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Feli M, Azimi I, Sarhaddi F, Sharifi-Heris Z, Niela-Vilen H, Liljeberg P, Axelin A, Rahmani AM. Preterm birth risk stratification through longitudinal heart rate and HRV monitoring in daily life. Sci Rep 2024; 14:19896. [PMID: 39191907 DOI: 10.1038/s41598-024-70773-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 08/21/2024] [Indexed: 08/29/2024] Open
Abstract
Preterm birth (PTB) remains a global health concern, impacting neonatal mortality and lifelong health consequences. Traditional methods for estimating PTB rely on electronic health records or biomedical signals, limited to short-term assessments in clinical settings. Recent studies have leveraged wearable technologies for in-home maternal health monitoring, offering continuous assessment of maternal autonomic nervous system (ANS) activity and facilitating the exploration of PTB risk. In this paper, we conduct a longitudinal study to assess the risk of PTB by examining maternal ANS activity through heart rate (HR) and heart rate variability (HRV). To achieve this, we collect long-term raw photoplethysmogram (PPG) signals from 58 pregnant women (including seven preterm cases) from gestational weeks 12-15 to three months post-delivery using smartwatches in daily life settings. We employ a PPG processing pipeline to accurately extract HR and HRV, and an autoencoder machine learning model with SHAP analysis to generate explainable abnormality scores indicative of PTB risk. Our results reveal distinctive patterns in PTB abnormality scores during the second pregnancy trimester, indicating the potential for early PTB risk estimation. Moreover, we find that HR, average of interbeat intervals (AVNN), SD1SD2 ratio, and standard deviation of interbeat intervals (SDNN) emerge as significant PTB indicators.
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Affiliation(s)
- Mohammad Feli
- Department of Computing, University of Turku, Turku, Finland.
| | - Iman Azimi
- Department of Computer Science, University of California, Irvine, USA
| | | | | | | | - Pasi Liljeberg
- Department of Computing, University of Turku, Turku, Finland
| | - Anna Axelin
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Amir M Rahmani
- Department of Computer Science, University of California, Irvine, USA
- School of Nursing, University of California, Irvine, USA
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Saito I, Maruyama K, Yamauchi K, Funakoshi Y, Kato T, Kawamura R, Takata Y, Osawa H. Pulse rate variability and health-related quality of life assessment with the Short Form-8 Japanese version in the general Japanese population. Sci Rep 2024; 14:4157. [PMID: 38378714 PMCID: PMC10879517 DOI: 10.1038/s41598-024-54748-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 02/15/2024] [Indexed: 02/22/2024] Open
Abstract
We aimed to investigate the association between pulse rate variability (PRV) and health-related quality of life (HRQOL) in the general population. A cross-sectional study was conducted with 5908 Japanese men and women aged 30-79 years. PRV was assessed at rest using 5-min recordings of pulse waves with a photoplethysmographic signal from a fingertip sensor, and the time and frequency domains of PRV were determined. HRQOL was assessed with the Short Form-8 (SF-8) Japanese version, and poor HRQOL was defined as an SF-8 sub-scale score < 50. A test for nonlinear trends was performed with the generalized additive model with a smoothing spline adjusted for confounders. The lowest multivariable-adjusted odds ratios for poor physical component score were found in those who had second or third quartile levels of standard deviation of normal-to-normal intervals (SDNN) and root mean square of successive difference (RMSSD), and high-frequency (HF) power and trended slightly upward in the higher levels. PRV-derived parameters were nonlinearly associated with poor physical component scores. In conclusion, reduced PRV-derived SDNN, RMSSD and HF power were associated with poor HRQOL in the domain of physical function. Higher levels of these parameters did not necessarily translate into better HRQOL.
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Affiliation(s)
- Isao Saito
- Department of Public Health and Epidemiology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita, 879-5593, Japan.
| | - Koutatsu Maruyama
- Department of Bioscience, Graduate School of Agriculture, Ehime University, Matsuyama, Ehime, Japan
| | - Kanako Yamauchi
- Faculty of Education, Fukuyama City University, Fukuyama, Hiroshima, Japan
| | - Yayoi Funakoshi
- Department of Public Health and Epidemiology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita, 879-5593, Japan
| | - Tadahiro Kato
- Division of Life Span Development and Clinical Psychology, Graduate School of Education, Ehime University, Matsuyama, Ehime, Japan
| | - Ryoichi Kawamura
- Department of Diabetes and Molecular Genetics, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Yasunori Takata
- Department of Diabetes and Molecular Genetics, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Haruhiko Osawa
- Department of Diabetes and Molecular Genetics, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
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Kim D, Lee J, Choi JY, Lee HJ, Min JY, Min KB. Association between health-related quality of life and heart rate variability in elderly individuals with cognitive impairment in Korea: cross-sectional study. BMC Geriatr 2023; 23:847. [PMID: 38093200 PMCID: PMC10716978 DOI: 10.1186/s12877-023-04529-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 11/28/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Cognitive impairment, a characteristic and prior stage of dementia, is a serious public health concern in Korea a country with rapidly aging population. In a neurovisceral integration model, cognitive ability is connected to emotional and autonomic regulation via an interconnection in the brain, which may be associated with health-related quality of life (HRQoL). METHODS This study investigated the association between the HRQoL and the autonomic nervous system (ANS) via EuroQoL-5 Dimension (EQ-5D) and heart rate variability (HRV) among 417 patients who visited the Neurology Department in Veterans Health Service Medical Center, Seoul, South Korea. RESULTS The mean age of 275 patients in the cognitive impairment group (CIG) was higher than that of 142 patients in the normal cognition group (NCG) (74.85 years vs. 72.96 years, p < 0.001). In a generalized linear model with a beta coefficient (β), an increase in HRQoL was associated with higher HRV levels was observed only in CIG (CIG: the standard deviation of all NN intervals (SDNN) (ln, ms): β = 0.02, p = 0.007; Total power spectral density (TP) (ln, ms2): β = 0.01, p = 0.007; High frequency (HF) (ln, ms2): β = 0.01, p = 0.015; Low frequency (LF) (ln, ms2): β = 0.01, p = 0.003) (NCG: SDNN (ln, ms): β = 0.01, p = 0.214; TP (ln, ms2): β = 0.01, p = 0.144; HF (ln, ms2): β = 0.00, p = 0.249; LF (ln, ms2): β = 0.01, p = 0.294). CONCLUSIONS We found a significant association between HRQoL and HRV in Korean elders with cognitive impairment. However, this study is cross-sectional, so we cannot define direct causation. Further studies are needed to support our findings and to elucidate the biological mechanisms underlying these associations, especially in people cognitively impaired.
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Affiliation(s)
- Donghoon Kim
- Department of Preventive Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, Republic of Korea
- Integrated Major in Innovative Medical Science, Seoul National University Graduate School, 103 Daehak-ro, Jongno-gu, Seoul, Republic of Korea
| | - Jaeho Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, Republic of Korea
- Integrated Major in Innovative Medical Science, Seoul National University Graduate School, 103 Daehak-ro, Jongno-gu, Seoul, Republic of Korea
| | - Ju-Young Choi
- Department of Preventive Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, Republic of Korea
| | - Hyo-Jung Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, Republic of Korea
| | - Jin-Young Min
- Veterans Medical Research Institute, Veterans Health Service Medical Center, 53, Jinhwangdo-ro 61-gil, Gangdong-gu, Seoul, Republic of Korea.
| | - Kyoung-Bok Min
- Department of Preventive Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, Republic of Korea.
- Integrated Major in Innovative Medical Science, Seoul National University Graduate School, 103 Daehak-ro, Jongno-gu, Seoul, Republic of Korea.
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Staszak K, Tylkowski B, Staszak M. From Data to Diagnosis: How Machine Learning Is Changing Heart Health Monitoring. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4605. [PMID: 36901614 PMCID: PMC10002005 DOI: 10.3390/ijerph20054605] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
The rapid advances in science and technology in the field of artificial neural networks have led to noticeable interest in the application of this technology in medicine. Given the need to develop medical sensors that monitor vital signs to meet both people's needs in real life and in clinical research, the use of computer-based techniques should be considered. This paper describes the latest progress in heart rate sensors empowered by machine learning methods. The paper is based on a review of the literature and patents from recent years, and is reported according to the PRISMA 2020 statement. The most important challenges and prospects in this field are presented. Key applications of machine learning are discussed in medical sensors used for medical diagnostics in the area of data collection, processing, and interpretation of results. Although current solutions are not yet able to operate independently, especially in the diagnostic context, it is likely that medical sensors will be further developed using advanced artificial intelligence methods.
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Affiliation(s)
- Katarzyna Staszak
- Institute of Chemical Technology and Engineering, Faculty of Chemical Technology, Poznan University of Technology, ul. Berdychowo 4, 60-965 Poznan, Poland
| | - Bartosz Tylkowski
- Eurecat, Centre Tecnològic de Catalunya, C/Marcellí Domingo s/n, 43007 Tarragona, Spain
| | - Maciej Staszak
- Institute of Chemical Technology and Engineering, Faculty of Chemical Technology, Poznan University of Technology, ul. Berdychowo 4, 60-965 Poznan, Poland
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Castillo-Aguilar M, Mabe Castro M, Mabe Castro D, Valdés-Badilla P, Herrera-Valenzuela T, Guzmán-Muñoz E, Lang M, Niño Méndez O, Núñez-Espinosa C. Validity and Reliability of Short-Term Heart Rate Variability Parameters in Older People in Response to Physical Exercise. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4456. [PMID: 36901466 PMCID: PMC10001824 DOI: 10.3390/ijerph20054456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/24/2023] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Currently, and to the best of our knowledge, there is no standardized protocol to measure the effect of low- to moderate-intensity physical exercise on autonomic modulation focused in older people. AIM Validate a test-retest short-term exercise protocol for measuring the autonomic response through HRV in older people. METHODS A test-retest study design was used. The participants were selected through intentional non-probabilistic sampling. A total of 105 older people (male: 21.9%; female: 78.1%) were recruited from a local community. The assessment protocol evaluated HRV before and immediately after the 2-min step test. It was performed twice on the same day, considering a time of three chronological hours between the two measurements. RESULTS The posterior distribution of estimated responses in the Bayesian framework suggests moderate to strong evidence favoring a null effect between measurements. In addition, there was moderate to robust agreement between heart rate variability (HRV) indices and assessments, except for low frequency and very low frequency, which showed weak agreement. CONCLUSIONS Our results provide moderate to strong evidence for using HRV to measure cardiac autonomic response to moderate exercise, suggesting that it is sufficiently reliable to show similar results to those shown in this test-retest protocol.
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Affiliation(s)
- Matías Castillo-Aguilar
- Centro Asistencial de Docencia e Investigación (CADI-UMAG), University of Magallanes, Punta Arenas 6200000, Chile
- Kinesiology Department, University of Magallanes, Punta Arenas 6200000, Chile
| | - Matías Mabe Castro
- Centro Asistencial de Docencia e Investigación (CADI-UMAG), University of Magallanes, Punta Arenas 6200000, Chile
- School of Medicine, University of Magallanes, Punta Arenas 6200000, Chile
| | - Diego Mabe Castro
- Centro Asistencial de Docencia e Investigación (CADI-UMAG), University of Magallanes, Punta Arenas 6200000, Chile
- Kinesiology Department, University of Magallanes, Punta Arenas 6200000, Chile
| | - Pablo Valdés-Badilla
- Department of Physical Activity Sciences, Faculty of Education Sciences, Universidad Católica del Maule, Talca 3480094, Chile
- Carrera de Entrenador Deportivo, Escuela de Educación, Universidad Viña del Mar, Viña del Mar 2520000, Chile
| | - Tomás Herrera-Valenzuela
- Department of Physical Activity, Sports and Health Sciences, Faculty of Medical Sciences, Universidad de Santiago de Chile (USACH), Santiago de Chile 9170022, Chile
| | - Eduardo Guzmán-Muñoz
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Talca 3480094, Chile
| | - Morin Lang
- Department of Rehabilitation Sciences and Human Movement, Faculty of Health Sciences, Universidad de Antofagasta, Antofagasta 1270300, Chile
- Center for Research in Physiology and Medicine of Altitude, Biomedical Department, Faculty of Health Sciences, Universidad de Antofagasta, Antofagasta 1270300, Chile
| | - Oscar Niño Méndez
- Facultad de Ciencias del Deporte y la Educación Física, Universidad de Cundinamarca, Bogotá 252211, Colombia
| | - Cristian Núñez-Espinosa
- Centro Asistencial de Docencia e Investigación (CADI-UMAG), University of Magallanes, Punta Arenas 6200000, Chile
- School of Medicine, University of Magallanes, Punta Arenas 6200000, Chile
- Interuniversity Center for Healthy Aging, Chile 3480094, Chile
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Watt J, Fitzpatrick J, Sozio SM, Jaar BG, Estrella MM, Tereshchenko LG, Monroy-Trujillo JM, Walsh M, Parekh RS. Association of abnormal electrocardiograph metrics with prolonged recovery time in incident hemodialysis patients. BMC Nephrol 2022; 23:46. [PMID: 35086494 PMCID: PMC8796483 DOI: 10.1186/s12882-022-02664-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 12/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patients receiving intermittent hemodialysis have variable times of recovery to feeling better after dialysis. QT prolongation, a precursor to clinical and subclinical cardiovascular events, may contribute to delayed recovery time. We hypothesized that abnormal electrocardiographic parameters indicating perturbations in ventricular action are associated with longer recovery times thus impacting a patient-centered quality of life. METHODS Among 242 incident in-center hemodialysis participants from the Predictors of Arrhythmic and Cardiovascular Risk in End Stage Renal Disease (PACE) study, corrected QT interval (QTc), QRST angle and heart rate variance were measured on non-dialysis days using a standard 5-min electrocardiograph recording. Left ventricular hypertrophy (LVH) was defined using the Cornell voltage product. Recovery time was ascertained during a phone interview with a standardized validated questionnaire. Associations between QTc, QRST angle, heart rate variance, and LVH and natural log-transformed recovery time were examined using linear regression adjusted for participant characteristics and electrolytes. RESULTS Mean age was 55 (standard deviation 13) years, 55% were male, 72% were African American. Longer QTc interval was associated with increased recovery time (per 10 ms increase in QTc, recovery time increased by 6.2%; 95% confidence interval: 0.0-10.5). QRST angle, heart rate, heart rate variability and LVH were not significantly associated with recovery time. CONCLUSION Longer QTc intervals are associated with longer recovery time independent of serum electrolytes. This supports a relationship between a patient's underlying arrhythmic status and time to recovery after hemodialysis. Future studies will determine if maneuvers to reduce QTc improves recovery time and quality of life of patients on hemodialysis.
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Affiliation(s)
- Jacqueline Watt
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jessica Fitzpatrick
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Stephen M Sozio
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD, USA
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Bernard G Jaar
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD, USA
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Nephrology Center of Maryland, Baltimore, MD, USA
| | - Michelle M Estrella
- Kidney Health Research Collaborative, Department of Medicine, University of California, San Francisco, USA
- Department of Medicine, San Francisco VA Medical Center, San Francisco, CA, USA
| | - Larisa G Tereshchenko
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Knight Cardiovascular Institute, Department of Medicine, Oregon Health and Science University, Portland, Oregon, USA
| | | | - Michael Walsh
- Division of Nephrology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Rulan S Parekh
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada.
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
- Division of Nephrology, Department of Pediatrics and Medicine, The Hospital for Sick Children, University Health Network and University of Toronto, 555 University Ave, Toronto, ON, M5G 1X8, Canada.
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Health-related quality of life and incident cardiovascular disease events in community-dwelling older people: A prospective cohort study. Int J Cardiol 2021; 339:170-178. [PMID: 34245793 PMCID: PMC9993351 DOI: 10.1016/j.ijcard.2021.07.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/17/2021] [Accepted: 07/02/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND Lower health-related quality of life (HRQoL) has been shown to predict a higher risk of hospital readmission and mortality in patients with cardiovascular disease (CVD). Few studies have explored the associations between HRQoL and incident CVD. We explored the associations between baseline HRQoL and incident and fatal CVD in community-dwelling older people in Australia and the United States. METHODS Longitudinal study using ASPirin in Reducing Events in the Elderly (ASPREE) trial data. This includes 19,106 individuals aged 65-98 years, initially free of CVD, dementia, or disability, and followed between March 2010 and June 2017. The physical (PCS) and mental component scores (MCS) of HRQoL were assessed using the SF-12 questionnaire. Incident major adverse CVD events included fatal CVD (death due to atherothrombotic CVD), hospitalizations for heart failure, myocardial infarction or stroke. Analyses were performed using Cox proportional-hazard regression. RESULTS Over a median 4.7 follow-up years, there were 922 incident CVD events, 203 fatal CVD events, 171 hospitalizations for heart failure, 355 fatal or nonfatal myocardial infarction and 403 fatal or nonfatal strokes. After adjustment for sociodemographic, health-related behaviours and clinical measures, a 10-unit higher PCS, but not MCS, was associated with a 14% lower risk of incident CVD, 28% lower risk of hospitalization for heart failure and 15% lower risk of myocardial infarction. Neither PCS nor MCS was associated with fatal CVD events or stroke. CONCLUSION Physical HRQoL can be used in combination with clinical data to identify the incident CVD risk among older individuals.
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Zinglersen AH, Iversen KK, Leffers HCB, Laugesen E, Fleischer J, Jacobsen S. Characteristics of cardiovascular autonomic dysfunction and association with quality of life in patients with systemic lupus erythematosus. Lupus Sci Med 2021; 8:e000507. [PMID: 34301853 PMCID: PMC8728380 DOI: 10.1136/lupus-2021-000507] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 07/09/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Cardiovascular autonomic neuropathy (CAN) may affect the clinical course of SLE leading to reduced quality of life. CAN is assessed by heart rate variability (HRV) measures and cardiovascular autonomic reflex tests (CARTs). In patients with SLE, we aimed to determine the characteristics of CAN and if CAN associates with health-related quality of life (HRQoL). METHODS Patients with SLE and healthy controls (HCs) were CAN tested with 5 min HRV and three CARTs to determine parameters reflecting parasympathetic and mixed sympathetic-parasympathetic function. Subjects were classified as having no, early or definitive CAN by having none, one or more than one abnormal CART, respectively. HRQoL as determined by the Short Form 12 (SF-12) was assessed in SLE. RESULTS Of 111 patients with SLE, 92 answered the SF-12 and 54 were matched with 54 HCs for characterisation of CAN. Definitive CAN was present in 24.1% (95% CI 15% to 37%) patients with SLE and 1.9% (95% CI 0.3% to 9.8%) HCs (OR 16.8, 95% CI 2.1 to 133.8, p=0.008). The corresponding prevalences of any CAN were 53.7% (95% CI 41% to 66%) and 22.6% (95% CI 13% to 35%). SLE patients with definitive CAN showed signs of mixed sympathetic-parasympathetic dysfunction, whereas patients without CAN primarily presented with impaired parasympathetic activity. Signs of parasympathetic as well as sympathetic-parasympathetic dysfunction were associated with low physical SF-12 component score (all: β>0.211, p<0.05). The mental SF-12 component score was not associated with any CAN indices. CONCLUSIONS CAN was a frequent finding in SLE and associated to self-report on impaired physical HRQoL. Even patients without CAN showed signs of impaired parasympathetic function compared with controls.
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Affiliation(s)
- Amanda Hempel Zinglersen
- Copenhagen Lupus and Vasculitis Clinic, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Katrine Kjær Iversen
- Copenhagen Lupus and Vasculitis Clinic, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Henrik Christian Bidstrup Leffers
- Copenhagen Lupus and Vasculitis Clinic, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Esben Laugesen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Jesper Fleischer
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Steno Diabetes Center Sjælland, Holbæk, Denmark
| | - Søren Jacobsen
- Copenhagen Lupus and Vasculitis Clinic, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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The Association Between Heart Rate Variability and Quality of Life in Patients with Functional Somatic Syndrome and Healthy Controls. Appl Psychophysiol Biofeedback 2021; 46:279-285. [PMID: 34132969 DOI: 10.1007/s10484-021-09515-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Functional somatic syndrome (FSS) includes a spectrum of somatic symptoms with insufficient medical explanation. Its underlying pathophysiology is considered to include dysfunctional stress-responsive systems or autonomic dysfunction. Among the autonomic dysfunction readouts, decreased heart rate variability (HRV) has been shown to be characteristic in patients with FSSs. However, its association with quality of life (QOL) has not been clearly examined. We examined the association between short-term resting HRV and QOL in patients with FSS (n = 47) and healthy controls (n = 28). The time domain parameters of HRV were mean heart rate per minute (HR), coefficient of variation of R-R intervals (CvRR) and root mean square of successive differences (RMSSD). The frequency domain parameters of HRV were low-frequency (LF) power and high-frequency (HF) power by power spectrum analysis. The Japanese version of the WHO's QOL scale (WHOQOL-BREF) (WHO/QOL26) was used for the QOL assessment. There was a significant positive association between the RMSSD and HF power of HRV and all the QOL domains in patients with FSSs who had lower QOL scores on average than controls, while there was no association between HRV and any of the QOL domains in the control group. HF power was more dominantly associated with QOL than the other variables in patients with FSS based on the analysis with a multiple linear regression model. The present study elucidated that the HF power of HRV was dominantly associated with QOL in patients with FSSs who had lower QOL than controls. Vagal index of HRV could be a valuable indicator of the pathological condition and a significant predictor of health-related QOL in patients with FSSs.
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Huang HY, Hung KS, Yeh ML, Chou HL, Yeh AL, Liao TY. Breathing-based leg exercises during hemodialysis improve quality of life: A randomized controlled trial. Clin Rehabil 2021; 35:1175-1184. [PMID: 33827283 DOI: 10.1177/02692155211000738] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate the effect of a 12-week breathing-based leg exercises program on quality of life under stabilizing heart rate variability and reducing fatigue in regular hemodialysis patients. DESIGN Randomized controlled trial. SETTING A 94-bed hemodialysis department at a medical center in northern Taiwan. PARTICIPANTS Eighty-six patients with end-stage renal disease undergoing hemodialysis were recruited and randomly assigned to the ExBr or control groups. INTERVENTIONS The breathing-based leg exercises program comprised abdominal breathing and low-intensity leg exercise, including leg lifts, quadriceps femoris contraction and knee flexion, and lasted for 15 minutes at one time, three times a week for 12 weeks. MAIN MEASURE Data was collected by using the World Health Organization quality of life assessment-brief, physiological signal recorder for heart rate variability and hemodialysis-related fatigue scale at baseline and on Week 4, Week 8, and Week 12. RESULTS Average (standard deviation) age was 53.70 (10.04) years in the ExBr group and 61.19 (10.19) years in the control group. The linear mixed model with adjusted age, creatinine, heart rate variability and fatigue revealed that the ExBr group had significantly higher quality of life than did the control group (P = 0.01), especially on Week 12 (P = 0.04). Fatigue was significantly correlated with quality of life (P < 0.001). CONCLUSION This study supported the benefits of the continued breathing-based leg exercises during hemodialysis for at least 12 weeks, which improved the quality of life of patients with end-stage renal disease and did not affect the stability of their vital signs.
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Affiliation(s)
- Hsin-Yi Huang
- Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan.,Department of Nursing, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Kuo-Sheng Hung
- Graduate Institute of Injury Prevention and Control, and Department of Neurosurgery, Wan Fang Hospital, Taipei Medical University, Taipei City, Taiwan
| | - Mei-Ling Yeh
- Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
| | - Hsiu-Ling Chou
- Department of Nursing, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Albert Lou Yeh
- Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
| | - Tzu-Yi Liao
- Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan.,Taipei European School, Taipei City, Taiwan
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Chen HH, Hung CH, Kao AW, Hsieh HF. Exploring Quality of Life, Stress, and Risk Factors Associated with Irritable Bowel Syndrome for Female University Students in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083888. [PMID: 33917268 PMCID: PMC8068066 DOI: 10.3390/ijerph18083888] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/02/2021] [Accepted: 04/05/2021] [Indexed: 12/13/2022]
Abstract
Irritable bowel syndrome (IBS) is a common recurrent functional gastrointestinal disorder that impacts on patients physically and mentally. Studies on IBS have focused on adults, yet few studies have examined IBS among female university students. The aim of this study was to investigate the prevalence of IBS for female university students and its related factors. Using a cross-sectional study design, a total of 2520 female university students were recruited in southern Taiwan. The structured questionnaires, including the Rome III IBS diagnostic questionnaire, IBS symptom severity scale, Perceived Stress Scale, and World Health Organization Quality of Life BREF questionnaire (WHOQOL-BREF) were used for data collection. A total of 1894 female students complete the questionnaires. The response rate was 75.15%. The results indicated 193 female students with IBS and the prevalence of IBS was 10.1%. IBS female students had higher levels of stress and lower QOL than non-IBS female students. The risk factors for female university students developing IBS were dysmenorrhea, food avoidance, class absenteeism, and the lower physical domain of QOL. It is advised to consider these factors when providing students with counselling and relevant services in the expectation of alleviating their IBS symptoms, reducing the incidence rate of IBS, and further improving their QOL.
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Affiliation(s)
- Huan-Hwa Chen
- School of Nursing, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Kaohsiung 807, Taiwan; (H.-H.C.); (H.-F.H.)
- School of Nursing, Chung Hwa University of Medical Technology, No. 34, Wenhua 1st St., Tainan 717, Taiwan
| | - Chich-Hsiu Hung
- School of Nursing, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Kaohsiung 807, Taiwan; (H.-H.C.); (H.-F.H.)
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100, Tzyou 1st Road, Kaohsiung 807, Taiwan
- Correspondence: ; Tel.: +886-7-3121101 (ext. 2601)
| | - Ai-Wen Kao
- Department of Internal Medicine, National Cheng Kung University Hospital, No. 138, Shengli Road, Tainan 704, Taiwan;
| | - Hsiu-Fen Hsieh
- School of Nursing, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Kaohsiung 807, Taiwan; (H.-H.C.); (H.-F.H.)
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100, Tzyou 1st Road, Kaohsiung 807, Taiwan
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Wardoku R, Blair C, Demmer R, Prizment A. Association between physical inactivity and health-related quality of life in adults with coronary heart disease. Maturitas 2019; 128:36-42. [PMID: 31561820 PMCID: PMC7261413 DOI: 10.1016/j.maturitas.2019.07.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 05/24/2019] [Accepted: 07/07/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Health-related quality of life (HRQoL) provides an accurate measure of the health status of patients with coronary heart disease (CHD). However, few studies have examined the relationship between physical inactivity and HRQoL in CHD survivors. We evaluated this association in a cross-sectional study of 21,936 CHD participants in the 2015 Behavioral Risk Factor Surveillance System. METHODS CHD diagnosis, HRQoL and physical activity were self-reported. Physical activity (PA) was categorized (1) based on intensity, into no PA, light to moderate PA and vigorous PA; and (2) based on duration and frequency, into no PA, insufficiently active and active. HRQoL was assessed by the CDC HRQoL questionnaire. Participants with 14+ physical or mental unhealthy days in a 30-day window were grouped into poor physical or mental HRQoL. We estimated the odd ratios (AOR) and 95% confidence intervals (CI) of poor HRQoL associated with PA after adjusting for age, sex, education, income level, social support, smoking status, ethnicity/race, BMI, chronic conditions, and CHD groups. RESULTS Compared with vigorous PA, adults with no PA had higher odds (95% CI) of poor physical HRQoL [1.82 (1.58, 2.10)] and poor mental HRQoL [1.28 (1.05, 1.55)]. When compared with active adults, AOR (95% CI) for adults with no PA were 1.80 (1.55, 2.01) and 1.17 (0.97, 1.42) for poor physical and mental HRQoL, respectively. CONCLUSIONS We found an association between physical inactivity and poor physical and mental HRQoL among CHD survivors. There is a need for longitudinal studies to determine the temporality of this association.
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Affiliation(s)
- Reginald Wardoku
- Division of Epidemiology and Community Health, University of Minnesota, United States
| | - Cindy Blair
- Department of Internal Medicine, University of New Mexico, United States; University of New Mexico Comprehensive Cancer Center, United States
| | - Ryan Demmer
- Division of Epidemiology and Community Health, University of Minnesota, United States; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Anna Prizment
- Division of Epidemiology and Community Health, University of Minnesota, United States; Masonic Cancer Center, University of Minnesota, United States.
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Pozzato I, Craig A, Gopinath B, Tran Y, Dinh M, Gillett M, Cameron I. Biomarkers of autonomic regulation for predicting psychological distress and functional recovery following road traffic injuries: protocol for a prospective cohort study. BMJ Open 2019; 9:e024391. [PMID: 30948569 PMCID: PMC6500247 DOI: 10.1136/bmjopen-2018-024391] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 01/14/2019] [Accepted: 03/04/2019] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Psychological distress is a prevalent condition often overlooked following a motor vehicle crash (MVC), particularly when injuries are not severe. The aim of this study is to examine whether biomarkers of autonomic regulation alone or in combination with other factors assessed shortly after MVC could predict risk of elevated psychological distress and poor functional recovery in the long term, and clarify links between mental and physical health consequences of traffic injury. METHODS AND ANALYSIS This is a controlled longitudinal cohort study, with follow-up occurring at 3, 6 and 12 months. Participants include up to 120 mild to moderately injured MVC survivors who consecutively present to the emergency departments of two hospitals in Sydney and who agree to participate, and a group of up to 120 non-MVC controls, recruited with matched demographic characteristics, for comparison. WHO International Classification of Functioning is used as the framework for study assessment. The primary outcomes are the development of psychological distress (depressive mood and anxiety, post-traumatic stress symptoms, driving phobia, adjustment disorder) and biomarkers of autonomic regulation. Secondary outcomes include indicators of physical health (presence of pain/fatigue, physical functioning) and functional recovery (quality of life, return to function, participation) as well as measures of emotional and cognitive functioning. For each outcome, risk will be described by the frequency of occurrence over the 12 months, and pathways determined via latent class mixture growth modelling. Regression models will be used to identify best predictors/biomarkers and to study associations between mental and physical health. ETHICS AND DISSEMINATION Ethical approvals were obtained from the Sydney Local Health District and the research sites Ethics Committees. Study findings will be disseminated to health professionals, related policy makers and the community through peer-reviewed journals, conference presentations and health forums. TRIAL REGISTRATION NUMBER ACTRN12616001445460.
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Affiliation(s)
- Ilaria Pozzato
- Sydney Medical School—Northern, John Walsh Centre for Rehabilitation Research, University of Sydney, St Leonards, New South Wales, Australia
| | - Ashley Craig
- Northern Clinical School, University of Sydney, St Leonards, New South Wales, Australia
| | - Bamini Gopinath
- Sydney Medical School—Northern, John Walsh Centre for Rehabilitation Research, University of Sydney, St Leonards, New South Wales, Australia
- Centre for Vision Research, University of Sydney, Sydney, New South Wales, Australia
| | - Yvonne Tran
- Sydney Medical School—Northern, John Walsh Centre for Rehabilitation Research, University of Sydney, St Leonards, New South Wales, Australia
| | - Michael Dinh
- Emergency Department, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Mark Gillett
- Emergency Department, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Ian Cameron
- Sydney Medical School—Northern, John Walsh Centre for Rehabilitation Research, University of Sydney, St Leonards, New South Wales, Australia
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Liao CD, Tsauo JY, Hsiao DJ, Liou TH, Huang SW, Lin LF. Association of physical capacity with heart rate variability based on a short-duration measurement of resting pulse rate in older adults with obesity. PLoS One 2017; 12:e0189150. [PMID: 29267296 PMCID: PMC5739389 DOI: 10.1371/journal.pone.0189150] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Accepted: 11/20/2017] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Obesity can limit physical capacity and lower physical activity levels in elderly people. Low physical activity levels may be mediated by autonomic dysfunction with decreased heart rate variability (HRV). However, the relationship between autonomic dysfunction and low physical capability remains unclear. This cross-sectional study investigated the association of low physical capability with HRV in older adults with obesity. MATERIALS AND METHODS We recruited 231 old man and 210 old women with a mean (range) age of 65.5 (51-78) and 62.9 (52-76) years, respectively. Physical capability was measured using mobility tasks, including functional reach, single-leg stance (SLS), gait speed (GS), timed up and go, and timed chair rise (TCR), and the scores on these tasks were merged and transformed into a global physical capability score (GPCS). HRV was measured using a 7-min resting pulse-based technique, and the time- and frequency-domain indices of HRV were obtained including standard deviation of normal-to-normal intervals (SDNN), root mean square of successive differences at rest (rMSSD), and high-frequency (HF) power. All HRV indices were natural log (ln) transformed for analysis. Participants were divided into high, moderate, and low physical-capability groups according to their physical performance. Multivariate analysis of covariance was performed to test differences in HRV indices among physical-capability groups with participants' characteristics serving as covariates. A stepwise regression model was established to identify the determinants of HRV indices. We used hierarchical regression analysis to identify the association of the GPCS with HRV indices. RESULTS In both men and women, the low physical-capability group exhibited significantly increased heart rate (P <0.05) and decreased HRV in terms of a decreased ln[SDNN] (P <0.001), ln[rMSSD] (P <0.05) and ln[HF] (P <0.05), compared with the high physical-capability group. GS positively predicted ln[SDNN], whereas SLS, GS, and TCR were determinants of ln[HF], regardless of gender. The GPCS in older men and women independently accounted for 29.9% (P <0.001) and 23.7% (P <0.001), respectively, in variance in ln[SDNN]. CONCLUSIONS A low physical-capability level is an independent determinant of decreased HRV in older adults with obesity.
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Affiliation(s)
- Chun-De Liao
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Jau-Yih Tsauo
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Dun-Jen Hsiao
- College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Tsan-Hon Liou
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Graduate Institute of Injury Prevention and control, Taipei Medical University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Shih-Wei Huang
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Li-Fong Lin
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan
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