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Eleveld N, Harmsen M, Elting JWJ, Maurits NM. Haemosync: A synchronisation algorithm for multimodal haemodynamic signals. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2024; 254:108298. [PMID: 38936154 DOI: 10.1016/j.cmpb.2024.108298] [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: 01/19/2024] [Revised: 05/30/2024] [Accepted: 06/17/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND Synchronous acquisition of haemodynamic signals is crucial for their multimodal analysis, such as dynamic cerebral autoregulation (DCA) analysis of arterial blood pressure (ABP) and transcranial Doppler (TCD)-derived cerebral blood velocity (CBv). Several technical problems can, however, lead to (varying) time-shifts between the different signals. These can be difficult to recognise and can strongly influence the multimodal analysis results. METHODS We have developed a multistep, cross-correlation-based time-shift detection and synchronisation algorithm for multimodal pulsatile haemodynamic signals. We have developed the algorithm using ABP and CBv measurements from a dataset that contained combinations of several time-shifts. We validated the algorithm on an external dataset with time-shifts. We additionally quantitatively validated the algorithm's performance on a dataset with artificially added time-shifts, consisting of sample clock differences ranging from -0.2 to 0.2 s/min and sudden time-shifts between -4 and 4 s. The influence of superimposed noise and variation in waveform morphology on the time-shift estimation was quantified, and their influence on DCA-indices was determined. RESULTS The instantaneous median absolute error (MedAE) between the artificially added time-shifts and the estimated time-shifts was 12 ms (median, IQR 12-12, range 11-14 ms) for drifts between -0.1 and 0.1 s/min and sudden time-shifts between -4 and 4 s. For drifts above 0.1 s/min, MedAE was higher (median 753, IQR 19 - 766, range 13 - 772 ms). When a certainty threshold was included (peak cross-correlation > 0.9), MedAE for all drifts-shift combinations decreased to 12 ms, with smaller variability (IQR 12 - 13, range 8 - 22 ms, p < 0.001). The time-shift estimation is robust to noise, as the MedAE was similar for superimposed white noise with variance equal to the signal variance. After time-shift correction, DCA-indices were similar to the original, non-time-shifted signals. Phase shift differed by 0.17° (median, IQR 0.13-0.2°, range 0.0038-1.1°) and 0.54° (median, IQR 0.23-1.7°, range 0.0088-5.6°) for the very low frequency and low frequency ranges, respectively. DISCUSSION This algorithm allows visually interpretable detection and accurate correction of time-shifts between pulsatile haemodynamic signals (ABP and CBv).
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Affiliation(s)
- Nick Eleveld
- University of Groningen, University Medical Center Groningen, Department of Neurology, 9713 GZ Groningen, the Netherlands.
| | - Marije Harmsen
- University of Groningen, University Medical Center Groningen, Department of Neurology, 9713 GZ Groningen, the Netherlands
| | - Jan Willem J Elting
- University of Groningen, University Medical Center Groningen, Department of Neurology, 9713 GZ Groningen, the Netherlands
| | - Natasha M Maurits
- University of Groningen, University Medical Center Groningen, Department of Neurology, 9713 GZ Groningen, the Netherlands
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Yamaya N, Hashimoto T, Ikeda S, Brilliant T D, Tsujimoto M, Nakagawa S, Kawashima R. Preventive effect of one-session brief focused attention meditation on state fatigue: Resting state functional magnetic resonance imaging study. Neuroimage 2024; 297:120709. [PMID: 38936650 DOI: 10.1016/j.neuroimage.2024.120709] [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: 01/05/2024] [Revised: 06/16/2024] [Accepted: 06/24/2024] [Indexed: 06/29/2024] Open
Abstract
INTRODUCTION The extended practice of meditation may reduce the influence of state fatigue by changing neurocognitive processing. However, little is known about the preventive effects of one-session brief focused attention meditation (FAM) on state fatigue in healthy participants or its potential neural mechanisms. This study examined the preventive effects of one-session brief FAM on state fatigue and its neural correlates using resting-state functional MRI (rsfMRI) measurements. METHODS We randomly divided 56 meditation-naïve participants into FAM and control groups. After the first rsfMRI scan, each group performed a 10-minute each condition while wearing a functional near-infrared spectroscopy (fNIRS) device for assessing brain activity. Subsequently, following a second rsfMRI scan, the participants completed a fatigue-inducing task (a Go/NoGo task) for 60 min. We evaluated the temporal changes in the Go/NoGo task performance of participants as an indicator of state fatigue. We then calculated changes in the resting-state functional connectivity (rsFC) of the rsfMRI from before to after each condition and compared them between groups. We also evaluated neural correlates between the changes in rsFC and state fatigue. RESULTS AND DISCUSSION The fNIRS measurements indicated differences in brain activity during each condition between the FAM and control groups, showing decreased medial prefrontal cortex activity and decreased functional connectivity between the medial prefrontal cortex and middle frontal gyrus. The control group exhibited a decrement in Go/NoGo task performance over time, whereas the FAM group did not. These results, thus, suggested that FAM could prevent state fatigue. Compared with the control group, the rsFC analysis revealed a significant increase in the connectivity between the left dorsomedial prefrontal cortex and right superior parietal lobule in the FAM group, suggesting a modification of attention regulation by cognitive effort. In the control group, increased connectivity was observed between the bilateral posterior cingulate cortex and left inferior occipital gyrus, which might be associated with poor attention regulation and reduced higher-order cognitive function. Additionally, the change in the rsFC of the control group was related to state fatigue. CONCLUSION Our findings suggested that one session of 10-minute FAM could prevent behavioral state fatigue by employing cognitive effort to modify attention regulation as well as suppressing poor attention regulation and reduced higher-order cognitive function.
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Affiliation(s)
- Noriki Yamaya
- Graduate School of Medicine, Tohoku University, 2-1 Seiryomachi, Aobaku, Sendai 9808575, Japan; Department of Functional Brain Imaging, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi, Aobaku, Sendai 9808575, Japan.
| | - Teruo Hashimoto
- Department of Functional Brain Imaging, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi, Aobaku, Sendai 9808575, Japan
| | - Shigeyuki Ikeda
- Faculty of Engineering, University of Toyama, Gofuku 3190, Toyama-shi, Toyama 9308555, Japan
| | - Denilson Brilliant T
- Graduate School of Medicine, Tohoku University, 2-1 Seiryomachi, Aobaku, Sendai 9808575, Japan; Department of Functional Brain Imaging, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi, Aobaku, Sendai 9808575, Japan
| | - Masayuki Tsujimoto
- Graduate School of Medicine, Tohoku University, 2-1 Seiryomachi, Aobaku, Sendai 9808575, Japan; Department of Functional Brain Imaging, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi, Aobaku, Sendai 9808575, Japan
| | - Seishu Nakagawa
- Division of Psychiatry, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyaginoku, Sendai, Miyagi 983-8536, Japan; Department of Human Brain Science, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi, Aobaku, Sendai 9808575, Japan
| | - Ryuta Kawashima
- Department of Functional Brain Imaging, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi, Aobaku, Sendai 9808575, Japan
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Skalski-Bednarz SB, Toussaint LL, Surzykiewicz J. Beyond HIV Shame: Effects of Self-Forgiveness in Improving Mental Health in HIV-Positive Individuals in Poland. JOURNAL OF RELIGION AND HEALTH 2024:10.1007/s10943-024-02084-7. [PMID: 39096441 DOI: 10.1007/s10943-024-02084-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/05/2024] [Indexed: 08/05/2024]
Abstract
Guided by the bio-psycho-socio-spiritual approach, this randomized controlled trial assessed the efficacy of a self-forgiveness intervention among 60 HIV-positive individuals in Poland. Participants underwent a 90-min "Restore: The Journey Toward Self-Forgiveness" session, in contrast to a wait-list control group. The intervention significantly enhanced self-forgiveness, spirituality, mental well-being, and heart rate variability in response to a cognitive stressor (i.e., a mental arithmetic challenge). Significant effects were observed in both between-group and within-subject comparisons. These results support the incorporation of self-forgiveness into psychological rehabilitation programs for HIV to improve quality of life and health outcomes.
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Affiliation(s)
- Sebastian Binyamin Skalski-Bednarz
- Institute of Psychology, Humanitas University, Kilinskiego 43, 41-200, Sosnowiec, Poland.
- Faculty of Philosophy and Education, Katholische Universität Eichstätt-Ingolstadt, Eichstätt, Germany.
| | | | - Janusz Surzykiewicz
- Faculty of Philosophy and Education, Katholische Universität Eichstätt-Ingolstadt, Eichstätt, Germany
- Faculty of Education, Cardinal Stefan Wyszyński University in Warsaw, Warsaw, Poland
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Watso JC, Robinson AT, Singar SAB, Cuba JN, Koutnik AP. Advanced cardiovascular physiology in an individual with type 1 diabetes after 10-year ketogenic diet. Am J Physiol Cell Physiol 2024; 327:C446-C461. [PMID: 38912731 DOI: 10.1152/ajpcell.00694.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 06/18/2024] [Accepted: 06/18/2024] [Indexed: 06/25/2024]
Abstract
Adults with type 1 diabetes (T1D) have an elevated risk for cardiovascular disease (CVD) compared with the general population. HbA1c is the primary modifiable risk factor for CVD in T1D. Fewer than 1% of patients achieve euglycemia (<5.7% HbA1c). Ketogenic diets (KD; ≤50 g carbohydrate/day) may improve glycemia and downstream vascular dysfunction in T1D by reducing HbA1c and insulin load. However, there are concerns regarding the long-term CVD risk from a KD. Therefore, we compared data collected in a 60-day window in an adult with T1D on exogenous insulin who consumed a KD for 10 years versus normative values in those with T1D (T1D norms). The participant achieved euglycemia with an HbA1c of 5.5%, mean glucose of 98 [5] mg/dL (median [interquartile range]), 90 [11]% time-in-range 70-180 mg/dL (T1D norms: 1st percentile for all), and low insulin requirements of 0.38 ± 0.03 IU/kg/day (T1D norms: 8th percentile). Seated systolic blood pressure (SBP) was 113 mmHg (T1D norms: 18th percentile), while ambulatory awake SBP was 132 ± 15 mmHg (T1D target: <130 mmHg), blood triglycerides were 69 mg/dL (T1D norms: 34th percentile), low-density lipoprotein was 129 mg/dL (T1D norms: 60th percentile), heart rate was 56 beats/min (T1D norms: >1SD below the mean), carotid-femoral pulse wave velocity was 7.17 m/s (T1D norms: lowest quartile of risk), flow-mediated dilation was 12.8% (T1D norms: >1SD above mean), and cardiac vagal baroreflex gain was 23.5 ms/mmHg (T1D norms: >1SD above mean). Finally, there was no indication of left ventricular diastolic dysfunction from echocardiography. Overall, these data demonstrate below-average CVD risk relative to T1D norms despite concerns regarding the long-term impact of a KD on CVD risk.NEW & NOTEWORTHY Adults with type 1 diabetes (T1D) have a 10-fold higher risk for cardiovascular disease (CVD) compared with the general population. We assessed cardiovascular health metrics in an adult with T1D who presented with a euglycemic HbA1c after following a ketogenic diet for the past 10 years. Despite concerns about the ketogenic diet increasing CVD risk, the participant exhibited below-average CVD risk relative to others with T1D when considering all outcomes together.
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Affiliation(s)
- Joseph C Watso
- Cardiovascular and Applied Physiology Laboratory, Department of Health, Nutrition, and Food Sciences, Florida State University, Tallahassee, Florida, United States
| | - Austin T Robinson
- Neurovascular Physiology Laboratory, Indiana University, Bloomington, Indiana, United States
| | - Saiful Anuar Bin Singar
- Department of Health, Nutrition, and Food Sciences, Florida State University, Tallahassee, Florida, United States
| | - Jens N Cuba
- Cardiovascular and Applied Physiology Laboratory, Department of Health, Nutrition, and Food Sciences, Florida State University, Tallahassee, Florida, United States
| | - Andrew P Koutnik
- Sansum Diabetes Research Institute, Santa Barbara, California, United States
- Human Healthspan, Resilience, and Performance, Florida Institute for Human and Machine Cognition, Pensacola, Florida, United States
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Fernández-Morales C, Espejo-Antúnez L, Clemente-Suárez VJ, Tabla-Hinojosa FB, Albornoz-Cabello M. Analysis of heart rate variability during emergency flight simulator missions in fighter pilots. BMJ Mil Health 2024; 170:296-302. [PMID: 36585028 DOI: 10.1136/military-2022-002242] [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: 09/02/2022] [Accepted: 12/07/2022] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Managing emergency situations in different simulated flight segments can entail a workload that could affect the performance of military pilots. The aim was to analyse the modifications in neurovegetative balance (using HR variability, HRV) of professional fighter pilots attending learning/training sessions on emergency situations in a flight simulator. METHODS A total of 18 pilots from the Spanish Air and Space Force were included. HRV was recorded simultaneously during diverse simulated emergency situations in three different flight segments: take-off, in-flight and landing. RESULTS The comparison between take-off and in-flight revealed a statistically significant increase (p<0.05) in percentage of consecutive RR intervals that differ by more than 50 ms from each other (pNN50), root mean square of the successive differences (rMSSD), standard desviation 1 and 2 (SD1 and SD2), and a statistically significant decrease (p<0.000) in stress score (SS) and in the sympathetic to parasympathetic ratio (S:PS). Between flight and landing, a statistically significant increase (p<0.05) in mean HR, minimum HR, maximum HR, SS and S:PS was shown, while experiencing a significant decrease (p<0.000) in pNN50, rMSSD and SD2. Finally, between take-off and landing, the variables which showed significant changes (p<0.05), with these changes being a significant increase, were mean HR, minimum HR, maximum HR, rMSSD, SD1 and SD2. SS and S:PS ratios showed a statistically significant decrease (p<0.000). CONCLUSIONS An emergency situation in a flight simulator manoeuvre produced an anticipatory anxiety response in pilots, demonstrated by low HRV, which increased during the flight segment and decreased during the landing segment of the flight. Trial registration number NCT04487899.
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Affiliation(s)
| | - L Espejo-Antúnez
- Department of Medical-Surgical Therapy, University of Extremadura, Badajoz, Spain
| | - V J Clemente-Suárez
- Faculty of Sports Sciences, European University - Campus Madrid, Madrid, Spain
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Venn R, Northey JM, Naumovski N, McKune A. Reliability of an "At-Home" Method for Monitoring Resting and Reactive Autonomic Nervous System Activity in Children: A Pilot Study. CHILDREN (BASEL, SWITZERLAND) 2024; 11:835. [PMID: 39062284 PMCID: PMC11275235 DOI: 10.3390/children11070835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 06/22/2024] [Accepted: 07/03/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Heart rate variability (HRV), an index of the functional status of the autonomic nervous system (ANS), provides an opportunity for early detection of ANS dysfunction. Lower resting, vagally related HRV parameters are associated with increased risk of physical and mental illness. External factors influencing the ANS, such as the testing environment, may impact the interpretation of HRV. This study's main aim was to determine the reliability of HRV resting and reactivity tests performed at home with children aged 4-9 years. METHODS Fourteen healthy children (female n = 8) aged 6.8 ± 1.5 years participated. Two HRV tests were performed at home via online supervision 7 days apart using a Polar H10 heart rate monitor. The absolute and relative reliability of the pre-exercise resting (5 min) and sub-maximal exercise step test recovery (4 × 30 s segments) HRV time and frequency domains were calculated. RESULTS The Pearson correlation coefficients for day 1 versus day 7 for the vagal activity HRV domains (RMSSD log) at rest and in the first 30 s and 30-60 s of recovery indicated good-to-excellent relative reliability (r > 0.8, p < 0.01). Absolute reliability was moderate for the resting RMSSD log, with a coefficient of variation (CV) of 5.2% (90% CI: 3.9, 7.8%), high for the first 30 s of standing recovery, with a CV of 10.7% (90% CI: 8.2, 15.7%), and moderate for 30-60 s of recovery, with a CV of 8.7% (90% CI: 6.6, 12.9%). CONCLUSIONS The findings of this pilot study indicate that the resting and exercise recovery HRV measures of vagal activity can be measured reliably at home in children. This represents a novel "at-home" protocol for monitoring ANS health and development in children.
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Affiliation(s)
- Rachel Venn
- School of Rehabilitation and Exercise Sciences, Faculty of Health, University of Canberra, Canberra, ACT 2617, Australia; (R.V.); (J.M.N.); (N.N.)
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT 2617, Australia
| | - Joseph M. Northey
- School of Rehabilitation and Exercise Sciences, Faculty of Health, University of Canberra, Canberra, ACT 2617, Australia; (R.V.); (J.M.N.); (N.N.)
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT 2617, Australia
| | - Nenad Naumovski
- School of Rehabilitation and Exercise Sciences, Faculty of Health, University of Canberra, Canberra, ACT 2617, Australia; (R.V.); (J.M.N.); (N.N.)
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT 2617, Australia
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Ngunnawal Land, Canberra, ACT 2617, Australia
- Department of Nutrition and Dietetics, Harokopio University, 17671 Kallithea, Attica, Greece
| | - Andrew McKune
- School of Rehabilitation and Exercise Sciences, Faculty of Health, University of Canberra, Canberra, ACT 2617, Australia; (R.V.); (J.M.N.); (N.N.)
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT 2617, Australia
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Ngunnawal Land, Canberra, ACT 2617, Australia
- School of Health Sciences, University of Kwazulu-Natal, Durban 3629, South Africa
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Feldman MJ, Bliss-Moreau E, Lindquist KA. The neurobiology of interoception and affect. Trends Cogn Sci 2024; 28:643-661. [PMID: 38395706 PMCID: PMC11222051 DOI: 10.1016/j.tics.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 01/25/2024] [Accepted: 01/26/2024] [Indexed: 02/25/2024]
Abstract
Scholars have argued for centuries that affective states involve interoception, or representations of the state of the body. Yet, we lack a mechanistic understanding of how signals from the body are transduced, transmitted, compressed, and integrated by the brains of humans to produce affective states. We suggest that to understand how the body contributes to affect, we first need to understand information flow through the nervous system's interoceptive pathways. We outline such a model and discuss how unique anatomical and physiological aspects of interoceptive pathways may give rise to the qualities of affective experiences in general and valence and arousal in particular. We conclude by considering implications and future directions for research on interoception, affect, emotions, and human mental experiences.
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Affiliation(s)
- M J Feldman
- Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - E Bliss-Moreau
- Department of Psychology, University of California Davis, Davis, CA, USA; California National Primate Research Center, University of California Davis, Davis, CA, USA
| | - K A Lindquist
- Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Jin K, Guo Z, Qiao Z, Liu M, Yang Y, Xu C. Agreement between Ultra-Short-Term and Standard Heart Rate Variability Analysis in Resting and Post-Exercise Conditions. Life (Basel) 2024; 14:837. [PMID: 39063591 PMCID: PMC11278104 DOI: 10.3390/life14070837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2024] [Revised: 06/28/2024] [Accepted: 06/29/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Short-term (5 min) heart rate variability (HRV) analysis is widely used in assessing autonomic nervous system activity during exercise. While shortening the HRV measurement duration can help improve its application efficiency, its accuracy needs to be verified. This study investigated the agreement between ultra-short-term (UST) HRV (3 or 4 min) and standard 5 min HRV and explored the optimal recording duration under resting and post-exercise conditions. METHODS Fourteen participants exercised on a cycle ergometer at 60% of their maximum peak power. Data were collected during the rest condition (Pre-E) and three post-exercise conditions (Post-E1, Post-E2, and Post-E3), with indicators of the standard deviation (SDNN) of the ultra-short and short-term RR intervals and the root mean square (RMSSD) of the continuous difference between RR intervals. Repeated measures ANOVA, Cohen's d statistic, Bland-Altman analysis, and interclass correlation coefficients (ICC) assessed the agreement between UST-HRV and ST-HRV. RESULTS The consistency results of SDNN and RMSSD in resting and post-exercise were different. At the Pre-E, Post-E2, and Post-E3 phases, no statistical differences for SDNN and RMSSD were observed, with ICCs surpassing 0.9, indicating a high level of agreement. However, at Post-E2, there was a significant difference between 3 min RMSSD and 5 min RMSSD (p < 0.05), as well as between 3 min SDNN, 4 min SDNN, and 5 min SDNN (p < 0.05). Furthermore, the limits of agreement were observed to decrease as the time duration increased in Bland-Altman plots. CONCLUSIONS UST-HRV analysis is a reliable substitute for standard 5 min HRV assessment, particularly during resting conditions. For post-exercise measurements, assessing the appropriateness of a 3- or 4 min duration based on the exercise's length is recommended to ensure accuracy and reliability.
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Affiliation(s)
- Kai Jin
- Department of Physical Education, Southeast University, Nanjing 210096, China;
| | - Zhenxiang Guo
- Sports Coaching College, Beijing Sport University, Beijing 100084, China; (Z.G.); (M.L.)
| | - Zining Qiao
- School of Strength and Conditioning Training, Beijing Sport University, Beijing 100084, China;
| | - Meng Liu
- Sports Coaching College, Beijing Sport University, Beijing 100084, China; (Z.G.); (M.L.)
| | - Yi Yang
- College of Physical Education, Hengxing University, Qingdao 266100, China
| | - Changnan Xu
- Physical Education Department, Nanjing University of Aeronautics and Astronautics, Nanjing 210016, China
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Manser P, de Bruin ED. Test-retest reliability and validity of vagally-mediated heart rate variability to monitor internal training load in older adults: a within-subjects (repeated-measures) randomized study. BMC Sports Sci Med Rehabil 2024; 16:141. [PMID: 38926777 PMCID: PMC11210148 DOI: 10.1186/s13102-024-00929-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 06/14/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Vagally-mediated heart rate variability (vm-HRV) shows promise as a biomarker of internal training load (ITL) during exergame-based training or motor-cognitive training in general. This study evaluated the test-retest reliability of vm-HRV during exergaming in healthy older adults (HOA) and its validity to monitor ITL. METHODS A within-subjects (repeated-measures) randomized study was conducted that included baseline assessments and 4 measurement sessions. Participants played 5 exergames at 3 standardized levels of external task demands (i.e., "easy", "challenging", and "excessive") in random order for 90 s. Test-retest reliability was assessed on the basis of repeated-measures analyses of variance (ANOVA), intraclass correlation coefficients (ICC3,1), standard errors of measurement (SEM), and smallest detectable differences (SDD). Validity was determined by examining the effect of game level on vm-HRV in the ANOVA. RESULTS Fourty-three HOA (67.0 ± 7.0 years; 58.1% females (25 females, 18 males); body mass index = 23.7 ± 3.0 kg·m-2) were included. Mean R-R time intervals (mRR) and parasympathetic nervous system tone index (PNS-Index) exhibited mostly good to excellent relative test-retest reliability with no systematic error. Mean SEM% and SDD% were 36.4% and 100.7% for mRR, and 44.6% and 123.7% for PNS-Index, respectively. Significant differences in mRR and PNS-Index were observed between standardized levels of external task demands, with mostly large effect sizes (mean r = 0.847). These results persisted irrespective of the type of neurocognitive domain trained and when only motoric and cognitive demands were manipulated while physical intensity was kept constant. The remaining vm-HRV parameters showed inconsistent or poor reliability and validity. CONCLUSION Only mRR and PNS-Index demonstrated reliable measurement and served as valid biomarkers for ITL during exergaming at a group level. Nonetheless, the presence of large SEMs hampers the detection of individual changes over time and suggests insufficient precision of these measurements at the individual level. Future research should further investigate the reliability and validity of vm-HRV with a specific focus on comparing different measurement methodologies and exercise conditions, particularly focusing on ultra-short-term HRV measurements, and investigate the potential implications (i.e., superiority to other markers of ITL or monitoring strategies?) of using vm-HRV as a biomarker of ITL.
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Affiliation(s)
- Patrick Manser
- Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.
| | - Eling D de Bruin
- Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Department of Health, OST - Eastern Swiss University of Applied Sciences, St. Gallen, Switzerland
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
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Chang LH, Huang MH, Lin IM. Developing a Five-Minute Normative Database of Heart Rate Variability for Diagnosing Cardiac Autonomic Dysregulation for Patients with Major Depressive Disorder. SENSORS (BASEL, SWITZERLAND) 2024; 24:4003. [PMID: 38931788 PMCID: PMC11207773 DOI: 10.3390/s24124003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 06/07/2024] [Accepted: 06/16/2024] [Indexed: 06/28/2024]
Abstract
Heart rate variability (HRV) is related to cardiac vagal control and emotional regulation and an index for cardiac vagal control and cardiac autonomic activity. This study aimed to develop the Taiwan HRV normative database covering individuals aged 20 to 70 years and to assess its diagnosing validity in patients with major depressive disorder (MDD). A total of 311 healthy participants were in the HRV normative database and divided into five groups in 10-year age groups, and then the means and standard deviations of the HRV indices were calculated. We recruited 272 patients with MDD for cross-validation, compared their HRV indices with the normative database, and then converted them to Z-scores to explore the deviation of HRV in MDD patients from healthy groups. The results found a gradual decline in HRV indices with advancing age in the HC group, and females in the HC group exhibit higher cardiac vagal control and parasympathetic activity than males. Conversely, patients in the MDD group demonstrate lower HRV indices than those in the HC group, with their symptoms of depression and anxiety showing a negative correlation with HRV indices. The Taiwan HRV normative database has good psychometric characteristics of cross-validation.
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Affiliation(s)
- Li-Hsin Chang
- Department of Psychology, College of Humanities and Social Sciences, Kaohsiung Medical University, Kaohsiung 807378, Taiwan; (L.-H.C.); (M.-H.H.)
| | - Min-Han Huang
- Department of Psychology, College of Humanities and Social Sciences, Kaohsiung Medical University, Kaohsiung 807378, Taiwan; (L.-H.C.); (M.-H.H.)
| | - I-Mei Lin
- Department of Psychology, College of Humanities and Social Sciences, Kaohsiung Medical University, Kaohsiung 807378, Taiwan; (L.-H.C.); (M.-H.H.)
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 807378, Taiwan
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11
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Chand K, Chandra S, Dutt V. A comprehensive evaluation of linear and non-linear HRV parameters between paced breathing and stressful mental state. Heliyon 2024; 10:e32195. [PMID: 38873683 PMCID: PMC11170182 DOI: 10.1016/j.heliyon.2024.e32195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 05/22/2024] [Accepted: 05/29/2024] [Indexed: 06/15/2024] Open
Abstract
Background Heart rate variability (HRV) is a crucial metric that provides valuable insight into the balance between relaxation and stress. Previous research has shown that most HRV parameters improve during periods of mental relaxation, while decreasing during tasks involving cognitive workload. Although a comprehensive analysis of both linear and non-linear HRV parameters has been carried out in existing literature, there still exists a need for further research in this area. Additionally, limited knowledge exists regarding how specific interventions may influence the interpretation of these parameters and how the different parameters correlate under different interventions. This study aims to address these gaps by conducting a thorough comparison of different linear and non-linear HRV parameters under mentally relaxed versus stressful states. Methodology Participants were randomly and equally divided among two between-subjects groups: relaxed-stress (RS) (N = 22) and stress-relaxed (SR) (N = 22). In the RS group, a paced breathing task was given for 5 min to create relaxation, and was followed by a 5-min time-based mental calculation task to create stress. In the SR group, the order of the stress and relaxed tasks was reversed. There was a washout period of 15 min after the first task in both groups. Results Of the 37 HRV parameters, 33 differed significantly between the two interventions. The majority of the parameters exhibited an improving and degrading tendency of HRV parameters in the relaxed and stressed states, respectively. The correlation of the majority of HRV parameters decreases during stress, while prominent time domain and geometric domain parameters stand out in the correlation. Conclusion Overall, HRV parameters can be reliably used to assess a person's relaxed and stressed mental states during paced breathing and mental arithmetic task respectively. Furthermore, non-linear HRV parameters provide accurate estimators of the mental state, in addition to the commonly used linear parameters.
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Affiliation(s)
- Kulbhushan Chand
- IIT Mandi iHub and HCi Foundation, Indian Institute of Technology Mandi, Kamand, HP, India , 175005
| | - Shilpa Chandra
- Indian Institute of Technology Mandi, Kamand, HP, India , 175005
| | - Varun Dutt
- Indian Institute of Technology Mandi, Kamand, HP, India , 175005
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12
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Garbilis A, Mednieks J. Differences in Heart Rate Variability in the Frequency Domain between Different Groups of Patients. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:900. [PMID: 38929516 PMCID: PMC11205485 DOI: 10.3390/medicina60060900] [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: 04/14/2024] [Revised: 05/22/2024] [Accepted: 05/27/2024] [Indexed: 06/28/2024]
Abstract
Background and Objectives: Heart rate variability (HRV) is defined as a physiological variation in duration between sinus beats. The aim of this study was to research and analyze the HRV between various groups of patients. Materials and Methods: A retrospective study was conducted in an outpatient setting. Patients who had undergone a tilt-table test were selected for this study and were divided into three groups based on their self-reported health anamnesis: group 1 (n = 84, mean age 45.8 ± 17.8) consisted of patients with no known orthostatic intolerance or neurodegenerative disease, group 2 consisted of patients with a known or suspected orthostatic intolerance (n = 50, mean age 46.5 ± 18.6), and group 3 consisted of patients with a known or suspected neurodegenerative disorder (n = 29, mean age 55.6 ± 20.4). During the tilt-table test, HRV frequency-domain parameters-normalized low frequency (LFnu) and high frequency (HFnu), absolute powers-absolute low frequency (LF-RRI), absolute high frequency (HF-RRI), and LF/HF ratio-were recorded during 5 min rest in the supine position. Results: Group 1 had a reduced LFnu at 52.93% (SD: 18.00) compared to group 2 at 58.57% (18.06) and group 3 at 61.80% (SD: 17.74), and group 1 had increased HFnu: group 1-47.08% (SD: 17.97), group 2-41.41% (SD: 18.03), and group 3-38.16% (SD: 14.7). LFnu and HFnu differences were statistically significant (p < 0.05). LF-RRI was reported as follows: group 1-531.32 ms2 (SD: 578.57), group 2-346.2 ms2 (SD: 447.96), and group 3-143.21 ms2 (SD: 166.96). HF-RRI was reported as follows: group 1-835.87 ms2 (SD: 1625.42), group 2-297.46 ms2 (SD: 507.15), and group 3-70.83 ms2 (SD: 75.67). LF-RRI and HF-RRI comparisons between groups were statistically significant (p < 0.001). LF/HF ratios were reported as follows: group 1-1.91 (SD: 2.29), group 2-2.43 (SD: 2.33), and group 3-2.54 (SD: 2.17). LF/HF ratio comparisons between groups were statistically significant at p < 0.05. Conclusions: This study shows that patients with known or suspected orthostatic intolerance and neurodegenerative disorders have reduced HRV, possibly caused by reduced parasympathetic modulation. HRV in patients with known or suspected neurodegenerative disorders is reduced more severely than in patients with orthostatic disorders. Other studies in HRV have indicated a possible increase of risk in cardiovascular disorders in patients with reduced HRV, and therefore, HRV analysis could be a potential clinical diagnostic tool. However, the lack of universally agreed upon methodology, reference values, and possible external and internal factor influence hinders the introduction of HRV examinations into wider clinical practice.
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Affiliation(s)
- Artūrs Garbilis
- Department of Residency, Rīga Stradiņš University, Dzirciema 16, LV-1007 Rīga, Latvia
- Department of Neurology and Neurosurgery, Rīga Stradiņš University, Pilsoņu 13, LV-1002 Rīga, Latvia;
| | - Jānis Mednieks
- Department of Neurology and Neurosurgery, Rīga Stradiņš University, Pilsoņu 13, LV-1002 Rīga, Latvia;
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13
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Addleman JS, Lackey NS, DeBlauw JA, Hajduczok AG. Heart Rate Variability Applications in Strength and Conditioning: A Narrative Review. J Funct Morphol Kinesiol 2024; 9:93. [PMID: 38921629 PMCID: PMC11204851 DOI: 10.3390/jfmk9020093] [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: 04/16/2024] [Revised: 05/23/2024] [Accepted: 05/24/2024] [Indexed: 06/27/2024] Open
Abstract
Heart rate variability (HRV) is defined as the fluctuation of time intervals between adjacent heartbeats and is commonly used as a surrogate measure of autonomic function. HRV has become an increasingly measured variable by wearable technology for use in fitness and sport applications. However, with its increased use, a gap has arisen between the research and the application of this technology in strength and conditioning. The goal of this narrative literature review is to discuss current evidence and propose preliminary guidelines regarding the application of HRV in strength and conditioning. A literature review was conducted searching for HRV and strength and conditioning, aiming to focus on studies with time-domain measurements. Studies suggest that HRV is a helpful metric to assess training status, adaptability, and recovery after a training program. Although reduced HRV may be a sign of overreaching and/or overtraining syndrome, it may not be a sensitive marker in aerobic-trained athletes and therefore has different utilities for different athletic populations. There is likely utility to HRV-guided programming compared to predefined programming in several types of training. Evidence-based preliminary guidelines for the application of HRV in strength and conditioning are discussed. This is an evolving area of research, and more data are needed to evaluate the best practices for applying HRV in strength and conditioning.
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Affiliation(s)
- Jennifer S. Addleman
- College of Osteopathic Medicine, Touro University California, Vallejo, CA 94592, USA
| | - Nicholas S. Lackey
- Center for Applied Biobehavioral Sciences (CABS), Alliant International University, San Diego, CA 92131, USA;
| | - Justin A. DeBlauw
- Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY 12866, USA
| | - Alexander G. Hajduczok
- Department of Cardiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA;
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14
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Yu JX, Hussein A, Mah L, Jean Chen J. The associations among glycemic control, heart variability, and autonomic brain function in healthy individuals: Age- and sex-related differences. Neurobiol Aging 2024; 142:41-51. [PMID: 39128180 DOI: 10.1016/j.neurobiolaging.2024.05.007] [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: 10/23/2023] [Revised: 05/08/2024] [Accepted: 05/11/2024] [Indexed: 08/13/2024]
Abstract
INTRODUCTION The purpose of this study was to clarify the relationships between glycemia and function of the autonomic nervous system (ANS), assessed via resting-state functional connectivity (FC) and heart-rate variability (HRV). METHODS Data for this study were extracted from the Leipzig Study for Mind-Body-Emotion Interactions, including 146 healthy adults (114 young, 32 older). Variables of interest were glycated hemoglobin (HbA1c), resting-state FC in the salience aspect of the central-autonomic (S-CAN) and salience network (SN) and HRV (RMSSD and high-frequency HRV (HF-HRV)). RESULTS HbA1c was inversely correlated with FC in the S-CAN but not SN. HbA1c was inversely correlated with HRV. Both RMSSD and log(HF-HRV) were correlated with FC in the S-CAN and SN. Age- (not sex-related) differences were observed in the Hb1Ac-FC associations (stronger in older adults) while sex- (not age-related) differences were observed in the HRV-FC (stronger in females). CONCLUSIONS These findings extend the diabetes literature to healthy adults in relating glycemia and brain function. The age- and sex-related differences in these relationships highlight the need to account for the potential effects of age and sex in future investigations.
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Affiliation(s)
- Jeffrey X Yu
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Ahmad Hussein
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
| | - Linda Mah
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - J Jean Chen
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Biomedical Engineering, University of Toronto, Toronto, ON, Canada.
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15
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Kreppke JN, Cody R, Beck J, Brand S, Donath L, Eckert A, Imboden C, Hatzinger M, Holsboer-Trachsler E, Lang UE, Mans S, Mikoteit T, Oswald A, Rogausch A, Schweinfurth-Keck N, Zahner L, Gerber M, Faude O. Cardiorespiratory fitness, perceived fitness and autonomic function in in-patients with different depression severity compared with healthy controls. J Psychiatr Res 2024; 175:437-445. [PMID: 38797040 DOI: 10.1016/j.jpsychires.2024.05.044] [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: 05/02/2023] [Revised: 03/26/2024] [Accepted: 05/20/2024] [Indexed: 05/29/2024]
Abstract
Over 300 million individuals worldwide suffer from major depressive disorder (MDD). Individuals with MDD are less physically active than healthy people which results in lower cardiorespiratory fitness (CRF) and less favorable perceived fitness compared with healthy controls. Additionally, individuals with MDD may show autonomic system dysfunction. The purpose of the present study was to evaluate the CRF, perceived fitness and autonomic function in in-patients with MDD of different severity compared with healthy controls. We used data from 212 in-patients (age: 40.7 ± 12.6 y, 53% female) with MDD and from 141 healthy controls (age: 36.7 ± 12.7 y, 58% female). We assessed CRF with the Åstrand-Rhyming test, self-reported perceived fitness and autonomic function by heart rate variability (HRV). In specific, we used resting heart rate, time- and frequency-based parameters for HRV. In-patients completed the Beck Depression Inventory-II (BDI-II) to self-assess the subjectively rated severity of depression. Based on these scores, participants were grouped into mild, moderate and severe MDD. The main finding was an inverse association between depression severity and CRF as well as perceived fitness compared with healthy controls. Resting heart rate was elevated with increasing depression severity. The time-based but not the frequency-based autonomic function parameters showed an inverse association with depression severity. The pattern of results suggests that among in-patients with major depressive disorder, those with particularly high self-assessed severity scores show a lower CRF, less favorable perceived fitness and partial autonomic dysfunction compared to healthy controls. To counteract these conditions, physical activity interventions may be effective.
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Affiliation(s)
- Jan-Niklas Kreppke
- Department for Sport, Exercise and Health, University of Basel, Basel, Switzerland.
| | - Robyn Cody
- Department for Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | | | - Serge Brand
- Department for Sport, Exercise and Health, University of Basel, Basel, Switzerland; Adult Psychiatric Clinics (UPKE), University of Basel, Basel, Switzerland; Substance Use Prevention Research Center and Sleep Disorder Research Center, Kermanshah University of Medical Sciences (KUMS), Kermanshah 6715847141, Iran; School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran; Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6719851115, Iran
| | - Lars Donath
- German Sport University Cologne, Department of Intervention Research in Exercise Training, Cologne, Germany
| | - Anne Eckert
- Adult Psychiatric Clinics (UPKE), University of Basel, Basel, Switzerland
| | - Christian Imboden
- Private Clinic Wyss, Münchenbuchsee, Switzerland; University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Martin Hatzinger
- Psychiatric Services, Solothurn, and Medical Faculty, University of Basel, Switzerland
| | | | - Undine E Lang
- Adult Psychiatric Clinics (UPKE), University of Basel, Basel, Switzerland
| | - Sarah Mans
- Private Clinic Wyss, Münchenbuchsee, Switzerland
| | - Thorsten Mikoteit
- Psychiatric Services, Solothurn, and Medical Faculty, University of Basel, Switzerland
| | - Anja Oswald
- Psychiatric Clinic Sonnenhalde, Riehen, Switzerland
| | | | | | - Lukas Zahner
- Department for Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Markus Gerber
- Department for Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Oliver Faude
- Department for Sport, Exercise and Health, University of Basel, Basel, Switzerland
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16
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Jarrett MS, Anderson T, Wideman L, Davis PG. Direct and indirect effects of adiposity on markers of autonomic nervous system activity in older adults. PLoS One 2024; 19:e0303117. [PMID: 38753844 PMCID: PMC11098483 DOI: 10.1371/journal.pone.0303117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 04/12/2024] [Indexed: 05/18/2024] Open
Abstract
Several cardiovascular disease (CVD) risk factors (e.g., hypertension, poor glycemic control) can affect and be affected by autonomic nervous system (ANS) activity. Since excess adiposity can influence CVD development through its effect on hypertension and diabetes mellitus, it is important to determine how adiposity and altered ANS activity are related. The present study employed structural equation modeling to investigate the relation between adiposity and ANS activity both directly and indirectly through biological variables typically associated with glycemic impairment and cardiac stress in older adults. Utilizing the Atherosclerosis Risk in Communities (ARIC) dataset, 1,145 non-smoking adults (74±4.8 yrs, 62.8% female) free from known CVD, hypertension, and diabetes and not currently taking beta-blockers were evaluated for fasting blood glucose (FBG), insulin, and HbA1c concentrations, waist circumference (WC), blood pressure (BP), and markers of ANS activity. WC was recorded just above the iliac crest and was used to reflect central adiposity. Resting 2-minute electrocardiograph recordings, pulse wave velocity, and ankle-brachial index data were used to assess the root mean square of successive differences in RR intervals (RMSSD) and the pre-ejection period (PEP), markers of parasympathetic and sympathetic activity, respectively. FBG, insulin, and HbA1c inferred a latent variable termed glycemic impairment (GI), whereas heart rate and diastolic BP inferred a latent variable termed cardiac stress (CS). The structural equation model fit was acceptable [root mean square error of approximation = 0.050 (90% CI = .036, .066), comparative fit index = .970, Tucker Lewis Index = 0.929], with adiposity having both significant direct (β = 0.208, p = 0.018) and indirect (β = -.217, p = .041) effects on PEP through GI. Adiposity displayed no significant direct effect on RMSSD. CS displayed a significant pathway (β = -0.524, p = 0.035) on RMSSD, but the indirect effect of WC on RMSSD through CS did not reach statistical significance (β = -0.094, p = 0.137). These results suggest that adiposity's relation to ANS activity is multifaceted, as increased central adiposity had opposing direct and indirect effects on markers of sympathetic activity in this population of older adults.
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Affiliation(s)
- Michael S. Jarrett
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina, United States of America
- Department of Exercise Physiology, Winston Salem State University, Winston Salem, North Carolina, United States of America
| | - Travis Anderson
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina, United States of America
- United States Olympic and Paralympic Committee, Colorado Springs, Colorado, United States of America
| | - Laurie Wideman
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina, United States of America
| | - Paul G. Davis
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina, United States of America
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17
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Hämmerle P, Aeschbacher S, Schlageter V, Coslovsky M, Hennings E, Krisai P, Coduri F, Blum MR, Rodondi N, Reichlin T, Müller A, Stauber A, Moschovitis G, Rigamonti E, Beer J, Ammann P, Bonati LH, Conen D, Osswald S, Kühne M, Zuern CS. Heart rate variability and stroke or systemic embolism in patients with atrial fibrillation. Heart Rhythm 2024:S1547-5271(24)02570-0. [PMID: 38762133 DOI: 10.1016/j.hrthm.2024.05.028] [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: 10/19/2023] [Revised: 04/22/2024] [Accepted: 05/13/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND Stroke remains one of the most serious complications in atrial fibrillation (AF) patients and has been linked to disturbances of the autonomic nervous system. OBJECTIVE The purpose of this study was to test the hypothesis that impaired cardiac autonomic function might be associated with an enhanced stroke risk in AF patients. METHODS A total of 1922 AF patients who were in either sinus rhythm (SR group; n = 1121) or AF (AF group; n = 801) on a 5-minute resting electrocardiographic (ECG) recording were enrolled in the study. Heart rate variability triangular index (HRVI), standard deviation of normal-to-normal intervals, root mean square root of successive differences of normal-to-normal intervals, mean heart rate, 5-minute total power, and power in the high-frequency, low-frequency, and very-low-frequency ranges were calculated. Cox regression models were constructed to examine the association of heart rate variability (HRV) parameters with the composite endpoint of stroke or systemic embolism. RESULTS Mean age was 71 ± 8 years in the SR group and 75 ± 8 years in the AF group. Thirty-seven patients in the SR group (3.4%) and 60 patients in the AF group (8.0%) experienced a stroke or systemic embolism during follow-up of 5 years. In patients with SR, HRVI <15 was the strongest HRV parameter to be associated with stroke or systemic embolism (hazard ratio 3.04; 95% confidence interval 1.3-7.0; P = .009) after adjustment for multiple confounders. In the AF group, no HRV parameter was found to be associated with the composite endpoint. CONCLUSION HRVI measured during SR on a single 5-minute ECG recording is independently associated with stroke or systemic embolism in AF patients. HRV analysis in SR may help to improve risk stratification in AF patients.
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Affiliation(s)
- Peter Hämmerle
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland; Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Stefanie Aeschbacher
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Vincent Schlageter
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Michael Coslovsky
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland; Department Clinical Research, University of Basel, University Hospital Basel, Basel, Switzerland
| | - Elisa Hennings
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland; Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Philipp Krisai
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland; Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Federica Coduri
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Manuel R Blum
- Institute of Primary Health Care (BIHAM), University Bern, Bern, Switzerland; Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Nicolas Rodondi
- Institute of Primary Health Care (BIHAM), University Bern, Bern, Switzerland; Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Tobias Reichlin
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andreas Müller
- Department of Cardiology, Triemli Hospital Zürich, Zürich, Switzerland
| | - Annina Stauber
- Department of Cardiology, Triemli Hospital Zürich, Zürich, Switzerland
| | - Giorgio Moschovitis
- Division of Cardiology, Ente Ospedaliero Cantonale (EOC), Cardiocentro Ticino Institute, Regional Hospital of Lugano, Lugano, Switzerland
| | - Elia Rigamonti
- Division of Cardiology, Ente Ospedaliero Cantonale (EOC), Cardiocentro Ticino Institute, Regional Hospital of Lugano, Lugano, Switzerland
| | - Jürg Beer
- Department of Medicine, Cantonal Hospital of Baden and Molecular Cardiology, University Hospital of Zürich, Zürich, Switzerland
| | - Peter Ammann
- Department of Cardiology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - Leo H Bonati
- Rheinfelden Rehabilitation Clinic, Rheinfelden, Switzerland
| | - David Conen
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Canada
| | - Stefan Osswald
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland; Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Michael Kühne
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland; Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Christine S Zuern
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland; Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.
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Lima TCP, Trevisan IR, Monma F, da Costa LT, Tinti JC, Ribeiro LTC, Pithon-Curi TC, Hirabara SM, Curi R, De Angelis K, De Souza DR, Santa-Rosa FA. Impact of Obesity on Cardiac Autonomic System Functioning in Military Police Officers. High Blood Press Cardiovasc Prev 2024; 31:321-327. [PMID: 38735994 DOI: 10.1007/s40292-024-00647-z] [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: 01/20/2024] [Accepted: 04/22/2024] [Indexed: 05/14/2024] Open
Abstract
INTRODUCTION Cardiac autonomic system functioning may be altered by obesity leading to cardiovascular diseases and associated complications. Military police officers are exposed to traditional and occupational risk factors for the development of CVD, however data on the cardiovascular health in this population is still scarce. AIM In this cross-sectional study, we investigated the impact of obesity on cardiac autonomic modulation and the hemodynamic profile in male active-duty military police officers. METHODS The body composition of the volunteers was assessed by octapolar electrical bioimpedance. Participants were classified as non-obese or obese in accordance with their body fat, with further subgroups as physically active obese or insufficiently active obese using International Physical Activity Questionnaire (IPAQ). Cardiac autonomic modulation was assessed by heart rate variability and the automatic oscillometric method allowed us to assess hemodynamic features. RESULTS 102 military police officers from the state of São Paulo participated in the study. Cardiac autonomic modulation revealed significant impairment in time and frequency domains and non-linear methods in the obese group compared to the non-obese (p < 0.05). A higher physical activity level did not alter these results in the obese group. However, no significant differences in the hemodynamic profile were observed between groups (p > 0.05). CONCLUSION These findings suggest a negative association between obesity and cardiac autonomic modulation in military police officers, unaffected by increased physical activity.
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Affiliation(s)
- Thabata Chaves Pereira Lima
- Department of Research and Development of Institutional Projects, School of Physical Education of the Military Police of the State of Sao Paulo, Sao Paulo, SP, Brazil
- Cruzeiro do Sul University - Interdisciplinary Postgraduate Program in Health Science, São Paulo, Brazil
| | | | - Fernanda Monma
- Department of Research and Development of Institutional Projects, School of Physical Education of the Military Police of the State of Sao Paulo, Sao Paulo, SP, Brazil
- Translational Physiology Laboratory, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
| | - Leonardo Thomaz da Costa
- Department of Research and Development of Institutional Projects, School of Physical Education of the Military Police of the State of Sao Paulo, Sao Paulo, SP, Brazil
| | - Julio Cesar Tinti
- Department of Research and Development of Institutional Projects, School of Physical Education of the Military Police of the State of Sao Paulo, Sao Paulo, SP, Brazil
- Cruzeiro do Sul University - Interdisciplinary Postgraduate Program in Health Science, São Paulo, Brazil
| | | | - Tânia Cristina Pithon-Curi
- Cruzeiro do Sul University - Interdisciplinary Postgraduate Program in Health Science, São Paulo, Brazil
| | - Sandro Massao Hirabara
- Cruzeiro do Sul University - Interdisciplinary Postgraduate Program in Health Science, São Paulo, Brazil
| | - Rui Curi
- Cruzeiro do Sul University - Interdisciplinary Postgraduate Program in Health Science, São Paulo, Brazil
| | - Kátia De Angelis
- Translational Physiology Laboratory, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
| | - Diego Ribeiro De Souza
- Department of Research and Development of Institutional Projects, School of Physical Education of the Military Police of the State of Sao Paulo, Sao Paulo, SP, Brazil.
- Cruzeiro do Sul University - Interdisciplinary Postgraduate Program in Health Science, São Paulo, Brazil.
| | - Fernando Alves Santa-Rosa
- Department of Research and Development of Institutional Projects, School of Physical Education of the Military Police of the State of Sao Paulo, Sao Paulo, SP, Brazil
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Keshmiri S, Tomonaga S, Mizutani H, Doya K. Respiratory modulation of the heart rate: A potential biomarker of cardiorespiratory function in human. Comput Biol Med 2024; 173:108335. [PMID: 38564855 DOI: 10.1016/j.compbiomed.2024.108335] [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: 01/20/2024] [Revised: 03/07/2024] [Accepted: 03/17/2024] [Indexed: 04/04/2024]
Abstract
In recent decade, wearable digital devices have shown potentials for the discovery of novel biomarkers of humans' physiology and behavior. Heart rate (HR) and respiration rate (RR) are most crucial bio-signals in humans' digital phenotyping research. HR is a continuous and non-invasive proxy to autonomic nervous system and ample evidence pinpoints the critical role of respiratory modulation of cardiac function. In the present study, we recorded longitudinal (7 days, 4.63 ± 1.52) HR and RR of 89 freely behaving human subjects (Female: 39, age 57.28 ± 5.67, Male: 50, age 58.48 ± 6.32) and analyzed their dynamics using linear models and information theoretic measures. While HR's linear and nonlinear characteristics were expressed within the plane of the HR-RR directed flow of information (HR→RR - RR→HR), their dynamics were determined by its RR→HR axis. More importantly, RR→HR quantified the effect of alcohol consumption on individuals' cardiorespiratory function independent of their consumed amount of alcohol, thereby signifying the presence of this habit in their daily life activities. The present findings provided evidence for the critical role of the respiratory modulation of HR, which was previously only studied in non-human animals. These results can contribute to humans' phenotyping research by presenting RR→HR as a digital diagnosis/prognosis marker of humans' cardiorespiratory pathology.
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Affiliation(s)
- Soheil Keshmiri
- Optical Neuroimaging Unit, Okinawa Institute of Science and Technology, Okinawa, Japan.
| | - Sutashu Tomonaga
- Neural Computation Unit (NCU), Okinawa Institute of Science and Technology, Okinawa, Japan.
| | - Haruo Mizutani
- Suntory Global Innovation Center Limited (SGIC), Suntory, Kyoto, Japan.
| | - Kenji Doya
- Neural Computation Unit (NCU), Okinawa Institute of Science and Technology, Okinawa, Japan.
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20
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Nicholson M, Poulus D, Robergs R, Kelly V, McNulty C. How Much Energy Do E'Athletes Use during Gameplay? Quantifying Energy Expenditure and Heart Rate Variability Within E'Athletes. SPORTS MEDICINE - OPEN 2024; 10:44. [PMID: 38630170 PMCID: PMC11024080 DOI: 10.1186/s40798-024-00708-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 03/26/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Research into esports suggests that e'athletes experience physiological stressors and demands during competition and training. The physiological demands of esports are poorly understood and need to be investigated further to inform future training guidelines, optimise performance outcomes, and manage e'athlete wellbeing. This research aimed to quantify the metabolic rate of esports gameplay and compare this outcome with heart rate variability within expert e'athletes. RESULTS Thirteen healthy male participants ranked within the top 10% of their respective esports title participated in the study (age = 20.7 ± 2.69 years; BMI = 24.6 ± 5.89 kg·m- 2). Expired gas analysis indirect calorimetry measured gas exchange during rest and gaming. Compared to resting conditions, competitive esports gameplay significantly increased median energy expenditure (1.28 (IQR 1.16-1.49) kcal·min- 1 vs. 1.45 (IQR 1.20-1.77) kcal·min- 1, p = .02), oxygen consumption (0.27 (IQR 0.24-0.30) L·min- 1 vs. 0.29 (IQR 0.24-0.35) L·min- 1, p = .02) and carbon dioxide production (0.20 (IQR 0.19-0.27) L·min- 1vs. 0.27 (IQR 0.24-0.33) L·min- 1, p = .01). Competitive gameplay also resulted in a significant increase in heart rate (84.5 (IQR 74.1-96.1) bpm vs. 87.1 (IQR 80.3-104) bpm, p = .01) and decrease in R-R interval's (710 (IQR 624-810) ms vs. 689 (IQR 579-747) ms, p = .02) when compared to rest. However, there were no significant differences in time or frequency measures of heart rate variability. CONCLUSIONS The data reveal increased physiological responses to metabolic rate, energy expenditure and cardiovascular function to esports game play within expert e'athletes. Further physiological research into the physical demands on e'athletes, the influence of different training programs to esport performance, and the added multivariate determinants to elite level esport performance are warranted.
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Affiliation(s)
- Mitchell Nicholson
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), Victoria Park Road, Kelvin Grove, Brisbane, QLD, 4059, Australia.
| | - Dylan Poulus
- Physical Activity, Sport and Exercise Research Theme, Faculty of Health, Southern Cross University, Gold Coast, QLD, Australia
- Manna Institute, Southern Cross University, Gold Coast, Australia
| | - Rob Robergs
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), Victoria Park Road, Kelvin Grove, Brisbane, QLD, 4059, Australia
| | - Vincent Kelly
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), Victoria Park Road, Kelvin Grove, Brisbane, QLD, 4059, Australia
| | - Craig McNulty
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), Victoria Park Road, Kelvin Grove, Brisbane, QLD, 4059, Australia
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21
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Kurosaka C, Tagata C, Nakagawa S, Kobayashi M, Miyake S. Effects of green tea and roasted green tea on human responses. Sci Rep 2024; 14:8588. [PMID: 38615105 PMCID: PMC11016062 DOI: 10.1038/s41598-024-59383-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 04/10/2024] [Indexed: 04/15/2024] Open
Abstract
Our objective was to elucidate the effects of tea consumption on refreshment and stress reduction/recovery through examining the multiple associations among factors such as various physiological responses and task performance. Participants included 20 healthy young men who performed a mental arithmetic task while 11 physiological responses were measured. The experiments were conducted twice under different beverage consumption conditions on separate days. The mental arithmetic task was executed six times in 1 day; participants ingested hot water, green tea, or roasted green tea (hojicha) before each task. Several subjective assessments: subjective fatigue, stress, mental workload, and flow were evaluated after each task. The R-R intervals, heart rate variability spectral components, the Poincaré plot indices (SD1 and SD2) and plethysmogram amplitude tended to decrease during task periods compared to resting periods. Tissue blood volume/flow (TBV, TBF) and near-infrared spectroscopy responses (NIRS) were lower in the tea condition than in the hot water condition. By scrutinizing various indicators, we found that aromatic stimulation of Japanese tea beverages has the potential to induce positive effects, enhance mental task performance, promote refreshment, and alleviate feelings of fatigue. These positive effects were observed even in small quantities and within a short duration, mirroring responses observed in daily consumption.
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Affiliation(s)
- Chie Kurosaka
- Department of Human, Information and Life Sciences, School of Health Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Fukuoka, Japan.
| | - Chika Tagata
- Central Research Institute, ITOEN, Ltd., Makinohara, Shizuoka, Japan
| | - Sae Nakagawa
- Central Research Institute, ITOEN, Ltd., Makinohara, Shizuoka, Japan
| | - Makoto Kobayashi
- Central Research Institute, ITOEN, Ltd., Makinohara, Shizuoka, Japan
| | - Shinji Miyake
- Graduate School of Science and Technology, Chitose Institute of Science and Technology, Chitose, Hokkaido, Japan
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22
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Regehr C, Birze A. Assessing the equivalency of face-to-face and online simulated patient interviews in an educational intervention. Adv Simul (Lond) 2024; 9:13. [PMID: 38581026 PMCID: PMC10998310 DOI: 10.1186/s41077-024-00286-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 03/24/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND In adapting to COVID-19, many health professional training programs moved abruptly from in-person to online simulated patient interviews for teaching and evaluation without the benefit of evidence regarding the efficacy of this mode of delivery. This paper reports on a multi-methods research project comparing in-person and online simulated patient interviews conducted by allied health professionals as part of an educational intervention offered at a large university teaching hospital. METHODS Twenty-three participants conducted two 15-min interviews with simulated patients using previously validated scenarios of patients presenting with suicide risk. In order to assess the equivalency of the two modalities, physiological and psychological stress were measured using heart rate variability parameters and the State-Trait Anxiety Inventory respectively, and then were compared across cohorts using t-tests. Reflective interviews elicited qualitative impressions of the simulations that were subject to thematic qualitative analysis. RESULTS There were no statistical differences in measures of psychological stress or physiological arousal of participant health care professionals who engaged with in-person versus online simulated interviews, suggesting they were equally effective in eliciting reactions commonly found in challenging clinical situations. In reflective interviews, participants commented on the realism of both modalities of simulated patient encounters and that simulated interviews provoked emotional and physiological responses consistent with actual patient encounters. CONCLUSIONS These findings provide developing evidence that carefully designed online clinical simulations can be a useful tool for the education and assessment of healthcare professionals.
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Affiliation(s)
- Cheryl Regehr
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada.
| | - Arija Birze
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
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23
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Yang J, Ben-Menachem E. Accuracy and clinical utility of heart rate variability derived from a wearable heart rate monitor in patients undergoing major abdominal surgery. J Clin Monit Comput 2024; 38:433-443. [PMID: 37831376 DOI: 10.1007/s10877-023-01080-8] [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: 03/29/2023] [Accepted: 09/16/2023] [Indexed: 10/14/2023]
Abstract
Low heart rate variability (HRV) can potentially identify patients at risk of intraoperative hypotension. However, it is unclear whether cheaper, readily accessible consumer heart rate (HR) monitors can provide similar utility to clinical Holter electrocardiograph (ECG) monitors. The objectives of this study were (1) to assess the validity of using the Polar H10 HR monitor as an alternative to a clinical Holter ECG and (2) to test total power (TP) as a predictor of intraoperative hypotension. The primary outcome was the level of agreement between Polar H10 and Holter ECG. Twenty-three patients undergoing major abdominal surgery with general anesthesia had 5-minute HR recordings taken concurrently with both devices during a pre-anesthetic consultation. Agreement between Polar H10 and Holter ECG was compared via Bland-Altman analysis and Lin's Concordance Correlation Coefficient. Patients were divided into groups based on TP < 500 m s 2 and TP > 500 m s 2 . Intraoperative hypotension was defined as MAP < 60 mmHg, systolic blood pressure < 80 mmHg, or 35% decrease in MAP from baseline. There was substantial agreement between Polar H10 and Holter ECG for average R-R interval, TP and other HRV indices. Reduced TP (< 500 ms 2 ) had a high sensitivity (80%) and specificity (100%) in predicting intraoperative hypotension. Patients with reduced TP were significantly more likely to require vasoactive drugs to maintain blood pressure.The substantial agreement between Polar H10 and Holter ECG may justify its use clinically. The use of preoperative recordings of HRV has the potential to become part of routine preoperative assessment as a useful screening tool to predict hemodynamic instability in patients undergoing general anesthesia.
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Affiliation(s)
- James Yang
- School of Clinical Medicine, Faculty of Medicine and Health, St Vincent's Healthcare Clinical Campus, UNSW Sydney, Sydney, Australia
| | - Erez Ben-Menachem
- Department of Anesthesia, St Vincent's Hospital, 390 Victoria St, Darlinghurst, Sydney, NSW, 2010, Australia.
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24
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Ellingson CJ, Shafiq MA, Ellingson CA, Neary JP, Dehghani P, Singh J. Assessment of cardiovascular functioning following sport-related concussion: A physiological perspective. Auton Neurosci 2024; 252:103160. [PMID: 38428323 DOI: 10.1016/j.autneu.2024.103160] [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: 11/30/2023] [Revised: 01/15/2024] [Accepted: 02/22/2024] [Indexed: 03/03/2024]
Abstract
There is still much uncertainty surrounding the approach to diagnosing and managing a sport-related concussion (SRC). Neurobiological recovery may extend beyond clinical recovery following SRC, highlighting the need for objective physiological parameters to guide diagnosis and management. With an increased understanding of the connection between the heart and the brain, the utility of assessing cardiovascular functioning following SRC has gained attention. As such, this review focuses on the assessment of cardiovascular parameters in the context of SRC. Although conflicting results have been reported, decreased heart rate variability, blood pressure variability, and systolic (ejection) time, in addition to increased spontaneous baroreflex sensitivity and magnitude of atrial contraction have been shown in acute SRC. We propose that these findings result from the neurometabolic cascade triggered by a concussion and represent alterations in myocardial calcium handling, autonomic dysfunction, and an exaggerated compensatory response that attempts to maintain homeostasis following a SRC. Assessment of the cardiovascular system has the potential to assist in diagnosing and managing SRC, contributing to a more comprehensive and multimodal assessment strategy.
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Affiliation(s)
- Chase J Ellingson
- College of Medicine, University of Saskatchewan Regina Campus, Regina, SK, Canada; Prairie Vascular Research Inc, Regina, SK, Canada
| | - M Abdullah Shafiq
- College of Medicine, University of Saskatchewan Regina Campus, Regina, SK, Canada; Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK, Canada
| | - Cody A Ellingson
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK, Canada
| | - J Patrick Neary
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK, Canada
| | | | - Jyotpal Singh
- Prairie Vascular Research Inc, Regina, SK, Canada; Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK, Canada.
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25
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Jdidi H, Dugué B, de Bisschop C, Dupuy O, Douzi W. The effects of cold exposure (cold water immersion, whole- and partial- body cryostimulation) on cardiovascular and cardiac autonomic control responses in healthy individuals: A systematic review, meta-analysis and meta-regression. J Therm Biol 2024; 121:103857. [PMID: 38663342 DOI: 10.1016/j.jtherbio.2024.103857] [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: 12/17/2023] [Revised: 04/12/2024] [Accepted: 04/15/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Cryostimulation and cold-water immersion (CWI) have recently gained widespread attention due to their association with changes in cardiovascular and cardiac autonomic control responses. Therefore, the aim of the present systematic review and meta-analysis was to identify the global impact of such cold exposures on cardiovascular and cardiac autonomic activity. METHODS Three databases (PubMed, Embase, Web-of-Science) were used. Studies were eligible for inclusion if they were conducted on healthy participants using cryostimulation and/or CWI. The outcomes included measurements of blood pressure (BP), heart rate (HR), and heart rate variability (HRV) indices: RR interval (RR), Root mean square of successive RR interval differences (RMSSD), low frequency band (LF), high frequency band (HF), and LF/HF ratio. RESULTS Among the 27 articles included in our systematic literature review, only 24 were incorporated into the meta-analysis. Our results reveal a significant increase in HRV indices: RMSSD (Standardized mean difference (SMD) = 0.61, p < 0.001), RR (SMD = 0.77, p < 0.001), and HF (SMD = 0.46, p < 0.001), as well as significantly reduced LF (SMD = -0.41, p < 0.001) and LF/HF ratio (SMD = -0.25, p < 0.01), which persisted up to 15 min following cold exposure. Significantly decreased heart rate (SMD = -0.16, p < 0.05), accompanied by slightly increased mean BP (SMD = 0.28, p < 0.001), was also observed. These results seem to depend on individual characteristics and the cooling techniques. CONCLUSION Our meta-analysis suggests that cryostimulation and/or CWI exposure enhance parasympathetic nervous activity. There is scarce scientific literature regarding the effect of individual characteristics on cold-induced physiological responses.
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Affiliation(s)
- Hela Jdidi
- University of Poitiers, Laboratory «Mobilité, Vieillissement, Exercice (MOVE)-UR 20296», Faculty of Sport Sciences, 86000, Poitiers, France.
| | - Benoit Dugué
- University of Poitiers, Laboratory «Mobilité, Vieillissement, Exercice (MOVE)-UR 20296», Faculty of Sport Sciences, 86000, Poitiers, France.
| | - Claire de Bisschop
- University of Poitiers, Laboratory «Mobilité, Vieillissement, Exercice (MOVE)-UR 20296», Faculty of Sport Sciences, 86000, Poitiers, France.
| | - Olivier Dupuy
- University of Poitiers, Laboratory «Mobilité, Vieillissement, Exercice (MOVE)-UR 20296», Faculty of Sport Sciences, 86000, Poitiers, France; University of Montreal, School of Kinesiology and Physical Activity Sciences (EKSAP), Faculty of Medicine, Montreal, QC, HC3 3J7, Canada.
| | - Wafa Douzi
- University of Poitiers, Laboratory «Mobilité, Vieillissement, Exercice (MOVE)-UR 20296», Faculty of Sport Sciences, 86000, Poitiers, France.
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26
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Borghesi F, Cremascoli R, Chirico A, Bianchi L, Di Moia A, Priano L, Piedimonte A, Mauro A, Cipresso P. Mind and body connection in expert meditators: a computational study based on central and peripheral nervous system. BMC Complement Med Ther 2024; 24:117. [PMID: 38454382 PMCID: PMC10921575 DOI: 10.1186/s12906-024-04413-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 02/27/2024] [Indexed: 03/09/2024] Open
Abstract
A meditative 'technique' is conceived as a continuum of different affective states involving mind and body jointly. Meditative practices can involve cognitive effort (e.g., focused attention and open-minded techniques), as well as automatic and implicit practices (e.g., transcendental techniques). The NGALSO tantric self-healing meditation technique is a brief, comprehensive meditation technique relying on mind and body connection. In this study, we aimed to investigate the state and the trait neurophysiological correlates of NGALSO meditation practice. First, 19 EEG channels and a 3-lead ECG signal were recorded from 10 expert meditators (more than 7 years of daily meditation) and 10 healthy inexpert participants (controls) who underwent the same meditative procedure. The neuropsychological profiles of experts and controls were compared. Results showed that expert meditators had significantly higher power spectra on alpha, theta and beta, and a higher sympathetic tone with lower parasympathetic tone after meditation. Conversely, the control group had significantly less power spectra on alpha, theta and beta, and a higher parasympathetic tone with lower sympathetic tone after meditation. A machine learning approach also allowed us to classify experts vs. controls correctly by using only EEG Theta bands before or after meditation. ECG results allowed us to show a significantly higher effort by expert meditators vs. controls, thus suggesting that a higher effort is required for this meditation, in line with the principle 'no pain, no gain' in body and mind.
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Affiliation(s)
| | - Riccardo Cremascoli
- Istituto Auxologico Italiano, IRCCS, Unit of Neurology and Neurorehabilitation, San Giuseppe Hospital Piancavallo, Verbania, Italy
| | - Alice Chirico
- Research Center in Communication Psychology, Universitá Cattolica del Sacro Cuore, Milan, Italy
| | - Laura Bianchi
- Istituto Auxologico Italiano, IRCCS, Unit of Neurology and Neurorehabilitation, San Giuseppe Hospital Piancavallo, Verbania, Italy
| | - Amalia Di Moia
- Istituto Auxologico Italiano, IRCCS, Unit of Neurology and Neurorehabilitation, San Giuseppe Hospital Piancavallo, Verbania, Italy
| | - Lorenzo Priano
- Istituto Auxologico Italiano, IRCCS, Unit of Neurology and Neurorehabilitation, San Giuseppe Hospital Piancavallo, Verbania, Italy
- Department of Neurosciences Rita Levi Montalcini, University of Turin, Turin, Italy
| | | | - Alessandro Mauro
- Istituto Auxologico Italiano, IRCCS, Unit of Neurology and Neurorehabilitation, San Giuseppe Hospital Piancavallo, Verbania, Italy
- Department of Neurosciences Rita Levi Montalcini, University of Turin, Turin, Italy
| | - Pietro Cipresso
- Department of Psychology, University of Turin, Turin, Italy
- Istituto Auxologico Italiano, IRCCS, Unit of Neurology and Neurorehabilitation, San Giuseppe Hospital Piancavallo, Verbania, Italy
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27
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Duman D, Sürmeli Döven S, Karpuz D, Danacı Vatansever E, Taşdelen B, Delibaş A. Autonomic activity and cardiovascular system risk assessment in pediatric patients with hemolytic uremic syndrome. Eur J Pediatr 2024; 183:1447-1454. [PMID: 38240764 PMCID: PMC10951013 DOI: 10.1007/s00431-024-05420-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/23/2023] [Accepted: 01/02/2024] [Indexed: 03/20/2024]
Abstract
In pediatric patients with hemolytic uremic syndrome (HUS), cardiac involvement and autonomic nervous system function can be evaluated by a non-invasive method called heart rate variability (HRV). This study aims to evaluate heart rate variability and electrocardiography findings in patients with HUS by comparing a healthy group. Patients who are diagnosed with HUS at a university hospital from December 2020 to June 2022 are screened by electrocardiography (ECG), echocardiography, and 24-h Holter ECG. A healthy control group, compatible in age and gender with the patient group, was selected from healthy subjects. HRV parameters, laboratory values, and ECG findings were analyzed and compared with the healthy group and each other. There were 25 patients with HUS and 51 participants in the healthy control group. Statistically significant differences were found in some HRV parameters: standard deviation of normal to normal intervals, the mean of the 5-min RR interval standard deviations, the standard deviation of 5-min RR interval means, the triangular interpolation of normal to normal interval, and very-low-frequency power. HUS patients had impaired and declined HRV values compared to the healthy group. There was a significant decrease in the PR distance, while a significant increase in the corrected QT and QT dispersion values was detected in the electrocardiographic findings of the patient group. HRV values impaired as renal failure parameters increased. Conclusion: Patients with HUS may have autonomic nervous system dysfunction. HRV measurement is a non-invasive method that can evaluate this. It can be thought that there may be an increased risk of cardiovascular events and arrhythmias in some patients with HUS. ECG should be also considered to detect arrhythmia. What is Known: • Hemolytic uremic syndrome (HUS) primarily effects the hematologic parameters and kidney. • Secondary cardiomyopathy with hypertension and renal failure could be observed in these patients. • Rhythm problems are not expected primarily in these patients. • There is very limited data in evaluating autonomic function and arrhythmia risk for these patients. What is New: • Patients with HUS may have autonomic nervous system dysfunction. • HRV measurement is a non-invasive method that can evaluate this. • Cardiovascular events and arrhythmias due to the deterioration of the balance between the sympathetic and parasympathetic systems could manifest in patients with HUS. • An ECG and screening patients for cardiac events, and monitoring them closely should be considered.
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Affiliation(s)
- Derya Duman
- Faculty of Medicine, Department of Pediatric Cardiology, Mersin University, 34. Cadde, Ciftlikkoy Kampusu, 33343, Mersin, Turkey.
| | - Serra Sürmeli Döven
- Faculty of Medicine, Department of Pediatric Nephrology, Mersin University, 34 Cadde, Ciftlikkoy Kampusu 33343, Mersin, Turkey
| | - Derya Karpuz
- Faculty of Medicine, Department of Pediatric Cardiology, Mersin University, 34. Cadde, Ciftlikkoy Kampusu, 33343, Mersin, Turkey
| | - Esra Danacı Vatansever
- Faculty of Medicine, Department of Pediatric Nephrology, Mersin University, 34 Cadde, Ciftlikkoy Kampusu 33343, Mersin, Turkey
| | - Bahar Taşdelen
- Faculty of Medicine, Department of Biostatistics and Medical Informatics, Mersin University, 33343, Mersin, Turkey
| | - Ali Delibaş
- Faculty of Medicine, Department of Pediatric Nephrology, Mersin University, 34 Cadde, Ciftlikkoy Kampusu 33343, Mersin, Turkey
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Ortega E, Bryan CYX, Christine NSC. The Pulse of Singapore: Short-Term HRV Norms. Appl Psychophysiol Biofeedback 2024; 49:55-61. [PMID: 37755550 DOI: 10.1007/s10484-023-09603-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2023] [Indexed: 09/28/2023]
Abstract
Short-term heart rate variability (HRV) is increasingly used to assess autonomic nervous system activity and found to be useful for monitoring and providing care due to its quick measurement. With evidence of low HRV associated with chronic diseases, mental disorders, and an increased risk of cardiovascular disease, having normative data of HRV across the age spectrum would be useful for monitoring health and well-being of a population. This study examines HRV of healthy Singapore sample, with ages ranging from 10 to 89 years. Short-term HRV of five minutes was measured from 2,143 participants. 974 males and 1,169 females, and overall HRV was found to be 42.4ms (RMSSD) and 52.0 ms (SDNN) with a further breakdown of HRV by age and gender. Overall HRV declined with age and gender, although gender differences dissipated in the 60s age range onwards, with the 50s age range having the sharpest decline in HRV. Short-term HRV norms were similar to Nunan et al.'s (2010) systematic review in various populations and less similar to Choi et al.'s (2020) study on Koreans.
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Affiliation(s)
- Emily Ortega
- School of Humanities and Behavioural Sciences, Singapore University of Social Sciences, Singapore, Singapore.
| | - Chan Yu Xiu Bryan
- School of Humanities and Behavioural Sciences, Singapore University of Social Sciences, Singapore, Singapore
| | - Ng Su Chin Christine
- School of Humanities and Behavioural Sciences, Singapore University of Social Sciences, Singapore, Singapore
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Martinez P, Grinand M, Cheggour S, Taieb J, Gourjon G. How to properly evaluate cardiac vagal tone in oncology studies: a state-of-the-art review. JOURNAL OF THE NATIONAL CANCER CENTER 2024; 4:36-46. [PMID: 39036385 PMCID: PMC11256691 DOI: 10.1016/j.jncc.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 07/23/2024] Open
Abstract
Heart rate variability (HRV) analysis provides an assessment of cardiac vagal tone and consequently global cardiac health as well as systemic condition. In systemic diseases such as cancer and during treatments that affect the whole body, like chemotherapy, the vagus nerve activity is low and deregulated. Some studies focus on using HRV to predict mortality in oncology. However, in cancer patients, systemic alterations substantially increase artifacts during HRV measurement, especially atrial ectopic beats. Moreover, HRV may be altered by various factors (duration and time of measurement, breathing, drugs, and other confounding factors) that alter each metric in different ways. The Standard Deviation of all Normal to Normal intervals (SDNN) is the most commonly used metric to evaluate HRV in oncology, but it does not appear to be specific to the cardiac vagal tone. Thus, cardiac vagal activity diagnosis and vital prognosis of cancer patients can be biased. Our review presents the main HRV metrics that can be currently used in oncology studies and their links with vagus nerve and cancer. We present the influence of external factors and the required duration and time of measurement. Considering all these parameters, this review proposes seven key points for an assessment of HRV and cardiac vagal tone in patients with cancer.
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Affiliation(s)
- Pierrick Martinez
- Scientific and Osteopathic Research Department, Institut de Formation en Ostéopathie du Grand Avignon, 403 Rue Marcel Demonque, Avignon, France
| | - Marilyne Grinand
- Département de recherche clinique, Centre hospitalier d'Avignon, 305A Rue Raoul Follereau, Avignon, France
| | - Saïda Cheggour
- Service de cardiologie, Centre hospitalier d'Avignon, 305A Rue Raoul Follereau, Avignon, France
| | - Jérôme Taieb
- Service de cardiologie, Centre Hospitalier du pays d'Aix-Pertuis, Avenue des Tamaris Aix-en-Provence, France
| | - Géraud Gourjon
- Scientific and Osteopathic Research Department, Institut de Formation en Ostéopathie du Grand Avignon, 403 Rue Marcel Demonque, Avignon, France
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Goodyke MP, Bronas UG, Baynard T, Tintle N, DeVon HA, Collins E, Dunn SL. Relationships Among Heart Rate Variability, Perceived Social Support, and Hopelessness in Adults With Ischemic Heart Disease. J Am Heart Assoc 2024; 13:e032759. [PMID: 38348815 PMCID: PMC11010109 DOI: 10.1161/jaha.123.032759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 01/17/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND Lower perceived social support is associated with hopelessness in patients with ischemic heart disease (IHD). Higher perceived social support is associated with higher heart rate variability (HRV) in adults following a stressful event, but the relationship between HRV and hopelessness has not been examined in patients with IHD. The purpose of this research was to evaluate the relationships among HRV, perceived social support, and hopelessness in patients with IHD. METHODS AND RESULTS Ninety-four participants were enrolled while hospitalized for an IHD event at a large hospital in the United States. Data collection occurred 2 weeks after hospital discharge and included the State-Trait Hopelessness Scale, ENRICHD Social Support Inventory, Patient Health Questionnaire-9, a demographic form, and a short-term HRV measurement taken at rest. Linear models were used to assess associations between variables in unadjusted and adjusted models. Most participants were men (67%), married (75%), and non-Hispanic White (96%) and underwent coronary artery bypass surgery (57%). There were inverse correlations between high frequency HRV and state hopelessness (r=-0.21, P=0.008) and root mean square of successive differences between normal heartbeats HRV and state hopelessness (r=-0.20, P=0.012) after adjusting for important covariates. High frequency and root mean square of successive differences between normal heartbeats did not show evidence of mediating the relationship between perceived social support and hopelessness. CONCLUSIONS There were significant inverse correlations between parasympathetic measures of HRV and hopelessness. Assessing high frequency and root mean square of successive differences between normal heartbeats during early recovery following an IHD event could provide promising evidence for understanding a possible precursor to hopelessness and targets for future interventions. Registration Information: clinicaltrials.gov. Identifiers: NCT03907891, NCT05003791.
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Affiliation(s)
| | - Ulf G. Bronas
- Columbia University, School of Nursing and Department of Rehabilitation MedicineNew YorkNYUSA
| | - Tracy Baynard
- University of Massachusetts Boston, Manning College of Nursing and Health SciencesBostonMAUSA
| | - Nathan Tintle
- University of Illinois Chicago, College of NursingChicagoILUSA
| | - Holli A. DeVon
- University of California Los Angeles, School of NursingLos AngelesCAUSA
| | - Eileen Collins
- University of Illinois Chicago, College of NursingChicagoILUSA
| | - Susan L. Dunn
- University of Illinois Chicago, College of NursingChicagoILUSA
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Duman D, Karpuz D, Taşdelen B, Kuyucu N. Assessing autonomic activity and prognostic risk factors comparing multisystem inflammatory syndrome and isolated viral myocarditis/myopericarditis. Cardiol Young 2024; 34:421-427. [PMID: 38303630 DOI: 10.1017/s1047951123004377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
INTRODUCTION AND AIM In pediatric multisystem inflammatory syndrome and isolated viral myocarditis/myopericarditis, autonomic nervous system function can be evaluated by a non-invasive method called heart rate variability. This study aims to evaluate heart rate variability in these two groups by comparing them with each other. This is the first study assessing these values in these two groups of patients. METHOD Patients who are diagnosed with multisystem inflammatory syndrome in children and isolated viral myocarditis/myopericarditis at a university hospital from September 2021 to February 2023 are screened by electrocardiography, echocardiography, and 24-hour Holter monitoring. A healthy control group, compatible in age and gender with the patient groups, was selected from healthy subjects that applied to the hospital for palpitation, murmur, and/or chest pain. Heart rate variability parameters and related laboratory markers were analyzed and compared among the three groups. RESULTS There were 30 patients with multisystem inflammatory syndrome in children, 43 patients with isolated viral myocarditis/myopericarditis, and 109 participants in the healthy control group. Statistically significant differences were found in most of the heart rate variability parameters: standard deviation of normal to normal intervals (SDNN), the mean of the 5- minute RR interval standard deviations (SDNNİ), the standard deviation of 5-minute R wave to R wave(RR) interval means (SDANN), the root mean square of successive RR interval differences (RMSSD), and the percentage of the beats with a consecutive RR interval difference of more than 50 ms (pNN50%), very low frequency, high frequency, low frequency, triangular index, and low frequency/high-frequency ratio. Multisystem inflammatory syndrome in children patients had impaired and declined heart rate variability values compared to the other two groups. In patients with myocarditis/myopericarditis, we couldn't find a significant difference in these parameters with the control group. CONCLUSION Heart rate variability can be used as an important non-invasive autonomic function parameter in determining prognosis and treatment plans, especially in patients diagnosed with multisystem inflammatory syndrome in children. This impairment of autonomic activity could be more prominent in patients with decreased left ventricular systolic functions.
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Affiliation(s)
- Derya Duman
- Department of Pediatric Cardiology, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Derya Karpuz
- Department of Pediatric Cardiology, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Bahar Taşdelen
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Necdet Kuyucu
- Department of Pediatric Infectious Disease, Faculty of Medicine, Mersin University, Mersin, Turkey
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Brinth LS, Jørgensen T, Mehlsen J, Petersen MW, Gormsen L, Linneberg A, Fink P, Benros ME, Dantoft TM. Normative values of short-term heart rate variability in a cross-sectional study of a Danish population. The DanFunD study. Scand J Public Health 2024; 52:48-57. [PMID: 36250428 DOI: 10.1177/14034948221124020] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
AIMS The autonomic nervous system includes parasympathetic and sympathetic components that monitor and regulate most of the bodily functions and play a central role in the physiology and homeostasis of the human body. Heart rate variability is a non-invasive tool for quantification of rhythmic fluctuations in heart rate that reflects the function of the autonomic nervous system. The study aims to describe the heart rate variability distribution in the general population, stratified in sex and age groups, which is currently insufficiently described. METHODS A cross-sectional population-based study recruited participants in 10 municipalities in the western part of the greater Copenhagen area in Denmark, including 6891 men and women aged 18-72 years (participation rate was 29.5%). Short-term heart rate variability measures were obtained and related to age and gender. RESULTS Both time and frequency domain measures showed a huge variation in the different sex and age groups. Women had a higher median heart rate than men, and the association with age was U-shaped. Measures indicating a predominance of the parasympathetic component in relation to the sympathetic component were more frequent in women and younger age groups. CONCLUSIONS Both sex and age influence the heart rate variability in this adult Danish population. Therefore, our age- and sex-related reference values of heart rate variability in the time and frequency domain should be used in further epidemiological and clinical research.
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Affiliation(s)
- Louise S Brinth
- Department of Clinical Physiology and Nuclear Medicine, Herlev and Gentofte Hospital, University of Copenhagen, Denmark
- Department of Clinical Physiology, North Zealand Hospital, University of Copenhagen, Hillerød, Denmark
| | - Torben Jørgensen
- Centre for Clinical Research and Prevention, Bispebjerg/Frederiksberg Hospital, Copenhagen, Denmark
- Department of Public Health, Faculty of Health and Medical Science, University of Copenhagen, Denmark
- Faculty of Medicine, Aalborg University, Denmark
| | - Jesper Mehlsen
- Section for Surgical Pathophysiology, Copenhagen University Hospital, Denmark
| | - Marie W Petersen
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Denmark
| | - Lise Gormsen
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Denmark
- Institute of Clinical Medicine, University of Aarhus, Denmark
| | - Allan Linneberg
- Centre for Clinical Research and Prevention, Bispebjerg/Frederiksberg Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Denmark
| | - Per Fink
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Denmark
- Institute of Clinical Medicine, University of Aarhus, Denmark
| | - Michael E Benros
- Biological and Precision Psychiatry, Mental Health Centre Copenhagen, Copenhagen University Hospital, Gentofte, Denmark
- Department of Immunology & Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Thomas M Dantoft
- Centre for Clinical Research and Prevention, Bispebjerg/Frederiksberg Hospital, Copenhagen, Denmark
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Lu L, Zhu T, Morelli D, Creagh A, Liu Z, Yang J, Liu F, Zhang YT, Clifton DA. Uncertainties in the Analysis of Heart Rate Variability: A Systematic Review. IEEE Rev Biomed Eng 2024; 17:180-196. [PMID: 37186539 DOI: 10.1109/rbme.2023.3271595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Heart rate variability (HRV) is an important metric with a variety of applications in clinical situations such as cardiovascular diseases, diabetes mellitus, and mental health. HRV data can be potentially obtained from electrocardiography and photoplethysmography signals, then computational techniques such as signal filtering and data segmentation are used to process the sampled data for calculating HRV measures. However, uncertainties arising from data acquisition, computational models, and physiological factors can lead to degraded signal quality and affect HRV analysis. Therefore, it is crucial to address these uncertainties and develop advanced models for HRV analysis. Although several reviews of HRV analysis exist, they primarily focus on clinical applications, trends in HRV methods, or specific aspects of uncertainties such as measurement noise. This paper provides a comprehensive review of uncertainties in HRV analysis, quantifies their impacts, and outlines potential solutions. To the best of our knowledge, this is the first study that presents a holistic review of uncertainties in HRV methods and quantifies their impacts on HRV measures from an engineer's perspective. This review is essential for developing robust and reliable models, and could serve as a valuable future reference in the field, particularly for dealing with uncertainties in HRV analysis.
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Tomes CD, Canetti EFD, Schram B, Orr R. Heart rate variability profile changes associated with specialist police selection activities: A case study. Work 2024; 77:1295-1303. [PMID: 38189726 DOI: 10.3233/wor-230297] [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] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND Police Tactical Groups (PTGs) are specialist police units tasked with rigorous physical and psychosocial duties. Consequently, selection courses (SCs) for service in these units must also be rigorous. Given the intensity of SCs, holistic monitoring for potential overstress may be beneficial. Heart Rate Variability (HRV) is one holistic stress measure that can be obtained in austere environments. OBJECTIVE The purpose of this study was to profile HRV during a PTG SC. Six (n = 6) qualified male police officers attempted a 36-hour PTG selection course held at an Australian state facility. METHODS HRV was obtained from Equivitaltrademark EQ02 + LifeMonitor bioharnesses. The selection course consisted of physically demanding events with minimal sleep (approx. 45 mins). Only one candidate completed the full selection course; whose results are reported here. RESULTS A visual time-series of 384 consecutive 5 min HRV analyses was generated. Contextual analysis was applied to appreciate HRV changes between SC serials. HRV decline occurred during the planning of a navigation exercise and a pack march. Increases in HRV were observed throughout the pack march exercise and rest period. CONCLUSION This case study demonstrates the potential utility for selection personnel to obtain additional insight into candidate responses to various occupational challenges throughout an SC. Information provided by HRV monitoring may support leadership decisions when evaluating personnel holistically. For example, the ability to continue occupational task execution even while experiencing potential overstress (as measured by HRV) and after food and sleep deprivation is desirable. HRV may potentially inform stakeholders regarding overstress in PTG candidates.
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Affiliation(s)
- Colin D Tomes
- Faculty of Health Science and Medicine, Bond University, Robina, QLD, Australia
- Tactical Research Unit, Bond University, Robina, QLD, Australia
| | - Elisa F D Canetti
- Faculty of Health Science and Medicine, Bond University, Robina, QLD, Australia
- Tactical Research Unit, Bond University, Robina, QLD, Australia
| | - Ben Schram
- Faculty of Health Science and Medicine, Bond University, Robina, QLD, Australia
- Tactical Research Unit, Bond University, Robina, QLD, Australia
| | - Robin Orr
- Faculty of Health Science and Medicine, Bond University, Robina, QLD, Australia
- Tactical Research Unit, Bond University, Robina, QLD, Australia
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Kajisa T, Kuroi T, Hara H, Sakai T. Correlation analysis of heart rate variations and glucose fluctuations during sleep. Sleep Med 2024; 113:180-187. [PMID: 38042028 DOI: 10.1016/j.sleep.2023.11.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 11/23/2023] [Accepted: 11/23/2023] [Indexed: 12/04/2023]
Abstract
OBJECTIVE The body's glucose concentration is influenced by carbohydrate intake, insulin-induced carbohydrate reduction, and hepatic glycogen breakdown induced by stress hormones. This study investigated the potential of employing glucose fluctuations as a measure of stress by examining the relationship between heart rate variability (HRV) data and glucose levels during sleep in healthy subjects. METHODS In this cross-sectional study, a chest-worn electrocardiogram (ECG) and continuous glucose monitoring device (CGM) were respectively used to monitor the heart rate intervals and glucose fluctuations of five subjects (two males, three females) during sleep. A time-series correlation analysis was performed on the HRV data extracted from heart rate intervals and the corresponding glucose fluctuation data. RESULTS The time-series analysis of ECG and CGM data collected from subjects during sleep (n = 25 nights) revealed a moderate negative correlation between glucose levels and HRV, with a cross-correlation coefficient of r = -0.453. CONCLUSION Similar to HRV, changes in stress levels can be detected by observing glucose fluctuations, particularly during sleep when the impact of food intake can be eliminated. Our findings highlight a significant correlation between glucose levels and HRV, indicating that glucose fluctuations can be used as an indicator of autonomic nervous system activity in an exploratory study.
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Affiliation(s)
- Taira Kajisa
- Course of Bio-Nano Science Fusion, Graduate School of Interdisciplinary New Science, Toyo University, 2100 Kujirai, Kawagoe, Saitama, 350-8585, Japan.
| | - Toshiya Kuroi
- Hakuju Institute for Health Science Co., Ltd, 1-37-5 Tomigaya, Shibuya, Tokyo, Japan
| | - Hiroyuki Hara
- Hakuju Institute for Health Science Co., Ltd, 1-37-5 Tomigaya, Shibuya, Tokyo, Japan
| | - Toshiyuki Sakai
- Department of Student, Student Support Division, Toyo University, 2100 Kujirai, Kawagoe, Saitama, 350-8585, Japan
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Agarwal V, Kaushik AS, Chaudhary R, Rehman M, Srivastava S, Mishra V. Transcutaneous vagus nerve stimulation ameliorates cardiac abnormalities in chronically stressed rats. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2024; 397:281-303. [PMID: 37421431 DOI: 10.1007/s00210-023-02611-5] [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: 03/14/2023] [Accepted: 07/01/2023] [Indexed: 07/10/2023]
Abstract
Chronically stressed patients often have low vagal tone and increased levels of proinflammatory cytokines, which increase their risk for developing cardiac dysfunction. Transcutaneous vagus nerve stimulation (taVNS) is a way to activate the parasympathetic system, which has the ability to reduce inflammation and antagonize excessive sympathetic responses. However, the effectiveness of taVNS in treating cardiac dysfunction caused by chronic unpredictable stress (CUS) has not been studied. To investigate this, we first validated a rat model of CUS, in which the rats were exposed to random stressors daily for 8 weeks. Post CUS, the rats were treated with taVNS (1.0 ms, 6 V, 6 Hz, for 40 min × 2 weeks, alternatively) and their cardiac function and cholinergic flow were evaluated. Furthermore, serum cardiac troponin I (cTnI), cardiac caspase-3, inducible nitric oxide synthase (iNOS), and transforming growth factor (TGF)-β1 expression in rats were also assessed. The chronically stressed rats showed depressed behavior with increased levels of serum corticosterone and proinflammatory cytokines. Electrocardiogram (ECG) and heart rate variability (HRV) studies revealed elevated heart rate, diminished vagal tone, and altered sinus rhythm in CUS rats. Furthermore, the CUS rats demonstrated cardiac hypertrophy and fibrosis with increased caspase-3, iNOS, and TGF-β expression in their myocardium and increased levels of serum cTnI. Interestingly, alternate taVNS therapy for 2 weeks, post CUS, helped alleviate these cardiac abnormalities. These suggest that taVNS could be a useful adjunctive and non-pharmacological approach for managing CUS induced cardiac dysfunction.
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Affiliation(s)
- Vipul Agarwal
- Department of Pharmaceutical Sciences, Babasaheb Bhimrao Ambedkar University, (A Central University), Vidya Vihar, Raebareli Road, Lucknow, U.P., 226025, India
| | - Arjun Singh Kaushik
- Department of Pharmaceutical Sciences, Babasaheb Bhimrao Ambedkar University, (A Central University), Vidya Vihar, Raebareli Road, Lucknow, U.P., 226025, India
| | - Rishabh Chaudhary
- Department of Pharmaceutical Sciences, Babasaheb Bhimrao Ambedkar University, (A Central University), Vidya Vihar, Raebareli Road, Lucknow, U.P., 226025, India
| | - Mujeeba Rehman
- Department of Pharmaceutical Sciences, Babasaheb Bhimrao Ambedkar University, (A Central University), Vidya Vihar, Raebareli Road, Lucknow, U.P., 226025, India
| | - Siddhi Srivastava
- Department of Pharmaceutical Sciences, Babasaheb Bhimrao Ambedkar University, (A Central University), Vidya Vihar, Raebareli Road, Lucknow, U.P., 226025, India
| | - Vikas Mishra
- Department of Pharmaceutical Sciences, Babasaheb Bhimrao Ambedkar University, (A Central University), Vidya Vihar, Raebareli Road, Lucknow, U.P., 226025, India.
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Zhou X, He G, Zhu H, Wang Y, Zhang W. Evaluation of driver stress intervention with guided breathing and positive comments. APPLIED ERGONOMICS 2024; 114:104144. [PMID: 37783049 DOI: 10.1016/j.apergo.2023.104144] [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: 01/25/2023] [Revised: 09/11/2023] [Accepted: 09/26/2023] [Indexed: 10/04/2023]
Abstract
While many methods have been proposed to detect driver stress with high accuracy, few studies have explored how to mitigate stress during driving effectively. This study proposed and evaluated two driver stress intervention methods, i.e., auditory Positive Comments w/o haptic Breathing guidance (BPC and PC). Sixty drivers were randomly assigned to four groups (i.e., no stress, stressful but no intervention-NI, PC, and BPC) and completed a simulated driving task with their physiological, psychological, and behavioral data collected. Driver stress was effectively induced by challenging simulated driving events. Haptic guidance provided by smartwatches efficiently regulated the breathing rate to the target. Engaging in the intervention was associated with increased RMSSD and did not worsen driving performance. Participants perceived moderate to large comfort effects. The complexity of driving scenarios should be considered for choosing interventions. Breathing intervention was less effective when complex maneuvers were required than normal driving. The findings provided implications regarding the design of in-vehicle stress intervention systems for intelligent transportation.
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Affiliation(s)
- Xin Zhou
- Department of Industrial Engineering, Tsinghua University, Beijing, 100084, China
| | - Gang He
- Chongqing Changan Automobile Co., Ltd, Chongqing, China
| | - Honghai Zhu
- Chongqing Changan Automobile Co., Ltd, Chongqing, China
| | - Yi Wang
- Department of Industrial Engineering, Tsinghua University, Beijing, 100084, China
| | - Wei Zhang
- Department of Industrial Engineering, Tsinghua University, Beijing, 100084, China.
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Srirubkhwa S, Brockmann L, Vichiansiri R, Hunt KJ, Saengsuwan J. Reliability of five-minute vs. one-hour heart rate variability metrics in individuals with spinal cord injury. PeerJ 2023; 11:e16564. [PMID: 38130919 PMCID: PMC10734434 DOI: 10.7717/peerj.16564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 11/12/2023] [Indexed: 12/23/2023] Open
Abstract
Background A previous study showed low reliability of 1-h HRV outcomes in participants with spinal cord injury (SCI), but it was not certain whether the low reliability was due to the unrestricted activity of participants. We aimed to investigate test-retest reliability of HRV metrics in individuals with SCI using a 1-h measurement in a supine position. Methods Individuals with SCI underwent two sessions of 1-h recording of the time between consecutive R waves (RR-intervals) in a supine position. HRV outcomes were obtained from a single 5-min data segment and for the full 1-h recording. HRV parameters of interest were: standard deviation of all normal-to-normal R-R intervals (SDNN) and square root of the mean of the squared differences between successive R-R intervals (RMSSD) (time domain); and high frequency power (HF), low frequency power (LF), very low frequency power (VLF), ultra-low frequency power (ULF) and total power (TP) (frequency domain). Relative reliability was assessed by intraclass correlation coefficient (ICC). Absolute reliability was assessed by coefficient of variation (CV) and Bland-Altman limits of agreement (LoA). Results Data from 37 individuals (14 with tetraplegia and 23 with paraplegia) were included. Relative reliability was higher for the 1-h (ICCs ranged from 0.13-0.71) than for the 5-min duration (ICCs ranged from 0.06-0.50) in the overall SCI group for all HRV metrics. Participants with tetraplegia had lower relative reliability compared to participants with paraplegia in all HRV metrics for the 5-min duration (ICCs ranged from -0.01-0.34 vs. 0.21-0.57). For the 1-h duration, participants with paraplegia showed higher relative reliability than participants with tetraplegia in all HRV metrics (ICCs ranged from 0.18-0.79 vs. 0.07-0.54) except TP (ICC 0.69 vs. 0.82). In terms of absolute reliability, the CVs and LoAs for the 1-h duration were better than for the 5-min duration. In general, time domain metrics showed better reliability than frequency domain metrics for both durations in participants with tetraplegia and paraplegia. The lowest CV and narrowest 95% LoA were found for SDNN in 5-min and 1-h durations overall and in both lesion levels. Conclusions The supine position did not provide better reliability compared to unrestricted activity in participants with SCI. HRV analysis using a 5-min duration is of limited value in SCI due to poor reliability. For the 1-h analysis duration, interpretation of the reliability of HRV varies according to lesion level: it is recommended to take lesion level into account when interpreting reliability measures.
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Affiliation(s)
- Siriwipa Srirubkhwa
- Department of Rehabilitation Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Lars Brockmann
- The Laboratory for Rehabilitation Engineering, Institute for Human Centred Engineering, Bern University of Applied Sciences, Biel, Switzerland
| | - Ratana Vichiansiri
- Department of Rehabilitation Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Kenneth J. Hunt
- The Laboratory for Rehabilitation Engineering, Institute for Human Centred Engineering, Bern University of Applied Sciences, Biel, Switzerland
| | - Jittima Saengsuwan
- Department of Rehabilitation Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- The Laboratory for Rehabilitation Engineering, Institute for Human Centred Engineering, Bern University of Applied Sciences, Biel, Switzerland
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Li K, Cardoso C, Moctezuma-Ramirez A, Elgalad A, Perin E. Heart Rate Variability Measurement through a Smart Wearable Device: Another Breakthrough for Personal Health Monitoring? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7146. [PMID: 38131698 PMCID: PMC10742885 DOI: 10.3390/ijerph20247146] [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: 08/03/2023] [Revised: 11/06/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023]
Abstract
Heart rate variability (HRV) is a measurement of the fluctuation of time between each heartbeat and reflects the function of the autonomic nervous system. HRV is an important indicator for both physical and mental status and for broad-scope diseases. In this review, we discuss how wearable devices can be used to monitor HRV, and we compare the HRV monitoring function among different devices. In addition, we have reviewed the recent progress in HRV tracking with wearable devices and its value in health monitoring and disease diagnosis. Although many challenges remain, we believe HRV tracking with wearable devices is a promising tool that can be used to improve personal health.
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Affiliation(s)
- Ke Li
- Center for Preclinical Cardiovascular Research, The Texas Heart Institute, Houston, TX 77030, USA
| | - Cristiano Cardoso
- Center for Preclinical Cardiovascular Research, The Texas Heart Institute, Houston, TX 77030, USA
| | - Angel Moctezuma-Ramirez
- Center for Preclinical Cardiovascular Research, The Texas Heart Institute, Houston, TX 77030, USA
| | - Abdelmotagaly Elgalad
- Center for Preclinical Cardiovascular Research, The Texas Heart Institute, Houston, TX 77030, USA
| | - Emerson Perin
- Center for Clinical Research, The Texas Heart Institute, Houston, TX 77030, USA
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Pyne JM, Constans JI, Wiederhold BK, Jegley S, Rabalais A, Hu B, Weber MC, Hinkson KD, Wiederhold MD. Predicting Post-Traumatic Stress Disorder Treatment Response Using Heart Rate Variability to Virtual Reality Environment and Modified Stroop Task: An Exploratory Study. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2023; 26:896-903. [PMID: 38032955 DOI: 10.1089/cyber.2023.0164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
Predicting treatment response can inform treatment decisions, expectations, and optimize use of mental health treatment resources. This study examined heart rate (HR), heart rate variability (HRV), and a modified Stroop task (mStroop) to predict post-traumatic stress disorder (PTSD) treatment response. We report on an observational, longitudinal study with 45 U.S. veterans in outpatient PTSD care, who had deployed to Iraq or Afghanistan. HR and HRV were collected before, during, and after virtual reality (VR) combat and civilian scenes. HRV recovery was defined as HRV after a 3-minute VR simulation minus HRV during a VR scene. mStroop threat variables included index scores for combat and general threat. Self-report data were collected at baseline and 6 months later. The outcome variable was the 17-item Clinician Administered PTSD Scale (CAPS). Controlling for baseline CAPS and number of combat experiences, the following baseline HRV recovery variables were significant predictors of 6-month CAPS: standard deviation of normal beat to beat interval (SDNN) after combat scene minus SDNN during combat scene and low-frequency (LF HRV) after civilian scene minus LF during civilian scene. HRV at rest, HR reactivity, HR recovery, and mStroop scores did not predict treatment response. In conclusion, HRV recovery variables in the context of a standardized VR stressor were significant predictors of PTSD treatment response after controlling for baseline CAPS and number of combat experiences. The direction of this relationship indicates that greater baseline HRV recovery predicts lower 6-month PTSD symptom severity. This was an exploratory study in need of replication.
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Affiliation(s)
- Jeffrey M Pyne
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, North Little Rock, Arkansas, USA
- South Central Mental Illness Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock, Arkansas, USA
- Division of Health Services Research, Department of Psychiatry, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Joseph I Constans
- Office of Research and Development, Veterans Health Administration, Washington, District of Columbia, USA
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA
- School of Medicine, Tulane University, New Orleans, Louisiana, USA
| | | | - Susan Jegley
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, North Little Rock, Arkansas, USA
- South Central Mental Illness Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock, Arkansas, USA
| | | | - Bo Hu
- Division of Health Services Research, Department of Psychiatry, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Marcela C Weber
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, North Little Rock, Arkansas, USA
- South Central Mental Illness Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock, Arkansas, USA
| | - Kent D Hinkson
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, North Little Rock, Arkansas, USA
- South Central Mental Illness Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock, Arkansas, USA
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Weston EB, Hassett AL, Khan SN, Weaver TE, Marras WS. Cognitive dissonance increases spine loading in the neck and low back. ERGONOMICS 2023; 66:2133-2147. [PMID: 36861457 DOI: 10.1080/00140139.2023.2186323] [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: 01/11/2023] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
Cognitive dissonance refers to a state where two psychologically inconsistent thoughts, behaviours, or attitudes are held at the same time. The objective of this study was to explore the potential role of cognitive dissonance in biomechanical loading in the low back and neck. Seventeen participants underwent a laboratory experiment involving a precision lowering task. To establish a cognitive dissonance state (CDS), study participants were provided negative feedback on their performance running counter to a pre-established expectation that their performance was excellent. Dependent measures of interest were spinal loads in the cervical and lumbar spines, calculated via two electromyography-driven models. The CDS was associated with increases to peak spinal loads in the neck (11.1%, p < .05) and low back (2.2%, p < .05). A greater CDS magnitude was also associated with a greater spinal loading increase. Therefore, cognitive dissonance may represent a risk factor for low back/neck pain that has not been previously identified.Practitioner summary: Upon establishing a cognitive dissonance state in a group of participants, spinal loading in the cervical and lumbar spines were increased proportional to the magnitude of the cognitive dissonance reported. Therefore, cognitive dissonance may represent a risk factor for low back and neck pain that has not been previously identified.
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Affiliation(s)
- Eric B Weston
- Spine Research Institute, The Ohio State University, Columbus, OH, USA
- Department of Integrated Systems Engineering, The Ohio State University, Columbus, OH, USA
| | - Afton L Hassett
- Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA
| | - Safdar N Khan
- Spine Research Institute, The Ohio State University, Columbus, OH, USA
- Department of Orthopedics, The Ohio State University, Columbus, OH, USA
| | - Tristan E Weaver
- Spine Research Institute, The Ohio State University, Columbus, OH, USA
- Department of Anesthesiology, The Ohio State University, Columbus, OH, USA
| | - William S Marras
- Spine Research Institute, The Ohio State University, Columbus, OH, USA
- Department of Integrated Systems Engineering, The Ohio State University, Columbus, OH, USA
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Turoni CJ, Benvenuto S, Marañón RO, Chahla R, de Bruno MP. Vascular and autonomic function as early predictive biomarkers of the progression to gestational hypertension. Eur J Obstet Gynecol Reprod Biol X 2023; 20:100236. [PMID: 37732111 PMCID: PMC10507205 DOI: 10.1016/j.eurox.2023.100236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/16/2023] [Accepted: 09/02/2023] [Indexed: 09/22/2023] Open
Abstract
Background The changes in endothelial function, arterial stiffness, and heart rate variability (HRV) produced in the first trimester of pregnancy in women who develop gestational hypertension (GH) are still being investigated. Objective: to evaluate the HVR, endothelial function, and arterial stiffness changes during the first trimester of pregnancy and their relationship with the development of GH. Methods A group of women normotensive during the first trimester (n = 43), who later did (GH; n = 11) or did not (no-GH; n = 32) develop GH in that pregnancy, were enrolled. In the first trimester, endothelial function and arterial stiffness were evaluated through photoplethysmography. HRV, parasympathetic (PNS), and sympathetic (SNS) indexes were measured in a 5-minute continuous electrocardiogram record at rest sitting. The Griess reaction measured urinary nitrite excretion (NOx). Results Systolic blood pressure (SBP) values were higher in GH (no-GH: 105.8 ± 2.0 vs. GH: 112.7 ± 3.0 mmHg; p < 0.05). Endothelial function was decreased, and arterial stiffness was increased in GH. Only in GH the arterial stiffness was correlated with SBP (Pearson's r: 0.5594; 95%CI: 0.06106-0.8681; p < 0.05). In HRV, GH decreased low-frequency power and the ratio SD2/SD1. The inhibition of PNS was lower in GH. The NOx was reduced in GH (no-GH: 3.4 ± 0.4 vs. GH: 0.3 ± 0.1 μM/L; p < 0.001). NOx was correlated negatively with the SNS index only in GH. Conclusions Developed GH is preceded early in pregnancy by endothelial dysfunction and increased arterial stiffness. In this context, there are SNS-PNS interrelation modifications with less inhibition of PNS.
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Affiliation(s)
- Claudio Joo Turoni
- Departamento Biomédico, Instituto de Fisiología, Facultad de Medicina - UNT; INSIBO -CONICET, Tucumán, Argentina
| | - Silvia Benvenuto
- Instituto de Maternidad Nuestra Señora de las Mercedes –Sistema Provincial de Salud (SIPROSA), Tucumán, Argentina
| | - Rodrigo O. Marañón
- Departamento Biomédico, Instituto de Fisiología, Facultad de Medicina - UNT; INSIBO -CONICET, Tucumán, Argentina
| | - Rossana Chahla
- Instituto de Maternidad Nuestra Señora de las Mercedes –Sistema Provincial de Salud (SIPROSA), Tucumán, Argentina
| | - María Peral de Bruno
- Departamento Biomédico, Instituto de Fisiología, Facultad de Medicina - UNT; INSIBO -CONICET, Tucumán, Argentina
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Dyab R, Zuccarella-Hackl C, Princip M, Sivakumar S, Meister-Langraf RE, Znoj H, Schmid JP, Barth J, Schnyder U, von Känel R, Gidron Y. Role of Heart Rate Variability in the Association between Myocardial Infarction Severity and Post-Myocardial Infarction Distress. Life (Basel) 2023; 13:2266. [PMID: 38137867 PMCID: PMC10744743 DOI: 10.3390/life13122266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/14/2023] [Accepted: 11/22/2023] [Indexed: 12/24/2023] Open
Abstract
OBJECTIVE Myocardial infarction (MI) results in mental health consequences, including depression and post-traumatic stress disorder (PTSD). The risk and protective factors of such mental consequences are not fully understood. This study examined the relation between MI severity and future mental health consequences and the moderating role of vagal nerve activity. METHODS In a reanalysis of data from the Myocardial Infarction-Stress Prevention Intervention (MI-SPRINT) study, 154 post-MI patients participated. MI severity was measured by the Killip Scale and by troponin levels. Depression and PTSD symptoms were assessed with valid questionnaires, both at 3 and 12 months. Vagal nerve activity was indexed by the heart rate variability (HRV) parameter of the root-mean square of successive R-R differences (RMSSD). Following multivariate analyses, the association between MI severity and distress was examined in patients with low and high HRV (RMSSD = 30 ms). RESULTS In the full sample, the Killip index predicted post-MI distress only at 3 months, while troponin predicted distress at 3- and 12-months post-MI. However, HRV moderated the effects of the Killip classification; Killip significantly predicted symptoms of depression and PTSD at 3- and 12-months post-MI, but only in patients with low HRV. Such moderation was absent for troponin. CONCLUSION MI severity (Killip classification) predicted post-MI depression and PTSD symptoms, but only in patients with low HRV, suggesting that the vagal nerve is a partial protective (moderating) factor in the relation between Killip score and post-MI distress.
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Affiliation(s)
- Reham Dyab
- The Cheryl Spencer Department of Nursing, Faculty of Social Welfare and Health Science, The University of Haifa, Haifa 3498838, Israel
- Lady Davis Carmel Medical Center, Haifa 3436212, Israel
| | - Claudia Zuccarella-Hackl
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zürich, 8091 Zurich, Switzerland; (C.Z.-H.); (M.P.); (S.S.); (R.E.M.-L.); (R.v.K.)
| | - Mary Princip
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zürich, 8091 Zurich, Switzerland; (C.Z.-H.); (M.P.); (S.S.); (R.E.M.-L.); (R.v.K.)
| | - Sinthujan Sivakumar
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zürich, 8091 Zurich, Switzerland; (C.Z.-H.); (M.P.); (S.S.); (R.E.M.-L.); (R.v.K.)
| | - Rebecca E. Meister-Langraf
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zürich, 8091 Zurich, Switzerland; (C.Z.-H.); (M.P.); (S.S.); (R.E.M.-L.); (R.v.K.)
- Faculty of Medicine, University of Zürich, 8006 Zurich, Switzerland;
- Clienia Schlössli AG, 8618 Oetwil am See, Switzerland
| | - Hansjörg Znoj
- Department of Clinical Psychology and Psychotherapy, University of Bern, 3012 Bern, Switzerland;
| | - Jean-Paul Schmid
- Department of Internal Medicine and Cardiology, Clinic Gais AG, 9056 Gais, Switzerland;
| | - Jürgen Barth
- Institute for Complementary and Integrative Medicine, University Hospital Zürich, University of Zürich, 8006 Zurich, Switzerland;
| | - Ulrich Schnyder
- Faculty of Medicine, University of Zürich, 8006 Zurich, Switzerland;
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zürich, 8091 Zurich, Switzerland; (C.Z.-H.); (M.P.); (S.S.); (R.E.M.-L.); (R.v.K.)
- Faculty of Medicine, University of Zürich, 8006 Zurich, Switzerland;
| | - Yori Gidron
- The Cheryl Spencer Department of Nursing, Faculty of Social Welfare and Health Science, The University of Haifa, Haifa 3498838, Israel
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Huang WL, Liao SC, Wu CS, Chiu YT. Clarifying the link between psychopathologies and heart rate variability, and the sex differences: Can neuropsychological features serve as mediators? J Affect Disord 2023; 340:250-257. [PMID: 37562561 DOI: 10.1016/j.jad.2023.08.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/23/2023] [Accepted: 08/07/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Patients with common mental disorders (depression, anxiety, and somatic symptoms) often exhibit lower heart rate variability (HRV) than healthy individuals. Under the hypothesis that disorder status affects cognitive function, we examined whether neuropsychological features can be mediators between psychopathologies and HRV and possible sex differences. METHODS We recruited 359 individuals (aged 42.47 ± 12.23) with and without common mental disorders. Questionnaires were used to measure their psychopathologies. Eight tests from the Cambridge Neuropsychological Test Automated Battery were selected to measure neuropsychological functions. Resting-state HRV measurements were obtained for 5 min. The associations among these constructs were analyzed using multiple linear regression analysis and structural equation modelling. RESULTS Among women, Reaction Time (RTI, a task of psychomotor speed) indicator mediated the relationship between depression and low-frequency power (LF); Emotion Recognition Task (ERT, a task of emotional regulation) indicator mediated the relationship between health anxiety and high-frequency power (HF). Among men, Intra-Extra Dimensional Set Shift (IED, a task of shifting) indicator mediated the relationship between depression and LF; Match to Sample Visual Search (MTS, a task of selective attention) indicator mediated the relationship between health cognition and HF. The depression-RTI-LF pathway in women tended to lower HRV; whereas health anxiety-ERT-HF in women, depression-IED-LF and health cognition-MTS-HF in men tended to increase HRV. LIMITATIONS Possible medication effects; not directly measuring brain activity; only gathering resting-state HRV. CONCLUSION Our findings support the notion that neuropsychological features mediate the relationship between psychopathologies and HRV, and that sex differences exist.
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Affiliation(s)
- Wei-Lieh Huang
- Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan; Cerebellar Research Center, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Shih-Cheng Liao
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Psychiatry, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu Hospital, Hsinchu, Taiwan
| | - Chi-Shin Wu
- Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan; National Center for Geriatrics and Welfare Research, National Health Research Institutes, Miaoli, Taiwan
| | - Yi-Ting Chiu
- Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
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Nour A, Fouad M, Salam ZA. Evaluation of cardiovascular autonomic dysfunction in symptomatic post-COVID-19 patients using the heart rate variability (HRV) and detection of subtle LV dysfunction using 2D global longitudinal strain (GLS). Int J Cardiovasc Imaging 2023; 39:2107-2118. [PMID: 37658987 PMCID: PMC10673727 DOI: 10.1007/s10554-023-02915-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 06/30/2023] [Indexed: 09/05/2023]
Abstract
AIM The COVID-19 disease primarily affects the respiratory system; however, cardiac involvement has been documented in the acute phase. We aimed to evaluate the cardiac autonomic function and subtle left ventricular dysfunction in those subjects recovered from mild to moderate acute COVID-19 patients but still symptomatic. METHODS AND RESULTS The study group was composed of 50 subjects with confirmed mild to moderate COVID-19. All subjects underwent routine 2D echocardiography assessment in addition to 2D speckle tracking and 24 h Holter monitoring for HRV analysis. The mean age of the study population was 42 ± 18 years; symptoms were reported as follows 27 (54%) had dyspnoea, 17 (34%) had palpitation, and 7 (14%) had dizziness. Time domain parameters Standard Deviation of NN intervals (SDNN), Standard Deviation of the Average NN intervals for each 5 min segment of a 24 h HRV recording (SDANN), and Root Mean Square of Successive RR interval Differences (rMSSD) were diminished with mean SDNN value being markedly impaired in 12 (24%) patients, while frequency domain parameters as assessed by the ratio of the Low-Frequency band power to the High-Frequency band power (LF/HF) with the mean of 1.837 with 8% of the patients being impaired. SDNN was significantly reduced in patients with impaired global longitudinal strain (p 0.000). The global longitudinal strain was diminished in 10 patients (20%); also, 80% of the patients with impaired GLS had decreased SDNN. CONCLUSION Our study targeted patients experiencing prolonged symptoms after COVID-19 illness. We detected a high incidence of GLS impairment using Speckle Tracking Echocardiography (STE) and a significant prevalence of diminished HRV. HRV (especially SDNN) and GLS were found to be significantly correlated.
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Affiliation(s)
- Amira Nour
- Cardiology department, Ain Shams University, Cairo, Egypt.
| | - Mirna Fouad
- Cardiology department, Ain Shams University, Cairo, Egypt
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Pinto AP, Lemos SL, de Almeida Fagundes A, das Neves MF, Lopes-Martins RÁB, Lima FPS, Lima MO. Transcranial photobiomodulation therapy associated with cardiorespiratory rehabilitation in spastic subjects. Lasers Med Sci 2023; 38:249. [PMID: 37910318 DOI: 10.1007/s10103-023-03922-y] [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: 07/25/2023] [Accepted: 10/24/2023] [Indexed: 11/03/2023]
Abstract
The objective of this study was to evaluate the effects of cardiorespiratory rehabilitation (CR) and transcranial photobiomodulation (tPBM) on exercise tolerance (ET), heart rate variability (HRV), and peripheral muscle activity in individuals with spasticity. Fifteen participants with spasticity were randomly assigned to two groups: the tPBM group (tPBMG) consisted of eight volunteers who underwent tPBM (on mode) and CR, while the control group (CG) consisted of seven volunteers who underwent simulated tPBM (off mode) and CR. The CR program included 12 weeks of treatment, twice a week for one hour, involving aerobic exercises and lower limb strengthening. For tPBM, a cluster with three lasers (λ = 680 nm, 808 nm), with a power of 100 mW/laser and energy of 36 J, applied to the F7, F8, and Fpz points. The following parameters were evaluated after 8 and 12 weeks: ET, HRV, and surface electromyography (EMG) of the rectus femoris muscle during orthostasis (ORT), isometric squatting (ISOM), and isotonic squatting (ISOT). Both groups showed a 40% increase in ET for the CG and a 30% increase for the tPBMG. The CG had more pronounced parasympathetic modulation alterations during post-exercise effort and recovery compared to the tPBMG. The EMG results showed that the tPBMG exhibited progressive improvement in muscle activity during ISOM and ISOT, as well as a decrease in the interlimb difference. In conclusion, both CR and tPBMG demonstrated improvements in ET. However, tPBMG specifically showed promising effects on HRV modulation and peripheral muscle electrical activity, providing additional benefits compared to CR alone.
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Affiliation(s)
- Ana Paula Pinto
- Sensorimotor Rehabilitation Engineering Laboratory, Research and Development Institute, Paraiba Valley University - UNIVAP, Av. Shishima Hifumi, São José Dos Campos, São Paulo, 2911, Brazil.
| | - Sérgio Luiz Lemos
- Sensorimotor Rehabilitation Engineering Laboratory, Research and Development Institute, Paraiba Valley University - UNIVAP, Av. Shishima Hifumi, São José Dos Campos, São Paulo, 2911, Brazil
| | - Alessandra de Almeida Fagundes
- Sensorimotor Rehabilitation Engineering Laboratory, Research and Development Institute, Paraiba Valley University - UNIVAP, Av. Shishima Hifumi, São José Dos Campos, São Paulo, 2911, Brazil
| | - Marcele Florêncio das Neves
- Sensorimotor Rehabilitation Engineering Laboratory, Research and Development Institute, Paraiba Valley University - UNIVAP, Av. Shishima Hifumi, São José Dos Campos, São Paulo, 2911, Brazil
| | - Rodrigo Álvaro Brandão Lopes-Martins
- Post-Graduate Program in Human Movement and Rehabilitation, Research Group in Biophotonics and Experimental Therapeutics in Health and Esthetics, Universidade Evangélica de Goiás - UniEVANGÉLICA, Anápolis, Goiás, Brazil
| | - Fernanda Pupio Silva Lima
- Sensorimotor Rehabilitation Engineering Laboratory, Research and Development Institute, Paraiba Valley University - UNIVAP, Av. Shishima Hifumi, São José Dos Campos, São Paulo, 2911, Brazil
| | - Mário Oliveira Lima
- Sensorimotor Rehabilitation Engineering Laboratory, Research and Development Institute, Paraiba Valley University - UNIVAP, Av. Shishima Hifumi, São José Dos Campos, São Paulo, 2911, Brazil
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Mangalam M, Sadri A, Hayano J, Watanabe E, Kiyono K, Kelty-Stephen DG. Multifractal foundations of biomarker discovery for heart disease and stroke. Sci Rep 2023; 13:18316. [PMID: 37880302 PMCID: PMC10600152 DOI: 10.1038/s41598-023-45184-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/17/2023] [Indexed: 10/27/2023] Open
Abstract
Any reliable biomarker has to be specific, generalizable, and reproducible across individuals and contexts. The exact values of such a biomarker must represent similar health states in different individuals and at different times within the same individual to result in the minimum possible false-positive and false-negative rates. The application of standard cut-off points and risk scores across populations hinges upon the assumption of such generalizability. Such generalizability, in turn, hinges upon this condition that the phenomenon investigated by current statistical methods is ergodic, i.e., its statistical measures converge over individuals and time within the finite limit of observations. However, emerging evidence indicates that biological processes abound with nonergodicity, threatening this generalizability. Here, we present a solution for how to make generalizable inferences by deriving ergodic descriptions of nonergodic phenomena. For this aim, we proposed capturing the origin of ergodicity-breaking in many biological processes: cascade dynamics. To assess our hypotheses, we embraced the challenge of identifying reliable biomarkers for heart disease and stroke, which, despite being the leading cause of death worldwide and decades of research, lacks reliable biomarkers and risk stratification tools. We showed that raw R-R interval data and its common descriptors based on mean and variance are nonergodic and non-specific. On the other hand, the cascade-dynamical descriptors, the Hurst exponent encoding linear temporal correlations, and multifractal nonlinearity encoding nonlinear interactions across scales described the nonergodic heart rate variability more ergodically and were specific. This study inaugurates applying the critical concept of ergodicity in discovering and applying digital biomarkers of health and disease.
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Affiliation(s)
- Madhur Mangalam
- Division of Biomechanics and Research Development, Department of Biomechanics, and Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE, 68182, USA.
| | - Arash Sadri
- Lyceum Scientific Charity, Tehran, Iran
- Interdisciplinary Neuroscience Research Program, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, P94V+8MF, Iran
| | - Junichiro Hayano
- Graduate School of Medicine, Nagoya City University, Nagoya, Aichi, 467-8601, Japan
| | - Eiichi Watanabe
- Division of Cardiology, Department of Internal Medicine, Fujita Health University Bantane Hospital, Nagoya, Aichi, 454-0012, Japan
| | - Ken Kiyono
- Graduate School of Engineering Science, Osaka University, Osaka, 560-8531, Japan
| | - Damian G Kelty-Stephen
- Department of Psychology, State University of New York at New Paltz, New Paltz, NY, 12561, USA
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Jacinto M, Matos R, Gomes B, Caseiro A, Antunes R, Monteiro D, Ferreira JP, Campos MJ. Physical Fitness Variables, General Health, Dementia and Quality of Life in Individuals with Intellectual and Developmental Disabilities: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:2688. [PMID: 37830725 PMCID: PMC10572461 DOI: 10.3390/healthcare11192688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 10/03/2023] [Accepted: 10/05/2023] [Indexed: 10/14/2023] Open
Abstract
The average life expectancy of individuals with intellectual and developmental disabilities (IDDs) is increasing. However, living more years does not mean living better, leading to the need for research on comorbidities associated with the aging process. Associated with this process are the physical characteristics most prevalent in an individual with IDD: low levels of all physical capacities, the accumulation of central fat, hyperglycemia, dyslipidemia, and hypertension, variables considered to be some of the main risk factors of the onset of metabolic and cardiovascular diseases, and variables that can negatively impact quality of life (QoL). Therefore, the aim of this study is to evaluate a sample of 21 institutionalized adults with IDD (42.81 ± 10.99 years old) in terms of their anthropometric characteristics, body composition, general health status, functional capacity, neuromuscular capacity, and dementia/cognitive function, and the possible associations with QoL. All assessments were performed in the laboratory of the Faculty of Sport Sciences and Physical Education-University of Coimbra. Participants, in the present study, have low levels of physical fitness and high metabolic and cardiovascular markets, which need to be improved. On the other hand, functional and neuromuscular ability seems to be associated with QoL (p ≤ 0.05). This study highlights the role of primary and secondary care providers in diagnosis, prevention, and supporting individuals with IDDs to promote QoL.
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Affiliation(s)
- Miguel Jacinto
- Faculty of Sport Sciences and Physical Education, University of Coimbra, 3040-248 Coimbra, Portugal; (B.G.); (A.C.); (J.P.F.); (M.J.C.)
- Life Quality Research Centre (CIEQV), 2040-413 Rio Maior, Portugal; (R.M.); (R.A.); (D.M.)
- ESECS—Polytechnic of Leiria, 2411-901 Leiria, Portugal
| | - Rui Matos
- Life Quality Research Centre (CIEQV), 2040-413 Rio Maior, Portugal; (R.M.); (R.A.); (D.M.)
- ESECS—Polytechnic of Leiria, 2411-901 Leiria, Portugal
| | - Beatriz Gomes
- Faculty of Sport Sciences and Physical Education, University of Coimbra, 3040-248 Coimbra, Portugal; (B.G.); (A.C.); (J.P.F.); (M.J.C.)
- Research Center for Sport and Physical Activity (CIDAF), 3040-248 Coimbra, Portugal
| | - André Caseiro
- Faculty of Sport Sciences and Physical Education, University of Coimbra, 3040-248 Coimbra, Portugal; (B.G.); (A.C.); (J.P.F.); (M.J.C.)
- Research Center for Sport and Physical Activity (CIDAF), 3040-248 Coimbra, Portugal
| | - Raul Antunes
- Life Quality Research Centre (CIEQV), 2040-413 Rio Maior, Portugal; (R.M.); (R.A.); (D.M.)
- ESECS—Polytechnic of Leiria, 2411-901 Leiria, Portugal
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, 2411-901 Leiria, Portugal
| | - Diogo Monteiro
- Life Quality Research Centre (CIEQV), 2040-413 Rio Maior, Portugal; (R.M.); (R.A.); (D.M.)
- ESECS—Polytechnic of Leiria, 2411-901 Leiria, Portugal
- Portugal Research Center in Sport Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
| | - José Pedro Ferreira
- Faculty of Sport Sciences and Physical Education, University of Coimbra, 3040-248 Coimbra, Portugal; (B.G.); (A.C.); (J.P.F.); (M.J.C.)
- Research Center for Sport and Physical Activity (CIDAF), 3040-248 Coimbra, Portugal
| | - Maria João Campos
- Faculty of Sport Sciences and Physical Education, University of Coimbra, 3040-248 Coimbra, Portugal; (B.G.); (A.C.); (J.P.F.); (M.J.C.)
- Research Center for Sport and Physical Activity (CIDAF), 3040-248 Coimbra, Portugal
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Ortiz-Guzmán JE, Mollà-Casanova S, Serra-Añó P, Arias-Mutis ÓJ, Calvo C, Bizy A, Alberola A, Chorro FJ, Zarzoso M. Short-Term Heart Rate Variability in Metabolic Syndrome: A Systematic Review and Meta-Analysis. J Clin Med 2023; 12:6051. [PMID: 37762990 PMCID: PMC10532399 DOI: 10.3390/jcm12186051] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/05/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Our aim was to determine the differences in short-term heart rate variability (HRV) between patients with metabolic syndrome (MS) and healthy controls. METHODS We searched electronic databases for primary works with short-term HRV recordings (≤30 min) that made comparisons between individuals with MS versus healthy controls. This systematic review and meta-analysis (MA) was performed according to PRISMA guidelines and registered at PROSPERO (CRD42022358975). RESULTS Twenty-eight articles were included in the qualitative synthesis and nineteen met the criteria for the MA. Patients with MS showed decreased SDNN (-0.36 [-0.44, -0.28], p < 0.001), rMSSD (-7.59 [-9.98, -5.19], p < 0.001), HF (-0.36 [-0.51, -0.20], p < 0.00001) and LF (-0.24 [-0.38, -0.1], p = 0.001). In subsequent subanalyses, we found a decrease in SDNN (-0.99 (-1.45, -0.52], p < 0.001), rMSSD (-10.18 [-16.85, -3.52], p < 0.01) and HF (-1.04 [-1.97, -0.1] p < 0.05) in women. In men, only LF showed a significant lower value (-0.26 [-0.5, -0.02], p < 0.05). We could not perform MA for non-linear variables. CONCLUSIONS Patients with MS showed changes in time-domain analyses, with lower values in SDNN and rMSSD. Regarding frequency-domain analyses, MS patients showed a decrease in HF and LF When sex was used as a grouping variable, the MA was only possible in one of both sexes (men or women) in rMSSD and LF/HF. Lastly, when data for both men and women were available, subanalyses showed a different behavior compared to mixed analyses for SDNN, HF and LF, which might point towards a different impact of MS in men and women.
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Affiliation(s)
- Johan E. Ortiz-Guzmán
- Department of Physiology, Universitat de València, Av. Blasco Ibáñez 15, 46010 Valencia, Spain; (J.E.O.-G.); (C.C.); (A.A.)
| | - Sara Mollà-Casanova
- Department of Physiotherapy, Universitat de València, Street Gascó Oliag 5, 46010 Valencia, Spain; (S.M.-C.); (P.S.-A.)
- UBIC Research Group, Department of Physiotherapy, Universitat de València, Street Gascó Oliag 5, 46010 Valencia, Spain
| | - Pilar Serra-Añó
- Department of Physiotherapy, Universitat de València, Street Gascó Oliag 5, 46010 Valencia, Spain; (S.M.-C.); (P.S.-A.)
- UBIC Research Group, Department of Physiotherapy, Universitat de València, Street Gascó Oliag 5, 46010 Valencia, Spain
| | - Óscar J. Arias-Mutis
- CEU Cardenal Herrera, Department of Biomedical Sciences, Street Lluís Vives 1, 46115 Valencia, Spain; (Ó.J.A.-M.); (A.B.)
- Health Research Institute—Instituto de Investigación Sanitaria del Hospital Clínico Universitario de Valencia (INCLIVA) Valencia, Street Menéndez y Pelayo 4, 46010 Valencia, Spain;
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBER-CV) Madrid, Av. Monforte de Lemos, 3–5, Pavilion 11, Floor 0, 28029 Madrid, Spain
| | - Conrado Calvo
- Department of Physiology, Universitat de València, Av. Blasco Ibáñez 15, 46010 Valencia, Spain; (J.E.O.-G.); (C.C.); (A.A.)
- CSIC-UPV, Instrumentation for Molecular Imaging Technologies Research Institute (I3M), Universitat Politècnica de València, 46022 Valencia, Spain
| | - Alexandra Bizy
- CEU Cardenal Herrera, Department of Biomedical Sciences, Street Lluís Vives 1, 46115 Valencia, Spain; (Ó.J.A.-M.); (A.B.)
| | - Antonio Alberola
- Department of Physiology, Universitat de València, Av. Blasco Ibáñez 15, 46010 Valencia, Spain; (J.E.O.-G.); (C.C.); (A.A.)
| | - Francisco J. Chorro
- Health Research Institute—Instituto de Investigación Sanitaria del Hospital Clínico Universitario de Valencia (INCLIVA) Valencia, Street Menéndez y Pelayo 4, 46010 Valencia, Spain;
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBER-CV) Madrid, Av. Monforte de Lemos, 3–5, Pavilion 11, Floor 0, 28029 Madrid, Spain
- Department of Medicine, Universitat de València, Av. Blasco Ibáñez 15, 46010 Valencia, Spain
| | - Manuel Zarzoso
- Department of Physiotherapy, Universitat de València, Street Gascó Oliag 5, 46010 Valencia, Spain; (S.M.-C.); (P.S.-A.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBER-CV) Madrid, Av. Monforte de Lemos, 3–5, Pavilion 11, Floor 0, 28029 Madrid, Spain
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Wang HM, Huang PY, Yang SC, Wu MK, Tai WC, Chen CH, Yao CC, Lu LS, Chuah SK, Lee YC, Liang CM. Correlation between Psychosomatic Assessment, Heart Rate Variability, and Refractory GERD: A Prospective Study in Patients with Acid Reflux Esophagitis. Life (Basel) 2023; 13:1862. [PMID: 37763266 PMCID: PMC10533115 DOI: 10.3390/life13091862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/28/2023] [Accepted: 09/01/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Gastroesophageal reflux disease (GERD) affects a significant proportion of individuals, with life stress being a contributing factor. This study aimed to investigate the correlation between psychosomatic evaluations, heart rate variability (HRV), and GERD in a cohort of individuals. Additionally, the study aimed to analyze the sequencing changes following proton pump inhibitor (PPI) treatment and identify predictive factors associated with refractory GERD. METHODS A prospective cohort of 105 individuals with reflux esophagitis and a control group of 50 participants without acid reflux symptoms were enrolled. Psychosomatic evaluations, including GERDQ, GERDQLQ, RSI, BAI, BDI, and SSS-8, were assessed at baseline and during treatment. HRV parameters were also evaluated. Multivariate analysis was used to identify predictive factors for refractory GERD. PPIs were administered regularly for the initial 2 months and then used on-demand. Refractory GERD was defined as less than 50% improvement in symptom relief or GERDQLQ score ≥ 20 after 8 weeks of PPI treatment. RESULTS The GERD group had higher scores in all psychosomatic evaluations compared to the control group (all p-values < 0.001). There were no significant changes in any parameters of HRV before and after treatment in the GERD group. Strong and consistent correlations were observed between GERD symptoms and psychological scores (BAI, BDI, and SSS-8) across all time points (W0, W4, and W8). Sequential reductions in GERD symptom scores and psychosomatic evaluations were observed during the initial eight weeks of treatment. Higher GERDQ (≥10) and SSS-8 (≥12) scores were predictive of refractory GERD (p = 0.004 and p = 0.009, respectively). CONCLUSIONS This study emphasizes the importance of considering physiological and psychological factors in the management of GERD. Psychosomatic evaluations provide valuable insights for assessing and treating GERD patients. Integrating stress management and comprehensive assessments into personalized treatment strategies is crucial.
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Affiliation(s)
- Hsin-Ming Wang
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta Pei Road, Niao-Sung Dist., Kaohsiung 833, Taiwan; (H.-M.W.); (P.-Y.H.); (S.-C.Y.); (W.-C.T.); (C.-H.C.); (C.-C.Y.); (L.-S.L.); (S.-K.C.)
| | - Pao-Yuan Huang
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta Pei Road, Niao-Sung Dist., Kaohsiung 833, Taiwan; (H.-M.W.); (P.-Y.H.); (S.-C.Y.); (W.-C.T.); (C.-H.C.); (C.-C.Y.); (L.-S.L.); (S.-K.C.)
| | - Shih-Cheng Yang
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta Pei Road, Niao-Sung Dist., Kaohsiung 833, Taiwan; (H.-M.W.); (P.-Y.H.); (S.-C.Y.); (W.-C.T.); (C.-H.C.); (C.-C.Y.); (L.-S.L.); (S.-K.C.)
| | - Ming-Kung Wu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan;
| | - Wei-Chen Tai
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta Pei Road, Niao-Sung Dist., Kaohsiung 833, Taiwan; (H.-M.W.); (P.-Y.H.); (S.-C.Y.); (W.-C.T.); (C.-H.C.); (C.-C.Y.); (L.-S.L.); (S.-K.C.)
| | - Chih-Hung Chen
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta Pei Road, Niao-Sung Dist., Kaohsiung 833, Taiwan; (H.-M.W.); (P.-Y.H.); (S.-C.Y.); (W.-C.T.); (C.-H.C.); (C.-C.Y.); (L.-S.L.); (S.-K.C.)
| | - Chih-Chien Yao
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta Pei Road, Niao-Sung Dist., Kaohsiung 833, Taiwan; (H.-M.W.); (P.-Y.H.); (S.-C.Y.); (W.-C.T.); (C.-H.C.); (C.-C.Y.); (L.-S.L.); (S.-K.C.)
| | - Lung-Sheng Lu
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta Pei Road, Niao-Sung Dist., Kaohsiung 833, Taiwan; (H.-M.W.); (P.-Y.H.); (S.-C.Y.); (W.-C.T.); (C.-H.C.); (C.-C.Y.); (L.-S.L.); (S.-K.C.)
| | - Seng-Kee Chuah
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta Pei Road, Niao-Sung Dist., Kaohsiung 833, Taiwan; (H.-M.W.); (P.-Y.H.); (S.-C.Y.); (W.-C.T.); (C.-H.C.); (C.-C.Y.); (L.-S.L.); (S.-K.C.)
| | - Yu-Chi Lee
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta Pei Road, Niao-Sung Dist., Kaohsiung 833, Taiwan; (H.-M.W.); (P.-Y.H.); (S.-C.Y.); (W.-C.T.); (C.-H.C.); (C.-C.Y.); (L.-S.L.); (S.-K.C.)
| | - Chih-Ming Liang
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta Pei Road, Niao-Sung Dist., Kaohsiung 833, Taiwan; (H.-M.W.); (P.-Y.H.); (S.-C.Y.); (W.-C.T.); (C.-H.C.); (C.-C.Y.); (L.-S.L.); (S.-K.C.)
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