Heart rate variability predicts levels of inflammatory markers: Evidence for the vagal anti-inflammatory pathway

Cooper, Timothy M.; McKinley, Paula S.; Seeman, Teresa E.; Choo, Tse‐Hwei; Lee, Seonjoo; Sloan, Richard P.

doi:10.1016/j.bbi.2014.12.017

Cited by 120 publications

(89 citation statements)

References 31 publications

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“…Lampert et al [34] demonstrated that decreased HRV, including VLF power, is associated with increased levels of C-reactive protein. Taken together, these studies have supported the evidence of vagal anti-inflammatory effects [35]. Thus, autonomic dysfunction might lead to inflammation, representing another plausible pathway of increased development of MACEs and hospitalization.…”

Section: Discussionsupporting

confidence: 61%

Heart Rate Variability Predicts Major Adverse Cardiovascular Events and Hospitalization in Maintenance Hemodialysis Patients

Huang

Kuo

Tsai

et al. 2017

Kidney Blood Press Res

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Background/Aims: Heart rate variability (HRV) has been linked to mortality in maintenance hemodialysis (HD) patients, but it is less clear whether HRV is associated with major adverse cardiovascular events (MACEs) and hospitalization. Methods: This study enrolled 179 maintenance HD patients. HRV was measured to assess its prognostic significance in relation to MACEs and hospitalization. Results: During the follow-up period of 33.3 ± 6.7 months, 36 (20.1%) patients had a MACE, and 98 (54.7%) experienced hospitalization. In multivariate adjusted Cox regression analysis, low very low frequency (VLF) power (hazard ratio [HR], 0.727; 95% confidence interval [CI], 0.624−0.848; p < 0.001), a history of coronary artery disease, high ultrafiltration rate, the use of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers, and the use of beta-blockers were all significantly associated with MACEs. Low VLF power (HR, 0.873; 95% CI, 0.785−0.971; p = 0.012), low serum albumin, low serum creatinine, low Kt/V levels, and high serum calcium-phosphorus product levels significantly predicted hospitalization in maintenance HD patients. Conclusions: Reduced VLF power is linked to an increased risk of MACEs and hospitalization in maintenance HD patients. Assessing cardiac autonomic function through HRV is of pivotal prognostic significance for this patient population.

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Section: Discussionsupporting

confidence: 61%

Heart Rate Variability Predicts Major Adverse Cardiovascular Events and Hospitalization in Maintenance Hemodialysis Patients

Huang

Kuo

Tsai

et al. 2017

Kidney Blood Press Res

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“…Alternatively, the hypothesis that the vagal anti-inflammatory pathway directly regulates inflammation may explain our results, especially for non-overweight individuals. 31 Animal models suggest that the hepatic parasympathetic nerve dysfunction causes the development of skeletal muscle insulin resistance, linking with the actions of hepatic insulin sensitizing substance (HISS) released from the liver and of the glucose uptake in the skeletal muscle. 32 The hepatic parasympathetic nerves regulate the HISS function; therefore, the impairment potentially lowers peripheral insulin sensitivity, which is consistent with our findings.…”

Section: Discussionmentioning

confidence: 99%

Heart Rate Variability, Insulin Resistance and Insulin Sensitivity in Japanese Adults: The Toon Health Study.

Saito

Maruyama

Nishida

et al. 2015

International Journal of Epidemiology

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Background: Although impaired cardiac autonomic function is associated with an increased risk of type 2 diabetes in Caucasians, evidence in Asian populations with a lower body mass index is limited. Methods: Between 2009-2012, the Toon Health Study recruited 1899 individuals aged 30-79 years who were not taking medication for diabetes. A 75-g oral glucose tolerance test was used to diagnose type 2 diabetes, and fasting and 2-h-postload glucose and insulin concentrations were measured. We assessed the homeostasis model assessment index for insulin resistance (HOMA-IR) and Gutt's insulin sensitivity index (ISI). Pulse was recorded for 5 min, and time-domain heart rate variability (HRV) indices were calculated: the standard deviation of normal-to-normal intervals (SDNN) and the root mean square of successive difference (RMSSD). Power spectral analysis provided frequency domain measures of HRV: high frequency (HF) power, low frequency (LF) power, and the LF:HF ratio. Results: Multivariate-adjusted logistic regression models showed decreased SDNN, RMSSD, and HF, and increased LF:HF ratio were associated significantly with increased HOMA-IR and decreased ISI. When stratified by overweight status, the association of RMSSD, HF, and LF:HF ratio with decreased ISI was also apparent in nonoverweight individuals. The interaction between LF:HF ratio and decreased ISI in overweight individuals was significant, with the odds ratio for decreased ISI in the highest quartile of LF:HF ratio in non-overweight individuals being 2.09 (95% confidence interval, 1.41-3.10). Conclusions: Reduced HRV was associated with insulin resistance and lower insulin sensitivity. Decreased ISI was linked with parasympathetic dysfunction, primarily in non-overweight individuals.

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“…The only method available in humans is HRV. Several observational studies have found inverse relationships between vagal HRV parameters and markers of inflammation in patients with rheumatoid arthritis [41] and brain injury [42] , as well as in crosssectional community samples [43][44][45] . However, in similar (patient) populations, these observations were not confirmed by others [46,47] .…”

Section: Human Studies Into the Anti-inflammatory Effects Of The Vagumentioning

confidence: 99%

Modulation of the Innate Immune Response through the Vagus Nerve

Kox

Pickkers

2015

Nephron

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The innate immune system is a defense mechanism that is of vital importance to our survival. However, excessive or unwanted activation of the innate immune system, which can occur in major surgery, sepsis, trauma, ischemia-reperfusion injury and autoimmune diseases, can lead to damage of the kidneys and other organs. Therefore, therapeutic approaches aimed at attenuating the innate immune response could have beneficial effects in these conditions. The vagus nerve exerts anti-inflammatory effects through the so-called cholinergic anti-inflammatory pathway. Since its discovery, numerous animal studies have shown beneficial effects of stimulation of this pathway in models of inflammatory diseases, either through (electrical) stimulation of the vagus nerve or pharmacological approaches. However, human data are very scarce. In this review, we present an overview of the molecular and anatomical bases of the cholinergic anti-inflammatory pathway, but mainly focus on human studies. We discuss the difficulties and drawbacks associated with investigating this pathway in humans, and finally, we provide future perspectives.

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Heart rate variability predicts levels of inflammatory markers: Evidence for the vagal anti-inflammatory pathway

Cited by 120 publications

References 31 publications

Heart Rate Variability Predicts Major Adverse Cardiovascular Events and Hospitalization in Maintenance Hemodialysis Patients

Heart Rate Variability Predicts Major Adverse Cardiovascular Events and Hospitalization in Maintenance Hemodialysis Patients

Heart Rate Variability, Insulin Resistance and Insulin Sensitivity in Japanese Adults: The Toon Health Study.

Modulation of the Innate Immune Response through the Vagus Nerve

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