Cardiac autonomic modulation at rest and during orthostatic stress among different systemic sclerosis subsets

Rodrigues, Gabriel Dias; Tobaldini, Eleonora; Bellocchi, Chiara; Santaniello, Alessandro; Caronni, Monica; Severino, Adriana; Froldi, M.; Beretta, Lorenzo; Soares, Pedro Paulo da Silva; Montano, Nicola

doi:10.1016/j.ejim.2019.06.003

Cited by 25 publications

(39 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…HRV markers at rest provide relevant information regarding cardiac autonomic modulation. However, the vagal and sympathetic contributions to cardiac regulation could be highlighted by the HRV response to an autonomic stimulus, such as active standing test (orthostatic stress) [14,16,27].…”

Section: Discussionmentioning

confidence: 99%

“…Recently, moderate to severe COPD patients showed an impaired HRV response to orthostatic stress and breathing maneuver, which was not present in less severely affected patients [6]. Although the HRV response to active standing test has been useful to add novel information regarding the association between cardiac autonomic regulation and cardiovascular outcomes in some disease conditions [16,27], the role of HRV analysis in relation to autonomic maneuvers must be further elucidated in patients with pulmonary disease.…”

Section: Discussionmentioning

confidence: 99%

“…The respiratory rate was significantly coupled with the HF component of the RR interval, as expressed by RR-RESP HFk 2 values (> 0.5) for all groups (Tables 2 and 3); LTx patients showed higher levels of RESP HF than HC. (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27), p = 0.02), a marker of sympathetic modulation, and lower levels of 2LV% (7 (4-13) vs. 11 (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18), p = 0.005), a marker of vagal modulation, in comparison to healthy controls ( Figure 1). These observations are consistent with the previous ones, confirming a higher sympathetic modulation and a lower vagal modulation in patients with end-stage lung disease.…”

Section: Autonomic Evaluation Of End-stage Lung Disease Patients Vs mentioning

confidence: 97%

See 2 more Smart Citations

Sympatho–Vagal Dysfunction in Patients with End-Stage Lung Disease Awaiting Lung Transplantation

Tobaldini

Rodrigues

Mantoan

et al. 2020

JCM

Self Cite

View full text Add to dashboard Cite

Although the literature demonstrates that cardiac autonomic control (CAC) might be impaired in patients with chronic pulmonary diseases, the interplay between CAC and disease severity in end-stage lung disease has not been studied yet. We investigated the effects of end-stage lung disease on CAC through the analysis of heart rate variability (HRV) among patients awaiting lung transplantation. Forty-nine patients on the waiting list for lung transplantation (LTx; 19 men, age 38 ± 15 years) and 49 healthy non-smoking controls (HC; 22 men, age 40 ± 16 years) were enrolled in a case–control study at Policlinico Hospital in Milan, Italy. LTx patients were divided into two groups, according to disease severity evaluated by the Lung Allocation Score (LAS). To assess CAC, electrocardiogram (ECG) and respiration were recorded at rest for 10 min in supine position and for 10 min during active standing. Spectral analysis identified low and high frequencies (LF, sympathetic, and HF, vagal). Symbolic analysis identified three patterns, i.e., 0V% (sympathetic) and 2UV% and 2LV% (vagal). Compared to HCs, LTx patients showed higher markers of sympathetic modulation and lower markers of vagal modulation. However, more severely affected LTx patients, compared to less severely affected ones, showed an autonomic profile characterized by loss of sympathetic modulation and predominant vagal modulation. This pattern can be due to a loss of sympathetic rhythmic oscillation and a subsequent prevalent respiratory modulation of heart rate in severely affected patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Autonomic Evaluation Of End-stage Lung Disease Patients Vs mentioning

confidence: 97%

See 1 more Smart Citation

Sympatho–Vagal Dysfunction in Patients with End-Stage Lung Disease Awaiting Lung Transplantation

Tobaldini

Rodrigues

Mantoan

et al. 2020

JCM

Self Cite

View full text Add to dashboard Cite

show abstract

“…For the heart rate variability (HRV) and BP analysis, time series 300 events of pulse intervals and systolic BP were interpolated (cubic spline) and decimated to obtain a series equally spaced in time [24]. e series were submitted to a Fast Fourier Transformation and analyzed with specific software (Heart Scope II, AMPS LLC, Brescia, Italy).…”

Section: Spectral Analysis Of Heart Rate and Blood Pressurementioning

confidence: 99%

Cardiovascular and Autonomic Responses after a Single Bout of Resistance Exercise in Men with Untreated Stage 2 Hypertension

Machado

Barbosa

Chrispino

et al. 2021

International Journal of Hypertension

Self Cite

View full text Add to dashboard Cite

The aim of this paper is to assess the integrated responses of ambulatory blood pressure (BP), cardiac autonomic modulation, spontaneous baroreflex sensitivity (BRS), and vascular reactivity after a single bout of resistance exercise (RE) in men with stage 2 hypertension who have never been treated before. Ten hypertensive men were subjected to a RE session of three sets of 20 repetitions and an intensity of 40% of the 1-repetition maximum (RM) test in seven different exercises. For the control (CTR) session, the volunteers were positioned on the exercise machines but did not perform any exercise. Forearm blood flow was measured by venous occlusion plethysmography. We also analyzed the heart rate variability (HRV), ambulatory BP, blood pressure variability (BPV), and BRS. All measurements were performed at different timepoints: baseline, 20 min, 80 min, and 24 h after both RE and CTR sessions. There were no differences in ambulatory BP over the 24 h between the RE and CTR sessions. However, the area under the curve of diastolic BP decreased after the RE session. Heart rate (HR) and cardiac output increased for up to 80 and 20 min after RE, respectively. Similarly, forearm blood flow, conductance, and vascular reactivity increased 20 min after RE ( p < 0.05 ). In contrast, HRV and BRS decreased immediately after exercise and remained lower for 20 min after RE. We conclude that a single bout of RE induced an increase in vascular reactivity and reduced the pressure load by attenuating AUC of DBP in hypertensive individuals who had never been treated with antihypertensive medications.

show abstract

“…Some manifestations of SSc including GI dysfunction [77] and impairment of microcirculation [78] are attributed to autonomic dysfunction [3]. Reduced vagal and increased sympathetic modulation at rest and deranged sympathetic response to orthostatic stress have been demonstrated by HRV analysis [79]. Cardiac autonomic dysfunction, which is related to right ventricular dysfunction [80], dysregulation of myocardial blood flow [81] and arrhythmic complications and mortality in patients with SSc [78] and precedes the development of fibrosis [82].…”

Section: Autonomic Dysfunction In Systemic Sclerodermamentioning

confidence: 99%

Ganglionic Acetylcholine Receptor Antibodies and Autonomic Dysfunction in Autoimmune Rheumatic Diseases

Imamura

Mukaino

Takamatsu

et al. 2020

IJMS

View full text Add to dashboard Cite

Autonomic neuropathy has been reported in autoimmune rheumatic diseases (ARD) including Sjögren’s syndrome, systemic sclerosis, rheumatoid arthritis, and systemic lupus erythematosus. However, the pathophysiological mechanism underlying autonomic dysfunction remains unknown to researchers. On the other hand, autoimmune autonomic ganglionopathy (AAG) is an acquired immune-mediated disorder, which causes dysautonomia that is mediated by autoantibodies against ganglionic acetylcholine receptors (gAChRs). The purpose of this review was to describe the characteristics of autonomic disturbance through previous case reports and the functional tests used in these studies and address the importance of anti-gAChR antibodies. We have established luciferase immunoprecipitation systems to detect antibodies against gAChR in the past and determined the prevalence of gAChR antibodies in various autoimmune diseases including AAG and rheumatic diseases. Autonomic dysfunction, which affects lower parasympathetic and higher sympathetic activity, is usually observed in ARD. The anti-gAChR antibodies may play a crucial role in autonomic dysfunction observed in ARD. Further studies are necessary to determine whether anti-gAChR antibody levels are correlated with the severity of autonomic dysfunction in ARD.

show abstract

Cardiac autonomic modulation at rest and during orthostatic stress among different systemic sclerosis subsets

Cited by 25 publications

References 26 publications

Sympatho–Vagal Dysfunction in Patients with End-Stage Lung Disease Awaiting Lung Transplantation

Sympatho–Vagal Dysfunction in Patients with End-Stage Lung Disease Awaiting Lung Transplantation

Cardiovascular and Autonomic Responses after a Single Bout of Resistance Exercise in Men with Untreated Stage 2 Hypertension

Ganglionic Acetylcholine Receptor Antibodies and Autonomic Dysfunction in Autoimmune Rheumatic Diseases

Contact Info

Product

Resources

About