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1.
Sci Rep ; 14(1): 3727, 2024 02 14.
Article in English | MEDLINE | ID: mdl-38355646

ABSTRACT

Remote work (REMOTE) causes an overlap between working and domestic demands. The study of the cardiac autonomic profile (CAP) by means of heart rate variability (HRV) provides information about the impact of REMOTE on workers' health. The primary aim was to determine whether CAP, self-perceived stress, environmental and workstation comfort are modified during REMOTE. The secondary aim was to explore how these indices are influenced by individual and environmental work-related factors. Fifty healthy office employees alternating REMOTE and in-office (OFFICE) working were enrolled, rated self-perceived stress, environmental and workstation comfort using a visual analogue scale and performed a 24-h electrocardiogram during REMOTE and OFFICE. Stress was lower (5.6 ± 2.2 vs. 6.4 ± 1.8), environmental comfort higher (7.7 ± 1.9 vs. 7.0 ± 1.5), and the workstation comfort poorer (6.2 ± 1.8 vs. 7.5 ± 1.2) during REMOTE. CAP was similar during REMOTE and OFFICE. CAP was influenced by some work-related factors, including the presence of offspring, absence of a dedicated workspace during REMOTE and number of working hours. All these variables determined a decreased vagal modulation. The working setting seems to impact the levels of perceived stress and comfort, but not the CAP. However, individual and environmental work-related factors reduce cardiac vagal modulation during REMOTE, potentially increasing the risk of developing cardiovascular diseases.


Subject(s)
Autonomic Nervous System , Occupational Health , Humans , Heart , Vagus Nerve , Heart Rate/physiology , Stress, Psychological/etiology
2.
Sci Rep ; 12(1): 14499, 2022 08 25.
Article in English | MEDLINE | ID: mdl-36008506

ABSTRACT

A reduced nocturnal cardiac vagal modulation has been observed in working women with preschoolers. Whether this adaptation also occurs in men remains an open question. The aim of this study was to analyze the cardiac autonomic profile of two groups of healthcare male professionals, one with and one without preschoolers, to be compared to females. Twenty-five working men with preschoolers (M_KID, age 35.41 ± 4.01 years) and 25 without (M_NOKID, 34.48 ± 6.00 years) were compared with 25 working women with preschoolers (W_KID, 37.7 ± 5.6 years) and 25 without (W_NOKID, 35.4 ± 7.2 years). A 24-h Holter electrocardiogram was performed for time and frequency domain analysis of the beat-to-beat variations of RR interval (RR) variability, during daytime (DAY) and nighttime (NIGHT). The power of RR variability in the high frequency band (HFRR) was considered as an index of cardiac vagal modulation. RR variability indices were similar in M_KID and M_NOKID during both DAY and NIGHT. In contrast, W_KID showed a reduced nocturnal HFRR compared to W_NOKID. The comparison of working men with and without preschoolers revealed no differences in the cardiac autonomic profile, in contrast with women. This suggests that sex and/or gender may represent a crucial factor in the cardiac neural control in the parental condition.


Subject(s)
Autonomic Nervous System , Heart , Adult , Autonomic Nervous System/physiology , Delivery of Health Care , Female , Heart/physiology , Heart Rate/physiology , Humans , Male , Vagus Nerve/physiology
3.
Sci Rep ; 11(1): 8161, 2021 04 14.
Article in English | MEDLINE | ID: mdl-33854133

ABSTRACT

The conciliation between career and family is a relevant issue for working women, in particular during the first years of motherhood. Data about the state of the cardiac autonomic regulation in working women with preschoolers are lacking. Aim of this study was to compare the cardiac autonomic profile of female healthcare professionals with and without preschoolers via the analysis of the variability of the time distance between two consecutive R-wave peaks (RR) from standard 24-h Holter electrocardiogram (ECG). Fifty healthy active female healthcare professionals were enrolled: 25 with at least one preschooler (W_KID) and 25 without (W_NOKID). A standard Holter ECG was obtained during a regular working day. Segments of 5000 consecutive RRs were selected during daytime (DAY) and nighttime (NIGHT). Heart rate variability analysis was performed and the following parameters were considered for comparison between the two groups: mean (µRR), variance (σ2RR), and the absolute power in high frequency component (HF) of RR (HFRR) series. HFRR was considered as a marker of vagal cardiac modulation. Only µRR significantly increased from DAY to NIGHT in both groups (699 ± 88 vs 887 ± 140 ms in W_KID and 728 ± 90 vs 942 ± 166 ms in W_NOKID). Instead, σ2RR and HFRR increased from DAY to NIGHT only in W_NOKID (from 3334 ± 2153 to 4816 ± 4063 ms2 and from 356 ± 334 to 1397 ± 1629 ms2, respectively). W_KID showed lower σ2RR and HFRR during NIGHT, compared to W_NOKID (2336 ± 3170 vs 4816 ± 4063 ms2 and 556 ± 950 vs 1397 ± 1629 ms2, respectively). The perceived stress according to the visual analogue scale was similar in the two groups (4.7 ± 2.1 in W_KID, 5.7 ± 2.1 in W_NOKID). The presence of preschoolers lowered nocturnal cardiac vagal modulation in female healthcare professionals. This might represent an adaptation with a finalistic purpose, scilicet the facilitation of a prompt reaction in case of a child's need.


Subject(s)
Health Personnel , Heart/physiology , Mothers , Vagus Nerve/physiology , Adaptation, Physiological , Adult , Child, Preschool , Circadian Rhythm , Cross-Sectional Studies , Electrocardiography, Ambulatory , Female , Heart Rate , Humans , Visual Analog Scale , Women, Working , Young Adult
4.
Vasc Health Risk Manag ; 15: 19-25, 2019.
Article in English | MEDLINE | ID: mdl-30833810

ABSTRACT

PURPOSE: Numerous studies on thromboembolic prevention for non-valvular atrial fibrillation (NVAF) have shown either equal or better efficacy and safety of non-vitamin K oral anticoagulants (NOACs) compared to warfarin, even for patients aged ≥75 years. Data on elderly patients, in particular, octogenarians, are lacking. Paradoxically, this population is the one with the highest risk of bleeding and stroke with a worse prognosis. This study aims to describe safety and effectiveness of NOACs in an elderly comorbid population. PATIENTS AND METHODS: REGIstry of patients on Non-vitamin K oral Anticoagulants (REGINA) is a prospective observational study enrolling consecutive NVAF patients started on NOACs and followed up to 1 year (at 1, 6, 12 months). The primary endpoint was the incidence rate of major bleeding (MB) and clinically relevant non-major bleeding (CRNMB). The secondary endpoints were the incidence of 1) stroke or systemic embolism, 2) hospitalization, 3) death, and 4) drug-related adverse events. RESULTS: We enrolled 227 patients aged 81.6±6.1 years (range 67-95 years; ≥80 years in 59.4%). The median CHA2DS2-VASc was 5 (IQR 4-5) and HAS-BLED was 4 (IQR 3-5). The estimated glomerular filtration rate was 59.27±24.12 mL/min. During follow-up, only 10 MB and 23 CRNMB occurred, with a total incidence of 4.4% (95% CI: 1.7%-7.17%) and 5.7% (95% CI: 2.68%-8.72%), respectively. There were 2 cerebral ischemic events, with a total incidence of 0.88% (95% CI: 0.84%-0.92%), 23 NOAC-related hospitalizations, no NOAC-related deaths, and 4 minor drug-related adverse effects. CONCLUSION: In a population of aged and clinically complex patients, mainly octogenarians, NOACs were safe and effective.


Subject(s)
Anticoagulants/administration & dosage , Atrial Fibrillation/drug therapy , Stroke/prevention & control , Administration, Oral , Age Factors , Aged , Aged, 80 and over , Anticoagulants/adverse effects , Atrial Fibrillation/diagnosis , Atrial Fibrillation/mortality , Comorbidity , Female , Hemorrhage/chemically induced , Hemorrhage/epidemiology , Hospitalization , Humans , Incidence , Italy/epidemiology , Male , Prospective Studies , Registries , Risk Factors , Stroke/diagnosis , Stroke/mortality , Time Factors , Treatment Outcome
5.
G Ital Cardiol (Rome) ; 10(8): 553-7, 2009 Aug.
Article in Italian | MEDLINE | ID: mdl-19771751

ABSTRACT

BACKGROUND: Recent data suggest that low triiodothyronine (T3) syndrome may contribute to the pathophysiology of cardiac diseases. Because the development of diastolic dysfunction occurs early in a failing heart, we evaluated whether patients with low T3 syndrome show abnormalities in diastolic function, also in absence of overt cardiovascular disease. METHODS: Thirty-four patients with low T3 syndrome and 34 controls with normal levels of free T3 (FT3) underwent a complete Doppler echocardiographic examination. Criteria of exclusion from the study were the presence of cardiovascular disease or traditional cardiovascular risk factors, a primitive thyroid disease, cachexia, and the use of drugs affecting the thyroid function. RESULTS: Patients with low T3 syndrome, if compared with controls, show evidence of left ventricular diastolic dysfunction, documented by prolongation of the isovolumic relaxation time (120 vs 75 ms, p < 0.0001) and a reduction in the early diastolic mitral flow velocity/late diastolic mitral flow velocity ratio (0.66 vs 2.05, p < 0.0001), mainly due to the increased A-wave (0.96 vs 0.40 m/s, p < 0.0001). These alterations increase proportionally with FT3 reduction. CONCLUSIONS: Patients with low T3 syndrome show evidence of impaired left ventricular relaxation. Doppler echocardiography may be a useful non-invasive technique for the assessment of diastolic performance in these patients.


Subject(s)
Euthyroid Sick Syndromes/diagnostic imaging , Euthyroid Sick Syndromes/physiopathology , Heart Diseases/diagnostic imaging , Heart Diseases/physiopathology , Ventricular Function, Left , Aged , Biomarkers/blood , Case-Control Studies , Diastole , Echocardiography, Doppler , Euthyroid Sick Syndromes/blood , Female , Heart Diseases/blood , Humans , Male , Middle Aged , Predictive Value of Tests , Retrospective Studies , Thyrotropin/blood , Thyroxine/blood , Triiodothyronine/blood , Ventricular Dysfunction, Left/diagnostic imaging , Ventricular Dysfunction, Left/physiopathology
6.
Acta Cardiol ; 62(1): 19-24, 2007 Feb.
Article in English | MEDLINE | ID: mdl-17375888

ABSTRACT

OBJECTIVES: A low T3 syndrome was described in patients with heart failure (HF), and it appears to be associated with adverse outcome, representing an independent predictor of mortality. However, it is not known if low T3 levels contribute to the pathophysiology of HF. On the other hand, it has been seen that an elevation of brain natriuretic peptides (BNP and NT-proBNP) may represent a warning signal for future cardiovascular disease and may be an early marker of diastolic dysfunction. Therefore we tested the hypothesis that low levels of free-triiodothyronine (FT3) are sufficient to determine an increased concentration of the amino-terminal fragment of pro-brain natriuretic peptide (NT-proBNP), as the result of an initial and asymptomatic cardiac impairment. METHODS: A total of 52 consecutive non-cardiac patients underwent thyroid function profile evaluation and NT-proBNP determination. On the basis of FT3 values they were divided in two subgroups: a low T3 group (19 patients) and a normal T3 group (33 patients). RESULTS: The median NT-proBNP concentration of patients with low T3 syndrome was significantly higher than in those with normal FT3 (370 vs. 120 pg/ml, P = 0.002). There is a strong and inverse correlation between FT3 and Log NT-proBNP (R = -0.47, P < 0.001); this relation persists in a multivariable regression analysis, after adjustment for other potentially confounding variables (P = 0.008). CONCLUSION: In absence of overt cardiovascular disease, patients with low T3 syndrome present an increased concentration of NT-proBNP. These data suggest that low FT3 levels may be a contributing factor for the development of cardiac dysfunction.


Subject(s)
Natriuretic Peptide, Brain/blood , Peptide Fragments/blood , Triiodothyronine/deficiency , Aged , Disease Progression , Female , Heart Failure/etiology , Heart Failure/physiopathology , Humans , Male , Prospective Studies
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