PURPOSE: The measurement of heart rate variability (HRV) is a non-invasive method to analyze the balance of the autonomic nervous system. The aim of this study was to compare the changes of HRV and base deficit (BD) during the treatment of trauma patients. METHODS: Forty-three trauma patients with a low injury severity scores (ISS < 24) and negative base excess on admission were included in this study. Based on the BD changes, patients were divided into three groups: 'end pointed' group (n = 13), patients' BDs instantly cleared after primary hydration; 'needs further resuscitation' group (n = 21), patients' BDs did not reach the end point and thus required further hydration or packed red blood cells transfusion; and 'hydration minimal change' group (n = 9), patients' BDs lower than 2.5 mmol/L at the onset of admission and thereafter had minimal change (near normal range). The changes in HRV during fluid resuscitation were detected and compared to BD changes in their arterial blood gases. All data were analysed using the SPSS software Version 15.0. Repeated measures ANOVA was used to determine the changes in HRV, heart rate, blood pressure, and BD among groups. RESULTS: A significant reverse correlation was found between the BD ratio and the HRV ratio (r = -0.562; p = 0.01). The HRV of patients with aggravated BDs after fluid resuscitation was decreased. There was an increase in HRV at the time of BD clearance. A decrease in HRV after primary crystalloid hydration bore a significant connection with the need for an ICU (p = 0.021) and transfusion of packed red blood cells (p < 0.001). CONCLUSION Increase in HRV may be a new non-invasive index for the end point of resuscitation in trauma patients.
Adolescent ; Adult ; Aged ; Autonomic Nervous System ; physiopathology ; Crystalloid Solutions ; administration & dosage ; Fluid Therapy ; Heart Rate ; Humans ; Injury Severity Score ; Middle Aged ; Resuscitation ; methods ; Wounds and Injuries ; diagnosis ; physiopathology ; Young Adult

Autonomic Nervous System ; physiopathology ; Blood Pressure ; physiology ; Cardiovascular Diseases ; therapy ; Cardiovascular System ; physiopathology ; Diabetic Neuropathies ; therapy ; Humans

Autonomic disturbances often occur in patients with acute cerebrovascular disease due to damage of the central autonomic network. We summarize the structures of the central autonomic network and the clinical tests used to evaluate the functions of the autonomic nervous system. We review the clinical and experimental findings as well as management strategies of post-stroke autonomic disturbances including electrocardiographic changes, cardiac arrhythmias, myocardial damage, thermoregulatory dysfunction, gastrointestinal dysfunction, urinary incontinence, sexual disorders, and hyperglycemia. The occurrence of autonomic disturbances has been associated with poor outcomes in stroke patients. Autonomic nervous system modulation appears to be an emerging therapeutic strategy for stroke management in addition to treatments for sensorimotor dysfunction.
Acute Disease ; Animals ; Autonomic Nervous System ; physiopathology ; Cerebrovascular Disorders ; complications ; physiopathology ; Humans ; Nerve Net ; injuries ; Sensorimotor Cortex ; physiopathology ; Stroke ; physiopathology

The autonomic nervous system consists of the sympathetic nervous system and the parasympathetic nervous system. These two systems control the heart and work in a reciprocal fashion to modulate myocardial energy metabolism, heart rate as well as blood pressure. Multiple cardiac pathological conditions are accompanied by autonomic imbalance, characterized by sympathetic overactivation and parasympathetic inhibition. Studies have shown that overactive sympathetic nervous system leads to increased cardiac inflammatory reaction. Orchestrated inflammatory response serves to clear dead cardiac tissue and activate reparative process, whereas excessive inflammation may result in pathological cardiac remodeling. Since the discovery of the α7 nicotinic acetylcholine receptor (α7nAChR)-mediated cholinergic anti-inflammatory pathway (CAP), the protective effects of the parasympathetic nervous system in cardiac inflammation have attracted more attention recently. In this review, we summarized the role and underlying mechanisms of the sympathetic and parasympathetic nervous systems in cardiac inflammation, in order to provide new insight into cardiac inflammatory response in cardiovascular diseases.
Autonomic Nervous System ; physiology ; Heart ; physiopathology ; Humans ; Inflammation ; physiopathology ; Parasympathetic Nervous System ; physiology ; alpha7 Nicotinic Acetylcholine Receptor ; physiology

OBJECTIVETo investigate the cardiac autonomic nerve function in girls with idiopathic central precocious puberty (ICPP).

METHODSA total of 66 girls with ICPP were enrolled, among whom 36 were obese and 30 were not obese. A total of 68 age-matched healthy girls (normal controls) and 51 girls with simple obesity were enrolled as controls. All the subjects underwent 24-hour ambulatory electrocardiography, and deceleration capacity of heart rate (DC), acceleration capacity of heart rate (AC), and heart rate variability (HRV), and body mass index (BMI) were compared between groups.

RESULTSCompared with the normal control group, the ICPP group had significantly lower DC, standard deviation of normal-to-normal R-R intervals (SDNN), standard deviation of the average normal-to-normal intervals (SDANN), root mean square of successive differences (RMSSD), and high-frequency power (HF) and significantly higher AC and BMI. The ICPP group had significantly lower RMSSD and BMI than the simple obesity group (P<0.05). Compared with the ICPP girls without obesity, those with obesity had significantly lower DC, RMSSD, and HF and significantly higher AC and BMI (P<0.05).

CONCLUSIONSCardiac autonomic dysfunction is seen in girls with ICPP, especially those with obesity, mainly presenting with reduced vagal tone.

Autonomic Nervous System ; physiopathology ; Body Mass Index ; Child ; Child, Preschool ; Female ; Heart ; innervation ; Heart Rate ; physiology ; Humans ; Obesity ; physiopathology ; Puberty, Precocious ; physiopathology

OBJECTIVETo analyze the deceleration capacity (DC) of heart rate, acceleration capacity (AC) of heart rate, and heat rate variability (HRV) in obese school-age children, and to observe the correlations of BMI with DC, AC, and HRV in these children.

METHODSA total of 108 obese school-age children were selected, including 75 cases of ortholiposis and 33 cases of dyslipidemia. A total of 103 healthy school-age children were selected as control group. All the subjects underwent 24-hour ambulatory electrocardiography. The comparisons of DC, AC, and HRV were made between the obese and control groups, as well as between children with ortholiposis and dyslipidemia in the obese group. The correlations of BMI with DC, AC, and HRV were analyzed in the obese group.

RESULTSThe obese group showed lower DC, standard deviation of normal-to-normal R-R intervals (SDNN), standard deviation of the average normal-to-normal intervals (SDANN), root mean square of successive differences (RMSSD), low-frequency power (LF), and high-frequency power (HF) than the control group. The AC of the obese group was significantly higher than that of the control group (P<0.05). In the obese group, children with dyslipidemia had significantly lower DC, SDNN, SDANN, RMSSD, LF, and HF, but significantly higher AC and BMI, as compared with those with ortholiposis (P<0.01). In the obese group, BMI was negatively correlated with DC, SDNN, SDANN, RMSSD, and HF (P<0.05), but positively correlated with AC (P<0.05).

CONCLUSIONSObese school-age children have impaired autonomic nerve function, presenting with reduced vagal tone, which is particularly prominent in those with dyslipidemia. The more obese the children, the lower the vagal tone, which may increase the risks of cardiovascular diseases.

Autonomic Nervous System ; physiopathology ; Child ; Female ; Heart ; innervation ; Heart Rate ; Humans ; Insulin Resistance ; Male ; Obesity ; complications ; physiopathology

Heart rate variability (HRV) is the difference between the successive changes in the heartbeat cycle, and it is produced in the autonomic nervous system modulation of the sinus node of the heart. The HRV is a valuable indicator in predicting the sudden cardiac death and arrhythmic events. Traditional analysis of HRV is based on a multielectrocardiogram (ECG), but the ECG signal acquisition is complex, so we have designed an HRV analysis system based on photoplethysmography (PPG). PPG signal is collected by a microcontroller from human's finger, and it is sent to the terminal via USB-Serial module. The terminal software not only collects the data and plot waveforms, but also stores the data for future HRV analysis. The system is small in size, low in power consumption, and easy for operation. It is suitable for daily care no matter whether it is used at home or in a hospital.
Autonomic Nervous System ; physiopathology ; Cardiovascular Diseases ; diagnosis ; Death, Sudden, Cardiac ; Electrocardiography ; Heart Rate ; Humans ; Monitoring, Ambulatory ; instrumentation ; Photoplethysmography ; instrumentation ; Sinoatrial Node ; physiopathology ; Software

Hypoglycemia is a major barrier to achieving the glycemic goal in patients with type 2 diabetes. In particular, severe hypoglycemia, which is defined as an event that requires the assistance of another person to actively administer carbohydrates, glucagon, or take other corrective actions, is a serious clinical concern in patients with diabetes. If severe hypoglycemia is not managed promptly, it can be life threatening. Hypoglycemia-associated autonomic failure (HAAF) is the main pathogenic mechanism behind severe hypoglycemia. Defective glucose counter-regulation (altered insulin secretion, glucagon secretion, and an attenuated increase in epinephrine during hypoglycemia) and a lack of awareness regarding hypoglycemia (attenuated sympathoadrenal activity) are common components of HAAF in patients with diabetes. There is considerable evidence that hypoglycemia is an independent risk factor for cardiovascular disease. In addition, hypoglycemia has a significant influence on the quality of life of patients with diabetes. To prevent hypoglycemic events, the setting of glycemic goals should be individualized, particularly in elderly individuals or patients with complicated or advanced type 2 diabetes. Patients at high-risk for the future development of severe hypoglycemia should be selected carefully, and intensive education with reinforcement should be implemented.
Autonomic Nervous System/physiopathology ; Biological Markers/blood ; Blood Glucose/*drug effects/metabolism ; Diabetes Mellitus, Type 2/blood/complications/diagnosis/*drug therapy/physiopathology ; Health Knowledge, Attitudes, Practice ; Humans ; Hypoglycemia/blood/chemically induced/epidemiology/physiopathology/*prevention & control ; Hypoglycemic Agents/*adverse effects ; Incidence ; Patient Education as Topic ; Prevalence ; Prognosis ; Risk Assessment ; Risk Factors

OBJECTIVETo compare the clinical efficacy difference in dysantonomia between transcutaneous electrical stimulation at Renying(ST 9) combined with stellate ganglion block(SGB) and simple SGB.

METHODSSixty patients in accord with the diagnostic criteria of dysantonomia were randomly divided into two groups,30 cases in each group. In the observation group,transcutaneous electrical stimulation at Renying(ST 9) combined with SGB were adopted; in the control group,simple SGB was applied. In the two groups, treatment was used three times a week,and nine treatments were considered as one course. There was an interval of one week between courses,and two courses were treated. Total seven weeks were required. Scores were evaluated according to subjective symptoms before treatment,one month and three months after treatment in the two groups.

RESULTSThe scores of subjective symptoms were not statistically different before treatment in the two groups(P>0. 05). The scores of subjective symptoms one month and three months after treatment were all lower than those before treatment(all P< 0. 01), and subjective symptoms scores in the observation group were lower than those in the control group(both P<0. 01).

CONCLUSIONTranscutaneous electrical stimulation at Renying(ST 9) combined with SGB could obviously enhance the clinical effects for dysantonomia, and the control and improvement for clinical symptoms are apparently superior to simple SGB.

Acupuncture Points ; Adult ; Anesthetics ; administration & dosage ; Autonomic Nerve Block ; Autonomic Nervous System Diseases ; drug therapy ; therapy ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Stellate Ganglion ; drug effects ; physiopathology ; Transcutaneous Electric Nerve Stimulation ; Young Adult

The purpose of this study is to discuss the feasibility of establishing capsaicin pain model and the possibility to evaluate different degrees of pain by the heart rate variability (HRV). It also aims to investigate the changes of autonomic nervous activity of volunteers during the process of pain caused by capsaicin. A total of 30 volunteers were selected, who were physically and mentally healthy, into the study. To assess the effects of capsaicin on the healthy volunteers, we recorded the Visual Analogue Scale (VAS) scores after the capsaicin stimulus. Additionally, the electrocardiogram signals and HRV analysis index before and after stimulating were also recorded, respectively. More specifically, the HRV analysis indexes included the time domain index, the frequency domain index, and the nonlinear analysis index. The results demonstrated that the activity of the autonomic nerves was enhanced in the process of capsaicin stimulus, especially for the sympathetic nerve, which exhibited a significantly differences in HRV. In conclusion, the degree of pain can be reflected by the HRV. It is feasible to establish a capsaicin pain model. And in further experiments, HRV analysis could be used as a reference index for quantitative evaluation of pain.
Autonomic Nervous System ; physiopathology ; Capsaicin ; Electrocardiography ; Feasibility Studies ; Healthy Volunteers ; Heart Rate ; Humans ; Pain ; physiopathology ; Pain Measurement ; methods