Clinical Autonomic Research最新文献

{"title":"Sit-up test to assess orthostatic hypotension in individuals with spinal cord injury.","authors":"Jill M Wecht, Matthew T Maher, Steven C Kirshblum, Miguel X Escalon, Joseph P Weir","doi":"10.1007/s10286-024-01102-8","DOIUrl":"10.1007/s10286-024-01102-8","url":null,"abstract":"<p><strong>Aim: </strong>Individuals with spinal cord injury (SCI) have an increased prevalence of orthostatic hypotension (OH). Diagnosis of OH is made with active standing or tilt table testing, with limited the use in individuals with SCI.</p><p><strong>Methods: </strong>An alternative approach to assess OH is the sit-up test, which involves passive repositioning from the supine to the seated position. The purpose of this study was to document the reliability and validity of the sit-up test, and determine whether the level or severity of injury related to orthostatic blood pressure (BP) responses in a large, diverse group of individuals with SCI.</p><p><strong>Results: </strong>A total of 166 participants-119 individuals with SCI and 47 uninjured control-completed two sit-up tests, and 36 individuals who completed the sit-up tests also underwent a head-up tilt test. Change in BP from sit-up test 1 to sit-up test 2 was not significantly different for either systolic BP or diastolic BP. Neither level nor severity of injury contributed to the reliability assessments, which showed disappointing results with generally low interclass correlation coefficients (ICC), with values ranging from 0 to 0.63, and large standard error of measurements (SEM), ranging from 5.2 to 13.7 mmHg. Comparison between BP responses to the sit-up test and the head-up tilt showed good sensitivity and specificity, with positive predictive values > 75%.</p><p><strong>Conclusion: </strong>Prevalent BP instability likely contributed to the poor reliability of the sit-up test, but the test is easy to perform with a high likelihood ratio for the valid assessment of OH in individuals with SCI.</p><p><strong>Clinical trial registration: </strong>NCT01758692.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"393-405"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540373","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":"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":"523-527"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","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":"Amplitude of low-frequency fluctuation (ALFF) alterations in heart transplant patients with cognitive impairment: a resting-state fMRI study.","authors":"Qian Qin, Jia Liu, Wenliang Fan, Xinli Zhang, Jue Lu, Xiaotong Guo, Ziqiao Lei, Jing Wang","doi":"10.1007/s10286-025-01124-w","DOIUrl":"10.1007/s10286-025-01124-w","url":null,"abstract":"<p><strong>Background: </strong>The aim of our study was to investigate the changes in brain functional activity in heart transplant patients and to explore the relationship between abnormal spontaneous brain activity and cognitive function through amplitude of low-frequency fluctuations (ALFF).</p><p><strong>Methods: </strong>Sixty-eight heart transplant patients and 56 healthy controls were assessed by the Montreal Cognitive Assessment (MoCA) scale and the Mini-Mental Status Examination (MMSE) scale, and resting-state functional magnetic resonance scans were performed. Cortical analysis was applied to calculate the ALFF, and two-sample t test was used to detect differences of mean ALFF in the brain region between the two groups. In addition, the correlations between abnormal functional activity brain regions, cognitive functions, and clinical indicators were analyzed.</p><p><strong>Results: </strong>Heart transplant patients had significantly lower MoCA scores and MMSE scores compared to healthy subjects. ALFF were found to be decreased in the right cerebellum anterior lobe, left parahippocampal gyrus, left temporal lobe, left parietal lobe, and right postcentral gyrus, and increased in the right superior frontal gyrus and left middle frontal gyrus. In addition, ALFF in right superior frontal gyrus was positively correlated with MoCA score (r = 0.397, P < 0.05), MMSE score (r = 0.356, P < 0.05), stroke volume (SV, r = 0.412, P < 0.05), and left ventricular ejection fraction (LVEF, r = 0.614, P < 0.05) in heart transplant patients.</p><p><strong>Conclusions: </strong>Cognitive function is impaired in heart transplant patients. The brain activity was altered in heart transplant recipients compared to healthy controls. ALFF changes in these brain regions may be associated with altered hemodynamics after transplantation, leading to impaired cognitive function. These findings help us to understand the neural mechanisms of cognitive changes in heart transplant recipients and provide a basis for developing interventions and rehabilitation strategies.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"501-509"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986451","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":"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":"365-379"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","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":"Chronic autonomic symptom burden in long-COVID: a follow-up cohort study.","authors":"Ella F Eastin, Jannika V Machnik, Lauren E Stiles, Nicholas W Larsen, Jordan Seliger, Linda N Geng, Hector Bonilla, Phillip C Yang, Mitchell G Miglis","doi":"10.1007/s10286-025-01111-1","DOIUrl":"10.1007/s10286-025-01111-1","url":null,"abstract":"<p><strong>Purpose: </strong>Autonomic dysfunction is a common and often debilitating feature of long-COVID (LC), however, studies evaluating frequency and severity of chronic autonomic dysfunction in LC are limited. We utilized an established online cohort of participants with LC to assess duration and severity of autonomic dysfunction, impact on quality of life, risk factors of autonomic diagnoses including postural tachycardia syndrome (POTS), and efficacy of common treatments.</p><p><strong>Methods: </strong>Our international cohort included 526 adults with LC aged 20-65 years who previously completed baseline evaluations of LC symptoms, autonomic symptom burden, and quality of life. Participants repeated survey instruments and completed new instruments assessing risk factors and symptom mitigation strategies. A subset of individuals completed a 10-min active stand test. Multivariable logistic regression identified predictors of autonomic symptom burden and incident autonomic diagnoses including POTS.</p><p><strong>Results: </strong>A total of 71.9% of participants with LC had a Composite Autonomic Symptom Score-31 (COMPASS-31) score ≥ 20, suggestive of moderate-to-severe autonomic dysfunction. The median symptom duration was 36 [30-40] months, and 37.5% of participants could no longer work or had to drop out of school due to their illness. In addition, 40.5% of individuals with autonomic dysfunction were newly diagnosed with POTS, representing 33% of the total LC cohort. Female sex and joint hypermobility were associated with an increased risk of autonomic dysfunction.</p><p><strong>Conclusions: </strong>Evidence of chronic moderate-to-severe autonomic dysfunction was seen in most participants with LC in our cohort and was significantly associated with reduced quality of life and functional disability. POTS was the most common post-COVID autonomic diagnosis.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"453-464"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188418","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":"Heartbeat signature for predicting motor and non-motor involvement among nonparkinsonian LRRK2 G2019S mutation carriers.","authors":"Claudia Carricarte Naranjo, Connie Marras, Naomi P Visanji, David J Cornforth, Lazaro Sanchez-Rodriguez, Birgitt Schüle, Samuel M Goldman, Mario Estévez, Phyllis K Stein, Herbert F Jelinek, Anthony E Lang, Andrés Machado","doi":"10.1007/s10286-024-01104-6","DOIUrl":"10.1007/s10286-024-01104-6","url":null,"abstract":"<p><strong>Purpose: </strong>Increased beat-to-beat heart rate variability (HRV) is a feature of patients with Parkinson's disease (PD) who carry the G2019S mutation in the LRRK2 gene (LRRK2-PD). Since LRRK2 mutations have incomplete penetrance, HRV changes preceding PD conversion would likely be observed only in a subset of LRRK2 non-manifesting carriers (NMC). We aimed to assess HRV in a subgroup of NMC with distinctive characteristics of LRRK2-PD, identified through clustering analysis.</p><p><strong>Methods: </strong>HRV measures derived from 300 normal heartbeat intervals extracted from the electrocardiograms of 25 NMC, 32 related non-carriers (RNC), 27 unrelated healthy controls, and 14 patients with LRRK2-PD were analyzed. Clinical symptoms were evaluated using questionnaires and scales, and three NMC subgroups were identified using a k-means cluster analysis on the basis of the deceleration capacity of heart rate (DC) and Rényi entropy. Standard and advanced HRV measures were compared using multiple regression analysis, controlling for age, sex, and mean heart rate.</p><p><strong>Results: </strong>Beat-to-beat HRV markers were significantly increased in a subgroup of seven NMC (NMC2, 28%) compared with RNC and controls. Increased irregularity and DC were also verified in the NMC2 compared with controls, and were typical traits in both the NMC2 and RNC. Overall, the HRV profile of NMC2 was comparable to that of patients with LRRK2-PD. NMC2 further exhibited greater motor and non-motor traits than the other NMC, RNC, and controls.</p><p><strong>Conclusions: </strong>Our results confirmed that HRV characteristics of LRRK2-PD are also found in a subset of NMC displaying clinical traits of LRRK2-PD. Further research is needed to clarify whether higher HRV represents a LRRK2-PD prodromal manifestation.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"407-419"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448395","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":"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":"381-391"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12137366/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maintained sympathetic reactivity but blunted pressor response to static handgrip exercise in heart failure with preserved ejection fraction.","authors":"Takuro Washio, Ryosuke Takeda, Sarah L Hissen, John D Akins, Andrew W D'Souza, Denis J Wakeham, Tiffany Brazile, Kevin Lutz, Christopher M Hearon, James P MacNamara, Satyam Sarma, Benjamin D Levine, Paul J Fadel, Qi Fu","doi":"10.1007/s10286-025-01114-y","DOIUrl":"10.1007/s10286-025-01114-y","url":null,"abstract":"<p><strong>Purpose: </strong>Recent studies have reported blunted increases in blood pressure (BP) during static handgrip (SHG) in patients with heart failure with preserved ejection fraction (HFpEF), which may be attributed to abnormal sympathetic reactivity during exercise and/or impaired muscle metaboreflex function. However, it is unknown whether the sympathetic neural response to SHG and isolated muscle metaboreflex activation via post-exercise circulatory occlusion (PECO) are attenuated in HFpEF.</p><p><strong>Methods: </strong>Thirty-nine patients with HFpEF and 24 age-matched non-HFpEF controls were studied in the supine position. BP, heart rate (HR), and muscle sympathetic nerve activity (MSNA) were measured during SHG at 40% of maximal voluntary contraction until fatigue followed by 2-min PECO.</p><p><strong>Results: </strong>Resting mean arterial pressure (MAP) was lower and peak increase (Δ) in MAP was smaller in patients with HFpEF than in controls during SHG (Δ23 ± 15 [standard deviation] vs. Δ34 ± 15 mmHg; P = 0.007) and PECO (Δ15 ± 11 vs. Δ19 ± 9 mmHg; P = 0.047). HR was greater in patients at rest but did not differ between the two groups at peak SHG. Patients had higher resting MSNA burst frequency than controls (37 ± 14 vs. 27 ± 13 bursts/min; P = 0.031); however, burst incidence was not different between the groups (P = 0.226). There were no differences in MSNA responses to SHG (Δ19 ± 15 vs. Δ18 ± 10 bursts/min at peak; P = 0.841) or PECO (Δ3 ± 12 vs. Δ5 ± 7 bursts/min; P = 0.495) between groups.</p><p><strong>Conclusion: </strong>The patients with HFpEF maintained sympathetic reactivity but had an attenuated pressor response during fatiguing SHG. Additionally, muscle metaboreflex activation of vasomotor sympathetic outflow appeared to be minimal in both groups, with no significant difference between patients and controls.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"487-500"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blunted baroreflex-mediated sympathoinhibition and vasodilation to countdown before exercise in young women compared to men.","authors":"Kazumasa Manabe, Andrew W D'Souza, Ryosuke Takeda, Sarah L Hissen, Takuro Washio, John D Akins, Belinda Sanchez, Qi Fu","doi":"10.1007/s10286-025-01132-w","DOIUrl":"https://doi.org/10.1007/s10286-025-01132-w","url":null,"abstract":"<p><strong>Purpose: </strong>In our previous study (Manabe et al., J Appl Physiol 128:1196-1206, 1985), we demonstrated that the cerebral and cardiovascular responses induced by a pre-exercise countdown elicited peripheral vasodilation via baroreflex-mediated sympathetic withdrawal, which is likely advantageous for rapid oxygen delivery to contracting skeletal muscles in young men. Whether this is also true in young women, who generally show different neuro-cardiovascular responses to stress compared to men, remains unknown. Thus, we examined whether biological sex would affect the neuro-cardiovascular responses to anticipation before exercise.</p><p><strong>Methods: </strong>Young healthy women (n = 11) and men (n = 10) performed 1 min of static handgrip at 30% of maximal voluntary contraction force twice; once with a 30 sec countdown and once after being immediately signaled to begin exercise (without countdown), with the order randomized. Middle cerebral artery blood velocity (V_MCA; transcranial Doppler), heart rate (HR), cardiac index [CI; HR × stroke volume (Modelflow)/body surface area], mean arterial pressure (MAP; finger photoplethysmography), muscle sympathetic nerve activity (MSNA; microneurography), and leg vascular conductance [LVC = superficial femoral artery blood flow (ultrasound)/MAP] were measured continuously.</p><p><strong>Results: </strong>During countdown, women exhibited smaller increases in CI, MAP, and LVC and a smaller decrease in MSNA than men (p < 0.05). Increases in V_MCA and HR, and the sympathetic baroreflex sensitivity did not differ between sexes (p > 0.05).</p><p><strong>Conclusion: </strong>Young women seem to have less baroreflex-mediated sympathetic withdrawal and peripheral vasodilatory responses to the countdown compared to young men, despite similar cerebral vascular responses. These findings may suggest women have reduced neuro-vascular responses to exercise anticipation, which could impact the ability of oxygen delivery at exercise onset.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086006","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":"Acute effects of bolus water intake on post-exercise orthostatic hypotension and cardiovascular hemodynamics.","authors":"Yuki Tajima, Mayu Komiyama, Naoya Mimura, Maika Yamamoto, Marina Fukuie, Rina Suzuki, Shinya Matsushima, Ai Hirasawa, Shigeki Shibata","doi":"10.1007/s10286-024-01077-6","DOIUrl":"10.1007/s10286-024-01077-6","url":null,"abstract":"<p><strong>Introduction: </strong>Water intake is known to be effective in preventing orthostatic hypotension (OH). However, it is unknown whether water intake would be effective in acutely preventing exercise-induced OH.</p><p><strong>Methods: </strong>Fourteen adults (men/women: 7/7, age: 20 ± 8 years) were recruited. Each subject underwent two protocols with and without 500 ml water intake using a randomized crossover design (Water vs. Control). Participants underwent 30 min of cycle ergometry at the 60-70% predicted VO₂ max. OH and hemodynamics were assessed before and after exercise, and immediately (Water 1) and 20 min (Water 2) after the water intake. OH was evaluated with a 1-min standing test as the criteria for systolic blood pressure (SBP) < 90 mmHg. A cross-spectral analysis for RR and SBP variability was used to evaluate the cardiac autonomic activity and baroreflex sensitivity.</p><p><strong>Results: </strong>In both protocols, the incidence of OH increased after the exercise. The incidence of OH was lower in Water than in Control at Water 1 (OR: 0.093, 95% CI: 0.015-0.591). Heart rate was lower and SBP was higher in Water than in Control at Water 1 and 2 (P < 0.05). High-frequency power of RR variability and transfer function gains in Water were normalized and higher than in Control at Water 1 and 2 (P < 0.05). The ratio of low- to high-frequency power of RR variability in Water was normalized and lower in Water than in Control at Water 1 (P < 0.05).</p><p><strong>Conclusion: </strong>Our findings indicate that water intake may prevent acute exercise-induced OH, accompanied by normalized cardiac autonomic activity and baroreflex sensitivity.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"231-241"},"PeriodicalIF":3.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544071","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}