Dataset Information

Autonomic nervous system dysregulation in response to postural change in patients with pectus excavatum in Taiwan: a pilot study.

ABSTRACT:

Background

Pectus excavatum (PE) negatively impacts psychological function, but its effect on autonomic nervous system (ANS) function has not been investigated. We evaluated ANS function following postural changes in patients with PE.

Methods

The participants were 14 healthy men (control group) and 20 men with PE (study group). Psychological function was assessed using the visual analog scale for pain, Brief Symptom Rating Scale-5, and Beck Depression Inventory-II. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). ANS regulation in response to postural change was measured in the supine position and immediately after sitting. All measurements were compared between the control and study groups at baseline and between the study groups before and after Nuss surgery.

Results

At baseline, upon postural change, symptomatic activity increased in the control group (50.3-67.4%, p = 0.035) but not in the study group (55.0-54.9%, p = 0.654); parasympathetic activity decreased in the control group (49.7-32.6%, p = 0.035) but not in the study group (45.1-45.1%, p = 0.654); and overall ANS regulation increased in the control group (1.02-2.08, p = 0.030) but not in the study group (1.22-1.22, p = 0.322). In response to postural change after Nuss surgery in the study group, sympathetic activity increased (48.7-70.2%, p = 0.005), parasympathetic activity decreased (51.3-29.8%, p = 0.005), and overall ANS regulation increased (0.95-2.36, p = 0.012).

Conclusion

ANS function in response to postural change is dysregulated in patients with PE, which improved after Nuss surgery. Trial registration ClinicalTrials.gov, ID: NCT03346876, November 15, 2017, retrospectively registered, https://register.

Clinicaltrials

gov/prs/app/action/SelectProtocol?sid=S0007KGI&selectaction=Edit&uid=U0003JZU&ts=2&cx=cstxeg.

SUBMITTER: Hsu YT

PROVIDER: S-EPMC9066713 | biostudies-literature | 2022 May

REPOSITORIES: biostudies-literature

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Publications

Autonomic nervous system dysregulation in response to postural change in patients with pectus excavatum in Taiwan: a pilot study.

Hsu Yu-Ting YT Cheng Yeung-Leung YL Chang Yi-Wei YW Lan Chou-Chin CC Wu Yao-Kuang YK Yang Mei-Chen MC

Journal of cardiothoracic surgery 20220503 1

<h4>Background</h4>Pectus excavatum (PE) negatively impacts psychological function, but its effect on autonomic nervous system (ANS) function has not been investigated. We evaluated ANS function following postural changes in patients with PE.<h4>Methods</h4>The participants were 14 healthy men (control group) and 20 men with PE (study group). Psychological function was assessed using the visual analog scale for pain, Brief Symptom Rating Scale-5, and Beck Depression Inventory-II. Sleep quality w ...[more]

PMID: 35505418

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Project description:Chagas disease (CD) induces autonomic dysfunction and inflammatory activity, which may promote metabolic abnormalities. We studied metabolism and his correlation with Autonomic Nervous System (ANS) and inflammation in CD.Sixty subjects were divided into 4 groups: control group (CG), IF (indeterminate form) group; ECG group (ECG abnormalities and normal left ventricular systolic function), and LVD group (left ventricular sistolic dysfunction). Levels of adiponectin, leptin, insulin, interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) were assayed in serum samples by ELISA. ANS was assessed by heart rate variability in frequency domain in 24-hour Holter and postural tilt test (rest and orthostatic position). High frequency (HFr) component values were used to estimate parasympathetic activity and low frequency (LFr) component, sympathetic activity. Analyzes were made of the correlations of each of the metabolic parameters (leptin and adiponectin) with the inflammatory cytokines (interleukin-6 and TNF- alpha) and with the ANS assessment measurements. No significant differences were observed in leptin and insulin levels. Adiponectin was higher in ECG and LVD groups: [CG = 4766.5 (5529.5), IF = 4003.5 (2482.5), ECG = 8376.5 (8388.5), LVD = 8798 (4188.0) ng/mL, p<0.001)]. IL-6 and TNF-alpha were higher in LVD group: [IL-6: CG = 1.85 (6.41); IF = 1.58 (1.91); ECG = 1.0 (1.57); LVD= 31.44 (72.19) pg/ml; p = 0.001. TNF-alpha: CG = 22.57 (88.2); IF = 19.31 (33.16); ECG = 12.45 (3.07); LVD = 75.15 (278.57) pg/ml; p = 0.04]. Adiponectin levels had a positive association with the HFr component (r = 0.539; p = 0.038) and an inverse association with the LFr component (r = - 0.539; p = 0.038) in ECG group. Leptin levels had a negative association with the HFr component (r= - 0.632; p = 0.011) and a positive association with the LFr component (r = 0.632; p = 0.011) in LVD group.We found increased adiponectin levels in Chagas' heart disease with systolic dysfunction and in patients with ECG abnormalities and normal systolic function at rest. Adipocytokines levels (adiponectin and leptin) were associated with ANS parameters in Chagas' heart disease.

Project description:IntroductionHow cardiorespiratory function changes following the surgical correction of pectus excavatum (PE) often gives mixed results, with meta-analyses demonstrating no benefit in terms of pulmonary function but improvement in cardiac function. Functional responses may depend on type of surgery, follow-up time and/or the patient's presurgical functional status, and debate persists on the purely aesthetic nature of such surgery. The aim of this protocol is to analyse data describing lung function and incremental exercise testing before vs after the surgical correction of PE.Methods and analysisA historical-prospective before-after surgical correction of PE cohort will be constituted. Historical inclusions are recruited during follow-up visits at approximately 12, 24, 36 or 48 months following a prior surgery (with presurgical data mined from patient records). Prospective inclusions are recruited during presurgical work-ups and followed for 1 year following surgery. The data collected include spirometry, incremental exercise testing, body mass index, body composition, questionnaires targeting general health status, self-esteem and body image. Any complications due to surgery are also described.The primary outcome is oxygen pulse during incremental exercise testing, and 44 data points are required to demonstrate a moderate postsurgical change (ie, a Cohen's effect of d=0.5). Wilcoxon signed-rank tests or t-tests for paired data will be used for before-after comparisons (with false discovery rate corrections for secondary analyses).Ethics and disseminationThis study will be conducted according to the principles of the Declaration of Helsinki (as revised in 2013) and was approved by a randomly assigned, independent, ethics committee (Comité de Protection des Personnes Sud-Méditerranée II, reference number: 218 B21) as per French law on 6 July 2018. Informed, written consent for study participation is required of all study candidates prior to enrolment. Results will be published in an international peer-reviewed journal.Trial registration numberNCT03770390; Clinicaltrials.gov.

Dataset Information

Autonomic nervous system dysregulation in response to postural change in patients with pectus excavatum in Taiwan: a pilot study.

Background

Methods

Results

Conclusion

Clinicaltrials

Publications

Autonomic nervous system dysregulation in response to postural change in patients with pectus excavatum in Taiwan: a pilot study.

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