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Cardiovascular Time Series in the Preclinical and Clinical Settings
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Cardiovascular Time Series in the Preclinical and Clinical Settings

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

Deadline for manuscript submissions: closed (20 March 2024) | Viewed by 8835

Special Issue Editors

Prof. Dr. Gianfranco Parati

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Guest Editor
1. Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
2. IRCCS, Istituto Auxologico Italiano, Department of Cardiology San Luca Hospital, Milan, Italy
Interests: cardiovascular risk, arterial hypertension, blood pressure measurement and monitoring, blood pressure variability, autonomic neural cardiovascualr regulation, heart failure, children and adolescents, cardiovascular effects of high altitude exposure, sleep apnea; arterial stiffness, pulmonary circulation
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Przemyslaw Guzik

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Guest Editor
1. Department of Cardiology-Intensive Therapy, Poznan University of Medical Sciences, Poznan, Poland
2. University Centre for Sports and Medical Studies, Poznan University of Medical Sciences, Poznan, Poland
Interests: heart rate variability, heart rate asymmetry, blood pressure variability, baroreflex function, continuous blood pressure and hemodynamics, echocardiography, arrhythmias, cardiopulmonary exercise test, sports cardiology, cardiovascular time series
Prof. Dr. Paolo Castiglioni

E-Mail Website
Guest Editor
IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy
Interests: complexity in biosignals; physiological time series; fractals in medicine; cardiovascular modeling; physiology in extreme environments; rehabilitation medicine
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The cardiovascular system is dynamic, and its functions change over time. Heart rate, pressure waveforms and transit times, hemodynamic (e.g., stroke volume, vascular resistance), atrioventricular conduction, QT interval, myocardial oxygen consumption, and muscle or brain oxygenation are examples of vital signals originating from or transferred by the heart and the vascular system.

The cardiovascular time series describing the dynamics of these signals can be defined at every heartbeat or breath or on equally spaced points in time sampled over periods of seconds, hours, days, weeks, or visits. Various mathematical methods are applied to analyze such time series, from simple indexes of dispersion such as standard deviation or counting statistics to more sophisticated approaches such as spectral, nonlinear, and complexity-based analyses. Methods of heart rate and blood pressure variability, baroreflex sensitivity, arterial stiffness, central and peripheral blood pressure, and hemodynamics provide useful information in many clinical areas, including intensive care, cardiology, internal medicine, and sports.

Cardiovascular time series have been explored in patients with hypertension, diabetes, heart failure, shock, sepsis, myocardial infarction, or ischaemic stroke, as well as in athletes in relation to their exercise capacity and sports discipline. Some derived parameters have diagnostic value, and others are used for risk prediction, monitoring the progress of the disease, and the effects of therapies or exercise training.

This Special Issue aims to collect submissions on advances in the monitoring and analysis of cardiovascular time series focusing only on human studies with clear physiological or clinical interpretation. Manuscripts challenging the current knowledge with novel findings are also cordially invited.

Only the following submissions are encouraged: original prospective studies and retrospective analyses, meta-analyses, reviews, and critical appraisals. Neither case nor a series of case studies will be further processed.

Clinicians are the primary readers of the Journal of Clinical Medicine. Therefore, the authors should avoid complex mathematical argumentation and modeling. However, some advanced statistical and analytical methodology (e.g., machine learning or artificial intelligence) may be necessary to provide meaningful clinical or physiological information. Such submissions are also invited to this Special Issue.

Prof. Dr. Gianfranco Parati
Prof. Dr. Przemyslaw Guzik
Prof. Dr. Paolo Castiglioni
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

  • cardiovascular time series
  • cardiopulmonary exercise test
  • sports cardiology
  • echocardiography
  • arrhythmias
  • heart rate variability
  • heart rate asymmetry
  • blood pressure variability

Published Papers (5 papers)

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13 pages, 1239 KiB  
Article
Midday Dipping and Circadian Blood Pressure Patterns in Acute Ischemic Stroke
by Nikolaos Kakaletsis, George Ntaios, Haralampos Milionis, Anastasia Karagiannaki, Ioanna Chouvarda, Vasiliki Dourliou, Ioannis Ladakis, Georgia Kaiafa, Konstantinos Vemmos and Christos Savopoulos
J. Clin. Med. 2023, 12(14), 4816; https://doi.org/10.3390/jcm12144816 - 21 Jul 2023
Viewed by 771
Abstract
The purpose of this study was to investigate the alterations in blood pressure (BP) during midday and the changes in circadian BP patterns in the acute phase of ischemic stroke (AIS) with the severity of stroke and their predictive role outcomes within 3 [...] Read more.
The purpose of this study was to investigate the alterations in blood pressure (BP) during midday and the changes in circadian BP patterns in the acute phase of ischemic stroke (AIS) with the severity of stroke and their predictive role outcomes within 3 months. A total of 228 AIS patients (a prospective multicenter follow-up study) underwent 24 h ambulatory blood pressure monitoring (ABPM). Mean BP parameters during the day (7:00–22:59), the midday (13:00–16:59), and the night (23:00–6:59), and midday and nocturnal dipping were calculated. Midday SBP dippers had less severe stroke, lower incidence of hypertension and SBP/DBP on admission, lower levels of serum glucose and WBCs, and delayed initiation of ABPM compared to risers. There was a reverse relation between midday SBP dipping and both nocturnal dipping and stroke severity. The “double dippers” (midday and nocturnal dipping) had the least severe stroke, the lowest SBP/DBP on admission, the lowest heart rate from ABPM, and a lower risk of an unfavorable outcome, while the “double risers” had the opposite results, by an approximately five-fold risk of death/disability at 3 months. These findings indicate different circadian BP patterns during the acute phase of AIS, which could be considered a marker of stroke severity and prognosis. Full article
(This article belongs to the Special Issue Cardiovascular Time Series in the Preclinical and Clinical Settings)
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17 pages, 333 KiB  
Article
Heart Rate Asymmetry, Its Compensation, and Heart Rate Variability in Healthy Adults during 48-h Holter ECG Recordings
by Greta Sibrecht, Jarosław Piskorski, Tomasz Krauze and Przemysław Guzik
J. Clin. Med. 2023, 12(3), 1219; https://doi.org/10.3390/jcm12031219 - 03 Feb 2023
Cited by 2 | Viewed by 1502
Abstract
Heart rate asymmetry (HRA) reflects different contributions of heart rate (HR) decelerations and accelerations to heart rate variability (HRV). In this study, we examined various properties of HRA, including its compensation and HRV, in 48-h electrocardiogram (ECG) recordings in healthy adults. Furthermore, we [...] Read more.
Heart rate asymmetry (HRA) reflects different contributions of heart rate (HR) decelerations and accelerations to heart rate variability (HRV). In this study, we examined various properties of HRA, including its compensation and HRV, in 48-h electrocardiogram (ECG) recordings in healthy adults. Furthermore, we compared sex differences in parameters used to quantify HRA and HRV. Variance-based and relative HRA and HRV parameters were computed for Holter ECG recordings lasting up to 48 h in 101 healthy volunteers. The median age of the subjects was 39 years, with 47 of them being men. The prevalence of all forms of HRA was statistically different from randomness (p < 0.0001). Specifically, HR decelerations contributed >50% (C1d) to short-term HRA in 98.02% of subjects, while HR decelerations contributed <50% to long-term HRA in 89.11% of recordings and to total HRA in 88.12% of recordings. Additionally, decelerations accounted for <50% of all changing heartbeats (Porta’s index) in 74.26% of subjects, and HRA compensation was present in 88.12% of volunteers. Our findings suggest that various HRA features are present in most healthy adults. While men had more pronounced HRA expression, the prevalence of short-, long-term, and total HRA and its compensation was similar in both sexes. For HRV, values of variance-based indices were higher in men than in women, but no differences were found for relative measures. In conclusion, our study references HRA and HRV for longer ECG recordings of up to 48 h, which have become increasingly important in clinical ECG monitoring. The findings can help understand and compare the characteristics of HRA and HRV in patients with different diseases. Full article
(This article belongs to the Special Issue Cardiovascular Time Series in the Preclinical and Clinical Settings)
14 pages, 2687 KiB  
Article
Changes in Maternal Heart Rate and Autonomic Regulation following the Antenatal Administration of Corticosteroids: A Secondary Analysis
by Maretha Bester, Rohan Joshi, Joyce H. A. M. van Dooren, Massimo Mischi, Rik Vullings and Judith O. E. H. van Laar
J. Clin. Med. 2023, 12(2), 588; https://doi.org/10.3390/jcm12020588 - 11 Jan 2023
Viewed by 2022
Abstract
While the effect of antenatally administered corticosteroids on fetal heart rate (HR) and heart rate variability (HRV) is well established, little information is available on how these drugs affect maternal physiology. In this secondary analysis of a prospective, observational cohort study, we quantify [...] Read more.
While the effect of antenatally administered corticosteroids on fetal heart rate (HR) and heart rate variability (HRV) is well established, little information is available on how these drugs affect maternal physiology. In this secondary analysis of a prospective, observational cohort study, we quantify how corticosteroids affect maternal HR and HRV, which serve as a proxy measure for autonomic regulation. Abdominal ECG measurements were recorded before and in the five days following the administration of betamethasone—a corticosteroid commonly used for fetal maturation—in 46 women with singleton pregnancies. Maternal HR and HRV were determined from these recordings and compared between these days. HRV was assessed with time- and frequency-domain features, as well as non-linear and complexity features. In the 24 h after betamethasone administration, maternal HR was significantly increased (p < 0.01) by approximately 10 beats per minute, while HRV features linked to parasympathetic activity and HR complexity were significantly decreased (p < 0.01 and p < 0.001, respectively). Within four days after the initial administration of betamethasone, HR decreases and HRV features increase again, indicating a diminishing effect of betamethasone a few days after administration. We conclude that betamethasone administration results in changes in maternal HR and HRV, despite the heterogeneity of the studied population. Therefore, its recent administration should be considered when evaluating these cardiovascular metrics. Full article
(This article belongs to the Special Issue Cardiovascular Time Series in the Preclinical and Clinical Settings)
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30 pages, 871 KiB  
Systematic Review
Heart Rate Variability and Cognition: A Narrative Systematic Review of Longitudinal Studies
by Paola Nicolini, Gabriella Malfatto and Tiziano Lucchi
J. Clin. Med. 2024, 13(1), 280; https://doi.org/10.3390/jcm13010280 - 04 Jan 2024
Viewed by 1428
Abstract
Background: Heart rate variability (HRV) is a reliable and convenient method to assess autonomic function. Cross-sectional studies have established a link between HRV and cognition. Longitudinal studies are an emerging area of research with important clinical implications in terms of the predictive value [...] Read more.
Background: Heart rate variability (HRV) is a reliable and convenient method to assess autonomic function. Cross-sectional studies have established a link between HRV and cognition. Longitudinal studies are an emerging area of research with important clinical implications in terms of the predictive value of HRV for future cognition and in terms of the potential causal relationship between HRV and cognition. However, they have not yet been the objective of a systematic review. Therefore, the aim of this systematic review was to investigate the association between HRV and cognition in longitudinal studies. Methods: The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The Embase, PsycINFO and PubMed databases were searched from the earliest available date to 26 June 2023. Studies were included if they involved adult human subjects and evaluated the longitudinal association between HRV and cognition. The risk of bias was assessed with the Newcastle–Ottawa Scale for Cohort Studies. The results were presented narratively. Results: Of 14,359 records screened, 12 studies were included in this systematic review, with a total of 24,390 participants. Two thirds of the studies were published from 2020 onwards. All studies found a longitudinal relationship between HRV and cognition. There was a consistent association between higher parasympathetic nervous system (PNS) activity and better cognition, and some association between higher sympathetic nervous system activity and worse cognition. Also, higher PNS activity persistently predicted better executive functioning, while data on episodic memory and language were more scant and/or controversial. Conclusions: Our results support the role of HRV as a biomarker of future cognition and, potentially, as a therapeutic target to improve cognition. They will need confirmation by further, more comprehensive studies also including unequivocal non-HRV sympathetic measures and meta-analyses. Full article
(This article belongs to the Special Issue Cardiovascular Time Series in the Preclinical and Clinical Settings)
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7 pages, 248 KiB  
Brief Report
Differences in Heart Rate Variability and Baroreflex Sensitivity between Male and Female Athletes
by M. Abdullah Shafiq, Cody A. Ellingson, Gregory P. Krätzig, Kim D. Dorsch, J. Patrick Neary and Jyotpal Singh
J. Clin. Med. 2023, 12(12), 3916; https://doi.org/10.3390/jcm12123916 - 08 Jun 2023
Cited by 3 | Viewed by 2360
Abstract
Heart rate variability (HRV), systolic blood pressure variability (BPV), and spontaneous baroreflex sensitivity (BRS) are indirect and approximate measures of autonomic regulation of the cardiovascular system. Studies have shown differences in HRV and BRS between males and females; however, no study has observed [...] Read more.
Heart rate variability (HRV), systolic blood pressure variability (BPV), and spontaneous baroreflex sensitivity (BRS) are indirect and approximate measures of autonomic regulation of the cardiovascular system. Studies have shown differences in HRV and BRS between males and females; however, no study has observed differences in BPV, HRV, or BRS between male and female athletes. One hundred males (age 21.2 ± 2.1 y; BMI 27.4 ± 4.5 kg/m2) and sixty-five females (age: 19.7 ± 1.6 y; BMI 22.7 ± 2.2 kg/m2) were assessed during the pre-season baseline. We collected resting beat-to-beat blood pressure and R-R intervals using finger photoplethysmography and a 3-lead electrocardiogram, respectively. Participants underwent a controlled slow breathing protocol (six breaths/minute: 5 s inhale, 5 s exhale) for 5 min. Spectral and linear analysis was conducted on blood pressure and ECG data. Regression curves were fitted to the blood pressure and R-R signals, with the slopes providing the BRS parameters. Male athletes had significantly (p < 0.05) lower mean heart rate, RR interval SD2/SD1, HRV % low-frequency, and higher BP high-frequency power during controlled respiration. No differences were found in any BRS parameters. HRV and BPV responses to a slow breathing protocol differed between male and female athletes; however, BRS responses did not. Full article
(This article belongs to the Special Issue Cardiovascular Time Series in the Preclinical and Clinical Settings)
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