Autonomic nervous system response to remote ischemic conditioning: heart rate variability assessment

Author: Daniel Noronha Osório; Ricardo Viana-Soares; João Pedro Marto; Marcelo D. Mendonça; Hugo P. Silva; Cláudia Quaresma; Miguel Viana-Baptista; Hugo Gamboa; Helena L. A. Vieira
Language: English
Published: 2019
Source: Directory of Open Access Journals: DOAJ Articles
Online Access: http://link.springer.com/article/10.1186/s12872-019-1181-5
https://doaj.org/toc/1471-2261
doi:10.1186/s12872-019-1181-5
1471-2261
https://doaj.org/article/a7824b7cee5e46fba99940e64dccc4d9
https://doi.org/10.1186/s12872-019-1181-5
https://doaj.org/article/a7824b7cee5e46fba99940e64dccc4d9
Identification number: ftdoajarticles:oai:doaj.org/article:a7824b7cee5e46fba99940e64dccc4d9

Summary

Abstract Background Remote ischemic conditioning (RIC) is a procedure applied in a limb for triggering endogenous protective pathways in distant organs, namely brain or heart. The underlying mechanisms of RIC are still not fully understood, and it is hypothesized they are mediated either by humoral factors, immune cells and/or the autonomic nervous system. Herein, heart rate variability (HRV) was used to evaluate the electrophysiological processes occurring in the heart during RIC and, in turn to assess the role of autonomic nervous system. Methods Healthy subjects were submitted to RIC protocol and electrocardiography (ECG) was used to evaluate HRV, by assessing the variability of time intervals between two consecutive heart beats. This is a pilot study based on the analysis of 18 ECG from healthy subjects submitted to RIC. HRV was characterized in three domains (time, frequency and non-linear features) that can be correlated with the autonomic nervous system function. Results RIC procedure increased significantly the non-linear parameter SD2, which is associated with long term HRV. This effect was observed in all subjects and in the senior (> 60 years-old) subset analysis. SD2 increase suggests an activation of both parasympathetic and sympathetic nervous system, namely via fast vagal response (parasympathetic) and the slow sympathetic response to the baroreceptors stimulation. Conclusions RIC procedure modulates both parasympathetic and sympathetic autonomic nervous system. Furthermore, this modulation is more pronounced in the senior subset of subjects. Therefore, the autonomic nervous system regulation could be one of the mechanisms for RIC therapeutic effectiveness.