Effect of hypovolemia on efficacy of reflex maintenance of blood pressure on orthostatic challenge

Yadav, Kavita; Akanksha, .; Jaryal, Ashok Kumar; Coshic, Poonam; Chatterjee, Kabita; Deepak, K K

doi:10.1007/s40292-016-0130-y

Cited by 3 publications

(2 citation statements)

References 16 publications

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“…The BPV was analysed in the time domain to calculate SDNN, CoV (coefficient of variance) and RMSSD (square root of the mean of the sum of the squares of differences between adjacent BP readings). Similarly, for spectral analysis, the PSD was calculated using FFT by a Hanning window in the LF (0.04‐0.15 Hz) and HF (0.15‐0.40 Hz) bands, along with the total power …”

Section: Methodsmentioning

confidence: 99%

Depressed baroreflex sensitivity from spontaneous oscillations of heart rate and blood pressure in SCA1 and SCA2

et al. 2019

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| INTRODUC TI ONSpinocerebellar ataxia (SCA) type 1 and 2 are dominantly inherited neurodegenerative disorders. These SCA subtypes are two of the most widely prevalent SCAs worldwide with a similar pattern found in India as well. SCA1 and SCA2 are caused by the abnormal expansion of CAG trinucleotide repeats in ATXN1 and ATXN2 genes, respectively. This results in progressive neuronal loss in the cerebellum along with certain cortical and subcortical brain regions in SCA subtypes 1,2 which subsequently leads to widespread clinical manifestations. Motor symptoms of SCA comprise cerebellar ataxia, peripheral neuropathy, ophthalmoplegia, pyramidal and extrapyramidal signs. 3 Furthermore, symptoms of autonomic dysfunction have also been observed in SCA patients. Thus, the evaluation of autonomic profile in SCA subtypes has an extensive clinical value. Objectives: To assess the time and frequency domain measures of cardiac autonomic activity/tone in patients of genetically defined spinocerebellar ataxia (SCA) types 1 and 2, as well as to decipher the probable associations among the cardiovascular autonomic parameters and genetic and clinical characteristics. Materials and methods:Simultaneous 5-min recording of RR interval (RRI) and blood pressure (BP) for the calculation of heart rate variability (HRV), blood pressure variability (BPV) and baroreflex sensitivity (BRS) were performed in genotypically confirmed SCA1 (n = 31) and SCA2 (n = 40) patients and healthy controls (n = 40).Additionally, the International Cooperative Ataxia Rating Scale (ICARS) was used for scoring of clinical severity in SCA patients.Results: Time and frequency domain parameters of HRV, BPV and BRS were depressed in SCA1 and SCA2 subtypes as compared to controls, although there was no statistically significant difference in autonomic tone between the two SCA subtypes.On correlation analysis, autonomic tone parameters were found to be associated with the clinical and genetic features of the SCA subtypes. Also, ICARS was associated with the genotype (CAG repeat length) in SCA2 patents. Conclusions:Cardiac autonomic tone is depressed in both SCA1 and 2 as compared to healthy controls while the two SCA subtypes do not differ in terms of autonomic tone. Also, a typical association exists between disease characteristics and autonomic indices. K E Y W O R D Sbaroreflex sensitivity, blood pressure variability, cardiac autonomic activity/tone, heart rate variability, spinocerebellar ataxia

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Section: Methodsmentioning

confidence: 99%

Depressed baroreflex sensitivity from spontaneous oscillations of heart rate and blood pressure in SCA1 and SCA2

et al. 2019

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“…The pathogenesis of VVS is complex and includes, but is not limited to, hypovolemia ( 2 – 4 ), enhanced sympathetic nerve activity ( 5 , 6 ) and catecholamine levels ( 7 ), and excessive peripheral vasodilation ( 8 ). It was found that during an attack of VVS, the orthostatic stress, which was the major trigger, may initially stagnate blood in the veins of lower extremities due to gravitational forces ( 9 ) and thereby reduced the circulating blood volume, which activated an aberrant autonomic regulation ( 10 ), resulting in bradycardia ( 11 , 12 ) and/or hypotension, and ultimately decreasing the cerebral blood flow ( 13 – 15 ) and oxygen saturation ( 15 , 16 ). The relative central hypovolemia can be the initial factor that promotes the whole process.…”

Section: Introductionmentioning

confidence: 99%

Predicting therapeutic efficacy of oral rehydration salts in children with vasovagal syncope

Tao

et al. 2023

Front. Pediatr.

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ObjectiveThis study was designed to develop an easy-to-perform and inexpensive measure to predict efficacy of the oral rehydration salts (ORS) in children with vasovagal syncope (VVS).Materials and methodsChildren diagnosed with VVS and treated with ORS for a median of 3 months at the Peking University First Hospital, China, were enrolled and followed up. Demographic data, clinical hemodynamic parameters, and variables related to red blood cells were collected at the baseline. On the basis of changes in symptom scores after treatment, participants were divided into effective or ineffective groups at the end of the follow-up. Logistic regression analysis was used to investigate parameters related to therapeutic efficacy of ORS and a predictive model of ORS effectiveness was created. The predictive efficiency was evaluated using the receiver operating characteristic curve. The accuracy/consistency was evaluated by the Hosmer–Lemeshow test and calibration curve. Internal validation was done using the bootstrap approach.ResultsTotally 97 pediatric participants were included in the study and 4 (4.1%) were lost during the follow-up. ORS therapy was effective in 46 children and ineffective in 47 children. Children in the effective group had higher baseline red blood cell count, hemoglobin, and hematocrit than those in the ineffective group (p < 0.01). Through logistic regression analysis, the baseline hematocrit and body mass index (BMI) were included in predictive model for the response to ORS treatment. The predictive efficacy of the model showed an area under the curve of 0.77 (p < 0.01). The predicted probability cut-off value of 0.5 was found to be optimal, with a resulting sensitivity of 67.4% and specificity of 80.9%. In the Hosmer–Lemeshow test, p-value was 0.75, and the calibration plot showed a good model fitness. Internal validation was performed using the bootstrap approach (n = 1,000), showing 95% confidence interval of 0.67–0.86.ConclusionHemoglobin combined with BMI was useful for predicting the therapeutic efficacy of ORS in children with VVS.

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Physiology of Cardiovascular System

Jaryal

Singh

Deepak

2020

Brain and Heart Crosstalk

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Effect of hypovolemia on efficacy of reflex maintenance of blood pressure on orthostatic challenge

Cited by 3 publications

References 16 publications

Depressed baroreflex sensitivity from spontaneous oscillations of heart rate and blood pressure in SCA1 and SCA2

Depressed baroreflex sensitivity from spontaneous oscillations of heart rate and blood pressure in SCA1 and SCA2

Predicting therapeutic efficacy of oral rehydration salts in children with vasovagal syncope

Physiology of Cardiovascular System

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