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Publications with CNSystems’ Task Force Monitor
Contents:
1.) Applications in Psychophysiology / Mental Health
2.) General Physiology
3.) Applications in Sports / Health Sciences
4.) Syncope / Tilt testing
5.) Neurology
6.) Pacemaker Optimization
1.) Applications in Psychophysiology / Mental Health
Hemodynamic abnormalities have been documented in a wide variety of psycho-physiologic conditions, indicating functional disturbances of the autonomic
nervous system responsible for cardiovascular control. Selected papers are gathered in fields of applications.
Depressive disorder / Anxiety
Author
Bajkó et al.
Year
2012
Vasudev et al.
2011
&
2012
Koschke et al.
2009
Berger et al.
2011
Title / Journal
Anxiety, depression and autonomic nervous
system dysfunction in hypertension / Journal of
the Neurological Sciences
A study of orthostatic hypotension, heart rate
variability and baroreflex sensitivity in late-life
depression / Journal of Affective Disorders //
Relationship Between Cognition, Magnetic
Resonance White Matter Hyperintensities, and
Cardiovascular Autonomic Changes in Late-Life
Depression / The American journal of geriatric
psychiatry
Autonomy of autonomic dysfunction in major
depression / Psychosomatic Medicine
No. of Pts.
86
hypertensive
+ 98 healthy
42 + 31
controls,
> 60 years
Results
Trait anxiety scores significantly correlate with sympatho/vagal
balance in passive tilt position. Anxiety could play a role in the
development of hypertension.
Depressed participants had lower low frequency heart rate
variability and lower baroreflex sensitivity than healthy controls.
75 + 75
controls
Autonomic modulation in healthy first-degree
relatives of patients with major depressive
disorder / Progress in NeuroPsychopharmacology & Biological Psychiatry
30 MDD & 30
relatives + 30
controls
Depressed patients: overall shift of autonomic balance towards
sympathetic predominance as compared with matched controls;
decrease in parasympathetic parameters and baroreflex
sensitivity
Genetic background for autonomic dysfunction (major
depressive disorder) is rather unlikely.
Selected publications with CNSystems’ Task Force Monitor
Date: 08.2014
1/10
Mental stress / Meditation
Author
Lackner et al.
Year
2013
Title / Journal
I got it! Transient Cardiovascular Response to
the Perception of Humor / Biological Psychology
No. of Pts.
56
Paine et al.
2013
Eccentric-exercise induced inflammation
attenuates the vascular responses to mental
stress / Brain, Behavior, and Immunity
18
Nesvold et al.
2012
Increased heart rate variability during
nondirective meditation / European Journal of
Preventive Cardiology
27
Lache et al.
2007
Social support predicts hemodynamic recovery
from mental stress in patients with implanted
defibrillators / Journal of Psychosomatic
Research
55 (ICD)
Results
Cardiovascular response to the perception of humor: detection
of punch line was accompanied by relative heart rate
acceleration and increased cardiac output (higher CO if more
amusing cartoon).
Mental stress increased blood pressure, heart rate and cardiac
output in eccentric-exercise induced inflammation attenuates
and controls. Only local moderation of the vascular responses to
mental stress.
Increased parasympathetic and reduced sympathetic nerve
activity and increased overall heart rate variability during
meditation  nondirective meditation may contribute to a
reduction of cardiovascular risk.
Social support is a predictor of cardiovascular recovery from
mental stress in patients with implanted cardioverterdefibrillators (ICD).
Chronic fatigue syndrome (CFS)
Author
Sullheim et al.
Year
2014
Frith et al.
2012
Wyller et al.
2007
Newton et al.
2007
Title / Journal
Disease Mechanisms and Clonidine Treatment in
Adolescent Chronic Fatigue Syndrome: A
Combined Cross-sectional and Randomized
Clinical Trial/ JAMA Pediatrics
Impaired blood pressure variability in chronic
fatigue syndrome--a potential biomarker / QJM :
monthly journal of the Association of Physicians
Sympathetic predominance of cardiovascular
regulation during mild orthostatic stress in
adolescents with chronic fatigue / Clin Physiol
Funct Imaging
No. of Pts.
120 CFS + 68
controls
Results
Adolescent CFS is associated with enhanced sympathetic
nervous activity and large activity reduction.
68 CFS + 68
controls
Abnormalities of blood pressure variability in CFS patients.
27 CFS + 33
controls
Symptoms of autonomic dysfunction in chronic
fatigue syndrome / QJM : Monthly Journal of
the Association of Physicians
40 CFS + 40
controls
Adolescents with CFS have sympathetic predominance of
cardiovascular regulation during very mild orthostatic stress:
increased LF⁄HF ratio, increased normalized LF power of RRinterval and BPV and decreased normalized HF power of RRinterval.
Autonomic dysfunction is associated with chronic fatigue
syndrome (CFS).
Selected publications with CNSystems’ Task Force Monitor
Date: 08.2014
2/10
Schizophrenia
Author
Bär et al.
Year
2007
2007
2007
2010
Title / Journal
Decreased baroreflex sensitivity in acute
schizophrenia / Journal of applied physiology //
Acute psychosis leads to increased QT variability
in patients suffering from schizophrenia /
Schizophrenia research // Non-linear complexity
measures of heart rate variability in acute
schizophrenia / Clinical neurophysiology //
Autonomic dysfunction in unaffected firstdegree relatives of patients suffering from
schizophrenia / Schizophrenia bulletin
No. of Pts.
21 + 21
controls
Title / Journal
Reduced baroreflex sensitivity in acute alcohol
withdrawal syndrome and in abstained
alcoholics / Drug and Acohol Dependence
// Increased QT interval variability index in
acute alcohol withdrawal / Drug and Acohol
Dependence
No. of Pts.
20;
Impaired cerebral autoregulation during acute
alcohol withdrawal / Endothelial dysfunction
during acute alcohol withdrawal syndrome /
Drug and Alcohol Dependence
20;
Impaired cerebral autoregulation during AAW.
30 + 30
Endothelial dysfunction in patients during AAW.
25 + 25
20
Results
Cardiac autonomic dysfunction in patients with acute
schizophrenia: reduction of baroreflex sensitivity accompanied
by tachycardia, greatly increased left ventricular work index and
decreased vagal activity.
First-degree relatives showed similar pattern than patients in QT
variability, decreased baroreflex sensitivity
36 relatives
Acute alcohol withdrawal
Author
Bär et al.
Jochum et al.
Year
2006 &
2007
2010 &
2011
Selected publications with CNSystems’ Task Force Monitor
Date: 08.2014
18 + 18
controls + 15
abstinent
Results
Significant reduction of baroreflex sensitivity during acute
alcohol withdrawal (AAW) and in long-term abstained subjects.
The left ventricular work index (LVWI) was positively correlated
with more severe alcohol withdrawal under treatment, which
indicates higher cardiac work.
Heart rate and QT variability were significantly increased in AAW
 may explain increased incidence of sudden cardiac death
3/10
Anorexia nervosa
Author
Koschke et al.
Year
2010
Title / Journal
Increased QT variability in patients with anorexia
nervosa--an indicator for increased cardiac
mortality? / The International Journal of Eating
Disorders
No. of Pts.
20 + 20
controls
Results
An increase in QT variability might, at least in part, account for
the higher risk of cardiac arrhythmias in patients with anorexia
nervosa.
No. of Pts.
35 + 29
controls
Results
Patients exhibited lower power in all heart rate variability
frequency bands, lower baroreflex sensitivity, reduced stroke
volume, left ventricular ejection time, and R-R interval.
Fibromyalgia syndrome (FMS)
Author
Reyes del Paso
et al.
Year
2010
2011
Title / Journal
Aberrances in autonomic cardiovascular
regulation in fibromyalgia syndrome and their
relevance for clinical pain reports /
Psychosomatic Medicine // Autonomic
cardiovascular control and responses to
experimental pain stimulation in fibromyalgia
syndrome /
Journal of Psychosomatic Research
Selected publications with CNSystems’ Task Force Monitor
Date: 08.2014
4/10
2.) General Physiology
Several scientific studies demonstrated the great potential for the use of CNSystems’ devices in general physiology.
Stimulation through cold, heat, water drinking
Author
Zalewski et al.
Year
2013
Title / Journal
Thermal and hemodynamic response to whole-body
cryostimulation in healthy subjects / Cryobiology
No. of Pts.
30
Lee et al.
2013
20
Brown et al.
2005
The magnitude of heat stress-induced reductions in
cerebral perfusion does not predict heat stressinduced reductions in tolerance to a simulated
hemorrhage / Journal of Applied Physiology
Cardiovascular responses to water drinking: does
osmolality play a role? / American Journal of
Physiology - Regulatory, Integrative and
Comparative Physiology.
Title / Journal
Investigation of autonomic function in idiopathic
REM sleep behavior disorder / Journal of
Neurology
Measurement of endogenous acetone and isoprene
in exhaled breath during sleep / Physiological
Measurement
No. of Pts.
15 + 15 +
15
Results
Autonomic dysfunction is present in subjects with idiopathic
REM sleep behavior disorder.
6
Steadily increasing breath concentrations were shown in the
case of acetone and isolated but pronounced concentration
peaks throughout the night where shown in the case of isoprene.
Title / Journal
Influence of somatic state on cardiovascular
measurements in pregnancy / Physiological
Measurement
No. of Pts.
28
Results
The longitudinal study shows that cardiovascular function in
pregnant women is best quantified during supine-to-standing
manoevre.
9
Results
A significant decrease in baroreceptor sensitivity (BRS)
occurred within several hours after WBC exposure (-120°C for
3min), and might be a risk factor for subjects with primarily
reduced baroreceptor sensitivity.
The magnitude of reduction in cerebral perfusion during heat
stress is not related to the reduction in tolerance to a lower
body negative pressure (LBNP) challenge.
(CNAP with Biopac system)
Water drinking simultaneously increases simultaneous
sympathetic and vagal activation: decreased HR, increased
TPR, HRV-HF & BRS. Effects were absent after drinking saline
solutions.
Sleep studies
Author
Frauscher et al.
Year
2012
King et al.
2012
Pregnancy
Author
A D’Silva et al.
Year
2014
Selected publications with CNSystems’ Task Force Monitor
Date: 08.2014
5/10
3.) Applications in Sports / Health Sciences
Many studies report the usefulness of assessing continuous hemodynamic parameters in the context of sports sciences. CNSystems products can be used
either during exercise (e.g. treadmill testing) or as pre- and post-exercise check-up test (e.g. orthostatic test). Selected papers are gathered in fields of sports
applications.
Treadmill Testing: Running / Cycle Ergometer
Author
Buchheit et al.
Year
2011
Sharman et al.
2008
Title / Journal
Effect of maturation on hemodynamic and
autonomic control recovery following maximal
running exercise in highly trained young soccer
players / Frontiers in Physiology
Nitric oxide does not significantly contribute to
changes in pulse pressure amplification during light
aerobic exercise / Hypertension
No. of Pts.
55
Results
Maturation of soccer players had little influence on the
hemodynamic and autonomic responses following maximal
running exercise on a treadmill.
12
Heart rate, peripheral vascular resistance, and cardiac output did
not differ between different drug infusions during exercise on a
cycle ergometer.
No. of Pts.
86
Results
After ultra-endurance exercise a great decline in systolic function
was found. The phenomenon of cardiac fatigue in response to
prolonged exercise was confirmed.
51
After fast marathon performance low basal sympathetic drive,
enhanced vasodilatation and preserved cardiac performance as
found.
27
The 0.05 to 0.17-Hz band of diastolic blood pressure variability
were related to Ironman-Triathlon competition time
31
Endurance exercise training leads to an improvement of
symptoms in patients with orthostatic intolerance.
Endurance Training / Marathon / Triathlon
Author
Ashley et al.
Year
2006
Gratze et al.
2008
Gratze et al.
2005
Winker et al.
2005
Title / Journal
Angiotensin-converting enzyme genotype predicts
cardiac and autonomic responses to prolonged
exercise / Journal of the American College of
Cardiology
Sympathetic reserve , serum potassium and
orthostatic intolerance after endurance exercise
and implications for neurocardiogenic syncope /
European Heart Journal
Hemodynamic and autonomic changes induced by
Ironman: prediction of competition time by blood
pressure variability / Journal of Applied Physiology
Endurance exercise training in orthostatic
intolerance: a randomized, controlled trial /
Hypertension
Selected publications with CNSystems’ Task Force Monitor
Date: 08.2014
6/10
Resistance Training
Author
Jakovljevic et al.
Year
2013
Takano et al.
2005
Lamotte et al.
2009
Title / Journal
Resistance exercise improves autonomic
regulation at rest and haemodynamic response
to exercise in non-alcoholic fatty liver disease /
Clinical Science
Hemodynamic and hormonal responses to a shortterm low-intensity resistance exercise with the
reduction of muscle blood flow / European Journal
of Applied Physiology
Hemodynamic response of an isokinetic testing and
training session / Isokinetics and Exercise Science
No. of Pts.
17
Results
11
Short-term low intensity resistance training with KAATSU (blood
flow restricted exercise) may become a unique method for
rehabilitation in patients with cardiovascular diseases.
20
Isokinetic training (on a Cybex Norm) for cardio-vascular risk
patients should be composed of shorter set duration and longer
rest periods as generally applied.
No. of Pts.
18
Results
Exposure to discontinuous hypoxia interacted with the
autonomic and cardiovascular adaptations to the “live high –
train low” session of competitive swimmers.
Resistance exercise resulted in a 14% reduction in heart rate
and 7% lower systolic blood pressure. Sympathovagal balance
(LF/HF ratio) was reduced by 37% (P=0.26).
Hypoxia: “Live High – Train Low”
Author
Cornolo et al.
Year
2006
Title / Journal
Interactions between exposure to hypoxia and the
training-induced autonomic adaptations in a "live
high-train low" session / European Journal of
Applied Physiology
Selected publications with CNSystems’ Task Force Monitor
Date: 08.2014
7/10
4.) Syncope / Tilt testing
Tilt testing is a common tool for the diagnosis of syncopes and the initiation of treatment. Many studies report the usefulness of assessing continuous
hemodynamic and autonomic parameters during tilt testing. Selected papers are gathered in fields of sports applications.
Author
Ruffolo et al.
Year
2014
Title / Journal
Neuroautonomic evaluation of patients with
unexplained syncope : incidence of complex
neurally mediated diagnoses in the elderly /
Clinical Interventions in Aging
Impedance cardiography: a role in vasovagal
syncope diagnosis? / Age and ageing
No. of Pts.
837
Results
The results suggest that complete neuroautonomic evaluation
should be done particularly in older patients since a complex
neurally mediated diagnosis is frequent in older people.
Parry et al.
2009
86 + 43
controls
2010
Modifications of Autonomic Activity and
Baroreceptor Response during Tilt-induced
Vasovagal Syncope / Computing in Cardiology
20 VVS + 20
controls
Laranjo et al.
2012
Tilt training increases vasoconstrictor reserve in
patients with neurocardiogenic syncope /
Revista Portuguesa de Cardiologia (Portuguese)
28 with NCS
Palmisano et al.
2012
Closed-loop cardiac pacing vs. conventional
dual-chamber pacing with specialized sensing
and pacing algorithms for syncope prevention
in patients with refractory vasovagal
syncope: results of a long-term follow-up /
Europace
41
Supine haemodynamic measures derived from transthoracic ICG
can simply, non-invasively and sensitively differentiate HUTpositive patients from those with negative tilt tests.
During HUT test patients with vasovagal syncope (VVS) had
increased LF/HF ratio and decreased baroreceptor sensitivity.
VVS subjects had vascular sympathetic dysfunction and postural
cardiac sympathetic hyperactivity.
Over the course of the tilt table program (9 sessions) there was a
significant increase in vasoconstrictor reserve with a decrease of
its varaince. Syncope recurred in 19%, so tilt training may be an
effective therapeutic option.
The data suggest that dualchamber closed-loop stimulation (CLS)
pacing is more effective than DDD pacing with conventional
pacing algorithms in order to prevent a recurrence of VVS in
patients with a cardioinhibitory response to head-up tilt test.
Cheng et al.
Selected publications with CNSystems’ Task Force Monitor
Date: 08.2014
8/10
5.) Neurology
Autonomic nervous system abnormalities are common in a wide variety of different diseases in Neurology, including Parkinson’s disease, complex
regional pain syndrome, systemic lupus erythematosus, rheumatoid arthritis.
Author
Nakamura et al.
Year
2014
Title / Journal
Role of cardiac sympathetic nerves in preventing
orthostatic hypotension in Parkinson’s disease /
Parkinsonism and Related Disorders
Age and Orthostatic Hypotension in Parkinson
Disease: Passive Tilt vs. Active Standing /
Neurology
No. of Pts.
96
Kaufmann et al.
2013
Bajkó et al.
2012
Anxiety, depression and autonomic nervous
system dysfunction in hypertension / Journal of
the Neurological Sciences
Heart Rate Variability in Complex Regional Pain
Syndrome during Rest and Mental and
Orthostatic Stress / Anesthesiology
86
hypertensive
+ 98 healthy
20 CRPS + 20
controls
Terkelsen et al.
2011
Aydemir et al.
2010
Cardiac autonomic profile in rheumatoid
arthritis and systemic lupus erythematosus /
Lupus
62 + 40
controls
Kovács et al.
2010
Cerebro- and cardiovascular reactivity and
neuropsychological performance in hypertensive
patients / Journal of the Neurological Sciences
81 + 94
controls
Selected publications with CNSystems’ Task Force Monitor
Date: 08.2014
233
Results
Failure to increase TPR in response to orthostatic stress is
significantly associated with OH in cardiac denervated Parkinson
patients
In younger patients with Parkinson disease active standing and
head up tilt (HUT) showed similar prevalence of orthostatic
hypotension whereas among patients 60 years and older the
prevalence was significantly higher with HUT
Trait anxiety scores significantly correlate with sympatho/vagal
balance in passive tilt position. Anxiety could play a role in the
development of hypertension.
The increased heart rate and decreased heart rate variability in
Complex Regional Pain Syndrome (CRPS) suggest a general
autonomic imbalance, which is an independent predictor for
increased mortality and sudden death.
Evaluation by the Task Force Monitor revealed that deterioration
of sophisticated autonomic parameters (such as HRV and BRS)
was more pronounced in the patient groups compared with
controls.
Decrease in neuropsychological performance along with
alterations of cardiovascular parameters is an early
manifestation of hypertension.
9/10
6.) Pacemaker Optimization
Cardiac resynchronization therapy (CRT) has become a standard care for selected heart failure patients. It improves left ventricular function and reduces
clinical symptoms, rate of hospitalizations and overall mortality. Impedance Cardiography (ICG) offered by our Task Force Monitor is an alternative method
to the complex and time-consuming Doppler echocardiography.
Author
Konstantin et al.
Year
2007
Braun et al.
2005
Keyl et al.
2007
Altmann et al.
2010
Title / Journal
Impedance cardiography: a useful and reliable
tool in optimization of cardiac resynchronization
devices / Europace
Impedance Cardiography as a Noninvasive
Technique for Atrioventricular Interval
Optimization in Cardiac Resynchronization
Therapy / Journal of Interventional Cardiac
Eloectrophysiology
Changes in pulse pressure variability during
cardiac resynchronization therapy in
mechanically ventilated patients / Critical Care
Noninvasive haemodynamic monitoring by
transthoracic impedance cardiography during
different ventricular activation sequences in CRT
patients / Cardiovascular Medicine
Selected publications with CNSystems’ Task Force Monitor
Date: 08.2014
No. of Pts.
46
Results
IC is a useful non-invasive technique for guiding modification of
both AV and VV intervals in patients with a CRT
24
Impedance cardiography as an easy and cost-effective technique
for AV-interval optimization is a promising alternative for
routine management of heart failure patients on a beat-tobeat analysis during CRT follow-up.
19
The findings indicate that changes in cardiac performance have a
significant influence on respiratory fluctuations in pulse
pressure.
ICG is able to detect intraindividual changes of haemodynamic
parameters induced by different pacing modes.
18
10/10