Stankus, Albinas

Aims: Autonomic regulation worsens after cardiac surgery (CS), but data about its dynamics are controversial. The aims of this study were to assess the dynamics of heart rate variability (HRV) parameters over two years after CS and to investigate if psychological factors were related to HRV score changes. Methods: HRV was evaluated in 75 CS patients (mean age - 59.4± 9.6 yrs, 73.3% males) at 1.5, 12, and 24 months after surgery. HRV parameters were measured using 5-minute ECG recordings at rest. We assessed RR intervals (NN), standard deviation of mean RR intervals (SDNN), the sympathetic activity index (LF/HF), and low (LFnu) and high (HFnu) frequency domains. For depression and distress measurement, depression and positive symptom distress (PSDI) scales of the Symptom Checklist-90-R (SCL-90R), were applied, and for alexithymia – the 20-item Toronto Alexithymia Scale (TAS-20) was used. At 24 months, the events of cardiac arrhythmias were recorded. Results: There were 30.7% (n=23) of patients with reduced NN, 72% (n=54) - with reduced SDNN, and 81.3% (n=61) - with increased LF/HF measures. The dynamics of the mean scores of all parameters was positive, but non-significant. At 24 months, the changes in mean scores were as follows: -23.0±152.0 (NNms), 0.1 (SDNN ms), -0.4±2.5 (LF/HF), - 3.9±20.2 (LFnu), and 3.0±17.0 (HFnu). The analyses have shown significant associations between PSDI and ΔNN (1.5-12 months); PSDI and ΔLF/HF (1.5-12 months); TAS-20 and ΔSDNN (1.5-12 months); TAS-20 and ΔLF/HF (1.5-12 months); TAS-20 and ΔLF/HF (1.5-24 months); TAS-20 and ΔLFnu (1.5-24 months); and depression and ΔLFnu (1.5-12 months). Cardiac arrhythmia events were observed in 6 patients, and the baseline SDNN and ΔSDNN (1.5-24 months) were significantly related to them (p=0.02, U=90.0, Z= - 2.3; p=0.04, U=100.5, Z= -2.1). Conclusion: CS patients demonstrated high sympathetic activity, and such states did not change significantly over two years after surgery ...

Aims: Altered autonomic regulation precipitates cardiac arrhythmias and increases the risk of cardiac death. It is known that depression is related with worsen course of cardiovascular diseases. Cardiac autonomic modulation (CAM) and depression were not investigated in cardiac surgery pts in Lithuania. Therefore the aim of this study was to research CAM and depression levels in pts after coronary artery bypass grafting (CABG) and after valve surgery (VS). Methods: Cardiac autonomic regulation and depression was evaluated in 80 CABG (mean age 60.0±7.9yrs, 75.0% male) and 48 VS pts (mean age 54.2±13.2 yrs, 66.7% male) at 1.5 month after surgery. Aims: Altered autonomic regulation precipitates cardiac arrhythmias and increases the risk of cardiac death. It is known that depression is related with worsen course of cardiovascular diseases. Cardiac autonomic modulation (CAM) and depression were not investigated in cardiac surgery pts in Lithuania. Therefore the aim of this study was to research CAM and depression levels in pts after coronary artery bypass grafting (CABG) and after valve surgery (VS). Methods: Cardiac autonomic regulation and depression was evaluated in 80 CABG (mean age 60.0±7.9yrs, 75.0% male) and 48 VS pts (mean age 54.2±13.2 yrs, 66.7% male) at 1.5 month after surgery. Heart rate variability (HRV) data were measured using short-term ECG 5-minute recordings at rest. There were assessed indices - RR intervals (NN), standard deviation of mean RR intervals (SDNN) and sympathetic activity index (LF/HF). SCL-90R was applied for depression measure. Data were analysed with the SPSS for Windows version 13.0 package. Results: Increased depression levels were achieved by 44(55%) pts after CABG and 24(50%) pts after VS. CABG pts have demonstrated low NN scores (19(23.8%)), low SDNN (57(71.3%)), high LF/HF (64(80.0%)). [...].

Background: To research if alexithymia, hostility, depression, anxiety, and distress are related to sympathetic activity according to the heart rate variability (HRV) parameters at rest and as responses to active orthostatic test (AOT) and to mental/arithmetic stress test (MST) in depressed post-cardiac surgery pts. Method: 74 post-cardiac surgery depressed pts (mean age 62.4±10.3 yrs, 67.6% male, SCL-90R depression subscale score N60 T) at 1.5 month after surgery filled in TAS-20 and SCL-90R questionnaire. HRV data were measured using short-termECG 5-minute recordings at rest, during AOT andMST. There was assessed heart rate (HR), standard deviation of RR intervals (SDNN), low frequency (LFnu) and high frequency (HFnu) components, and sympathetic activity index (LF/HF) at each period and the responses to AOT and to MST. Data were analysed with the SPSS for Windows version 13.0 statistical package (SPSS Inc., Chicago, II). Results: This study demonstrated, that TAS-20 was significantly related to LFnu during AOT (p=0.04, ß=0.280, 95%CI= 0.018- 0.757; F2: p=0.012, ß=0.260, 95%CI=0.328-2.543). Depression was associated with LFnu response to mental stress (p=0.015, ß=-0.295, 95%CI = -1.605 – [-0.175]), with HR at rest (p=0.005, ß=0.339, 95%CI=0.205-1.114), with HR during MST (p=0.014, ß=0.298, 95%CI=0.130-1.133), and with LF/HF during MST (p=0.028, ß=0.268, 95%CI = 0.009-0.163). It was estimated significant relationship between Anxiety and HR at rest (p=0.002, ß=0.254, 95%CI=0.02-0.706), between Anxiety and HR during AOT (p=0.038, ß=0.254, 95%CI=0.02-0.706). Global Severity Index was related to HR at rest (p=0.006, ß=0.333, 95%CI=0.125-0.715) and during MST (p=0.047, ß=0.243, 95%CI=0.004-0.664). Conclusion: The findings of this research suggest, that almost all investigated PRF for cardiovascular diseases are related to one or more sympathetic HRV parameters – LF power, HR or LF/HF in depressed pos[...].

The model for relation of depression from age, fatige, physical fitness and NYHA functional class was developed using data of 1180 CAD patients. The intercorrelation matrix for variables was used for calculation of weight coefficients demonstrating that the most important risk factors for depression are age, mental fatigue, and sleep quality. Physical fitness has negative relation. [...].

An independent randomly selected sample of 694 (35.3%) of them were males) citizens of Palanga, aged 35-74 were investigated/ Questioning and objective investigation were performed. A model based on binary logistic regression analysis was developed to determine the relative significance of sleep- quality assessed by PQI as a predictive variable according to sociodemographic and CAD risk factors. Depressive mood was chosen as a dependent variable. Poor sleep in males was predicted by depressive mood, headaches, use of hypnotics or general fatigue. Poor sleep in females was predicted by age, headaches, use of hypnotics or anxiety reducing drugs, genral or disease-specific fatigue. [...].

Objective: To examine CBT effectiveness on the changes in stress, quality of life (QOL) and heart rate variability (HRV) scores in older CS patients (pts). Methods: The CBT impact was analysed in CBT-1 (20 60 years old or more pts) and CBT-2 (23 younger than 60 years old pts) subgroups. It compared the findings with the ones in Control-1 (25 pts) and Control-2 (21 pts) subgroups. All patients were administered with SCL-90R, SF-36, and HRV investigations. Results: Global severity index has decreased in CBT-1 and CBT-2 subgroups, the between-group analysis did not show significant difference. There were no changes in SCL-90R subscales in both control subgroups. QOL has changed according to the seven out of nine subscales in CBT-1 and according to the four ones in CBT-2 subgroups. The between-group analysis did not demonstrate any significant differences between these subgroup results. There were no significant SF-36 changes in Control-1 subgroup, two of its subscales have shown significant changes in Control-2. The betweengroup analysis has shown the significant difference between CBT-1 and Control-1 subgroups in four SF-36 subscales. RR interval has changed in CBT-1 subgroup, it did not change in Control-1 subgroup, however the between-group analysis using change scores did not show the difference between these findings. Conclusions: The study shows the tendency of positive CBT impact on the psychosocial status of elderly CS pts, and these changes are similar to the ones found in younger patients. A larger study on the CBT impact on the HRV in CS pts is needed.

The general point of this study is an assessment of the carotid artery pulse wave characteristics and the relationships between its parameters, heart rate and blood pressure. In this experiment were recording changes in pulsation of the carotid artery by the local electroimpedance method for 5 min. Amplitudes of early (ESP) and late systolic peak (LSP) were separated in each pulse wave. We investigated 558 patients with IHD and 77 healthy subjects. The carotid artery pulse waveform in the HS and the IHD was distinctly different. In the healthy subjects, the amplitude of ESP was higher than LSP, and in the IHD patients LSP was higher than ESP. This situation is usually defined as an increase in vasomotor tonus. After analysis of the distribution of the parameters according to the heart rate, a general tendency was seen: when the heart rate was higher, the amplitude of the reflected wave was lower. An inverted relation exists between distolic pressure and variability of carotid artery amplitudes. [...].

The purpose of the sudy - to determine the degree of uncertainly or irregularity of heart rhythm transitions from one state to another. Clear in advance that the stability of the probabilities in the rows of the matrix depends on the number of RR-intervals involved in crossing the line. Therefore, the obtained values of entropy were weighed on the share of RR intervals. The paper presents the weighted value of the entropy and its dynamics depending on the number of levels. Introduction. Heart rate fluctuations show two types of variability: short-term and long-term. Most of the works in the study of circadian heart rate designed to estimate its dynamics and variability in the study of circadian heart rate designed to estimate its dynamics and variability in the four main frequency bands of heart rate regulation. Certain negative contribution to the distribution of the total variance in the frequency axis is influenced by uncertainty (chaos). Nowadays is often used Poincare mapping, which is visually monitoring heart rate values of one-step transitions to other values of the distribution [1]. Graphic image shows good values in non-stationary scattering. This one-step representation example is characterized by two quantities: the longitudinal and transverse dispersion. Other analysis tools are not applied. [...].

Heart rate (HR) and its variability (HRV) analysis based on spectral methods have been widely applied for assessment of autonomic nervous system activities. However, an observation of existing frequency dynamic in particular spectral bands of HRV, especially when analysis is done in short time RR interval series, is problematic using these methods. We used self-developed digital filters to solve this problem. The high-frequency (HF; 0.15-0.4 Hz) band of RR intervals is filtered with 3 finite (FIR) and 4 infinite imnpulse response (IIR) filters from original 24-hour HR record. We showed that the use of various filters for identification of respiration influence on HR. An analysis usingFIR filters gives more accurate results, but requires more calculation resources. No differences between results obtained using filtering and spectral analysis were observed. The use of FIR and IIR filters are simple and effective for processing of both, 24-hour data and short-time series of RR intervals. [...].