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At least 199 records · Page 11
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The Effects of Autogenic Feedback Training Exercise on Heart Rate Variability

INTRODUCTION: The development of Motion Sickness (MS) symptoms is correlated with increased sympathetic influence and irregular patterns of vagal activity. Such autonomic actions can be characterized by indices of heart rate variability (HRV), which reflect autonomic balance through neurocardiac function. Nonpharmacological interventions aimed at attenuating MS symptoms may therefore produce an effect on HRV. One such intervention that has been shown to mitigate MS symptoms is Autogenic Feedback Training Exercise (AFTE), which combines principles of autogenic therapy and biofeedback. AFTE teaches individuals to manipulate various physiological parameters in provocative environments and shows promise as a potential MS intervention in military aviators. The effects of AFTE on HRV have not previously been examined. Understanding HRV changes following AFTE may help to elucidate its indirect effects and inform its implementation for MS mitigation. METHODS: Twenty-four subjects received 2 hours of AFTE over 4 days. Pre- and post-AFTE rotating chair tests, which included stationary periods of baseline data, were conducted to evaluate the effects of AFTE. HRV data were recorded by SOMNOtouch™ NIBP. Post hoc analysis of pre- and post-AFTE short-term HRV (RMSSD, LF, HF, LF/HF) was performed. RESULTS: RMSSD, HF, and LF/HF were not significantly changed following AFTE. However, LF showed a statistically significant (p=0.015) decrease following AFTE. DISCUSSION: AFTE prescribes a respiratory rate of 15 breaths per minute (BPM), which is typically faster than participants’ pre-AFTE BPM (M=12.65). Healthy individuals can increase respiratory sinus arrhythmia (RSA) by slow, deep breathing. However, increasing the respiratory rate to 15 BPM may decrease RSA and subsequently HF. Increasing RSA potentially negates any influence of AFTE on HF, resulting in no significant change. RMSSD is correlated with HF power and was likewise not affected by AFTE. LF power, however, decreased significantly following AFTE, potentially indicating a lower sympathetic response in the post-AFTE measurement.

motion sickness↗
DOE OSTI2022

Development and validation of a mathematical model of heart rate response to fluid perturbation

Physiological closed-loop controlled (PCLC) medical devices monitor and automatically adjust the patient’s condition by using physiological variables as feedback, ideally with minimal human intervention to achieve the target levels set by a clinician. PCLC devices present a challenge when it comes to evaluating their performance, where conducting large clinical trials can be expensive. Virtual physiological patients simulated by validated mathematical models can be utilized to obtain preclinical evidence of safety and assess the performance of the PCLC medical device during normal and worst-case conditions that are unlikely to happen in a limited clinical trial. A physiological variable that plays a major role during fluid resuscitation is heart rate (HR). For in silico assessment of PCLC medical devices regarding fluid perturbation, there is currently no mathematical model of HR validated in terms of its predictive capability performance. This paper develops and validates a mathematical model of HR response using data collected from sheep subjects undergoing hemorrhage and fluid infusion. The model proved to be accurate in estimating the HR response to fluid perturbation, where averaged between 21 calibration datasets, the fitting performance showed a normalized root mean square error (NRMSE) of 7.41 ± 2.8%. The model was also evaluated in terms of model predictive capability performance via a leave-one-out procedure (21 subjects) and an independent validation dataset (6 subjects). Two different virtual cohort generation tools were used in each validation analysis. The generated envelope of virtual subjects robustly met the defined acceptance criteria, in which 95% of the testing datasets presented simulated HR patterns that were within a deviation of 50% from the observed data. In addition, out of 16000 and 18522 simulated subjects for the leave one-out and independent datasets, the model was able to generate at least one virtual subject that was close to the real subject within an error margin of 9.56 ± 3.15% and 11.1 ± 1.22% NRMSE, respectively. In conclusion, the model can generate valid virtual HR physiological responses to fluid perturbation and be incorporated into future non-clinical simulated testing setups for assessing PCLC devices intended for fluid resuscitation.

59 BASIC BIOLOGICAL SCIENCES↗
DOE OSTI2020

Non-coding RNAs: update on mechanisms and therapeutic targets from the ESC Working Groups of Myocardial Function and Cellular Biology of the Heart

Abstract Vast parts of mammalian genomes are actively transcribed, predominantly giving rise to non-coding RNA (ncRNA) transcripts including microRNAs, long ncRNAs, and circular RNAs among others. Contrary to previous opinions that most of these RNAs are non-functional molecules, they are now recognized as critical regulators of many physiological and pathological processes including those of the cardiovascular system. The discovery of functional ncRNAs has opened up new research avenues aiming at understanding ncRNA-related disease mechanisms as well as exploiting them as novel therapeutics in cardiovascular therapy. In this review, we give an update on the current progress in ncRNA research, particularly focusing on cardiovascular physiological and disease processes, which are under current investigation at the ESC Working Groups of Myocardial Function and Cellular Biology of the Heart. This includes a range of topics such as extracellular vesicle-mediated communication, neurohormonal regulation, inflammation, cardiac remodelling, cardio-oncology as well as cardiac development and regeneration, collectively highlighting the wide-spread involvement and importance of ncRNAs in the cardiovascular system.

Bär, Christian↗
DOE OSTI2020

Converting Clinical Pathways to BPM+ Standards: A Case Study in Stable Ischemic Heart Disease

Clinical pathways (CPs) are structured healthcare plans designed to implement evidence-based clinical guidelines, medical algorithms, and protocols. In recent years, a community called BPM+ Health has worked to establish a shareable and computer-consumable representation of CP, leveraging standard notations. These notations, collectively referred to as BPM+, include the Business Process Management and Notation (BPMN), Case Management Model and Notation (CMMN), and Decision Model and Notation (DMN), which aim to support clinical management and standardized communication between different stakeholders. However, the adaptation of these notations for the existing guidelines has largely been left unexplored. This paper introduces procedural steps and criteria considerations to apply components of BPM+ notations to reconstruct a guideline for Stable Ischemic Heart Disease. This paper describes how each of the three different notations is mapped to a medical guideline and discusses the advantages and limitations of representing CPs with BPM+ as compared with paper-based medical guidelines.

Chae, Junghoon↗
DOE OSTI2023

American Heart Association Protein Atlas Portal for Accelerated Drug Discovery

The American Heart Association's Protein Atlas Data Portal is a cutting-edge, open-source atlas of the structural determinants of the binding of drugs to (all of) their target proteins as an unbiased means to accelerate drug discovery. The portal will provide researchers with access to comprehensive data that can help increase the selection of effective drugs and cut the time-to-market of new drugs by half.

drug targets↗
DOE OSTI2025

Regulation of sarcomere formation and function in the healthy heart requires a titin intronic enhancer

Heterozygous truncating variants in the sarcomere protein titin (TTN) are the most common genetic cause of heart failure. To understand mechanisms that regulate abundant cardiomyocyte (CM) TTN expression, we characterized highly conserved intron 1 sequences that exhibited dynamic changes in chromatin accessibility during differentiation of human CMs from induced pluripotent stem cells (hiPSC-CMs). Homozygous deletion of these sequences in mice caused embryonic lethality, whereas heterozygous mice showed an allele-specific reduction in Ttn expression. A 296 bp fragment of this element, denoted E1, was sufficient to drive expression of a reporter gene in hiPSC-CMs. Deletion of E1 downregulated TTN expression, impaired sarcomerogenesis, and decreased contractility in hiPSC-CMs. Site-directed mutagenesis of predicted binding sites of NK2 homeobox 5 (NKX2-5) and myocyte enhancer factor 2 (MEF2) within E1 abolished its transcriptional activity. In embryonic mice expressing E1 reporter gene constructs, we validated in vivo cardiac-specific activity of E1 and the requirement for NKX2-5- and MEF2-binding sequences. Moreover, isogenic hiPSC-CMs containing a rare E1 variant in the predicted MEF2-binding motif that was identified in a patient with unexplained dilated cardiomyopathy (DCM) showed reduced TTN expression. Together, these discoveries define an essential, functional enhancer that regulates TTN expression. Manipulation of this element may advance therapeutic strategies to treat DCM caused by TTN haploinsufficiency.

Kim, Yuri↗
DOE OSTI2023

Prescribed fires, smoke exposure, and hospital utilization among heart failure patients

Abstract Background Prescribed fires often have ecological benefits, but their environmental health risks have been infrequently studied. We investigated associations between residing near a prescribed fire, wildfire smoke exposure, and heart failure (HF) patients’ hospital utilization. Methods We used electronic health records from January 2014 to December 2016 in a North Carolina hospital-based cohort to determine HF diagnoses, primary residence, and hospital utilization. Using a cross-sectional study design, we associated the prescribed fire occurrences within 1, 2, and 5 km of the patients’ primary residence with the number of hospital visits and 7- and 30-day readmissions. To compare prescribed fire associations with those observed for wildfire smoke, we also associated zip code-level smoke density data designed to capture wildfire smoke emissions with hospital utilization amongst HF patients. Quasi-Poisson regression models were used for the number of hospital visits, while zero-inflated Poisson regression models were used for readmissions. All models were adjusted for age, sex, race, and neighborhood socioeconomic status and included an offset for follow-up time. The results are the percent change and the 95% confidence interval (CI). Results Associations between prescribed fire occurrences and hospital visits were generally null, with the few associations observed being with prescribed fires within 5 and 2 km of the primary residence in the negative direction but not the more restrictive 1 km radius. However, exposure to medium or heavy smoke (primarily from wildfires) at the zip code level was associated with both 7-day (8.5% increase; 95% CI = 1.5%, 16.0%) and 30-day readmissions (5.4%; 95% CI = 2.3%, 8.5%), and to a lesser degree, hospital visits (1.5%; 95% CI: 0.0%, 3.0%) matching previous studies. Conclusions Area-level smoke exposure driven by wildfires is positively associated with hospital utilization but not proximity to prescribed fires.

Raab, Henry↗
DOE OSTI2023

Proteomic Determinants of Variation in Cholesterol Efflux: Observations from the Dallas Heart Study

High-density lipoproteins (HDLs) are promising targets for predicting and treating atherosclerotic cardiovascular disease (ASCVD), as they mediate removal of excess cholesterol from lipid-laden macrophages that accumulate in the vasculature. This functional property of HDLs, termed cholesterol efflux capacity (CEC), is inversely associated with ASCVD. HDLs are compositionally diverse, associating with >250 different proteins, but their relative contribution to CEC remains poorly understood. Our goal was to identify and define key HDL-associated proteins that modulate CEC in humans. The proteomic signature of plasma HDL was quantified in 36 individuals in the multi-ethnic population-based Dallas Heart Study (DHS) cohort that exhibited persistent extremely high (>=90th%) or extremely low CEC (<=10th%) over 15 years. Levels of apolipoprotein (Apo)A-I associated ApoC-II, ApoC-III, and ApoA-IV were differentially correlated with CEC in high (r = 0.49, 0.41, and —0.21 respectively) and low (r = —0.46, —0.41, and 0.66 respectively) CEC groups (p for heterogeneity (pHet) = 0.03, 0.04, and 0.003 respectively). Further, we observed that levels of ApoA-I with ApoC-III, complement C3 (CO3), ApoE, and plasminogen (PLMG) were inversely associated with CEC in individuals within the low CEC group (r = —0.11 to —0.25 for subspecies with these proteins vs. r = 0.58 to 0.65 for subspecies lacking these proteins; p < 0.05 for heterogeneity). These findings suggest that enrichment of specific proteins on HDLs and, thus, different subspecies of HDLs, differentially modulate the removal of cholesterol from the vasculature.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2022

The Poor Old Heart of the Milky Way

Our Milky Way should host an ancient, metal-poor, and centrally concentrated stellar population, which reflects the star formation and enrichment in the few most massive progenitors that coalesced at high redshift to form the proto-Galaxy. While metal-poor stars are known to reside in the inner few kiloparsecs of our Galaxy, current data do not yet provide a comprehensive picture of such a metal-poor "heart" of the Milky Way. We use information from Gaia Data Release 3, especially the XP spectra, to construct a sample of 2 million bright (G BP < 15.5 mag) giant stars within 30° of the Galactic center (GC) with robust [M/H] estimates, δ[M/H] ≲ 0.1. For ~1.25 million stars we calculate orbits from Gaia Radial Velocity Spectrometer velocities and astrometry. This sample reveals an extensive, ancient, and metal-poor population that includes ~18,000 stars with -2.7 < [M/H] < -1.5, representing a stellar mass of ≳5 × 10 7 M ⊙ . The spatial distribution of these [M/H] < -1.5 stars has a Gaussian extent of only σ R$_{GC}$ around the GC, with most orbits confined to the inner Galaxy. At high orbital eccentricities, there is clear evidence for accreted halo stars in their pericentral orbit phase. Most stars show [α/Fe] enhancement and [Al/Fe]–[Mn/Fe] abundances expected for an origin in the more massive portions of the proto-Galaxy. Stars with [M/H] < -2 show no net rotation, whereas those with [M/H] ~ -1 are rotation dominated. These central, metal-poor stars most likely predate the oldest disk population (τ age ≈ 12.5 Gyr), which implies that they formed at z ≳ 5, forging the proto-Milky Way.

79 ASTRONOMY AND ASTROPHYSICS↗
DOE OSTI2022

Commitment to Hypertension Control During the COVID-19 Pandemic: Million Hearts Initiative Exemplars

Hypertension is a major risk factor for cardiovascular diseases, but 3 of 4 US adults do not have their blood pressure adequately controlled. Million Hearts (US Department of Health and Human Services) is a national initiative that promotes a set of priorities and interventions to optimize delivery of evidence-based strategies to manage cardiovascular disease, including hypertension. The COVID-19 pandemic, however, has disrupted routine care and preventive service delivery. We identified examples of clinical and health organizations that adapted services and care processes to continue a focus on monitoring and controlling hypertension during the pandemic. Eight Hypertension Control Exemplars were identified and interviewed. They reported various adapted care strategies including telemedicine, engaging patients in self-measured blood pressure monitoring, adapting or implementing medication management services, activating partnerships to respond to patient needs or expand services, and implementing unique patient outreach approaches. Documenting these hypertension control strategies can help increase adoption of adaptive approaches during public health emergencies and routine care.

59 BASIC BIOLOGICAL SCIENCES↗
NASA NTRS1966

Phonocardiograph system monitors heart sounds

Phonocardiograph system monitors the mechanical activity of the heart in extreme environments. It uses a piezoelectric-crystal microphone with an integral preamplifier, and a signal conditioner having special frequency characteristics. The output signals can be recorded on tape, presented aurally, or transmitted telemetrically to a remote station.

Source record↗