Application of cardiac autonomous indices in the study of neurogenic erectile dysfunction.

A research area of increasing interest consists of studying the benefits of using spectral analysis to screen neurogenic erectile dysfunctions. Our hypothesis is that spectral analysis consists of a non-invasive and simple procedure to investigate such patients. Subjects were allocated into two groups: control, no erectile dysfunction (n = 17), and patients with erectile dysfunction (n = 15). RR intervals (RRI), systolic blood pressure, diastolic blood pressure and baroreflex sensitivity recordings were performed continuously in the supine position, followed by the seated position, and finally standing position. In the supine position, the control group had a higher RRI and a lower diastolic blood pressure. For frequency domain analyses of RRI in the supine position, the erectile dysfunction group had a higher normalized low-frequency (LF) index and low-frequency/high-frequency (LF/HF) ratio while showing a lower normalized HF index. In the seated position, the erectile dysfunction group presented a higher LF/HF ratio. Regarding systolic blood pressure, the erectile dysfunction group showed lower normalized LF and higher normalized HF indices only in the supine position. The α index in HF was lower in the erectile dysfunction group in the three positions. Spectral analyses of cardiac sympathovagal drive constitute a fruitful non-invasive approach to evaluate alterations in cardiovascular autonomic modulation in neurogenic erectile dysfunction patients.

Empirical mode decomposition to assess cardiovascular autonomic control in rats.

Heart beat rate and blood pressure, together with baroreflex sensitivity, have become important tools in assessing cardiac autonomic system control and in studying sympathovagal balance. These analyses are usually performed thanks to spectral indices computed from standard spectral analysis techniques. However, standard spectral analysis and its corresponding rigid band-pass filter formulation suffer from two major drawbacks. It can be significantly distorted by non-stationarity issues and it proves unable to adjust to natural intra- and inter-individual variability. Empirical mode decomposition (EMD), a tool recently introduced in the literature, provides us with a signal-adaptive decomposition that proves useful for the analysis of non-stationary data and shows a strong capability to precisely adjust to the spectral content of the analyzed data. It is based on the concept that any complicated set of data can be decomposed into a finite number of components, called intrinsic mode functions, associated with different spectral contributions. The aims of this study were twofold. First, we studied the changes in the sympathovagal balance induced by various pharmacological blockades (phentolamine, atropine and atenolol) of the autonomic nervous system in normotensive rats. Secondly, we assessed the use of EMD for the analysis of the cardiac sympathovagal balance after pharmacological injections. For this, we developed a new (EMD-based) low frequency vs. high frequency spectral decomposition of heart beat variability and systolic blood pressure, we define the corresponding EMD spectral indices and study their relevance to detect and analyze changes accurately in the sympathovagal balance without having recourse to any a priori fixed high-pass/low-pass filters.

The in vitro effect of dual combinations of ritodrine, nicardipine and atosiban on contractility of pregnant rat myometrium.

OBJECTIVE: To compare the tocolytic potency of ritodrine, nicardipine and atosiban, used alone and in dual combinations, to see whether combinations of these drugs, which act via different pathways, could improve inhibition of uterine contractility. DESIGN: Study on myometrial contractility in vitro. SETTING: Laboratory of physiology, Lyon, France. SAMPLE: Longitudinal myometrial strips from non-labouring timed pregnant Wistar rats (18 gestational days). METHODS: Strips were simultaneously exposed to EC(25), EC(50) or EC(75) of dual combinations of either ritodrine and nicardipine, ritodrine and atosiban or nicardipine and atosiban (n = 10/group). Basal contractile activity and contractile activity after addition of each combination was measured using the 10 min integral of activity. Changes were expressed as percentage from the basal 10 min integral activity. The observed percentage inhibition of activity was compared with the expected percentage inhibition in an additive pharmacological model. When no significant difference occurred, the combination was deemed simply to have an additive tocolytic effect. When inhibition of activity was significantly greater compared with the expected percentage inhibition, the combination was deemed to have a synergistic effect. MAIN OUTCOME MEASURE: Changes in integral contractile activity in response to tocolytic combinations. RESULTS: Ritodrine and atosiban inhibited integral activity to a greater extent than expected [e.g. using EC(50): observed inhibition 88.9% (13.8%) vs expected inhibition 75%; P < 0.015]. Actual inhibition by nicardipine/ritodrine [78.55% (20.4%) vs 75%; P = n.s.] and nicardipine/atosiban [78.94% (17.8%) vs 75%; P = n.s.] was not significantly different from expected. CONCLUSIONS: A combination of ritodrine plus atosiban exhibits a synergistic inhibition for myometrial activity, thus allowing the use of lower concentrations of each drug to achieve the same effect compared with each drug used alone. Combination of nicardipine plus ritodrine and nicardipine plus atosiban achieves only an additive effect. The potential for decreasing side effects (beta-mimetics) and costs (atosiban) when using a combination in clinical practice needs to be evaluated.