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293 Autonomic cardiovascular regulation in obesity
114
Abstracts
/International
Journal
Conclusions: (1) BP reactivity is not solely related to changes in either CO or SVR. (2) Perception of threat or challenge does not influence magnitude of BP response to mental stress. (3) Those who perceive threat experience vasoconstrictive responses, whereas those who perceive challenge experience increased cardiac output.
291 PSYCHOPHYSIOLOGIC APY OF POSTMYOCARDIAL
ASPECIS OF SPA THERINFARCTION PATIENTS
A. D&&t, J. Lietava, Z. Mike: and L. GaSpar 2nd Dept. Internal Med. Comenius Univ., Mickiewiczova 13, Bratislava 813 69, Slovakia Complex rehabilitation of patients after myocardial infarction is organised in conditions of Slovakia involving spa treatment. Spa therapy is referred to increase the vagal activity, but exact measurements are not present. Complex cardiac rehabilitation among these patients increases the tolerance of physical load and of parasympathetic activity. Interaction of both of these prognostic factors is also not clear yet. From 241 consecutive patients treated in spa SliaC, Slovakia, 24 patients up to 1 year after MI were studied (21 men, 3 women with mean of 55, 4 + 12,0 year. Exercise test (Franz protocol) with bioimpedance cardiogpphy (TEB) and heart rate variability (HRV) (Medicro Cafts) in time and spectral domains were measured at the beginning and the end of 3-4 weeks of spa treatment. This consisted of diet, physical rehabilitation, psychological therapy and of complex balneotherw Both sympathetic and vagal indexes showed no significant changes after spa treatment in time domain, (RR SD 31, 8 vs 36,6 ms; p < 0.05) and spectral domain (TP 1260 vs 1.602 ms2; p < 0.01; HF 44,4 vs 39%; p < 0,03). Resting vagal tone indirectly correlated with index of contractility (IC) with TEB. 14 patients exhibit usual improvement of exercise capacity, those increased TP (1957,2 vs 1104,O m-l; p < O.OOl), MF/HF ratio (51,l vs 26,9%; p < 0.001) after therapy to contrary to non-improved group. After spa therapy cardiac index decreased (5,4 vs 4, 0 l/min/m2) at the peak of load test and IC decreased (0,48 vs 0,52 I/secv2). Obligatory lowering of corresponding peak blood pressure showed to an economisation of cardiac hemodynamica. Multivariate regression analysis didn’t show the relation-ship between HRV and parameters of exercise test. Thus spa treatment among patients after myocardial infarction leads to signilicant improvement of hemodynamic reaction to load and HRV, but the changes in vegetative functions cannot be simplified as vagal or sympathetic improvement.
292 CORRELATION OF PERIPHERAL BLOOD REGULATION PATTERNS AND PERSONALIT
FLOW
of Psychophysiology
30 (1998)
95-271
A.V. Tarasov, L.G. Koreneva*, A.G. Markov and P.V. Zakharov Institute of Radioengineering and Electronics RAS Moscow, Starosadskii 8, 101000 Russia The existence of strong correlation (r = 0.8-0.9, p < 0.01) between patterns of temperature dynamics on human hands and several features of human personality was shown in more than 200 experiments. The personality features concerned are such as activity, patience, persistence, stress endurance, anxiety predisposition, as revealed by psychological tests, color Luscher’s test for example. Temperature dynamics features as studied by dynamical IR-thermography are: amplitudes of spontaneous and evoked temperature changes; patterns of spontaneous temperature oscillations; temporal characteristics of changes due to functional probes; the reproducibility of thermogram patterns. For example, the amplitudes of all temperature changes decrease several times from active impatient persons to patient persistent and further to anxious ones. The arguments in favor of the suggestion that the features mentioned are due to differences in the role of humoral factors in regulating peripheral blood flow are discussed. The possibilities of using dynamical IR-thermography in psychophysiology, especially concerning the stable personality features, are considered.
293 AUTONOMIC IN OBESITY
CARDIOVASCULAR
REGULATION
Kurt Laederach-Hofmann* , Lutz Mussgay, and Heinz Riiddel Inselspital, University of Beme, Freiburgstrasse, 3010 Beme, Switzerland Aim: Obese persons suffer an increased mortality risk due to cardiovascular disorders supposedly caused by continuously heightened sympathetic activation and increased catecholaminelevels. The present cross-sectional correlation-study tries to establish the relationship between various degrees of obesity on one hand and altered autonomic regulation and cortisol levels. Method: We investigated a total number of 35 patients. According to their respective body weight, patients were sorted into 3 equal cohorts containing the same number of patients of both sex, and age, covering body mass index-ranges of 27.5 to 32, 33 to 39, and above 40. Cardiovascular reactivity was assessed in each patient in our psychophysiolgical laboratory where cardiovascular activity (ECG), continuous finger blood pressure, and respiratory activity were recorded at baseline and in response to a reaction-time-task (BonnDet) to cover the additional aspect of stress reactivity. Salivary cortisol was collected concurrently. Autonomic cardiovascular regulation was assessed by use of heart rate variability measures and continuous blood pressure recordings. By calculation of spectral power time series indices of sympathetic and parasympa-
Abstracts
/International
Journal
thetic activation and an estimate of baro-reflex-sensitivity were delineated. Results: The sample of the 35 patients consisted of 23 women, and 12 males. Out of the 23 women, 15 were premenopausal. The mean age of the whole study group was 42.1 f 8.9 years, the age of premenopausal women was 39.4 f 6.0, postmenopausal 52.3 f 4.3 yrs. Body mass index, and waist/hip ratio (with age partialled out) were inversely correlated to sympathetic activity in rest and under mental stress conditions (r = -0.4, p < 0.01, r = -0.3, p < 0.05 for BMI and WHR respectively in resting conditions, and r = -0.3, p < 0.02 for BMI in stress conditions). Resting values of modulus, expressing baro-reflex sensitivity were 7.7 + 6.1 ms2, with a negative correlation to BMI an WHR (r = -0.3, p < 0.02 r = -0.4, p < 0.01, respectively). No significant correlations were found between salivary cortisol levels and BMI or WHR, irrespective of sex and age. Conclusions: In this study, contrary to expectations, no overstimulation by sympathetic drive and/or higher cortisol levels were found in relation to body weight. However, a significant deterioration of baro-reflex functioning was observable. This opens questions as to whether and to what extent a limited adaptational capacity to mental stress might contribute to the higher mortality rate of obese patients or if other mechanisms have to be postulated.
294 PSYCHOPHYSIOLOGY CARDIOLOGY
AND
PSYCHOSOMATIC
G. Cultrera*, T. Scrimali and V. Rapisarda University of Catania, Viace Andrea Doria N, 6, 95125 Catania, Italy Many studies demonstrate the elevated sensitivity of the nervous system to emotional stimuli. Among the neurouegetatiue functions affected by the modifications resulting from stress we find the heart rate, the blood pressure and electrodemral activity. The functions of the cardiovascular apparatus, from an epidemiological and clinical point of view and as a disability, have a considerable inpact on society. Studies in Psychosomatic Medicine have underlined how stress can constitute a significant co-risk factor in coronary heart disease, myocardial infarction, sudden cardiac arrest and essential hypertension. In the research project developed by the authors, great value is placed on the use of a complex and multimodal psychophysiological assessment, which permits the drawing of data concerning the psychophysiological, behavioural and cognitive aspects and aims at the prevention of psychosomatic cardiovascular disease and the planning of treatment as an instrument of great utility in the practice of clinical therapy. The study included the systematic treatment of two groups of patients affected by psychosomatic cardiovascular pathology of which one group was treated according to the Laboratory Psychophysiology Methodology while the other, in addition to cognitive behavioural intervention, was given the opportunity
of Psychophysiologv
30 (1998)
95-271
115
to utilize Field Psychophysiology equipment for the daily monitoring of certain heart rate and electrodermal activity parameters and the practice of biofeedback in a real-life setting. The objective of the research was the evaluation of the bio-psycho-social approach, the complex and multimodal psychophysiological assessment in the treatment of cardiological pathologies and the investigation of the eventual utility, validity, and reliability of Field Psychophysiological techniques. The authors present the data drawn from their research.
295 ON-LINE ANALYSIS OF BARORECEPTOR DIAC REFLEX SENSITIVITY
CAR-
A. Gustav0 Reyes de1 Paso Departamento de Psicologia, Facultad de Humanidades CC.EE., Universidad de JaCn, 23071 Jatn, Espana
y
The baroreceptor reflex is a basic mechanism for the regulation of blood pressure, a powerful source of vagal afferent input to the central nervous system, and one of the most important physiological mechanisms affecting efferent cardiac vagal activity. The evidence presently available suggests that the Parasympathetic Nervous System and the sympatheticparasympathetic interactions could play a relevant role in the pathophysiology of cardiovascular disorders and, specifically, in hypertension. A loss of sensitivity qf the baroreceptor reflex figures as a fundamental mechanism amongst the factors that have been emphasized to explain the deficits found in the parasympathetic cardiac control in cardiovascular disease. The baroreceptor cardiac reflex function is also sensitive to psychological manipulations, reducing its sensitivity during mental stress and increasing it during relaxation. Using pharmacological blockade procedures, we have found that the sensitivity of the cardiac branch of the baroreflex (expressed as the change in heart period per unit change in systolic blood pressure) is a better predictor of between-subject tonic parasympathetic cardiac control than respiratory sinus arrhythmia (the most used non-invasive index of the parasympathetic cardiac control). It is described a computerized system for the on-line analysis of the baroreceptor cardiac reflex function using the non invasive spontaneous sequence method in the time domain. The system provides a feedback of the baroreceptor reflex sensitivity differentially both when the systolic blood pressure is increasing and when it is decreasing. The method used involves simultaneous signal acquisition, analysis, and graphic display in real time. The validity of this procedure to assess baroreceptor cardiac reflex sensitivity has been tested against spectral analysis techniques. The program could be of use, both to undertake a rapid evaluation of the function of the reflex and for using it as a biofeedback system with the objective of increasing baroreflex sensitivity.
Abstracts
/International
Journal
Conclusions: (1) BP reactivity is not solely related to changes in either CO or SVR. (2) Perception of threat or challenge does not influence magnitude of BP response to mental stress. (3) Those who perceive threat experience vasoconstrictive responses, whereas those who perceive challenge experience increased cardiac output.
291 PSYCHOPHYSIOLOGIC APY OF POSTMYOCARDIAL
ASPECIS OF SPA THERINFARCTION PATIENTS
A. D&&t, J. Lietava, Z. Mike: and L. GaSpar 2nd Dept. Internal Med. Comenius Univ., Mickiewiczova 13, Bratislava 813 69, Slovakia Complex rehabilitation of patients after myocardial infarction is organised in conditions of Slovakia involving spa treatment. Spa therapy is referred to increase the vagal activity, but exact measurements are not present. Complex cardiac rehabilitation among these patients increases the tolerance of physical load and of parasympathetic activity. Interaction of both of these prognostic factors is also not clear yet. From 241 consecutive patients treated in spa SliaC, Slovakia, 24 patients up to 1 year after MI were studied (21 men, 3 women with mean of 55, 4 + 12,0 year. Exercise test (Franz protocol) with bioimpedance cardiogpphy (TEB) and heart rate variability (HRV) (Medicro Cafts) in time and spectral domains were measured at the beginning and the end of 3-4 weeks of spa treatment. This consisted of diet, physical rehabilitation, psychological therapy and of complex balneotherw Both sympathetic and vagal indexes showed no significant changes after spa treatment in time domain, (RR SD 31, 8 vs 36,6 ms; p < 0.05) and spectral domain (TP 1260 vs 1.602 ms2; p < 0.01; HF 44,4 vs 39%; p < 0,03). Resting vagal tone indirectly correlated with index of contractility (IC) with TEB. 14 patients exhibit usual improvement of exercise capacity, those increased TP (1957,2 vs 1104,O m-l; p < O.OOl), MF/HF ratio (51,l vs 26,9%; p < 0.001) after therapy to contrary to non-improved group. After spa therapy cardiac index decreased (5,4 vs 4, 0 l/min/m2) at the peak of load test and IC decreased (0,48 vs 0,52 I/secv2). Obligatory lowering of corresponding peak blood pressure showed to an economisation of cardiac hemodynamica. Multivariate regression analysis didn’t show the relation-ship between HRV and parameters of exercise test. Thus spa treatment among patients after myocardial infarction leads to signilicant improvement of hemodynamic reaction to load and HRV, but the changes in vegetative functions cannot be simplified as vagal or sympathetic improvement.
292 CORRELATION OF PERIPHERAL BLOOD REGULATION PATTERNS AND PERSONALIT
FLOW
of Psychophysiology
30 (1998)
95-271
A.V. Tarasov, L.G. Koreneva*, A.G. Markov and P.V. Zakharov Institute of Radioengineering and Electronics RAS Moscow, Starosadskii 8, 101000 Russia The existence of strong correlation (r = 0.8-0.9, p < 0.01) between patterns of temperature dynamics on human hands and several features of human personality was shown in more than 200 experiments. The personality features concerned are such as activity, patience, persistence, stress endurance, anxiety predisposition, as revealed by psychological tests, color Luscher’s test for example. Temperature dynamics features as studied by dynamical IR-thermography are: amplitudes of spontaneous and evoked temperature changes; patterns of spontaneous temperature oscillations; temporal characteristics of changes due to functional probes; the reproducibility of thermogram patterns. For example, the amplitudes of all temperature changes decrease several times from active impatient persons to patient persistent and further to anxious ones. The arguments in favor of the suggestion that the features mentioned are due to differences in the role of humoral factors in regulating peripheral blood flow are discussed. The possibilities of using dynamical IR-thermography in psychophysiology, especially concerning the stable personality features, are considered.
293 AUTONOMIC IN OBESITY
CARDIOVASCULAR
REGULATION
Kurt Laederach-Hofmann* , Lutz Mussgay, and Heinz Riiddel Inselspital, University of Beme, Freiburgstrasse, 3010 Beme, Switzerland Aim: Obese persons suffer an increased mortality risk due to cardiovascular disorders supposedly caused by continuously heightened sympathetic activation and increased catecholaminelevels. The present cross-sectional correlation-study tries to establish the relationship between various degrees of obesity on one hand and altered autonomic regulation and cortisol levels. Method: We investigated a total number of 35 patients. According to their respective body weight, patients were sorted into 3 equal cohorts containing the same number of patients of both sex, and age, covering body mass index-ranges of 27.5 to 32, 33 to 39, and above 40. Cardiovascular reactivity was assessed in each patient in our psychophysiolgical laboratory where cardiovascular activity (ECG), continuous finger blood pressure, and respiratory activity were recorded at baseline and in response to a reaction-time-task (BonnDet) to cover the additional aspect of stress reactivity. Salivary cortisol was collected concurrently. Autonomic cardiovascular regulation was assessed by use of heart rate variability measures and continuous blood pressure recordings. By calculation of spectral power time series indices of sympathetic and parasympa-
Abstracts
/International
Journal
thetic activation and an estimate of baro-reflex-sensitivity were delineated. Results: The sample of the 35 patients consisted of 23 women, and 12 males. Out of the 23 women, 15 were premenopausal. The mean age of the whole study group was 42.1 f 8.9 years, the age of premenopausal women was 39.4 f 6.0, postmenopausal 52.3 f 4.3 yrs. Body mass index, and waist/hip ratio (with age partialled out) were inversely correlated to sympathetic activity in rest and under mental stress conditions (r = -0.4, p < 0.01, r = -0.3, p < 0.05 for BMI and WHR respectively in resting conditions, and r = -0.3, p < 0.02 for BMI in stress conditions). Resting values of modulus, expressing baro-reflex sensitivity were 7.7 + 6.1 ms2, with a negative correlation to BMI an WHR (r = -0.3, p < 0.02 r = -0.4, p < 0.01, respectively). No significant correlations were found between salivary cortisol levels and BMI or WHR, irrespective of sex and age. Conclusions: In this study, contrary to expectations, no overstimulation by sympathetic drive and/or higher cortisol levels were found in relation to body weight. However, a significant deterioration of baro-reflex functioning was observable. This opens questions as to whether and to what extent a limited adaptational capacity to mental stress might contribute to the higher mortality rate of obese patients or if other mechanisms have to be postulated.
294 PSYCHOPHYSIOLOGY CARDIOLOGY
AND
PSYCHOSOMATIC
G. Cultrera*, T. Scrimali and V. Rapisarda University of Catania, Viace Andrea Doria N, 6, 95125 Catania, Italy Many studies demonstrate the elevated sensitivity of the nervous system to emotional stimuli. Among the neurouegetatiue functions affected by the modifications resulting from stress we find the heart rate, the blood pressure and electrodemral activity. The functions of the cardiovascular apparatus, from an epidemiological and clinical point of view and as a disability, have a considerable inpact on society. Studies in Psychosomatic Medicine have underlined how stress can constitute a significant co-risk factor in coronary heart disease, myocardial infarction, sudden cardiac arrest and essential hypertension. In the research project developed by the authors, great value is placed on the use of a complex and multimodal psychophysiological assessment, which permits the drawing of data concerning the psychophysiological, behavioural and cognitive aspects and aims at the prevention of psychosomatic cardiovascular disease and the planning of treatment as an instrument of great utility in the practice of clinical therapy. The study included the systematic treatment of two groups of patients affected by psychosomatic cardiovascular pathology of which one group was treated according to the Laboratory Psychophysiology Methodology while the other, in addition to cognitive behavioural intervention, was given the opportunity
of Psychophysiologv
30 (1998)
95-271
115
to utilize Field Psychophysiology equipment for the daily monitoring of certain heart rate and electrodermal activity parameters and the practice of biofeedback in a real-life setting. The objective of the research was the evaluation of the bio-psycho-social approach, the complex and multimodal psychophysiological assessment in the treatment of cardiological pathologies and the investigation of the eventual utility, validity, and reliability of Field Psychophysiological techniques. The authors present the data drawn from their research.
295 ON-LINE ANALYSIS OF BARORECEPTOR DIAC REFLEX SENSITIVITY
CAR-
A. Gustav0 Reyes de1 Paso Departamento de Psicologia, Facultad de Humanidades CC.EE., Universidad de JaCn, 23071 Jatn, Espana
y
The baroreceptor reflex is a basic mechanism for the regulation of blood pressure, a powerful source of vagal afferent input to the central nervous system, and one of the most important physiological mechanisms affecting efferent cardiac vagal activity. The evidence presently available suggests that the Parasympathetic Nervous System and the sympatheticparasympathetic interactions could play a relevant role in the pathophysiology of cardiovascular disorders and, specifically, in hypertension. A loss of sensitivity qf the baroreceptor reflex figures as a fundamental mechanism amongst the factors that have been emphasized to explain the deficits found in the parasympathetic cardiac control in cardiovascular disease. The baroreceptor cardiac reflex function is also sensitive to psychological manipulations, reducing its sensitivity during mental stress and increasing it during relaxation. Using pharmacological blockade procedures, we have found that the sensitivity of the cardiac branch of the baroreflex (expressed as the change in heart period per unit change in systolic blood pressure) is a better predictor of between-subject tonic parasympathetic cardiac control than respiratory sinus arrhythmia (the most used non-invasive index of the parasympathetic cardiac control). It is described a computerized system for the on-line analysis of the baroreceptor cardiac reflex function using the non invasive spontaneous sequence method in the time domain. The system provides a feedback of the baroreceptor reflex sensitivity differentially both when the systolic blood pressure is increasing and when it is decreasing. The method used involves simultaneous signal acquisition, analysis, and graphic display in real time. The validity of this procedure to assess baroreceptor cardiac reflex sensitivity has been tested against spectral analysis techniques. The program could be of use, both to undertake a rapid evaluation of the function of the reflex and for using it as a biofeedback system with the objective of increasing baroreflex sensitivity.