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Is the strength of the baroreflex involvement during orthostatic position related to the impact of fibromyalgia on quality of life?
Abstracts / Autonomic Neuroscience: Basic and Clinical 192 (2015) 56–141 b
Department of Morphology and Pathology Department of Gerontology, Federal University of São Carlos, São Paulo, Brazil d Department of Biomedical Sciences for Health, University of Milan e Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy c
Background: Aging promotes increased levels of circulating proinflammatory markers and decrease in cardiac autonomic function that can be evaluated by high sensitivity C-reactive protein (hsCRP) and heart rate variability (HRV), respectively. Studies shown relation between the immune system and HRV, however, few studies are related to the baroreflex sensitivity (BRS). Aim: To evaluate the relationship between cardiovascular autonomic nervous system (BRS) and hsCRP in natural human aging in a wide range of age and gender. Methods: One hundred and ten apparently healthy individuals (without hsCRP values suggestive of acute inflammation, above 3.0 mg/L) were divided into 2 groups (men and women) and then, equally assigned into 5 groups (21-30; 31-40; 41-50; 51-60 and 61-70 years), 11 subjects in each group. The electrocardiographic, respiratory and noninvasive finger arterial pressure signals were recorded for 15 minutes, in rest supine (REST) and in orthostatic position (STAND), and sampled at 400Hz. Stable sequences of 256 points in REST and STAND were chosen. Cross-spectral analysis was performed to compute coherence, phase and BRS in low (LF) frequency. Blood was collected after a 12-hour fasting. The turbidimetry method was used for hsCRP analysis. Results: Spearman correlation test showed a negative significant relationship (p b 0.05) between hsCRP and phase (r = -0.576) and between hsCRP and BRS (r = -0.356) in LF in STAND in women, however, no correlation was found in men. Conclusion: The relationship between proinflammatory marker and cardiovascular autonomic nervous system showed a gender dependency therefore gender should be taken into account in the analysis of the cardiovascular autonomic nervous system. Financial support: FAPESP: 2010/52070-4; CNPq: 311938/2013-2; CNPq: 140164/2015-4. doi:10.1016/j.autneu.2015.07.106
P7.14 Cardiac baroreflex sensitivity in coronary patients with and without type 2 diabetes M.O. Goisa,d, R.P. Simõesa, V.C. Kunzb, S.C.G. Moura-Tonelloa, A. Portac, A.M. Cataia a Department of Physical Therapy, Federal University of São Carlos b Adventist University Center of São Paulo, Brazil c Department of Biomedical Sciences for Health and IRCCS Galeazzi Orthopedic Institute d Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy Background: Coronary artery disease (CAD) can promote impairments of cardiac autonomic nervous system. Nevertheless, when CAD is associated to other comorbidities, such as the type 2 diabetes mellitus (DM), is unknown the magnitude of impairments in baroreflex sensitivity (BRS). Aim: to evaluate the baroreflex sensitivity in CAD patients (CAD, n = 18), CAD patients with DM (CADDM, n = 16), and healthy group (H, n = 19). Methods: The recording of R-R interval (RR) of the ECG was performed in the MC5 lead and the non-invasive finger blood pressure were recorded during rest supine and standing, both for 15 minutes. Signals were sampled at 1000 Hz. The BRS α index was computed as the square root of the ratio of the power of RR series on that of systolic arterial pressure (SAP) series in the low frequency (0.04-0.15Hz). Two-way
87
ANOVA test was used to compare BRS between the groups and conditions. Results: no difference in age and anthropometric date between the groups was observed. The α index decreased during standing (5.33 ± 2.72 vs 4.80 ± 3.34 vs 2.76 ± 1.44; H vs CAD vs CADDM) when compared to rest supine (10.55 ± 6.70 vs 7.74 ± 5.86 vs 6.10 ± 4.30; H vs CAD vs CAD-DM) in all groups. The CAD-DM group shows lower values of α index compared to H group in rest supine and standing positions. Conclusion: Although CAD groups had a normal response to the orthostatic stimuli, the CAD-DM group showed lower values of BRS in both conditions. Thus, a higher impairment of cardiovascular control can be observed in patients with type 2 diabetes. Financial support: CAPES/ CSF/PVE no. 23038.007721/2013-41; CAPES/PNPD no. 23038.006927/ 2011-92; FAPESP no. 2010/52070-4 e CNPq no. 311938/2013-2
doi:10.1016/j.autneu.2015.07.107
P7.15 Is the strength of the baroreflex involvement during orthostatic position related to the impact of fibromyalgia on quality of life? A.R. Zamunéra, A. Portab,c, C.P. Andradea, A. Marchid, M. Fortia, R. Furlane, F. Barbice, A.M. Cataia, E. Silvaa a Department of Physical Therapy, Federal University of Sao Carlos, Brazil b Department of Biomedical Sciences for Health, University of Milan c IRCCS Galeazzi Orthopedic Institute d Department of Electronics Information and Bioengineering, Politecnico di Milano e Internal Medicine, Humanitas Research Hospital, BIOMETRA Department, University of Milan, Italy Background: Cardiovascular autonomic control has been widely studied in fibromyalgia syndrome (FMS). Nevertheless, there are many methodological difficulties in quantifying baroreflex sensitivity by traditional indices, especially regarding the issue of causality. Thus, a Granger causality approach has been recently proposed, revealing a reduced strength of baroreflex control during orthostatic stimulus in women with FMS. However, whether the reduced strength of the baroreflex control during orthostatic stimulus is related to the impact of fibromyalgia on quality of life is unknown. Objective: To evaluate the relationship between the strength of the baroreflex involvement during orthostatic position and the impact of fibromyalgia on quality of life. Methods: Twenty women with FMS took part in the study. The electrocardiogram, non-invasive finger blood pressure and respiratory activity were continuously recorded for all participants during 15 minutes in orthostatic position reached by active standing. A Granger causality approach was utilized to assess, through the calculation of the causality ratio, the strength of the causal relation from systolic arterial pressure (SAP) to heart period (HP) variability series (CRSAP → HP). The more negative the CRSAP → HP, the higher the strength of the causal link from SAP to HP. The impact of fibromyalgia on quality of life was quantified by the Fibromyalgia Impact Questionnaire (FIQ). Results: Pearson correlation analysis revealed a positive relationship between the CRSAP → HP and the FIQ scores (r = 0.56, p b 0.01). Conclusions: The stronger the baroreflex involvement during orthostatic position in women with FMS, the lower the impact of fibromyalgia on quality of life.
doi:10.1016/j.autneu.2015.07.108
Department of Morphology and Pathology Department of Gerontology, Federal University of São Carlos, São Paulo, Brazil d Department of Biomedical Sciences for Health, University of Milan e Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy c
Background: Aging promotes increased levels of circulating proinflammatory markers and decrease in cardiac autonomic function that can be evaluated by high sensitivity C-reactive protein (hsCRP) and heart rate variability (HRV), respectively. Studies shown relation between the immune system and HRV, however, few studies are related to the baroreflex sensitivity (BRS). Aim: To evaluate the relationship between cardiovascular autonomic nervous system (BRS) and hsCRP in natural human aging in a wide range of age and gender. Methods: One hundred and ten apparently healthy individuals (without hsCRP values suggestive of acute inflammation, above 3.0 mg/L) were divided into 2 groups (men and women) and then, equally assigned into 5 groups (21-30; 31-40; 41-50; 51-60 and 61-70 years), 11 subjects in each group. The electrocardiographic, respiratory and noninvasive finger arterial pressure signals were recorded for 15 minutes, in rest supine (REST) and in orthostatic position (STAND), and sampled at 400Hz. Stable sequences of 256 points in REST and STAND were chosen. Cross-spectral analysis was performed to compute coherence, phase and BRS in low (LF) frequency. Blood was collected after a 12-hour fasting. The turbidimetry method was used for hsCRP analysis. Results: Spearman correlation test showed a negative significant relationship (p b 0.05) between hsCRP and phase (r = -0.576) and between hsCRP and BRS (r = -0.356) in LF in STAND in women, however, no correlation was found in men. Conclusion: The relationship between proinflammatory marker and cardiovascular autonomic nervous system showed a gender dependency therefore gender should be taken into account in the analysis of the cardiovascular autonomic nervous system. Financial support: FAPESP: 2010/52070-4; CNPq: 311938/2013-2; CNPq: 140164/2015-4. doi:10.1016/j.autneu.2015.07.106
P7.14 Cardiac baroreflex sensitivity in coronary patients with and without type 2 diabetes M.O. Goisa,d, R.P. Simõesa, V.C. Kunzb, S.C.G. Moura-Tonelloa, A. Portac, A.M. Cataia a Department of Physical Therapy, Federal University of São Carlos b Adventist University Center of São Paulo, Brazil c Department of Biomedical Sciences for Health and IRCCS Galeazzi Orthopedic Institute d Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy Background: Coronary artery disease (CAD) can promote impairments of cardiac autonomic nervous system. Nevertheless, when CAD is associated to other comorbidities, such as the type 2 diabetes mellitus (DM), is unknown the magnitude of impairments in baroreflex sensitivity (BRS). Aim: to evaluate the baroreflex sensitivity in CAD patients (CAD, n = 18), CAD patients with DM (CADDM, n = 16), and healthy group (H, n = 19). Methods: The recording of R-R interval (RR) of the ECG was performed in the MC5 lead and the non-invasive finger blood pressure were recorded during rest supine and standing, both for 15 minutes. Signals were sampled at 1000 Hz. The BRS α index was computed as the square root of the ratio of the power of RR series on that of systolic arterial pressure (SAP) series in the low frequency (0.04-0.15Hz). Two-way
87
ANOVA test was used to compare BRS between the groups and conditions. Results: no difference in age and anthropometric date between the groups was observed. The α index decreased during standing (5.33 ± 2.72 vs 4.80 ± 3.34 vs 2.76 ± 1.44; H vs CAD vs CADDM) when compared to rest supine (10.55 ± 6.70 vs 7.74 ± 5.86 vs 6.10 ± 4.30; H vs CAD vs CAD-DM) in all groups. The CAD-DM group shows lower values of α index compared to H group in rest supine and standing positions. Conclusion: Although CAD groups had a normal response to the orthostatic stimuli, the CAD-DM group showed lower values of BRS in both conditions. Thus, a higher impairment of cardiovascular control can be observed in patients with type 2 diabetes. Financial support: CAPES/ CSF/PVE no. 23038.007721/2013-41; CAPES/PNPD no. 23038.006927/ 2011-92; FAPESP no. 2010/52070-4 e CNPq no. 311938/2013-2
doi:10.1016/j.autneu.2015.07.107
P7.15 Is the strength of the baroreflex involvement during orthostatic position related to the impact of fibromyalgia on quality of life? A.R. Zamunéra, A. Portab,c, C.P. Andradea, A. Marchid, M. Fortia, R. Furlane, F. Barbice, A.M. Cataia, E. Silvaa a Department of Physical Therapy, Federal University of Sao Carlos, Brazil b Department of Biomedical Sciences for Health, University of Milan c IRCCS Galeazzi Orthopedic Institute d Department of Electronics Information and Bioengineering, Politecnico di Milano e Internal Medicine, Humanitas Research Hospital, BIOMETRA Department, University of Milan, Italy Background: Cardiovascular autonomic control has been widely studied in fibromyalgia syndrome (FMS). Nevertheless, there are many methodological difficulties in quantifying baroreflex sensitivity by traditional indices, especially regarding the issue of causality. Thus, a Granger causality approach has been recently proposed, revealing a reduced strength of baroreflex control during orthostatic stimulus in women with FMS. However, whether the reduced strength of the baroreflex control during orthostatic stimulus is related to the impact of fibromyalgia on quality of life is unknown. Objective: To evaluate the relationship between the strength of the baroreflex involvement during orthostatic position and the impact of fibromyalgia on quality of life. Methods: Twenty women with FMS took part in the study. The electrocardiogram, non-invasive finger blood pressure and respiratory activity were continuously recorded for all participants during 15 minutes in orthostatic position reached by active standing. A Granger causality approach was utilized to assess, through the calculation of the causality ratio, the strength of the causal relation from systolic arterial pressure (SAP) to heart period (HP) variability series (CRSAP → HP). The more negative the CRSAP → HP, the higher the strength of the causal link from SAP to HP. The impact of fibromyalgia on quality of life was quantified by the Fibromyalgia Impact Questionnaire (FIQ). Results: Pearson correlation analysis revealed a positive relationship between the CRSAP → HP and the FIQ scores (r = 0.56, p b 0.01). Conclusions: The stronger the baroreflex involvement during orthostatic position in women with FMS, the lower the impact of fibromyalgia on quality of life.
doi:10.1016/j.autneu.2015.07.108