Googling as avoidance: anxiety responses to online health information about long COVID

Objective To observe the influence of low epidural anesthesia on heart rate variability(HRV)and blood pressure,heart rate in elderly hypertensive patients. Methods 125 patients who were adopted routine selective pelvic cavity operation or lower limb operation were divided into the two groups,the observation group(56 cases) complicate with hypertension,control group(69 cases)with normal blood pressure.The heart rate,blood pressure and low frequency,high frequency of HRV before and 5min,15min,45min after anesthesia were monitored and compared. Results Before operation and 5,15,45 min after anesthesia,the systolic blood pressure were(150.2 ±12.4)mm Hg,(142.6±12.9)mm Hg,(127.6±12.9)mm Hg,(123.7±11.3)mm Hg,diastolic blood pressure were(84.2±12.3)mm Hg,(75.3±10.4)mm Hg,(73.7±8.61)mm Hg,(71.7±7.3)mm Hg,heart rates were (88.4±11.3)times/min,(82.3±9.1)times/min,(78.4±10.5)times/min,(77.5±10.5)times/min,low frequency of HRV were(87.5±23.7)Hz,(76.4±22.2)Hz,(55.4±22.1)Hz,(62.4±21.3)Hz,high frequency of HRV were(50.2±22.2)Hz,(32.3±16.7)Hz,(29.5±18.3)Hz,(26.3±18.4)Hz in the observation group;The systolic blood pressure were(133.6±11.4)mm Hg,(123.1±9.5)mm Hg,(121.6±10.1)mm Hg,(120.3±16.3) mm Hg,diastolic blood pressure were(77.3±11.8)mm Hg,(71.4±10.5)mm Hg,(70.4±10.2)mm Hg,(71.2±8.6) mm Hg,heart rate were(85.8±10.7)times/min,(85.8±10.7)times/min,(84.3±11.4)times/min,(84.5± 11.9)times/min,low frequency of HRV were(69.1±20.7)Hz,(59.6±22.1)Hz,(45.7±26.8)Hz,(56.3± 17.4)Hz,high frequency of HRV were(39.5±20.3)Hz,(34.6±18.9)Hz,(40.6±21.7)Hz,(41.1±18.1)Hz in the control group;The systolic blood pressure and diastolic blood pressure in the observation group after anesthesia were lower than those before operation(systolic blood pressure:t=4.622,5.361,5.732,all P<0.05;diastolic blood pressure:t=4.778,5.246,5.835,all P<0.05),The systolic blood pressure and diastolic blood pressure in the control group after anesthesia were lower than those before operation(systolic blood pressure:t=3.135,3.526,3.778,all P<0.05;diastolic blood pressure:t=3.636,3.578,3.467,all P<0.05),The systolic blood pressure and diastolic blood pressure in the observation group declined by a larger margin than those in the control group(t=3.782,3.825,3.562,all P<0.05),the heart rate after anesthesia were lower than those before operation both groups(observation group:t=4.613,5.724,6.146,all P<0.05;control group:t=3.143, 3.672,3.572,all P<0.05),the heart rate in the observation group declined by a larger margin than those in the control group(t=3.052,3.462,3.782,all P<0.05),low frequency of HRV and high frequency of HRV in the observation group after anesthesia were lower than those before operation(low frequency of HRV:t=4.144,5.156,4.714,all P<0.05;high frequency of HRV:t=4.614,4.352,4.667,all P<0.05),low frequency of HRV and high frequency of HRV in the control group after anesthesia were lower than those before operation(low frequency of HRV:t=2.625,3.622,3.725,all P<0.05;high frequency of HRV:t=3.273,3.605,3.726,all P< 0.05),low frequency of HRV and high frequency of HRV in the observation group declined by a larger margin than those in the control group(low frequency of HRV:t=3.578,3.061,3.136,all P<0.05;high frequency of HRV:t=3.851,3.414,3.684,all P<0.05). Conclusion Low epidural anesthesia would exert huge impact to the autonomic nervous system of elderly hypertensive patients. Key words: hypertension; epidural anesthesia; heart rate variability; heart rate

A-44 Implications of the Heart Rate Variability Power Spectrum on the Relationship between Prenatal Anxiety Exposure and Child Anxiety in 5-Year-Olds

Cardiac and vascular function is mainly under autonomic nervous control within seconds to minutes, although the control is not mature at birth. We studied sympathovagal control of heart rate and blood pressure in chronically catheterized foetal lambs in the last trimester of gestation. Power spectral analysis was used to quantitate the frequency-specific heart rate variability (HRV) and blood pressure variability. We performed 15 experiments in seven foetal lambs. These preliminary studies showed that parasympathetic blockade by atropine (eight experiments) had no significant effect on the distribution of HRV to different frequencies. Beta-sympathetic blockade by propranolol (seven experiments) decreased the ratio of low and mid to high frequency (0.025-0.13 to 0.13-1.00 Hz) HRV (P = 0.02). The increased high frequency HRV in the absence of a similar increase in blood pressure variability and tracheal pressure variability suggests enhanced baroreflex responsiveness after propranolol administration. The frequency-specific sympathetic control of HRV in foetal lambs, the change in ratio of low and mid to high frequency HRV, might have clinical implications in estimating the level of foetal sympathetic activation in the follow-up of high-risk pregnancies.

Computer analysis of non‐invasive measures of cardiovascular variability for deducing autonomic function and for risk stratification

High frequency heart-rate variability predicts adolescent depressive symptoms, particularly anhedonia, across one year

Hopelessness, a negative outlook and sense of helplessness toward the future, is present in 27-52% of patients with ischemic heart disease (IHD) and is associated with increased morbidity and mortality. Physiologic dynamics of hopelessness in patients with IHD are largely unknown. Purpose : To examine how stress adaptation, measured by high frequency (HF) heart rate variability (HRV), following an IHD event may be associated with hopelessness. Subgroup differences focusing on characteristics known to be associated with hopelessness and/or HRV will also be examined (i.e., IHD event, marital status, sex). Hypothesis : Decreased HF HRV will be associated with greater levels of hopelessness. Methods : Participants were enrolled while hospitalized for an IHD event after being identified as appropriate for HRV analysis (n=69). Two weeks after hospital discharge, participants wore a Polar H7 heart rate monitor for 10 minutes while supine for HRV data collection. A demographic questionnaire and State-Trait Hopelessness Scale were then completed. From the 10-minutes of HRV data, a 5-minute HRV segment with the least amount of artifact (&lt;5%) was used for analysis. HRV data was log transformed to account for non-normality. Linear regression was used to assess the relationship between HRV and state hopelessness. Results : There was a moderate negative correlation between HF HRV and state hopelessness (r= -0.35, p=0.004). This remained significant in multivariable regression models when controlling for history of depression and factors known to influence HRV (i.e., time of day, age, and smoking status). No sex differences (Cohen’s d=-0.04, p=0.78) were observed for HF HRV, but persons who underwent bypass surgery had lower HF compared to those that did not (Cohen’s d=0.63, p=0.04). Due to high correlation with HF and root mean square of successive differences between normal heartbeats (rMSSD) and SD1 (r=0.85), patterns of association with hopelessness and those variables were similar throughout. Conclusion : Decreased HF was moderately correlated with increased state hopelessness following an IHD event. Assessing HRV in patients following an IHD event could provide promising evidence of a biomarker to assist in identifying patients at risk for hopelessness.

The familiality of infant sleeping heart rate (HR) and cardiac-related autonomic activity, as indexed by spectral analysis of HR variability (HRV) and response to postural change, was investigated in 322 5-month-old twin pairs. The postural change elicited only minor changes in cardiovascular activity. As a result, analyses focused on supine cardiovascular activity. Multivariate genetic modeling indicated that individual differences in sleeping HR and high frequency (HF) HRV were determined by unique environmental and distinct additive genetic factors. These variables, along with low frequency (LF) HRV, were also affected by overlapping familial environmental influences. Familial influences in HF HRV were more pronounced for baby girls than boys. Estimates of relative LF and HF HRV were determined by common (familial) and unique environmental factors; familial influences on these estimates did not overlap with familial influences on sleeping HR.

e20713 Background: Objectives were: (1) To characterize the physiologic changes of the autonomic nervous system, demonstrated by heart rate variability (HRV) high frequency (HF) spectral analysis, before and after a 15 minute, one-time, guided relaxation program for cancer patients. (2) To assess whether changes of HRV correlate with subjective feeling for anxiety, based on the Edmonton Symptom Assessment Scale (ESAS), and the summed ESAS score. Methods: 20 patients with any cancer diagnosis and normal cognition were recruited for the study. The ECG electrodes were attached and a 5-minute period of heart rate variability was recorded (HRVbefore) after 15 minutes of supine resting. The patient then began the brief relaxation program via recorded audio. Another 5 minute period of HRV was then recorded (HRVafter). The ESAS was completed before and immediately after the relaxation program. Parasympathetic activity assessed by heart rate variability, as measured by high frequency spectral analysis, was the primary outcome measure. The differences between the pre and post values of low and high frequency HRV, of the ESAS anxiety score, and of the summed ESAS score were compared using a Wilcoxan signed rank test. Results: No statistically significant differences were found in HF HRV power between the pre and post relaxation program. However, the summed ESAS scores were significantly lower after the relaxation program (p &lt;0.001). There was also a trend of decrease in the ESAS anxiety score (p = 0.086). There was no correlation between the change in HRV HF and change in the ESAS anxiety score. Conclusions: A brief guided relaxation program can significantly improve symptoms as measured by ESAS, but not HF HRV power. No significant financial relationships to disclose.

Introduction: Hopelessness is present in up to 52% of patients with ischemic heart disease (IHD) and associated with a 3.4 times increased risk of death and adverse outcomes. Decreased perceived social support (PSS) has been associated with hopelessness in patients with IHD reporting moderate-severe hopelessness but has not been examined in a well-powered sample with varying levels of hopelessness. Increased PSS is associated with increased high frequency (HF) heart rate variability (HRV) in adults following a stressful event, but the relationship between HRV and hopelessness has not been examined in patients with IHD. Hypothesis: The purpose of this research was to test the hypotheses that 1) lower PSS would be associated with higher hopelessness, and 2) lower HF HRV would be associated with higher hopelessness. Methods: Utilizing a cross-sectional design, 178 participants were enrolled while hospitalized for an IHD event at one large hospital in the Midwestern United States. Data collection occurred two weeks after hospital discharge using the State-Trait Hopelessness Scale, ENRICHD Social Support Inventory, Patient Health Questionnaire-9, a demographic form, and a short-term HRV measurement at rest. Linear models were used to assess association between variables in unadjusted models and models adjusted for demographic and medical history. Results: Majority of participants were male (67%), married (67%), non-Hispanic white (92%), and underwent coronary artery bypass surgery (61%). There was a moderate inverse correlation between PSS and state ( r = -0.31, p &lt; 0.001) and trait ( r = -0.28, p &lt; 0.001) hopelessness in unadjusted models. The relationships remained significant in adjusted models and did not differ between groups comparing sex, type of IHD event, and marital status. There was a moderate inverse correlation between HF HRV and state hopelessness ( r = -0.24, p = 0.023). Results remained significant in adjusted models and did not differ between groups comparing sex, type of IHD event, and beta-blocker prescription. Conclusions: There were significant inverse associations between PSS and hopelessness and HF HRV and hopelessness. Persons with low PSS and/or HF HRV may be at greater risk for experiencing hopelessness following an IHD event.

Delayed heart rate (HR) recovery in the immediate postexercise period has been linked to adverse cardiovascular prognosis. The after effects of an acute bout of exercise on HR modulation in postmenopausal women (PMW) and the influence of estrogen therapy are unknown. In 13 sedentary PMW (54 ± 2 y, mean ± SEM), we assessed HR variability (HRV)--an index of HR modulation--and the influence of estrogen therapy on HRV. HRV in the frequency domain was quantified during supine rest and again 60 minutes after treadmill exercise for 45 minutes, at 60% VO2peak. PMW were studied before and after 4 weeks of oral estradiol. To obtain reference values for the after effects of exercise on HRV in healthy young women, 14 premenopausal women (PreM) completed the identical exercise protocol. Compared with PreM, PMW demonstrated lower high frequency (vagal modulation) and total HRV (P < 0.05) at rest. In PreM, all HRV values were similar before and after exercise. In contrast, in PMW after exercise, despite having identical HR to PreM, high frequency and total HRV were all lower (all P ≤ 0.01) compared with pre-exercise HRV values. Estrogen therapy had no effect on pre or postexercise values for HRV. When compared with PreM, PMW have identical HR, but lower vagal HR modulation at rest and delayed HRV recovery after exercise. Estrogen does not restore baseline HRV or accelerate HRV recovery postexercise, suggesting aging rather than estrogen deficiency per se may lower HRV in PMW.

Nrf2 protects the lung from adverse responses to oxidants, including 100% oxygen (hyperoxia) and airborne pollutants like particulate matter (PM) exposure, but the role of Nrf2 on heart rate (HR) and heart rate variability (HRV) responses is not known. We hypothesized that genetic disruption of Nrf2 would exacerbate murine HR and HRV responses to severe hyperoxia or moderate PM exposures. Nrf2−/− and Nrf2+/+ mice were instrumented for continuous ECG recording to calculate HR and HRV (low frequency (LF), high frequency (HF), and total power (TP)). Mice were then either exposed to hyperoxia for up to 72 hrs or aspirated with ultrafine PM (UF-PM). Compared to respective controls, UF-PM induced significantly greater effects on HR (P < 0.001) and HF HRV (P < 0.001) in Nrf2−/− mice compared to Nrf2+/+ mice. Nrf2−/− mice tolerated hyperoxia significantly less than Nrf2+/+ mice (~22 hrs; P < 0.001). Reductions in HR, LF, HF, and TP HRV were also significantly greater in Nrf2−/− compared to Nrf2+/+ mice (P < 0.01). Results demonstrate that Nrf2 deletion increases susceptibility to change in HR and HRV responses to environmental stressors and suggest potential therapeutic strategies to prevent cardiovascular alterations.

Effects of Chronic Pelvic Pain on Heart Rate Variability in Women

Spectral analysis of heart rate variability (HRV) is often used as a noninvasive index of cardiac sympathetic and/or parasympathetic activity during sleep. During controlled wake recordings, the low frequency (LF) component of HRV can be unreliable within experimental sessions and against other direct sympathetic measurements. In contrast, the high frequency (HF) component of HRV has higher reported reproducibility within controlled wake sessions. It remains unknown if the frequency component of HRV is reliable across sleep cycles within individuals during stable sleep. The purpose of the present study was to determine HRV reliability during stable stage II (N2) sleep, slow wave sleep (SWS) and rapid eye movement (REM) sleep. We hypothesized that both LF and HF components of HRV would be less reliable during REM sleep than during SWS and N2 sleep. Twenty‐seven participants (11 male, 16 female, 26±1 years, 27±1 kg/m2) were enrolled in the present study. Overnight polysomnography (PSG; NATUS, Middleton, WI) and continuous two‐lead electrocardiography (ECG) were recorded during an 8‐hour sleep opportunity. The nocturnal ECG recordings were imported into a custom software (WinCPRS, Absolute Aliens, Finland) for analysis of HRV via fast‐Fourier transformation function. Autonomic cardiac activity was quantified as LF (0.04‐0.15 Hz) and HF (0.15‐0.4 Hz) HRV. Two separate stable periods of sleep (range, 5‐10 min) absent of cortical arousal were selected from each sleep stage for comparison. Raw LF and HF HRV underwent logarithmic transformation due to non‐normal distribution. Statistical analysis included bivariate correlation of HRV across differing sleep stage cycles (α = 0.05). LF HRV was significantly correlated across two independent sleep cycles in N2 (r=0.694, p&lt;0.001, n=26), SWS (r=0.765, p&lt;0.001, n=25), and REM sleep (r=0.699, p&lt;0.001, n=20). Similarly, HF HRV was reliable across two independent sleep cycles in N2 sleep (r=0.839, p&lt;0.001, n=26), SWS (r=0.765, p&lt;0.001, n=25), and REM sleep (r=0.881 p&lt;0.001, n=21). Taken together, both LF and HF HRV measures were reliable across stable N2, SWS, and REM sleep. Our results support the reliability of frequency domain analysis of HRV during key PSG sleep stages within a single night, but further research across nights is warranted.

Heart rate variability (HRV) analysis of 24 healthy newborn sleeping babies was performed by a short-time Fourier transform in three frequency bands, reflecting the activity of both branches of the autonomic nervous system (ANS), vagal and sympathetic. The means of the three extracted time signals, computed over records of 512 heartbeats, were used as a material for principal component analysis, and for discriminant factor analyses, to separate sleep states and conceptional age (CA) groups. This study suggests that sleep state discrimination, on the basis of an opposition between high (purely vagal in its origin) and low (vagal and sympathetic) frequency HRV, is regularly improved from 31 to 41 weeks CA; and a strong increase in ANS activity, mainly vagal, as reflected by high-frequency HRV, occurs precociously, not later than 38 weeks CA. >

Parents’ ability to regulate their emotions is essential to providing supportive caregiving behaviours when their child is in pain. Extant research focuses on parent self-reported experience or observable behavioural responses. Physiological responding, such as heart rate (HR) and heart rate variability (HRV), is critical to the experience and regulation of emotions and provides a complementary perspective on parent experience; yet, it is scarcely assessed. This pilot study examined parent (n = 25) cardiac response (HR, HRV) at rest (neutral film clip), immediately before the cold pressor task (pre-CPT), and following the CPT (post-CPT). Further, variables that may influence changes in HR and HRV in the context of pediatric pain were investigated, including (1) initial HRV, and (2) parent perception of their child’s typical response to needle procedures. Time-domain (root mean square of successive differences; RMSSD) and frequency-domain (high-frequency heart rate variability; HF-HRV) parameters of HRV were computed. HR and HF-HRV varied as a function of time block. Typical negative responses to needle pain related to higher parental HR and lower HRV at rest. Parents with higher HRV at baseline experienced the greatest decreases in HRV after the CPT. Consequently, considering previous experience with pain and resting HRV levels are relevant to understanding parent physiological responses before and after child pain.