Nonlinear analysis of heart rhythm in preeclampsia: a route for translational clinical applications in neuroinflammation
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Preeclampsia is a pregnancy-specific condition which gets detected through hypertension and excessive protein excretion in urine. While preeclampsia used to be regarded as a self-limiting maternal condition which resolved with the delivery of the placenta, it is nowadays considered a complex and multifactorial disease that affects the offspring. Unfortunately, the etiology and pathophysiology of this multifaceted disorder remain elusive. Recent findings have confirmed that an altered maternal autonomic function may play a vital role in developing preeclampsia in conjunction with an imbalanced maternal immune system. Additionally, further evidence supports the crucial role of an exacerbated immune response driven by a non-infectious trigger during preeclampsia. Therefore, as a sterile inflammation, the elucidation of the neuroinflammatory mechanisms of preeclampsia warrants obtaining relevant knowledge suitable for translational clinical applications.Heart rate variability (HRV) is an affordable and non-invasive method for indirectly assessing the autonomic nervous system and the cholinergic anti-inflammatory pathway (CAP). Notably, the nonlinear analysis of HRV offers novel indexes to explore the neuroimmune interactions in diverse preclinical and clinical settings of inflammation. Given that the dynamics of HRV is nonlinear in health, we hypothesized that a neuroinflammatory condition in preeclampsia might be associated with changes in nonlinear features of maternal and fetal HRV. Thus, the present review aims to present evidence of the potential changes in maternal-fetal HRV associated with neuroinflammatory modifications in preeclamptic women. We considered that there is still a need for assessing the nonlinear features of maternal and fetal HRV as complementary biomarkers of inflammation in this population in future studies, being a potential route for translational clinical applications.
Abstract
Preeclampsia is a pregnancy-specific condition which gets detected through hypertension and excessive protein excretion in urine. While preeclampsia used to be regarded as a self-limiting maternal condition which resolved with the delivery of the placenta, it is nowadays considered a complex and multifactorial disease that affects the offspring. Unfortunately, the etiology and pathophysiology of this multifaceted disorder remain elusive. Recent findings have confirmed that an altered maternal autonomic function may play a vital role in developing preeclampsia in conjunction with an imbalanced maternal immune system. Additionally, further evidence supports the crucial role of an exacerbated immune response driven by a non-infectious trigger during preeclampsia. Therefore, as a sterile inflammation, the elucidation of the neuroinflammatory mechanisms of preeclampsia warrants obtaining relevant knowledge suitable for translational clinical applications.Heart rate variability (HRV) is an affordable and non-invasive method for indirectly assessing the autonomic nervous system and the cholinergic anti-inflammatory pathway (CAP). Notably, the nonlinear analysis of HRV offers novel indexes to explore the neuroimmune interactions in diverse preclinical and clinical settings of inflammation. Given that the dynamics of HRV is nonlinear in health, we hypothesized that a neuroinflammatory condition in preeclampsia might be associated with changes in nonlinear features of maternal and fetal HRV. Thus, the present review aims to present evidence of the potential changes in maternal-fetal HRV associated with neuroinflammatory modifications in preeclamptic women. We considered that there is still a need for assessing the nonlinear features of maternal and fetal HRV as complementary biomarkers of inflammation in this population in future studies, being a potential route for translational clinical applications.
참고문헌 (72)
- Cornelius DC, "Preeclampsia : from inflammation to immunoregulation", Clin Med Insights Blood Disord, 11, pp.1179545~ (2018)
- Malik A, "Preeclampsia : disease biology and burden, its management strategies with reference to India", Pregnancy Hypertens, 15, pp.23~31 (2019)
- William R, "A new era in global health: nursing and the United Nations 2030 agenda for sustainable development", pp.519~567 (2018), Springer Publishing Company
- "Health in 2015: from MDGs to SDGs" (2015)[URL]
- "Maternal mortality ratio (modeled estimate, per 100,000 live births)" (2015)[URL]
- Singla A, "A ten year audit of maternal mortality : millennium development still a distant goal", Indian J Community Med, 42, pp.102~106 (2017)
- Alimohamadi Y, "Human development index, maternal mortality rate and under 5 years mortality rate in west and south Asian countries, 1980-2010 : an ecological study", East Mediterr Health J, 25, pp.189~196 (2019)
- Pennington KA, "Preeclampsia : multiple approaches for a multifactorial disease", Dis Model Mech, 5, pp.9~18 (2012)
- Chaswal M, "Heart rate variability and cardiovascular reflex tests for assessment of autonomic functions in preeclampsia", Int J Hypertens, 2018, pp.8163824~ (2018)
- Vianna P, "Distress conditions during pregnancy may lead to pre-eclampsia by increasing cortisol levels and altering lymphocyte sensitivity to glucocorticoids", Med Hypotheses, 77, pp.188~191 (2011)
- George EM, "New approaches for managing preeclampsia : clues from clinical and basic research", Clin Ther, 36, pp.1873~1881 (2014)
- Yousif D, "Autonomic dysfunction in preeclampsia : a systematic review", Front Neurol, 10, pp.816~ (2019)
- Harmon AC, "The role of inflammation in the pathology of preeclampsia", Clin Sci(Lond), 130, pp.409~419 (2016)
- Ma Y, "Immune imbalance is associated with the development of preeclampsia", Medicine(Baltimore), 98, pp.e15080~ (2019)
- Matthiesen L, "Immunology of preeclampsia", Chem Immunol Allergy, 89, pp.49~61 (2005)
- Nutma E, "Neuroimmunology : the past, present and future", Clin Exp Immunol, 197, pp.278~293 (2019)
- Williams DP, "Heart rate variability and inflammation : a meta-analysis of human studies", Brain Behav Immun, 80, pp.219~226 (2019)
- Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology, "Heart rate variability: standards of measurement, physiological interpretation, and clinical use", Eur Heart J, 17, pp.354~381 (1996)
- Huston JM, "The pulse of inflammation : heart rate variability, the cholinergic anti-inflammatory pathway and implications for therapy", J Intern Med, 269, pp.45~53 (2011)
- Barizien N, "Clinical characterization of dysautonomia in long COVID-19 patients", Sci Rep, 11, pp.14042~ (2021)
- Papaioannou V, "Association of heart rate variability and inflammatory response in patients with cardiovascular diseases : current strengths and limitations", Front Physiol, 4, pp.174~ (2013)
- Carney RM, "Heart rate variability and markers of inflammation and coagulation in depressed patients with coronary heart disease", J Psychosom Res, 62, pp.463~467 (2007)
- Papaioannou V, "Heart rate variability : a potential tool for monitoring immunomodulatory effects of parenteral fish oil feeding in patients with sepsis", Nutr Metab Insights, 12, pp.1178638819847486~ (2019)
- Aeschbacher S, "Heart rate, heart rate variability and inflammatory biomarkers among young and healthy adults", Ann Med, 49, pp.32~41 (2017)
- Tonhajzerova I, "Vagal function indexed by respiratory sinus arrhythmia and cholinergic anti-inflammatory pathway", Respir Physiol Neurobiol, 187, pp.78~81 (2013)
- Eftekhari G, "Heart rate variability, vagal activity and the pulse of inflammation", J Intern Med, 274, pp.490~491 (2013)
- Cooper TM, "Heart rate variability predicts levels of inflammatory markers : evidence for the vagal anti-inflammatory pathway", Brain Behav Immun, 49, pp.94~100 (2015)
- Garzoni L, "Fetal cholinergic anti-inflammatory pathway and necrotizing enterocolitis : the brain-gut connection begins in utero", Front Integr Neurosci, 7, pp.57~ (2013)
- Mazloom R, "The role of α7 nicotinic acetylcholine receptor in modulation of heart rate dynamics in endotoxemic rats", PLoS One, 8, pp.e82251~ (2013)
- Voss A, "Short-term vs long-term heart rate variability in ischemic cardiomyopathy risk stratification", Front Physiol, 4, pp.364~ (2013)
- Spasić SZ, "Editorial : nonlinearity in living systems : theoretical and practical perspectives on metrics of physiological signal complexity", Front Physiol, 10, pp.298~ (2019)
- Cornelius DC, "Inflammatory mediators : a causal link to hypertension during preeclampsia", Br J Pharmacol, 176, pp.1914~1921 (2019)
- Aggarwal R, "Association of pro-and anti-inflammatory cytokines in preeclampsia", J Clin Lab Anal, 33, pp.e22834~ (2019)
- Nunes PR, "Downregulation of CD163 in monocytes and its soluble form in the plasma is associated with a pro-inflammatory profile in pregnant women with preeclampsia", Immunol Res, 67, pp.194~201 (2019)
- Daneva AM, "Correlation of the system of cytokines in moderate and severe preeclampsia", Clin Exp Obstet Gynecol, 43, pp.220~224 (2016)
- Gadonski G, "Hypertension produced by reductions in uterine perfusion in the pregnant rat : role of interleukin 6", Hypertension, 48, pp.711~716 (2006)
- Conrad KP, "Circulating levels of immunoreactive cytokines in women with preeclampsia", Am J Reprod Immunol, 40, pp.102~111 (1998)
- Žák P, "Correlation of tumor necrosis factor alpha, interleukin 6and interleukin 10 with blood pressure, risk of preeclampsia and low birth weight in gestational diabetes", Physiol Res, 68, pp.395~408 (2019)
- Fodor P, "Inflammation : the role of ATP in pre-eclampsia", Microcirculation, 27, pp.e12585~ (2020)
- Yang CC, "Preeclamptic pregnancy is associated with increased sympathetic and decreased parasympathetic control of HR", Am J Physiol Heart Circ Physiol, 278, pp.H1269~H1273 (2000)
- Perucci LO, "Resolution of inflammation pathways in preeclampsia : a narrative review", Immunol Res, 65, pp.774~789 (2017)
- Xu H, "Downregulation of α7 nicotinic acetylcholine receptors in peripheral blood monocytes is associated with enhanced inflammation in preeclampsia", BMC Pregnancy Childbirth, 19, pp.188~ (2019)
- Piovesana R, "Cholinergic modulation of neuroinflammation : focus on α7 nicotinic receptor", Int J Mol Sci, 22, pp.4912~ (2021)
- Liu Y, "Activation of the cholinergic anti-inflammatory pathway by nicotine ameliorates lipopolysaccharideinduced preeclampsia-like symptoms in pregnant rats", Placenta, 49, pp.23~32 (2017)
- Martelli D, "Anti-inflammatory reflex action of splanchnic sympathetic nerves is distributed across abdominal organs", Am J Phys Regul Integr Comp Phys, 316, pp.R235~R242 (2019)
- Reyes LM, "Preeclampsia is not associated with elevated muscle sympathetic reactivity", J Appl Physiol(1985), 130, pp.139~148 (2021)
- Prins JR, "Microglia, the missing link in maternal immune activation and fetal neurodevelopment; and a possible link in preeclampsia and disturbed neurodevelopment?", J Reprod Immunol, 126, pp.18~22 (2018)
- Canga L, "Non-linear analysis of heart rate variability and its application to predict hypotension during spinal anesthesia for cesarean delivery", Comput Cardiol(2010), 39, pp.413~416 (2012)
- Schumacher A, "Linear and nonlinear approaches to the analysis of R-R interval variability", Biol Res Nurs, 5, pp.211~221 (2004)
- Henriques T, "Nonlinear methods most applied to heart-rate time series : a review", Entropy(Basel), 22, pp.309~ (2020)
- Nikolic VN, "An inverse correlation between TNF alpha serum levels and heart rate variability in patients with heart failure", J Cardiol, 62, pp.37~43 (2013)
- Reyes-Lagos JJ, "Symbolic analysis of heart rate fluctuations identifies cardiac autonomic modifications during LPS-induced endotoxemia", Auton Neurosci, 221, pp.102577~ (2019)
- Elorza-Ávila AR, "Oxytocin’s role on the cardiorespiratory activity of endotoxemic rats", Respir Physiol Neurobiol, 236, pp.19~22 (2017)
- Reyes-Lagos JJ, "Exogenous oxytocin reduces signs of sickness behavior and modifies heart rate fluctuations of endotoxemic rats", Physiol Behav, 165, pp.223~230 (2016)
- Reyes-Lagos JJ, "Neuroautonomic activity evidences parturition as a complex and integrated neuro-immune-endocrine process", Ann N Y Acad Sci, 1437, pp.22~30 (2019)
- Davis EF, "Pre-eclampsia and offspring cardiovascular health : mechanistic insights from experimental studies", Clin Sci(Lond), 123, pp.53~72 (2012)
- Faber R, "Baroreflex sensitivity, heart rate, and blood pressure variability in hypertensive pregnancy disorders", J Hum Hypertens, 18, pp.707~712 (2004)
- Moors S, "Heart rate variability in hypertensive pregnancy disorders : a systematic review", Pregnancy Hypertens, 20, pp.56~68 (2020)
- Francesco B, "Linear and nonlinear heart rate variability indexes in clinical practice", Comput Math Methods Med, 2012, pp.219080~ (2012)
- Abuiessa SA, "Preeclamptic fetal programming alters neuroinflammatory and cardiovascular consequences of endotoxemia in sex-specific manners", J Pharmacol Exp Ther, 373, pp.325~336 (2020)
- Speranza RJ, "1023: autonomic regulation of maternal heart rate variability in preeclampsia", Am J Obstet Gynecol, 220(1 Suppl), pp.S657~ (2019)
- Lakhno I, "Autonomic imbalance captures maternal and fetal circulatory response to pre-eclampsia", Clin Hypertens, 23, pp.5~ (2017)
- Hoyer D, "Monitoring fetal maturation-objectives, techniques and indices of autonomic function", Physiol Meas, 38, pp.R61~88 (2017)
- Hossen A, "Identification of patients with preeclampsia from normal subjects using wavelet-based spectral analysis of heart rate variability", Technol Health Care, 25, pp.641~649 (2017)
- Musa SM, "Heart rate variability and autonomic modulations in preeclampsia", PLoS One, 11, pp.e0152704~ (2016)
- Lakhno I, "The impact of preeclampsia on fetal ECG morphology and heart rate variability", Arch Perinat Med, 20, pp.7~10 (2014)
- Fiskum C, "Nonlinear heart rate variability as a discriminator of internalizing psychopathology and negative affect in children with internalizing problems and healthy controls", Front Physiol, 9, pp.561~ (2018)
- ScheffJD, "Complex systems and computational biology approaches to acute inflammation", pp.125~141 (2013), Springer
- Leistedt SJ, "Decreased neuroautonomic complexity in men during an acute major depressive episode : analysis of heart rate dynamics", Transl Psychiatry, 1, pp.e27~ (2011)
- Herlitz GN, "Physiologic variability at the verge of systemic inflammation : multiscale entropy of heart rate variability is affected by very low doses of endotoxin", Shock, 43, pp.133~139 (2015)
- Tejera E, "Network centrality and multiscale transition asymmetry in the heart rate variability analysis of normal and preeclamptic pregnancies", Commun Nonlinear Sci Numer Simul, 16, pp.1589~1596 (2011)
- de Godoy MF, "Nonlinear analysis of heart rate variability : a comprehensive review", J Cardiol Ther, 3, pp.528~533 (2016)