confirmed the usefulness of photoplethysmogram signals from routine pulse oximetry in identifying AF rhythms 38 . Another study showed that systolic arterial blood pressure variability can also be powerful in predicting outcome in critical care 39 . Incorporating multi-parameter monitoring in the future can broaden the usefulness of autonomic function in critical settings.…”

Linear and non-linear analysis of heart rate variability in HIV-positive patients on two different antiretroviral therapy regimens

“…As inclusion criteria, all subjects of the three groups had to present a normal ECG, echocardiography, and X-ray of the thorax. We excluded patients with the following conditions: congestive cardiac failure, acute coronary failure, diabetes mellitus, Chagas’ disease, tuberculosis, malnutrition, dehydration, alcohol addiction, with acute phase response, carriers of artificial pacemaker, using tricycle anti-depressant drugs, amphotericin B, antiarrhythmic, contraceptive, β-blocker and centrally acting antihypertensive agents, opportunistic infections that could interfere with the ability to maintain ANS homeostasis [ 47 ].…”