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https://www.readbyqxmd.com/read/29342011/utility-of-time-and-frequency-domain-parameters-of-heart-rate-variability-in-the-context-of-autonomic-disorders-characterized-by-orthostatic-dysfunction
#1
Jacquie Baker, Juan M Racosta, Brittany Balint, Kurt Kimpinski
PURPOSE: The clinical significance of heart rate variability in the context of autonomic dysfunction continues to be a matter of debate. A consensus is lacking on the best heart rate variability measures for clinical purposes. Therefore, the purpose of this study was to investigate the utility of heart rate variability parameters in healthy versus autonomic dysfunction. METHODS: Healthy young (n = 134), healthy older (n = 32), and patients with mild (postural tachycardia syndrome; n = 25) and severe (neurogenic orthostatic hypotension; n = 34) autonomic dysfunction were included...
January 16, 2018: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/29334945/blood-pressure-change-does-not-associate-with-center-of-pressure-movement-after-postural-transition-in-geriatric-outpatients
#2
Sjoerd T Timmermans, Esmee M Reijnierse, Jantsje H Pasma, Marijke C Trappenburg, Gerard J Blauw, Andrea B Maier, Carel G M Meskers
BACKGROUND: Orthostatic hypotension (OH), a blood pressure drop after postural change, is associated with impaired standing balance and falls in older adults. This study aimed to assess the association between blood pressure (BP) and a measure of quality of standing balance, i.e. Center of Pressure (CoP) movement, after postural change from supine to standing position in geriatric outpatients, and to compare CoP movement between patients with and without OH. METHODS: In a random subgroup of 75 consecutive patients who were referred to a geriatric outpatient clinic, intermittent BP measurements were obtained simultaneously with CoP measurements in mediolateral and anterior-posterior direction directly after postural change during 3 min of quiet stance with eyes open on a force plate...
January 15, 2018: BMC Geriatrics
https://www.readbyqxmd.com/read/29333725/chemoreflex-function-and-brain-blood-flow-during-upright-posture-in-men-and-women
#3
Christopher Hazlett, Heather Edgell
Orthostatic intolerance is more common in women than men, and some studies have found that women in the early follicular (EF) phase of the menstrual cycle experience the greatest feelings of lightheadedness. Chemoreflex function while supine or upright was investigated to determine the potential contribution of ventilatory control to these phenomena. Men (n = 13) and women (n = 14) were tested while supine and 70° upright (head-up tilt [HUT]) and given: (1) normoxia or (2) hypercapnia (5% CO2 ). Women were tested during the EF phase (days 2-5) and the midluteal phase (ML; days 18-24)...
January 2018: Physiological Reports
https://www.readbyqxmd.com/read/29332741/abdominal-and-pelvic-floor-electromyographic-analysis-during-abdominal-hypopressive-gymnastics
#4
Lucas Ithamar, Alberto Galvão de Moura Filho, Marco Aurélio Benedetti Rodrigues, Kelly Cristina Duque Cortez, Vinícius Gomes Machado, Claudia Regina Oliveira de Paiva Lima, Eduarda Moretti, Andrea Lemos
INTRODUCTION: Abdominal hypopressive gymnastics appeared as an alternative to traditional abdominal exercises to promote abdominal muscles strength without overloading the pelvic floor muscles (PFM). To determine the activation level of abdominal muscles and PFM and the posture influence in the level of activation in these muscles during abdominal hypopressive gymnastics, we used surface electromyography in young and healthy multipara women. METHODS: This is an observational study with eutrophic nulliparous women aged between 18 and 35 years, with abdominal skinfold less than or equal to 3 cm and active or irregularly active physical activity...
January 2018: Journal of Bodywork and Movement Therapies
https://www.readbyqxmd.com/read/29331491/investigating-the-relationship-between-cardiac-interoception-and-autonomic-cardiac-control-using-a-predictive-coding-framework
#5
Andrew P Owens, Karl J Friston, David A Low, Christopher J Mathias, Hugo D Critchley
Predictive coding models, such as the 'free-energy principle' (FEP), have recently been discussed in relation to how interoceptive (afferent visceral feedback) signals update predictions about the state of the body, thereby driving autonomic mediation of homeostasis. This study appealed to 'interoceptive inference', under the FEP, to seek new insights into autonomic (dys)function and brain-body integration by examining the relationship between cardiac interoception and autonomic cardiac control in healthy controls and patients with forms of orthostatic intolerance (OI); to (i) seek empirical support for interoceptive inference and (ii) delineate if this relationship was sensitive to increased interoceptive prediction error in OI patients during head-up tilt (HUT)/symptom provocation...
January 9, 2018: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/29330767/ivabradine-for-the-treatment-of-postural-orthostatic-tachycardia-syndrome-a-systematic-review
#6
REVIEW
Megan E Gee, Alicia K Watkins, Jamie N Brown, Emily J A Young
INTRODUCTION: Postural orthostatic tachycardia syndrome (POTS) impacts millions of patients, but there is currently no gold standard treatment for this condition. Ivabradine is a novel heart rate (HR) lowering agent that acts on the sinoatrial node cells by selectively inhibiting the If-current. OBJECTIVE: The objective of this systematic review is to evaluate the evidence for the efficacy and safety of ivabradine for the treatment of POTS. METHODS: MEDLINE (from 1956 to August 2017) and EMBASE (from 1957 to August 2017) were queried with the following search term: "postural orthostatic tachycardia syndrome" OR "postural tachycardia syndrome" OR "chronic orthostatic intolerance" AND "ivabradine...
January 12, 2018: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/29329523/early-commitment-of-cardiovascular-autonomic-modulation-in-brazilian-patients-with-congenital-generalized-lipodystrophy
#7
Clarisse Mourão Melo Ponte, Virgínia Oliveira Fernandes, Maria Helane Costa Gurgel, Izabella Tamira Galdino Farias Vasconcelos, Lia Beatriz de Azevedo Souza Karbage, Christiane Bezerra Rocha Liberato, Carlos Antônio Negrato, Marília de Brito Gomes, Ana Paula Dias Rangel Montenegro, Renan Magalhães Montenegro Júnior
BACKGROUND: Metabolic abnormalities in congenital generalized lipodystrophy (CGL) are associated with microvascular complications. However, the evaluation of different types of neuropathy in these patients, including the commitment of cardiovascular autonomic modulation, is scarce. The objective of the present study was to determine the prevalence of cardiovascular autonomic neuropathy (CAN) in patients with CGL compared with individuals with type 1 diabetes and healthy subjects. METHODS: Ten patients with CGL, 20 patients with type 1 diabetes and 20 healthy subjects were included in the study...
January 12, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29326369/successful-treatment-of-postural-orthostatic-tachycardia-and-mast-cell-activation-syndromes-using-naltrexone-immunoglobulin-and-antibiotic-treatment
#8
Leonard B Weinstock, Jill B Brook, Trisha L Myers, Brent Goodman
A patient with severe postural orthostatic tachycardia syndrome (POTS) and mast cell activation syndrome (MCAS) received immunotherapy with low-dose naltrexone (LDN) and intravenous immunoglobulin (IVIg) and antibiotic therapy for small intestinal bacterial overgrowth (SIBO). A dramatic and sustained response was documented. The utility of IVIg in autoimmune neuromuscular diseases has been published, but clinical experience with POTS is relatively unknown and has not been reported in MCAS. As a short-acting mu-opioid antagonist, LDN paradoxically increases endorphins which then bind to regulatory T cells which regulate T-lymphocyte and B-lymphocyte production and this reduces cytokine and antibody production...
January 11, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29313153/first-symptoms-in-multiple-system-atrophy
#9
Jake H McKay, William P Cheshire
PURPOSE: The initial symptoms of multiple system atrophy (MSA) and, in particular, early autonomic symptoms, have received less attention than motor symptoms. Whereas pathognomonic motor signs are essential to diagnostic specificity, early symptoms important to recognition of a neurodegenerative disorder may be less apparent or diagnostically ambiguous. This observational study sought to identify the very earliest symptoms in the natural history of MSA. METHODS: Detailed clinical histories focusing on early symptoms were obtained from 30 subjects recently diagnosed with MSA...
January 8, 2018: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/29280070/safety-of-human-papillomavirus-vaccines-an-updated-review
#10
REVIEW
Anastasia Phillips, Cyra Patel, Alexis Pillsbury, Julia Brotherton, Kristine Macartney
Human papillomavirus (HPV) vaccines are now included in immunisation programmes in 71 countries. Unfortunately, uptake has been impacted in some countries by reduced confidence in the safety of the HPV vaccine. In 2013, we published an extensive review demonstrating a reassuring safety profile for bivalent (2vHPV) and quadrivalent (4vHPV) vaccines. A nonavalent (9vHPV) vaccine is now available and HPV immunisation programmes have been extended to males in 11 countries. The aim of this updated narrative review was to examine the evidence on HPV vaccine safety, focusing on the 9vHPV vaccine, special populations and adverse events of special interest (AESI)...
December 26, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/29222896/serum-vitamin-b-12-in-children-presenting-with-vasovagal-syncope
#11
Ayhan Pektas, Resit Koken, Halit Bugra Koca
BACKGROUND AND OBJECTIVES: The present study aims to determine the serum vitamin B-12 in children presenting with vasovagal syncope. METHODS AND STUDY DESIGN: This is a prospective review of 160 children presenting with vasovagal syncope. Subgroup analysis was done based on the results of head up tilt test. RESULTS: Head up tilt test gave positive results in 80 children and yielded negative results in the remaining 80 children. The tilt test positive children had significantly lower thyroid stimulating hormone concentrations (p=0...
2018: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/29222399/pediatric-disorders-of-orthostatic-intolerance
#12
REVIEW
Julian M Stewart, Jeffrey R Boris, Gisela Chelimsky, Phillip R Fischer, John E Fortunato, Blair P Grubb, Geoffrey L Heyer, Imad T Jarjour, Marvin S Medow, Mohammed T Numan, Paolo T Pianosi, Wolfgang Singer, Sally Tarbell, Thomas C Chelimsky
Orthostatic intolerance (OI), having difficulty tolerating an upright posture because of symptoms or signs that abate when returned to supine, is common in pediatrics. For example, ∼40% of people faint during their lives, half of whom faint during adolescence, and the peak age for first faint is 15 years. Because of this, we describe the most common forms of OI in pediatrics and distinguish between chronic and acute OI. These common forms of OI include initial orthostatic hypotension (which is a frequently seen benign condition in youngsters), true orthostatic hypotension (both neurogenic and nonneurogenic), vasovagal syncope, and postural tachycardia syndrome...
January 2018: Pediatrics
https://www.readbyqxmd.com/read/29217363/positional-brain-single-photon-emission-computed-tomography-findings-in-a-case-of-limb-shaking-syndrome
#13
Caroline Bund, Céline Heimburger, Valérie Wolff, Izzie Jacques Namer
An 84-year-old man, who presented lower limbs limb-shaking syndrome at orthostatism lasting a few seconds, was referred in our stroke unit. Magnetic resonance imaging showed an acute infarction in the right thalamus and the insular cortex, left extracranial carotid stenosis at 80%, and low flow in the right middle cerebral artery but did not explain limb-shaking syndrome symptomatology. We performed comparative positional brain perfusion single-photon emission computed tomography (SPECT), in the upright and in the supine position, to explore and localize hypoperfusion-endangered brain structures that may be involved in the presenting symptoms...
December 4, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29210841/comparison-of-heart-rate-variability-parameters-to-the-autonomic-reflex-screen-in-postural-orthostatic-tachycardia-syndrome-and-neurogenic-orthostatic-hypotension
#14
Jacquie Baker, Juan M Racosta, Kurt Kimpinski
PURPOSE: The clinical significance of heart rate variability (HRV) in the context of autonomic dysfunction continues to be a matter of debate. Therefore, the purpose of the current study was to investigate the clinical relevance of HRV in the context of autonomic dysfunction. METHODS: Heart rate variability data from 225 volunteers consisting of controls (n = 166) and patients with mild (n = 25) and severe (n = 34) autonomic dysfunction were retrospectively analyzed...
November 23, 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/29202333/aortic-atherosclerosis-is-a-key-modulator-of-the-prognostic-value-of-postural-blood-pressure-changes
#15
Pierre-Yves Courand, Brahim Harbaoui, Helène Fay, Adrien Grandjean, Hugues Milon, Pierre Lantelme
BACKGROUND AND AIMS: Orthostatic blood pressure decrease or increase has been related to cardiovascular events in hypertensive patients. Large blood pressure changes after orthostatic stress are associated with autonomic and neurohormonal abnormalities; aortic atherosclerosis (ATS) may also play a role. METHODS: We investigated the interaction of ATS on the prognostic value of postural blood pressure changes. In a cohort of 958 hypertensive patients with an aortography (mean ± standard deviation age 44 ± 11 years, 61% men, mean blood pressure 182/110 mmHg), blood pressure was measured after 10 min of rest in the supine position...
November 26, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/29163185/orthostatic-intolerance-in-older-persons-etiology-and-countermeasures
#16
REVIEW
Nandu Goswami, Andrew P Blaber, Helmut Hinghofer-Szalkay, Jean-Pierre Montani
Orthostatic challenge produced by upright posture may lead to syncope if the cardiovascular system is unable to maintain adequate brain perfusion. This review outlines orthostatic intolerance related to the aging process, long-term bedrest confinement, drugs, and disease. Aging-associated illness or injury due to falls often leads to hospitalization. Older patients spend up to 83% of hospital admission lying in bed and thus the consequences of bedrest confinement such as physiological deconditioning, functional decline, and orthostatic intolerance represent a central challenge in the care of the vulnerable older population...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/29124548/development-of-an-experimental-and-digital-cardiovascular-arterial-model-for-transient-hemodynamic-and-postural-change-studies-a-preliminary-framework-analysis
#17
Rodward L Hewlin, John P Kizito
The ultimate goal of the present work is to aid in the development of tools to assist in the treatment of cardiovascular disease. Gaining an understanding of hemodynamic parameters for medical implants allow clinicians to have some patient-specific proposals for intervention planning. In the present work an experimental and digital computational fluid dynamics (CFD) arterial model consisting of a number of major arteries (aorta, carotid bifurcation, cranial, femoral, jejunal, and subclavian arteries) were fabricated to study: (1) the effects of local hemodynamics (flow parameters) on global hemodynamics (2) the effects of transition from bedrest to upright position (postural change) on hemodynamics, and (3) diffusion of dye (medical drug diffusion simulation) in the arterial system via experimental and numerical techniques...
November 9, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/29111543/syncope-in-young-women-broadening-the-differential-diagnosis
#18
Nachiket Patel, Naila Choudhary, Christine Tompkins, Khawaja Afzal Ammar, A Jamil Tajik, Krishnaswamy Chandrasekaran, Timothy E Paterick
Syncope is defined as a sudden transient loss of consciousness (TLOC) with concomitant loss of postural tone followed by spontaneous recovery. It is a subset of a broader class of medical conditions, including postural orthostatic tachycardia syndrome (POTS), orthostatic hypotension, and neurally mediated syncope (NMS), that may result in TLOC. The overlap of these clinical conditions leads to confusion regarding syncope classification that can hinder evaluation strategies, and pose challenges for diagnosis and treatment, particularly in young women...
2017: Reviews in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29102451/autonomic-dysfunction-in-cardiology-pathophysiology-investigation-and-management
#19
REVIEW
Amy C Arnold, Jessica Ng, Lucy Lei, Satish R Raj
Presyncope and syncope are common medical findings, with a > 40% estimated lifetime prevalence. These conditions are often elicited by postural stress and can be recurrent and accompanied by debilitating symptoms of cerebral hypoperfusion. Therefore, it is critical for physicians to become familiar with the diagnosis and treatment of common underlying causes of presyncope and syncope. In some patients, altered postural hemodynamic responses result from a failure of compensatory autonomic nervous system reflex mechanisms...
December 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29081752/multi-system-deconditioning-in-3-day-dry-immersion-without-daily-raise
#20
Steven De Abreu, Liubov Amirova, Ronan Murphy, Robert Wallace, Laura Twomey, Guillemette Gauquelin-Koch, Veronique Raverot, Françoise Larcher, Marc-Antoine Custaud, Nastassia Navasiolava
Dry immersion (DI) is a Russian-developed, ground-based model to study the physiological effects of microgravity. It accurately reproduces environmental conditions of weightlessness, such as enhanced physical inactivity, suppression of hydrostatic pressure and supportlessness. We aimed to study the integrative physiological responses to a 3-day strict DI protocol in 12 healthy men, and to assess the extent of multi-system deconditioning. We recorded general clinical data, biological data and evaluated body fluid changes...
2017: Frontiers in Physiology
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