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Effect of Hyperventilation on Periodic Repolarization Dynamics.

Dominik Schüttler1,2,3, Lukas von Stülpnagel1,4, Konstantinos D Rizas1,2

  • 1Medizinische Klinik und Poliklinik I, University Hospital Munich, Ludwig-Maximilians University Munich (LMU), Munich, Germany.

Frontiers in Physiology
|October 12, 2020
PubMed
Summary
This summary is machine-generated.

Hyperventilation significantly increases sympathetic activity, as measured by periodic repolarization dynamics (PRD) and T wave vector changes (dT°). This study shows PRD is a reliable indicator of autonomic nervous system response during cardiorespiratory coupling.

Keywords:
T wave vectorautonomic functionhyperventilationperiodic repolarization dynamicsrepolarization instabilitysympathetic nervous system

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Area of Science:

  • Cardiology
  • Autonomic Neuroscience
  • Physiology

Background:

  • Cardiorespiratory coupling is modulated by the autonomic nervous system, with hyperventilation known to activate the sympathetic branch.
  • Assessing autonomic activity within cardiorespiratory coupling remains challenging.
  • Periodic repolarization dynamics (PRD), an ECG-based biomarker, reflects cardiac sympathetic activity's impact on ventricular myocardium via T wave vector (dT°) variations.

Purpose of the Study:

  • To investigate the effects of a standardized hyperventilation maneuver on PRD and its underlying dT° signal in healthy subjects.
  • To explore PRD as a potential method for assessing autonomic activity in cardiorespiratory coupling.

Main Methods:

  • A standardized hyperventilation maneuver was performed on 11 healthy subjects.
  • Electrocardiogram (ECG) was used to measure beat-to-beat variations of the T wave vector (dT°).
  • Periodic repolarization dynamics (PRD) were calculated based on dT° variations.

Main Results:

  • Hyperventilation led to a characteristic pattern in dT°, with normalized dT° values significantly increasing compared to baseline and recovery.
  • PRD values were significantly increased after hyperventilation compared to baseline.
  • The observed increase in PRD was independent of heart rate changes.

Conclusions:

  • Hyperventilation induces significant changes in T wave vector dynamics and increases periodic repolarization dynamics, indicating heightened sympathetic activity.
  • PRD emerges as a promising biomarker for assessing sympathetic activity associated with repolarization instability during cardiorespiratory interactions.
  • These findings offer valuable insights into the physiological responses to hyperventilation and its impact on autonomic control of the heart.