Day–night variation in heart rate variability changes induced by endotoxaemia in healthy volunteers

Alamili, Mahdi; Rosenberg, Jacob; Gögenur, Ismail

doi:10.1111/aas.12472

Cited by 10 publications

(7 citation statements)

References 42 publications

(67 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Body temperature and medications (e.g., sedatives, beta-blockers, inotropic drugs) that can affect HRV were not evaluated in this study. Day-night variation in heart rate variability was not considered in the design of this study, although its existence has already been demonstrated in healthy volunteers with endotoxaemia[42]. The majority of 20-minute Holter measures were made during the day, and there were no significant differences between the percentage of day recordings from surviving and non-surviving groups.…”

Section: Discussionmentioning

confidence: 99%

Heart rate variability as predictor of mortality in sepsis: A prospective cohort study

et al. 2017

View full text Add to dashboard Cite

BackgroundSepsis is a serious medical condition with increasing prevalence and high mortality. The role of the autonomic nervous system in pathophysiology of sepsis has been increasingly researched. The objective of this study is to evaluate the Heart rate variability (HRV) as a predictor of mortality in septic patients.MethodsThis was a prospective cohort of patients diagnosed with sepsis. Patient recruitment was carried out at ICU in tertiary university hospital between March 2012 and February 2014. Clinical data and laboratory exams were collected at admission. Each patient underwent a 20-minute Holter and a 24-hour Holter on the first day of enrollment. The primary outcome was the 28-day all-cause mortality.ResultsA total of 63 patients were included. Patients were categorized into nonsurvivor group (n = 16) or survivor group (n = 47) depending on this endpoint. Survivors were younger (48.6 years vs. 63.0 years), had better renal function and lower values in severity scores (APACHE II and SOFA) compared to nonsurvivors. In the 20-minute Holter, SDNN, Total Power, VLF Power, LF Power and LF/HF of nonsurvivors were significantly lower than those of survivors (p = <0.001, p = 0.003, p = 0.002, p = 0.006, p = 0.009 respectively). ROC curve of SDNN was built, showing area under the curve of 0.772 (0.638–0.906) for mortality. The value of 17ms was chosen as best SDNN cutoff to discriminate survivors and nonsurvivors. In the Cox proportional regression, adjusted for SOFA score and for APACHE II, a SDNN ≤ 17ms was associated with a greater risk of death, with hazard ratios of 6.3 (1.4–28.0; p = 0.015) and 5.5 (1,2–24,8; p = 0.027), respectively. The addition of the dichotomized SDNN to the SOFA model reduced AIC and increased the concordance statistic and the R2, indicating that predictive power of the SDNN + SOFA model is better than predictive power of SOFA only.ConclusionsSeveral HRV parameters are reduced in nonsurviving septic patients. SDNN ≤17 is a risk factor for death in septic patients, even after adjusting for severity scores.

show abstract

Section: Discussionmentioning

confidence: 99%

Heart rate variability as predictor of mortality in sepsis: A prospective cohort study

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Experimental polymicrobial sepsis has been shown to reduce ANS activity, causing baroreflex impairment and suggesting that severe sepsis could lead to refractory septic shock and death (32). In one study, healthy volunteers who received lipopolysaccharide endotoxin showed decreases in heart rate variability (HRV) indexes (2). Oscillations in HRV constitute physiological phenomenon determined predominantly by the ANS (53).…”

Section: Introductionmentioning

confidence: 99%

Wharton’s jelly-derived mesenchymal stem cells attenuate sepsis-induced organ injury partially via cholinergic anti-inflammatory pathway activation

Capcha

Rodrigues

Moreira

et al. 2020

American Journal of Physiology-Regulatory, Integrative and Comp

View full text Add to dashboard Cite

Sepsis induces organ dysfunction due to overexpression of the inflammatory host response, resulting in cardiopulmonary and autonomic dysfunction, thus increasing the associated morbidity and mortality. Wharton’s jelly-derived mesenchymal stem cells (WJ-MSCs) express genes and secrete factors with anti-inflammatory properties, neurological and immunological protection, as well as improve survival in experimental sepsis. The cholinergic anti-inflammatory pathway (CAP) is mediated by α7-nicotinic acetylcholine receptors (α7nAChRs), which play an important role in the control of systemic inflammation. We hypothesized that WJ-MSCs attenuate sepsis-induced organ injury in the presence of an activated CAP pathway. To confirm our hypothesis, we evaluated the effects of WJ-MSCs as a treatment for cardiopulmonary injury and on neuroimmunomodulation. Male Wistar rats were randomly divided into four groups: control (sham-operated); cecal ligation and puncture (CLP) alone; CLP+WJ-MSCs (1 × 106 cells, at 6 h post-CLP); and CLP+methyllycaconitine (MLA)+WJ-MSCs (5 mg/kg body wt, at 5.5 h post-CLP, and 1 × 106 cells, at 6 h post-CLP, respectively). All experiments, including the assessment of echocardiographic parameters and heart rate variability, were performed 24 h after CLP. WJ-MSC treatment attenuated diastolic dysfunction and restored baroreflex sensitivity. WJ-MSCs also increased cardiac sympathetic and cardiovagal activity. WJ-MSCs reduced leukocyte infiltration and proinflammatory cytokines, effects that were abolished by administration of a selective α7nAChR antagonist (MLA). In addition, WJ-MSC treatment also diminished apoptosis in the lungs and spleen. In cardiac and splenic tissue, WJ-MSCs downregulated α7nAChR expression, as well as reduced the phospho-STAT3-to-total STAT3 ratio in the spleen. WJ-MSCs appear to protect against sepsis-induced organ injury by reducing systemic inflammation, at least in part, via a mechanism that is dependent on an activated CAP.

show abstract

“…Endotoxemia during both night and day resulted in a depression of HF, LF, and SDNN intervals along with an increased ratio of LF/HF and mean HR. However, nighttime endotoxemia was associated with a more pronounced depression of LF, HF, and SDNN, and a more pronounced increase in the ratio of LF/HF and mean HR, suggesting that changes in HRV mediated by endotoxemia show diurnal variation (Alamili et al, 2015).…”

Section: Variability Characterizes the Biological Systems And Heart mentioning

confidence: 92%

A Personalized Signature and Chronotherapy-Based Platform for Improving the Efficacy of Sepsis Treatment

Kenig

Ilan

2019

Front. Physiol.

View full text Add to dashboard Cite

Sepsis remains a major therapeutic challenge and is associated with a high rate of morbidity and mortality. It is a dynamic condition in which multiple parameters change over time, rendering it difficult to overcome the various injurious responses, which worsen the prognosis in these patients. The prognosis of sepsis is associated with a disbalance of compensatory responses to infectious triggers, part of which can be deleterious. Marked inter-and intra-patient variability characterizes the mechanisms that underlie sepsis progression and determine the response to therapy. In this paper, we review some of the data on the use of chronopharmacological approaches for the treatment of patients with sepsis and discuss the role of the autonomic nervous system in the mechanisms associated with immune response and chronotherapy in these patients. We describe the implementation of an individualized platform that is based on the personalized autonomic nervous system, immune, and chronobiologyderived parameters for generating a patient-tailored therapeutic regimen. The notion of overcoming the deleterious compensatory response in a highly dynamic system in sepsis is presented to ensure an improved response to current therapies.

show abstract

Day–night variation in heart rate variability changes induced by endotoxaemia in healthy volunteers

Abstract: Endotoxaemia induced changes in HRV exhibit a day-night difference. This difference may have clinical consequences in patients with sepsis.

Cited by 10 publications

References 42 publications

Heart rate variability as predictor of mortality in sepsis: A prospective cohort study

Heart rate variability as predictor of mortality in sepsis: A prospective cohort study

Wharton’s jelly-derived mesenchymal stem cells attenuate sepsis-induced organ injury partially via cholinergic anti-inflammatory pathway activation

A Personalized Signature and Chronotherapy-Based Platform for Improving the Efficacy of Sepsis Treatment

Contact Info

Product

Resources

About