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Sameer S, N P, Kuppusamy S, Adole PS, Kayal S. Cardiac Autonomic and Endothelial Function in Acute Lymphoblastic Leukaemia Patients Immediately After Chemotherapy and at the Three-Month Follow-up. Cureus 2024; 16:e55108. [PMID: 38558679 PMCID: PMC10979077 DOI: 10.7759/cureus.55108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2024] [Indexed: 04/04/2024] Open
Abstract
INTRODUCTION Acute lymphoblastic leukemia (ALL) is a malignant uncontrolled overproduction of immature lymphoid cells in blood and bone marrow. The primary treatment of ALL is chemotherapy. Chemotherapy can have myriad systemic side effects, notably cardiovascular derangement. Autonomic derangement occurrence in cancer patients signifies cardiovascular risk in them and is a determinant of cardiovascular morbidity and mortality. Elevated soluble vascular cell adhesion molecule-1 (sVCAM-1) and soluble intercellular adhesion molecule-1 (sICAM-1) levels implicated in the regulation of inflammation indicate endothelial dysfunction. High levels of high-sensitivity C-reactive protein (hsCRP) can be indicative of low-grade inflammation. Hence, in this study the cardiac autonomic function and endothelial and inflammatory biomarker levels in adult patients with ALL were assessed immediately and three months after chemotherapy. METHODS In this longitudinal study, 30 ALL patients (23 males, seven females) aged between 18 to 50 years, who had completed chemotherapy regimens, and 30 age and gender-matched healthy participants (controls) were recruited. Cardiac autonomic function tests (short-term heart rate variability (HRV), 30:15 ratio, synaptic excitation and inhibition (E/I) ratio, diastolic blood pressure (DBP) response to isometric hand grip), endothelial markers (sVCAM-1 and sICAM-1), and inflammatory marker (hsCRP) were assessed immediately and at three months after chemotherapy. RESULTS Magnitudes of time domain and frequency domain indices, conventional autonomic function test indices, and biomarkers were deranged in ALL patients immediately after chemotherapy. After three months, cardiac autonomic function parameters were found to improve in the form of increased root mean square of successive differences between normal heartbeats (RMSSD), standard deviation of the interbeat intervals of normal sinus beats (SDNN), total power, high-frequency (HF)nu, and decreased low-frequency(LF)nu & LF-HF ratio. Endothelial (sVCAM-1) and inflammatory markers (hsCRP) were lower in the patient group as compared to the controls immediately after chemotherapy. Three months after chemotherapy, the levels of endothelial and inflammatory markers did not show much change. CONCLUSION In this study, we found ALL patients showed higher sympathetic drive, decreased parasympathetic modulation, and sympathovagal imbalance immediately after chemotherapy as compared to the controls, indicating cardiovascular risk. After three months, improvement in cardiovascular autonomic function was observed. ALL itself is a state of inflammation with elevated endothelial and inflammatory markers; thus, the decreased endothelial and inflammatory markers could be attributed to the immediate effect of chemotherapy.
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Affiliation(s)
- Sameer Sameer
- Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Prabhu N
- Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Saranya Kuppusamy
- Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Prashant S Adole
- Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Smita Kayal
- Medical Oncology, Regional Cancer Center, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
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Ryu JS, Lee S, Chu Y, Koh SB, Park YJ, Lee JY, Yang S. Deep Learning Algorithms for Estimation of Demographic and Anthropometric Features from Electrocardiograms. J Clin Med 2023; 12:jcm12082828. [PMID: 37109165 PMCID: PMC10146401 DOI: 10.3390/jcm12082828] [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: 03/12/2023] [Revised: 04/02/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023] Open
Abstract
The electrocardiogram (ECG) has been known to be affected by demographic and anthropometric factors. This study aimed to develop deep learning models to predict the subject's age, sex, ABO blood type, and body mass index (BMI) based on ECGs. This retrospective study included individuals aged 18 years or older who visited a tertiary referral center with ECGs acquired from October 2010 to February 2020. Using convolutional neural networks (CNNs) with three convolutional layers, five kernel sizes, and two pooling sizes, we developed both classification and regression models. We verified a classification model to be applicable for age (<40 years vs. ≥40 years), sex (male vs. female), BMI (<25 kg/m2 vs. ≥25 kg/m2), and ABO blood type. A regression model was also developed and validated for age and BMI estimation. A total of 124,415 ECGs (1 ECG per subject) were included. The dataset was constructed by dividing the entire set of ECGs at a ratio of 4:3:3. In the classification task, the area under the receiver operating characteristic (AUROC), which represents a quantitative indicator of the judgment threshold, was used as the primary outcome. The mean absolute error (MAE), which represents the difference between the observed and estimated values, was used in the regression task. For age estimation, the CNN achieved an AUROC of 0.923 with an accuracy of 82.97%, and a MAE of 8.410. For sex estimation, the AUROC was 0.947 with an accuracy of 86.82%. For BMI estimation, the AUROC was 0.765 with an accuracy of 69.89%, and a MAE of 2.332. For ABO blood type estimation, the CNN showed an inferior performance, with a top-1 accuracy of 31.98%. For the ABO blood type estimation, the CNN showed an inferior performance, with a top-1 accuracy of 31.98% (95% CI, 31.98-31.98%). Our model could be adapted to estimate individuals' demographic and anthropometric features from their ECGs; this would enable the development of physiologic biomarkers that can better reflect their health status than chronological age.
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Affiliation(s)
- Ji Seung Ryu
- Department of Precision Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea
| | - Solam Lee
- Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea
| | - Yuseong Chu
- Department of Biomedical Engineering, Yonsei University, Wonju 26493, Republic of Korea
| | - Sang Baek Koh
- Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea
| | - Young Jun Park
- Division of Cardiology, Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea
| | - Ju Yeong Lee
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea
| | - Sejung Yang
- Department of Precision Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea
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Bullock T, MacLean MH, Santander T, Boone AP, Babenko V, Dundon NM, Stuber A, Jimmons L, Raymer J, Okafor GN, Miller MB, Giesbrecht B, Grafton ST. Habituation of the stress response multiplex to repeated cold pressor exposure. Front Physiol 2023; 13:752900. [PMID: 36703933 PMCID: PMC9871365 DOI: 10.3389/fphys.2022.752900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 11/21/2022] [Indexed: 01/12/2023] Open
Abstract
Humans show remarkable habituation to aversive events as reflected by changes of both subjective report and objective measures of stress. Although much experimental human research focuses on the effects of stress, relatively little is known about the cascade of physiological and neural responses that contribute to stress habituation. The cold pressor test (CPT) is a common method for inducing acute stress in human participants in the laboratory; however, there are gaps in our understanding of the global state changes resulting from this stress-induction technique and how these responses change over multiple exposures. Here, we measure the stress response to repeated CPT exposures using an extensive suite of physiologic measures and state-of-the-art analysis techniques. In two separate sessions on different days, participants underwent five 90 s CPT exposures of both feet and five warm water control exposures, while electrocardiography (ECG), impedance cardiography, continuous blood pressure, pupillometry, scalp electroencephalography (EEG), salivary cortisol and self-reported pain assessments were recorded. A diverse array of adaptive responses are reported that vary in their temporal dynamics within each exposure as well as habituation across repeated exposures. During cold-water exposure there was a cascade of changes across several cardiovascular measures (elevated heart rate (HR), cardiac output (CO) and Mean Arterial Pressure (MAP) and reduced left ventricular ejection time (LVET), stroke volume (SV) and high-frequency heart rate variability (HF)). Increased pupil dilation was observed, as was increased power in low-frequency bands (delta and theta) across frontal EEG electrode sites. Several cardiovascular measures also habituated over repeated cold-water exposures (HR, MAP, CO, SV, LVET) as did pupil dilation and alpha frequency activity across the scalp. Anticipation of cold water induced stress effects in the time-period immediately prior to exposure, indexed by increased pupil size and cortical disinhibition in the alpha and beta frequency bands across central scalp sites. These results provide comprehensive insight into the evolution of a diverse array of stress responses to an acute noxious stressor, and how these responses adaptively contribute to stress habituation.
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Affiliation(s)
- Tom Bullock
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States,Institute for Collaborative Biotechnologies, University of California, Santa Barbara, Santa Barbara, CA, United States,*Correspondence: Tom Bullock,
| | - Mary H. MacLean
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States,Institute for Collaborative Biotechnologies, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Tyler Santander
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States,Institute for Collaborative Biotechnologies, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Alexander P. Boone
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Viktoriya Babenko
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States,Institute for Collaborative Biotechnologies, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Neil M. Dundon
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States,Institute for Collaborative Biotechnologies, University of California, Santa Barbara, Santa Barbara, CA, United States,Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Freiburg, Freiburg im Breisgau, Germany
| | - Alexander Stuber
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States,Institute for Collaborative Biotechnologies, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Liann Jimmons
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States,Institute for Collaborative Biotechnologies, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Jamie Raymer
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States,Institute for Collaborative Biotechnologies, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Gold N. Okafor
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States,Institute for Collaborative Biotechnologies, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Michael B. Miller
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States,Institute for Collaborative Biotechnologies, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Barry Giesbrecht
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States,Institute for Collaborative Biotechnologies, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Scott T. Grafton
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States,Institute for Collaborative Biotechnologies, University of California, Santa Barbara, Santa Barbara, CA, United States
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Lundstrom CJ, Foreman NA, Biltz G. Practices and Applications of Heart Rate Variability Monitoring in Endurance Athletes. Int J Sports Med 2023; 44:9-19. [PMID: 35853460 DOI: 10.1055/a-1864-9726] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Heart rate variability reflects fluctuations in the changes in consecutive heartbeats, providing insight into cardiac autonomic function and overall physiological state. Endurance athletes typically demonstrate better cardiac autonomic function than non-athletes, with lower resting heart rates and greater variability. The availability and use of heart rate variability metrics has increased in the broader population and may be particularly useful to endurance athletes. The purpose of this review is to characterize current practices and applications of heart rate variability analysis in endurance athletes. Important considerations for heart rate variability analysis will be discussed, including analysis techniques, monitoring tools, the importance of stationarity of data, body position, timing and duration of the recording window, average heart rate, and sex and age differences. Key factors affecting resting heart rate variability will be discussed, including exercise intensity, duration, modality, overall training load, and lifestyle factors. Training applications will be explored, including heart rate variability-guided training and the identification and monitoring of maladaptive states such as overtraining. Lastly, we will examine some alternative uses of heart rate variability, including during exercise, post-exercise, and for physiological forecasting and predicting performance.
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Affiliation(s)
| | - Nicholas A Foreman
- School of Kinesiology, University of Minnesota Twin Cities, Minneapolis, United States
| | - George Biltz
- School of Kinesiology, University of Minnesota Twin Cities, Minneapolis, United States
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5
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Pouriamehr S, Dabidi Roshan V, Shirani F. Does long-term exposure to air pollution suppress parasympathetic reactivation after incremental exercise among healthy males and females? Inhal Toxicol 2023; 35:14-23. [PMID: 36416472 DOI: 10.1080/08958378.2022.2149905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE As consequences of industrial processes, air pollution has led to increased cardiovascular diseases resulting in mortality. However, there are few pieces of evidence expressing physical fitness and gender impacts in such environments. Regarding long-term exposure to air pollution, this study aimed to determine the effect of physical fitness on post-exercise cardiac parasympathetic reactivation among healthy males and females. METHODS 120 individuals (46 ± 5 years) participated and were categorized into two main groups (n = 60; EG, CG); (1) The experimental group included individuals living in an air-polluted environment; (2) The control group included the citizens of a clean air region; and two physical fitness status subgroups (n = 30; active vs. sedentary) across both sexes. The heart rate (HR) changes at different timing after performing an incremental exercise, and T30 were calculated as metrics of cardiac parasympathetic reactivation. RESULTS The heart rate recovery values were substantially lower in EG in comparison to CG (p < 0.001) at different timing, while, T30 was significantly greater in residents of the air-polluted city compared to CG (p < 0.001). As for heart rate recovery at the 5th minute, the values were significantly lower in the steady-female group in comparison to the active females living in the air-polluted city (p < 0.01). CONCLUSION Based on our findings, although physical fitness modifies the adverse impacts of long-term exposure to air pollution on post-exercise cardio-parasympathetic reactivation, it appears to parallel the acute/intermediate recovery of the thermoregulatory and vascular systems, among both sexes, it does not prevent them.
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Affiliation(s)
- Sara Pouriamehr
- Department of Exercise Physiology, Faculty of Sport Science, University of Mazandaran, Babolsar, Iran
| | - Valiollah Dabidi Roshan
- Department of Exercise Physiology, Faculty of Sport Science, University of Mazandaran, Babolsar, Iran.,Athletic Performance and Health Research Center, Faculty of Sport Science, University of Mazandaran, Babolsar, Iran
| | - Farimah Shirani
- Ph.D. Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Science, Isfahan, Iran
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6
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Maharjan A, Khwaounjoo P, Peng M, Cakmak YO. Non-contact neuromodulation of the human autonomic nervous system function via different odors: Sex, menstrual cycle, and odor dose- and duration-specific effects. Front Neurosci 2022; 16:950282. [PMID: 36312014 PMCID: PMC9596915 DOI: 10.3389/fnins.2022.950282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 08/17/2022] [Indexed: 11/24/2022] Open
Abstract
In recent decades, it has been uncovered that the autonomic nervous system (ANS) can be influenced using non-contact neuromodulation via odor stimulation. Increasing parasympathetic-vagal activation of the ANS is integral to improving the sympathovagal balance between the sympathetic- and parasympathetic nervous systems, which is often imbalanced in several chronic inflammatory disorders, such as rheumatoid arthritis and inflammatory bowel diseases. Although research into olfactory stimulation has been observed on the ANS, it is still lacking in the exploration of odor concentration and odor-specific effects. This is particularly the case as research has not utilized specified tools, such as the olfactometer to provide precise odor delivery. Furthermore, no research has compared the results in separate sex cohorts to investigate the role of sex or the menstrual stage on the subsequent interactions. In this study, we investigated the olfactory stimulation effects of four natural odors (mushroom, lavender, jasmine, and rose) in three concentrations (low, moderate, and high) on the ANS. To observe activity from the ANS, we used an electrocardiogram (ECG) based heart rate variability (HRV) and eye-tracker technology (pupil diameter). We found for the first time in literature that there were acute dose- and duration-specific odor effects of odors on the ANS. We also found sex and menstrual cycle effects in this interaction. Furthermore, there were stark distinctions in sympathovagal activity dependent ANS activation (HRV) in comparison to the oculomotor nerve-parasympathetic/cervical sympathetic nerves dependent ANS responses (pupil diameter). Sympathovagal activity dependent HRV showed odor, sex, and menstrual-stage interactions in both divisions of the ANS while the pupil responses only indicated increased sympathetic activation. These results shed light on the use of odor-specific stimulation to modulate the ANS activity in the context of sex and the menstrual stage. Future studies should be performed using a chronic odor delivery design to investigate the long-term effects of odors on the ANS.
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Affiliation(s)
- Ashim Maharjan
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - Prashanna Khwaounjoo
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
- Medical Technologies Centre of Research Excellence, Auckland, New Zealand
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Mei Peng
- Sensory Neuroscience Laboratory, Department of Food Science, University of Otago, Dunedin, New Zealand
| | - Yusuf Ozgur Cakmak
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
- Medical Technologies Centre of Research Excellence, Auckland, New Zealand
- Brain Health Research Centre, Dunedin, New Zealand
- Centre for Bioengineering and Nanotechnology, Point of Care Technologies, University of Otago, Dunedin, New Zealand
- *Correspondence: Yusuf Ozgur Cakmak,
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Seizure-related differences in biosignal 24-h modulation patterns. Sci Rep 2022; 12:15070. [PMID: 36064877 PMCID: PMC9445076 DOI: 10.1038/s41598-022-18271-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 08/08/2022] [Indexed: 11/08/2022] Open
Abstract
A seizure likelihood biomarker could improve seizure monitoring and facilitate adjustment of treatments based on seizure risk. Here, we tested differences in patient-specific 24-h-modulation patterns of electrodermal activity (EDA), peripheral body temperature (TEMP), and heart rate (HR) between patients with and without seizures. We enrolled patients who underwent continuous video-EEG monitoring at Boston Children's Hospital to wear a biosensor. We divided patients into two groups: those with no seizures and those with at least one seizure during the recording period. We assessed the 24-h modulation level and amplitude of EDA, TEMP, and HR. We performed machine learning including physiological and clinical variables. Subsequently, we determined classifier performance by cross-validated machine learning. Patients with seizures (n = 49) had lower EDA levels (p = 0.031), EDA amplitudes (p = 0.045), and trended toward lower HR levels (p = 0.060) compared to patients without seizures (n = 68). Averaged cross-validated classification accuracy was 69% (AUC-ROC: 0.75). Our results show the potential to monitor and forecast risk for epileptic seizures based on changes in 24-h patterns in wearable recordings in combination with clinical variables. Such biomarkers might be applicable to inform care, such as treatment or seizure injury risk during specific periods, scheduling diagnostic tests, such as admission to the epilepsy monitoring unit, and potentially other neurological and chronic conditions.
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Ogden RS, Dobbins C, Slade K, McIntyre J, Fairclough S. The psychophysiological mechanisms of real-world time experience. Sci Rep 2022; 12:12890. [PMID: 35902608 PMCID: PMC9330997 DOI: 10.1038/s41598-022-16198-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 07/06/2022] [Indexed: 11/21/2022] Open
Abstract
Our sense of time is fallible, often resulting in the sensation of time flying by quickly or dragging slowly. It has been suggested that changes in sympathetic (SNS) and parasympathetic nervous system (PNS) activity may influence the perceived passage of time, however this proposition has never been tested during real-world temporal experience. The current study directly tested the relationship between the passage of time and SNS–PNS activity in the real-world. Sixty-seven participants completed a normal day’s activities whilst wearing sensors to capture electrocardiography (ECG), electrodermal activity (EDA) and movement. They also provided hourly rating of the subjective speed at which time was passing. Results revealed that greater SNS activity (e.g., increased heart rate, frequency of phasic skin conductance response) was associated with time passing more quickly. PNS activity was not related to time experience. Whilst the findings support previous suggestions that changes in physiological arousal are associated with distortions to the passage of time, the effects are small and other factors are likely to contribute to real-world temporal experience.
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Affiliation(s)
- Ruth S Ogden
- School of Psychology, Liverpool John Moores University, Liverpool, L33AF, UK.
| | - Chelsea Dobbins
- School of Information Technology and Electrical Engineering, University of Queensland, St Lucia, QLD, 4072, Australia
| | - Kate Slade
- Department of Psychology, Lancaster University, Lancaster, LA14YW, UK
| | - Jason McIntyre
- School of Psychology, Liverpool John Moores University, Liverpool, L33AF, UK
| | - Stephen Fairclough
- School of Psychology, Liverpool John Moores University, Liverpool, L33AF, UK
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The association of salivary alpha-amylase, heart rate variability, and psychological stress on objectively measured sleep behaviors among college students. FRONTIERS OF NURSING 2022. [DOI: 10.2478/fon-2022-0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Objective
This study aimed to evaluate sleep behaviors among college students, to assess salivary alpha-amylase (sAA) and heart rate variability (HRV) in association with stress, and to investigate sleep-related factors including sAA, HRV, and stress among them.
Methods
Saliva samples for sAA assessment and HRV measurements in the supine position were taken between 3 PM and 6 PM. The level of prolonged psychological stress for the previous week was evaluated using the Korean version of the Global Assessment of Recent Stress (GARS-K), and sleep behaviors were assessed using an actigraphy device.
Results
A total of 86 healthy college students participated in this study. Sleep behaviors of the college students were not good, with 84% sleep efficiency (SE) and 62.7 min wake after sleep onset (WASO). The average sAA level was 65.8 U/mL in the participants. Although neither the sAA level nor HRV indices were significantly correlated with prolonged psychological stress, decreased normalized high frequency (nHF) on HRV was independently associated with a higher level of stress when adjusted for age and sex. Higher stress (r = −0.276, P = 0.011) and lower sAA (r = 0.266, P = 0.030) had significant correlations with shorter time in bed; however, it was sAA that was independently associated with time in bed (β = 0.244, p = 0.044). Decreased nHF (β = 0.245, P = 0.027) and higher body mass index (BMI) (β = −0.224, P = 0.043) were independently related to and poorer SE.
Conclusions
Poor sleep behaviors were associated with decreased parasympathetic activity, a physiological change to psychological stress, rather than with psychological stress itself among college students. Thus, sAA and HRV should be considered as significant factors for impaired sleep behaviors in relation to psychological stress.
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Analysis of Gender Differences in HRV of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Using Mobile-Health Technology. SENSORS 2021; 21:s21113746. [PMID: 34071326 PMCID: PMC8197911 DOI: 10.3390/s21113746] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/20/2021] [Accepted: 05/22/2021] [Indexed: 01/09/2023]
Abstract
In a previous study using mobile-health technology (mHealth), we reported a robust association between chronic fatigue symptoms and heart rate variability (HRV) in female patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). This study explores HRV analysis as an objective, non-invasive and easy-to-apply marker of ME/CFS using mHealth technology, and evaluates differential gender effects on HRV and ME/CFS core symptoms. In our methodology, participants included 77 ME/CFS patients (32 men and 45 women) and 44 age-matched healthy controls (19 men and 25 women), all self-reporting subjective scores for fatigue, sleep quality, anxiety, and depression, and neurovegetative symptoms of autonomic dysfunction. The inter-beat cardiac intervals are continuously monitored/recorded over three 5-min periods, and HRV is analyzed using a custom-made application (iOS) on a mobile device connected via Bluetooth to a wearable cardiac chest band. Male ME/CFS patients show increased scores compared with control men in all symptoms and scores of fatigue, and autonomic dysfunction, as with women in the first study. No differences in any HRV parameter appear between male ME/CFS patients and controls, in contrast to our findings in women. However, we have found negative correlations of ME/CFS symptomatology with cardiac variability (SDNN, RMSSD, pNN50, LF) in men. We have also found a significant relationship between fatigue symptomatology and HRV parameters in ME/CFS patients, but not in healthy control men. Gender effects appear in HF, LF/HF, and HFnu HRV parameters. A MANOVA analysis shows differential gender effects depending on the experimental condition in autonomic dysfunction symptoms and HF and HFnu HRV parameters. A decreased HRV pattern in ME/CFS women compared to ME/CFS men may reflect a sex-related cardiac autonomic dysfunction in ME/CFS illness that could be used as a predictive marker of disease progression. In conclusion, we show that HRV analysis using mHealth technology is an objective, non-invasive tool that can be useful for clinical prediction of fatigue severity, especially in women with ME/CFS.
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Xu J, Chen W. Impact of Water Temperature on Heart Rate Variability during Bathing. Life (Basel) 2021; 11:life11050378. [PMID: 33922202 PMCID: PMC8145520 DOI: 10.3390/life11050378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/16/2021] [Accepted: 04/20/2021] [Indexed: 02/07/2023] Open
Abstract
Background: Heart rate variability (HRV) is affected by many factors. This paper aims to explore the impact of water temperature (WT) on HRV during bathing. Methods: The bathtub WT was preset at three conditions: i.e., low WT (36–38 °C), medium WT (38–40 °C), and high WT (40–42 °C), respectively. Ten subjects participated in the data collection. Each subject collected five electrocardiogram (ECG) recordings at each preset bathtub WT condition. Each recording was 18 min long with a sampling rate of 200 Hz. In total, 150 ECG recordings and 150 WT recordings were collected. Twenty HRV features were calculated using 1-min ECG segments each time. The k-means clustering analysis method was used to analyze the rough trends based on the preset WT. Analyses of the significant differences were performed using the multivariate analysis of variance of t-tests, and the mean and standard deviation (SD) of each HRV feature based on the WT were calculated. Results: The statistics show that with increasing WT, 11 HRV features are significantly (p < 0.05) and monotonously reduced, four HRV features are significantly (p < 0.05) and monotonously rising, two HRV features are rising first and then reduced, two HRV features (fuzzy and approximate entropy) are almost unchanged, and vLF power is rising. Conclusion: The WT has an important impact on HRV during bathing. The findings in the present work reveal an important physiological factor that affects the dynamic changes of HRV and contribute to better quantitative analyses of HRV in future research works.
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Lischke A, Pahnke R, Mau-Moeller A, Weippert M. Heart Rate Variability Modulates Interoceptive Accuracy. Front Neurosci 2021; 14:612445. [PMID: 33536870 PMCID: PMC7849500 DOI: 10.3389/fnins.2020.612445] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 12/02/2020] [Indexed: 12/17/2022] Open
Abstract
Our emotional experiences depend on our interoceptive ability to perceive and interpret changes in our autonomous nervous system. An inaccurate perception and interpretation of autonomic changes impairs our ability to understand and regulate our emotional reactions. Impairments in emotion understanding and emotion regulation increase our risk for mental disorders, indicating that interoceptive deficits play an important role in the etiology and pathogenesis of mental disorders. We, thus, need measures to identify those of us whose interoceptive deficits impair their emotion understanding and emotion regulation. Here, we used cardiac measures to investigate how our ability to engage prefrontal and (para-)limbic brain region regions affects our ability to perceive and interpret cardiac changes. We administered a heartbeat detection task to a sample of healthy individuals (n = 113) whose prefrontal-(para-) limbic engagement had been determined on basis of a heart rate variability recording. We found a positive association between heartbeat detection and heart rate variability, implying that individuals with higher heart rate variability were more accurate in heartbeat detection than individuals with lower heart rate variability. These findings suggest that our interoceptive accuracy depends on our prefrontal-(para-)limbic engagement during the perception and interpretation of cardiac changes. Our findings also show that cardiac measures may be useful to investigate the association between interoceptive accuracy and prefrontal-(para-)limbic engagement in a time- and cost-efficient manner.
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Affiliation(s)
- Alexander Lischke
- Department of Psychology, University of Greifswald, Greifswald, Germany
| | - Rike Pahnke
- Department of Sport Science, University of Rostock, Rostock, Germany
| | - Anett Mau-Moeller
- Department of Sport Science, University of Rostock, Rostock, Germany
| | - Matthias Weippert
- Department of Sport Science, University of Rostock, Rostock, Germany
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Sumi Y, Nakayama C, Kadotani H, Matsuo M, Ozeki Y, Kinoshita T, Goto Y, Kano M, Yamakawa T, Hasegawa-Ohira M, Ogawa K, Fujiwara K. Resting Heart Rate Variability Is Associated With Subsequent Orthostatic Hypotension: Comparison Between Healthy Older People and Patients With Rapid Eye Movement Sleep Behavior Disorder. Front Neurol 2020; 11:567984. [PMID: 33329309 PMCID: PMC7719719 DOI: 10.3389/fneur.2020.567984] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 10/12/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Orthostatic hypotension (OH) caused by autonomic dysfunction is a common symptom in older people and patients with idiopathic rapid eye movement sleep behavior disorder (iRBD). The orthostatic challenge test is a standard autonomic function test that measures a decrease of blood pressure during a postural change from supine to standing positions. Although previous studies have reported that changes in heart rate variability (HRV) are associated with autonomic dysfunction, no study has investigated the relationship between HRV before standing and the occurrence of OH in an orthostatic challenge test. This study aims to examine the connection between HRV in the supine position and the occurrence of OH in an orthostatic challenge test. Methods: We measured the electrocardiograms of patients with iRBD and healthy older people during an orthostatic challenge test, in which the supine and standing positions were held for 15 min, respectively. The subjects were divided into three groups: healthy controls (HC), OH-negative iRBD [OH (-) iRBD], and OH-positive iRBD [OH (+) iRBD]. HRV measured in the supine position during the test were calculated by time-domain analysis and Poincaré plots to evaluate the autonomic dysfunction. Results: Forty-two HC, 12 OH (-) iRBD, and nine OH (+) iRBD subjects were included. HRV indices in the OH (-) and the OH (+) iRBD groups were significantly smaller than those in the HC group. The multivariate logistic regression analysis for OH identification for the iRBD groups showed the model whose inputs were the HRV indices, i.e., standard deviation 2 (SD2) and the percentage of adjacent intervals that varied by more than 50 ms (pNN50), had a receiver operating characteristic curve with area under the curve of 0.840, the sensitivity to OH (+) of 1.000, and the specificity to OH (-) of 0.583 (p = 0.023). Conclusions: This study showed the possibility that short-term HRV indices in the supine position would predict subsequent OH in iRBD patients. Our results are of clinical importance in terms of showing the possibility that OH can be predicted using only HRV in the supine position without an orthostatic challenge test, which would improve the efficiency and safety of testing.
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Affiliation(s)
- Yukiyoshi Sumi
- Department of Psychiatry, Shiga University of Medical Science, Otsu, Japan
| | - Chikao Nakayama
- Department of Systems Science, Kyoto University, Kyoto, Japan
| | - Hiroshi Kadotani
- Department of Sleep and Behavioral Sciences, Shiga University of Medical Science, Otsu, Japan
| | - Masahiro Matsuo
- Department of Psychiatry, Shiga University of Medical Science, Otsu, Japan
| | - Yuji Ozeki
- Department of Psychiatry, Shiga University of Medical Science, Otsu, Japan
| | | | - Yuki Goto
- Department of Systems Science, Kyoto University, Kyoto, Japan
| | - Manabu Kano
- Department of Systems Science, Kyoto University, Kyoto, Japan
| | - Toshitaka Yamakawa
- Department of Priority Organization for Innovation and Excellence, Kumamoto University, Kumamoto, Japan
| | | | - Keiko Ogawa
- Graduate School of Humanities and Social Sciences, Hiroshima University, Higashihiroshima, Japan
| | - Koichi Fujiwara
- Department of Systems Science, Kyoto University, Kyoto, Japan.,Department of Materials Process Engineering, Nagoya University, Nagoya, Japan
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14
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On the Variability of Heart Rate Variability-Evidence from Prospective Study of Healthy Young College Students. ENTROPY 2020; 22:e22111302. [PMID: 33263356 PMCID: PMC7711844 DOI: 10.3390/e22111302] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/06/2020] [Accepted: 11/13/2020] [Indexed: 12/29/2022]
Abstract
Heart rate variability (HRV) has been widely used as indices for autonomic regulation, including linear analyses, entropy and multi-scale entropy based nonlinear analyses, and however, it is strongly influenced by the conditions under which the signal is being recorded. To investigate the variability of healthy HRV under different settings, we recorded electrocardiograph (ECG) signals from 56 healthy young college students (20 h for each participant) at campus using wearable single-lead ECG device. Accurate R peak to R peak (RR) intervals were extracted by combing the advantages of five commonly used R-peak detection algorithms to eliminate data quality influence. Thorough and detailed linear and nonlinear HRV analyses were performed. Variability of HRV metrics were evaluated from five categories: (1) different states of daily activities; (2) different recording time period in the same day during free-running daily activities; (3) body postures of sitting and lying; (4) lying on the left, right and back; and (5) gender influence. For most of the analyzed HRV metrics, significant differences (p < 0.05) were found among different recording conditions within the five categories except lying on different positions. Results suggested that the standardization of ECG data collection and HRV analysis should be implemented in HRV related studies, especially for entropy and multi-scale entropy based analyses. Furthermore, this preliminary study provides reference values of HRV indices under various recording conditions of healthy young subjects that could be useful information for different applications (e.g., health monitoring and management).
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15
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Bahlinger K, Lincoln TM, Krkovic K, Clamor A. Linking psychophysiological adaptation, emotion regulation, and subjective stress to the occurrence of paranoia in daily life. J Psychiatr Res 2020; 130:152-159. [PMID: 32823048 DOI: 10.1016/j.jpsychires.2020.07.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/12/2020] [Accepted: 07/17/2020] [Indexed: 12/22/2022]
Abstract
As stress is relevant to the formation of paranoia, maladaptive behavioral and physiological stress regulation is discussed as a crucial indicator of vulnerability. This is supported by research linking psychosis to the tendency to make less use of functional and more use of dysfunctional emotion regulation strategies (ER) and with a lower vagally-mediated heart rate variability (HRV). However, it remains unclear whether ER serves as a mediator between resting-state HRV on the one hand and subjective stress levels and paranoia on the other and whether this is specific to paranoia as compared to depression. We used an experience sampling method during seven days to repeatedly assess the experience of stress, usage of ER strategies, paranoia und depression (9/day) in a sample with subclinical positive symptoms (N = 32). Resting-state HRV was measured during a 5min interval in the laboratory. Data was analyzed by multi-level models. Higher resting-state HRV was predictive of lower stress-levels and of using more functional ER strategies (reappraisal, acceptance) in daily life, but did not predict the use of dysfunctional strategies (rumination, suppression) or paranoia. The association between resting-state HRV and stress was mediated by the usage of functional ER. Less functional and more dysfunctional ER were linked to higher levels of stress, paranoia and depression. Our study highlights that deficits in ER represent a link between psychophysiological and phenomenological aspects of paranoia but also of depression. This encourages to further investigate transdiagnostic prevention and therapy programs aiming to improve ER and to increase HRV.
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Affiliation(s)
- Katrin Bahlinger
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Human Movement Sciences, Universität Hamburg, Germany.
| | - Tania M Lincoln
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Human Movement Sciences, Universität Hamburg, Germany
| | - Katarina Krkovic
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Human Movement Sciences, Universität Hamburg, Germany
| | - Annika Clamor
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Human Movement Sciences, Universität Hamburg, Germany
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16
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Monfredi O, Lakatta EG. Complexities in cardiovascular rhythmicity: perspectives on circadian normality, ageing and disease. Cardiovasc Res 2020; 115:1576-1595. [PMID: 31150049 DOI: 10.1093/cvr/cvz112] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 02/06/2019] [Accepted: 05/25/2019] [Indexed: 12/13/2022] Open
Abstract
Biological rhythms exist in organisms at all levels of complexity, in most organs and at myriad time scales. Our own biological rhythms are driven by energy emitted by the sun, interacting via our retinas with brain stem centres, which then send out complex messages designed to synchronize the behaviour of peripheral non-light sensing organs, to ensure optimal physiological responsiveness and performance of the organism based on the time of day. Peripheral organs themselves have autonomous rhythmic behaviours that can act independently from central nervous system control but is entrainable. Dysregulation of biological rhythms either through environment or disease has far-reaching consequences on health that we are only now beginning to appreciate. In this review, we focus on cardiovascular rhythms in health, with ageing and under disease conditions.
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Affiliation(s)
- Oliver Monfredi
- Division of Medicine, Department of Cardiology, The Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD, USA.,Laboratory of Cardiovascular Sciences, Intramural Research Program, National Institute on Aging, National Institutes of Health, 251 Bayview Blvd, Baltimore, MD, USA
| | - Edward G Lakatta
- Laboratory of Cardiovascular Sciences, Intramural Research Program, National Institute on Aging, National Institutes of Health, 251 Bayview Blvd, Baltimore, MD, USA
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17
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Marcel-Millet P, Ravier G, Esco MR, Groslambert A. Does firefighters' physical fitness influence their cardiac parasympathetic reactivation? Analysis with post-exercise heart rate variability and ultra-short-term measures. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2020; 28:153-161. [PMID: 32586212 DOI: 10.1080/10803548.2020.1738689] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose. This study assessed the influence of firefighters' physical fitness on performances and parasympathetic reactivation in rescue interventions, and tested the validity of post-exercise ultra-short-term heart rate variability. Methods. Twenty-four firefighters were assigned to two groups based on their fitness and performed three simulated interventions. The mean completion time was recorded. The post-exercise root mean square of successive differences of R-R intervals (LnRMSSD) was determined from both criterion (between 5 and 10 min) and ultra-short-term (every 1-min segment from minutes 0-6) analyses. Results. Completion time was better for the highest fitness group in the three simulated interventions while post-exercise LnRMSSD was not influenced by the firefighters' fitness. Reliability between ultra-short-term and criterion analyses differed between the segments tested; minute 5-6 revealed the highest intra-class correlations (0.86-0.97). Concerning sensitivity of both analyses, the criterion analysis revealed differences between the three rescue interventions and the fitness test, but these results were not observed with ultra-short-term measures. Conclusions. Fitness was associated with firefighters' performances but not with parasympathetic reactivation in the firefighting intervention. The ultra-short-term measures do not seem to be a suitable post-exercise LnRMSSD analysis because of the low sensitivity to reveal differences among exercise conditions.
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Affiliation(s)
| | - Gilles Ravier
- Department of Sport and Performance, University of Bourgogne-Franche-Comte, France
| | | | - Alain Groslambert
- Department of Sport and Performance, University of Bourgogne-Franche-Comte, France
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18
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Cosgun A, Oren H. Variation of the T-wave peak-end interval and heart rate variability values in healthy males and females at various hours of the same day, and relationship of them. J Arrhythm 2020; 36:118-126. [PMID: 32071630 PMCID: PMC7011832 DOI: 10.1002/joa3.12296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 12/03/2019] [Accepted: 12/12/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The prolongation of repolarization time between the myocardial epicardium and endocardial cells is closely related to malignant ventricular arrhythmias. The purpose of our study was to compare repolarization markers, namely, T-wave peak-end interval (Tp-e), QT, corrected QT (QTc), Tp-e/QT, Tp-e/corrected QT (QTc), and Heart Rate Variability (HRV) values in healthy men and women and to investigate their daily variations. METHODS A total of 74 male and 78 female participants, being a government employee, and having no health problems, were included in the two study groups (males and females). A 24-hour, 12-lead Holter monitoring was performed on the volunteers. Then, the Tp-e interval and QT interval were measured on recordings. cTp-e and QTc were calculated by the use of Bazzet's formula. RESULTS There was no statistically significant difference between the groups in the cTp-e interval at 07.00 pm; however, it was significantly lower in the female group as compared with the male group at 07.00 am and 01.00 pm. It was significantly higher in the female group at 01.00 am compared with the male group. There were statistically significant moderate negative correlations between Tp-e intervals and a standard deviation of between two normal beats interval (SDNN) values at various hours of the same day. CONCLUSION There were statistically significant differences in terms of Tp-e and cTp-e intervals at various hours of the same day in both groups. In addition, there were statistically significant moderate negative correlations between Tp-e intervals and SDNN at various hours of the same day.
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Affiliation(s)
- Ayhan Cosgun
- Department of CardiologySincan State HospitalAnkaraTurkey
| | - Huseyin Oren
- Department of CardiologyAnkara City HospitalAnkaraTurkey
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19
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Hnatkova K, Šišáková M, Smetana P, Toman O, Huster KM, Novotný T, Schmidt G, Malik M. Sex differences in heart rate responses to postural provocations. Int J Cardiol 2019; 297:126-134. [PMID: 31611089 PMCID: PMC6926477 DOI: 10.1016/j.ijcard.2019.09.044] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 09/16/2019] [Accepted: 09/24/2019] [Indexed: 01/21/2023]
Abstract
Sex differences are known in several facets of cardiac electrophysiology, mostly concerning myocardial repolarisation. In this study, heart rate and heart rate variability (HRV) responses to postural provocations were compared in 175 and 176 healthy females and males, respectively (aged 33.1 ± 9.1 years). Two different postural provocative tests with position changes supine→sitting→standing→supine and supine→standing→sitting→supine (15-min standing, 10-min other positions) were performed up to 4 times in each subject. Heart rate and heart rate variability spectral indices were measured in 5-min windows before positional changes. At supine position, females had averaged heart rate approximately 5 beats per minute (bpm) faster than males and this sex difference was practically constant during the postural changes. In both sexes, change supine→sitting and supine→standing increased heart rate by approximately 10 and 30 bpm, respectively, with no statistical differences between the sex groups. At supine baseline, females had normalised high frequency components (nHF) of HRV approximately 7% larger compared to males (p < 0.001). While the same difference in nHF was found at sitting, the change to standing position lead to significantly larger nHF reduction in females compared to males (mean changes 22.5 vs 17.2%, p < 0.001). This shows that despite similar heart rate increase, females respond to standing by more substantial shifts in cardiac sympatho-vagal modulations. This makes it plausible to speculate that the differences in autonomic reactions to stress contribute to the known sex-differences in psychosocial responses to stressful situations and to the known difference in susceptibility to ventricular fibrillation between females and males.
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Affiliation(s)
- Katerina Hnatkova
- National Heart and Lung Institute, Imperial College, 72 Du Cane Road, Shepherd's Bush, London, W12 0NN, England, UK
| | - Martina Šišáková
- Department of Internal Medicine and Cardiology, University Hospital Brno, Faculty of Medicine, Masaryk University, Jihlavská 20, 625 00, Brno, Czech Republic
| | - Peter Smetana
- Wilhelminenspital der Stadt Wien, Montleartstraße 37, 1160, Vienna, Austria
| | - Ondřej Toman
- Department of Internal Medicine and Cardiology, University Hospital Brno, Faculty of Medicine, Masaryk University, Jihlavská 20, 625 00, Brno, Czech Republic
| | - Katharina M Huster
- Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, D-81675, Munich, Germany
| | - Tomáš Novotný
- Department of Internal Medicine and Cardiology, University Hospital Brno, Faculty of Medicine, Masaryk University, Jihlavská 20, 625 00, Brno, Czech Republic
| | - Georg Schmidt
- Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, D-81675, Munich, Germany
| | - Marek Malik
- National Heart and Lung Institute, Imperial College, 72 Du Cane Road, Shepherd's Bush, London, W12 0NN, England, UK.
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20
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Riganello F, Prada V, Soddu A, di Perri C, Sannita WG. Circadian Rhythms and Measures of CNS/Autonomic Interaction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2336. [PMID: 31269700 PMCID: PMC6651187 DOI: 10.3390/ijerph16132336] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 06/17/2019] [Accepted: 06/27/2019] [Indexed: 12/19/2022]
Abstract
The physiological role and relevance of the mechanisms sustaining circadian rhythms have been acknowledged. Abnormalities of the circadian and/or sleep-wakefulness cycles can result in major metabolic disorders or behavioral/professional inadequacies and stand as independent risk factors for metabolic, psychiatric, and cerebrovascular disorders and early markers of disease. Neuroimaging and clinical evidence have documented functional interactions between autonomic (ANS) and CNS structures that are described by a concept model (Central Autonomic Network) based on the brain-heart two-way interplay. The circadian rhythms of autonomic function, ANS-mediated processes, and ANS/CNS interaction appear to be sources of variability adding to a variety of environmental factors, and may become crucial when considering the ANS major role in internal environment constancy and adaptation that are fundamental to homeostasis. The CNS/ANS interaction has not yet obtained full attention and systematic investigation remains overdue.
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Affiliation(s)
- Francesco Riganello
- Coma Science Group, GIGA-Consciousness, GIGA Institute, University Hospital of Liège, 4000 Liège, Belgium
| | - Valeria Prada
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, University of Genova, Polyclinic Hospital San Martino IRCCS, 16132 Genova, Italy
| | - Andres Soddu
- Department of Physics and Astronomy, Brain and Mind Institute, The University of Western Ontario, London, ON N6A 3K7, Canada
| | - Carol di Perri
- Coma Science Group, GIGA-Consciousness, GIGA Institute, University Hospital of Liège, 4000 Liège, Belgium
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, EH16 4SB, UK
| | - Walter G Sannita
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, University of Genova, Polyclinic Hospital San Martino IRCCS, 16132 Genova, Italy.
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21
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Vitale JA, Bonato M, La Torre A, Banfi G. Heart Rate Variability in Sport Performance: Do Time of Day and Chronotype Play A Role? J Clin Med 2019; 8:jcm8050723. [PMID: 31117327 PMCID: PMC6571903 DOI: 10.3390/jcm8050723] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 05/10/2019] [Accepted: 05/20/2019] [Indexed: 12/20/2022] Open
Abstract
A reliable non-invasive method to assess autonomic nervous system activity involves the evaluation of the time course of heart rate variability (HRV). HRV may vary in accordance with the degree and duration of training, and the circadian fluctuation of this variable is crucial for human health since the heart adapts to the needs of different activity levels during sleep phases or in the daytime. In the present review, time-of-day and chronotype effect on HRV in response to acute sessions of physical activity are discussed. Results are sparse and controversial; however, it seems that evening-type subjects have a higher perturbation of the autonomic nervous system (ANS), with slowed vagal reactivation and higher heart rate values in response to morning exercise than morning types. Conversely, both chronotype categories showed similar ANS activity during evening physical tasks, suggesting that this time of day seems to perturb the HRV circadian rhythm to a lesser extent. The control for chronotype and time-of-day effect represents a key strategy for individual training schedules, and, in perspective, for primary injury prevention.
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Affiliation(s)
| | - Matteo Bonato
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy.
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Giuseppe Colombo 71, 20133 Milan, Italy.
| | - Antonio La Torre
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy.
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Giuseppe Colombo 71, 20133 Milan, Italy.
| | - Giuseppe Banfi
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy.
- Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy.
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22
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Hinton T, Jelinek HF, Viengkhou V, Johnston GA, Matthews S. Effect of GABA-Fortified Oolong Tea on Reducing Stress in a University Student Cohort. Front Nutr 2019; 6:27. [PMID: 30972340 PMCID: PMC6443991 DOI: 10.3389/fnut.2019.00027] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 02/22/2019] [Indexed: 02/06/2023] Open
Abstract
GABA-containing tea has gained popularity as an accessible intervention to reduce the impact of chronic stress-induced autonomic imbalance and increased risk for cardiovascular disease despite a lack of evidence concerning the γ-aminobutyric acid (GABA) content in a cup of the tea and its effects on physiological and psychological stress as measures of cognitive function. We aimed to measure the effects of GABA-fortified tea consumption on heart rate variability (HRV) and stress in 30 participants using a pre-post cohort study design. Ten minute lead II ECG recordings were analyzed with Kubios software. Frequency domain parameters including total power, high and low frequency power, along with heart rate, were determined. A control group that consumed a non-fortified tea was included in the research. Statistical analysis was by two-way ANOVA for two-group comparison with time as an interaction and a significance level of p < 0.05. Oolong tea consumption led to a significant decrease in the immediate stress score and a significant improvement in HRV. We conclude that autonomic imbalance and HRV in people with acute stress is significantly reduced following a cup of GABA fortified oolong tea and highlights the complex interaction between autonomic nervous system function and mood.
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Affiliation(s)
- Tina Hinton
- Pharmacology, School of Medical Sciences, University of Sydney, Sydney, NSW, Australia
| | - Herbert F. Jelinek
- Clinical Medicine, Macquarie University, Sydney, NSW, Australia
- School of Community Health, Charles Sturt University, Bathurst, NSW, Australia
| | - Vincent Viengkhou
- Pharmacology, School of Medical Sciences, University of Sydney, Sydney, NSW, Australia
| | - Graham A. Johnston
- Pharmacology, School of Medical Sciences, University of Sydney, Sydney, NSW, Australia
| | - Slade Matthews
- Pharmacology, School of Medical Sciences, University of Sydney, Sydney, NSW, Australia
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23
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Diurnal cardiac sympathetic hyperactivity after exposure to acute particulate matter 2.5 air pollution. J Electrocardiol 2019; 52:112-116. [DOI: 10.1016/j.jelectrocard.2018.11.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 09/23/2018] [Accepted: 11/15/2018] [Indexed: 01/30/2023]
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24
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Nano MM, Fonseca P, Vullings R, Aarts RM. Measures of cardiovascular autonomic activity in insomnia disorder: A systematic review. PLoS One 2017; 12:e0186716. [PMID: 29059210 PMCID: PMC5653329 DOI: 10.1371/journal.pone.0186716] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 10/08/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Insomnia disorder is a widespread sleep disorder with a prevalence of approximately 10%. Even though the link between insomnia and cardiovascular activity is not exactly clear, it is generally assumed that cardiovascular autonomic modifications could occur as a result of sleeplessness, or, alternatively, that autonomic alterations could be an expression of a hyper-arousal state. This review investigates whether cardiovascular measures are different between insomniacs and controls. METHODS Electronic databases were systematically searched, and 34 studies were identified. Heart rate variability features, the association of cardiac and EEG activity, physiologic complexity measures, and cardiovascular activity, assessed by measures such as pre-ejection time, blood pressure, and heart rate dynamics were studied. Given the heterogeneity of the studies, a narrative synthesis of the findings was performed. RESULTS This review study found overall differences in cardiovascular activity between insomniacs and controls in most of the observational studies (21/26), while the expression of cardiovascular regulation varied between the examined insomniac groups. All the studies that investigated the association of cardiac activity and EEG power reported an altered relation between autonomic activity and EEG parameters in insomniacs. CONCLUSION Autonomic regulation tends to be consistent between insomniacs, as long as they are grouped according to their respective phenotype, as shown in the insomnia subgroup with objectively short sleep duration. Our hypothesis is that these differences in the expression of cardiovascular activity could be explained by the heterogeneity of the disorder. Therefore, the determination of insomnia phenotypes, and the study of cardiovascular measures, rather than heart rate variability alone, will give more insight into the link between insomnia and cardiovascular regulation. This study suggests that cardiovascular activity differs between insomniacs and controls. These new findings are of interest to clinicians and researchers for a more accurate insomnia assessment, and the development of personalized technological solutions in insomnia.
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Affiliation(s)
- Marina-Marinela Nano
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Sleep Medicine Centre Kempenhaeghe, Heeze, The Netherlands
- Philips Research, High Tech Campus, Eindhoven, The Netherlands
| | - Pedro Fonseca
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Philips Research, High Tech Campus, Eindhoven, The Netherlands
| | - Rik Vullings
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Ronald M. Aarts
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Philips Research, High Tech Campus, Eindhoven, The Netherlands
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Roos LE, Knight EL, Beauchamp KG, Berkman ET, Faraday K, Hyslop K, Fisher PA. Acute stress impairs inhibitory control based on individual differences in parasympathetic nervous system activity. Biol Psychol 2017; 125:58-63. [PMID: 28268165 DOI: 10.1016/j.biopsycho.2017.03.004] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 01/12/2017] [Accepted: 03/02/2017] [Indexed: 12/28/2022]
Abstract
Identifying environmental influences on inhibitory control (IC) may help promote positive behavioral and social adjustment. Although chronic stress is known to predict lower IC, the immediate effects of acute stress are unknown. The parasympathetic nervous system (PNS) may be a mechanism of the stress-IC link, given its psychophysiological regulatory role and connections to prefrontal brain regions critical to IC. We used a focused assessment of IC (the stop-signal task) to test whether an acute social stressor (the Trier Social Stress Test) affected participants' pre- to post-IC performance (n=58), compared to a control manipulation (n=31). High frequency heart-rate variability was used as an index of PNS activity in response to the manipulation. Results indicated that stress impaired IC performance, blocking the practice effects observed in control participants. We also investigated the associations between PNS activity and IC; higher resting PNS activity predicted better pre-manipulation IC, and greater PNS stressor reactivity protected against the negative effects of stress on IC. Together, these results are the first to document the immediate effects of acute stress on IC and a phenotypic marker (PNS reactivity to stressors) of susceptibility to stress-induced IC impairment. This study suggests a new way to identify situations in which individuals are likely to exhibit IC vulnerability and related consequences such as impulsivity and risk taking behavior. Targeting PNS regulation may represent a novel target for IC-focused interventions.
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Affiliation(s)
- Leslie E Roos
- Department of Psychology, 1227 University of Oregon, Eugene, OR, 97402, USA.
| | - Erik L Knight
- Department of Psychology, 1227 University of Oregon, Eugene, OR, 97402, USA.
| | - Kathryn G Beauchamp
- Department of Psychology, 1227 University of Oregon, Eugene, OR, 97402, USA.
| | - Elliot T Berkman
- Department of Psychology, 1227 University of Oregon, Eugene, OR, 97402, USA.
| | - Kelsie Faraday
- Department of Psychology, 1227 University of Oregon, Eugene, OR, 97402, USA.
| | - Katie Hyslop
- Department of Psychology, 1227 University of Oregon, Eugene, OR, 97402, USA.
| | - Philip A Fisher
- Department of Psychology, 1227 University of Oregon, Eugene, OR, 97402, USA.
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Quintana DS, Alvares GA, Heathers JAJ. Guidelines for Reporting Articles on Psychiatry and Heart rate variability (GRAPH): recommendations to advance research communication. Transl Psychiatry 2016; 6:e803. [PMID: 27163204 PMCID: PMC5070064 DOI: 10.1038/tp.2016.73] [Citation(s) in RCA: 222] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 03/18/2016] [Accepted: 03/23/2016] [Indexed: 12/11/2022] Open
Abstract
The number of publications investigating heart rate variability (HRV) in psychiatry and the behavioral sciences has increased markedly in the last decade. In addition to the significant debates surrounding ideal methods to collect and interpret measures of HRV, standardized reporting of methodology in this field is lacking. Commonly cited recommendations were designed well before recent calls to improve research communication and reproducibility across disciplines. In an effort to standardize reporting, we propose the Guidelines for Reporting Articles on Psychiatry and Heart rate variability (GRAPH), a checklist with four domains: participant selection, interbeat interval collection, data preparation and HRV calculation. This paper provides an overview of these four domains and why their standardized reporting is necessary to suitably evaluate HRV research in psychiatry and related disciplines. Adherence to these communication guidelines will help expedite the translation of HRV research into a potential psychiatric biomarker by improving interpretation, reproducibility and future meta-analyses.
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Affiliation(s)
- D S Quintana
- Division of Mental Health and Addiction, NORMENT, KG Jebsen Centre for Psychosis Research, University of Oslo, Oslo University Hospital, Oslo, Norway,Division of Mental Health and Addiction, NORMENT, KG Jebsen Centre for Psychosis Research, University of Oslo, Oslo University Hospital, Building 49, Oslo University Hospital, Ullevål, Kirkeveien 166, PO Box 4956, Nydalen, Oslo N-0424, Norway. E-mail:
| | - G A Alvares
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia,Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, QLD, Australia
| | - J A J Heathers
- School of Psychology, University of Sydney, Sydney, NSW, Australia,Department of Cardiology and Intensive Therapy, Poznań University of Medical Sciences, Poznań, Poland
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Santangeli P, Di Biase L, Basile E, Al-Ahmad A, Natale A. Outcomes in Women Undergoing Electrophysiological Procedures. Arrhythm Electrophysiol Rev 2016; 2:41-4. [PMID: 26835039 DOI: 10.15420/aer.2013.2.1.41] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The number of invasive electrophysiological procedures is steadily increasing in Western countries, as the age of the population increases and technologies advance. In recent years, gender-related differences in cardiac rhythm disorders have been increasingly appreciated, which can potentially have a great impact on the outcomes of invasive electrophysiological procedures. Among supraventricular arrhythmias, women have a higher incidence of atrioventricular nodal re-entrant tachycardia and a significantly lower incidence of atrioventricular re-entrant tachycardia compared with males, and present to ablation procedures later and after having failed more antiarrhythmic drugs. The results of catheter ablation of atrial fibrillation in women have been reported worse than in men. This finding is possibly due to a later referral of females to ablation procedures, who present older and with a higher incidence of long-standing persistent atrial fibrillation. With regard to cardiac device implantation procedures, a smaller survival benefit from prophylactic implantable cardioverter defibrillator (ICD) implantation has been shown in women, essentially due to gender-specific differences in the clinical course of patients with severe left ventricular dysfunction, with women dying predominantly from non-arrhythmic causes. On the other side, the clinical outcome of cardiac resynchronisation therapy seems to be more favourable in women, who experience a greater degree of reverse left ventricular remodelling and a striking decrease of heart failure events or mortality after biventricular pacing. This review will summarise the available evidence on gender-related differences in outcomes of invasive electrophysiological procedures.
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Affiliation(s)
- Pasquale Santangeli
- Division of Cardiology, Stanford University School of Medicine, California, US; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Texas, US; Department of Cardiology, University of Foggia, Foggia, Italy
| | - Luigi Di Biase
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Texas, US; Department of Cardiology, University of Foggia, Foggia, Italy
| | - Eloisa Basile
- Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy
| | - Amin Al-Ahmad
- Division of Cardiology, Stanford University School of Medicine, California, US
| | - Andrea Natale
- Division of Cardiology, Stanford University School of Medicine, California, US; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Texas, US
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Sannino G, Melillo P, Stranges S, De Pietro G, Pecchia L. Short term Heart Rate Variability to predict blood pressure drops due to standing: a pilot study. BMC Med Inform Decis Mak 2015; 15 Suppl 3:S2. [PMID: 26391336 PMCID: PMC4705494 DOI: 10.1186/1472-6947-15-s3-s2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Standing from a bed or chair may cause a significant lowering of blood pressure (ΔBP), which may have severe consequences such as, for example, falls in older subjects. The goal of this study was to develop a mathematical model to predict the ΔBP due to standing in healthy subjects, based on their Heart Rate Variability, recorded in the 5 minutes before standing. Methods Heart Rate Variability was extracted from an electrocardiogram, recorded from 10 healthy subjects during the 5 minutes before standing. The blood pressure value was measured before and after rising. A mathematical model aiming to predict ΔBP based on Heart Rate Variability measurements was developed using a robust multi-linear regression and was validated with the leave-one-subject-out cross-validation technique. Results The model predicted correctly the ΔBP in 80% of experiments, with an error below the measurement error of sphygmomanometer digital devices (±4.5 mmHg), a false negative rate of 7.5% and a false positive rate of 10%. The magnitude of the ΔBP was associated with a depressed and less chaotic Heart Rate Variability pattern. Conclusions The present study showes that blood pressure lowering due to standing can be predicted by monitoring the Heart Rate Variability in the 5 minutes before standing.
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Computation of nonlinear parameters of heart rhythm using short time ECG segments. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2015; 2015:983479. [PMID: 25688286 PMCID: PMC4320930 DOI: 10.1155/2015/983479] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 09/15/2014] [Accepted: 09/30/2014] [Indexed: 11/17/2022]
Abstract
We propose the method to compute the nonlinear parameters of heart rhythm (correlation dimension D₂ and correlation entropy K₂) using 5-minute ECG recordings preferred for screening of population. Conversion of RR intervals' time series into continuous function x(t) allows getting the new time series with different sampling rate dt. It has been shown that for all dt (250, 200, 125, and 100 ms) the cross-plots of D₂ and K₂ against embedding dimension m for phase-space reconstruction start to level off at m = 9. The sample size N at different sampling rates varied from 1200 at dt = 250 ms to 3000 at dt = 100 ms. Along with, the D₂ and K₂ means were not statistically different; that is, the sampling rate did not influence the results. We tested the feasibility of the method in two models: nonlinear heart rhythm dynamics in different states of autonomous nervous system and age-related characteristics of nonlinear parameters. According to the acquired data, the heart rhythm is more complex in childhood and adolescence with more influential parasympathetic influence against the background of elevated activity of sympathetic autonomous nervous system.
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Short-term heart rate variability in a population-based sample of 10-year-old children. Pediatr Cardiol 2015; 36:41-8. [PMID: 25056158 PMCID: PMC4457514 DOI: 10.1007/s00246-014-0962-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 07/02/2014] [Indexed: 10/25/2022]
Abstract
Heart rate variability (HRV) is a non-invasive quantitative marker of cardiac autonomic function derived from continuous electrocardiogram (ECG) recordings. Normative HRV values and development factors have not been established in pediatric populations. The objective was to derive referent time- and frequency-domain HRV values for a population-based sample of children. Children aged 9-11 years (N = 1,036) participated in the Québec Longitudinal Study of Child Development cohort cardiovascular health screening. Registered nurses measured anthropometrics (height, weight) and children wore an ambulatory Holter monitor to continuously record an ECG signal. HRV variables included time (SDNN, pNN50, RMSSD, SDANN) and frequency (HF, LF, LF/HF ratio) domain variables. Normative HRV values, stratified by age, sex, and heart rate, are presented. Greater heart rate (β avg = -0.60, R avg (2) = 0.39), pubertal maturation (β avg = -0.11, R avg (2) = 0.01), later ECG recording times (β avg = -0.19, R avg (2) = 0.07), and higher diastolic blood pressure (β avg = -0.11, R avg (2) = 0.01) were significantly associated with reduced HRV in 10-year-old children. The normative HRV values permit clinicians to monitor, describe, and establish pediatric nosologies in primary care and research settings, which may improve treatment of diseases associated with HRV in children. By better understanding existing values, the practical applicability of HRV among clinicians will be enhanced. Lastly, developmental (e.g., puberty) and procedural (e.g., recording time) factors were identified that will improve recording procedures and interpretation of results.
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Nicolini P, Ciulla MM, Malfatto G, Abbate C, Mari D, Rossi PD, Pettenuzzo E, Magrini F, Consonni D, Lombardi F. Autonomic dysfunction in mild cognitive impairment: evidence from power spectral analysis of heart rate variability in a cross-sectional case-control study. PLoS One 2014; 9:e96656. [PMID: 24801520 PMCID: PMC4011966 DOI: 10.1371/journal.pone.0096656] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 04/11/2014] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Mild cognitive impairment (MCI) is set to become a major health problem with the exponential ageing of the world's population. The association between MCI and autonomic dysfunction, supported by indirect evidence and rich with clinical implications in terms of progression to dementia and increased risk of mortality and falls, has never been specifically demonstrated. AIM To conduct a comprehensive assessment of autonomic function in subjects with MCI by means of power spectral analysis (PSA) of heart rate variability (HRV) at rest and during provocative manoeuvres. METHODS This cross-sectional study involved 80 older outpatients (aged ≥ 65) consecutively referred to a geriatric unit and diagnosed with MCI or normal cognition (controls) based on neuropsychological testing. PSA was performed on 5-minute electrocardiographic recordings under three conditions--supine rest with free breathing (baseline), supine rest with paced breathing at 12 breaths/minute (parasympathetic stimulation), and active standing (orthosympathetic stimulation)--with particular focus on the changes from baseline to stimulation of indices of sympathovagal balance: normalized low frequency (LFn) and high frequency (HFn) powers and the LF/HF ratio. Blood pressure (BP) was measured at baseline and during standing. Given its exploratory nature in a clinical population the study included subjects on medications with a potential to affect HRV. RESULTS There were no significant differences in HRV indices between the two groups at baseline. MCI subjects exhibited smaller physiological changes in all three HRV indices during active standing, consistently with a dysfunction of the orthosympathetic system. Systolic BP after 10 minutes of standing was lower in MCI subjects, suggesting dysautonomia-related orthostatic BP dysregulation. CONCLUSIONS Our study is novel in providing evidence of autonomic dysfunction in MCI. This is associated with orthostatic BP dysregulation and the ongoing follow-up of the study population will determine its prognostic relevance as a predictor of adverse health outcomes.
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Affiliation(s)
- Paola Nicolini
- Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Department of Clinical and Community Sciences, University of Milan, Milan, Italy
| | - Michele M. Ciulla
- Cardiovascular Diseases Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Department of Clinical and Community Sciences, University of Milan, Milan, Italy
| | - Gabriella Malfatto
- Department of Cardiology, Ospedale San Luca, Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - Carlo Abbate
- Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Department of Clinical and Community Sciences, University of Milan, Milan, Italy
| | - Daniela Mari
- Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Department of Clinical and Community Sciences, University of Milan, Milan, Italy
| | - Paolo D. Rossi
- Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Department of Clinical and Community Sciences, University of Milan, Milan, Italy
| | - Emanuela Pettenuzzo
- Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Department of Clinical and Community Sciences, University of Milan, Milan, Italy
| | - Fabio Magrini
- Cardiovascular Diseases Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Department of Clinical and Community Sciences, University of Milan, Milan, Italy
| | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Federico Lombardi
- Cardiovascular Diseases Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Department of Clinical and Community Sciences, University of Milan, Milan, Italy
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Sex differences in cardiac autonomic regulation and in repolarisation electrocardiography. Pflugers Arch 2013; 465:699-717. [PMID: 23404618 DOI: 10.1007/s00424-013-1228-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Accepted: 01/28/2013] [Indexed: 12/16/2022]
Abstract
The review summarises the present knowledge on the sex differences in cardiac autonomic regulations and in related aspects of electrocardiography with particular attention to myocardial repolarisation. Although some of the sex differences are far from fully established, multitude of observations show consistent differences between women and men. Despite more pronounced parasympathetic cardiac regulation, women have higher resting heart rate and lower baroreflex sensitivity. Of the electrocardiographic phenomena, women have longer QT interval duration, repolarisation sequence more synchronised with the inverse of the depolarisation sequence, and likely increased regional heterogeneity of myocardial repolarisation. Studies investigating the relationship of these sex disparities to hormonal differences led frequently to conflicting results. Although sex hormones seem to play a key role by influencing both autonomic tone and electrophysiological properties at the cellular level, neither the truly relevant hormones nor their detailed actions are known. Physiologic usefulness of the described sex differences is also unknown. The review suggests that new studies are needed to advance the understanding of the physiologic mechanisms responsible for these inequalities between women and men and provides key methodological suggestions that need to be followed in future research.
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Nonlinear heart rate dynamics: Circadian profile and influence of age and gender. Med Eng Phys 2012; 34:108-17. [DOI: 10.1016/j.medengphy.2011.07.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2010] [Revised: 07/04/2011] [Accepted: 07/11/2011] [Indexed: 11/22/2022]
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Li X, Shaffer ML, Rodriguez-Colon S, He F, Wolbrette DL, Alagona P, Wu C, Liao D. The circadian pattern of cardiac autonomic modulation in a middle-aged population. Clin Auton Res 2011; 21:143-50. [PMID: 21240538 PMCID: PMC3093547 DOI: 10.1007/s10286-010-0112-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2010] [Accepted: 12/14/2010] [Indexed: 12/19/2022]
Abstract
Objectives To examine the circadian pattern of cardiac autonomic modulation (CAM) and its attributes in general population. Methods We obtained 24-h beat-to-beat RR data using a high resolution 12-lead Holter ECG in a community-dwelling sample of 115 non-smokers. We performed heart rate variability (HRV) analysis on the normal RRs from each 5-min segment to obtain time-specific HRV indices: high (HF; 0.15–0.40 Hz) and low (LF; 0.04–0.15 Hz) frequency powers, standard deviation of RR intervals (SDNN), and the square root of the mean of the sum of the squared differences of the adjacent RR intervals (RMSSD). For each individual, we fit the segment-specific HRV data to a cosine periodic function, and estimated 3 individual-level cosine function parameters to quantify the circadian variation: the mean (M), amplitude (A), and acrophase (θ). We then used a random-effects meta-analysis to summarize the M, A, and θ, and their 95% confidence intervals (CI). Results The mean age was 56 (SD 8) years, with 63% female and 76% white. The averages of M, A and θ (95%CI) of log HF were 3.59 (3.43–3.76) ms2, 0.61 (0.54–0.68) ms2, and 3:10 (2:25–3:55) AM, respectively, and that of RMSSD were 22.3 (20.5–24.1) ms, 6.5 (5.4–7.5) ms, 3:45 (2:55–4:35) AM, respectively. Older age is associated with lower mean of HRV. Males have higher oscillation amplitude than females. The acrophase of LF/HF was earlier in females than in males, and in younger individuals than in older individuals. Conclusions The circadian pattern of CAM can be quantified by 3 cosine parameters of HRV, which are correlated with age and gender.
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Affiliation(s)
- Xian Li
- Department of Public Health Sciences, Penn State University College of Medicine, 600 Centerview Dr. Suite 2200, A210, Hershey, PA 17033 USA
- Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Michele L. Shaffer
- Department of Public Health Sciences, Penn State University College of Medicine, 600 Centerview Dr. Suite 2200, A210, Hershey, PA 17033 USA
| | - Sol Rodriguez-Colon
- Department of Public Health Sciences, Penn State University College of Medicine, 600 Centerview Dr. Suite 2200, A210, Hershey, PA 17033 USA
| | - Fan He
- Department of Public Health Sciences, Penn State University College of Medicine, 600 Centerview Dr. Suite 2200, A210, Hershey, PA 17033 USA
| | - Deborah L. Wolbrette
- Department of Medicine, Division of Cardiology, Penn State University College of Medicine, Hershey, PA USA
| | - Peter Alagona
- Department of Medicine, Division of Cardiology, Penn State University College of Medicine, Hershey, PA USA
| | - Chuntao Wu
- Department of Public Health Sciences, Penn State University College of Medicine, 600 Centerview Dr. Suite 2200, A210, Hershey, PA 17033 USA
| | - Duanping Liao
- Department of Public Health Sciences, Penn State University College of Medicine, 600 Centerview Dr. Suite 2200, A210, Hershey, PA 17033 USA
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Electrophysiological characteristics associated with symptoms in pacemaker patients with paroxysmal atrial fibrillation. J Interv Card Electrophysiol 2009; 26:31-40. [PMID: 19636688 DOI: 10.1007/s10840-009-9411-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2009] [Accepted: 04/23/2009] [Indexed: 10/20/2022]
Abstract
PURPOSE The purpose of this study is to identify the electrophysiological factors affecting symptoms in paroxysmal atrial fibrillation (PAF) using patients with paroxysmal atrial fibrillation and pacemakers with advanced atrial fibrillation (AF) diagnostics. METHODS Seventy-nine patients (age 71.0 +/- 8.2, 54.4% male) with symptomatic PAF and AF burden of 1% to 50% with DDDRP pacemakers implanted were assessed for 6 months. Patients recorded symptom onset and duration and these were correlated with device-derived electrophysiological data. RESULTS Of 2,638 AF episodes, 333 were symptomatic and 2,305 asymptomatic, with 194 non-atrial tachyarrhythmia symptomatic episodes giving a sensitivity of 12.6% and a positive predictive value of 63.2% for specific AF symptoms. Symptomatic AF episodes were 3.8 times more common diurnally than nocturnally (p < 0.001). Diurnally, symptomatic AF was significantly associated with a shorter AF cycle length (CL; p = 0.04), faster ventricular rate (p = 0.004), shorter PR interval (p < 0.001), faster preceding heart rate (p = 0.001) and increased early recurrence of AF (p < 0.04). Nocturnally, a significantly longer AF CL (p = 0.04) and PR interval (p < 0.001) prior to AF onset predicted symptomatic AF. CONCLUSIONS Symptoms in PAF are predicted by changes in AF episode duration, ventricular rate during AF, preceding sinus heart rate, AV nodal conduction and AF cycle length but not ventricular irregularity. Excess diurnal sympathetic tone and excess nocturnal vagal tone predispose to symptomatic PAF. These findings may have relevance for therapies for symptom control of PAF.
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Sztajzel J, Jung M, Bayes de Luna A. Reproducibility and gender-related differences of heart rate variability during all-day activity in young men and women. Ann Noninvasive Electrocardiol 2008; 13:270-7. [PMID: 18713328 DOI: 10.1111/j.1542-474x.2008.00231.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Only few data are available on reproducibility over time in healthy young men and women and the corresponding gender-related changes of heart rate variability (HRV) measurements. METHODS We studied temporal and spectral HRV indices obtained from 24-hour Holter recordings in 32 healthy volunteers (14 men and 18 women, mean age 29 +/- 3 years) during 2 days of their usual all-day activity. RESULTS Time-domain measures and the spectral low-frequency (LF) and high-frequency (HF) components as well as the LF/HF ratio were comparable on both test days. Significantly higher values on test day 2 were observed only for the spectral very-low-frequency (VLF) component and for the resulting total power. Compared to men, women had higher day- and nighttime vagus-associated HRV indices, including root mean square of successive differences (RMSSD), pNN50 (NN50 count divided by the total number of all NN intervals), and HF power, and lower day- and nighttime VLF and LF power with lower LF/HF ratio and total power. CONCLUSIONS Temporal indices and the LF and HF spectral HRV measures are reproducible over usual all-day activity in young healthy subjects. Young women have higher day-and nighttime vagal tone than men with similar age range.
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Affiliation(s)
- Juan Sztajzel
- Cardiology Service and General Internal Medical Service, University Hospital, Geneva, Switzerland.
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Kurpesa M, Trzos E, Rechciński T, Krzemińska-Pakuła M. The relationship between heart rate variability and heart rate turbulence dynamics after primary coronary angioplasty. Ann Noninvasive Electrocardiol 2007; 12:50-8. [PMID: 17286651 PMCID: PMC6931964 DOI: 10.1111/j.1542-474x.2007.00138.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The application of heart rate turbulence (HRT) analysis for risk assessment after pharmacologically treated myocardial infarction (MI) was described in 1999. The aim of the present study was to evaluate the dynamics of HRT changes in long-term observation after MI treated with primary coronary angioplasty (PTCA). Moreover, the usefulness was assessed of early postinfarction heart rate variability (HRV) analysis for predicting HRT dynamics. METHODS The study group consisted of 96 patients with MI treated with primary PTCA. Holter monitoring with HRV and HRT analysis was performed 3 days after the procedure and 1 year later. RESULTS Twelve months after primary PTCA, an improvement (Type I HRT dynamics) was noted in 51 patients, and the worsening of both the HRT parameters (Type II HRT dynamics) in 34 patients. Fourteen patients showed the worsening of only one HRT parameter (Type III HRT dynamics). The following HRV parameters recorded in early postinfarction Holter monitoring had a significant influence on the risk of Type II HRT dynamics: SDNN, RMSSD, Triangle Index and Delta LF/HF (mean day-time LF/HF - mean night-time LF/HF). Only the latter was found in the multivariate analysis as significantly connected with worsened HRT. During the follow-up, SDNN and Triangular Index improved in all the patients. CONCLUSIONS HRT after myocardial infarction treated with primary PTCA presents a significant dynamics, which is different than dynamics of HRV. An abnormal circadian pattern of autonomic activity is a finding that helps identify patients who need to have HRT analysis repeated during a long-term follow-up, due to the tendency for HRT to change with time toward the prognostically unfavorable values.
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Affiliation(s)
- Małgorzata Kurpesa
- II Chair and Department of Cardiology, Medical University of Lodz, Bieganski Hospital, Poland.
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Abstract
Heart rate variability (HRV) is a reliable reflection of the many physiological factors modulating the normal rhythm of the heart. In fact, they provide a powerful means of observing the interplay between the sympathetic and parasympathetic nervous systems. It shows that the structure generating the signal is not only simply linear, but also involves nonlinear contributions. Heart rate (HR) is a nonstationary signal; its variation may contain indicators of current disease, or warnings about impending cardiac diseases. The indicators may be present at all times or may occur at random-during certain intervals of the day. It is strenuous and time consuming to study and pinpoint abnormalities in voluminous data collected over several hours. Hence, HR variation analysis (instantaneous HR against time axis) has become a popular noninvasive tool for assessing the activities of the autonomic nervous system. Computer based analytical tools for in-depth study of data over daylong intervals can be very useful in diagnostics. Therefore, the HRV signal parameters, extracted and analyzed using computers, are highly useful in diagnostics. In this paper, we have discussed the various applications of HRV and different linear, frequency domain, wavelet domain, nonlinear techniques used for the analysis of the HRV.
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Rajendra Acharya U, Paul Joseph K, Kannathal N, Lim CM, Suri JS. Heart rate variability: a review. Med Biol Eng Comput 2006; 44:1031-51. [PMID: 17111118 DOI: 10.1007/s11517-006-0119-0] [Citation(s) in RCA: 1233] [Impact Index Per Article: 68.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2005] [Accepted: 10/10/2006] [Indexed: 12/16/2022]
Abstract
Heart rate variability (HRV) is a reliable reflection of the many physiological factors modulating the normal rhythm of the heart. In fact, they provide a powerful means of observing the interplay between the sympathetic and parasympathetic nervous systems. It shows that the structure generating the signal is not only simply linear, but also involves nonlinear contributions. Heart rate (HR) is a nonstationary signal; its variation may contain indicators of current disease, or warnings about impending cardiac diseases. The indicators may be present at all times or may occur at random-during certain intervals of the day. It is strenuous and time consuming to study and pinpoint abnormalities in voluminous data collected over several hours. Hence, HR variation analysis (instantaneous HR against time axis) has become a popular noninvasive tool for assessing the activities of the autonomic nervous system. Computer based analytical tools for in-depth study of data over daylong intervals can be very useful in diagnostics. Therefore, the HRV signal parameters, extracted and analyzed using computers, are highly useful in diagnostics. In this paper, we have discussed the various applications of HRV and different linear, frequency domain, wavelet domain, nonlinear techniques used for the analysis of the HRV.
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Affiliation(s)
- U Rajendra Acharya
- Department of ECE, Ngee Ann Polytechnic, 535 Clementi Road, Singapore, Singapore 599 489.
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40
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Rajendra Acharya U, Paul Joseph K, Kannathal N, Lim CM, Suri JS. Heart rate variability: a review. Med Biol Eng Comput 2006. [PMID: 17111118 DOI: 10.1007/s1151700601190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Heart rate variability (HRV) is a reliable reflection of the many physiological factors modulating the normal rhythm of the heart. In fact, they provide a powerful means of observing the interplay between the sympathetic and parasympathetic nervous systems. It shows that the structure generating the signal is not only simply linear, but also involves nonlinear contributions. Heart rate (HR) is a nonstationary signal; its variation may contain indicators of current disease, or warnings about impending cardiac diseases. The indicators may be present at all times or may occur at random-during certain intervals of the day. It is strenuous and time consuming to study and pinpoint abnormalities in voluminous data collected over several hours. Hence, HR variation analysis (instantaneous HR against time axis) has become a popular noninvasive tool for assessing the activities of the autonomic nervous system. Computer based analytical tools for in-depth study of data over daylong intervals can be very useful in diagnostics. Therefore, the HRV signal parameters, extracted and analyzed using computers, are highly useful in diagnostics. In this paper, we have discussed the various applications of HRV and different linear, frequency domain, wavelet domain, nonlinear techniques used for the analysis of the HRV.
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Affiliation(s)
- U Rajendra Acharya
- Department of ECE, Ngee Ann Polytechnic, 535 Clementi Road, Singapore, Singapore 599 489.
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Sroka K. On the genesis of myocardial ischemia. ACTA ACUST UNITED AC 2005; 93:768-83. [PMID: 15492892 DOI: 10.1007/s00392-004-0137-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2003] [Accepted: 11/27/2003] [Indexed: 12/19/2022]
Abstract
About three quarters of myocardial ischemic events are triggered by the autonomic nervous system. The pathognomonic constellation is a combination of an almost complete withdrawal of tonic vagal activity with increased sympathetic activity. The reduction of tonic vagal activity, which is characteristic for ischemic heart disease, and the acute withdrawal of vagal drive preceding the onset of ischemia are not dependent on coronary artery disease. In this paper, the pathophysiological steps that lead from sympathetic-parasympathetic imbalance to myocardial ischemia shall be discussed. A considerable increase of aerobic glycolysis within the myocardium as a result of the autonomic imbalance is of special importance in this process.
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Affiliation(s)
- K Sroka
- Stellinger Weg 47, 20255 Hamburg, Germany.
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Acharya U R, N K, Sing OW, Ping LY, Chua T. Heart rate analysis in normal subjects of various age groups. Biomed Eng Online 2004; 3:24. [PMID: 15260880 PMCID: PMC493278 DOI: 10.1186/1475-925x-3-24] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2004] [Accepted: 07/20/2004] [Indexed: 11/18/2022] Open
Abstract
Background Analysis of heart rate variation (HRV) has become a popular noninvasive tool for assessing the activities of the autonomic nervous system (ANS). HRV analysis is based on the concept that fast fluctuations may specifically reflect changes of sympathetic and vagal activity. It shows that the structure generating the signal is not simply linear, but also involves nonlinear contributions. Linear parameters, Power spectral indice (LF/HF) is calculated with nonlinear indices Poincare plot geometry(SD1,SD2), Approximate Entropy (ApEn), Largest Lyapunov Exponent (LLE) and Detrended Fluctuation Analysis(DFA). The results show that, with aging the heart rate variability decreases. In this work, the ranges of all linear and nonlinear parameters for four age group normal subjects are presented with an accuracy of more than 89%. As a pre-analysis step, the HRV data is tested for nonlinearity using surrogate data analysis and the results exhibited a significant difference in the ApEn, LLE, SD1/SD2 and DFA parameters of the actual data and the surrogate data. Methods The heart rate is analyzed using the various time domain parameters, frequency domain parameter and nonlinear parameters like Poincare geometry, ApEn, LLE and DFA. Results In this work, the different linear and nonlinear parameters evaluated show a particular range for various cardiac abnormalities. And the results of these were subjected to 't' test with more than 89% confidence interval giving excellent 'p' values in all cases. Conclusions Heart rate variability (HRV) signal can be used as a reliable indicator of state of the heart. It becomes less random with the aging(less chaotic). This is evaluated by using various time domain, frequency domain and nonlinear parameters like SD1/SD2, ApEn, LLE αs and αl. Different ranges of non-linear parameters for various age groups are presented with 'p' value ≤ 0.12.
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Affiliation(s)
- Rajendra Acharya U
- Dept. of ECE, Ngee Ann Polytechnic, 535, Clementi Road, Singapore 599 489
| | - Kannathal N
- Dept. of ECE, Ngee Ann Polytechnic, 535, Clementi Road, Singapore 599 489
| | - Ong Wai Sing
- Dept. of ECE, Ngee Ann Polytechnic, 535, Clementi Road, Singapore 599 489
| | - Luk Yi Ping
- Dept. of ECE, Ngee Ann Polytechnic, 535, Clementi Road, Singapore 599 489
| | - TjiLeng Chua
- Dept. of ECE, Ngee Ann Polytechnic, 535, Clementi Road, Singapore 599 489
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Takagi M, Tanaka Y, Yamasaki Y, Yamamoto M, Hori M, Nakaniwa T, Niwa M, Uchino H, Tamura Y, Nomiyama T, Watada H, Kawamori R. Responsiveness of insulin-induced cardiac sympathetic nerve activation associates with blood pressure regulation in diabetics. Am J Physiol Endocrinol Metab 2003; 284:E1022-6. [PMID: 12569084 DOI: 10.1152/ajpendo.00169.2002] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
To quantitatively evaluate the effect of insulin on cardiac sympathetic nerve activity (SNA) and analyze clinical factors associated with insulin sensitivity for the regulation of SNA in diabetics, 29 Japanese type 2 diabetics without neuropathy were recruited. A 2-h control study and a 2-h hyperinsulinemic euglycemic glucose clamp study were performed. From the power spectral analysis of R-R intervals on ECG during both studies, two major components, the low-frequency (LF) and the high-frequency component (HF), were obtained. Then %LF was calculated as LF/(LF +HF), and the ratio of the average %LF during the last 30 min of the clamp or the control to the average %LF for the entire time for clamp or control (R-%LF) was used as a marker of changes in SNA. R-%LF was significantly higher during the clamp than in the control (1.07 +/- 0.04 vs. 1.03 +/- 0.03, P < 0.05). High responders (individual R-%LF during clamp > or = mean + 2SD in control) showed a higher basal mean blood pressure (BP) before the clamp (89 +/- 3 vs. 82 +/- 2, P < 0.03) but not a higher glucose infusion rate (GIR) compared with low responders (<mean + 2SD). Furthermore, R-%LF showed a positive correlation with basal mean BP (P < 0.02) but not with GIR. These data demonstrate that an acute insulin load stimulates cardiac SNA, and insulin sensitivity in the regulation of SNA may be associated with BP regulation independently of peripheral insulin sensitivity.
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Affiliation(s)
- Miki Takagi
- Department of Medicine, Metabolism, and Endocrinology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
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Evans JM, Ziegler MG, Patwardhan AR, Ott JB, Kim CS, Leonelli FM, Knapp CF. Gender differences in autonomic cardiovascular regulation: spectral, hormonal, and hemodynamic indexes. J Appl Physiol (1985) 2001; 91:2611-8. [PMID: 11717226 DOI: 10.1152/jappl.2001.91.6.2611] [Citation(s) in RCA: 174] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The autonomic nervous system drives variability in heart rate, vascular tone, cardiac ejection, and arterial pressure, but gender differences in autonomic regulation of the latter three parameters are not well documented. In addition to mean values, we used spectral analysis to calculate variability in arterial pressure, heart rate (R-R interval, RRI), stroke volume, and total peripheral resistance (TPR) and measured circulating levels of catecholamines and pancreatic polypeptide in two groups of 25 +/- 1.2-yr-old, healthy men and healthy follicular-phase women (40 total subjects, 10 men and 10 women per group). Group 1 subjects were studied supine, before and after beta- and muscarinic autonomic blockades, administered singly and together on separate days of study. Group 2 subjects were studied supine and drug free with the additional measurement of skin perfusion. In the unblocked state, we found that circulating levels of epinephrine and total spectral power of stroke volume, TPR, and skin perfusion ranged from two to six times greater in men than in women. The difference (men > women) in spectral power of TPR was maintained after beta- and muscarinic blockades, suggesting that the greater oscillations of vascular resistance in men may be alpha-adrenergically mediated. Men exhibited muscarinic buffering of mean TPR whereas women exhibited beta-adrenergic buffering of mean TPR as well as TPR and heart rate oscillations. Women had a greater distribution of RRI power in the breathing frequency range and a less negative slope of ln RRI power vs. ln frequency, both indicators that parasympathetic stimuli were the dominant influence on women's heart rate variability. The results of our study suggest a predominance of sympathetic vascular regulation in men compared with a dominant parasympathetic influence on heart rate regulation in women.
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Affiliation(s)
- J M Evans
- Center for Biomedical Engineering and Division of Cardiology, University of Kentucky, Lexington, KY 40506-0070, USA.
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