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Cardiovascular Autonomic Function: From Bench to Bedside

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 2560

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Special Issue Editors

Dr. Vera Geraldes

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Guest Editor

Assistant Professor, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
Interests: autonomic nervous system; cardiovascular diseases: neurogenic hypertension; cardiac autonomic modulation; heart rate variability; dysautonomia
Special Issues, Collections and Topics in MDPI journals

Dr. Alessandra Fanciulli

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Guest Editor

Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
Interests: multiple system atrophy; neurogenic orthostatic hypotension; supine hypertension

Dr. Isabel Rocha

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Guest Editor

Associate Professor, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
Interests: autonomic function; physiology; pathophysiology and evaluation
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The autonomic nervous system (ANS) regulates involuntary physiological processes and is integral in controlling most organ systems of the body through a series of neural reflexes. It is also responsible for modulating and adapting the function of all organs to constantly changing external and internal conditions in order to maintain the body's homeostasis.

Dysfunctions of the autonomic nervous system are associated with the development of various diseases and are in the background of major, frequent, internal, and neurological conditions (such as diabetes, hypertension, and Parkinson's disease). Recently, neuromodulatory techniques have emerged as potential therapeutic approaches for the complete or partial treatment of autonomic disorders. In addition, ANS has been shown to be involved in the co-modulation of body functions, together with the immune system, the neuroendocrine system, and the inflammatory system. It thus forms an important interface between the central nervous system, the environment, and the development of chronic non-communicable diseases.

This Special Issue aims to collect reviews and original research articles that provide up-to-date information and future perspectives on various ANS areas of physiology and clinical medicine that affect all levels of autonomic function.

We are pleased to invite you to contribute to this Special Issue covering all aspects of the autonomic nervous system in humans and animals, including functional anatomy; physiology; pharmacology and therapeutics; behavioral aspects; neuromodulation; the dysfunction and ageing of autonomic neurons and their circuits; as well as the integrative role and emotional, physical, and motivational aspects of autonomic regulation.

We look forward to receiving your contributions.

You may choose our Joint Special Issue in Biology.

Dr. Vera Geraldes
Dr. Alessandra Fanciulli
Dr. Isabel Rocha
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

dysautonomia
heart rate variability
autonomic function testing
cardiovascular autonomic function
autonomic neuroscience
syncope
orthostatic hypotension
baroreflex

Published Papers (3 papers)

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Research

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18 pages, 1831 KiB

Open AccessArticle

In Ischemic Heart Disease, Reduced Sensitivity to Pressure at the Sternum Accompanies Lower Mortality after Five Years: Evidence from a Randomized Controlled Trial

by Søren Ballegaard, Jens Faber, Christian Selmer, Finn Gyntelberg, Svend Kreiner, Benny Karpatschof, Tobias Wirenfeldt Klausen, Åke Hjalmarson and Albert Gjedde

J. Clin. Med. 2023, 12(24), 7585; https://doi.org/10.3390/jcm12247585 - 8 Dec 2023

Cited by 1 | Viewed by 684

Abstract

Background: Autonomic nervous system dysfunction (ANSD) is associated with negative prognosis of ischemic heart disease (IHD). Elevated periosteal pressure sensitivity (PPS) at the sternum relates to ANSD and sympathetic hyperactivity. Two previous observational case–control studies of the effect of reduction of PPS suggested lower all-cause mortality from IHD and stroke. We now used a specific daily, adjunct, non-pharmacological program of reduction of elevated PPS to test the hypothetical association between the intervention and reduced all-cause mortality in patients with stable IHD in a randomized controlled trial (RCT). Methods: We completed active (n = 106) and passive interventions (n = 107) and compared the five-year mortalities. We also compared the five-year individual all-cause mortality of each participant to approximately 35.000 members of the general population of Denmark. Pooling the mortality data from the active group of the RCT with the two preliminary studies, we registered the mortality following active intervention of 1.168 person-years, compared to 40 million person-years of the pooled general population. Results: We recorded fewer deaths of the active RCT intervention group than of the corresponding control group from the general population (p = 0.01), as well as of the passive RCT intervention group (p = 0.035). The meta-analysis of the three studies together demonstrated reduced 4.2-year all-cause mortality of 60% (p = 0.007). Conclusions: The test of the hypothetical effect of an intervention aimed at the attenuation of ANSD accompanied by a lowered PPS revealed reduced all-cause mortality in patients with stable IHD. Full article

(This article belongs to the Special Issue Cardiovascular Autonomic Function: From Bench to Bedside)

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12 pages, 1096 KiB

Open AccessArticle

Orthostatic Stress and Baroreflex Sensitivity: A Window into Autonomic Dysfunction in Lone Paroxysmal Atrial Fibrillation

by Mónica Ferreira, Sérgio Laranjo, Pedro Cunha, Vera Geraldes, Mário Oliveira and Isabel Rocha

J. Clin. Med. 2023, 12(18), 5857; https://doi.org/10.3390/jcm12185857 - 8 Sep 2023

Cited by 2 | Viewed by 712

Abstract

The abnormal neural control of atria has been considered one of the mechanisms of paroxysmal atrial fibrillation (PAF) pathogenesis. The baroreceptor reflex has an important role in cardiovascular regulation and may serve as an index of autonomic function. This study aimed to analyze the baroreceptor reflex’s role in heart rate regulation during upright tilt (HUT) in patients with lone PAF. The study included 68 patients with lone PAF and 34 healthy individuals who underwent baroreflex assessment. Parameters such as baroreflex sensitivity (BRS), number of systolic blood pressure (BP) ramps, and the baroreflex effectiveness index (BEI) were evaluated. The study found that PAF patients had comparable resting BPs and heart rates (HRs) to healthy individuals. However, unlike healthy individuals, PAF patients showed a sustained increase in BP with an upright posture followed by the delayed activation of the baroreceptor function with a blunted HR response and lower BEI values. This indicates a pronounced baroreflex impairment in PAF patients, even at rest. Our data suggest that together with BRS, BEI could be used as a marker of autonomic dysfunction in PAF patients, making it important to further investigate its relationship with AF recurrence after ablation and its involvement in cardiovascular autonomic remodeling. Full article

(This article belongs to the Special Issue Cardiovascular Autonomic Function: From Bench to Bedside)

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Other

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18 pages, 1525 KiB

Open AccessSystematic Review

Short-Term Heart Rate Variability in Metabolic Syndrome: A Systematic Review and Meta-Analysis

by Johan E. Ortiz-Guzmán, Sara Mollà-Casanova, Pilar Serra-Añó, Óscar J. Arias-Mutis, Conrado Calvo, Alexandra Bizy, Antonio Alberola, Francisco J. Chorro and Manuel Zarzoso

J. Clin. Med. 2023, 12(18), 6051; https://doi.org/10.3390/jcm12186051 - 19 Sep 2023

Cited by 1 | Viewed by 936

Abstract

Background: Our aim was to determine the differences in short-term heart rate variability (HRV) between patients with metabolic syndrome (MS) and healthy controls. Methods: We searched electronic databases for primary works with short-term HRV recordings (≤30 min) that made comparisons between individuals with MS versus healthy controls. This systematic review and meta-analysis (MA) was performed according to PRISMA guidelines and registered at PROSPERO (CRD42022358975). Results: Twenty-eight articles were included in the qualitative synthesis and nineteen met the criteria for the MA. Patients with MS showed decreased SDNN (−0.36 [−0.44, −0.28], p < 0.001), rMSSD (−7.59 [−9.98, −5.19], p < 0.001), HF (−0.36 [−0.51, −0.20], p < 0.00001) and LF (−0.24 [−0.38, −0.1], p = 0.001). In subsequent subanalyses, we found a decrease in SDNN (−0.99 (−1.45, −0.52], p < 0.001), rMSSD (−10.18 [−16.85, −3.52], p < 0.01) and HF (−1.04 [−1.97, −0.1] p < 0.05) in women. In men, only LF showed a significant lower value (−0.26 [−0.5, −0.02], p < 0.05). We could not perform MA for non-linear variables. Conclusions: Patients with MS showed changes in time-domain analyses, with lower values in SDNN and rMSSD. Regarding frequency-domain analyses, MS patients showed a decrease in HF and LF When sex was used as a grouping variable, the MA was only possible in one of both sexes (men or women) in rMSSD and LF/HF. Lastly, when data for both men and women were available, subanalyses showed a different behavior compared to mixed analyses for SDNN, HF and LF, which might point towards a different impact of MS in men and women. Full article

(This article belongs to the Special Issue Cardiovascular Autonomic Function: From Bench to Bedside)

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