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Effects of Acute Hypoxia on Heart Rate Variability in Patients with Pulmonary Vascular Disease.

ABSTRACT: Pulmonary vascular diseases (PVDs), defined as arterial or chronic thromboembolic pulmonary hypertension, are associated with autonomic cardiovascular dysregulation. Resting heart rate variability (HRV) is commonly used to assess autonomic function. Hypoxia is associated with sympathetic overactivation and patients with PVD might be particularly vulnerable to hypoxia-induced autonomic dysregulation. In a randomised crossover trial, 17 stable patients with PVD (resting PaO₂ ≥ 7.3 kPa) were exposed to ambient air (FiO₂ = 21%) and normobaric hypoxia (FiO₂ = 15%) in random order. Indices of resting HRV were derived from two nonoverlapping 5-10-min three-lead electrocardiography segments. We found a significant increase in all time- and frequency-domain HRV measures in response to normobaric hypoxia. There was a significant increase in root mean squared sum difference of RR intervals (RMSSD; 33.49 (27.14) vs. 20.76 (25.19) ms; p < 0.01) and RR50 count divided by the total number of all RR intervals (pRR50; 2.75 (7.81) vs. 2.24 (3.39) ms; p = 0.03) values in normobaric hypoxia compared to ambient air. Both high-frequency (HF; 431.40 (661.56) vs. 183.70 (251.25) ms²; p < 0.01) and low-frequency (LF; 558.60 (746.10) vs. 203.90 (425.63) ms²; p = 0.02) values were significantly higher in normobaric hypoxia compared to normoxia. These results suggest a parasympathetic dominance during acute exposure to normobaric hypoxia in PVD.

SUBMITTER: Meszaros M

PROVIDER: S-EPMC10003175 | biostudies-literature | 2023 Feb

REPOSITORIES: biostudies-literature

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Effects of Acute Hypoxia on Heart Rate Variability in Patients with Pulmonary Vascular Disease.

Meszaros Martina M Schneider Simon R SR Mayer Laura C LC Lichtblau Mona M Pengo Martino F MF Berlier Charlotte C Saxer Stéphanie S Furian Michael M Bloch Konrad E KE Ulrich Silvia S Schwarz Esther I EI

Journal of clinical medicine 20230223 5

Pulmonary vascular diseases (PVDs), defined as arterial or chronic thromboembolic pulmonary hypertension, are associated with autonomic cardiovascular dysregulation. Resting heart rate variability (HRV) is commonly used to assess autonomic function. Hypoxia is associated with sympathetic overactivation and patients with PVD might be particularly vulnerable to hypoxia-induced autonomic dysregulation. In a randomised crossover trial, 17 stable patients with PVD (resting PaO<sub>2</sub> ≥ 7.3 kPa) ...[more]

PMID: 36902567

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Project description:Background and objectiveAcute pancreatitis (AP) is a complex inflammatory disorder with potential systemic repercussions including sepsis, multiple organ failure and mortality. As such, the development of a prognostic tool to assess the complications and severity of AP is critical as urgent medical intervention is warranted in cases of severe AP to prevent complications and reduce mortality. Despite the plethora of scoring systems such as the Acute Physiology and Chronic Health Evaluation II (APACHE II) score available for prognostication of AP, they often require manual invasive blood testing and lack the ability to monitor the dynamic progression of the disease. To this end, heart rate variability (HRV), a measure of the autonomic nervous system's modulation on cardiac activity, has emerged as a promising tool. Having been previously posited as a tool to monitor the progression of cardiovascular and neurological conditions, the use of HRV as a risk stratification tool for AP is highly plausible. Therefore, this study aims to synthesize the existing literature regarding the usage of HRV as a tool for the prognostication and monitoring of AP.MethodsA comprehensive literature search was conducted in PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, Scopus and Embase from inception to December 2023. Articles with mentions of AP and HRV were reviewed, and the complications of AP and its effects on HRV parameters were analyzed.Key content and findingsEarly studies on the use of HRV in AP have revealed the association of decreased HRV parameters with the development of subsequent complications, reflecting the suppression of sympathetic activity as a predominant driving force. In addition, HRV has also been shown to outperform other established scoring systems in predicting outcomes of the complications of AP, but more studies are needed to validate its accuracy.ConclusionsPreliminary studies have shown that certain parameters of HRV may be used to predict the severity of AP and prognosticate outcomes. Although HRV monitoring demonstrates potential to be superior to existing scoring systems in AP, more research is needed to validate its use as a prognostic tool. Nevertheless, the prospective utility of HRV monitoring in predicting the onset and outcomes of AP and its complications remains optimistic.

Project description:ObjectiveTo explore the correlation between Heart Rate Variability Index (HRV) and poor prognosis in patients with acute decompensated heart failure (ADHF).MethodsA retrospective compilation of clinical data encompassed 128 cases of patients afflicted with acute decompensated heart failure (ADHF) who were admitted to and discharged from our hospital between April 2019 and July 2022. Subsequent to assessing their follow-up progress during the tracking period, the subjects were categorized into two cohorts: the poor prognosis group (n = 31) and the good prognosis group (n = 97). Comparative analysis of clinical data and Heart Rate Variability (HRV) parameters was executed between these two groups. Moreover, a multiple linear regression analysis was employed to identify the contributing factors associated with adverse prognoses in ADHF patients. Furthermore, the receiver operating characteristic (ROC) curve was employed to evaluate the prognostic predictive capability of HRV parameters among ADHF patients.ResultsThe levels of SDNN (t = 3.924, P < 0.001), SDANN (t = 4.520, P < 0.001) and LF (t = 2.676, P = 0.018) in the poor prognosis group were significantly higher than those in the good prognosis group, and the differences were statistically significant (P < 0.05). The levels of PNN50 (t = 2.132, P = 0.035), HF (t = 11.781, P < 0.001) and LF/HF (t = 11.056, P < 0.001) in the poor prognosis group were significantly lower than those in the good prognosis group (P < 0.05). The results of multiple linear regression analysis indicated that SDNN, SDANN, LF, PNN50, and HF were factors influencing poor prognosis in ADHF patients (P < 0.05). The results of the ROC curve analysis indicate that the area under the curve (AUC) for predicting poor prognosis in ADHF patients using HRV parameters were as follows: SDNN (AUC = 0.818, 95% CI [0.722-0.914]), SDANN (AUC = 0.684, 95% CI [0.551-0.816]), PNN50 (AUC = 0.754, 95% CI [0.611-0.841]), LF/HF (AUC = 0.787, 95% CI [0.679-0.896]), and combined diagnosis (AUC = 0.901, 95% CI [0.832-0.970]). Among these, the combined diagnosis exhibited the highest AUC, sensitivity, and specificity for predicting poor prognosis in ADHF patients (P < 0.001).ConclusionThe HRV parameters of SDNN, SDANN, PNN50 and LF/HF are closely related to the prognosis of ADHF patients. The combined detection of the above HRV parameters can improve the efficacy of predicting the poor prognosis of ADHF patients. This suggests that clinical staff can identify ADHF patients at risk of poor prognosis by long-term monitoring of HRV in the future.

Dataset Information

Effects of Acute Hypoxia on Heart Rate Variability in Patients with Pulmonary Vascular Disease.

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Effects of Acute Hypoxia on Heart Rate Variability in Patients with Pulmonary Vascular Disease.

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