Influence of Different Types of Corticosteroids on Heart Rate Variability of Individuals with Duchenne Muscular Dystrophy—A Pilot Cross Sectional Study

Background and Objective: Duchenne muscular dystrophy (DMD) is a degenerative X-linked muscle disease. Death frequently results from complications in cardiopulmonary systems. Preclinical/early diagnosis of cardiac autonomic abnormalities may aid initiate cardioprotective therapy and enhance prognosis. Methods: A cross sectional, prospective study of 38 DMD boys compared with 37 age-matched healthy controls was conducted. Lead II electrocardiography and beat-to-beat blood pressure were recorded to assess heart rate variability (HRV), blood pressure variability (BPV), and baroreceptor sensitivity (BRS) in a standardized environment. Data were analysed and correlated with disease severity and genotype. Results: In the DMD group, the median age at assessment was 8 years [IQR 7–9 years], the median age at disease onset was 3 years [IQR, 2–6 years], and the mean duration of illness was 4 years [IQR, 2.5–5]. DNA sequencing showed deletions in 34/38 (89.5 %) and duplications in 4/38 (10.5%) patients. The median heart rate in DMD children was significantly higher [101.19 (Range, 94.71–108.49)] /min compared to controls [81 (Range, 76.2–92.76)] /min (p < 0.05). All the assessed HRV and BPV parameters were significantly impaired in DMD cases except for the coefficient of variance of systolic blood pressure. Further, BRS parameters were also significantly reduced in DMD, excluding alpha-LF. A positive correlation was found between alpha HF with age at onset and duration of illness. Conclusion: This study demonstrates a distinct early impairment of neuro-cardio-autonomic regulation in DMD. Simple yet effective non-invasive techniques such as HRV, BPV, and BRS may help identify cardiac dysfunction in a pre-clinical state, paving the way for early cardio-protective therapies and limiting disease progression in DMD patients.

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Neuro-Cardio-Autonomic Modulations in Children with Duchenne Muscular Dystrophy

Inbaraj

Krishnamurthy

Adoor

et al. 2023

JND

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Heart Rate Variability during Virtual Reality Activity in Individuals after Hospitalization for COVID-19: A Cross-Sectional Control Study

et al. 2023

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(1) Background: COVID-19 can lead to many complications, including cardiorespiratory complications and dysautonomia. This can be assessed by heart rate variability (HRV), which reflects the autonomic nervous system. There are different possibilities for physical rehabilitation after COVID, one of which that has been growing fast is the use of Virtual reality (VR) for rehabilitation. VR may represent an innovative and effective tool to minimize deficits that could lead to permanent disabilities in patients of outpatient rehabilitation services. The aim of this protocol is to establish whether practicing a task using a VR game with body movements influences physiological variables, such as heart rate, HRV, oxygen saturation, blood pressure, and perceptual variables during exercise in individuals post-hospitalization for COVID. (2) Methods: This cross-sectional study evaluated individuals divided into two groups, a post-hospitalization for COVID-19 group and a healthy control group. Subjects underwent one session of a VR task, and physiological variables, including HRV, were measured during rest, VR activity, and recovery. In addition, considering the influence of age in HRV and the impact of COVID-19, we divided participants by age. (3) Results: In all HRV indices and in both groups, an increase in sympathetic and a decrease in parasympathetic activity were found during VR. Additionally, the older post-COVID-19 group performed worse in non-linear indices, peripheral oxygen saturation, and rating of perceived exertion (RPE). (4) Conclusions: The VR game positively affects physiological variables and can therefore be utilized as a secure physical activity in both healthy individuals and individuals after hospitalization for COVID-19. COVID-19 affects the autonomic nervous system of older patients’ post-hospitalization, which may be partly due to a higher BMI and the reduced exercise capacity in this population, affecting their ability to perform exercise activities. Other important observations were the higher RPE in COVID-19 patients during and after exercise, which may reflect altered physiological and autonomic responses. Taken together with the high reporting of fatigue after COVID-19, this is an important finding, and considering that RPE is usually lower during VR exercise compared to non-VR strengthens the potential for the use of VR in COVID-19 patients.

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Altered Cardiac Autonomic Regulation in Individuals with Myasthenia Gravis—A Systematic Review and Meta-Analysis

Zawadka-Kunikowska,

Rzepiński,

Tafil-Klawe

et al. 2023

Neurology International

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The aim of this systematic review with meta-analysis was to determine differences in cardiovascular autonomic parameters between patients with myasthenia gravis (MG) and healthy controls (HCs). Two reviewers searched four electronic databases, namely PubMed, Web of Science, EMBASE, and SCOPUS, from database inception to 7 July 2023 for studies investigating cardiovascular autonomic parameters in MG vs. HCs. A random-effects meta-analysis was performed to compute Hedges’ g ± 95% confidence intervals (CI). Out of a total of 2200 records, 8 observational studies with a sample size of 301 patients with MG and 454 HCs were included in the systematic review. Meta-analysis revealed lower values of expiration/inspiration ratio (g = −0.45, I2 = 74.7), baroreflex sensitivity (g = −0.56, 95%CI −0.80, −0.33; I2 = 0.3), percentage of adjacent NN intervals differing by more than 50 ms (g = −1.2, I2 = 82.8), square root of the mean of squared differences between successive beat intervals (g = −1.94, I2 = 95.1), mean of the standard deviations of all NN intervals (g = −0.83, 95%CI −1.37, −0.28; I2 = 55.5), and high frequency of HRV during tilt (g = −0.75, 95%CI −0.11, −0.39; I2 = 0). MG patients vs. HCs had higher systolic blood pressure (g = 0.39; I2 = 56.1), sympathovagal balance at rest/during tilt (LF/HF-RRIsupine, g = 0.44; I2 = 0; LF/HF-RRItilt, g = 0.86; I2 = 0; LF/HFtilt, g = 0.40; I2 = 0). As a group, MG patients have altered cardiac autonomic function, including decreased parasympathetic function, lower baroreflex sensitivity, and higher sympathovagal balance at rest and during orthostatic challenges.

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Influence of Different Types of Corticosteroids on Heart Rate Variability of Individuals with Duchenne Muscular Dystrophy—A Pilot Cross Sectional Study

Cited by 4 publications

References 59 publications

Neuro-Cardio-Autonomic Modulations in Children with Duchenne Muscular Dystrophy

Neuro-Cardio-Autonomic Modulations in Children with Duchenne Muscular Dystrophy

Heart Rate Variability during Virtual Reality Activity in Individuals after Hospitalization for COVID-19: A Cross-Sectional Control Study

Altered Cardiac Autonomic Regulation in Individuals with Myasthenia Gravis—A Systematic Review and Meta-Analysis

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