Heart Rate Assessment Research Articles

High-intensity interval aerobic exercise delays recovery from heart rate variability: a systematic review with meta-analysis.

The present review investigates the responses of heart rate variability indices following high-intensity interval aerobic exercise, comparing it with moderate-intensity continuous exercise in adults, with the aim of informing clinical practice. Searches were conducted in four databases until March 2023. Eligible studies included randomized controlled trials that assessed heart rate variability indices such as the standard deviation of normal-to-normal heartbeat intervals (SDNN), the root mean square of successive differences (RMSSD), the proportion of the number of pairs of successive normal-to-normal (NN or R-R) intervals that differ by more than 50 ms (NN50) divided by the total number of NN intervals (pNN50), power in high frequency range (HF), power in low frequency range (LF), and LF/HF before and after high-intensity interval and moderate-intensity continuous aerobic exercise. The risk of bias in included studies was evaluated using the RoB 2 tool. A total of 16 studies were included in the systematic review, while 9 were included in the meta-analysis. Overall, the majority of included individuals were healthy and young. Our meta-analysis indicated that individuals who performed high-intensity interval exercise showed a slower recovery to baseline levels for HF (standardized mean difference, SMD-0.98 [95% CI -1.52 to -0.44], p<0.001) and LF (SMD-0.42 [95% CI -0.81 to -0.02], p=0.04) within the first 10 min of recovery, which did not occur after 1 h. Among the 16 included studies, 10 had some concerns related to bias risk, while 6 were classified as high risk. High-intensity interval aerobic exercise results in delayed recovery of HF and LF indices within the first 10 min after the session. However, our review indicates that healthy individuals restore modulation of the autonomic nervous system to baseline levels after this time interval, regardless of exercise intensity.

Effects of Auto-Titrating Mandibular Advancement Device on Autonomic Nervous System in Obstructive Sleep Apnea.

Background/Objectives: One prior study revealed that a newly developed auto-titrating mandibular advancement device (AMAD) could potentially enhance polysomnographic outcomes in individuals with obstructive sleep apnea (OSA). However, evidence regarding its impact on autonomic nervous system dysregulation in OSA remains limited. In this study, we aimed to compare the effects of conventional mandibular advancement devices (MADs) and AMDA on autonomic function. Methods: We retrospectively reviewed data from patients who visited a sleep center with complaints of snoring and sleep apnea (30 and 15 patients in the conventional MAD and AMAD groups, respectively). We assessed heart rate variability (HRV) frequency-domain metrics such as total power (TP), very low frequency (VLF), low frequency (LF), and high frequency (HF) using ultra-short-term and short-term modalities, assessing sympathetic and parasympathetic activity changes across treatment groups. Results: Conventional MAD treatment was associated with reductions in LF and LF/HF ratios, whereas AMAD treatment was linked to decreases in TP, VLF, LF, and LF/HF ratios. Notably, in patients with moderate OSA, LF values were significantly lower in the AMAD group than in the conventional MAD group. Conclusions: These findings suggest that both devices could reduce sympathetic over-activity in patients with OSA, with AMAD demonstrating greater efficacy, particularly in those with moderate OSA.

Orthostatic blood pressure reactions and resting heart rate in relation to lung function - the Swedish CArdioPulmonary bioImage Study (SCAPIS)

BackgroundThere is a well-known comorbidity between chronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD) which is only partially explained by common risk factors. Markers of cardiovascular autonomic dysfunction (CVAD), such as orthostatic hypotension and increased resting heart rate, are strongly associated with CAD. The autonomic nervous system also innervates the airways, and several studies have shown an association between autonomic dysfunction and COPD. However, less is known about whether CVAD and impairment of respiratory capacity are related in the population. We thus aimed to assess the relationship between markers of subtle CVAD and lung function in middle-aged subjects.MethodsIn this cross-sectional study, we analysed data from CVAD assessment (orthostatic blood pressure and heart rate measurements) and pulmonary function tests from 5886 individuals from the Swedish CArdioPulmonary bioImage Study (SCAPIS). Subjects were middle aged and randomly selected from the Swedish population. Linear regression models and ANOVA analyses were used to relate orthostatic blood pressure and resting heart rate to lung function parameters (forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC-ratio, diffusion capacity for carbon monoxide (DLCO), respiratory resistance at 5 Hz (R5), respiratory resistance at 20 Hz (R20), decrease in resistance from R5 to R20 (R5-R20), reactance in distal airways (X5), resonant frequency (Fres) and reactance area (AX)).ResultsIncreasing systolic orthostatic blood pressure, decreasing diastolic orthostatic blood pressure, and increased resting heart rate associated with lower FVC (all p < 0.001) and FEV1 (p = 0.001; p = 0.005; p < 0.001, respectively) in models including age, sex and height. Apart from diastolic orthostatic blood pressure and FEV1, all relationships remained significant after adjustment for possible confounders. Increased resting heart rate was associated with reduced DLCO (p < 0.001).ConclusionsIncreasing systolic orthostatic blood pressure, decreasing diastolic orthostatic blood pressure, and increased resting heart rate are associated with lower lung function, after adjustments for age, sex and height. These finding indicates associations between signs of cardiovascular autonomic dysfunction and lower lung function in the general population. However, the observed differences in lung function were small and the clinical application is unclear.

Impact of a music intervention on heart rate variability in very preterm infants.

Infants born very preterm spend their early postnatal life in a neonatal intensive care unit, where irregular and unpredictable sounds replace the structured and familiar intrauterine auditory environment. Music interventions may contribute to alleviate these deleterious effects by reducing stress and providing a form of environmental enrichment. This was an ancillary study as part of a blinded randomised controlled clinical trial entitled the effect of music on preterm infant's brain development. It measured the impact of music listening on the autonomic nervous system (ANS), we assessed heart rate variability (HRV) through high-resolution recordings of heart rate monitoring, at three specific postmenstrual ages in premature infants. From 29 included subjects, 18 were assessed for complete HRV dataset, including nine assigned to the music intervention and nine to the control group. Postmenstrual age appeared to be the main factor influencing HRV from 33 weeks to term equivalent age. Further analyses did not reveal any detectable effect of music intervention on ANS response. This study found that ANS responses were not modified by recorded music intervention in very preterm infants during wakefulness or sleep onset. Further research is warranted to explore other factors influencing ANS development in this population.

Non-invasive recording of heartbeats in Danio rerio and Daphnia magna to assess the toxicity of imidacloprid and glyphosate

Non-invasive optical registration and subsequent analysis of heart rate (HR) and heart rate variability (HRV) in transparent aquatic animals have recently been proposed as convenient toxicological endpoints, well-suited for automation data acquisition and processing. This approach was evaluated in experiments involving juvenile Daphnia magna and zebrafish (Danio rerio) embryos exposed to glyphosate solutions (20 mg/L, 2 mg/L, 0.2 mg/L, and 0.02 mg/L) and imidacloprid solutions (30 mg/L, 3 mg/L, 0.3 mg/L, and 0.03 mg/L). The findings indicate that cardiac performance assessment is a promising approach for short-term toxicity evaluation. However, the sensitivity of this physiological endpoint to various external factors may limit its broader application. Results from the two model species highlight their differing sensitivities to the tested substances, emphasizing the need for thorough preliminary studies before establishing this method as a standardized toxicological tool. The potential development and improvement of techniques for assessing heart rate in zebrafish and daphnids are discussed.

Accuracy of Wrist-Worn Heart Rate Monitors: A Comprehensive Review of Smartwatches in Exercise Monitoring

Wrist-worn heart rate monitors have become integral in personal health monitoring, particularly during exercise and daily activities. This review evaluates the precision of various commercially available smartwatches in assessing heart rate, focusing on their accuracy across different physical activities, such as walking, running, cycling, and elliptical training. A systematic analysis of 29 peer-reviewed studies, encompassing over 900 participants, was conducted to compare devices like the Apple Watch, Fitbit, Garmin, and others. The results demonstrate significant variation in accuracy depending on the device, type of activity, and individual factors such as body mass index and skin tone. The Apple Watch consistently outperformed other devices, showing the lowest mean absolute percentage error (MAPE), particularly during moderate-intensity activities. In contrast, devices such as the Fitbit Blaze exhibited greater error rates, especially during high-intensity exercises or activities involving significant arm movement. Although wrist-worn heart rate monitors provide users with convenient real-time data, limitations such as motion artifacts, device placement, and external factors may affect their reliability.

Slidingan analysis of analytical signal of non-contact photoplethysmography for assessing heart rate

The paper proposes a method for studying the variability of the subject’s heart rate based on the intellectual analysis of the pulse wave measured with remote photoplethysmography. The logically related stages of the formation of quadrature components based on the Hilbert transform of biomedical signals’ dynamics are presented. Within the framework of modern methods of intellectual analysis of non-stationary time series, realizations of adaptive estimates of instantaneous frequencies and periods of the heartbeat basic tone are obtained.

Effects of a synthetic analogue of the bovine appeasing pheromone on the overall welfare of dairy calves from birth through weaning

Environmental enrichment in the form of synthetic analogs of appeasing pheromones have shown promising results in improving the welfare of domestic animals including dogs, pigs, horses, and cattle. The main objective of this study was to determine if the use of the bovine appeasing pheromone (BAP) would improve the welfare of dairy calves; therefore, in this randomized controlled trial, 72 Holstein Friesian dairy calves were housed in individual hutches after birth and were randomly allocated to receive BAP or a placebo once every 2 weeks from birth through weaning. After weaning, calves were moved to group hutches according to treatment for 4 additional weeks. It was hypothesized that dairy calves treated with BAP would display fewer signs of stress compared with calves receiving the placebo during the weaning process. To operationalize stress, calves were fitted with triaxial accelerometers on the hind leg after birth, and activity levels were monitored throughout the experiment. Data on live weight gain (ADG) and cortisol levels in saliva and hair were also obtained. Calves were fitted with heart rate monitors every week for at least 24 h to assess heart rate variability (HRV). The use of BAP had a positive effect on ADG after weaning and during group housing and resulted in increased resting time after weaning. Moreover, BAP, was associated with a reduction in the activation of the neuroendocrine system evidenced by higher HRV parameters after weaning, including increased standard deviation of beat to beat of normal sinus beats (SDNN) and root mean squares of successive differences (RMSSD). These results suggest a potential welfare benefit of the use of BAP during the artificial rearing of dairy calves.

Promoting mental health in higher education students: a pilot study

Abstract Introduction The mental health and well-being of higher education students is a relevant topic today, given the high prevalence of mental disorders and their increasing trend. Therefore, it is imperative to develop health education programs that aim to develop strategies to promote psychological well-being and reduce suffering in this population. Objectives To develop and implement a mental health promotion program, with interventions based on Yoga/meditation and Auriculotherapy, and evaluate its impact on the mental health of higher education students. Methodology Pretest-posttest design, with assessment before (T0), after the intervention (T1) and with a three-month follow-up (T2). Evaluation with the Portuguese version of the Mental Health Inventory (Pais-Ribeiro, 2001), and physiological assessment (heart rate, respiratory rate and blood pressure). 22 students participated in the intervention, randomly divided into two groups: Yoga/meditation group (GY) and Auriculotherapy group (GA), each with 11 students. Results The physiological parameters evaluated showed, in all sessions, a decrease in averages, regardless of the technique implemented. In the assessment at T0 and T1, it was found that there was a significant decrease in the Distress (p = 0.037) and Anxiety (p = 0.031) dimensions. In the evaluation over time (T0, T1 and T2), it was found, regardless of the technique implemented, that the intervention had a positive effect on the mental health of the students. Discussion The results point to the importance of developing mental health promotion programs in higher education.

Comprehensive stress echocardiography uncovers the heterogenity of phenotypes in non-ischemic heart failure with abnormal ejection fraction

Abstract Background Heart failure (HF) with abnormal left ventricular (LV) ejection fraction (EF) manifests in multiple phenotypes, each presenting distinct and potentially actionable therapeutic targets. This study aimed to assess the potential of the ABCDE+ stress echocardiography (SE) protocol in uncovering different phenotypes of non-ischemic HF. Methods With a retrospective analysis of prospectively acquired data, we identified 265 patients (mean age: 65.7±12.6 years; 154 males, 59.9%) with non-ischemic HF with EF&amp;lt;50% (mean =41.4±7.5) enrolled by 23 certified laboratories between 2021 and 2023. Ischemic origin was excluded based on data of angiography and medical history. ABCDE-SE was evaluated with exercise (n=98, 37.0%), dobutamine (n=50, 18.9%), or vasodilators (n=117, 44.1%). The protocol consisted of several steps: A assessed regional wall motion abnormality (RWMA); B evaluated number of B-lines; C measured left ventricular contractile reserve; Step D with coronary flow velocity reserve (CFVR) in the left anterior descending artery (LAD) was completed in 102 patients (38.5%); step E assessed heart rate reserve. Additionally, step F (evaluated in 188 patients at rest and 107 at peak stress) noted the presence of rest or stress-induced moderate-to-severe secondary mitral regurgitation. The SE response was graded on a scale from 0 (all steps normal) to 5 (all ABCDE+ steps abnormal). Results The mean ABCDE score was 1.5±1.2, ranging from 0 (n=59, 22.3%) to 5 (n=2, 0.8%) (see distribution of scores in Figure 1A). Abnormal results were observed in 21 subjects (7.9%) for A, 86 (32.5 %) for B, 147 (55.5%) for C, 42/102 (41.2%) for D, and 101 (38.1%) for E steps. Step F was abnormal in 22/188 (11.8%) at rest and in 16/107 (14.9%) at peak stress. The predominant "solitary phenotypes" (only one step abnormal) were impaired LV contractile function phenotype (step C in 47, 51.1%) followed by chronotropic insufficiency (step E in 17, 18.5%) and congestive phenotype (step B in 17, 18.5%) (see Figure 1B). The most frequent combined phenotype was BCE – congestive phenotype with impaired ventricular and heart rate reserves (28 [62.2%]). Notably, 38 patients (14.3%) demonstrated improved regional contractility, while 27 patients (10.2%) showed new regional wall motion abnormality (see Table). Conclusion Non-ischemic HF patients with abnormal EF exhibit a broad spectrum of phenotypes. Impaired left ventricular contractility, interstitial congestion, and chronotropic insufficiency are the most frequent abnormalities detected by ABCDE-SE. Up to one-quarter of such patients demonstrate normal SE results. This comprehensive approach paves the way for personalized, SE-guided therapy.

A systematic catalog of studies on fetal heart rate pattern and neonatal outcome variables.

To study the methodology and results of studies assessing the relationship between fetal heart rate and specified neonatal outcomes including, heart rate, infection, necrotizing enterocolitis, intraventricular hemorrhage, hypoxic-ischemic encephalopathy, and seizure. Embase, Medline ALL, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, and CINAHL were searched from inception to October 5, 2023. Forty-two studies were included, encompassing 57,232 cases that underwent fetal monitoring and were evaluated for neonatal outcome. Heterogeneity was observed in the timing and duration of fetal heart rate assessment, classification guidelines used, number of assessors, and definition and timing of neonatal outcome assessment. Nonreassuring fetal heart rate was linked to lower neonatal heart rate variability. A significant increase in abnormal fetal heart rate patterns were reported in neonates with hypoxic-ischemic encephalopathy, but the predictive ability was found to be limited. Conflicting results were reported regarding sepsis, seizure and intraventricular hemorrhage. No association was found between necrotizing enterocolitis rate and fetal heart rate. There is great heterogeneity in the methodology used in studies evaluating the association between fetal heart rate and aforementioned neonatal outcomes. Hypoxic-ischemic encephalopathy was associated with increased abnormal fetal heart rate patterns, although the predictive ability was low. Further research on developing and evaluating an automated early warning system that integrates computerized cardiotocography with a perinatal health parameter database to provide objective alerts for patients at-risk is recommended.

Agreement between resting heart rate measured by unattended automated office and office blood pressure measurement, ambulatory blood pressure monitoring, or electrocardiography.

The application of unattended blood pressure measurement (uAOBPM) for resting heart rate (RHR) assessment is unknown. To assess the agreement between RHR measured during uAOBPM and other methods, the authors conducted a comparability study with office blood pressure measurement (OBPM), ambulatory blood pressure monitoring (ABPM), and electrocardiogram (ECG) in a group of 110 participants referred for ABPM. RHR measured with uAOBPM (70.8±12.5 bpm) was significantly lower than OBPM (72.8±12.6 bpm) but higher than measured by 24h ABPM (67.5±10.2 bpm). There was no significant difference was found between RHR measured by uAOBPM and daytime ABPM (70.3±11.2 bpm) or ECG (69.1±11.6 bpm). Using Bland-Altman statistics, the authors discovered a small difference in agreement between RHR measured by uAOBPM and daytime ABPM (bias: 0.4 with 95% confidence interval: -0.8 to 1.6 bpm), with a poorer agreement with OBPM (bias -2 with 95% confidence interval: -2.8 to -1.3 bpm) and ECG (bias 1.6 with 95% confidence interval: 0.5 to 2.7 bpm). The authors found significant agreement between uAOBPM and ECG in identifying subjects with RHR>80 bpm OBPM, with Cohen's kappa coefficients of 0.783 and 0.671, respectively. Their findings indicate that RHR measured with uAOBPM remains in acceptable agreement with OBPM, ABPM, and ECG, the best agreement obtained with RHR from daytime ABPM.

Using heart rate variability to predict neurological outcomes in preterm infants: a scoping review.

Infants born preterm are at higher risk of neurological complications, including intraventricular haemorrhage and white matter injury. After discharge, these infants may experience adverse neurodevelopmental outcomes and exhibit lower educational attainment. Early detection of brain injury and accurate prediction of neurodevelopmental impairment would allow early intervention and support. Heart rate variability (HRV) describes the variation of time intervals between each subsequent heartbeat. HRV is controlled by the autonomic nervous system, which may be affected by hypoxia and compromised blood flow. While HRV has primarily been investigated in neonatal sepsis, the association between HRV, brain injury and neurodevelopmental outcomes in preterm infants is less established. The present scoping review examines the utility of HRV monitoring for predicting short-term and long-term neurological outcomes in preterm infants. Following systematic search of Medline, Embase, Web of Science and the Cochrane Library, 15 studies were included. Nine studies examined the relationship between HRV and brain injury, with all but two showed an association. Eight studies examined the relationship between HRV and long-term outcomes and all eight found an association. This scoping review suggests that decreased HRV in the neonatal period is associated with short- and long-term neurodevelopmental outcomes in preterm infants. IMPACT: Changes in heart rate variability correlate with the occurrence of intraventricular haemorrhage in preterm infants. A decrease in heart rate variability may precede the development of intraventricular haemorrhage. Alterations in heart rate variability correlate with long-term neurodevelopmental outcomes. Significant variability exists in metrics used in assessing heart rate variability.

Consistency of the Non-Invasive Monitoring Preemie Car Seat (PreeCASE) Device in Assessing Heart Rate, SpO2 Level, and Body Temperature of the Infants

Advancements in technology have made pulse oximeter devices the preferred choice for parents monitoring their baby's health. However, existing devices present challenges for infants, especially preemies, who need continuous monitoring after being discharged from the hospital. Using conventional baby car seats with wired connections and unstable external vital sign monitors may lead to inaccurate data readings. To resolve this issue, the non-invasive monitoring preemie car seat (PreeCASE) device is well-developed. In this study, we focus on investigating the consistency of the PreeCASE device in assessing the heart rate, SpO2 level, and body temperature of healthy infants. For the methods, ten healthy infants are selected to use the PreeCASE device, and the data is collected and analyzed using standard procedure. The PreeCASE device provides consistent data readings for the three main physiological parameters, heart rate SpO2 level, and body temperature that are displayed on an LCD screen based on the user’s respective levels. The PreeCASE device is precisely designed to facilitate easy and rapid monitoring of infants, especially preemie infants. This innovative device holds significant potential to improve and support pediatricians in effectively caring for infants in Malaysia.

Safety and efficacy of a novel dexmedetomidine nasal spray for pre-anesthetic sedation in children: a randomized, double-blind, placebo-controlled trial

BackgroundOff-label intranasal administration of injectable dexmedetomidine has been widely applied in the pediatric sedation setting. However, the development of an improved drug delivery system that is easy to use is needed. We developed a novel dexmedetomidine nasal spray that can be administered directly without dilution or configuration for pediatric pre-anesthetic sedation. This nasal spray has a fixed dose and is stable during storage. To the best of our knowledge, this is the first licensed nasal spray preparation of dexmedetomidine worldwide.ObjectiveTo evaluate the pre-anesthetic sedation efficacy and safety of the novel dexmedetomidine nasal spray in children.MethodsThe study was conducted at 11 sites in China between 24 November 2021 and 20 May 2022 and was registered in ClinicalTrials.gov (NCT05111431, first registration date: 20/10/2021). Subjects (n = 159) between 2 and 6 years old who were to undergo elective surgery were randomized to the dexmedetomidine group (n = 107) or the placebo group (n = 52) in a 2:1 ratio. The dosage was 30 µg or 50 µg based on the stratified body weight. The primary outcome measure was the proportion of subjects who achieved the desired child-parent separation and Ramsay scale ≥ 3 within 45 min of administration. Safety was monitored via the assessments of adverse events, blood pressure, heart rate, respiratory rate and blood oxygen saturation.ResultsThe proportion of subjects achieving desired parental separation and Ramsay scale ≥ 3 within 45 min was significantly higher in the dexmedetomidine group (94.4%) vs the placebo group (32.0%) (P < 0.0001). As compared with placebo, dexmedetomidine treatment led to more subjects achieving Ramsay scale ≥ 3 or UMSS ≥ 2, and shorter time to reach desired parental separation, Ramsay scale ≥ 3 and UMSS ≥ 2 (all P < 0.0001). Adverse events were reported in 90.7% and 84.0% of subjects in the dexmedetomidine and placebo groups, respectively, and all the events were mild or moderate in severity.ConclusionsThis novel dexmedetomidine nasal spray presented effective pre-anesthetic sedation in children with a tolerable safety profile.

3M: Measuring Vital Signs With Markov-Gauss Model.

Measuring vital signs (VS) contained in the echoes is crucial to the analyses of breathing and heartbeat signals using medical radar. Although many advanced signal processing algorithms have been developed for radar-based VS measurement and make some improved progress, existing schemes cannot achieve a good estimation of echo phases modulated by the respiratory and cardiac activities with high accuracy or low computation, and thus resulting in serious performance degradation on the subsequent separation of breathing and heartbeat patterns as well as the assessment of breathing rate (BR), heart rate (HR), and heart rate variability (HRV). In this paper, we propose a simple yet effective method to measure VS for medical radar, named 3M method. Specifically, our method firstly introduces the Markov-Gauss model to obtain the recursive expression of the echo phases carrying VS, and secondly derive a simple observation equation (SOE) to reflect the relationship between the observed signal and VS of radar measurement. Thirdly, the aforementioned Markov-Gauss model and SOE are fused by Kalman filter to measure VS with accurate estimation. The 3M method demonstrates an elegant structure, low complexity and excellent features introduced by Kalman filter. Simulation results show the superiority of 3M over other methods. Then, we conduct extensive experiments with insightful visualizations to validate the effectiveness of the 3M method. Comparative results on different scenarios illustrate that the 3M method not only achieves state-of-the-art VS measurement performance but also expresses robust properties to HRV analysis.

A pilot study of the proarrhythmic effects of pimobendan injection in clinically healthy cats.

Pimobendan is not currently approved for use in cats, although its usefulness in feline hypertrophic cardiomyopathy has been suggested. Reports indicate an increase in arrhythmic events following oral administration to healthy cats. Given the greater potency of intravenous administration compared to oral intake, it is conceivable that the incidence of arrhythmias may be increased following pimobendan injection. Therefore, this study aimed to investigate the proarrhythmic effects of pimobendan injection in cats. Five clinically healthy cats underwent physical examination, echocardiography, blood pressure measurements, and 24-hour Holter electrocardiography immediately before and after receiving pimobendan as an intravenous bolus dose of 0.15mg/kg twice daily for 3 days. Additionally, a 24-hour Holter electrocardiography recording was conducted on the third day of pimobendan or placebo IV administration to assess heart rate, arrhythmias, and heart rate variability. Following pimobendan administration, there was a significant increase in total 24-hour heart rate. Echocardiography revealed a significant increase in mitral valve annulus systolic velocity (S') on the ventricular septal wall side, indicative of enhanced contractility. Only one cat exhibited paroxysmal ventricular tachycardia and an increase in the frequency of arrhythmic events. Conversely, in the remaining cats, a decreasing trend in the number of arrhythmias was observed. These findings indicate that intravenous administration of pimobendan may not be implicated in the onset of arrhythmias. Nevertheless, further research is warranted to explore the effects of intravenous pimobendan administration in cats with myocardial disease.

Association between Resting Heart Rate and Homeostatic Model Assessment of Insulin Resistance in South Korean Adults

Association between Resting Heart Rate and Homeostatic Model Assessment of Insulin Resistance in South Korean Adults

Teachers' Heart Rate Variability and Behavioral Reactions in Aggressive Interactions: Teachers Can Downregulate Their Physiological Arousal, and Progesterone Favors Social Integrative Teacher Responses.

Aggressive student behavior is considered one of the main risk factors for teacher stress. The present study investigated teachers' physiological and behavioral reactions when facing aggressive student behavior and examined which resources favor adaptive teacher reactions. The sample included 42 teachers. We assessed (a) teacher self-reports (i.e., resources, risk factors, and vital exhaustion) (b) classroom observations, (c) ambulatory assessments of teachers' heart rate and heart rate variability, and (d) teachers' progesterone concentrations in the hair. The present study focused on a subsample of ten teachers (9 females, Mage = 34.70, SD = 11.32) managing classes which were potentially very stressful as they had a high density of aggressive behavior. High levels of work satisfaction, hair progesterone, and a low level of work overload fostered social integrative teacher responses. Moreover, in 75% of the cases, teachers succeeded in downregulating their physiological reaction. Our results support the notion that teachers evaluate stressors in light of their resources. When they perceive their resources as insufficient for coping with a challenging situation, stress arises, and subsequently, they react inefficiently to aggressive behavior. Thus, teacher education could benefit from strengthening teacher resources and strategies for coping with aggressive student behavior.

Usefulness of Dynamic Assessment of Clinical and Laboratory Factors in Severe Acute Pancreatitis.

Background/Objectives: Early identification of patients at risk of developing severe acute pancreatitis (SAP) is still an issue. Dynamic assessment of clinical and laboratory parameters within the first 48 h of admission may offer valuable insights into the prediction of unfavorable outcomes such as SAP and death. Methods: A prospective observational study was conducted on a cohort of patients admitted for AP at a tertiary referral hospital. Clinical and laboratory data were collected on admission and at 48 h. Patients were classified based on the Revised Atlanta classification. Logistic regression analysis was performed to identify independent risk factors for SAP. Likelihood ratios and post-test probabilities were calculated to assess the clinical usefulness of predictive markers. Results: 227 patients were included, with biliary etiology being the most common and a prevalence of SAP and death of 10.7% and 5.7%, respectively. BISAP ≥ 2 on admission, presence of SIRS after 48 h, rise in heart rate over 20 bpm, and any increase in BUN after 48 h were independent risk factors for SAP. The combination of these factors increased the post-test probability of SAP and death, with BISAP ≥ 2 combined with the presence of SIRS after 48 h showing the highest probability (82% and 73%, respectively). Conclusions: Dynamic assessment of BUN, heart rate, and SIRS within the first 48 h of admission can aid in predicting the development of SAP and death in patients with AP. These findings underscore the importance of continuous monitoring, although multicenter studies are warranted to refine predictive models for SAP.