Transgenerational effects of violence in adolescents exposed to grandmaternal intimate partner violence during pregnancy: Heart rate variability and DNA methylation.

Intimate Partner Violence

The aim of this test–retest reliability study was to evaluate the reliability and reactivity of heart rate variability (HRV) and pupillometry metrics under conditions with controlled cognitive stimulation and paced breathing within a virtual reality protocol. After habituation, 30 English-speaking university students completed a four-phase protocol on two occasions separated by 1 week. HRV and pupillometry were continuously measured during the following phases: baseline, cognitive testing, guided breathing with nature immersion, and spontaneous breathing with nature immersion. Strong day-to-day relative reliability was confirmed for both HRV (pooled ICC: 0.75 to 0.83) and pupillometry (pooled ICC: 0.66 to 0.87). HRV metrics of sympathovagal balance in the time, frequency, and non-linear domains showed reactivity with significant differences between all phases. Pupillometry metrics increased progressively from cognitive testing to guided breathing nature immersion to nature immersion, suggesting psychological rather than respiratory influences. Relatively large minimal detectable change values were determined across HRV (22 to 54% deviation from baseline) and pupillometry (33 to 88% deviation from baseline) metrics. Although the relatively large ratio limits of agreement and minimal detectable change values suggest that detecting systematic changes in these metrics over time might be difficult at the individual level, strong relative reliability supports the use of HRV and pupillometry metrics to detect differences in sympathovagal balance between groups. Additionally, the responsiveness of these metrics demonstrates the efficacy of the proposed virtual reality protocol in inducing detectable physiological reactivity across HRV and pupillometry metrics.

The relative contributions of parasympathetic and sympathetic autonomic nervous system control of cardiac activity is often assessed through non‐invasive heart rate variability (HRV) metrics. There are various HRV metrics utilized to measure cardiac autonomic balance. However, the relationship between HRV metrics and cardiac autonomic tone is understudied and controversial. We assessed the internal consistency of using three specific HRV metrics of cardiac autonomic balance at rest using electrocardiography (ECG) in a larger number of healthy participants: time domain, frequency domain and Poincaré plots. Data was analyzed from a large set (n=136) of archived files from previous studies, where a 5‐min segment of resting baseline ECG was previously‐recorded in young, healthy men and women (ADInstruments, LabChart HRV module, v8). The three specific HRV metrics quantified from the ECG baseline were time domain (SDRR and RMSSD; ms), frequency domain (LF, HF, LF/HF; n.u.) and Poincaré plots (SD1, SD2, SD1/SD2; ms). The HRV metrics considered to be associated with cardiac parasympathetic activity are RMSSD, HF and SD1, whereas SDRR, LF and SD2 are considered to be associated with mixed cardiac parasympathetic and sympathetic activity (i.e., sympathetic influence). We correlated the three parasympathetic HVR metrics (RMSSD, HF and SD1), within‐individual. We also correlated the three mixed cardiac autonomic metrics (SDRR, LF and SD2), within‐individual. Regarding the three parasympathetic metrics, (a) RMSSD and SD1 were strongly, positively and significantly‐correlated (r=1.0, P<0.0001), suggesting similar mathematical calculations for each and (b) both RMSSD and HF, and SD1 and HF were moderately, positively and significantly‐correlated (both, r s =0.41, P<0.00001). Regarding mixed parasympathetic and sympathetic metrics, (a) SDRR and SD2 were strongly, positively and significantly‐correlated (r=0.96, P<0.0001), suggesting similar mathematical calculations for each, (b) SDRR and LF were not significantly‐correlated (r s =‐0.1, P=0.25) and (c) SD2 and LF were no significantly correlated (r s =0.01, P=0.9). Our analysis on a large data set suggests high agreement and internal consistency between parasympathetic cardiac metrics, within‐individual. However, on metrics with mixed parasympathetic and sympathetic influence, HRV metrics lacked agreement and internal consistently. These data suggest that (a) any of the three parasympathetic metrics are likely useful in assessing cardiac parasympathetic tone, but that (b) caution should be used in interpreting HRV metrics typically utilized in assessing cardiac sympathetic tone.

BackgroundIt has been shown that linear and non-linear heart rate variability (HRV) metrics are suitable to assess workload of anesthetists administering anesthesia. In pre-hospital emergency care, these parameters have not yet been evaluated. We hypothesized that heart rate (HR) and HRV metrics discriminate between differing workload levels of an emergency physician.MethodsElectrocardiograms were obtained from 13 emergency physicians. Mean HR, ten linear and seven non-linear HRV metrics were analyzed. For each sortie, four different levels of workload were defined. Mixed-effects models and the area under the receiver operating characteristics curve (AUC) were used to test and quantify the HR and HRV metrics’ ability to discriminate between levels of workload. This was conducted for mean HR and each HRV metric as well as for groups of metrics (time domain vs. frequency domain vs. non-linear metrics).ResultsThe non-linear HRV metric Permutation entropy (PeEn) discriminated best between the time before the alarm and primary patient care (AUC = 0.998, 1st rank of 18 HRV metrics). In contrast, AUC of the mean HR was low (0.558, 17th rank). In the multivariable approach, the non-linear HRV metrics provided a higher AUC (0.998) compared to the frequency domain (0.677) and to the time domain metrics (0.680).ConclusionNon-linear heart rate metrics and, specifically, PeEn provided good validity for the assessment of different levels of a physician’s workload in the setting of pre-hospital emergency care. In contradiction to earlier findings, the physicians’ mean HR was not a valid marker of workload.

Influence of Intimate Partner Violence (IPV) Exposure on Cardiovascular and Salivary Biosensors: Is There a Relationship?

BackgroundThe Apolipoprotein E (APOE) ε4 allele has been identified as a critical genetic risk factor for developing Alzheimer’s disease. Heart rate variability (HRV) metrics are non‐invasive indicators of autonomic nervous system function associated with cognitive performance in patients with dementia and mild cognitive impairment. Some evidence suggests reduced HRV complexity in elderly adults carrying the ε4 allele beyond the effects of aging. However, no study has evaluated whether cognitively normal middle‐aged adults differ in their HRV based on their APOE carrier status.MethodThe present cross‐sectional analysis was based on the larger Physical Activity and Alzheimer’s Disease 2 clinical trial (NIH: R01AG058919). Eighty‐six cognitively normal middle‐aged adults (sex: 85.9% female; age: 57.5±5.9 years; height: 166.5±8.8 cm; mass: 78.3±18.8 kg) had height, mass, and resting blood pressure assessed and completed a series of surveys. Participants provided a saliva sample via passive drool to determine APOE ε4 carrier status and also completed a 5‐minute seated electrocardiogram assessment. R‐waves were identified, and the RR interval time series were filtered prior to HRV analysis. HRV metrics of the standard deviation of the normal‐to‐normal interval, root mean square of successive differences, high and low‐frequency power, and sample entropy were calculated. Differences in HRV metrics between ε4 carriers (n = 32) and non‐carriers (n = 54) were tested via general linear models. Differences were also tested after controlling for sex, age, education, ethnicity, body mass index, moderate to vigorous physical activity, and mean arterial pressure.ResultNo differences in any HRV metric were observed between APOE ε4 carriers and non‐carriers (all p’s > 0.05), including after controlling for all and sets of covariates.ConclusionThe absence of significant associations between carrier status and HRV in cognitively normal adults suggests that HRV is not predictive of Alzheimer’s disease risk in the same manner as genetic factors. Rather, HRV may be concurrently altered with cognitive decline and thus serve as a non‐invasive biomarker that could be monitored to indicate when more intensive cognitive testing is required. Future research should test the similarity in HRV and cognition trajectories in APOE ε4 carriers and non‐carriers.

Elucidating the association between heart rate variability (HRV) metrics obtained through non-invasive methods and mental health symptoms could provide an accessible approach to mental health monitoring. This study explores the correlation between HRV, estimated using photoplethysmography (PPG) signals, and self-reported symptoms of depression and anxiety. A 4-week longitudinal study was conducted among 47 participants. Time-domain and frequency-domain HRV metrics were derived from PPG signals collected via smartwatches. Mental health symptoms were evaluated using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) at baseline, week 2, and week 4. Among the investigated HRV metrics, RMSSD, SDNN, SDSD, LF, and the LF/HF ratio were significantly associated with the PHQ-9 score, although the number of significant correlations was relatively small. Furthermore, only SDNN, SDSD and LF showed significant correlations with the GAD-7 score. All HRV metrics showed negative correlations with self-reported clinical symptoms. Our findings indicate the potential of PPG-derived HRV metrics in monitoring mental health, thereby providing a foundation for further research. Notably, parasympathetically biased HRV metrics showed weaker correlations with depression and anxiety scores. Future studies should validate these findings in clinically diagnosed patients.

Childhood intimate partner violence (IPV) exposure increases the likelihood of internalizing and externalizing problems. There is substantial variability in children's outcomes following IPV exposure, but the reasons behind this are unclear, particularly among preschool-age children. The current study aimed to examine the direct and indirect effects of IPV on preschoolers' mental health through parent factors (parenting and parental depression), exploring child temperament as a potential moderator of the relation between IPV and child outcomes. Participants were 186 children (85 girls) and their parents living in the United States. Data were initially collected when children were age three, with follow-up at ages four and six. Both parents' baseline IPV perpetration had adverse effects on child outcomes. Mothers' IPV was associated with greater paternal depression, paternal overractivity, and maternal laxness, whereas fathers' IPV was associated with more paternal overreactivity. Only paternal depression mediated the effect of mothers' IPV on child outcomes. Parenting did not mediate nor did child temperament moderate the relation between IPV and child outcomes. Results shed insight into the need to address parental mental health in families experiencing IPV and underline the need for a further exploration of individual- and family-level mechanisms of adjustment following IPV exposure.

The purpose of this study was to examine the intra-individual variation of heart rate variability (HRV) and heart rate using an orthostatic challenge in elite male athletes during a training camp. Heart rate (variability) was measured upon waking. Log-transformed HRV metrics were evaluated in three segments (first min discarded for stabilization): 0-3min supine, 3-6min supine, and standing. Heart rate was assessed while supine, 15s after standing and average final 30s standing (Rusko protocol). A RM-ANOVA compared intra-individual means, standard deviations (SD) and coefficients of variation (CV%) for HRV and heart rate. The intraclass correlation coefficient (ICC) and standard error of measurement (SEmeas) were used for relative and absolute reliability, respectively. Time and frequency domain HRV metrics had low variation (CV% <8.5%; SEmeas% ≤4.0%) for 0-3min supine which was not improved during 3-6min. Standing HRV had lower ICC and higher SEmeas than supine values. Variability and reliability outcomes for heart rate were comparable to log-transformed HRV metrics. This study uniquely describes the intra-individual variation of HRV metrics during an orthostatic challenge and demonstrated low variability in this cohort of elite male athletes. These data can be helpful for identifying when true individual changes occur for the autonomic nervous system indices in supine and standing positions.

The aim of this investigation was to observe the association in the time course in recovery between multiple heart rate variability (HRV) metrics and neuromuscular performance, as assessed by mean bar velocity (BVM) in the back squat, over a 72-h period after an exhaustive back squat protocol. Eight resistance-trained males completed five laboratory visits within a 7-d period. The first visit involved short-term HRV recordings followed by a familiarization of BVM procedures and a one-repetition maximum test of the back squat. Forty-eight hours later, participants returned to the laboratory for prestimulus measurements, immediately followed by a back squat protocol (8 sets of 10 repetitions at 70% of one-repetition maximum with a 2-min rest). The HRV and the BVM measurements were replicated at 0.5, 24, 48, and 72 h after squat protocol. A multivariate profile analysis and repeated-measures correlation between recovery scores [(new/prestimulus) × 100] for each HRV metric and BVM was computed. All log-transformed (ln) HRV metrics, except low frequency (lnLF) (P = 0.051), had a significant interaction with BVM over time (P < 0.05), indicating that recovery scores in BVM and HRV were not parallel. In addition, recovery scores in all HRV metrics significantly differed from BVM (P < 0.05) in at least one time point across the 72-h period. Furthermore, repeated-measures correlation analysis indicated a lack of intraindividual association (P > 0.05) between the change in BVM and all HRV measurements over time. The time course in recovery in HRV measurements after an exhaustive bout of lower-body resistance exercise was not associated with neuromuscular performance recovery.

We examined the inter-day repeatability of cardiovagal baroreflex sensitivity (BRS) and heart rate variability (HRV) metrics during a dual-intensity cycling protocol in healthy young males and females. Forty young adults (20 males, 20 females; age: 18-31 years) completed two randomized reclined cycling bouts at a moderate (50% heart rate reserve [HRR]) and vigorous (80% HRR) exercise intensity on separate days. HRV metrics and spontaneous BRSwere analyzed over 2-min bins, using RR intervals and beat-to-beat systolic pressure obtained in a semi-recumbent position. The repeatability of BRS and HRV metrics was examined using coefficients of variation (CV), intra-class correlation coefficients (ICC), and Bland-Altman plots with 95% limits of agreement. BRS showed overall good-to-excellent inter-day repeatability, which was similar across sex and exercise intensities (Females: 50%HRR: CV = 14%, ICC = 0.86, 95% LOA: -1.85 to 1.48 ms/mmHg; 80% HRR: CV = 20%, ICC = 0.86, 95% LOA: -2.24 to 1.98 ms/mmHg; Males: 50% HRR CV = 15%, ICC = 0.82, 95% LOA: -2.10 to 1.78 ms/mmHg; 80% HRR CV = 22%, ICC = 0.77, 95% LOA: -2.69 to 2.07 ms/mmHg). Vagal-related HRV metrics (high-frequency power, SD1, SDNN) exhibited good inter-day repeatability,not altered by vigorous-intensity exercise, with females showing lower repeatability for SD1 and SDNN compared to males (female: CV ~ 20-25%, ICC:0.70-0.85; male: CV ~ 15-20%; ICC:0.75-0.90). The root-mean square of successive differences exhibited the greatest repeatability for HRV metrics, being similar across sex and exercise intensity (CV ~ 13-16%, ICC ~ 0.90). BRS and vagal-related HRV metrics were repeatable during cyclingacross intensities andsex, supporting their use in detecting cardiac autonomic changes in clinical and active populations. NCT06617117.

Heart rate variability with photoplethysmography in 8 million individuals: a cross-sectional study

ABSTRACTBackground: Violence against women is a global public health problem. A better understanding of risk factors for intimate partner violence (IPV) exposure during pregnancy is important to develop interventions for supporting women being exposed to IPV.Objective: The purpose of this study was to measure the prevalence of IPV during pregnancy and analyse how social support and various risk factors are associated with IPV.Methods: A cross-sectional study conducted among 1309 pregnant women in Dong Anh district, Vietnam. Information about socio-economic conditions and previous exposure to IPV was collected when women attended antenatal care before the 24th gestational week. Information about social support information and exposure to IPV during pregnancy was collected in the 30th-34th gestational week. Multivariable regression was used to identify associations between IPV, social support and other potential risk factors.Results: The prevalence of IPV exposure during pregnancy was 35.2% (Emotional violence: 32.2%; physical violence: 3.5% and sexual violence: 9.9%). There was a statistically significant association between previous IPV exposure, lack of social support and IPV exposure during pregnancy. After adjustment for socioeconomic characteristics, pregnant women who had previously been exposed to IPV were more likely to be exposed IPV at least one time (AOR = 6.3; 95% CI: 4.9–8.2) as well as multiple times (AOR = 6.0; 95% CI: 4.5–8.0). Similarly, pregnant women having a lack of social support had a higher likelihood of being exposed to IPV at least one time (AOR = 3.1; 95% CI: 2.4–3.9) or multiple times (AOR = 2.9; 95% CI: 2.2–3.8).Conclusion: IPV is relatively high during pregnancy in Vietnam. Previous exposure to IPV and lack of social support is associated with increased risk of violence exposure among pregnant women in Vietnam.

Introduction: Few studies have examined the associations of intimate partner violence (IPV) exposure during pregnancy and types of IPV with antenatal depression among underserved pregnant women. Methods: Data came from participants from a Healthy Start program in South Carolina between 2015 and 2019 (n = 1,629). The first two questions in the Woman Abuse Screening Tool (WAST) were used to measure IPV exposure, that is, having a problematic relationship with their partner. Those who had IPV exposure were assessed with six additional questions of the WAST. Principal component analysis was conducted on the 8-item WAST data to identify underlying types of IPV exposure. Antenatal depression was defined as the Center for Epidemiologic Studies Depression scores ≥16. Results: Participants were racially diverse (71% black, 21% white) with 85% Medicaid recipients. Nearly 12% of participants reported IPV exposure and 30% reported antenatal depression. The odds of having IPV exposure were higher among unmarried women, those with less than a high school education, and those who lacked family support. The odds of having antenatal depression were 2.5 times higher (95% CI: 1.9-3.5) among women with IPV exposure. After controlling for covariates, a one-point increase in the scores for psychological IPV (Factor 1) or a problematic relationship (Factor 3) was associated with increased odds of antenatal depression. Conclusion: This is one of the first studies to estimate the prevalence of IPV exposure using a proxy measure (a problematic relationship) among underserved U.S. pregnant women. Its positive association with antenatal depression suggests the utility of screening for a problematic relationship using a two-item WAST and providing assistance to those with IPV exposure.

The aim of this study was to examine the relationship between resting morning heart rate variability (HRV) metrics and indirect markers of hydration status in elite male athletes. Twenty-two field hockey players (age 26.8 ± 3.4 yr; height 178.4 ± 6.3 cm; body mass 76.2 ± 7.4 kg) were monitored over 10-d during a pre-Olympic training camp. Measurement of heart rate variability (HRV) during an orthostatic challenge, urine specific gravity (Usg, first morning void) and body mass were captured on seven of the mornings. Individual generalized linear mixed models evaluated the relationships between supine and standing HRV metrics with Usg and day-to-day change in body mass. No meaningful relationships were identified between supine (estimates −0.002 to 0.001) or standing (−0.002 to 0.003) HRV metrics and Usg as well as between supine (−0.003 to 0.016) or standing (−0.004 to 0.006) HRV metrics and changes in body mass. These outcomes indicate that supine and standing HRV metrics are not influenced by indirect indices of hydration status in elite male field hockey players.