Clinical Autonomic Research最新文献

{"title":"Attenuated cardiac autonomic function in patients with long-COVID with impaired orthostatic hemodynamics.","authors":"Rashmin Hira, Jacquie R Baker, Tanya Siddiqui, Aishani Patel, Felix Gabriel Ayala Valani, Matthew G Lloyd, John S Floras, Carlos A Morillo, Robert S Sheldon, Satish R Raj","doi":"10.1007/s10286-025-01107-x","DOIUrl":"https://doi.org/10.1007/s10286-025-01107-x","url":null,"abstract":"<p><strong>Purpose: </strong>Long-coronavirus disease (long-COVID) is associated with initial orthostatic hypotension and postural orthostatic tachycardia syndrome. Whether altered autonomic tone underlies these abnormalities is unknown. We compared autonomic function between patients with long-COVID and healthy controls, and within patients with long-COVID with different orthostatic hemodynamic phenotypes.</p><p><strong>Methods: </strong>Patients with long-COVID (n = 94; F = 76; 42 years [36, 53 years] with initial orthostatic hypotension: n = 40; F = 32; 49 years [39, 57 years]; postural orthostatic tachycardia syndrome: n = 29; F = 26; 39 years [33, 47 years]; or no abnormalities: n = 25; F = 18; 42 years [35, 49 years]), and healthy controls (n = 33; F = 25; 49 years [30, 62 years]) completed a 10-min active stand with beat-to-beat hemodynamics. Heart rate variability, blood pressure variability, and baroreflex sensitivity were calculated as indirect measures of cardiovascular autonomic health. Continuous data (median [95% confidence interval]) were analyzed with Mann-Whitney U tests or Kruskal-Wallis tests with Dunn's corrections.</p><p><strong>Results: </strong>Patients with long-COVID had lower upright high frequency heart rate variability (p = 0.04) and low frequency blood pressure variability (p = 0.001) than controls. Patients with initial orthostatic hypotension had lower supine baroreflex sensitivity compared with patients without abnormalities (p = 0.01), and lower supine baroreflex sensitivity (p = 0.001) and high frequency heart rate variability (p = 0.03) than patients with postural orthostatic tachycardia syndrome. Patients with postural orthostatic tachycardia syndrome had lower upright high frequency heart rate variability (p < 0.001) and baroreflex sensitivity (p < 0.001) compared with patients without abnormalities and lower upright low frequency blood pressure variability (p = 0.04) compared with controls.</p><p><strong>Conclusions: </strong>Patients with long-COVID have attenuated cardiac autonomic function. Patients with initial orthostatic hypotension have lower supine baroreflex sensitivity. Patients with postural orthostatic tachycardia syndrome have lower upright vascular sympathetic and cardiac parasympathetic modulation. Long-COVID subgroups do not present with homogeneous pathophysiology, necessitating targeted treatment strategies.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-COVID and postural orthostatic tachycardia syndrome: a preliminary comparison of neuropsychological performance.","authors":"Aitana Ruiz de Lazcano, Paula Pérez-Núñez, Mercè Pallarès-Sastre, Maddalen García-Sanchoyerto, Irune García, Imanol Amayra","doi":"10.1007/s10286-025-01106-y","DOIUrl":"https://doi.org/10.1007/s10286-025-01106-y","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the study is to analyze and compare the cognitive profile between 59 patients with long-COVID [LC; 30 of them with and 29 without a positive coronavirus disease 2019 (COVID-19) confirmatory test] and 31 patients with postural orthostatic tachycardia syndrome (POTS) and a matched group of 39 healthy control participants.</p><p><strong>Methods: </strong>Participants were examined on a battery of neuropsychological tests, including verbal memory, visuospatial abilities, attention, processing speed, verbal fluency, working memory, and visual memory. Anxious-depressive symptomatology was also analyzed and then controlled for possible influence on cognitive performance.</p><p><strong>Results: </strong>Patients with LC and POTS showed significantly lower performance compared with healthy peers. Differences on anxious and depressive symptoms were also found between the clinical and control groups, resulting in LC without a positive confirmatory test group exhibiting the highest rates of anxious symptoms. After controlling the effects of anxious-depressive symptomatology, the differences were eliminated for some of the cognitive variables, but additional differences were found between patients with LC and POTS after post hoc analysis.</p><p><strong>Conclusions: </strong>Findings from the present study contribute toward the reinforcement of the evidence on cognitive alterations associated with LC and POTS. Anxious-depressive symptomatology has to be considered in both clinical groups since it could be affecting cognitive performance.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-intensity interval aerobic exercise delays recovery from heart rate variability: a systematic review with meta-analysis.","authors":"Rodrigo Leal-Menezes, Josianne Rodrigues-Krause, Gabriela Cristina Dos Santos, Jéssica do Nascimento Queiroz, Cassiano Silva da Silva, Daniel Umpierre, Alvaro Reischak-Oliveira","doi":"10.1007/s10286-024-01103-7","DOIUrl":"https://doi.org/10.1007/s10286-024-01103-7","url":null,"abstract":"<p><strong>Purpose: </strong>The present review investigates the responses of heart rate variability indices following high-intensity interval aerobic exercise, comparing it with moderate-intensity continuous exercise in adults, with the aim of informing clinical practice.</p><p><strong>Methods: </strong>Searches were conducted in four databases until March 2023. Eligible studies included randomized controlled trials that assessed heart rate variability indices such as the standard deviation of normal-to-normal heartbeat intervals (SDNN), the root mean square of successive differences (RMSSD), the proportion of the number of pairs of successive normal-to-normal (NN or R-R) intervals that differ by more than 50 ms (NN50) divided by the total number of NN intervals (pNN50), power in high frequency range (HF), power in low frequency range (LF), and LF/HF before and after high-intensity interval and moderate-intensity continuous aerobic exercise. The risk of bias in included studies was evaluated using the RoB 2 tool.</p><p><strong>Results: </strong>A total of 16 studies were included in the systematic review, while 9 were included in the meta-analysis. Overall, the majority of included individuals were healthy and young. Our meta-analysis indicated that individuals who performed high-intensity interval exercise showed a slower recovery to baseline levels for HF (standardized mean difference, SMD -0.98 [95% CI -1.52 to -0.44], p < 0.001) and LF (SMD -0.42 [95% CI -0.81 to -0.02], p = 0.04) within the first 10 min of recovery, which did not occur after 1 h. Among the 16 included studies, 10 had some concerns related to bias risk, while 6 were classified as high risk.</p><p><strong>Conclusions: </strong>High-intensity interval aerobic exercise results in delayed recovery of HF and LF indices within the first 10 min after the session. However, our review indicates that healthy individuals restore modulation of the autonomic nervous system to baseline levels after this time interval, regardless of exercise intensity.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anhidrosis in septin-7 autoimmunity.","authors":"Shemonti Hasan, Yong Guo, Paola Sandroni, Divyanshu Dubey, Andrew McKeon","doi":"10.1007/s10286-025-01108-w","DOIUrl":"https://doi.org/10.1007/s10286-025-01108-w","url":null,"abstract":"","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resting beat-to-beat blood pressure variability in humans: role of alpha-1 adrenergic receptors.","authors":"Rosa V D Guerrero, Lauro C Vianna, Georgia C S Lehnen, Mauricio Daher, André L Teixeira, Igor A Fernandes","doi":"10.1007/s10286-024-01105-5","DOIUrl":"https://doi.org/10.1007/s10286-024-01105-5","url":null,"abstract":"<p><strong>Purpose: </strong>Resting beat-to-beat blood pressure variability is a strong predictor of cardiovascular events and mortality. However, its underlying mechanisms remain incompletely understood. Given that the sympathetic nervous system plays a pivotal role in cardiovascular regulation, we hypothesized that alpha-1 adrenergic receptors (the main sympathetic receptor controlling peripheral vasoconstriction) may contribute to resting beat-to-beat blood pressure variability.</p><p><strong>Methods: </strong>Beat-to-beat heart rate (electrocardiography) and blood pressure (photoplethysmography) were continuously measured before and 2 h following, selective blockade of alpha-1 adrenergic receptors via oral administration of prazosin (1 mg/20 kg) in ten young healthy adults (two women). Cardiac output and total peripheral resistance were estimated using the ModelFlow method.</p><p><strong>Results: </strong>Selective blockade of alpha-1 adrenergic receptors was confirmed by the marked reduction in the pressor response to intravenous infusion of phenylephrine hydrochloride (-80 ± 15%, P = 0.001 versus pre-prazosin). The blockade significantly decreased the standard deviation of the systolic (pre-prazosin versus post-prazosin: 5.6 ± 1.4 versus 3.8 ± 0.7 mmHg, P = 0.002), diastolic (3.2 ± 1.2 versus 2.2 ± 0.5 mmHg, P = 0.022), and mean blood pressure (3.7 ± 1.2 versus 2.5 ± 0.5 mmHg, P = 0.009), as well as total peripheral resistance (0.8 ± 0.5 versus 0.5 ± 0.1 mmHg/L/min, P = 0.047), but not cardiac output (521 ± 188 versus 453 ± 160 mL/min, P = 0.321). Similar results were found using different indices of variability.</p><p><strong>Conclusion: </strong>These findings indicate that alpha-1 adrenergic receptors play a significant role in regulating resting beat-to-beat blood pressure variability in young, healthy adults.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the NASA Lean Test a suitable tool to diagnose cardiovascular autonomic disorders?","authors":"Yvonne Teuschl, Alessandra Fanciulli, Anne Pavy-Le Traon, Mario Habek, Roland D Thijs, Antun R Pavelic, Walter Struhal","doi":"10.1007/s10286-024-01097-2","DOIUrl":"https://doi.org/10.1007/s10286-024-01097-2","url":null,"abstract":"","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Haemodynamic effects of fludrocortisone and midodrine in patients with symptoms due to hypotension.","authors":"Frederik J de Lange, Steven van Zanten, Giulia Rivasi, Antonella Groppelli, Vincenzo Russo, Roberto Maggi, Marco Capacci, Sara Nawaz, Angelo Comune, Andrea Ungar, Gianfranco Parati, Michele Brignole, Artur Fedorowski","doi":"10.1007/s10286-024-01096-3","DOIUrl":"https://doi.org/10.1007/s10286-024-01096-3","url":null,"abstract":"<p><strong>Aim: </strong>The study aimed to assess the haemodynamic effects of fludrocortisone and midodrine, alone or combined, in patients with recurrent syncope and/or symptoms due to hypotension and ≥ 1 daytime systolic blood pressure (SBP) drop < 90 mmHg or ≥ 2 daytime SBP drops < 100 mmHg recorded by 24-h ambulatory blood pressure monitoring (ABPM1).</p><p><strong>Method: </strong>A total of 53 patients (mean age, 40.9 ± 18.5 years, 37 female) were treated with fludrocortisone (0.05-0.2 mg per day) and/or midodrine (2.5-10 mg two or three times per day). A second ABPM (ABPM2) was performed within 6 months and the results of ABPM1 AND ABPM2 were compared to assess the effects of BP-rising drugs.</p><p><strong>Results: </strong>In 32 patients assigned to fludrocortisone, 24-h SBP increased from 107.1 ± 9.9 mmHg to 116.3 ± 14.9 (p = 0.0001), the number of daily SBP drops < 90 mmHg decreased by 73% (p = 0.0001) and that of drops < 100 mmHg decreased by 41% (p = 0.0005). In 14 patients assigned to midodrine, 24-h SBP increased from 112.7 ± 7.4 mmHg to 115.0 ± 9.1 (p = 0.12), the number of daily SBP drops < 90 mmHg decreased by 52% (p = 0.04) and that of drops < 100 mmHg decreased by 34% (p = 0.007). In the seven patients taking both fludrocortisone and midodrine, 24-h SBP increased from 110.1 ± 11.5 mmHg to 114.0 ± 12.4 (p = 0.002), the number of daily SBP drops < 90 mmHg decreased by 69% (p = 0.22) and that of drops < 100 mmHg decreased by 44% (p = 0.04).</p><p><strong>Conclusions: </strong>Both fludrocortisone and midodrine effectively increased 24-h SBP and reduced SBP drops on ABPM but fludrocortisone seemed to be more effective than midodrine. Further randomised studies are needed to confirm these observations.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orthostatic test shows higher systolic blood pressure and sympathetic response in uncomplicated type 1 diabetes patients with normal V̇O_2max vs. healthy controls.","authors":"Samu Sorola, Vesa Hyrylä, Timo Eronen, Saana Kupari, Mika Venojärvi, Heikki Tikkanen, Mika Tarvainen, Harri Lindholm","doi":"10.1007/s10286-024-01094-5","DOIUrl":"https://doi.org/10.1007/s10286-024-01094-5","url":null,"abstract":"<p><strong>Purpose: </strong>Cardiovascular autonomic neuropathy remains underdiagnosed in type 1 diabetes mellitus, posing a risk for severe complications, particularly in patients with lowered V̇O_2max, compared to controls. This study aimed to determine whether heart rate variability during cardiovascular autonomic reflex tests reveals early signs of cardiovascular autonomic neuropathy in patients with uncomplicated type 1 diabetes mellitus and normal cardiovascular fitness, compared to healthy controls.</p><p><strong>Methods: </strong>A type 1 diabetes mellitus group (n = 14) with no other diagnosed diseases (diabetes duration 15 ± 7 years) and a control group (n = 31) underwent deep breathing test, passive orthostatic test, and cardiopulmonary exercise test. Participants were assessed for heart rate variability, heart rate, blood pressure, and V̇O_2max (mL/min/kg).</p><p><strong>Results: </strong>Participant characteristics, including V̇O_2max (mL/min/kg), showed no significant differences. The type 1 diabetes mellitus group had higher systolic blood pressure during the supine phase of the orthostatic test than healthy controls (131.6 ± 14.7 mmHg vs. 122.4 ± 10.8 mmHg, p = 0.022). After 5 mins in the upright position, systolic blood pressure (132.2 ± 20.6 mmHg vs. 118.7 ± 11.7 mmHg, p = 0.036), heart rate (85 (76; 89) bpm vs. 75 (72; 83) bpm, p = 0.013), and the root mean square of successive RR interval differences (20.22 (11.22; 27.42) vs. 27.11 (19.90; 35.52), p = 0.033) were significantly different compared to controls.</p><p><strong>Conclusion: </strong>Patients with uncomplicated type 1 diabetes mellitus, despite having normal cardiorespiratory fitness, exhibited higher systolic pressure and greater sympathetic activation in orthostatic tests, suggesting subclinically altered cardiovascular autonomic function.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of bradycardia and asystole during microelectrode recordings from the human vagus nerve.","authors":"Mikaela Patros, David G S Farmer, Matteo M Ottaviani, Tye Dawood, Marko Kumric, Josko Bozic, Matt I Badour, Antony R Bain, Ivan Drvis, Otto F Barak, Zeljko Dujic, Vaughan G Macefield","doi":"10.1007/s10286-024-01101-9","DOIUrl":"https://doi.org/10.1007/s10286-024-01101-9","url":null,"abstract":"","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of tactile auricular vagus nerve stimulation using heated and humidified airflow on cardiac autonomic activity: a pilot experimental study.","authors":"Soohyun Wi, Sungwoo Park, Byung-Mo Oh, Han Gil Seo, Yae Lim Lee, Woo Hyung Lee","doi":"10.1007/s10286-024-01095-4","DOIUrl":"https://doi.org/10.1007/s10286-024-01095-4","url":null,"abstract":"","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}