ECG Holter analysis to detect induced deconditioning on cardiac activity in bedridden volunteers

Abstract

Abstract Introduction Prolonged bed rest (BR) is an unnatural state, often related to hospitalization, chronic diseases and ageing, inducing reduced functional capacity in multiple body systems, possibly leading to cardiovascular deconditioning. We hypothesized that measuring this decline over time could represent the first step for the formulation of appropriate countermeasures or rehabilitation programs while in the hospital. Accordingly, our aim was to assess the effects of 10-day horizontal BR on cardiac electrical activity. Methods Ten healthy male volunteers (23±5 years) were enrolled in an hospital, after ethical approval and signed consent, to participate to a 10-day strict horizontal BR campaign, preceded and followed by 2 days in the facility, respectively as acclimatization and recovery. The 12-leads 24-hours Holter ECG (1000 Hz, H12+, Mortara Instrument Inc.) was acquired 1 day before BR (PRE), the 5th (BR5) and 10th day (BR10) of bedridden immobilization. From each recording, beat-to-beat RR and QTend interval series, as well as T wave amplitude (Tamp) and upslope (Tslope) were computed. Statistical analysis was applied to test changes induced by BR (ANOVA with Tukey test, p<0.05), separately for day (7:00–23:00) and night (23:00–7:00) periods. Results Daily RR and QTend duration increased during BR, with peak changes at BR5 compared to PRE (+13.3% and +3% respectively), and were still prolonged at BR10 (+12.6% and +2.6%). During the night, while RR increased (BR5:+5.3%; BR10:+1.3%), QTend was found progressively shortened (BR5: −1.6%; BR10: −2.9%). Also, day and night Tamp (BR10: −19.5%) and Tslope (BR10 day: −17.1%; night: −7.8%) were found progressively reduced with the duration of BR. Conclusion During BR, cardiac electrical activity is affected by 10-days bedridden immobilization. Noticeably, a mismatch in RR-QTend relation was visible at night, where vagal autonomic system activity is prevailing. Funding Acknowledgement Type of funding source: Other. Main funding source(s): Agenzia Spaziale Italiana (ASI)