Associations Of Heart Rate Variability Research Articles

Heart rate variability is associated with global cognition and cognitive impairment: Results from the einstein aging study

AbstractBackgroundThe role of autonomic function in cognitive impairment is unclear. Heart rate variability (HRV) provides a feasible, non‐invasive measure of cardiac autonomic control. We examined whether HRV is associated with global cognition and cognitive impairment using 7‐day ambulatory ECG assessments in the Einstein Aging Study.MethodAnalyses included 84 participants free of dementia (mean age 78.1 (± 5.2) years; 82% female; 39% non‐Hispanic White, 44% non‐Hispanic Black, mean education 14.7 (± 3.3 years)). Participants wore a small, single lead ECG device continuously over 7 days. Power spectral analyses were applied to determine HRV over 5‐minute epochs in the high (0.15‐0.40 Hz, hfHRV) and low (0.04‐0.15 Hz, lfHRV) frequency bands, and values were log transformed. Demographics, comorbidities, and cognition were assessed during clinic visits. Two tests per domain evaluated memory, executive function, language, visuo‐spatial and attention with impairment defined as performance ≥ 1.5 SD below the age, sex, education standardized norm on at least one test. Global cognition was assessed using the MoCA, and Mild Cognitive Impairment (MCI) was defined using Jak‐Bondi criteria. Associations of HRV with cognition were examined using logistic (MCI, domain specific impairment) and linear (MoCA) regression adjusting for age, sex, race/ethnicity and education, diabetes, and hypertension.ResultMean MoCA score was 24 (SD 3.5), 21 (25%) had MCI and impairment was identified in 25% (memory), 28.6% (executive function), 21.4% (attention), 17.9% (language) and 27.4% (visuospatial). Both hfHRV and lfHRV were inversely associated with MCI (OR per 1 SD increase in log HRV: 0.47, p = 0.02 for hfHRV and 0.42, p = 0.01 for lfHRV) and with memory impairment (OR per 1 SD increase in log HRV: 0.52, p = 0.03 for hfHRV and 0.43, p = 0.01 for lfHRV). Higher hfHRV and lfHRV were each associated with better MoCA score (β for 1 SD increase in log HRV: 0.65, p = 0.046 for hfHRV; 0.80, p = 0.02).ConclusionWhether HRV is associated with cognitive impairment remains unclear, particularly the role of hfHRV, indicative of parasympathetic control. Findings suggest that hfHRV is related to cognitive performance and impairment. Results for lfHRV also suggest joint effects of the sympathetic and parasympathetic systems.

Neuroimaging Studies of the Neural Correlates of Heart Rate Variability: A Systematic Review.

Direct and indirect links between brain regions and cardiac function have been reported. We performed a systematic literature review to summarize current knowledge regarding the associations of heart rate variability (HRV) and brain region morphology, activity and connectivity involved in autonomic control at rest in healthy subjects. Both positive and negative correlations of cortical thickness and gray matter volumes of brain structures with HRV were observed. The strongest were found for a cluster located within the cingulate cortex. A decline in HRV, as well as cortical thickness with increasing age, especially in the orbitofrontal cortex were noted. When associations of region-specific brain activity with HRV were examined, HRV correlated most strongly with activity in the insula, cingulate cortex, frontal and prefrontal cortices, hippocampus, thalamus, striatum and amygdala. Furthermore, significant correlations, largely positive, between HRV and brain region connectivity (in the amygdala, cingulate cortex and prefrontal cortex) were observed. Notably, right-sided neural structures may be preferentially involved in heart rate and HRV control. However, the evidence for left hemispheric control of cardiac vagal function has also been reported. Our findings provide support for the premise that the brain and the heart are interconnected by both structural and functional networks and indicate complex multi-level interactions. Further studies of brain-heart associations promise to yield insights into their relationship to health and disease.

Association of heart rate variability with progression of retinopathy among adults with type 2 diabetes.

AimWe evaluated the associations of heart rate variability (HRV) with incident vision‐threatening retinopathy and retinopathy progression among adults with type 2 diabetes.MethodsParticipants recruited to the ACCORD (Action to Control Cardiovascular Risk in Diabetes) study with HRV measures at baseline were analysed. HRV measures included standard deviation of all normal‐to‐normal intervals (SDNN) and root mean square of successive differences between normal‐to‐normal intervals (rMSSD). Low SDNN was defined as SDNN <8.2 ms; low rMSSD as rMSSD <8.0 ms. We used multivariable adjusted Cox proportional hazards and modified Poisson regression models to generate risk estimates for incident vision‐threatening retinopathy and retinopathy progression, respectively.ResultsA total of 5810 participants without incident vision‐threatening retinopathy at baseline (mean age 62 years, 40.5% women, 63.5% White) were included. Over a median of 4.7 years, 280 incident vision‐threatening retinopathy cases requiring treatment occurred. Low HRV (vs. normal HRV) was associated with higher risk of incident vision‐threatening retinopathy (adjusted hazard ratio 1.32 [95%CI 1.03–1.71] and 1.14 [95%CI 1.01–1.28] for low SDNN and rMSSD, respectively). In the subset of 2184 participants with complete eye examinations at baseline and 4 years, 191 experienced retinopathy progression, and low HRV (vs. normal HRV) was associated with a higher risk of retinopathy progression (adjusted relative risks 1.36 [95%CI 1.01–1.83] and 1.36 [95%CI 1.01–1.84] for low SDNN and rMSSD, respectively).ConclusionsCardiac autonomic neuropathy, as assessed by low HRV, was independently associated with increased risks of incident vision‐threatening retinopathy and overall retinopathy progression in a large cohort of adults with type 2 diabetes.

Compassion Is Not a Benzo: Distinctive Associations of Heart Rate Variability With Its Empathic and Action Components.

Recent studies have linked compassion with higher vagally mediated heart rate variability (vmHRV), a measure of parasympathetic activity, and meta-analytic evidence confirmed significant and positive associations. Compassion, however, is not to be confused with soothing positive emotions: in order to engage in actions aimed to alleviate (self or others) suffering, the pain should resonate, and empathic sensitivity should be experienced first. The present study examined the association between vmHRV and the empathic sensitivity and action components of trait and state compassion. To do so, several dispositional questionnaires were administered and two videos inducing empathic sensitivity (video 1) and compassionate actions (video 2) were shown, while the ECG was continuously recorded, and momentary affect was assessed. Results showed that (i) scores on subscales assessing the empathic component of trait compassion were inversely related to resting vmHRV; (ii) vmHRV decreased after video 1 but significantly increased after video 2. As to momentary affect, video 1 was accompanied with an increase in sadness and a decrease in positive affect, whereas video 2 was characterized by an increase in anger, a parallel decrease in sadness, and an increase (although non-significant) in positive affect. Overall, present findings support the notion that it is simplistic to link compassion with higher vmHRV. Compassion encompasses increased sensitivity to emotional pain, which is naturally associated with lower vmHRV, and action to alleviate others’ suffering, which is ultimately associated with increased vmHRV. The importance of adopting a nuanced perspective on the complex physiological regulation that underlies compassionate responding to suffering is discussed.

Associations of biological stress markers in hurricane survivors: Heartrate variability, Interleukin-2 and Interleukin-6 in depression and PTSD

Inflammatory and immunologic cytokines and vagal activity have important roles in health and mental health, and may influence each other. The authors assessed relationships of representative biomarkers linked to disaster exposure-heart rate variability (HRV) with Interleukin-2 (IL-2, cell-medicated immunity) and Interleukin-6 (IL-6, pro-inflammatory and pro-immunologic), stratified by psychiatric diagnosis. Participants were assessed for psychiatric diagnosis, IL-2, IL-6, HRV, and HR reactivity to trauma reminders. Outpatient university psychiatry clinics in Oklahoma City and Tulsa. Relocated Katrina survivors and demographically matched controls, not on psychiatric, cardiovascular, or inflammatory medications. SCID-IV, baseline serum IL-2 and IL-6, HRV through power spectral analysis. Survivors had higher sympathetic and lower parasympathetic activity at baseline and lower parasympathetic HR reactivity than controls, with flattened parasympathetic reactivity in the presence of depression and of post-traumatic stress disorder (PTSD). Survivors' IL-2 and IL-6 did not differ from controls and did not differ in PTSD or depression. Depressed survivors' sympathetic reactivity correlated negatively with IL-2 and parasympathetic reactivity correlated positively with IL-2. HRV differed after hurricane exposure and with survivors& depression and/or PTSD, more sensitively capturing somatic sequelae than assessed cytokines. Higher sympathetic HR reactivity associated with lower immuno-logic IL-2 may indicate a double biological "hit" in depressed disaster survivors, possibly rendering them more vulnerable to cardiovascular and immunologic illness as well as depression. Associations of HRV with IL-2 may support reciprocal influences of cytokines and vagal activity. Lack of significant correlations of IL-6 with HRV measures is consistent with its pleiotropic role.

Associations Of Heart Rate Variability Measured During Orthostatic Test And During Daily Routine Activities

Associations Of Heart Rate Variability Measured During Orthostatic Test And During Daily Routine Activities

Female Sexual Function and Heart Rate Variability

Few studies have examined the associations of resting heart rate variability (HRV) with female sexual function and behavior. Therefore, we welcome the recent study finding that women with below average resting HRV (as assessed by the standard deviation of NN intervals; SDNN) had lower sexual arousal and lower global sexual function than women with average or above average SDNN (while viewing a neutral film) (Stanton et al. 2015). The SDNN reflects relatively lower sympathetic activity and/or relatively higher parasympathetic activity. Those authors noted the lack of studies on female sexuality and HRV, but missed citing an important study which explored the associations of HRV with women’s frequency of orgasm produced by several different sexual behaviors (Costa and Brody 2012). In that study, it was found that women who had any orgasm triggered by penile-vaginal intercourse (PVI) without simultaneous clitoral masturbation (henceforth, vaginal orgasm) in the past month had higher resting HRV (as assessed by the standard deviation of heart rate, a relatively similar index of HRV) than women who did not have a vaginal orgasm in the past month (Costa and Brody 2012). Of note, orgasm produced by other sexual behaviors including PVI with concurrent clitoral masturbation for the orgasm, clitorally-focused partnered masturbation, oral sex, solitary masturbation, and anal sex were unrelated to resting HRV. Orgasm from vaginally-focused masturbation by the woman’s partner was nearly significantly associated with higher HRV, but this marginal association disappeared in multivariate analyses controlling for the other orgasm trigger frequencies, resulting in only vaginal orgasm being associated with women’s greater resting HRV. These findings were discussed in terms of lower HRV being a reflection of pathophysiological processes that can impair female orgasmic responsiveness specifically during PVI (Costa and Brody 2012). This raises the possibility that vaginal responsiveness is more easily adversely affected by psychological and physiological dysfunctional processes than responding to direct clitoral masturbation. The vagus nerve (the main driver of the parasympathetic nervous system influences on HRV) transmits afferent sensory information from the proximal vagina and cervix to the brain, but is not stimulated by the clitoris (Komisaruk and Whipple 1998; Komisaruk et al. 2004). Given that appropriate afferent vagal stimulation might increase (or ‘‘tune’’) efferent vagal activity on a relatively long-term basis (Gellhorn 1967), it is plausible that PVI may enhance HRV with concomitant health benefits (Costa and Brody 2012). These findings are congruent with another study finding that greater resting HRV (standard deviation of heart rate) was associated with greater PVI frequency in a sample of both sexes, and the sex of the research participant was not a significant confounding variable (Brody and Preut 2003). Unlike in the study by Stanton and colleagues, in these two studies, resting HRV was measured without an inserted vaginal probe (Brody and Preut 2003; Costa and Brody 2012), which Stanton and colleagues listed as a potential confounder in their own study. In a large nationally representative Czech sample, female sexual arousal disorder was related to lack of history of vaginal orgasm and difficulties in focusing on & Rui M. Costa rmscosta@gmail.com

Heart rate variability, but not heart rate, is associated with handgrip strength and mortality in older Africans at very low cardiovascular risk: A population-based study

A high heart rate and a low heart rate variability at rest are established predictors of various forms of functional impairment, morbidity, and mortality [1–6]. Two explanations can be given for these associations. On one hand, a high heart rate and a low heart rate variability are thought to reflect dysfunction of the flexible autonomic regulation of the heart rate in particular and of the body's functioning in general that arises during ageing [3–5]. On the other hand, a high heart rate and a low heart rate variability are brought about by cardiovascular risk factors, such as obesity, hyperlipidaemia, diabetes, hypertension, and physical inactivity [2,3,7–9]. Since research on heart rate and heart rate variability has almost exclusively been conducted in western populations with an affluent sedentary lifestyle and high prevalences of these risk factors, it has been difficult to determine whether or not heart rate and heart rate variability are associated with functional impairment, morbidity, and mortality independently of cardiovascular risk factors.

ASSOCIATION BETWEEN HEART RATE VARIABILITY AND COMPONENTS OF THE METABOLIC SYNDROME IN WOMEN WITH RHEUMATOID ARTHRITIS

Aim. To study the relationship between heart rate variability (HRV) and components of the metabolic syndrome (MS) in women with rheumatoid arthritis (RA). Material and methods. Female patients (n=291) with a firm RA diagnosis under 60 years of age were examined. Evaluation of traditional cardiovascular risk factors, MS components (International Diabetes Federation criteria), 24-hour ECG monitoring were performed along with the assessment of clinical symptoms, the degree of activity and severity of RA. Results. Weak associations of HRV with waist circumference, blood pressure level, hypertriglyceridemia, hypoalphalipoproteinemia and smoking were found in the correlation analysis. Patients with RA were divided into three groups depending on the number of existing MS components. Group 1 (0-1 component) included 113 women (39%), group 2 (2-3 components) – 109 women (37%) and group 3 (4-5 components) – included 69 women with RA (24%). Progressive decrease in the absolute values and the increase in the percentage of the low values of all the studied time and frequency HRV indices, adjusted by age and heart rate, from the 1st to the 3rd group of women with RA were determined. Significant increase in sympathovagal index from the 1st to the 3rd group was also shown. Conclusion. A combination of several components of the MS in RA plays a greater role in the development of disorders of neurovegetative autonomic control of heart activity (increased influence of the sympathetic and/or reduced influence of the parasympathetic nervous system on cardiac function) than each traditional cardiovascular risk factor taken separately. Abnormality in autonomic regulation of cardiac activity may be an important link in the pathogenesis of cardiac arrhythmias, sudden cardiac death and overall cardiovascular mortality in women with RA.

Heart rate variability measures poorly predict atrial fibrillation after off-pump coronary artery bypass grafting

Study Objective To investigate associations of heart rate variability (HRV) measurements with postoperative atrial fibrillation (AF) in patients undergoing off-pump coronary surgery. Design Prospective, observational, exploratory study. Setting Large university-affiliated community medical center. Patients 50 patients undergoing off-pump coronary artery bypass grafting (CABG). Interventions Preoperative recording of electrocardiograms (ECGs) with subsequent off-line HRV analysis. Monitored ECG telemetry for 5 days after operation. Measurements Frequency and time domain analyses, and additional non-linear HRV determinations. Multivariate regression analysis of predictors of postoperative AF. Main Results AF occurred in 23 (46%) patients. Only the low to high-frequency ratio was associated with AF (2.35 ± 1.8 v. 4.57 ± 5.0 for patients without AF, P < 0.05). Conclusions The off-pump approach does not protect against AF, and nonlinear HRV analyses provide little value in predicting AF after off-pump CABG.

Non-photic solar associations of heart rate variability and myocardial infarction

Alignment of serial epidemiological, physiological, including electrocardiographic data with variations in galactic cosmic rays, geomagnetic activity, and atmospheric pressure suggests the possibility of links among these physical environmental variations and health risks, such as myocardial infarctions and ischemic strokes, among others. An increase in the incidence of myocardial infarction in association with magnetic storms, reported by several investigators from Russia, Israel, Italy and Mexico, accounts in Minnesota for a 5% ( 220 cases/ year ) increase in mortality during years of maximal solar activity by comparison with years of minimal solar activity. Magnetic storms are also found to decrease heart rate variability (HRV), indicating a possible mechanism since a reduced HRV is a prognostic factor for coronary artery disease and myocardial infarction. Longitudinal electrocardiographic monitoring for a week or much longer spans in different geographic locations, notably in the auroral oval, further suggests that the decrease in HRV affects spectral regions other than that around 3.6 s (0.15– 0.40 Hz ), reportedly associated with the parasympathetic nervous system. Differences in some associations are observed from solar cycle to solar cycle, and as a function of solar cycle stage, a finding resolving controversies. Coordinated physiological and physical monitoring, the scope of an international project on the Biosphere and the Cosmos, seeks reference values for a better understanding of environmental effects on human health and for testing the merit of space weather reports that could prompt countermeasures in space and on earth. Physiological data being collected systematically worldwide and morbidity/mortality statistics from causes such as myocardial infarction and stroke constitute invaluable data bases for assessing changes within the physiological range, for detecting environmental effects and for recognizing endogenous as well as exogenous disease-risk syndromes. Timely and timed intervention may then be instituted to lower risk, in preference to exclusive current focus on treating overt disease. These chronodiagnostics are particularly important for those venturing into regions away from hospitals, such as astronauts in space.

Heart rate variability associated with particulate air pollution

Background: Epidemiologic studies have linked fine particulate air pollution with cardiopulmonary mortality, yet underlying biologic mechanisms remain unknown. Changes in heart rate variability (HRV) may reflect changes in cardiac autonomic function and risk of sudden cardiac death. This study evaluated changes in mean heart rate and HRV in human beings associated with changes in exposure to particulate air pollution. Methods: Repeated ambulatory electrocardiographic monitoring was conducted on 7 subjects for a total of 29 person-days before, during, and after episodes of elevated pollution. Mean HR, the standard deviation of normal-to-normal (NN) intervals (SDNN), the standard deviation of the averages of NN intervals in all 5-minute segments of the recording (SDANN), and the square root of the mean of squared differences between adjacent NN intervals (r-MSSD) were calculated for 24-hour and 6-hour time segments. Associations of HRV with particulate pollution levels were evaluated with fixed-effects regression models. Results: After controlling for differences across patients, elevated particulate levels were associated with (1) increased mean HR, (2) decreased SDNN, a measure of overall HRV, (3) decreased SDANN, a measure that corresponds to ultralow frequency variability, and (4) increased r-MSSD, a measure that corresponds to high-frequency variability. The associations between HRV and particulates were small but persisted even after controlling for mean HR. Conclusions: This study suggests that changes in cardiac autonomic function reflected by changes in mean HR and HRV may be part of the pathophysiologic mechanisms or pathways linking cardiovascular mortality and particulate air pollution. (Am Heart J 1999;138:890-9.)