• 대한통합의학회지
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• 제11권4호
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• pp.27-39
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• 2023

Purpose : The aim of this study was to identify the influence of transient isokinetic exercise on cardiac autonomic modulation and muscle properties in healthy male subjects. Methods : Twenty-eight healthy males underwent isokinetic exercise of both knee joints using a Biodex systems 3 isokinetic dynamometer with an angular velocity of 60 °/sec. The changes in activity of the autonomic nervous system, as determined by heart rate variability (HRV), and in muscle properties were evaluated at three times: pre-exercise, immediately post-exercise, and 10 min post-exercise. Results : The time domain analysis of HRV revealed significant changes in the beat count and mean and minimal heart rate (HR) measured at pre-exercise, immediately post-exercise, and 10 min post-exercise (p<.001). The beat count and mean HR were markedly increased immediately post-exercise compared to pre-exercise, but then significantly decreased at 10 min post-exercise (p<.001). All parameters of the frequency domain were significantly altered by isokinetic exercise (p<.01). The low frequency/high frequency (LF/HF) ratio, as an index for the sympathovagal balance, was elevated by exercise and remained at a similarly high level at 10 min post-exercise (p<.01). The muscle properties of rectus femoris were changed as follows: Muscle tone and stiffness were significantly increased between pre-exercise and immediately post-exercise (p<.001), and between pre-exercise and at 10 min post-exercise (p<.001). Whereas, the elasticity showed no significant change. Conclusion : These results demonstrated that transient isokinetic exercise could induce changes in cardiac autonomic control and muscle properties. In particular, up-regulation of LF/HF ratio after exercise signifies thus enhanced sympathetic modulation by isokinetic exercise. Therefore, it is needed to understand the cardiovascular risks that may arise during isokinetic exercise for providing the basic evidence to establish appropriate isokinetic exercise protocols as effective rehabilitation exercises.

• The Korean Journal of Physiology and Pharmacology
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• 제27권1호
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• pp.49-59
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• 2023

Metabolic syndrome (MetS) involves multi-factorial conditions linked to an elevated risk of type 2 diabetes mellitus and cardiovascular disease. Pre-metabolic syndrome (pre-MetS) possesses two MetS components but does not meet the MetS diagnostic criteria. Although cardiac autonomic derangements are evident in MetS, there is little information on their status in pre-MetS subjects. In this study, we sought to examine cardiac autonomic functions in pre-MetS and to determine which MetS component is more responsible for impaired cardiac autonomic functions. A total of 182 subjects were recruited and divided into healthy controls (n=89) and pre-MetS subjects (n=93) based on inclusion and exclusion criteria. We performed biochemical profiles on fasting blood samples to detect pre-MetS. Using standardized protocols, we evaluated anthropometric data, body composition, baroreflex sensitivity (BRS), heart rate variability (HRV), and autonomic function tests (AFTs). We further examined these parameters in pre-MetS subjects for each MetS component. Compared to healthy controls, we observed a significant cardiac autonomic dysfunction (CAD) through reduced BRS, lower overall HRV, and altered AFT parameters in pre-MetS subjects, accompanied by markedly varied anthropometric, clinical and biochemical parameters. Furthermore, all examined BRS, HRV, and AFT parameters exhibited an abnormal trend and significant correlation toward hyperglycemia. This study demonstrates CAD in pre-MetS subjects with reduced BRS, lower overall HRV, and altered AFT parameters. Hyperglycemia was considered an independent determinant of alterations in all the examined BRS, HRV, and AFT parameters. Thus, hyperglycemia may contribute to CAD in pre-MetS subjects before progressing to MetS.

• International Journal of Vascular Biomedical Engineering
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• 제3권2호
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• pp.10-16
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• 2005

Because patients with coronary artery disease (CAD) have depressed vagal modulation and the mortality risk from acute myocardial infarction is lower in patients with higher vagal modulation, methods that can increase vagal modulation are desirable in patients with CAD. We intended to inspect the effect of recumbent posture on vagal modulation. By using angiography, 33 patients with abnormal (CAD group) and 33 patients with normal coronary arteries (control group) were studied. The nonlinear as well as the linear characteristics of heart rate variability (HRV) were analyzed on these patients in three recumbent postures: namely, the supine, right lateral decubitus, and left lateral decubitus postures. The lower the normalized high-frequency power (nHF) in the supine or left lateral decubitus posture, the higher the increase in the nHF when the posture was changed from supine or left lateral decubitus to right lateral decubitus in both groups of patients. Right lateral decubitus posture can lead to the highest vagal modulation and the lowest sympathetic modulation among the three recumbent postures in both normal and patients with CAD. Therefore, the right lateral decubitus posture can be used as an effective physiologic vagal enhancer in patients with CAD.

• 수면정신생리
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• 제11권2호
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• pp.100-105
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• 2004

목 적：본 연구의 목적은 주요우울장애환자를 대상으로 Heart Rate Variability(HRV) 검사를 이용하여 비침습적으로 자율신경계의 기능, 심혈관조절체계 및 항상성을 측정하여 정상대조군과 비교해보고 생리학적, 임상적 의미를 고찰해보는 것이다. 방 법：DSM-Ⅳ의 진단기준에 의하여 주요우울장애로 진단받은 환자 30명과 정상대조군 30명을 대상으로 하였다. 검사는 SA-2000E 기기를 사용하여 HRV parameter를 측정한 후 시(time) 영역과 주파수(frequency)영역별로 분석하였다. 결 과：Heart rate(HR)는 환자군에서 유의하게 증가된 소견을 나타내었으며 the standard deviation of the NN interval(SDNN), the root square of successive differences(RMSSD)도 환자군에서 유의하게 낮은 소견을 보였다. Total power(TP) band, very low frequency(VLF：$0.003{\sim}0.04\;Hz$) band, low frequency(LF：$0.04{\sim}0.15\;Hz$) band, high frequency(HF：$0.15{\sim}0.4\;Hz$) band는 환자군에서 유의하게 낮은 수치를 보였고, LF/HF의 비는 유의한 차이를 나타내지 않았다. 결 론：우울증 환자는 심박수의 증가와 HRV의 감소를 보였으며, 교감 신경과 미주 신경의 불균형이 높은 심혈관계 사망률과 부분적으로 연관이 있는 것 같다. 우울증 환자들은 심장에서 자율신경기능의 이상을 나타내며 이렇게 교감/부교감 신경활성 조절능력이 저하되어 균형이 깨짐으로써 높은 심혈관계 사망률을 보인다고 할 수 있다.

• 대한예방한의학회지
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• 제14권2호
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• pp.105-120
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• 2010

Objectives : This study aims to evaluate the effects of expiration-to-inspiration time ratio (E/I-ratio) on heart rate, which represents cardiac autonomic function, and cold-heat in the healthy people. Methods : 49 healthy young volunteers(male : female = 32 : 17) were recruited in the study. The participants completed the questionnaire for yin-yang pattern identification and then we measured the chest plethysmogram for respiration signal and the electrocardiogram for NN intervals during different E/I-ratio from 1 to 2. We compared heart rate variability including RMS-SD, VLF, LF and HF, and the trend-cycle factors decomposed from NN interval data by time series analysis among the respective E/I-ratio. We also confirmed the difference on the trend-cycle factors according to the score of the questionnaire for cold and heat pattern identification. Results : There were differences on the trend-cycle factors from NN interval data, but no significant difference on heart rate variability, among the respective E/I-ratio. We also found significant relationship between the trend-cycle factors and the heat pattern identification scores. Conclusions : The results indicate that cardiac autonomic function can be modulated by the E/I-ratio and the modulation will be slower and more tendencious than respiratory sinus arrhythmia.

• Tuberculosis and Respiratory Diseases
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• 제41권2호
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• pp.73-86
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• 1994

In addition to classic cholinergic and adrenergic pathways, the existence of a third division of autonomic control in the human airways has been proved. It is called a nonadrenergic noncholinergic(NANC) nervous system, and difficult to study in the absence of specific blockers. Neuropeptides are certainly suggested to be transmitters of this NANC nervous system. It is very frustrating to understand the pathophysiologic role of these peptides in the absence of any specific antagonists. However, further studies of neuropeptides might eventually lead to novel forms of treatment for bronchial asthma. Another study of the interaction between different components of the autonomic nervous system, either in ganglionic neurotransmission or by presynaptic modulation of neurotransmitters at the end-organ will elute neural control in airway disease, particularly in asthma. Studies of how autonomic control may be disordered in airway disease should lead to improvements in clinical management. Epithelial damage due to airway inflammation in asthma may induce bronchial hyperresponsiveness. Axon reflex mechanism is one of possible mechanisms in bronchial hyperresponsiveness. Epithelial damage may expose sensory nerve terminals and C-fiber nrve endings are stimulated by inflammatory mediators. Bi-directional communication between the nerves and mast cells may have important roles in allergic process. The psychological factors and conditioning of allergic reactions is suggested that mast cell activation might be partly regulated by the central nervous system via the peripheral nerves. Studies in animal models, in huamn airways in vitro and in patients with airway disease will uncover the interaction between allergic disease processes and psychologic factors or neural mechainsms.

• The Korean Journal of Pain
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• 제7권2호
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• pp.307-313
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• 1994

Cutaneous stimulation has had a long history as a method of pain control. While there is general agreement that modern techniques such as electrical stimulation and massage often provide relief from acute pain and may in some cases significantly affect chronic pain, the mechanism by which these techniques affect pain remain unclear. Significant attention has been focused on the effects of stimulation on the autonomic nervous system(ANS) along with the increasing evidence of important ANS modulation of nociceptive activity throughout the pain pathway. However, inconsistent results on the presence and direction of ANS changes from cutaneous stimulation characterize the recent literature. The present study investigated a non-electrical cutaneous stimulation device, the Dermapoints massage roller, as well as an active placebo massage. The results indicate that the Dermapoints massage roller has both general effects associated with simple skin stimulation (such as increased skin temperature), as well as specific effects from increased stimulation by the tooth design of the roller. These specific effects include decreased muscle tension (at least for some muscle sites) and increased sympathetic activation. The results are consistent with a model of activation of Pacinian receptors as a possible mechanism for the antinociceptive properties of cutaneous stimulation.

• Clinical and Experimental Pediatrics
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• 제52권7호
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• pp.752-755
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• 2009

It is well known that hemodynamic load is one of the most important determinants of cardiac structure and function. Circadian variations in blood pressure (BP) are usually accompanied by consensual changes in peripheral resistance and/or cardiac output. In recent years, reduction in circadian variations in BP and, in particular, loss of nocturnal decline of BP were observed in hypertensive patients with left ventricular hypertrophy (LVH). The patients with only a slight or no loss of nocturnal decline of BP were considered "non-dippers". Regression of LVH was observed after prolonged antihypertensive therapy. Restoration of the circadian rhythm of BP was also observed. However, the classification of patients into "dippers" and "non-dippers" is arbitrary and poorly standardized and repeatable, and in the recent studies, most hypertensive patients with LVH were "dippers". Therefore, we should be particularly cautious about the conclusions drawn using this index. On the other hand, reduced activity of low-pressure cardiopulmonary baroreceptors and impaired day-to-night modulation of autonomic nervous system activity were observed in patients with only LVH. Therefore, alterations in cardiac structure may impair BP modulation. On the other hand, the reverse can also be trueprimary alterations in BP modulation, through a persistently elevated afterload, can increase cardiac mass. Thus, the interrelationship between cardiac structure and BP modulation is complex. Hence, new and more specific methods of evaluating circadian changes in BP are needed to better clarify the abovementioned reciprocal influences.

• 생물정신의학
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• 제24권1호
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• pp.26-31
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• 2017

Objectives A normal circadian rhythm of autonomic nervous system function stands for the daily change of sympathetic and parasympathetic modulation, which can be measured by heart rate variability (HRV). Generally, patients in the intensive care unit (ICU) are prone to sleep-wake cycle dysregulation, therefore, it may have an influence on the circadian rhythm of autonomic nervous system. This study was designed to interpret possible dysregulation of autonomic nervous system in ICU patients by using HRV. Methods HRV was assessed every 3 hours in 21 ICU patients during a 7-minute period. The statistical differences of HRV features between the morning (AM 6 : 00-PM 12 : 00), and the afternoon (PM 12 : 00-PM 18 : 00) periods were evaluated in time domain and frequency domain. Results Patients showed significantly increased normalized power of low frequencey (nLF), absolute power of low frequencey (LF)/absolute power of high frequencey (HF) in the afternoon period as compared to the morning period. However, normalized power of high frequency (nHF) was significantly decreased in the afternoon period. There was no statistically significant difference between the morning period and the afternoon period in the time domain analysis. Conclusions The increased sympathetic tone in the afternoon period supports possible dysregulation in the circadian rhythm of autonomic nervous system in ICU patients. Future studies can help to interpret the association between autonomic dysregulation and negative outcomes of ICU patients.

• 대한감각통합치료학회지
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• 제1권1호
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• pp.61-72
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• 2003

The suck/swallow/breathe(SSB) synchrony, serving as the earlist primary motor mechanism, is the rhythmical, coordinated pattern of sucking, swallowing and breathing. The development of an intact SSB is an important precursor for further sensorimotor and cognitive development including speech and language development, state regulation, postural control, feeding, eye/hand coordination and social/emotional development. Arousal means a neurological mechanism for preparing one's body to orienting stimulus. Its levels are regulated with an interaction of the reticular formation, the limbic system, the hypothalamus and the autonomic nervous system. General strategies such as blowing, sucking, chewing, munching and licking to effectively modulate arousal state are related to SSB. The SSB synchrony is an important treatment principle for children with sensory integration disorder and problems with the modulation of arousal. The purpose of this article is to review concepts of SSB synchrony and the underlying relation between the modulation of arousal and SSB synchrony.