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Li B, Guo S, Xu H, Zhou Y, Zhang M, Wang J, Chen Y, Chen H, Song J, Tan S. Abnormal circadian rhythm of heart rate variability and their association with symptoms in patients with major depressive disorder. J Affect Disord 2024; 362:14-23. [PMID: 38942206 DOI: 10.1016/j.jad.2024.06.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 06/21/2024] [Accepted: 06/25/2024] [Indexed: 06/30/2024]
Abstract
BACKGROUND Heart rate variability (HRV) is often reduced in patients with major depressive disorder (MDD) and is linked to symptoms. However, prior studies have mainly focused on short-term HRV, with limited exploration of the 24-h HRV circadian rhythm, despite its ability to comprehensively capture overall HRV distribution and dynamic fluctuations. In this study, we investigated the circadian rhythms of 24-h HRV indices in patients with MDD and their associations with symptom severity. METHODS We recorded 24-h electrocardiograms in 73 patients with MDD (53 in major depressive episode and 20 in remission period) and 31 healthy controls. An extended cosine model was used to model the circadian rhythm of six HRV indices by five parameters: the mesor, amplitude, duty cycle, curve smoothness, and acrophase. Symptom severity was evaluated using the Hamilton Depression Scale and Hamilton Anxiety Scale. RESULTS Compared with the control group, patients with MDD had a significantly smaller SampEn mesor, higher HF duty cycle, and lower heart rate (HR) duty cycle. They also had a significantly higher curve smoothness for HR, RMSSD, and HF. The mesor for SampEn, along with the curve smoothness for HR and ln RMSSD, were associated with certain symptoms in patients with MDD. LIMITATIONS The cross-sectional design and psychiatric treatment of most patients with MDD limited our findings. CONCLUSION Patients with MDD exhibit abnormal HRV circadian rhythms that are associated with symptoms. Moreover, 24-h ECG monitoring may potentially serve as an adjunct value to objectively evaluate clinical symptoms in these patients.
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Affiliation(s)
- Bing Li
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing 100096, China
| | - Sheng Guo
- Image Processing Center, Beihang University, Beijing 100191, China
| | - Hao Xu
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing 100096, China; North China University of Science and Technology, Tangshan 063210, China
| | - Yanfang Zhou
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing 100096, China
| | - Meng Zhang
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing 100096, China
| | - Jinghan Wang
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing 100096, China
| | - Yan Chen
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing 100096, China
| | - Haitao Chen
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing 100096, China
| | - Jiaqi Song
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing 100096, China
| | - Shuping Tan
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing 100096, China.
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Basta M, Skourti E, Simos P, Soumaki E, Li Y, Gerostergios G, Samiotakis G, Dafermos V, Drakaki M, Papadakis N, Vgontzas AN. Associations between sleep complaints, suicidal ideation and depressive symptoms among adolescents and young adults in Greece. J Sleep Res 2023; 32:e13900. [PMID: 37039423 DOI: 10.1111/jsr.13900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 03/08/2023] [Accepted: 03/21/2023] [Indexed: 04/12/2023]
Abstract
Depression prevalence increases significantly during adolescence/early adulthood. Depression in youth may present suicidal ideation, while suicide represents the leading cause of death in this age group. Moreover, adolescents/young adults frequently report sleep complaints that may partially be due to depressive symptoms. Studies on the associations between depression, sleep complaints and suicidality in this age group are limited. We aimed to examine associations between depressive symptoms, sleep complaints and suicidal ideation in a large (n = 2771), representative sample of adolescents (age: 15-17 years, n = 512) and young adults (age: 18-24 years, n = 2259) from the general population in Greece. A telephone structured questionnaire was administered. Depressive symptoms were assessed using the modified Patient Health-7 questionnaire score, while presence of suicidal ideation and sleep complaints were assessed using the ninth and third question of Patient Health-9 questionnaire, respectively. Mediation logistic regression analysis revealed significant direct paths from depressive symptoms to sleep complaints (odds ratio [OR] 1.22, 95% confidence interval [CI] 1.19-1.24; OR 1.21, 95% CI 1.18-1.24) and suicidal ideation (OR 1.18, 95% CI 1.14-1.22; OR 1.18, 95% CI 1.14-1.22), as well as sleep complaints and suicidal ideation (OR 1.82, 95% CI 1.32-2.50; OR 1.91, 95% CI 1.33-2.76) in the total group and in young adults, respectively, but not among adolescents. Moreover, we detected a significant indirect effect of depressive symptoms on suicidal ideation mediated by sleep complaints (18.8%) in young adults. These findings support the hypothesis that treatment of sleep disturbances among youth with depression may independently further reduce suicidal risk.
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Affiliation(s)
- M Basta
- Department of Psychiatry, University Hospital of Heraklion, Crete, Greece
- Sleep Research and Treatment Center, Department of Psychiatry, Penn State University, Hershey, Pennsylvania, USA
- Department of Child and Adolescent Psychiatry, University Hospital of Heraklion, Crete, Greece
| | - E Skourti
- Department of Psychiatry, University Hospital of Heraklion, Crete, Greece
| | - P Simos
- Department of Psychiatry, University Hospital of Heraklion, Crete, Greece
- Computational Biomedicine Lab, Institute of Computer Science, Foundation for Research and Technology-Hellas, Heraklion, Greece
| | - E Soumaki
- Department of Child and Adolescent Psychiatry, University Hospital of Heraklion, Crete, Greece
| | - Y Li
- Department of Sleep Medicine, Mental Health Center of Shantou University, Shantou, Guangdong, China
| | - G Gerostergios
- Department of Child and Adolescent Psychiatry, University Hospital of Heraklion, Crete, Greece
| | - G Samiotakis
- Department of Child and Adolescent Psychiatry, University Hospital of Heraklion, Crete, Greece
| | - V Dafermos
- Department of Political Science, University of Crete, Rethymno, Greece
| | - M Drakaki
- Department of Political Science, University of Crete, Rethymno, Greece
| | - N Papadakis
- Department of Political Science, University of Crete, Rethymno, Greece
| | - A N Vgontzas
- Department of Psychiatry, University Hospital of Heraklion, Crete, Greece
- Sleep Research and Treatment Center, Department of Psychiatry, Penn State University, Hershey, Pennsylvania, USA
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Žunkovič B, Kejžar N, Bajrović FF. Standard Heart Rate Variability Parameters-Their Within-Session Stability, Reliability, and Sample Size Required to Detect the Minimal Clinically Important Effect. J Clin Med 2023; 12:jcm12093118. [PMID: 37176559 PMCID: PMC10179119 DOI: 10.3390/jcm12093118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/16/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023] Open
Abstract
Many intervention studies assume the stability of heart rate variability (HRV) parameters, and their sample sizes are often small, which can significantly affect their conclusions. The aim of this study is to assess the stability and reliability of standard HRV parameters within a single resting session, and to estimate the sample size required to detect the minimal clinically important effect of an intervention. Heart rate was recorded in 50 adult healthy subjects for 50 min in a seated position. Eight standard HRV parameters were calculated from five evenly spaced 5 min intervals. Stability was assessed by comparing the mean values of HRV parameters between the consecutive five test-retest measurements. Absolute reliability was determined by standard error of measurement, and relative reliability by intraclass correlation coefficient. The sample size required to detect a mean difference of ≥30% of between-subject standard deviation was estimated. As expected, almost all HRV parameters had poor absolute reliability but most HRV parameters had substantial to excellent relative reliability. We found statistically significant differences in almost all HRV parameters between the first 20 min and the last 30 min of the session. The estimated sample size ranged from 19 to 300 subjects for the first 20 min and from 36 to 194 subjects for the last 30 min of the session, depending on the selected HRV parameter. We concluded that optimal HRV measurement protocols in a resting seated position should be performed within the first 20 min or between 20 and 50 min after assuming a resting seated position. Future interventional HRV studies should include a sufficient number of subjects and consider the Bonferroni correction according to the number of selected HRV parameters to achieve an appropriate level of study power and precision.
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Affiliation(s)
- Breda Žunkovič
- Clinical Institute of Clinical Neurophysiology, University Medical Centre Ljubljana, Zaloška Cesta 2, 1000 Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Vrazov Trg 2, 1000 Ljubljana, Slovenia
| | - Nataša Kejžar
- Institute for Biostatistics and Medical Informatics, Faculty of Medicine, University of Ljubljana, Vrazov Trg 2, 1000 Ljubljana, Slovenia
| | - Fajko F Bajrović
- Department of Vascular Neurology and Intensive Neurological Therapy, University Medical Centre Ljubljana, Zaloška Cesta 2, 1000 Ljubljana, Slovenia
- Institute of Pathophysiology, Faculty of Medicine, University of Ljubljana, Zaloška Cesta 4, 1000 Ljubljana, Slovenia
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Sibrecht G, Piskorski J, Krauze T, Guzik P. Heart Rate Asymmetry, Its Compensation, and Heart Rate Variability in Healthy Adults during 48-h Holter ECG Recordings. J Clin Med 2023; 12:jcm12031219. [PMID: 36769867 PMCID: PMC9917705 DOI: 10.3390/jcm12031219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/26/2023] [Accepted: 02/01/2023] [Indexed: 02/05/2023] Open
Abstract
Heart rate asymmetry (HRA) reflects different contributions of heart rate (HR) decelerations and accelerations to heart rate variability (HRV). In this study, we examined various properties of HRA, including its compensation and HRV, in 48-h electrocardiogram (ECG) recordings in healthy adults. Furthermore, we compared sex differences in parameters used to quantify HRA and HRV. Variance-based and relative HRA and HRV parameters were computed for Holter ECG recordings lasting up to 48 h in 101 healthy volunteers. The median age of the subjects was 39 years, with 47 of them being men. The prevalence of all forms of HRA was statistically different from randomness (p < 0.0001). Specifically, HR decelerations contributed >50% (C1d) to short-term HRA in 98.02% of subjects, while HR decelerations contributed <50% to long-term HRA in 89.11% of recordings and to total HRA in 88.12% of recordings. Additionally, decelerations accounted for <50% of all changing heartbeats (Porta's index) in 74.26% of subjects, and HRA compensation was present in 88.12% of volunteers. Our findings suggest that various HRA features are present in most healthy adults. While men had more pronounced HRA expression, the prevalence of short-, long-term, and total HRA and its compensation was similar in both sexes. For HRV, values of variance-based indices were higher in men than in women, but no differences were found for relative measures. In conclusion, our study references HRA and HRV for longer ECG recordings of up to 48 h, which have become increasingly important in clinical ECG monitoring. The findings can help understand and compare the characteristics of HRA and HRV in patients with different diseases.
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Affiliation(s)
- Greta Sibrecht
- Department of Cardiology–Intensive Therapy, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznan, Poland
| | - Jarosław Piskorski
- Institute of Physics, University of Zielona Gora, Szafrana 4a, 65-516 Zielona Gora, Poland
| | - Tomasz Krauze
- Department of Cardiology–Intensive Therapy, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznan, Poland
| | - Przemysław Guzik
- Department of Cardiology–Intensive Therapy, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznan, Poland
- Correspondence:
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5
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Deng S, Wang Q, Fan J, Yang X, Mei J, Lu J, Chen G, Yang Y, Liu W, Wang R, Han Y, Sheng R, Wang W, Ba L, Ding F. Correlation of Circadian Rhythms of Heart Rate Variability Indices with Stress, Mood, and Sleep Status in Female Medical Workers with Night Shifts. Nat Sci Sleep 2022; 14:1769-1781. [PMID: 36225321 PMCID: PMC9549795 DOI: 10.2147/nss.s377762] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 09/12/2022] [Indexed: 12/02/2022] Open
Abstract
PURPOSE Heart rate variability (HRV) indices have been used as stress indicators. Rare studies investigated the associations of circadian rhythms of the HRV indices with the stress, mood, and sleep conditions in populations under stress. METHODS In total 257 female participants (203 shift workers and 54 non-shift workers) were included. All the participants completed a structured questionnaire to assess the stress, mood, and sleep conditions and performed 24-hour Holter electrocardiogram monitoring on the day away from shifts. Using epochs of 1-min or 5-min beat-to-beat intervals, the HRV indices (SDNN, RMSSD, LF, HF, LF/HF, and LFnu, SD1, SD2, SD1/SD2) were plotted as a function of time and fitted into cosine periodic curves, respectively. Three mathematical parameters based on the cosine periodic curves were extracted, MESOR (M, overall averages of the cosine curve), amplitude (A, amplitude of the peak of the cosine curve), and acrophase (θ, latency to the peak) to quantify the circadian rhythms of the HRV indices. Multivariable linear regression models were used to reveal the associations of these parameters with the clinical assessments of stress, mood, or sleep conditions, as well as with the 24-h averages of the HRV indices. RESULTS The parameters M and A of SDNN, RMSSD, LF, and HF, and θ of LF/HF and LFnu significantly differ between shift and non-shift workers. The parameter θ of LF/HF positively correlates with the severity of stress and anxiety. The parameter A of LF/HF and LFnu also positively correlates with daytime sleepiness and sleep fragmentation. In addition, the parameters M and A instead of θ of SDNN, RMSSD, LF, LF/HF, and LFnu significantly correlate with the 24-h averages of HRV indices. CONCLUSION The circadian rhythms of the HRV indices over 24 hours can, to some extent, predict the severity of stress, emotion and sleep conditions in female populations under stress.
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Affiliation(s)
- Saiyue Deng
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Quan Wang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430000, People's Republic of China
| | - Jingjing Fan
- Cardiac Unit, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Xiaoyun Yang
- Cardiac Unit, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Junhua Mei
- Department of Neurology, Wuhan No.1 Hospital, Wuhan, 430022, People's Republic of China
| | - Jiajia Lu
- Cardiac Unit, Wuhan No.1 Hospital, Wuhan, 430022, People's Republic of China
| | - Guohua Chen
- Department of Neurology, Wuhan No.1 Hospital, Wuhan, 430022, People's Republic of China
| | - Yuan Yang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Wenhua Liu
- Department of Clinical Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430000, People's Republic of China
| | - Runsen Wang
- Huawei Technologies Co, Shenzhen, People's Republic of China
| | - Yujia Han
- Huawei Technologies Co, Shenzhen, People's Republic of China
| | - Rong Sheng
- Huawei Technologies Co, Shenzhen, People's Republic of China
| | - Wei Wang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Li Ba
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Fengfei Ding
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China.,Department of Pharmacology, Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China
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Dias ARL, de Souza KA, Dos Santos KM, Peçanha T, Ferreira JC, Cambri LT, Arsa G. Acute Exercise Increases the Ambulatory Cardiac Modulation of Young Men With Overweight/Obesity. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2021; 92:796-804. [PMID: 32857946 DOI: 10.1080/02701367.2020.1786488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 06/08/2020] [Indexed: 06/11/2023]
Abstract
Purpose: To verify whether excess body mass influences 24-h ambulatory heart rate variability (HRV) after a moderate-intensity continuous exercise (MICE) session. Method: Participants included 27 non-trained young men that were divided into two groups, 1) normal-weight (n = 10) and 2) overweight and obese (n = 17). Participants underwent a single MICE session of 30 minutes at 50-60% of heart rate reserve (HRR), and a control session (CT). Heart rate (HR) and HRV indices were recorded at 60-minute intervals and were used to obtain the area under the curve (AUC) for 24-h ambulatory measurements following MICE or CT. SDNN (standard deviation of RR intervals in milliseconds) and RMSSD (root mean square of successive differences between adjacent RR interval in milliseconds), Ln-LF (log-transformed values of the absolute power of the low-frequency band) and HF (log-transformed values of the absolute power of the high-frequency band) were analyzed. Results: The overweight and obese group presented higher AUC of RMSSD (p = .006), Ln-LF (p = .002), and Ln-HF (p = .005) indices after MICE than CT. Nighttime periods were more responsive to the effects of MICE on RMSSD and Ln-HF indices (p < .05), regardless of group. Conclusion: MICE promoted an increase in the 24-h ambulatory cardiac autonomic modulation in the group overweight and obese, mainly at nighttime during sleep. These results revealed a potential benefit of MICE on the cardiac autonomic modulation for young men with overweight and obesity.
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Bernardi J, Aromolaran KA, Zhu H, Aromolaran AS. Circadian Mechanisms: Cardiac Ion Channel Remodeling and Arrhythmias. Front Physiol 2021; 11:611860. [PMID: 33519516 PMCID: PMC7841411 DOI: 10.3389/fphys.2020.611860] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 12/18/2020] [Indexed: 12/31/2022] Open
Abstract
Circadian rhythms are involved in many physiological and pathological processes in different tissues, including the heart. Circadian rhythms play a critical role in adverse cardiac function with implications for heart failure and sudden cardiac death, highlighting a significant contribution of circadian mechanisms to normal sinus rhythm in health and disease. Cardiac arrhythmias are a leading cause of morbidity and mortality in patients with heart failure and likely cause ∼250,000 deaths annually in the United States alone; however, the molecular mechanisms are poorly understood. This suggests the need to improve our current understanding of the underlying molecular mechanisms that increase vulnerability to arrhythmias. Obesity and its associated pathologies, including diabetes, have emerged as dangerous disease conditions that predispose to adverse cardiac electrical remodeling leading to fatal arrhythmias. The increasing epidemic of obesity and diabetes suggests vulnerability to arrhythmias will remain high in patients. An important objective would be to identify novel and unappreciated cellular mechanisms or signaling pathways that modulate obesity and/or diabetes. In this review we discuss circadian rhythms control of metabolic and environmental cues, cardiac ion channels, and mechanisms that predispose to supraventricular and ventricular arrhythmias including hormonal signaling and the autonomic nervous system, and how understanding their functional interplay may help to inform the development and optimization of effective clinical and therapeutic interventions with implications for chronotherapy.
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Affiliation(s)
- Joyce Bernardi
- Masonic Medical Research Institute, Utica, NY, United States
| | | | - Hua Zhu
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, United States
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Goyal M, Goel A, Singh R, Chowdhury N, Verma N, Tiwari S, Deepak KK. Circadian rhythm of airways caliber and its autonomic modulation. Chronobiol Int 2020; 37:845-855. [PMID: 32077322 DOI: 10.1080/07420528.2020.1731525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The autonomic nervous system (ANS) is one of the effector pathways for circadian variation of many physiological parameters. Autonomic tone and airways caliber have been reported to exhibit circadian variation in separate studies. A simultaneous investigation of heart rate variability (HRV) and airway caliber might ascertain how airway caliber is modulated by autonomic tone. This study was planned to identify the variations in airway caliber and autonomic function tone during a 24-hour span. A total of 56 healthy male subjects with almost similar daily routines were studied. Time domain, frequency domain and nonlinear analysis of R-R interval from 5 min electrocardiogram (ECG) was done seven times during the daytime wake span at 3-hour intervals starting at 05:00 h in the morning until 23:00 h in the night. Simultaneously peak expiratory flow rate (PEFR) was determined using a mini Wright's peak flow meter. Rhythmometric analysis was done for PEFR and HRV parameters. Significant circadian variation in low frequency (LF) and high frequency (HF) variance was identified in this group of healthy subjects. The circadian rhythm of LF variance was characterized by a gradual increase and corresponding reciprocal change in HF variance from morning until night. The LF/HF ratio and SD2/SD1 ratio reflecting sympatho-vagal balance showed low to high values from morning to evening. The acrophase of the PEFR temporal pattern is similar to that of LF power and almost opposite in phase to that of HF power. PEFR is positively correlated with LF power. The circadian rhythm of airway caliber co-varies with cardiac autonomic tone. It appears that the temporal pattern of cardiac autonomic tone precedes in time that of airways caliber, thereby suggesting the latter operates under the modulatory effect of the 24-hour pattern in sympatho-vagal balance.
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Affiliation(s)
- Manish Goyal
- Department of Physiology, All India Institute of Medical Sciences , Bhubaneswar, India
| | - Arun Goel
- Department of Physiology, All India Institute of Medical Sciences , Rishikesh, India
| | - Ruchi Singh
- Department of Physiology, All India Institute of Medical Sciences , Bhopal, India
| | - Nilotpal Chowdhury
- Department of Physiology, All India Institute of Medical Sciences , Rishikesh, India
| | - Narsingh Verma
- Department of Physiology, King George's Medical University , Lucknow, India
| | - Sunita Tiwari
- Department of Physiology, King George's Medical University , Lucknow, India
| | - Kishore Kumar Deepak
- Department of Physiology, All India Institute of Medical Sciences , Delhi, India
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Spina GD, Gonze BB, Barbosa ACB, Sperandio EF, Dourado VZ. Presence of age- and sex-related differences in heart rate variability despite the maintenance of a suitable level of accelerometer-based physical activity. ACTA ACUST UNITED AC 2019; 52:e8088. [PMID: 31389489 PMCID: PMC6686273 DOI: 10.1590/1414-431x20198088] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 05/21/2019] [Indexed: 12/26/2022]
Abstract
There is currently a lack of information adjacent on the influence of sex and age in heart rate variability (HRV), adjusted according to accelerometer-based physical activity (PADL). We hypothesized that the effect of sex and age on the HRV should be reduced or absent in individuals with a suitable PADL level. We aim to evaluate the influence of sex and age on HRV, adjusted for the confounding effects of the PADL level. A total of 485 age-stratified subjects (18–39, 40–59, and ≥60 years) underwent HRV analyses at rest and 7-day assessments of accelerometer-based PADL. Multivariate analyses of covariance were done using log-transformed HRV indices as outcomes, age and sex as fixed factors, and PADL, cardiovascular risk, fat body mass, and heart rate (HR) at rest as covariates. Despite the adjustment for directly measured PADL, women had better indices of vagal tone, whereas men had higher sympathetic influence. Also, compared to middle-aged and older adults, younger individuals (ages 18–39 years) presented better HRV. Multiple regression analyses confirmed that age and sex were the main predictors of HRV indices, even after adjusting for PADL directly assessed by triaxial accelerometer and HR. We also observed that the correlation between some HRV indexes and the different indexes of physical activity directly evaluated was significant, but not very consistent. Thus, HRV indices are influenced by age and sex, regardless of accelerometer-based physical activity. Interventions with physical activity and exercise aimed at improving the autonomic modulation of asymptomatic adults should take such differences into account.
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Affiliation(s)
- G D Spina
- Laboratório de Epidemiologia e Movimento Humano, Universidade Federal de São Paulo, Santos, SP, Brasil
| | - B B Gonze
- Laboratório de Epidemiologia e Movimento Humano, Universidade Federal de São Paulo, Santos, SP, Brasil
| | - A C B Barbosa
- Laboratório de Epidemiologia e Movimento Humano, Universidade Federal de São Paulo, Santos, SP, Brasil
| | - E F Sperandio
- Laboratório de Epidemiologia e Movimento Humano, Universidade Federal de São Paulo, Santos, SP, Brasil
| | - V Z Dourado
- Laboratório de Epidemiologia e Movimento Humano, Universidade Federal de São Paulo, Santos, SP, Brasil
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10
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de Zambotti M, Javitz H, Franzen PL, Brumback T, Clark DB, Colrain IM, Baker FC. Sex- and Age-Dependent Differences in Autonomic Nervous System Functioning in Adolescents. J Adolesc Health 2018; 62:184-190. [PMID: 29198773 PMCID: PMC6415527 DOI: 10.1016/j.jadohealth.2017.09.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 09/07/2017] [Accepted: 09/08/2017] [Indexed: 01/19/2023]
Abstract
PURPOSE We assessed sex- and age-dependent differences in a cross-sectional analysis of cardiac autonomic nervous system (ANS) regulation during sleep in adolescents. METHODS Nocturnal heart rate (HR) and heart rate variability (HRV) metrics, reflecting ANS functioning, were analyzed across the night and within undisturbed rapid eye movement (REM) and non-REM sleep in 149 healthy adolescents (12-22 years; 67 female) from the National Consortium on Alcohol and Neurodevelopment in Adolescence. RESULTS Nocturnal HR was slower in older, more pubertally advanced boys than in younger boys. In girls, HR did not vary according to age or maturity, although overall HRV and vagal modulation declined with age. Although younger boys and girls had similar HR, the male-female HR difference increased by ~2.4 bpm every year (p < .01, higher in older girls). Boys and girls showed expected increases in total HRV across the night but this within-night "recovery" was blunted in girls compared with boys (p < .05). Also, the non-REM and REM difference in HR was greater in girls (p < .01). Models exploring a role of covariates (sleep, mood, reproductive hormones, activity) in influencing HR and HRV showed few significant effects, apart from sedentary activity (higher in older girls), which partially mediated the sex × age interaction in HR. CONCLUSIONS Sex-related differences in cardiac ANS function emerge during adolescence. The extent to which sex-age divergences in ANS function are adaptive or reflect underlying sex-specific vulnerability for the development of psychopathology and other health conditions in adolescence needs to be determined.
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Affiliation(s)
| | - Harold Javitz
- Division of Education, SRI International, Menlo Park, CA, USA
| | - Peter L. Franzen
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Ty Brumback
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Duncan B. Clark
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Ian M. Colrain
- Center for Health Sciences, SRI International, Menlo Park, CA, USA;,Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Fiona C. Baker
- Center for Health Sciences, SRI International, Menlo Park, CA, USA;,Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
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11
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Sarlon J, Plaszczyk S, Engel S, Oertel-Knöchel V. Electrophysiological parameters as biomarkers for psychiatry: Intra-individual variability and influencing factors. Int J Psychophysiol 2017; 123:42-47. [PMID: 29155050 DOI: 10.1016/j.ijpsycho.2017.11.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 10/21/2017] [Accepted: 11/15/2017] [Indexed: 12/22/2022]
Affiliation(s)
- Jan Sarlon
- Laboratory for Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Heinrich-Hoffmann-Str. 10, 60528 Frankfurt am Main, Germany; Psychiatric Hospital, Oberbergkliniken, Oberberg 1, 78132 Hornberg, Germany.
| | - Simone Plaszczyk
- Laboratory for Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Heinrich-Hoffmann-Str. 10, 60528 Frankfurt am Main, Germany
| | - Sinah Engel
- Laboratory for Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Heinrich-Hoffmann-Str. 10, 60528 Frankfurt am Main, Germany; Department of Neurology, University of Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Viola Oertel-Knöchel
- Laboratory for Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Heinrich-Hoffmann-Str. 10, 60528 Frankfurt am Main, Germany
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12
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Koenig J, Rash JA, Campbell TS, Thayer JF, Kaess M. A Meta-Analysis on Sex Differences in Resting-State Vagal Activity in Children and Adolescents. Front Physiol 2017; 8:582. [PMID: 28883794 PMCID: PMC5573740 DOI: 10.3389/fphys.2017.00582] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 07/28/2017] [Indexed: 12/17/2022] Open
Abstract
Lower vagal activity is associated with psychopathology independent of age. Research suggests that alterations of vagal activity precede the development of psychopathology. The present review aimed to quantify sex differences in vagal activity in children and adolescents. Studies reporting on sex differences on measures of vagally-mediated heart rate variability derived from short-term recordings under resting conditions in boys and girls were included. Drawing on data from more than 5,000 children and adolescents, we provide evidence that healthy young girls display lower vagal activity and greater mean heart rate compared to boys, a finding that may have implications for risk associated with the development of internalizing psychopathology and somatic ill-health.
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Affiliation(s)
- Julian Koenig
- Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department for Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of HeidelbergHeidelberg, Germany
| | - Joshua A Rash
- Department of Psychology, University of CalgaryCalgary, AB, Canada.,Department of Psychology, Memorial University of NewfoundlandSt. John's, NL, Canada
| | - Tavis S Campbell
- Department of Psychology, University of CalgaryCalgary, AB, Canada
| | - Julian F Thayer
- Department of Psychology, The Ohio State UniversityColumbus, OH, United States
| | - Michael Kaess
- Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department for Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of HeidelbergHeidelberg, Germany.,University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of BernBern, Switzerland
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13
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Becker BK, Feagans AC, Chen D, Kasztan M, Jin C, Speed JS, Pollock JS, Pollock DM. Renal denervation attenuates hypertension but not salt sensitivity in ET B receptor-deficient rats. Am J Physiol Regul Integr Comp Physiol 2017; 313:R425-R437. [PMID: 28701323 DOI: 10.1152/ajpregu.00174.2017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 06/16/2017] [Accepted: 07/06/2017] [Indexed: 02/07/2023]
Abstract
Hypertension is a prevalent pathology that increases risk for numerous cardiovascular diseases. Because the etiology of hypertension varies across patients, specific and effective therapeutic approaches are needed. The role of renal sympathetic nerves is established in numerous forms of hypertension, but their contribution to salt sensitivity and interaction with factors such as endothelin-1 are poorly understood. Rats deficient of functional ETB receptors (ETB-def) on all tissues except sympathetic nerves are hypertensive and exhibit salt-sensitive increases in blood pressure. We hypothesized that renal sympathetic nerves contribute to hypertension and salt sensitivity in ETB-def rats. The hypothesis was tested through bilateral renal sympathetic nerve denervation and measuring blood pressure during normal salt (0.49% NaCl) and high-salt (4.0% NaCl) diets. Denervation reduced mean arterial pressure in ETB-def rats compared with sham-operated controls by 12 ± 3 (SE) mmHg; however, denervation did not affect the increase in blood pressure after 2 wk of high-salt diet (+19 ± 3 vs. +16 ± 3 mmHg relative to normal salt diet; denervated vs. sham, respectively). Denervation reduced cardiac sympathetic-to-parasympathetic tone [low frequency-high frequency (LF/HF)] during normal salt diet and vasomotor LF/HF tone during high-salt diet in ETB-def rats. We conclude that the renal sympathetic nerves contribute to the hypertension but not to salt sensitivity of ETB-def rats.
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Affiliation(s)
- Bryan K Becker
- Cardio-Renal Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Amanda C Feagans
- Cardio-Renal Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Daian Chen
- Cardio-Renal Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Malgorzata Kasztan
- Cardio-Renal Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Chunhua Jin
- Cardio-Renal Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Joshua S Speed
- Cardio-Renal Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Jennifer S Pollock
- Cardio-Renal Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - David M Pollock
- Cardio-Renal Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
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14
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Ferreira Mansilha H. Fat intake and cardiac autonomic dysfunction in obese children: What is the relationship? Rev Port Cardiol 2017; 36:509-511. [PMID: 28673780 DOI: 10.1016/j.repc.2017.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Helena Ferreira Mansilha
- Unidade de Nutrição, Serviço de Pediatria, Departamento da Infância e Adolescência, Centro Materno-Infantil do Norte, Porto, Portugal; Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal.
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15
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Fat intake and cardiac autonomic dysfunction in obese children: What is the relationship? REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2017. [DOI: 10.1016/j.repce.2017.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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16
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Melkani GC, Panda S. Time-restricted feeding for prevention and treatment of cardiometabolic disorders. J Physiol 2017; 595:3691-3700. [PMID: 28295377 PMCID: PMC5471414 DOI: 10.1113/jp273094] [Citation(s) in RCA: 113] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 02/01/2017] [Indexed: 12/11/2022] Open
Abstract
The soaring prevalence of obesity and diabetes is associated with an increase in comorbidities, including elevated risk for cardiovascular diseases (CVDs). CVDs continue to be among the leading causes of death and disability in the United States. While increased nutritional intake from an energy-dense diet is known to disrupt metabolic homeostasis and contributes to the disease risk, circadian rhythm disruption is emerging as a new risk factor for CVD. Circadian rhythms coordinate cardiovascular health via temporal control of organismal metabolism and physiology. Thus, interventions that improve circadian rhythms are prospective entry points to mitigate cardiometabolic disease risk. Although light is a strong modulator of the neural circadian clock, time of food intake is emerging as a dominant agent that affects circadian clocks in metabolic organs. We discovered that imposing a time-restricted feeding (TRF) regimen in which all caloric intakes occur consistently within ≤ 12 h every day exerts many cardiometabolic benefits. TRF prevents excessive body weight gain, improves sleep, and attenuates age- and diet-induced deterioration in cardiac performance. Using an integrative approach that combines Drosophila melanogaster (fruit fly) genetics with transcriptome analyses it was found that the beneficial effects of TRF are mediated by circadian clock, ATP-dependent TCP/TRiC/CCT chaperonin and mitochondrial electron transport chain components. Parallel studies in rodents have shown TRF reduces metabolic disease risks by maintaining metabolic homeostasis. As modern humans continue to live under extended periods of wakefulness and ingestion events, daily eating pattern offers a new potential target for lifestyle intervention to reduce CVD risk.
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Affiliation(s)
- Girish C. Melkani
- Department of Biology, Molecular Biology and Heart InstitutesSan Diego State University San DiegoCA92182USA
| | - Satchidananda Panda
- Regulatory Biology LaboratorySalk Institute for Biological StudiesLa JollaCA92037USA
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Alquadan KF, Singhania G, Koratala A, Ejaz AA. Office orthostatic blood pressure measurements and ambulatory blood pressure monitoring in the prediction of autonomic dysfunction. Clin Hypertens 2017; 23:3. [PMID: 28331633 PMCID: PMC5351249 DOI: 10.1186/s40885-016-0059-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Accepted: 12/26/2016] [Indexed: 11/30/2022] Open
Abstract
Background In this retrospective analysis we investigated the predictive performance of orthostatic hypotension (OH) and ambulatory blood pressure monitoring (ABP) to predict autonomic dysfunction. Methods Statistical associations among the candidate variables were investigated and comparisons of predictive performances were performed using Receiver Operating Characteristics (ROC) curves. Results Ninety-four patients were included for analysis. No significant correlations could be demonstrated between OH and components of ABP (reversal of circadian pattern, postprandial hypotension and heart rate variability), nor between OH and autonomic reflex screen. Reversal of circadian pattern did not demonstrate significant correlation (r = 0.12, p = 0.237) with autonomic reflex screen, but postprandial hypotension (r = 0.39, p = 0.003) and heart rate variability (r = 0.27, p = 0.009) demonstrated significant correlations. Postprandial hypotension was associated with a five-fold (OR 4.83, CI95% 1.6–14.4, p = 0.005) increased risk and heart rate variability with a four-fold (OR 3.75, CI95% 1.3–10.6, p = 0.013) increased risk for autonomic dysfunction. Per ROC curves, heart rate variability (0.671, CI95% 0.53–0.81, p = 0.025) and postprandial hypotension (0.668, CI95% 0.52–0.72, p = 0.027) were among the best predictors of autonomic dysfunction in routine clinical practice. Conclusion Postprandial hypotension and heart rate variability on ambulatory blood pressure monitoring are among the best predictors of autonomic dysfunction in routine clinical practice.
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Affiliation(s)
- Kawther F Alquadan
- Division of Nephrology, Hypertension and Renal Transplantation, University of Florida, P.O. Box 100224, Gainesville, FL 32610-0224 USA
| | - Girish Singhania
- Division of Nephrology and Hypertension, University of Utah, Salt Lake City, USA
| | - Abhilash Koratala
- Division of Nephrology, Hypertension and Renal Transplantation, University of Florida, P.O. Box 100224, Gainesville, FL 32610-0224 USA
| | - Abutaleb A Ejaz
- Division of Nephrology, Hypertension and Renal Transplantation, University of Florida, P.O. Box 100224, Gainesville, FL 32610-0224 USA
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Nixon PA, Washburn LK, O’Shea TM, Shaltout HA, Russell GB, Snively BM, Rose JC. Antenatal steroid exposure and heart rate variability in adolescents born with very low birth weight. Pediatr Res 2017; 81:57-62. [PMID: 27632775 PMCID: PMC5235986 DOI: 10.1038/pr.2016.173] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 07/26/2016] [Indexed: 01/18/2023]
Abstract
BACKGROUND Reduced heart rate variability (HRV) suggests autonomic imbalance in the control of heart rate and is associated with unfavorable cardiometabolic outcomes. We examined whether antenatal corticosteroid (ANCS) exposure had long-term programming effects on HRV in adolescents born with very low birth weight (VLBW). METHODS Follow-up study of a cohort of VLBW 14-y olds born between 1992 and 1996 with 50% exposed to ANCS. HRV in both the time and frequency domains using Nevrokard Software was determined from a 5-min electrocardiogram tracing. RESULTS HRV data from 89 (35 male, 53 non-black) exposed (ANCS+) and 77 (28 male, 29 non-black) unexposed (ANCS-) adolescents were analyzed. HRV did not differ between ANCS+ and ANCS- black participants. However, in non-black participants, a significant interaction between ANCS and sex was observed, with ANCS- females having significantly greater HRV than ANCS+ females and males, and ANCS- males for both time and frequency domain variables. CONCLUSION Among non-black adolescents born with VLBW, ANCS exposure is associated with reduced HRV with apparent sex-specificity. Reduced HRV has been associated with development of adverse cardiometabolic outcomes, thus supporting the need to monitor these outcomes in VLBW adolescents as they mature.
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Affiliation(s)
- Patricia A. Nixon
- Department of Health and Exercise Science, Wake Forest University, Winston Salem, NC, USA,Department of Pediatrics, Wake Forest University School of Medicine, Winston Salem, NC, USA,Corresponding Author: Patricia A. Nixon, PhD, Dept. of Health & Exercise Science, PO Box 7868, Wake Forest University, Winston-Salem, NC 27109-7868, , Phone: 336-758-4642, FAX: 336-758-4680
| | - Lisa K. Washburn
- Department of Pediatrics, Wake Forest University School of Medicine, Winston Salem, NC, USA
| | - T. Michael O’Shea
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Hossam A. Shaltout
- Department of Obstetrics and Gynecology, Wake Forest University School of Medicine, Winston Salem, NC, USA
| | - Gregory B. Russell
- Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston Salem, NC, USA
| | - Beverly M. Snively
- Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston Salem, NC, USA
| | - James C. Rose
- Department of Obstetrics and Gynecology, Wake Forest University School of Medicine, Winston Salem, NC, USA
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Impact of Diabetes Type 1 in Children on Autonomic Modulation at Rest and in Response to the Active Orthostatic Test. PLoS One 2016; 11:e0164375. [PMID: 27788152 PMCID: PMC5082837 DOI: 10.1371/journal.pone.0164375] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 09/24/2016] [Indexed: 12/15/2022] Open
Abstract
Introduction Cardiovascular autonomic neuropathy is one of the most common complications of diabetes mellitus type 1 (DM1), of which one of the first subclinical manifestations is changes in heart rate variability (HRV). Thus, analysis of HRV associated with the autonomic active orthostatic test is important in this population. Objectives To analyze the autonomic modulation responses induced by the implementation of the active orthostatic test, in children with DM1, and study the autonomic modulation by means of HRV indices. Method Data of 35 children were analyzed, of both sexes, aged between 7 and 15 years, who were divided into two groups: Diabetic (n = 16) and Control (n = 19). The following variables were collected initially: weight, height, body fat percentage, heart rate, blood pressure and casual blood glucose. Subsequently, for analysis of autonomic modulation, the beat-to-beat heart rate was captured by a heart rate monitor in the supine position for 30 minutes and after 10 minutes standing during performance of the active orthostatic test. HRV indices were calculated in the time and frequency domains. For data analysis, covariance analysis was used to compare groups and ANOVA for repeated measures to compare the effects of the active orthostatic test. These data were adjusted for age, sex, ethnicity, body fat percentage and casual blood glucose, with a 5% significance level. Results The results suggested that diabetic children at rest present a decrease in SDNN (50.4 vs. 75.2), rMSSD (38.7 vs 57.6) and LF [ms2] (693.6 vs 1874.6). During the active orthostatic test the children in both groups demonstrated a reduction in SDNN, RMSSD and LF [ms2] compared to the resting position, and this response was less pronounced in the diabetic group. Conclusion We conclude that regardless of age, sex, ethnicity, body fat percentage and casual blood glucose, performing the active orthostatic test promoted increased sympathetic modulation and reduced parasympathetic modulation in both groups, and this response was less pronounced in diabetic children, who presented reduced overall variability and parasympathetic modulation.
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Sex differences in healthy human heart rate variability: A meta-analysis. Neurosci Biobehav Rev 2016; 64:288-310. [PMID: 26964804 DOI: 10.1016/j.neubiorev.2016.03.007] [Citation(s) in RCA: 434] [Impact Index Per Article: 54.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 03/04/2016] [Indexed: 12/17/2022]
Abstract
The present meta-analysis aimed to quantify current evidence on sex differences in the autonomic control of the heart, indexed by measures of heart rate variability (HRV) in healthy human subjects. An extensive search of the literature yielded 2020 titles and abstracts, of which 172 provided sufficient reporting of sex difference in HRV. Data from 63,612 participants (31,970 females) were available for analysis. Meta-analysis yielded a total of 1154 effect size estimates (k) across 50 different measures of HRV in a cumulated total of 296,247 participants. Females showed a significantly lower mean RR interval and standard deviation of RR intervals (SDNN). The power spectral density of HRV in females is characterized by significantly less total power that contains significantly greater high- (HF) and less low-frequency (LF) power. This is further reflected by a lower LF/HF ratio. Meta-regression revealed significant effects of age, respiration control and the length of recording available for analysis. Although women showed greater mean heart rate, they showed greater vagal activity indexed by HF power of HRV. Underlying mechanisms of these findings are discussed.
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"Broken" autonomic cardiac circadian clock in obese adolescents: evidence and implications. Clin Auton Res 2014; 24:247-8. [PMID: 25366348 DOI: 10.1007/s10286-014-0260-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 10/21/2014] [Indexed: 10/24/2022]
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