Renal transplantation normalizes baroreflex sensitivity through improvement in central arterial stiffness

Kaur, Manpreet; Chandran, Dinu S; Lal, Charanjit; Bhowmik, D; Jaryal, Ashok Kumar; Deepak, Kishore Kumar; Agarwal, Sanjay Kumar

doi:10.1093/ndt/gft099

Cited by 23 publications

(20 citation statements)

References 38 publications

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“…Similar independent association of NAFLD with subclinical atherosclerosis has been observed in Asian Indians also [11]. In other clinical settings, it has been shown that arterial stiffness is inversely related to heart rate variability [12, 13]. However, there are only a few studies in which heart rate variability has been evaluated in NAFLD [9, 14, 15].…”

Section: Introductionsupporting

confidence: 52%

“…A recent systematic review of 27 studies showed an association of NAFLD with subclinical atherosclerosis independent of traditional risk factors and metabolic syndrome [10]. In other clinical settings, it has been shown that arterial stiffness is inversely related to heart rate variability [12, 13]. It is probable that increase in stiffness of arteries due to subclinical atherosclerosis leads to decrease in the transducer function of the baroreceptors.…”

Section: Discussionmentioning

confidence: 99%

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Cardiovascular Autonomic Dysfunction in Patients of Nonalcoholic Fatty Liver Disease

Kumar

Singh

Jaryal

et al. 2016

International Journal of Hepatology

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Aim. The present study was designed to evaluate the heart rate variability (HRV) in nonalcoholic fatty liver disease (NAFLD) and to assess the effect of grade of NAFLD and diabetic status on HRV. Methods. This cross-sectional study included 75 subjects (25 NAFLD without diabetes, 25 NAFLD with diabetes, and 25 controls). Measurements included anthropometry, body composition analysis, estimation of plasma glucose, serum lipids, hsCRP, and serum insulin. HRV analysis was performed in both time and frequency domains. Results. The time and frequency domain indices of overall variability (SDNN, total power) were significantly lower in NAFLD with diabetes as compared to the controls. However, the LF : HF ratio did not differ among the three groups. The variables related to obesity, lipid profile, and glucose metabolism were also higher in NAFLD with diabetes and those with Grade II NAFLD without diabetes, as compared to controls. Multivariate stepwise regression analysis showed a negative correlation between HRV and total cholesterol and fat percentage. Conclusion. The grade of NAFLD as well as diabetic status contributes to the decrease in the cardiovascular autonomic function, with diabetic status rather than grade of NAFLD playing a critical role. Serum lipids and adiposity may also contribute to cardiac autonomic dysfunction.

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Section: Introductionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Cardiovascular Autonomic Dysfunction in Patients of Nonalcoholic Fatty Liver Disease

Kumar

Singh

Jaryal

et al. 2016

International Journal of Hepatology

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“…Only one prospective study has examined the association between change of arterial stiffness and that of BRS over time, and reported that renal transplantation improves systemic arterial stiffness accompanied by improvement of BRS; although AI, but not carotid-femoral PWV, also improved following renal transplantation in that prospective study. 27 Thus, the strength of the present study is that it allowed confirmation of the association of baPWV with BRS on longitudinal assessments. It was found that change in BRS during a 1-year period after the start of antihypertensive medication had a significant association with that of baPWV during the same period; no such association of change in BRS with time was observed with that of AI/CBP or FMD.…”

Section: Discussionmentioning

confidence: 72%

Pathophysiological Contribution of Vascular Function to Baroreflex Regulation in Hypertension

Tomiyama

Matsumoto

Kimura

et al. 2014

Circ J

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Background:We examined which pathophysiological abnormalities of vascular function might be closely associated with abnormal baroreflex regulation in subjects with hypertension. Methods and Results:In the cross-sectional assessment, 280 subjects with hypertension were enrolled for measurement of brachial-ankle pulse wave velocity (baPWV), radial augmentation index (rAI), flow-mediated vasodilatation (FMD) of the brachial artery and baroreceptor sensitivity (BRS). These parameters were measured again as prospective assessment in some of these subjects. In the cross-sectional assessment, after adjustment for confounding variables including anti-hypertensive medication, the baPWV, but not the rAI or FMD, was found to have a significant independent relationship with BRS (standardization coefficient, -0.149, P<0.043). In the subjects who were newly started on anti-hypertensive medication (n=40), regression of baPWV before and 1 year after the start of medication was significantly associated with change in BRS during the same period. In subjects already on anti-hypertensive medication (n=92) also, the evolutional change of baPWV over a follow-up period >1.5 years was significantly associated with change in BRS during the same period. Conclusions:Increased stiffness of the large-to middle-sized arteries, rather than abnormal central hemodynamics or endothelial dysfunction, appears to contribute to abnormal baroreflex regulation in patients with hypertension.

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“…The quantification of BRS was done by time domain/sequence and frequency domain/spectral methods . The criteria for the detection of sequences were as follows: (a) R‐R variation >5 ms, (b) BP changes >0.5 mm Hg, (c) sequences >3 beats and (d) sequences correlation coefficient >0.85.…”

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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Renal transplantation normalizes baroreflex sensitivity through improvement in central arterial stiffness

Abstract: Our data suggest that RT normalizes BRS in ESRD patients by 6 months which follows the improvement in the AI and central pulse pressure.

Cited by 23 publications

References 38 publications

Cardiovascular Autonomic Dysfunction in Patients of Nonalcoholic Fatty Liver Disease

Cardiovascular Autonomic Dysfunction in Patients of Nonalcoholic Fatty Liver Disease

Pathophysiological Contribution of Vascular Function to Baroreflex Regulation in Hypertension

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

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