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Abstract: The data collected by ambulatory blood pressure monitoring have been studied in the phase-space of R–R interval and blood pressure and their individual distribution quantified by the slope of the regression line through 24-h values. This slope has been termed “ambulatory autonomic reciprocity index” and abbreviated as AARIs and AARId, the “s” and “d” indicating the relation with systolic and diastolic blood pressure respectively. Ambulatory monitoring was performed in 200 normotensive (NT: 135 females) and 200 untreated hypertensive patients (HT: 59 females). The AARIs was: NT: −6.04±2.7 and HT: −4.69±2.4ms/mmHg, respectively (p <0.001); the AARId was: −7.04±2.9 for NT and −5.79±2.8 for HT subjects (p <0.001). When distributed by decades of life the steepest AARIs occurred at the 20–29 decade, while the flattest at the 60–69 decade. At the 60–69 decade and above, the AARIs was similar in both groups (ANOVA o.w. NT: p <0.001; HT: p <0.01). AARIs and AARId were strongly correlated with 24-h variability of R–R interval, either 24-h standard deviation or coefficient of variation (p <0.001), and poorly correlated with 24-h variability of blood pressure. These data suggest that the AARI, when seen in the context of the “Autonomic Space”, may be viewed as a 24-h period index of centrally driven cardiovagal function. Being based on both blood pressure and heart rate measurements, the AARI may become clinically useful to address life style changes and pharmacological treatment of hypertensive patients towards optimal results. [Copyright &y& Elsevier]

Abstract: In this paper, we investigated ambulatory sleep heart period variability in panic disorder participants with nocturnal panic (NP) compared to daytime panic attacks only. A time-derived measure of heart period variability (HPV) during sleep was significantly reduced in the NP group (n =32) relative to the daytime panic (n =17) and nonanxious (n =17) control groups. Consistent with previous work, NP participants also reported greater fear of relaxation and sleep than daytime panic and control groups. Based on a neurovisceral model of attention [Thayer, J. F., & Lane, R. D. (2000). A model of neurovisceral integration in emotion regulation and dysregulation. Journal of Affective Disorders, 61, 210–216] that predicts that decreased HPV is related to disregulated behavioral adaptation, we hypothesized that HPV measured during sleep would be most reduced in NP participants. These findings indicate that HPV is related to nocturnal panic disorder insofar as it is measured during sleep. [Copyright &y& Elsevier]

Abstract: Previous studies suggest depression is a risk factor for all cause mortality, with depressed men at greater risk than depressed women. Diminished cardiac vagal control (CVC) in depressed patients has also been found to increase risk of cardiac mortality. Previous research found that depressed women have higher CVC than depressed men suggesting CVC might be related to the discrepancy in mortality rates between depressed men and women. This finding, however, was in the context of a study with several methodological weaknesses. The current study sought to replicate the sex difference in CVC in a sample of 137 medically healthy and clinically diagnosed depressed patients. Main effects of sex and age significantly predicted CVC such that depressed women had greater CVC and CVC decreased with age in the cross-sectional sample. The results suggest greater CVC in depressed women might confer cardioprotective functions, which may partially explain the sex difference in mortality rates in the depressed population. [Copyright &y& Elsevier]

Abstract: The purpose was to examine the effect of verbal response and task difficulty on cardiovascular response to the Stroop task. Heart rate, mean arterial blood pressure, forearm blood flow (FBF), and catecholamine response of 13 males was assessed during 3, 5-min differing versions of the Stroop task. Heart rate, epinephrine, and FBF were significantly greater during Stroop 1 (the color-word conflict task) compared to Stroop 3 (a non-verbal version of Stroop where participants responded cognitively without any oral or behavioural response), whereas mean arterial pressure was significantly greater during Stroop 1 than that of Stroop 2 (slides in monochrome without color conflict) and Stroop 3. Rating of level of difficulty and concentration was lower for Stroop 2 compared to the other two Stroop tasks. These results suggest that performance of the traditional Stroop task caused significant cardiovascular, FBF, and epinephrine reactivity. This reactivity was attenuated during reading of monochrome words and was virtually abolished when performing the Stroop without verbally responding. [Copyright &y& Elsevier]

Abstract: Objective: The aim of this study was to examine the effects of breast feeding on autonomic nervous system (ANS) response to stressors. Methods: Sympathetic and parasympathetic activities were examined before, during, and after standard laboratory stressors in women who were either exclusively breast feeding (n=14) or nonexclusively breast feeding (n=14), and in non-postpartum controls (n=15). Results: Mothers who breast fed exclusively showed greater levels of parasympathetic cardiac modulation and slower heart rate (HR) throughout the session and less HR increase and preejection period (PEP) shortening to mental arithmetic (MA) than did nonexclusive breast feeders and controls. Nonexclusive breast-feeders showed greater electrodermal reactivity to, and greater differences in skin conductance response (SCR) frequency between baseline and recovery from cold pressor (CP) than did either exclusive breast-feeders or controls. Sympathetic activity was negatively related to the number of breast feedings and positively related to bottle feedings. Conclusion: Breast feeding shifts maternal ANS balance toward relatively greater parasympathetic and lesser sympathetic activity; the opposite occurs with bottle feeding. The frequency of feeding also is a critical factor in determining breast feeding effects on maternal ANS function. [Copyright &y& Elsevier]

Objective: To measure the effects of fluoxetine and pemoline on heart period and QT variability. Methods: Healthy volunteers were randomly assigned treatment with 20 mg daily of fluoxetine (n=7), 56.25 mg of pemoline (n=7) or placebo (n=9). Twenty-four-hour Holter ECGs were obtained before and after approximately 8 weeks of double-blind treatment. Results: There were no significant changes in the fluoxetine group. Pemoline was associated with a significant decrease in the high frequency (HF) power (0.15–0.5 Hz, P=.02) and fractal dimension of RR time series (P=.03). QTvi, a measure of QT interval variability, increased in the pemoline group (P=.05). Conclusion: Pemoline, but not fluoxetine, decreases heart period variability (HPV) in the HF power, suggesting a vagolytic effect on cardiac autonomic function. Pemoline is also associated with an increase in QT interval variability, a measure that is sensitive to adrenergic agonists. [Copyright &y& Elsevier]

Vagus nerve stimulation (VNS) has been suggested as an adjunctive treatment for drug-resistant epilepsy when surgery is inadvisable. The overall safety profile of VNS seems to be favorable as only minor adverse effects have been described. The purpose of this study was to determine if cardiac vagal tone is eventually modified by short- and long-term VNS. The effects of short- and long-term VNS were evaluated in seven subjects with intractable epilepsy. Autonomic cardiac function has been carried out by means of a 24-h analysis of RR variability at baseline (t0), 1 month (t1, short-term VNS) and 36 months after VNS initiation (t2, long-term VNS). Frequency- and time-domain parameters were calculated. Periodic cardiological and neurological evaluations were performed.Clinically relevant cardiac effects were not observed throughout the study. Despite the limited number of patients and the variety of data among them, for all the patients, a common trend towards a nocturnal decrease in the high-frequency (HF) component of the spectrum was observed after long-term VNS (mean±S.D.: 40±18 normalized units (nu) at t0, 38±17 nu at t1, 18±10 nu at t2; p<0.05 of t2 vs. either t0 or t1). The day-to-night changes in the power of low-frequency (LF) and HF components were significantly blunted after long-term VNS (LF day-to-night change: +16±13 nu at t0 and +15±8 nu at t1 vs. +3±13 nu at t2, p<0.02; HF day-to-night change: −18±13 nu at t0 and −13±11 nu at t1 vs. +3±12 nu at t2, p<0.003). No significant changes were observed with regard to the time-domain parameters of the heart rate variability.Throughout the neurological follow-up, one subject became seizure-free, three experienced a seizure reduction of >50%, two patients of <50% and one had no changes in his seizure frequency.Our findings suggest that long-term VNS might slightly affect cardiac autonomic function with a reduction of the HF component of the spectrum during night and a flattening of sympathovagal circadian changes, not inducing, however, clinically relevant cardiac side effects. [Copyright &y& Elsevier]

The aim of the present study was to examine autonomic function in response to negatively and positively valenced pictures under different levels of conscious recognition. Heart period variability (HPV) and heart rate (HR) reactivity were studied in 53 males and females who were being shown pictures of angry and happy faces. The pictures, which were backwardly masked, were presented once every 30 s during a 5-min period and under three conditions (counterbalanced for type of facial expression): below the level of conscious recognition (17 ms), at an intermediate level (56 ms), and at a clearly recognizable level (2370 ms). Analyses of HR power spectrum (for 5 min in each condition) in the high frequency region (HF: 0.15–0.5 Hz) that reflects respiratory sinus arrhythmia, as well as analysis of phasic heart rate responses (7.5 s in 0.5 epochs following every picture presentation) were carried out. The main findings were that HF-power was higher, and cardiac midinterval acceleration lower, in response to angry as opposed to happy faces, a result obtained only for the men, however. No interaction effect between facial expression and the three exposure conditions was found, suggesting that the pictures induced emotional activation both subliminally and supraliminally. The results were discussed in terms of increased attention to aversive stimuli. [Copyright &y& Elsevier]

: ObjectivesThe purpose of our investigation was to examine serial changes in autonomic nervous system activity along with measurements of hemodynamics and cardiac contractility, in assessing the mechanism(s) that underlie neurally mediated cardiac syncope (NMCS) in children.: BackgroundPrevious research that used heart rate variability analysis alone to understand changes in autonomic activity that result in NMCS has provided conflicting results. We performed simultaneous heart rate and blood pressure variability analyses to characterize dynamic alterations in sympathetic and vagal tone during tilt-table testing in 23 children with a history of syncope or frequent dizziness.: MethodsPower spectra of heart rate and blood pressure variability were analyzed using autoregressive modeling. Maximum dP/dT of systolic blood pressure and the electrical-mechanical activation time were used to assess cardiac contractility.: ResultsTilt-table testing was positive in 12 children and negative in 11. Syncope was associated with decreased heart rate, blood pressure and low-frequency (LF) power. Before episodes of syncope, systolic blood pressure dP/dT decreased, and the electrical-mechanical activation time was prolonged. The decrease in blood pressure LF power exceeded and occurred before the decrease in heart rate LF power. Despite similar early increases in LF power to the initial stress of upright tilting, no significant decline in LF power (heart rate or blood pressure) was observed during negative tilt-table tests.: ConclusionsAll of these changes considered in total provide evidence supporting the hypothesis of sympathetic withdrawal/failure, resulting in a decrease in peripheral vascular tone and cardiac contractility, which results in profound hypotension in children with NMCS. [Copyright &y& Elsevier]