Progressive Impairment of Cardiac Autonomic Regulation as the Number of Metabolic Syndrome Components Increases.

Background: Metabolic syndrome (MetS) is associated with an increased risk of cardiovascular diseases. Compelling evidence supports the key role of dysfunction in the autonomic nervous system in that association, as well as mutual correlation among the components of MetS. The autonomic nervous system index (ANSI) is a percentile-ranked unitary proxy of cardiac autonomic regulation (CAR) that is designed to be free of age and sex bias, with higher values indicating better autonomic control.

Assessing the cardiac autonomic response to bicycle exercise in Olympic athletes with different loads of endurance training: new insights from statistical indicators based on multilevel exploratory factor analysis.

The mechanisms governing the organism's response to exercise are complex and difficult to study. Spectral analysis of heart rate variability (HRV) could represent a convenient methodology for studying humans' autonomic nervous system (ANS). However, difficulties in interpreting the multitude of correlated HRV-derived indices, mainly when computed over different time segments, may represent a barrier to its usage.

Psychological Intervention Based on Mental Relaxation to Manage Stress in Female Junior Elite Soccer Team: Improvement in Cardiac Autonomic Control, Perception of Stress and Overall Health.

Chronic stress may represent one of the most important factors that negatively affects the health and performance of athletes. Finding a way to introduce psychological strategies to manage stress in everyday training routines is challenging, particularly in junior teams. We also must consider that a stress management intervention should be regarded as "efficacious" only if its application results in improvement of the complex underlying pathogenetic substratum, which considers mechanistically interrelated factors, such as immunological, endocrine and autonomic controls further to psychological functioning and behavior.

Relationship between Body Composition and Cardiac Autonomic Regulation in a Large Population of Italian Olympic Athletes.

Athletic performance is determined by many factors, such as cardiorespiratory fitness, muscular strength and psychological features, which all interact simultaneously. The large Italian National Olympic Committee database of Olympic athletes offers a unique healthy population to verify the strength of the interplay among a number of major elements of training, including autonomic nervous system (ANS) modulation, biochemical indicators and body composition, in a system medicine approach. This observational, retrospective study involved 583 individuals.

Altered Cardiac Autonomic Regulation in Overweight and Obese Subjects: The Role of Age-and-Gender-Adjusted Statistical Indicators of Heart Rate Variability and Cardiac Baroreflex.

In the context of functional determinants of cardiovascular risk, a simple excess in body weight, as indexed by a rise in body mass index (BMI), plays a significant, well-recognized causal role. Conversely, BMI reductions toward normal result in an improvement of risk. Obesity is associated with impaired cardiac autonomic regulation (CAR), through either vagal or sympathetic mechanisms, which could favor the tendency to foster hypertension.

Out-of-hospital cardiac arrest (OHCA) Survey in Lombardy: data analysis through prospective short time period assessment.

Background And Aim Of The Work: The results of out-of-hospital cardiac arrests (OHCA) are usually reported through data collected collected via "ad hoc"  registries, but in large populations, samples of short time periods can be used to apply the results to the entire population. We would like to describe the situation of Lombardy to provide evidence on successful procedures, which may be carried out in a larger context.

Methods: Observational, prospective, analytical, single cohort study in Lombardy population.

Cardiac Baroreflex, HRV, and Statistics: An Interdisciplinary Approach in Hypertension.

Interests about the fine underpinnings of cardiovascular beat-by-beat variability have historical roots. Over the last decades, various aspects of the relationships between arterial pressure and heart period were taken as a proxy of the baroreflex in physiology and medicine, stimulating the interest of investigators in several interconnected scientific fields, in particular, bioengineering, neurophysiology, and clinical medicine. Studies of the overall system facilitated the emergence of a simplified negative (vagal) feedback model of the baroreflex and overshadowed the simultaneous interaction with excitatory, sympathetic positive-feedback mechanisms that would, however, better suit the model of a "paired antagonistic (parasympathetic/sympathetic) innervation of the internal organs.

Autonomic Differentiation Map: A Novel Statistical Tool for Interpretation of Heart Rate Variability.

In spite of the large body of evidence suggesting Heart Rate Variability (HRV) alone or combined with blood pressure variability (providing an estimate of baroreflex gain) as a useful technique to assess the autonomic regulation of the cardiovascular system, there is still an ongoing debate about methodology, interpretation, and clinical applications. In the present investigation, we hypothesize that non-parametric and multivariate exploratory statistical manipulation of HRV data could provide a novel informational tool useful to differentiate normal controls from clinical groups, such as athletes, or subjects affected by obesity, hypertension, or stress. With a data-driven protocol in 1,352 ambulant subjects, we compute HRV and baroreflex indices from short-term data series as proxies of autonomic (ANS) regulation.

May a unitary autonomic index help assess autonomic cardiac regulation in elite athletes? Preliminary observations on the national Italian Olympic committee team.

Background: Long term endurance training, as occurring in elite athletes, is associated to cardiac neural remodeling in favor of cardioprotective vagal mechanisms, resulting in resting bradycardia and augmented contribution of cardiac parasympathetic nerve activity. Autonomic assessment can be performed by way of heart rate variability. This technique however provides multiple indices, and there is not yet complete agreement on their specific significance.

A composite autonomic index as unitary metric for heart rate variability: a proof of concept.

Background: This study addresses whether a unitary cardiac autonomic nervous system index (ANSI), obtained combining multiple metrics from heart rate variability (HRV) into a radar plot could provide an easy appreciation of autonomic performance in a clinical setting.

Materials And Methods: Data are standardized using percentile ranking of autonomic proxies from a relatively large reference population (n = 1593, age 39 ± 13 years). Autonomic indices are obtained from autoregressive spectral analysis of (ECG derived) HRV at rest and during standing up.

Reducing the risk of metabolic syndrome at the worksite: preliminary experience with an ecological approach.

Aim: Given the time spent at work, the workplace represents an ideal setting to implement preventive programs for non-communicable diseases, the major cause of mortality and morbidity in Western and developing countries. We sought to verify if an ecological approach based on corporate culture, employees' education and concrete modifications of workplace environment, offering easy opportunity to assume healthy lifestyle, could be associated with reduced cardiometabolic risk.

Methods: The study involved 1089 workers in two multinational companies following different workplace health promotion policies.

May autonomic indices from cardiovascular variability help identify hypertension?

Introduction: Altered profile of RR variability and reduced baroreflex gain, as autonomic proxies, are observed in hypertensive individuals.

Aim: To assess whether using logistic models and cross-validation techniques autonomic proxies can be used to identify clinical hypertensive and normotensive groups.

Methods: An observational study on 405 individuals (155 mild hypertensive and 250 controls).

Health promotion in the workplace: assessing stress and lifestyle with an intranet tool.

Background: Chronic noncommunicable conditions, particularly cardiovascular and metabolic diseases, are the major causes of death and morbidity in both industrialized and low- to middle-income countries. Recent epidemiological investigations suggest that management of lifestyle factors, such as stress and lack of physical activity, could have an important value in cardiometabolic conditions, while information technology tools could play a significant facilitatory role.

Objectives: The objective of our study was to verify the feasibility of using a private website, directed to the workers of a major Italian company, to describe their health profile and lifestyle and work habits using an ad hoc self-administered questionnaire.

Complementary medicine for the management of chronic stress: superiority of active versus passive techniques.

Background: Recent epidemiological data indicate that chronic stress is an important component of cardiovascular risk, implicitly suggesting that stress management might offer a useful complement to orthodox medical treatment and prevention of hypertension. In this context, information on mechanisms, such as subclinical increases in arterial pressure and sympathetic drive, is well documented. Conversely, evidence on methodologies and comparative efficacy needs to be improved.

Thyroid dysfunction in women with systemic sclerosis.

Hypothyroidism has been frequently reported in systemic sclerosis (SSc), but whether SSc itself increases the risk of thyroid dysfunction is still controversial. The aim of the present study was to determine whether routine thyroid function screening in SSc should be warranted. Serum levels of free triiodothyronine, free thyroxine, and thyroid-stimulating hormone, and the presence of thyroid-specific autoantibodies (antithyroid peroxidase and antithyreoglobulin) were measured in 79 women with SSc and 81 age-matched women with osteoarthritis (OA) serving as controls.