Blunted Cardiac Autonomic Responsiveness to Hypoxemic Stress in Healthy Older Adults

Lucy, S. Deborah; Kowalchuk, John M.; Hughson, Richard L.; Paterson, Donald H.; Cunningham, David A.

doi:10.1139/h03-040

Cited by 9 publications

(7 citation statements)

References 43 publications

(110 reference statements)

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“…There were no significant differences in menstrual cycle phase distribution between IBS and control women. IBS patients did not differ significantly from controls in mean age; however, age did significantly affect our HRV in our models, a finding previously reported in literature, and was controlled for in our analysis. Irritable bowel syndrome patients and controls did not significantly differ in mean BMI.…”

Section: Resultssupporting

confidence: 59%

Autonomic response to a visceral stressor is dysregulated in irritable bowel syndrome and correlates with duration of disease

Cheng

Shih

Alberto

et al. 2013

Neurogastroenterology Motil

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Background Previous studies reported altered autonomic nervous system (ANS) responses in IBS at baseline and to colonic balloon distension. This study examined heart rate variability (HRV) and plasma catecholamines as an index of ANS responsiveness in IBS during flexible sigmoidoscopy (FS) and explored associations of HRV with clinical measures. Methods Rome III positive IBS patients and healthy controls completed questionnaires measuring GI and psychological symptoms. HRV measures were calculated using electrocardiogram (ECG) data at rest and during FS. Plasma catecholamines were measured before and after the FS. Linear mixed effects models were used to compare HRV with IBS status and IBS duration across six time points. Significance was assessed at the 0.05 level. Results 36 IBS patients (53% F, mean age 37.89) and 31 controls (58% F, mean age 37.26) participated. After adjusting for age, sex, BMI, and HAD anxiety, IBS patients had a non-significant lower cardiovagal tone (p=0.436) and higher cardiosympathetic balance (p=0.316) at rest. During FS, controls showed a transient increase in cardiosympathetic balance and decrease in cardiovagal tone. However, IBS patients had significantly less cardiosympathetic and cardiovagal responsiveness both leading up to (p=0.003, p=0.005) and following (p=0.001, p=0.001) this stimulus. Those with longer duration of disease had less cardiosympathetic (p=0.014) and cardiovagal (p=0.009) responsiveness than those with shorter duration. No differences in catecholamines between IBS and controls were found. Conclusion IBS demonstrated dysregulated ANS responses to a visceral stressor which could be related to disease duration. Therefore, autonomic dysregulation is an objective physiologic correlate of IBS.

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Section: Resultssupporting

confidence: 59%

Autonomic response to a visceral stressor is dysregulated in irritable bowel syndrome and correlates with duration of disease

Cheng

Shih

Alberto

et al. 2013

Neurogastroenterology Motil

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“…47 In older adults HRV spectral power remains unchanged during hypoxia, providing further evidence of an age-related blunting of cardiac autonomic function. 48 However, in the present study BMI was clinically not much different, and would lead to lower sympathetic and parasympathetic activities in the MI patients than in the NV. We therefore speculate that the listed findings are even more important than they may actually appear.…”

Section: Study Limitationscontrasting

confidence: 59%

Autonomic and Cardiovascular Effects of Acute High Altitude Exposure After Myocardial Infarction and in Normal Volunteers

Messerli‐Bürgy

Meyer

Steptoe³

et al. 2009

Circ J

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Background: High sympathetic tone creates a significant risk for ventricular arrhythmias and sudden death, which can especially affect patients after a myocardial infarction (MI) when exercising in a hypoxic environment. Methods and Results: The 16 patients after MI and 10 normal volunteers (NV) underwent a 1-day trip from low altitude (540 m, Bern) to high altitude (3,564 m Jungfraujoch, Swiss Alps). Autonomic function under resting and mental stress conditions at low and high altitude was assessed. MI patients demonstrated a significantly lower stroke volume (P<0.05) at rest compared with the NV at low as well as high altitude. High altitude exposure was accompanied by higher low-frequency/high-frequency values in the MI patients compared with NV (P<0.01). Following mental stress, MI patients failed to show the normal return to resting values at high altitude, suggesting sustained sympathetic and diminished parasympathetic activation during post-stress recovery. Conclusions: Although all MI patients were either on β-blockers or AII inhibitors, they showed higher sympathetic activity during exposure to high altitude compared with NV. In addition, the respective parasympathetic tone was reduced, especially during recovery. This puts patients after MI at an increased risk for cardiac arrhythmias and they should be advised of this if going to high altitudes. (Circ J 2009; 73: 1485 -1491

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“…To put this in perspective, one can typically measure physiologic responses to changes in SpO 2 that reach approximately 70%. 76,77 There are no known physiological responses to changes of 1% in the range of nearly saturated hemoglobin (97%-99%). Also, the control subjects were not age-matched to the pPOAG group, since patients with pPOAG were those who had relatively long-standing glaucoma compared with those with uPOAG and were also those who had shown progression.…”

Section: Figurementioning

confidence: 99%

Retinal Arteriolar Vascular Reactivity in Untreated and Progressive Primary Open-Angle Glaucoma

Venkataraman

Hudson

Rachmiel

et al. 2010

Invest. Ophthalmol. Vis. Sci.

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Purpose. To determine (1) the magnitude of retinal arteriolar vascular reactivity to normoxic hypercapnia in patients with untreated primary open-angle glaucoma (uPOAG) or progressive (p)POAG and in control subjects and (2) the effect of treatment with 2% dorzolamide on retinal vascular reactivity in uPOAG. Methods. The sample comprised 11 patients with uPOAG (after undergoing treatment, they became treated (t)POAG), 17 patients with pPOAG (i.e., manifesting optic disc hemorrhage), and 17 age-similar control subjects. The partial pressure of end-tidal CO(2) (PetCO(2)) was stabilized at 38 mm Hg at baseline. After baseline (10 minutes), normoxic hypercapnia was then induced (15 minutes) with an automated gas flow controller. Retinal arteriolar and optic nerve head (ONH) blood hemodynamics were assessed. The procedures were repeated after treatment with 2% dorzolamide for 2 weeks in tPOAG. Results. Baseline arteriolar hemodynamics were not different across the groups. In control subjects, diameter, velocity, and flow increased (P < 0.001) in response to normoxic hypercapnia. There was no change in all three hemodynamic parameters to normoxic hypercapnia in uPOAG, whereas only blood flow increased (P = 0.030) in pPOAG. Vascular reactivity was decreased in uPOAG and pPOAG patients compared with that in control subjects. After treatment with topical 2% dorzolamide for 2 weeks, the tPOAG group showed an increase in diameter, velocity, and flow (P

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Blunted Cardiac Autonomic Responsiveness to Hypoxemic Stress in Healthy Older Adults

Cited by 9 publications

References 43 publications

Autonomic response to a visceral stressor is dysregulated in irritable bowel syndrome and correlates with duration of disease

Autonomic response to a visceral stressor is dysregulated in irritable bowel syndrome and correlates with duration of disease

Autonomic and Cardiovascular Effects of Acute High Altitude Exposure After Myocardial Infarction and in Normal Volunteers

Retinal Arteriolar Vascular Reactivity in Untreated and Progressive Primary Open-Angle Glaucoma

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