Assessment Of Cardiac Autonomic Function Research Articles

Assessment of Cardiac Autonomic Function by Short-Term Sensor-Based and Long-Term Heart Rate Variability Analyses in Individuals with Spinal Cord Injury After Long-Term Table Tennis Training

This study aimed to examine the acute and chronic effects of an exercising table tennis program on cardiac Autonomic Nervous System (ANS) and functional capacity in people with tetraplegia. Twenty males with tetraplegia (C6–C7), with a mean age of 38.50 ± 4.04 years old, were randomly assigned into two equal groups: A, who followed a 6-month exercise training program with table tennis 3 times per week, and B, who remained untrained. Additionally, 11 healthy sedentary men (group C) with a mean age of 39.71 ± 5.87 years old participated in the study as healthy controls. At baseline, all participants underwent a short-term (5 min) and a long-term (24 h ambulatory) ECG monitoring to evaluate the heart rate variability (HRV) indices and a maximal arm ergometric and dynamometric testing of the upper limbs. Moreover, the acute cardiac autonomic responses to maximal arm cycle exercise test were evaluated by Polar S810i sensor chest strap. At the end of the 6-month study, all parameters were revaluated only in groups A and B. At baseline, there was no statistically significant difference between the two patient groups. However, intra-group changes at the end of the 6-month study regarding the 24-h HRV monitoring indicated that group A statistically increased the standard deviation of R-R intervals (SDNN) by 13.9% (p = 0.007), the standard deviation of R-R intervals calculated every 5 min (SDANN) by 8.4% (p = 0.007), the very low frequency (VLF) by 7.1% (p = 0.042), and the low frequency [LF (ms2)] by 10.5% (p = 0.009), which almost reached the levels of group C. Favorable improvements were also noticed at the end of the study for group A in maximal exercise time of the upper limbs by 80.4% (p < 0.001) and maximal strength of the right hand by 27.8% (p < 0.001). Linear regression analysis after training showed that maximal exercise time was positively correlated with SDNN (r = 0.663, p = 0.036) and with LF (ms2) (r = 0.623, p = 0.045). Our results indicate that a 6-month table tennis training program is efficient and can improve cardiac ANS activity mainly by increasing sympathovagal balance.

Predictive value of heart rate variability and electrochemical skin conductance measurements for cardiovascular autonomic neuropathy persistence in type 2 diabetes and prediabetes: A 3-year follow-up study

ObjectiveThe study aimed to explore risk stratification approaches for cardiovascular autonomic neuropathy (CAN) in individuals with prediabetes and type 2 diabetes (T2DM) over a three-year follow-up period. MethodsParticipants underwent evaluations of autonomic function encompassing cardiovascular autonomic reflex tests (CARTs), baroreflex sensitivity (BRS), heart rate variability (HRV) in time domains (standard deviation of all normal RR intervals (SDNN)) and frequency domains (high frequency/low frequency ratio), and electrochemical skin conductance (ESC). The diagnosis of CAN relied on abnormal CART results. Subjects were categorized into 4 groups, based on their assessment of cardiac autonomic function at 3-year follow-up, relative to the presence or absence of CAN at baseline assessment: Persistent absence of CAN; Resolution of CAN; Progression to CAN; and Persistent CAN. ResultsParticipants with T2DM/prediabetes (n = 91/7) were categorized as: Persistent absence of CAN (n = 25), Resolution of CAN (n = 10), Progression to CAN (n = 18), and Persistent CAN (n = 45) groups. The Persistent absence of CAN group showed significant associations with SDNN. The Resolution of CAN group exhibited notable associations with mean HbA1C (follow-up), while the Progression to CAN group displayed a significant link with baseline estimated glomerular filtration rate. The Persistent CAN group demonstrated significant associations with SDNN and Sudoscan CAN risk score. Screening recommendations involve biennial to annual assessments based on risk levels, aiding in CAN detection and subsequent comprehensive and time-intensive autonomic function tests for confirmation. The study's findings offer improved risk categorization approaches for detecting CAN, which has relevance for shaping public health strategies.

Assessment of Cardiac Autonomic Function in Women With Polycystic Ovary Syndrome Through Ewing's Battery, Heart Rate Variability Analysis, and Composite Autonomic Symptom Score-31 Scale.

Introduction Polycystic ovary syndrome (PCOS) is a frequently occurringendocrine condition prevalent in women of reproductive age characterized by chronic anovulation, hyperandrogenism, insulin resistance, and a low-grade inflammatory state. Patients with PCOS are more vulnerable to developing cardiac and metabolic co-morbidities. Sympathetic overactivity is also reported in PCOS patients. Objective This study aimed to assess cardiac autonomic function in PCOS by Heart Rate Variability Analysis, Ewing's Test, and Composite Autonomic Symptom Scale-31 (COMPASS-31). Methods Thirty female PCOS patients and 30 age-matched control females were enrolled in the study. Both cases and controls were subdivided into sub-groups based on body mass index (BMI) and waist-to-hip ratio (WHR). The cardiac autonomic functions were assessed by the COMPASS-31 questionnaire, Ewing's battery tests, and short-term heart rate variability analysis. Results There was no significant difference in age, BMI, and WHR of both groups. Additionally, cases had a significantly higher low frequency to high frequency (LF/HF) ratio and COMPASS-31 score andalsoreported more derangement in Ewing's battery test, indicating cardiac autonomic dysfunction in PCOS patients. Conclusion Patients with PCOS are more prone to developing cardiac and metabolic co-morbidities.Early assessment of cardiac autonomic function can prevent future complications with timely interventions. Altered autonomic function in PCOS patients can be due to hyperandrogenism and insulin resistance.

Assessment of Cardiac Autonomic Functions in Prehypertensive Individuals with and without a Family History of Hypertension: A Cross-sectional Study

Introduction: Individuals with prehypertension are at an increased risk of developing hypertension. Family history is one of the paramount non modifiable risk factors for developing hypertension. Hence, it becomes mandatory to assess the cardiac autonomic functions, which play an important role in the regulation of Blood Pressure (BP), in prehypertensive individuals with a family history. Aim: To compare the variations in parameters of cardiac autonomic function tests in prehypertensive individuals with and without a family history of hypertension. Materials and Methods: This cross-sectional study was conducted at the Institute of Physiology and Experimental Medicine, Madras Medical College, Chennai, Tamil Nadu, India from October 2020 to October 2021. The study included 30 prehypertensive individuals without a family history of hypertension and 30 prehypertensive individuals with a family history of hypertension, aged between 20 and 50 years, of both genders. They were recruited from the non communicable diseases Outpatient Department (OPD) at Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India. The prehypertensive range refers to a Systolic Blood Pressure (SBP) of 120-139 mmHg or a Diastolic Blood Pressure (DBP) of 80-89 mmHg. After obtaining informed consent, baseline parameters such as resting Heart Rate Variability (HRV) using AD instruments powerlab recorder, deep breathing test, Valsalva maneuver, isometric handgrip test, and Cold Pressor Test (CPT) were evaluated. The data obtained was statistically analysed using a Student’s t-test. Results: The mean age of prehypertensive individuals without a family history was 36.90±4.6 years, and in prehypertensive individuals with a family history, it was 36.43±5.3 years. The male to female ratio was higher. The resting SBP and DBP, as well as the basal heart rate, were significantly increased in the prehypertensive subjects with a family history. Time domain variables such as the mean RR, Root Mean Square of Successive Difference (RMSSD), and pRR50 were reduced in prehypertensive individuals with a family history. Among the frequency domain variables, the total power was reduced, while the low-frequency component and LF:HF ratio were significantly increased. The E/I ratio and Valsalva Ratio (VR) were also significantly reduced in prehypertensive individuals with a family history. Thus, the results emphasise that there is significant autonomic dysfunction in prehypertensive individuals with a family history of hypertension compared to prehypertensive individuals without a family history. Conclusion: Cardiac autonomic function tests in prehypertensive individuals with a family history indicate a definite sympathovagal imbalance in the form of sympathetic overactivity. This may substantiate the role of genetic predisposition in them. Chronic activation of the sympathetic nervous system makes them more prone to developing early hypertension.

A study of Heart Rate Variability (HRV) in healthy offsprings with parental history of type 2 diabetes mellitus

Introduction: Type 2 diabetes mellitus (T2DM) is a heterogeneous polygenic metabolic disease condition that is caused by insulin resistance leading to hyperglycemia. Since, T2DM is genetically inherited and autonomic dysfunction is its major complications, healthy offsprings of diabetic parents are highly vulnerable to manifest dysautonomia leading to insulin resistance.
 Objectives: We aimed to assess cardiac autonomic function using heart rate variability (HRV) parameters in healthy offsprings having parental history of T2DM.
 Methodology: A comparative cross-sectional study was carried out in the laboratory of department of Physiology enrolling 30 healthy offsprings of non-diabetic parents (Group 1) and 30 healthy offsprings of diabetic parents (Group 2). Anthropometric, biochemical and cardiovascular variables were assessed using standard procedures. Time domain and frequency domain parameters of HRV spectrum were assessed using photoplethysmography principle.
 Results: HRV findings revealed that markers of sympathetic regulation were significantly higher and those of parasympathetic function were significantly reduced in subject group having parental history of T2DM. LF/HF ratio was significantly increased suggesting sympatho-vagal imbalance in offspring of diabetic parents even in their euglycemic state.
 Conclusion: Alteration of cardiovascular autonomic function is found in healthy offspring of diabetic parents, characterized by reduced vagal activity and pronounced sympathetic regulation. Assessment of cardiac autonomic function would help in timely detection of such dysautonomia and reducing the life-threatening effects on offspring having parental history of T2DM.

Assessment of Cardiac Autonomic Functions by Heart Rate Recovery Indices in Patients Receiving Chest Radiotherapy

Assessment of Cardiac Autonomic Functions by Heart Rate Recovery Indices in Patients Receiving Chest Radiotherapy

Parasympathetic Reactivity and Oxidative Stress among Participants Suffering from the Polycystic Ovarian Syndrome

Background: Burden of PCOs is increasing throughout the world with a prevalence of 8% - 13% of females getting affected around the globe. Many studies have also reported autonomic dysfunction among participants with PCOs with poor response to the parasympathetic nervous system and increased response to the sympathetic nervous system in contrast to that in normal counterparts. This study will aim to assess the parasympathetic reactivity of the cardiac system and oxidative stress among participants suffering from PCOs in a tertiary care hospital in Pakistan. Females with PCOs will be compared to normal counterparts of similar age and weight. Methodology: A cross-sectional study was conducted in the Department of Physiology of Jinnah Hospital, Lahore Pakistan from January 2021 to December 2021. Participants were recruited by purposive sampling following meeting inclusion and exclusion criteria. PCOs participants were matched with non-affected females with similar weight and age. The participants were assessed for oxidative stress by undergoing examination of serum catalase and MDA levels. Autonomic reactivity was assessed by recording ECG on taking deep breaths, on standing and following Valsalva maneuver. Both groups were compared for outcomes and measurement. Results: The outcomes of this study showed that the group with PCOs females showed a significantly higher rate of heartbeat per minute, resting systolic and diastolic blood pressure in comparison to their normal counterparts. The serology reports showed PCOs affected group to have lower levels of catalase and increased levels of MDA in opposition to non-affected females. Furthermore, it was seen with serology and ECG measurement that E: I ratio, E-I difference, 30:15 ratio, and Valsalva ratio were all found to be positively associated with levels of plasma catalase, whereas all measurements were negatively associated with serum MDA levels in a group consisting of PCOs affected females. Conclusion: This study concludes that a variation is seen in the parasympathetic stimulation among participants suffering from PCOs and this alteration of autonomic reactivity correlates to reduced response to parasympathetic inputs leading to a deficiency. The results of the study did not signify ay neuropathy which could be suggested by measurement of assessment of cardiac autonomic function. However, it cannot be overlooked that these measurements were different from that of normal counterparts. Lower catalase levels and increased levels of MDA among the PCOs group signify oxidative stress. Keywords: Parasympathetic reactivity, Oxidative stress, Polycystic ovarian syndrome

Exercise based assessment of cardiac autonomic function in type 1 versus type 2 diabetes mellitus.

BackgroundCardiac autonomic neuropathy (CAN) is a complication of diabetes mellitus (DM) that is associated with increased mortality. Exercise-based assessment of autonomic function has identified diminished parasympathetic reactivation after exercise in type 2 DM. It is postulated herein, that this would be more prominent among those with type 1 DM.MethodsSixteen subjects with type 1 DM (age 32.9 ± 10.1 years), 18 subjects with type 2 DM (55.4 ± 8.0 years) and 30 controls (44.0 ± 11.6 years) underwent exercise-based assessment of autonomic function. Two 16-min submaximal bicycle tests were performed followed by 45 min of recovery. On the second test, atropine (0.04 mg/kg) was administered near end-exercise so that all of the recovery occurred under parasympathetic blockade. Plasma epinephrine and norepinephrine levels were measured at rest, during exercise, and during recovery.ResultsThere were no differences in resting or end-exercise heart rates in the three groups. Parasympathetic effect on RR-intervals during recovery (p < 0.03) and heart rate recovery (p = 0.02) were blunted in type 2 DM. Type 1 DM had higher baseline epinephrine and norepinephrine levels (p < 0.03), and exhibited persistent sympathoexcitation during recovery.ConclusionsDespite a longer duration of DM in the study patients with type 1 versus type 2 DM, diminished parasympathetic reactivation was not noted in type 1 DM. Instead, elevation in resting plasma catecholamines was noted compared to type 2 DM and controls. The variable pathophysiology for exercise-induced autonomic abnormalities in type 1 versus type 2 DM may impact prognosis.

Assessment of Cardiac Autonomic Functions by Heart Rate Recovery Indices in Patients Receiving Chest Radiotherapy

Assessment of Cardiac Autonomic Functions by Heart Rate Recovery Indices in Patients Receiving Chest Radiotherapy

Telemedical cardiac risk assessment by implantable cardiac monitors in patients after myocardial infarction with autonomic dysfunction (SMART-MI-DZHK9): a prospective investigator-initiated, randomised, multicentre, open-label, diagnostic trial

Cardiac autonomic dysfunction after myocardial infarction identifies patients at high risk despite only moderately reduced left ventricular ejection fraction. We aimed to show that telemedical monitoring with implantable cardiac monitors in these patients can improve early detection of subclinical but prognostically relevant arrhythmic events. We did a prospective investigator-initiated, randomised, multicentre, open-label, diagnostic trial at 33 centres in Germany and Austria. Survivors of acute myocardial infarction with left ventricular ejection fraction of 36-50% had biosignal analysis for assessment of cardiac autonomic function. Patients with abnormal periodic repolarisation dynamics (≥5·75 deg2) or abnormal deceleration capacity (≤2·5 ms) were randomly assigned (1:1) to telemedical monitoring with implantable cardiac monitors or conventional follow-up. Primary endpoint was time to detection of serious arrhythmic events defined by atrial fibrillation 6 min or longer, atrioventricular block class IIb or higher and fast non-sustained (>187 beats per min; ≥40 beats) or sustained ventricular tachycardia or fibrillation. This study is registered with ClinicalTrials.gov, NCT02594488. Between May 12, 2016, and July 20, 2020, 1305 individuals were screened and 400 patients at high risk were randomly assigned (median age 64 years [IQR 57-73]); left ventricular ejection fraction 45% [40-48]) to telemedical monitoring with implantable cardiac monitors (implantable cardiac monitor group; n=201) or conventional follow-up (control group; n=199). During median follow-up of 21 months, serious arrhythmic events were detected in 60 (30%) patients of the implantable cardiac monitor group and 12 (6%) patients of the control group (hazard ratio 6·33 [IQR 3·40-11·78]; p<0·001). An improved detection rate by implantable cardiac monitors was observed for all types of serious arrhythmic events: atrial fibrillation 6 min or longer (47 [23%] patients vs 11 [6%] patients; p<0·001), atrioventricular block class IIb or higher (14 [7%] vs 0; p<0·001) and ventricular tachycardia or ventricular fibrillation (nine [4%] patients vs two [1%] patients; p=0·054). In patients at high risk after myocardial infarction and cardiac autonomic dysfunction but only moderately reduced left ventricular ejection fraction, telemedical monitoring with implantable cardiac monitors was highly effective in early detection of subclinical, prognostically relevant serious arrhythmic events. German Centre for Cardiovascular Research (DZHK) and Medtronic Bakken Research Center.

Assessment of cardiac autonomic function in patients with permanent and paroxysmal atrial fibrillation

Abstract Background Atrial fibrillation (AF) is the commonest abnormal heart rhythm with significant related morbidity and mortality. There is increasing evidence that abnormalities of the cardiac autonomic nervous system (ANS) are involved in the pathogenesis of AF. Exploring the ANS is possible through heart rate variability (HRV) evaluation. Purpose To investigate whether HRV is more abnormal in patients with permanent AF compared to paroxysmal AF. Design In a cross-sectional comparison, we studied two patient groups: permanent AF (n=30) and paroxysmal AF (n=31). Time-domain, frequency-domain and non-linear measures of HRV were determined using eMotion Faros ECG sensor. Participant's breathing was controlled with a metronome set at 12 breaths per minute. Data was analysed using SPSS software. Results Time-domain and non-linear indices of HRV were significant higher in permanent AF group compared to paroxysmal AF (table 1). Permanent AF was the only independent predictor of HRV on multivariable analysis in this cohort of patients (p=0.006) Conclusions First study investigating autonomic function in patients with permanent AF and paroxysmal AF. HRV indices were significantly higher in permanent AF compared to paroxysmal AF which may suggest pronounced cardiac autonomic influence in the pathophysiology of permanent AF. Funding Acknowledgement Type of funding sources: None.

Resting heart rate variability in regular yoga practitioners - A cross-sectional study

Heart rate variability (HRV) is a useful and powerful non-invasive tool for quantitative assessment of cardiac autonomic function. Recent studies have shown that low heart rate variability is an indication of increased risk for cardiac diseases and sudden cardiac death. Yoga has been associated with improved cardio-respiratory performance. Thirty male regular yoga practitioners doing yoga for more than 3 years, age between 25-45 years (yoga group) and 30 male non-yoga practitioners, age-matched (control group) were included. A computerized Niviqure ECG system with HRV software was used for heart rate variability recording. Our results show that frequency-domain parameters like LF power, LF n.u, and LF/HF ratio were significantly lower in yoga group compared to control group. Time-domain parameters like mean RR, NN50, pNN50 were significantly higher in yoga group compared to control group. We conclude that the yoga increases heart rate variability by optimizing the autonomic functions, which is a good indicator of cardiac autonomic activity during rest.

A Study of Assessment of Cardiac Autonomic Functions after Yogasana and Pranayama

A Study of Assessment of Cardiac Autonomic Functions after Yogasana and Pranayama

Music therapy on non linear assessment of cardiac autonomic function in patients with major depressive disorder

Background :Non linear measure of heart rate variability (HRV) is an emerging method to detect changes in cardiac autonomic nerve function in major depressive disorder (MDD).&#x0D; Objective: To observe the effect of music therapy on non linear measures of HRV in newly diagnosed MDD patients.&#x0D; Methods: This prospective interventional study was done in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka in 2018 on 60 newly diagnosed MDD patients aged 20-40 years, both male and female. They were further subdivided into 30 patients with only antidepressant medication (Mirtazapine) and 30 patients received music therapy with Raga kafi (Rabindrasangeet) along with the same medication for 3 months. Age, sex and BMI matched healthy control were also enrolled. HRV non linear parameters were recorded by Power Lab 8/35. For statistical analysis paired sample ‘t’ test and independent sample ‘t’ test were done.&#x0D; Result: SD1, SD2 and SD1/SD2 were found significantly lower in MDD patients compared to healthy control at baseline. After 3 months of music therapy, significant increment of these parameters occurred with trend of improvement in cardiac autonomic nerve function (CANF) in these patients.&#x0D; Conclusion: This study concluded that music therapy can improve CANF by increasing parasympathetic and reducing sympathetic activity in MDD patients.&#x0D; J Bangladesh Soc Physiol. 2019, June; 14(1): 7-13

Assessment of Cardiac Autonomic Function in Relation to Methylmercury Neurotoxicity.

After the European Food Safety Authority reviewed reports of methylmercury and heart rate variability (HRV) in 2012, the panel concluded that, although some studies of cardiac autonomy suggested an autonomic effect of methylmercury, the results were inconsistent among studies and the implications for health were unclear. In this study, we reconsider this association by adding a perspective on the physiological context. Cardiovascular rhythmicity is usually studied within different frequency domains of HRV. Three spectral components are usually detected; in humans these are centered at <0.04 Hz, 0.15 Hz (LF), and 0.3 Hz (HF). LF and HF (sympathetic and parasympathetic activities, respectively) are evaluated in terms of frequency and power. By searching PubMed, we identified 13 studies examining the effect of methylmercury exposure on HRV in human populations in the Faroe Islands, the Seychelles and other countries. Considering both reduced HRV and sympathodominant state (i.e., lower HF, higher LF, or higher LF/HF ratio) as autonomic abnormality, eight of them showed the significant association with methylmercury exposure. Five studies failed to demonstrate any significant association. In conclusion, these data suggest that increased methylmercury exposure was consistently associated with autonomic abnormality, though the influence of methylmercury on HRV (e.g., LF) might differ for prenatal and postnatal exposures. The results with HRV should be included in the risk characterization of methylmercury. The HRV parameters calculated by frequency domain analysis appear to be more sensitive to methylmercury exposure than those by time domain analysis.

Assessment of cardiac autonomic functions by heart rate variability in patients with restless leg syndrome

Assessment of cardiac autonomic functions by heart rate variability in patients with restless leg syndrome

Assessment of cardiac autonomic functions by heart rate variability in patients with restless leg syndrome.

The aim of the present study was to investigate cardiac autonomic effects in restless leg syndrome (RLS) using heart rate variability (HRV). A total of 35 patients with RLS and 35 healthy individuals were enrolled in the study. The severity of RLS symptoms was assessed using the International Restless Legs Syndrome Study Group rating scale (IRLS). The correlation between the severity of RLS symptoms and HRV parameters measured on an electrocardiogram was analyzed. There were no statistically significant differences between the 2 groups with respect to age, gender, or body mass index. The mean heart rate was 85±7.1 bpm in the RLS group compared with 79.6±5.5 bpm in the control group (p=0.001). The standard deviation (SD) of all normal to normal (NN) intervals (SDNN), the mean of the deviation of 5-minute NN intervals over the entire recording (SDNN index), and the SD of the average NN intervals calculated over a 5-minute period of the entire recording (SDANN) were significantly lower in the RLS group compared with the control group (p<0.05 for all). There were no statistically significant differences between the 2 groups in the square root of the mean squared differences of successive NN intervals (RMSSD) and the proportion of adjacent RR intervals differing by >50 milliseconds in the 24-hour recording (pNN50) values (p=0.119 and p=0.07, respectively). In patients with RLS, the low frequency (LF) power and LF/high frequency (HF) ratio were significantly higher than those in the control group (2248.6±245.6 vs 712.1±346.3, 10.7±3.7 vs 2.9±1.8; p<0.0001 and p<0.0001, respectively). Compared with the control group, the RLS group had lower values for HF power, but the difference was not statistically significant (p=0.07). The severity of RLS symptoms was negatively correlated with the SDNN, SDANN index, and pNN50 (r=-0.453 and p=0.009, r=-0.340 and p=0.046, r=-0.446 and p=0.007, respectively), and positively correlated with LF power (r=0.681 and p<0.0001). The study data demonstrated that cardiac autonomic impairment is associated with RLS.

Assessment of Cardiac Autonomic Function by Post Exercise Heart Rate Recovery in Diabetics

Abstract Background and Aims: Autonomic dysfunction in type 2 diabetes mellitus (DM) patients may translate into an increased cardiovascular morbidity and mortality. Autonomic system regulates ‘heart rate recovery’ (HRR), an important predictor of cardiovascular mortality, which can be assessed using the exercise electrocardiogram (ECG). Hence, utilizing HRR, this study assessed the autonomic function of the cardiovascular system after one minute of exercise stress test in both, patients with and without type 2 DM. Materials and Methods: A prospective case control study involving 50 patients with type 2 DM and 50 without type 2 DM, matched for age and sex, was carried out. Each subject underwent an exercise stress test by treadmill using the Bruce protocol. Cardiovascular parameters like heart rate was recorded using a 12 lead ECG along with blood pressure. Results: Patients with T2DM had lesser HRR after exercise (p &lt; 0.001). Exercise capacity was significantly reduced among patients with T2DM when compared to controls (p = 0.01). A multiple linear regression analysis (R2=0.26) revealed that duration of diabetes (β=−0.02, p=0.048) and resting systolic blood pressure (SBP) (β=−010, p=0.048) are independent predictors of HRR. Conclusion: The study revealed HRR to be significantly reduced among patients with type 2 DM. HRR may hint at the presence of cardiac autonomic dysfunction and predict the cardiovascular mortality.

OP-090 Assessment of Cardiac Autonomic Functions by Heart Rate Recovery Indices in Patients with Myocardial Bridge

OP-090 Assessment of Cardiac Autonomic Functions by Heart Rate Recovery Indices in Patients with Myocardial Bridge

Assessment of Cardiac Autonomic Functions in Medical Students With Type D Personality.

Type D personality experiences joint occurrence of Negative Affectivity and Social Inhibition. It is an emerging risk factor for cardiovascular disease, with prevalence being 18-53% among cardiac patients. Type D personality people have exaggerated cardiovascular activity mediated by increased sympathetic drive and decreased vagal control of the heart which leads to enhanced risk of hypertension and is an independent risk factor for coronary heart disease. To compare the cardiac autonomic function of Type D and non-Type D students. To compare cardiac autonomic functions among male and female students and students with and without family history of hypertension and coronary artery disease among Type D. To find the most affected test among Type D students. Thirty Type D and 30 non- Type D medical students were identified by DS14. The Parasympathetic cardiac autonomic tests done assessed Heart Rate response to valsalva manoeuvre, immediate heart rate response to standing and heart rate variation during deep breathing. Sympathetic tests assessed BP response to standing and Sustained Hand Grip. The heart rate and R-R interval measurement were got from lead II of ECG recordings on Polyrite D. Statistical analysis was done using SPSS software. Unpaired student's t-test was used and p-value <0.05 was considered to be statistically significant. Type D students showed slightly decreased parasympathetic activity and increased sympathetic activity when compared to non-Type D students even though there was no statistically significant difference between them. There is a statistically significant decrease in valsalva ratio among females (p<0.01) when compared to males. There is a statistically significant decrease in 30:15 ratio and BP response to handgrip (p<0.05) among students with family history of hypertension and coronary artery disease when compared with students with no family history of coronary artery disease. Valsalva ratio is the most affected test in Type D students. Cardiac autonomic functions of Type D personality persons without cardiovascular disease is not different from that of non-Type D. Regular follow up studies over years are required to find if Type D personality is associated with cardiovascular risk in healthy individuals.