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Cardiovascular Neural Regulation in Adults from Daily Life to Occupational Environment

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (28 February 2021) | Viewed by 25605

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Dr. Franca Barbic

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1. Department of Biomedical Sciences, Humanitas University, 20090 Pieve Emanuele, Milan, Italy
2. Internal Medicine, Humanitas Clinical and Research Center - IRCCS, 20089 Rozzano, Milan, Italy
Interests: occupational and environmental health; cardiovascular autonomic nervous system and work ability; shift work; sleep disorders; syncope and orthostatic intolerance syndromes; heart rate, blood pressure and respiratory activity variability
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Prof. Dr. Antonio Roberto Zamuner

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Departamento de Kinesiología, Universidad Católica del Maule (UCM), Talca 3466706, Chile
Interests: cardiovascular autonomic disorders; baroreflex; cardiovascular rehabilitation; physical therapy; exercise
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Dr. Eleonora Tobaldini

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1. Department of Clinical Sciences and Community Health, The University of Milan, 20122 Milan, Italy
2. Department of Internal Medicine, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
Interests: autonomic nervous system; dysautonomia; sleep; syncope
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Special Issue Information

Dear Colleagues,

As a link between the central nervous system and the body viscera, the autonomic nervous system guarantees an adequate response to different environmental stimuli, in healthy adults. Cardiovascular neural regulation is a crucial component of this complex model, particularly in the presence of physical and psychological stress, in response to physical and chemical agents including pollutants, in different environmental microclimates, during orthostatic stress and in response to circadian rhythms alteration as happens, for example, during irregular work schedules.

The neural control of circulation involves baroreceptors and vagal nerves that connect the bulbar structures to the heart and sympathetic nerves that project to the spinal cord. Both nerve pathways contain afferent and efferent fibers. Bulbar and spinal nuclei are under the final control of supra-spinal and cortical structures.

The alteration of this complex network may significantly impact the human capability to adapt itself to different environmental stimuli including those characterizing different occupational settings and tasks. This may reduce human performances, promote diseases, increase the risk of accidents, and negatively impact public health.

In this Special Issue, the mechanisms of cardiovascular neural regulation in adults will be addressed in health and disease, with a special emphasis on its role in adaptation to environmental daily stimuli.

Prof. Dr. Franca Barbic
Prof. Dr. Roberto Antonio Zamuner
Prof. Dr. Eleonora Tobaldini
Guest Editors

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Keywords

Working environments
Shift-work
Heart rate and blood pressure variabilities
Baroreceptor control
Physical and psychological stress
Syncope
Orthostatic hypotension
Hypertension
Cognitive performance
Fibromyalgia

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Published Papers (8 papers)

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Research

11 pages, 636 KiB

Open AccessArticle

High Job Burnout Predicts Low Heart Rate Variability in the Working Population after a First Episode of Acute Coronary Syndrome

by Yunke Shi, Ruxin Jiang, Caifeng Zhu, Min Zhang, Hongyan Cai, Zhao Hu, Yujia Ye, Yixi Liu, Huang Sun, Yiming Ma, Xingyu Cao, Dan Yang, Mingqiang Wang, Adrian Loerbroks and Jian Li

Int. J. Environ. Res. Public Health 2021, 18(7), 3431; https://doi.org/10.3390/ijerph18073431 - 26 Mar 2021

Cited by 6 | Viewed by 3203

Abstract

(1) Background: Job burnout may affect the prognosis of patients with acute coronary syndrome (ACS) through mechanisms involving heart rate variability (HRV). However, no study has yet examined those potential associations. Hence, we conducted the present study to investigate this issue. (2) Method: Participants included patients who presented with a first episode of ACS and who were employed. The Copenhagen Burnout Inventory (CBI) was used to assess job burnout. Twenty-four-hour ambulatory electrocardiography recorded HRV on four occasions, i.e., during the hospitalization and follow-ups at one, six, and 12 months, respectively. (3) Results: A total of 120 participants who at least completed three Holter examinations throughout the study were enrolled in the final analysis. Job burnout scores at baseline were inversely associated with LnSDNN, LnTP, LnHF, LnLF, LnULF, and LnVLF during the consequent one-year follow-up. Each 1 SD increase in job burnout scores predicted a decline ranging from 0.10 to 0.47 in the parameters described above (all p < 0.05), and all relationships were independent of numerous confounders, including anxiety and depression. (4) Conclusion: High job burnout predicted reduced HRV parameters during the one-year period post-ACS in the working population. Full article

(This article belongs to the Special Issue Cardiovascular Neural Regulation in Adults from Daily Life to Occupational Environment)

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9 pages, 2672 KiB

Open AccessArticle

Analysis of Heart-Rate Variability during Angioedema Attacks in Patients with Hereditary C1-Inhibitor Deficiency

by Francesca Perego, Beatrice De Maria, Maria Bova, Angelica Petraroli, Azzurra Marcelli Cesoni, Valeria De Grazia, Lorenza Chiara Zingale, Alberto Porta, Giuseppe Spadaro and Laura Adelaide Dalla Vecchia

Int. J. Environ. Res. Public Health 2021, 18(6), 2900; https://doi.org/10.3390/ijerph18062900 - 12 Mar 2021

Cited by 3 | Viewed by 2666

Abstract

C1-inhibitor hereditary angioedema (C1-INH-HAE) is a rare disease characterized by self-limiting edema associated with localized vasodilation due to increased levels of circulating bradykinin. C1-INH-HAE directly influences patients’ everyday lives, as attacks are unpredictable in frequency, severity, and the involved anatomical site. The autonomic nervous system could be involved in remission. The cardiac autonomic profile has not yet been evaluated during the attack or prodromal phases. In this study, a multiday continuous electrocardiogram was obtained in four C1-INH-HAE patients until attack occurrence. Power spectral heart rate variability (HRV) indices were computed over the 4 h preceding the attack and during the first 4 h of the attack in three patients. Increased vagal modulation of the sinus node was detected in the prodromal phase. This finding may reflect localized vasodilation mediated by the release of bradykinin. HRV analysis may furnish early markers of an impending angioedema attack, thereby helping to identify patients at higher risk of attack recurrence. In this perspective, it could assist in the timing, titration, and optimization of prophylactic therapy, and thus improve patients’ quality of life. Full article

(This article belongs to the Special Issue Cardiovascular Neural Regulation in Adults from Daily Life to Occupational Environment)

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10 pages, 338 KiB

Open AccessArticle

Response of the Cardiac Autonomic Control to Exposure to Nanoparticles and Noise: A Cross-Sectional Study of Airport Ground Staff

by Luigi Isaia Lecca, Gabriele Marcias, Michele Uras, Federico Meloni, Nicola Mucci, Francesca Larese Filon, Giorgio Massacci, Giorgio Buonanno, Pierluigi Cocco and Marcello Campagna

Int. J. Environ. Res. Public Health 2021, 18(5), 2507; https://doi.org/10.3390/ijerph18052507 - 3 Mar 2021

Cited by 7 | Viewed by 2362

Abstract

Airport activity causes the emission of particulate matter and noise, two environmental contaminants and potential health hazards, particularly for the personnel operating nearby taxiways. We explored the association between exposure to fine/ultrafine particles (UFPs) and noise with heart rate variability (HRV), an early indicator of cardiovascular autonomic response, among a sample of airport ground staff. Between May and June 2018, thirty-four male operators (mean age = 43 years and SD = 6.7) underwent personal monitoring of exposure to nanoparticles and noise, and HRV during their work activity. We conducted univariate and multivariate analysis to test the effect of UFP and noise exposure HRV. Total Lung Deposition Surface Area (LDSA) was significantly associated with a decrease in HRV Total Power and Triangular index (β = −0.038 p = 0.016 and β = −7.8 × 10⁻⁵, p = 0.042, respectively). Noise peak level showed an opposite effect, which was significant for Total Power (β = 153.03, p = 0.027), and for Triangular index (β = 0.362, p = 0.035). Further investigation is warranted to clarify the effect of the concurrent exposure to UFPs and noise on early changes of cardiac autonomic regulation. Full article

(This article belongs to the Special Issue Cardiovascular Neural Regulation in Adults from Daily Life to Occupational Environment)

12 pages, 955 KiB

Open AccessArticle

Cardiovascular Autonomic Control, Sleep and Health Related Quality of Life in Systemic Sclerosis

by Angelica Carandina, Chiara Bellocchi, Gabriel Dias Rodrigues, Lorenzo Beretta, Nicola Montano and Eleonora Tobaldini

Int. J. Environ. Res. Public Health 2021, 18(5), 2276; https://doi.org/10.3390/ijerph18052276 - 25 Feb 2021

Cited by 9 | Viewed by 2691

Abstract

Chronic pain and dysautonomic symptoms deteriorate Systemic sclerosis (SSc) patients’ health-related quality of life with serious repercussions on social life and even on sleep. Heart Rate Variability (HRV) analysis can identify cardiovascular autonomic control impairment in subclinical condition. The aim of the present observational cross-sectional study was to assess the relationship between dysautonomic symptoms, quality of life status and cardiovascular autonomic profile. ECG and respiration were recorded at rest in 20 SSc patients. HRV analysis was performed using two different approaches: Linear spectral analysis and non-linear symbolic analysis. Pain was evaluated using the Numeric Rating Scale (NRS) and 3 questionnaires were administered for the evaluation of sleep quality (PSQI), mood tone (PHQ-9) and disability (HAQ). We found that sleep impairment was related to sympathetic predominance at rest measured as low-frequency/high-frequency ratio (LF/HF) (r = 0.48 and p = 0.033); poorer sleep quality was related to higher pain values (r = 0.48 and p = 0.034) and depressive symptoms (r = 0.82 and p < 0.01); higher pain scores were related to higher cardiovascular vagal modulation and higher disability indexes (r = 0.47 and p = 0.038 & r = 0.55 and p = 0.012, respectively). In conclusion dysautonomia and chronic pain showed a severe impact on sleep quality and disability with a consequent worsening of depressive symptom in our cohort of SSc patients. Full article

(This article belongs to the Special Issue Cardiovascular Neural Regulation in Adults from Daily Life to Occupational Environment)

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12 pages, 997 KiB

Open AccessArticle

Association between Cardiac Autonomic Control and Postural Control in Patients with Parkinson’s Disease

by Yoan Espinoza-Valdés, Rocio Córdova-Arellano, Maiter Espinoza-Espinoza, Diego Méndez-Alfaro, Juan Pablo Bustamante-Aguirre, Hernán Antonio Maureira-Pareja and Antonio Roberto Zamunér

Int. J. Environ. Res. Public Health 2021, 18(1), 249; https://doi.org/10.3390/ijerph18010249 - 31 Dec 2020

Cited by 8 | Viewed by 2695

Abstract

Parkinson’s disease (PD) is a neurodegenerative disorder that affects postural and cardiac autonomic control. However, since it is unknown whether these changes are associated, the objective of this study was to determine whether such a relationship exists. Twenty-three patients with PD participated. The RR intervals were recorded in different positions and heart rate variability (HRV) was analyzed. Postural sway was analyzed based on the center of pressure. No significant differences on HRV indices were induced by postural change. A correlation was found between these indices and postural control, high frequency (HF), and anterior-posterior (AP) root mean square (RMS-AP) (r = 0.422, p = 0.045), low frequency (LF)/HF, and AP mean velocity (r = 0.478, p = 0.021). A correlation was found between HRV induced by postural change and postural control, Δ LF/HF and RMS-AP (r = 0.448, p = 0.032), Δ LF/HF and ellipse area (r = 0.505, p = 0.014), Δ LF/HF and AP mean velocity (r = −0.531; p = 0.009), and Δ LF and AP mean velocity (r = −0.424, p = 0.044). There is an association between the autonomic and postural systems, such that PD patients with blunted cardiac autonomic function in both the supine and orthostatic positions have worse postural control. Full article

(This article belongs to the Special Issue Cardiovascular Neural Regulation in Adults from Daily Life to Occupational Environment)

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9 pages, 308 KiB

Open AccessArticle

Effects of Cigarette Smoking on Cardiac Autonomic Responses: A Cross-Sectional Study

by Nadeen Makhoul, Ishay Avivi, Sapir Barak Lanciano, Ella Haber Kaptsenel, Hana Bishara, Hagar Palacci, Chen Chaiat, Giris Jacob and Udi Nussinovitch

Int. J. Environ. Res. Public Health 2020, 17(22), 8571; https://doi.org/10.3390/ijerph17228571 - 19 Nov 2020

Cited by 2 | Viewed by 2458

Abstract

It has been suggested that some of the adverse, long-term cardiovascular outcomes of smoking are mediated by impaired autonomic nervous system (ANS) activity. Yet, this association is currently inconclusive. Heart rate variability (HRV) and the deep breathing test (DBT) represent common quantitative markers of ANS activity due to their simplicity and reliability. This large cross-sectional study was designed to assess the effect of active smoking on ANS function as manifested by HRV or DBT abnormalities. Electrocardiograms were recorded at rest for 5 min and during forced metronomic breathing. HRV and DBT were calculated according to accepted standards. Participants were divided into two groups based on current smoking status. The study included 242 healthy volunteers (196 nonsmokers and 46 smokers). There were no significant differences in age, sex, and BMI between groups. Cumulative smoking exposure burden (CSEB) for the study group was 5.3 ± 1.3 pack-years. Comparative analysis of HRV and DBT parameters according to smoking status revealed no significant differences between groups. Significant (p < 0.05), yet weak or moderate correlations (r < 0.7) were found between CSEB and abnormal change in HRV parameters consistent with sympathetic overactivity and decreased parasympathetic tone. In conclusion, smoking for a relatively short period in healthy adults does not seem to lead to significant impairment in ANS function. Yet, the consequences of smoking seem to be amplified when cumulative exposure burden increases. Full article

(This article belongs to the Special Issue Cardiovascular Neural Regulation in Adults from Daily Life to Occupational Environment)

15 pages, 1402 KiB

Open AccessArticle

Work Ability Assessment and Its Relationship with Cardiovascular Autonomic Profile in Postural Orthostatic Tachycardia Syndrome

by Franca Barbic, Maura Minonzio, Beatrice Cairo, Dana Shiffer, Antonio Roberto Zamuner, Silvia Cavalieri, Franca Dipaola, Nicola Magnavita, Alberto Porta and Raffaello Furlan

Int. J. Environ. Res. Public Health 2020, 17(21), 7836; https://doi.org/10.3390/ijerph17217836 - 26 Oct 2020

Cited by 18 | Viewed by 3756

Abstract

Postural orthostatic tachycardia syndrome (POTS) negatively impacts quality of life. The excessive increase in cardiac sympathetic modulation during standing, which characterizes POTS patients, leads to many symptoms and signs of orthostatic intolerance. Little is known about the consequences of the disease on work performance and its relationship with individual autonomic profiles. Twenty-two POTS patients regularly engaged in working activity (20 females, age 36 ± 12 years) and 18 gender- and age-matched controls underwent a clinical evaluation and filled out the Work Ability Index (WAI) questionnaire. POTS patients completed the Composite Autonomic Symptom Score (COMPASS31) questionnaire, underwent continuous electrocardiogram, blood pressure and respiratory activity recordings while supine and during a 75° head-up tilt (HUT). A power spectrum analysis provided the index of cardiac sympatho-vagal balance (LF/HF). WAI scores were significantly reduced in POTS patients (29.84 ± 1.40) compared to controls (45.63 ± 0.53, p < 0.01). A significant inverse correlation was found between individual WAI and COMPASS31 scores (r = −0.46; p = 0.03), HUT increase in heart rate (r = −0.57; p = 0.01) and LF/HF (r = −0.55; p = 0.01). In POTS patients, the WAI scores were inversely correlated to the intensity of autonomic symptoms and to the excessive cardiac sympathetic activation induced by the gravitational stimulus. Full article

(This article belongs to the Special Issue Cardiovascular Neural Regulation in Adults from Daily Life to Occupational Environment)

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13 pages, 1297 KiB

Open AccessArticle

Time Course of Autonomic Symptoms in Postural Orthostatic Tachycardia Syndrome (POTS) Patients: Two-Year Follow-Up Results

by Franca Dipaola, Caterina Barberi, Elena Castelnuovo, Maura Minonzio, Roberto Fornerone, Dana Shiffer, Beatrice Cairo, Antonio Roberto Zamuner, Franca Barbic and Raffaello Furlan

Int. J. Environ. Res. Public Health 2020, 17(16), 5872; https://doi.org/10.3390/ijerph17165872 - 13 Aug 2020

Cited by 17 | Viewed by 4876

Abstract

Postural orthostatic tachycardia syndrome (POTS) is a multifactorial condition capable of chronically reducing the quality of life and the work ability of patients. The study aim was to assess the burden of autonomic symptoms in a cohort of POTS patients over 2 years. Patients’ clinical profiles were assessed by the 31-item Composite Autonomic Symptom Score questionnaire (COMPASS 31) and a visual analog scale (VAS). One-way ANOVA for repeated measures followed by Dunnett’s post-hoc test were used to compare symptoms at baseline and at 1 and 2 years. Out of 42 enrolled patients, 25 had a 1-year follow-up and 12 had a 2-year follow-up. At baseline, the reported burden of autonomic symptoms was high (overall COMPASS 31 = 49.9 ± 14.3 /100). Main complaints were related to orthostatic intolerance according to both COMPASS 31 and VAS. Fourteen patients were rendered inactive because of symptoms. At 1-year follow-up, a statistically significant improvement in pupillomotor function and overall score was detected by the COMPASS 31. These findings were confirmed at 2 years, together with a significant reduction in quality of life impairment, assessed by VAS. However, these improvements did not change patients’ occupational status. Awareness of POTS diagnosis, patient monitoring, and tailored therapies can help to improve patients’ condition. Full article

(This article belongs to the Special Issue Cardiovascular Neural Regulation in Adults from Daily Life to Occupational Environment)

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