Comparison of spontaneous vs. metronome-guided breathing on assessment of vagal modulation using RR variability

R-R interval variability (RR variability) is increasingly being used as an index of autonomic activity. High-frequency (HF) power reflects vagal modulation of the sinus node. Since vagal modulation occurs at the respiratory frequency, some investigators have suggested that HF power cannot be interpreted unless the breathing rate is controlled. We hypothesized that HF power during spontaneous breathing would not differ significantly from HF power during metronome-guided breathing. We measured HF power during spontaneous breathing in 20 healthy subjects and 19 patients with heart disease. Each subject's spontaneous breathing rate was determined, and the calculation of HF power was repeated with a metronome set to his or her average spontaneous breathing rate. There was no significant difference between the logarithm of HF power measured during spontaneous and metronome-guided breathing [4.88 +/- 0.29 vs. 5.29 +/- 0.30 ln(ms(2)), P = 0.32] in the group as a whole and when patients and healthy subjects were examined separately. We did observe a small (9.9%) decrease in HF power with increasing metronome-guided breathing rates (from 9 to 20 breaths/min). These data indicate that HF power during spontaneous and metronome-guided breathing differs at most by very small amounts. This variability is several logarithmic units less than the wide discrepancies observed between healthy subjects and cardiac patients with a heterogeneous group of cardiovascular disorders. In addition, HF power is relatively constant across the range of typical breathing rates. These data indicate that there is no need to control breathing rate to interpret HF power when RR variability (and specifically HF power) is used to identify high-risk cardiac patients.     

Forearm vascular resistance increases during static exercise in heart transplant recipients.

In heart transplant recipients but not in normal humans, total peripheral vascular resistance increases during static exercise. To determine whether this augmented vasoconstriction limits the vasodilation normally seen in the nonexercising forearm, we measured arterial pressure, heart rate, and forearm blood flow during 30% maximal static handgrip in 9 heart transplant recipients and 10 control subjects. Handgrip evoked comparable increases in mean arterial pressure in the transplant recipients and control subjects (+19 +/- 2 vs. +20 +/- 2 mmHg). Heart rates increased by 14 +/- 3 beats/min in the control subjects but did not change in the transplant recipients. Directionally opposite patterns of forearm vascular resistance were observed in the two groups. In the control subjects, forearm resistance fell during handgrip (-8.8 +/- 1.9 units, P less than 0.05). In contrast, in the transplant recipients, forearm resistance rose during this intervention (+9.0 +/- 2.9 units, P less than 0.05). Thus the vasodilation that normally occurs in the nonexercising forearm during static handgrip is reversed in heart transplant recipients. Vasoconstriction in the forearm contributes to the increase in total peripheral resistance that occurs during static exercise in these individuals.     

Unexpected course of nonlinear cardiac interbeat interval dynamics during childhood and adolescence

The fluctuations of the cardiac interbeat series contain rich information because they reflect variations of other functions on different time scales (e.g., respiration or blood pressure control). Nonlinear measures such as complexity and fractal scaling properties derived from 24 h heart rate dynamics of healthy subjects vary from childhood to old age. In this study, the age-related variations during childhood and adolescence were addressed. In particular, the cardiac interbeat interval series was quantified with respect to complexity and fractal scaling properties. The R-R interval series of 409 healthy children and adolescents (age range: 1 to 22 years, 220 females) was analyzed with respect to complexity (Approximate Entropy, ApEn) and fractal scaling properties on three time scales: long-term (slope β of the power spectrum, log power vs. log frequency, in the frequency range 10(-4) to 10(-2) Hz) intermediate-term (DFA, detrended fluctuation analysis, α(2)) and short-term (DFA α(1)). Unexpectedly, during age 7 to 13 years β and ApEn were higher compared to the age <7 years and age >13 years (β: -1.06 vs. -1.21; ApEn: 0.88 vs. 0.74). Hence, the heart rate dynamics were closer to a 1/f power law and most complex between 7 and 13 years. However, DFA α(1) and α(2) increased with progressing age similar to measures reflecting linear properties. In conclusion, the course of long-term fractal scaling properties and complexity of heart rate dynamics during childhood and adolescence indicates that these measures reflect complex changes possibly linked to hormonal changes during pre-puberty and puberty.     

Heart rate variability and spontaneous baroreflex sequences in supine healthy volunteers subjected to nasal positive airway pressure.

To determine the dynamic effects of short-term nasal positive airway pressure (nPAP) on cardiovascular autonomic control, continuous recordings of noninvasively obtained hemodynamic measurements and heart rate variability (HRV) were obtained in 10 healthy subjects during frequency-controlled breathing (between 0.20 and 0.24 Hz) in supine posture under different pressures of nPAP ranging from 3 to 20 cmH(2)O. HRV was assessed using spectral analysis of the R-R interval. The slope of the regression line between spontaneous systolic blood pressure and pulse interval changes was taken as an index of the sensitivity of arterial baroreflex modulation of heart rate (sequence method). Application of nPAP resulted in a pressure-dependent decrease of cardiac output and stroke volume (P < 0.05, ANOVA) and in an increase in total peripheral resistance (P < 0.03, ANOVA). Hemodynamic changes under increasing nPAP were accompanied by a decrease in total power of HRV despite mean R-R interval remaining unchanged. The overall decrease in HRV was accompanied by a reduction across all frequency bands when absolute units were used (P < 0.01). When the power of low frequency and high frequency was calculated in normalized units, a diminished high frequency and an increased low-to-high frequency ratio were observed (P < 0.05). Compared with low levels of nPAP, pressure levels of >10 cmH(2)O were associated with a significant decline in the mean slope of spontaneous baroreceptor sequences (P < 0.04). These findings indicate that short-term administration of nPAP in normal subjects exerts significant alterations in R-R interval variability and spontaneous baroreflex modulation of heart rate.     

An approach to remote monitoring of heart rate variability (HRV) using microwave radar during a calculation task

Recently, nonrestrictive and noninvasive sensing techniques to measure vital signs have been actively researched and developed. This study aimed to develop a prototype system to monitor cardiac activity using microwave radar without making contact with the body and without removing clothing--namely, a completely noncontact, remote monitoring system. In addition, heart rate and changes in heart rate variability (HRV) during simple mental arithmetic tasks were observed with the prototype system. The prototype system has a microwave Doppler radar antenna with 24 GHz frequency and approximately 7 mW output power. The experiments were conducted with seven subjects (23.00±0.82 years). We found that the prototype system captured heart rate and HRV precisely. The strong relationship between the heart rates during tasks (r=0.96), LF (cross-correlation=0.76), and LF/HF (cross-correlation=0.73) of HRV calculated from the prototype system and from electrocardiograph (ECG) measurements were confirmed. The proposed completely noncontact, remote method appears promising for future monitoring of cardiac activity as an indicator of changes in mental workload in workplaces.     

Heart rate and its cholinergic control in the sole (Solea vulgaris), acclimatized to different temperatures

• 1.1. The effects of thermal acclimatization at 10 and 24°C on heart rate were investigated on unrestrained soles (Solea vulgaris).
• 2.2. The sensitivity of heart rate to temperature changes induced by temperature acclimatization was higher in cold-acclimatized than in warm-acclimatized soles.
• 3.3. Heart rate of cold-acclimatized fish to temperature changes was not affected by blocking the vagal tone with atropine.
• 4.4. After atropine treatment the ability of heart rate to show thermal compensation decreased in warm-acclimatized soles.
• 5.5. It is suggested that the vagus nerve can function differently at different temperatures.

     

The impact of experimental instruction on changes in EEG power during verbal creative thinking in men and women

Features of EEG pattern during verbal creative thinking depending on experimental instruction were studied in men and women. Spectral power density was analyzed in six frequency bands (4-30 Hz). Performance of a creative task produced an increase in the power of theta (4-6 Hz) and beta2 (20-40 Hz) components and decrease in the power of alpha (8-13 Hz) and betal (13-20 Hz). Changes in the alpha and betal bands were observed, predominantly, in the posterior areas, whereas power of the thetal and beta2 bands increased in the anterior areas. Independently of instruction, women demonstrated greater synchronization in the theta1 band than men, whereas in men the desynchronization in the alpha2 band (10-13 Hz) was more pronounced. When the subjects were instructed to create original sentences, a widespread decrease in the EEG power was observed in the band of 8-30 Hz as compared to instruction "to create sentences". Thus, the instruction-related changes in EEG power were not gender-specific. They may reflect neural activity mediating selective attention.     

Changes of external respiration, brain circulation and the EEG in acute hypoxia in the subjects with different hypoxic resistance

Two groups of individuals were distinguished in experiments with acute hypoxic action (respiration of oxygen-nitrogen mixture with 8 % oxygen content) - with low (LHR) and high (HHR) resistance to hypoxia. In subjects of the LR group, slowing down of the pulse rate and lowering of arterial pressure in the shoulder artery were observed on the 5th-10th minute of hypoxia. In the HHR subjects, primary growth of the pulse rate was followed by its stabilization; no significant changes of the arterial pressure were observed. In LHR subjects, in the first 5-10 min of the hypoxia, a significantly lower level of the blood oxygen saturation was observed in comparison to the HHR. In the LHR group, there was a higher increment of amplitude-frequency index of the rheoencephalogram in comparison to the HHR, indicating a higher increment of the cerebral blood flow. The slowing down of the pulse rate in the LHR subjects was accompanied with increasing cerebral pulse volume, so that in spite of the pulse rate slowing, the minute volume of cerebral circulation increased. In the LHR subjects, two-phased dynamics of the EEG was observed: in the first phase there was a slow growth of theta- and delta-band EEG spectral power, in the second phase (on the 5th-10th min of hypoxia), sharp (200-300 % of the background level) growth of the EEG spectral power in those bands was observed. In the HHR subjects, gradual growth of EEG spectral power occurred with relative stabilization on the 10th-12th min of hypoxia. Possible role of the stress in the collapse-like reaction during acute hypoxia is analysed, which might cause increase of the oxygen request of the brain, higher growth of cerebral blood flow and more pronounced lowering of functional activity of the brain in the LHR subjects.     

Maximal strength and power assessment in novice weight trainers

The purpose of this study was to investigate whether changes in maximal strength and power output occurred over time in the absence of strength and power training in novice weight trainers. It also investigated whether differences existed between upper- and lower-body assessments and unilateral and bilateral assessments. The power output and maximal strength (1 repetition maximum [1RM]) of 10 male novice subjects were measured on 4 occasions, each assessment 7-10 days apart. The exercises used to measure the upper- and lower-body strength and power outputs were the bench press and supine squat, respectively. Significant (p < 0.05) changes in unilateral (9.8-16.8%) and bilateral 1RM (6.8-15.0%) leg strength were found, the first assessment being significantly different from all other assessments and assessment 2 significantly different from assessment 4. Changes in the upper body (10-13.6%) were also observed. The only significant difference was between assessment 1 and the other testing occasions. No differences in power output were observed for both the upper and lower body during the study. It would seem that considerable changes in maximal strength occur rapidly and in the absence of any formal strength training program in novice weight trainers.     

Preservation of myocardial oxygen balance and functional reserve by coronary vasodilators

Reduced myocardial function at very high heart rates may be due to limited coronary blood supply. The effects of the vasodilators nitroglycerin (10 micrograms kg-1 min-1) and elevated CO2 upon regional function during tachycardia were studied. In open-chest anaesthetized dogs, regional contractile force, epicardial tissue blood flow and local NADH redox level were recorded during graded ventricular pacing. It was found that the vasodilating action of nitroglycerin in the unpaced heart was much lower than produced by CO2 (23.6 +/- 5.8% vs. 137.6 +/- 33.5%). Maximal pacing at 275 bpm caused only a moderate flow elevation in control (20 +/- 6.8%) and CO2 conditions (20.3 +/- 4.03%), but marked vasodilation during nitroglycerin infusion (85.2 +/- 14.6%). Regional function during tachycardia was improved similarly by both vasodilators. NADH levels increased with heart rates under all experimental conditions, but the absolute NADH levels were consistently lower following vasodilator treatments. The lowest NADH levels were observed during nitroglycerin treatment at all heart rates. It is suggested that nitroglycerin augments myocardial functional reserve by preserving oxygen balance more than predicted by its vasodilatory effect alone.     

Spatial dependency of trapezius muscle activity during repetitive shoulder flexion.

The purpose of this study was to explore changes in spatial muscle activation within the three divisions of the trapezius muscle during a dynamic, cyclic task of the upper limb. Surface EMG signals were detected from thirteen healthy subjects from the upper, middle and lower divisions of the trapezius muscle at multiple electrode sites in the cephalad-caudal direction during a repetitive shoulder flexion task. Initial values and rate of change of average rectified value (ARV) and of instantaneous mean power spectral frequency (iMNF) were estimated at 45 degrees , 90 degrees and 120 degrees of shoulder flexion throughout the 5-min task. The location of the electrodes had a significant effect on initial EMG ARV for both the upper and middle division of the trapezius muscle (P<0.05). Both the rate of change and normalized rate of change of ARV were greatest for the most cranial muscle fibers of the upper division (P<0.05). Initial values and rates of change of iMNF were also affected by electrode location for the upper and lower divisions of the trapezius muscle (P<0.05). These results demonstrate that muscle activity and its changes over time depend on position within the three divisions of the trapezius muscle during a dynamic, cyclic task of the upper limb. This suggests non-uniform muscle fiber distribution and/or recruitment. The results also highlight the importance of multiple recording sites when investigating trapezius muscle function in dynamic tasks.     

Heart rate response to treadmill exercise in children of ages 4-6 years

In order to investigate some characteristics of physical fitness in children, we measured the heart rate of 1069 kindergarten children (aged 4-6 years) and 20 adults during treadmill running. After analyzing the data we obtained the following results: heart rate before, during, and after the running tended to diminish with the increase in age of the subjects in both men/boys and women/girls. The relationship of the heart rates before running and the maximum heart rates during in 25 m run, standing long jump, and softball throw, showed a significant level of 5-0.1% in both boys/men and girls/women. The heart rates of children before, during and after running were higher than those of adults. The rate of increase in heart rate was higher in adults, while more rapid recovery of heart rate was observed in children, when compared to adults.     

Age dependency of cardiovascular autonomic responses to head-up tilt in healthy subjects.

In elderly subjects, heart rate responses to postural change are attenuated, whereas their vascular responses are augmented. Altered strategy in maintaining blood pressure homeostasis during upright position may result from various cardiovascular changes, including age-related cardiovascular autonomic dysfunction. This exploratory study was conducted to evaluate impact of age on cardiovascular autonomic responses to head-up tilt (HUT) in healthy subjects covering a wide age range. The study population consisted of 63 healthy, normal-weight, nonsmoking subjects aged 23-77 yr. Five-minute electrocardiogram and finger blood pressure recordings were performed in the supine position and in the upright position 5 min after 70 degrees HUT. Stroke volume was assessed from noninvasive blood pressure signals by the arterial pulse contour method. Heart rate variability (HRV) and systolic blood pressure variability (SBPV) were analyzed by using spectral analysis, and baroreflex sensitivity (BRS) was assessed by using sequence and cross-spectral methods. Cardiovascular autonomic activation during HUT consisted of decreases in HRV and BRS and an increase in SBPV. These changes became attenuated with aging. Age correlated significantly with amplitude of HUT-stimulated response of the high-frequency component (r = -0.61, P < 0.001) and the ratio of low-frequency to high-frequency power of HRV (r = -0.31, P < 0.05) and indexes of BRS (local BRS: r = -0.62, P < 0.001; cross-spectral baroreflex sensitivity in the low-frequency range: r = -0.38, P < 0.01). Blood pressure in the upright position was maintained well irrespective of age. However, the HUT-induced increase in heart rate was more pronounced in the younger subjects, whereas the increase in peripheral resistance was predominantly observed in the older subjects. Thus it is likely that whereas the dynamic capacity of cardiac autonomic regulation decreases, vascular responses related to vasoactive mechanisms and vascular sympathetic regulation become augmented with increasing age.     

The Observation of an Ultradian Rhythm of Heart Rate in Low Birth Weight Infants

The relationship between ultradian rhythm of heart rate and schedules of body contact or feeding was studied in five low birth weight infants of conceptional ages of 34-36 weeks. The differential contribution of body contact and feeding to the formation of the ultradian rhythm of heart rate was evaluated by applying two different schedules of two- and three-hour periods for feeding with a single schedule of three hours for body contact during an observation period of seven days. A chi-square periodogram was used to calculate the period of ultradian rhythm. As a result, a three-hour ultradian rhythm of heart rates was detected in all subjects, which seems to correspond to either schedule of body contact or of feeding. However, no clear changes in the ultradia n rhythm of heart rate were observed corresponding to changes in feeding schedules. The ultradian rhythm of heart rate seems to correspond more to body contact than to feeding.     

The Observation of an Ultradian Rhythm of Heart Rate in Low Birth Weight Infants

The relationship between ultradian rhythm of heart rate and schedules of body contact or feeding was studied in five low birth weight infants of conceptional ages of 34-36 weeks. The differential contribution of body contact and feeding to the formation of the ultradian rhythm of heart rate was evaluated by applying two different schedules of two- and three-hour periods for feeding with a single schedule of three hours for body contact during an observation period of seven days. A chi-square periodogram was used to calculate the period of ultradian rhythm. As a result, a three-hour ultradian rhythm of heart rates was detected in all subjects, which seems to correspond to either schedule of body contact or of feeding. However, no clear changes in the ultradia n rhythm of heart rate were observed corresponding to changes in feeding schedules. The ultradian rhythm of heart rate seems to correspond more to body contact than to feeding.     

The Astrand-Ryhming nomogram revisited

Relationships among O2 uptake (VO2), heart rate, and work rate during constant-load submaximal cycle ergometry and ramp-forced exercise to exhaustion have been studied in core groups of trained (n = 15) and untrained (n = 10), 20- to 29-yr-old males. A signal aim was to improve on the accuracy of the 1954 Astrand-Ryhming (A-R) nomogram predicting maximum aerobic power from heart rate elevation at submaximum work rates. A new nomogram has been developed based on a linear relationship, established in experimental groups, between VO2 and delta HR, the latter being defined as the elevation of exercise heart rate above that reached during zero-load pedaling at 90 rpm. The delta HR variable used in a nomogram linking it and submaximum VO2 (either derived by calculation from the concomitant steady-state work rate or measured directly from respiratory gas analysis) successfully differentiated maximum aerobic power of trained from untrained subjects in core groups whose different abilities could not otherwise be distinguished by the A-R nomogram itself. In a validation group of trained (n = 5), untrained (n = 5), and moderately trained (n = 4) 20- to 29-yr-old males, the correlation measured between VO2max values and those predicted from the new nomogram was significantly better (r = 0.98) (P less than 0.05) than predictions made from the A-R nomogram (r = 0.80).     

Man's physiologic response to long-term work during thermal and pollutant stress.

Metabolic, temperature, and cardiorespiratory responses of 19 healthy males, age range 18-30 yr for one group and 40-55 yr for another, were studied during 210 minutes submaximal work at 35% Vo2 max. The subjects were exposed to four different pollutant gas mixtures at two different temperatures, 25 degrees C and 35 degrees C (relative humidity 30%). The four gas mixtures were filtered air (FA), 50 ppm carbon monoxide in filtered air (CO), 0.24 ppm peroxyacetyl nitrate in filtered air (PAN), and a combination of all three mixtures (PANCO). In the CO exposure, the heart rate was significantly greater than that observed during FA conditions (P less than 0.05). Metabolic and thermoregulatory responses to long-term work were not different in the various pollutant environments. Significant decreases in stroke volume and increases in heart rate were observed during the course of the 25 degrees C exposures with no alteration in cardiac output. Heart rates were higher during 35 degrees C exposures while cardiac output remained at the same level with a consequent further reduction in stroke output.     

Baroreflex function in endurance- and static exercise-trained men

The effect of exercise training mode on reflex cardiovascular control was studied in a cross-sectional design. We examined the cardiovascular responses to progressive incremental phenylephrine (PE) infusion to maximal rates of 120 micrograms/min and the delta heart rate/delta blood pressure responses to lower body negative pressure (LBNP) to -50 Torr in 30 men who were either endurance exercise trained (ET), untrained (UT), or weight trained (WT). During PE infusion, measures of blood pressures, forearm blood flow, heart rate and cardiac output, and calculations of forearm vascular resistance, stroke volume, and peripheral vascular resistance were made at each infusion rate when steady-state blood pressure was attained. No significant differences (P less than 0.05) in forearm blood flow or resistance were observed between the groups at any dose of PE, suggesting that the vasoconstrictor response was similar among the groups. Regression analyses of heart rate against mean blood pressure during the PE infusion were performed to evaluate baroreflex function. A linear model was used and correlation coefficients ranging from 0.82 to 0.96 were obtained (P less than 0.05). The slope of the line of best fit for the ET subjects (-0.57) was significantly less (P less than 0.05) than the slopes obtained for either the UT (-0.91) or WT (-0.88) subjects. In addition, the delta heart rate/delta blood pressure measurements obtained during LBNP reflected a similarly significant attenuation of reflex chronotropic control in the ET subjects.(ABSTRACT TRUNCATED AT 250 WORDS)     

Altered autonomic cardiac regulation in individuals with Down syndrome

We tested the hypothesis that individuals with Down syndrome, but without congenital heart disease, exhibit altered autonomic cardiac regulation. Ten subjects with Down syndrome (DS) and ten gender-and age-matched healthy control subjects were studied at rest and during active orthostatism, which induces reciprocal changes in sympathetic and parasympathetic traffic to the heart. Autoregressive power spectral analysis was used to investigate R-R interval variability. Baroreflex modulation of sinus node was assessed by the spontaneous baroreflex sequences method. No significant differences between DS and control subjects were observed in arterial blood pressure at rest or in response to standing. Also, R-R interval did not differ at rest. R-R interval decreased significantly less during standing in DS vs. control subjects. Low-frequency (LFNU) and high-frequency (HFNU) (both expressed in normalized units) components of R-R interval variability did not differ between DS and control subjects at rest. During standing, significant increase in LFNU and decrease in HFNU were observed in control subjects but not in DS subjects. Baroreflex sensitivity (BRS) did not differ between DS and control subjects at rest and underwent significant decrease on going from supine to upright in both groups. However, BRS was greater in DS vs. control subjects during standing. These data indicate that subjects with DS exhibit reduced HR response to orthostatic stress associated with blunted sympathetic activation and vagal withdrawal and with a lesser reduction in BRS in response to active orthostatism. These findings suggest overall impairment in autonomic cardiac regulation in DS and may help to explain the chronotropic incompetence typically reported during exercise in subjects with DS without congenital heart disease.     

Core temperature regulation of heart rate during exercise in humans

The relationship between two abnormalities of exercise physiology in chronic heart failure patients was investigated: chronotropic incompetence and decrease in core temperature. While at rest, 13 heart failure patients had an average sinus heart rate that was significantly higher than seven normals (92 +/- 13 vs. 82 +/- 10 min-1, P less than 0.05). However, during exercise, the trend of increase in sinus heart rate as a function of work load and O2 uptake was significantly greater in normals compared with heart failure (P less than 0.05), and the absolute increase in heart rate at 50 W of cycle ergometry was larger in normals compared with heart failure (38 +/- 17 vs. 22 +/- 13 min-1, P less than 0.05). Differences in core temperature regulation were also observed. In the normals, core temperature increased from 37.13 +/- 0.33 degrees C at rest to 37.37 +/- 0.31 degrees C at 50 W of exercise (P less than 0.01). In the heart failure patients, core temperature decreased from 36.99 +/- 0.33 degrees C at rest to 36.66 +/- 0.39 degrees C at 50 W of exercise (P less than 0.01). As expected, significant differences in hemodynamic and gas exchange variables were observed between the normals and the heart failure patients both at rest and during exercise. A multiple linear regression analysis was performed of heart rate changes as the dependent variable and thermoregulatory and hemodynamic changes as the independent variables to test for their influence on heart rate.(ABSTRACT TRUNCATED AT 250 WORDS)