Short-Term Rhythms of the Iorespiratory Sy Significance in Neonatology

Latent disturbances in the control of respiration and heart rate (HR) may be important factors in the pathogenesis of life-threatening events during infancy. A method of determining the control of the autonomic nervous system functions involves the analysis of time-dependent ultradian changes of its parameters. The breathing signal and HR variability contain rhythmic components that are generated within the cardiorespiratory network of the brain stem, through reflexes, and by feedback mechanisms. The analysis of these components may provide insights into the functioning of the cardiorespiratory control system. The prominence and precision of the rhythms are correlated with states of vigilance and underlie distinct development during the first months of life. The results of studies on infants at risk (for example, for sudden infant death), with the help of statistical and spectral analysis of time series to obtain new indices, have proved to be inconsistent in their prognostic value of thus studied parameters. Recently, the importance of qualitative and quantitative assessment of the dynamic and complex behavior of time series, based on nonlinear characteristics of the control system, has been emphasized. To what extent, however, the analysis of the dynamic behavior can be utilized for clinical purposes, such as judging the prognosis of deficiencies in control, requires further study regarding physiological baselines and the possible changes resulting from pathological states.     

Short-Term Rhythms of the Iorespiratory Sy Significance in Neonatology

Latent disturbances in the control of respiration and heart rate (HR) may be important factors in the pathogenesis of life-threatening events during infancy. A method of determining the control of the autonomic nervous system functions involves the analysis of time-dependent ultradian changes of its parameters. The breathing signal and HR variability contain rhythmic components that are generated within the cardiorespiratory network of the brain stem, through reflexes, and by feedback mechanisms. The analysis of these components may provide insights into the functioning of the cardiorespiratory control system. The prominence and precision of the rhythms are correlated with states of vigilance and underlie distinct development during the first months of life. The results of studies on infants at risk (for example, for sudden infant death), with the help of statistical and spectral analysis of time series to obtain new indices, have proved to be inconsistent in their prognostic value of thus studied parameters. Recently, the importance of qualitative and quantitative assessment of the dynamic and complex behavior of time series, based on nonlinear characteristics of the control system, has been emphasized. To what extent, however, the analysis of the dynamic behavior can be utilized for clinical purposes, such as judging the prognosis of deficiencies in control, requires further study regarding physiological baselines and the possible changes resulting from pathological states.     

Regular physical exercise, heart rate variability and turbulence in a 6-year randomized controlled trial in middle-aged men: the DNASCO study

HRV and HRT are independent predictors of cardiovascular mortality. Aging reduces HRV, but results from the physical exercise trials are controversial. The primary aim was to study changes in heart rate variability (HRV) and heart rate turbulence (HRT) in a six-year controlled randomized trial at regular low to moderate intensity physical exercise. One hundred forty men aged 53--63 years were randomized in to an exercise or a control groups. The participants underwent a maximal bicycle ergometer exercise test with respiratory gas analyses annually for six years. At baseline and after intervention, 24-h ambulatory ECG registrations were performed to assess HRV (n=100). HRT was determined among subjects with single ventricular premature complexes (VPC) (n=73). In the exercise group, ventilatory aerobic threshold (VAT) increased by 16% indicating enhanced submaximal cardiorespiratory fitness. No significant differences were found in any of the HRV or HRT parameters between the groups. However, the observed increase in VAT correlated significantly with the improvement in HRV parameters. The change in turbulence slope (TS) correlated with the changes in most HRV variables and the change in turbulence onset (TO) correlated with the changes in three frequency domain parameters. Our results suggest that in addition to improvement in submaximal cardiorespiratory fitness, regular low to moderate intensity physical exercise seems to have beneficial effects also on cardiac autonomic nervous function, a clinically relevant predictor of cardiovascular morbidity and mortality.     

Physiological monitoring of cardiorespiratory adaptations during rehearsal and performance of contemporary dance

Previous research has shown that dance class and rehearsal stress different cardiorespiratory energy systems than dance performance. The aim of the present study was to monitor the physiological parameters of a number of dancers during a 12-week rehearsal period and an 8-week performance schedule. Seventeen dancers (8 men and 9 women) from 2 companies undertook the multistage dance specific aerobic fitness test before the rehearsal period, before the performance period, and after the performance period. Heart rate data were collected throughout the test; the mean heart rate during stage 5 and blood lactate levels were measured at the end of the test. No significant changes in heart rate or lactate parameters were noted between the prerehearsal and preperformance tests, but significant decreases during the preperformance and postperformance tests were shown in both parameters (p < 0.01 and p < 0.01, respectively), which suggests an increase in the subjects' aerobic capacities during the performance period. Implications from the present study suggest that dancers are not adequately physiologically prepared to perform to the same degree to which their skills are honed. The study suggests that supplemental training is required to bridge this physical gap and better prepare the dancer for performance.     

Positive End-Expiratory Pressure may alter breathing cardiovascular variability and baroreflex gain in mechanically ventilated patients

Background

Baroreflex allows to reduce sudden rises or falls of arterial pressure through parallel RR interval fluctuations induced by autonomic nervous system. During spontaneous breathing, the application of positive end-expiratory pressure (PEEP) may affect the autonomic nervous system, as suggested by changes in baroreflex efficiency and RR variability. During mechanical ventilation, some patients have stable cardiorespiratory phase difference and high-frequency amplitude of RR variability (HF-RR amplitude) over time and others do not. Our first hypothesis was that a steady pattern could be associated with reduced baroreflex sensitivity and HF-RR amplitude, reflecting a blunted autonomic nervous function. Our second hypothesis was that PEEP, widely used in critical care patients, could affect their autonomic function, promoting both steady pattern and reduced baroreflex sensitivity.

Methods

We tested the effect of increasing PEEP from 5 to 10 cm H2O on the breathing variability of arterial pressure and RR intervals, and on the baroreflex. Invasive arterial pressure, ECG and ventilatory flow were recorded in 23 mechanically ventilated patients during 15 minutes for both PEEP levels. HF amplitude of RR and systolic blood pressure (SBP) time series and HF phase differences between RR, SBP and ventilatory signals were continuously computed by complex demodulation. Cross-spectral analysis was used to assess the coherence and gain functions between RR and SBP, yielding baroreflex-sensitivity indices.

Results

At PEEP 10, the 12 patients with a stable pattern had lower baroreflex gain and HF-RR amplitude of variability than the 11 other patients. Increasing PEEP was generally associated with a decreased baroreflex gain and a greater stability of HF-RR amplitude and cardiorespiratory phase difference. Four patients who exhibited a variable pattern at PEEP 5 became stable at PEEP 10. At PEEP 10, a stable pattern was associated with higher organ failure score and catecholamine dosage.

Conclusions

During mechanical ventilation, stable HF-RR amplitude and cardiorespiratory phase difference over time reflect a blunted autonomic nervous function which might worsen as PEEP increases.     

五指山小型猪高脂血症模型的心脏自主神经功能变化

目的观察五指山小型猪高脂血症模型的心脏自主神经功能的动态变化,探讨血脂异常对自主神经功能的影响和与昼夜的关系。方法利用高脂饮食诱发五指山小型猪高脂血症,造模后,每2周一次测定小型猪TG、TC、HDL-C和LDL-C和监测动态心电图,并进行24 h和昼夜心率变异性（HRV）分析,以评估小型猪的心脏自主神经功能。结果高脂饮食2周后五指山小型猪血清TC、HDL-C、LDL-C水平均显著升高（P〈0.01）,TG水平亦在高脂饮食后6周显著升高（P〈0.05）,其中,TC、LDL-C在高脂饮食0～4周时呈快速上升,在4～6周达到高峰,8～10周基本稳定并维持在一定水平;HDL-C在高脂饮食0～2周迅速上升并达到高峰,2～10周基本稳定。HRV参数分析结果,时域指标（RRI、SDNN、RMSDD、SDANN、PNN50、SDANN index、STV、LTV）和频域指标（VLF、LF、HF和TP）均渐进性显著降低（P〈0.05,P〈0.01）,LF/HF升高（P〈0.05）,夜间HRV参数变化程度均高于白天;相关分析显示HRV各参数与TC、LDL-C、TC/HDL-C、LDL-C/HDL-C具有显著的相关性（P〈0.05,P〈0.01）,经多元线性逐步回归分析发现,SDNN与TC、LDL-C、TC/HDL-C、LDL-C/HDL-C比值的相关性依次为0.673、0.672、0.665、0.681。结论高脂饮食诱发五指山小型猪高脂血症的血脂异常可引起自主神经功能的下降和紊乱,自主神经功能的紊乱程度与高血脂状态的持续时间有关;血脂异常所致心血管疾病的危险程度夜间高于白天;HRV降低与TC、LDL-C、TC/HDL-C和LDL-C/HDL-C比值升高呈一定的依赖性,SDNN降低可作为预测高脂血症引发心血管病风险的独立相关指标。     

Effect of anxiety on the function of the cardiorespiratory system

The effects of anxiety on the external respiration system and respiratory sinus arrhythmia (RSA) were studied in healthy subjects in real-life conditions. Changes in external respiration parameters and heart rate variability (HRV) in students going to take their end-of-term exams were assessed relative to a midterm period, and the cardiorespiratory system was monitored in a longitudinal study for 50 days. The function of the cardiorespiratory system was characterized by measuring external respiration parameters and calculating HRV parameters. State anxiety (SA) was assessed using Spielberger’s scale. An increase in SA before an exam was accompanied by a higher breathing rate, a higher tidal volume, and lower HRV indices, especially those related to respiratory sinus arrhythmia (HF and HF _norm). The changes in the parameters depended on the increase in SA. A negative correlation was observed between midterm HF and pre-exam SA. The longitudinal study revealed a distinct negative correlation between respiratory sinus arrhythmia parameters and peak expiratory flow (PEF) and a positive correlation between SA and PEF in the majority of subjects. Changes in cardiorespiratory parameters depended on the changes in SA in the longitudinal study. An increase in SA was accompanied by substantial changes in respiratory sinus arrhythmia (RAS) and external respiration parameters, and their correlation was assumed to indicate that modification of parasympathetic activity plays a leading role in increasing PEF.     

Regulation of homeostasis and oncogenesis in the intestinal epithelium by Ras

Much of our current state of knowledge pertaining to the mechanisms controlling intestinal epithelial homeostasis derives from epidemiological, molecular genetic, cell biological, and biochemical studies of signaling pathways that are dysregulated during the process of colorectal tumorigenesis. Activating mutations in members of the RAS oncoprotein family play an important role in the progression of colorectal cancer (CRC) and, by extension, intestinal epithelial homeostasis. Mutations in K-RAS account for 90% of the RAS mutations found in CRC. As such, the study of RAS protein function in the intestinal epithelium is largely encompassed by the study of K-RAS function in CRC. In this review, we summarize the data available from genetically defined in vitro and in vivo models of CRC that aim to characterize the oncogenic properties of mutationally activated K-RAS. These studies paint a complex picture of a multi-functional oncoprotein that engages an array of downstream signaling pathways to influence cellular behaviors that are both pro- and anti-tumorigenic. While the complexity of K-RAS biology has thus far prevented a comprehensive understanding of its oncogenic properties, the work to date lays a foundation for the development of new therapeutic strategies to treat K-RAS mutant CRC.     

Improved physical fitness failed to alter the EEG patterns of sleep in young women

We investigated the effect of a 12-week physical training programme on the sleep of nine unfit women. Data were collected at 0, 4, 8 and 12 weeks of the training programme. Changes in fitness were assessed by changes in maximal oxygen consumption (VO2max) and onset of blood lactate turn point (LTP). Lean body mass (LBM) was calculated from total body potassium measurements. The all-night sleep recordings were made following days during which the subjects carried out their normal daily routines and did no extra exercise. Although cardiorespiratory fitness improved significantly as indicated by an increase in both VO2max and LTP, there was no change in LBM. The improvement in cardiorespiratory fitness did not result in any changes in the sleep parameters measured. Other workers have reported an improvement in sleep quality in eight army recruits during their basic training. The male recruits showed improved cardiorespiratory fitness and an increase in muscle bulk. These results suggest that increased fitness only facilitates sleep when there is an associated increase in LBM. Alternatively it may be that the response of sleep to improved fitness is sex-linked.     

Plasticity of central autonomic neural circuits in diabetes

Regulation of energy metabolism is controlled by the brain, in which key central neuronal circuits process a variety of information reflecting nutritional state. Special sensory and gastrointestinal afferent neural signals, along with blood-borne metabolic signals, impinge on parallel central autonomic circuits located in the brainstem and hypothalamus to signal changes in metabolic balance. Specifically, neural and humoral signals converge on the brainstem vagal system and similar signals concentrate in the hypothalamus, with significant overlap between both sensory and motor components of each system and extensive cross-talk between the systems. This ultimately results in production of coordinated regulatory autonomic and neuroendocrine cues to maintain energy homeostasis. Therapeutic metabolic adjustments can be accomplished by modulating viscerosensory input or autonomic motor output, including altering parasympathetic circuitry related to GI, pancreas, and liver regulation. These alterations can include pharmacological manipulation, but surgical modification of neural signaling should also be considered. In addition, central control of visceral function is often compromised by diabetes mellitus, indicating that circuit modification should be studied in the context of its effect on neurons in the diabetic state. Diabetes has traditionally been handled as a peripheral metabolic disease, but the central nervous system plays a crucial role in regulating glucose homeostasis. This review focuses on key autonomic brain areas associated with management of energy homeostasis and functional changes in these areas associated with the development of diabetes.     

Baroreflex dysfunction in rats submitted to protein restriction

Earlier studies from the authors' laboratory showed that malnourishment induces alterations in the cardiovascular homeostasis increasing the basal mean arterial pressure and heart rate. In this study, the authors evaluated whether the sympathetic and parasympathetic efferent activities contribute to changes in the cardiovascular homeostasis through altered modulation of the arterial baroreflex of malnourished rats. After weaning, male Fischer rats were given 15% (Normal Protein--NP) or 6% (Low Protein--LP) protein diet for 35 d. The baroreflex gain and latency were evaluated before and after selective autonomic blockades in control and malnourished rats. It was observed that malnourishment affected the baroreflex gain in response to activation and deactivation of the arterial baroreflex. Moreover, malnourished rats showed increased baroreflex latency as compared to that of control rats. Regarding the autonomic efferent activity directed to the heart, the data showed increased sympathetic and decreased parasympathetic efferent activities in malnourished rats, and such alterations could be related to the observed changes in the arterial baroreflex gain as well as in the basal mean arterial pressure and heart rate.     

Visceral and not subcutaneous abdominal adiposity reduction drives the benefits of a 1-year lifestyle modification program

Excess visceral adipose tissue (VAT) is associated with an increased cardiometabolic risk. The study examined whether changes in cardiometabolic risk markers after a 1-year lifestyle intervention in viscerally obese men were associated with changes in VAT or with changes in subcutaneous abdominal adipose tissue (SAT). The relative contributions of changes in global adiposity vs. changes in cardiorespiratory fitness to changes in VAT were also quantified. One hundred and forty four men were selected on the basis of an increased waist circumference (≥ 90 cm) associated with dyslipidemia (triglycerides ≥ 1.69 and/or high-density lipoprotein (HDL)-cholesterol <1.03 mmol/l); 117 men completed the 1-year intervention which consisted in a healthy eating, physical activity/exercise program. Body weight, body composition, and fat distribution were assessed by anthropometry and dual-energy X-ray absorptiometry (DEXA)/computed tomography. Cardiorespiratory fitness, plasma adipokine/inflammatory markers, fasting lipoprotein-lipid profile, and oral glucose tolerance test (OGTT) were assessed. VAT volume decreased by 26%, cardiorespiratory fitness improved by 20% (P < 0.0001) after 1 year. Plasma adipokine/inflammatory markers, lipids/lipoproteins, and glucose homeostasis were improved. One-year changes in triglyceride (r = 0.29), apolipoprotein B (r = 0.21), 120-min OGTT-glucose (r = 0.27), and fasting insulin (r = 0.27) levels correlated with changes in VAT (all P < 0.05) after adjustment for changes in SAT. Using a multilinear regression model, VAT reduction was independently associated with SAT reduction and with improvement in cardiorespiratory fitness (R(2) = 0.58, P < 0.0001). Therefore, this healthy eating-physical activity/exercise program improved the cardiometabolic risk profile of viscerally obese men in relation to the reduction of VAT. Furthermore, the reduction in VAT was independently related to the reduction in global adiposity and to the improvement in cardiorespiratory fitness.     

Influence of moderate physical exercise on the cardiac rhythm parameters of elementary and junior high school children

To reveal the specific features of the influence of moderate exercise (running) on the autonomic regulation of the cardiac rhythm, changes in the heart rate variability (HRV) parameters have been analyzed during three months in 292 children aged 9–14, as dependent on the sex and the baseline autonomic tone estimated by means of cluster analysis. It has been shown that, in schoolchildren engaged in running for health, HRV changes give evidence for the optimization of the mechanisms of autonomic regulation. The HRV parameters in the girls were more resistant to muscular activity compared to boys. The data obtained indicate that running for health requires a differential approach to dosing of the exercise, taking into account the sex and the baseline autonomic tone.     

Long-term effects of graduated compression stockings on cardiorespiratory performance

The use of graduated compression stockings (GCS) in sport has been increasing in the last years due to their potential positive effects for athletes. However, there is little evidence to support whether these types of garments actually improve cardiorespiratory performance. The aim of this study was to examine the cardiorespiratory responses of GCS during running after three weeks of regular use. Twenty recreational runners performed three tests on different days: test 1) – a 5-min maximal effort run in order to determine the participants’ maximal aerobic speed; and tests 2) and 3) – a fatigue running test of 30 minutes at 80% of their maximal aerobic speed with either GCS or PLACEBO stockings at random. Cardiorespiratory parameters (minute ventilation, heart rate, relative oxygen consumption, relative carbon dioxide production, ventilatory equivalents for oxygen and carbon dioxide, and oxygen pulse) were measured. Before each test in the laboratory, the participants trained with the randomly assigned stockings (GCS or PLACEBO) for three weeks. No significant differences between GCS and PLACEBO were found in any of the cardiorespiratory parameters. In conclusion, the present study provides evidence that running with GCS for three weeks does not influence cardiorespiratory parameters in recreational runners.     

Effect of Post-Weaning Individual Housing on Autonomic Responses in Male Rats to Sexually Receptive Female Rats

Post-weaning individual housing induces significant alterations in the reward system of adult male rats presented with sexually receptive female rats. In this study, we examined the effects of post-weaning individual housing on autonomic nervous activity in adult male rats during encounters with sexually receptive female rats to assess whether different affective states depending on post-weaning housing conditions are produced. Changes in heart rate and spectral parameters of heart rate variability indicated that in post-weaning individually housed male rats, both sympathetic and parasympathetic activity increased with no change in the sympathovagal balance, while in post-weaning socially housed male rats, both sympathetic and parasympathetic activity decreased with a predominance of parasympathetic activity. These two patterns of shifts in sympathovagal balances closely resembled changes in autonomic nervous activity with regard to classical appetitive conditioning in male rats. The autonomic changes in male rats housed individually after weaning corresponded to changes associated with the reward-expecting state evoked by the conditioned stimulus, and the autonomic changes observed in male rats housed socially after weaning corresponded to changes associated with the reward-receiving state evoked by the unconditioned stimulus. These results suggest that different affective states were induced in adult male rats during sexual encounters depending on male–male social interactions after weaning. The remarkable change caused by post-weaning individual housing may be ascribed to alteration of the reward system during sexual encounters induced by deficiency of intermale social communication after weaning.     

Anomalies in Network Bridges Involved in Bile Acid Metabolism Predict Outcomes of Colorectal Cancer Patients

Biomarkers prognostic for colorectal cancer (CRC) would be highly desirable in clinical practice. Proteins that regulate bile acid (BA) homeostasis, by linking metabolic sensors and metabolic enzymes, also called bridge proteins, may be reliable prognostic biomarkers for CRC. Based on a devised metric, “bridgeness,” we identified bridge proteins involved in the regulation of BA homeostasis and identified their prognostic potentials. The expression patterns of these bridge proteins could distinguish between normal and diseased tissues, suggesting that these proteins are associated with CRC pathogenesis. Using a supervised classification system, we found that these bridge proteins were reproducibly prognostic, with high prognostic ability compared to other known markers.     

B chromosomes and developmental homeostasis in the yellow-necked mouse, Apodemus flavicollis (Rodentia, Mammalia): effects on nonmetric traits

B chromosomes are found in almost all populations of the yellow-necked mouse, Apodemus flavicollis (Rodentia, Mammalia). Their effects on developmental homeostasis in this species were analyzed using morphological nonmetric traits (number of foramina) in a sample of 218 animals from locality Mt Jastrebac in the former Yugoslavia. Variations of the parameters of developmental homeostasis (the degree of fluctuating asymmetry--FA, the number of asymmetrical characters per individual--NA, and the total phenotypic variability--PV) were examined in three groups: in animals without Bs, with one B chromosome, and with more than one B chromosome. Significant differences in the level of FA between groups of animals were found for two characters. Carriers of one B chromosome displayed the highest level of phenotypic variability. Parameters of developmental stability (DS) were monitored in the population in which significant variations in the frequency of animals with Bs (fB) were established during the season earlier. The FA levels for four foramina out of a total of 12 examined followed the changes of frequencies of animals with Bs. Furthermore, a significant seasonal correlation between NA and fB was found. The presence of B does not cause a disturbance of homeostasis in a way that allows changes in homeostasis to be directly related to B chromosome's presence. However, carriers of B react differently to environmental changes than do noncarriers.     

Use of a Physiological Monitoring Model for Comprehensive Evaluation of Adaptive Capacities in Schoolchildren during Learning: I. Influence of Various Motor Activity Regimens on Cardiac Rhythm Indices in Junior Schoolchildren

The dynamics of changes in the indices of the autonomic regulation of cardiac rhythm was studied in junior schoolchildren during adaptation to physical exercise. An analysis of variation pulsometry parameters throughout the school year showed the role of the sympathetic and parasympathetic parts of the autonomic nervous system in the formation of body adaptive reactions to various motor activity regimens.