Decreased Heart Rate Variability Research Articles

Prefrontal activity and heart rate variability during cognitive tasks may show different changes in young and older adults with and without mild cognitive impairment

BackgroundAge-related decline in cognitive function is often linked to changed prefrontal cortex (PFC) activity and heart rate variability (HRV). Mild cognitive impairment (MCI), a transitional stage between normal aging and dementia, might have further degeneration beyond aging. This study aimed to investigate the differences between young and older adults with or without MCI in cognitive functions, task-induced PFC activation and HRV changes.MethodsThirty-one healthy young adults (YA), 44 older adults (OA), and 28 older adults with MCI (OA-MCI) were enrolled and compared in this cross-sectional study. Each participant received a one-time assessment including cognitive and executive functions, as well as the simultaneous recording of PFC activity and HRV during a cognitive task paradigm.ResultsWe observed age-related decrease in global cognitive functions, executive functions, HRV, and increase in PFC activity. The MCI further deteriorated the global cognitive and executive performances, but not the HRV or the prefrontal activation.ConclusionOlder people showed lower performances in general cognitive function and executive function, compensatory increase of PFC activity, and reduced HRV. Older people with MCI had further deterioration in cognitive performance, but not in PFC activation and HRV.

Cardiovascular Dysautonomy as a Sequel of SARS COV 2. Case Series

The impact of COVID-19, caused by the SARS-CoV-2 virus, a pandemic that originated in Wuhan, China, can lead to serious complications, in addition to mild symptoms, with special interest in the autonomic nervous system (ANS). Damage to the ANS by SARS-CoV-2 can cause dysautonomia, an imbalance between the sympathetic and parasympathetic system, with unclear mechanisms such as cytokine storm, excessive inflammation, and virus neurotropism. A significant sequelae of COVID-19 is cardiac dysautonomia, which affects heart rate, blood pressure and other autonomic reflexes, causing postural tachycardia, orthostatic hypotension, arrhythmias and fatigue. There is decreased heart rate variability (HRV) in patients, suggesting dysautonomia. Long COVID syndrome can also include cardiac dysautonomia. To diagnose cardiac autonomic neuropathy, at least two of six criteria must be met, such as an SDNN less than 50 ms and an RMSSD less than 15 ms. The cases of cardiac dysautonomia below present several of these criteria met. Methods to evaluate cardiac dysautonomia include the COMPASS 31 scale and the orthostatic hypotension questionnaire (OHQ), but more research is still needed, especially in Mexico. The case study shows that those who followed non-pharmacological recommendations such as cardiovascular exercise, increased water intake and BMI control had improvement, while cases that did not follow these recommendations did not show significant improvements. Cardiac dysautonomia is a post-COVID-19 sequelae with high prevalence, highlighting the importance of non-invasive methods for its diagnosis. Even without symptoms, people can have this sequelae, so it is important to suspect cardiovascular disorders. The need for early intervention and monitoring of hygienic-dietary measures is emphasized to avoid the worsening and chronicity of cardiac dysautonomia, with the hope of preventing the development of chronic diseases and fatal outcomes.

Decreased Heart Rate Variability in Sympathetic Dominant States in Parkinson’s Disease and Isolated REM Sleep Behavior Disorder

Decreased Heart Rate Variability in Sympathetic Dominant States in Parkinson’s Disease and Isolated REM Sleep Behavior Disorder

Unearthing Subtle Cognitive Variations: A Digital Screening Tool for Detecting and Monitoring Mild Cognitive Impairment

Early diagnosis of mild cognitive impairment (MCI) is pivotal in mitigating the risk of cognitive impairment and the onset of dementia. However, prevailing clinical cognitive screening tests and biomarker assessment approaches often suffer from drawbacks such as high cost, invasiveness, time consumption, or subjectivity. In China, existing digital cognitive assessment tools face multiple challenges due to their distinctive cultural, language, and healthcare landscape. Therefore, we embarked on a study to develop a digital cognitive assessment tool, evaluate its efficacy in distinguishing between healthy individuals and MCI patients, and examine its acceptability among Chinese older adults. Through a series of symposiums, programming, and interviews with stakeholders, we iteratively designed the "BrainNursing" mobile application. The system consists of eleven single tasks and three dual tasks, each taking only 1–3 minutes. Subsequently, we conducted statistical comparisons of movement kinetics and physiological signals recorded during cognitive testing in 181 older adults to investigate which parameters could serve as effective digital biomarkers for MCI screening. Leveraging machine learning classifiers and a majority voting principle, we evaluated the classification performance of the BrainNursing system in detecting MCI, yielding an accuracy rate of 90.3%. Furthermore, our analysis of movement kinetics revealed that time, score, and sequence features are crucial in cognitive assessment. Contrasting with their healthy counterparts, MCI patients exhibited decreased heart rate variability, increased sympathetic nervous system activity, and weakened autonomic nervous system regulation in response to stimuli during cognitive testing. Finally, user experience feedback indicated that participants universally perceived BrainNursing as a convenient and user-friendly cognitive screening tool and provided valuable insights for further improvement.

Compassionate mind training for people with Parkinson's disease: A pilot study and predictors of response.

People with Parkinson's disease (PD) often present with disabling neuropsychiatric symptoms. Compassionate mind training (CMT) is a psychological approach effective in reducing stress and promoting psychological well-being. Heart rate variability (HRV), a measure reflecting sympathovagal balance, has been associated with psychological well-being and a compassionate attitude. To assess the feasibility and effectiveness of CMT in enhancing the quality of life and psychological well-being in PD patients. Additionally, we evaluated HRV as a physiomarker for assessing the CMT outcomes. Twenty-four PD patients participated in the study. A 6-week online CMT intervention was delivered on a weekly basis. At baseline and post-intervention patients completed questionnaires assessing depression, anxiety and quality of life. In a subsample of 11 patients, HRV was measured at baseline and post-intervention in three conditions: at rest, during stress and after 3 min of deep breathing. The attendance rate was 94.3%. Quality of life and perceived stigma improved post-intervention as compared with baseline (p = 0.02 and p = 0.03 for PD Questionnaire-39 total score and Stigma subscore, respectively). After CMT, patients presented better physiological regulation to stress, as measured by higher HRV as compared with baseline (p = 0.005). Notably, patients who were more resilient to stress at baseline (less decrease in HRV during stress) experienced a more substantial reduction in anxiety and depression following CMT. CMT is feasible and can improve quality of life and stigma in PD patients. HRV emerges as a promising physiomarker for predicting and measuring the outcomes of psychological interventions in PD.

Heart Rate Variability as a Prognostic Tool for Gastroschisis Infants in the Neonatal Intensive Critical Unit.

Gastroschisis is the most common congenital abdominal wall defect, with an increasing incidence. It results in extrusion of abdominal contents with associated delayed intestinal motility. Abnormal heart rate characteristics (HRCs) such as decreased variability occur due to the inflammatory response to sepsis in preterm infants. This study aimed to test the hypothesis that infants with gastroschisis have decreased heart rate variability (HRV) after birth and that this physiomarker may predict outcomes. We analyzed heart rate data from and clinical variables for all infants admitted with gastroschisis from 2009 to 2020. Forty-seven infants were admitted during the study period and had available data. Complex gastroschisis infants had reduced HRV after birth. For those with sepsis and necrotizing enterocolitis, abnormal HRCs occurred early in the course of illness. Decreased HRV was associated with complex gastroschisis. Infants in this group experienced complications that prolonged time to full enteral feeding and time on total parenteral nutrition. · Infants with gastroschisis can be classified into two subcategories, simple and complex disease.. · Those with complex disease often require prolonged stays in the neonatal intensive care unit and costly hospitalizations. We hypothesized that infants with complex gastroschisis are more likely to have abnormal HRC due to intestinal inflammation.. · In this study, we identified associations between abnormal HRV, heart rate characteristicHRC, and the development of gastroschisis complications. Additionally, we described differences in clinical characteristics between infants with complex versus simple gastroschisis..

Effects of cortisol administration on heart rate variability and functional connectivity across women with different depression histories

Abnormalities within the hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system have been implicated in depression. Studies have reported glucocorticoid insensitivity and reduced heart rate variability (HRV) in depressive disorders. However, little is known about the effects of cortisol on HRV and resting-state functional connectivity (rsFC) of the central autonomic network (CAN) in depression. We collected resting-state fMRI and cardiac data for women with different depression histories (n = 61) after administration of cortisol and placebo using a double-blind crossover design. We computed rsFC for R-amygdala and L-amygdala seeds and assessed the change in HRV after cortisol (cortisol-placebo). Analyses examined the effects of acute cortisol administration on HRV and rsFC of the R-amygdala and L-amygdala. There was a significant interaction between HRV and treatment for rsFC between the amygdala and CAN regions. We found lower rsFC between the L-amygdala and putamen for those with a greater decrease in HRV after cortisol. There was also reduced rsFC between the R-amygdala and dorsomedial prefrontal cortex, putamen, middle cingulate cortex, insula, and cerebellum in those with lower HRV after cortisol. These results remained significant after adjusting for depression symptoms, age, and race. Our findings suggest that the effect of cortisol on CAN connectivity is related to its effects on HRV. Overall, these results could inform transdiagnostic interventions targeting HRV and the stress response systems across clinical and non-clinical populations.

Assessment of cardiovascular functioning following sport-related concussion: A physiological perspective

There is still much uncertainty surrounding the approach to diagnosing and managing a sport-related concussion (SRC). Neurobiological recovery may extend beyond clinical recovery following SRC, highlighting the need for objective physiological parameters to guide diagnosis and management. With an increased understanding of the connection between the heart and the brain, the utility of assessing cardiovascular functioning following SRC has gained attention. As such, this review focuses on the assessment of cardiovascular parameters in the context of SRC. Although conflicting results have been reported, decreased heart rate variability, blood pressure variability, and systolic (ejection) time, in addition to increased spontaneous baroreflex sensitivity and magnitude of atrial contraction have been shown in acute SRC. We propose that these findings result from the neurometabolic cascade triggered by a concussion and represent alterations in myocardial calcium handling, autonomic dysfunction, and an exaggerated compensatory response that attempts to maintain homeostasis following a SRC. Assessment of the cardiovascular system has the potential to assist in diagnosing and managing SRC, contributing to a more comprehensive and multimodal assessment strategy.

Using a wearable patch to develop a digital monitoring biomarker of inflammation in response to LPS challenge.

Remote inflammation monitoring with digital health technologies (DHTs) would provide valuable information for both clinical research and care. Controlled perturbations of the immune system may reveal physiological signatures which could be used to develop a digital biomarker of inflammatory state. In this study, molecular and physiological profiling was performed following an invivo lipopolysaccharide (LPS) challenge to develop a digital biomarker of inflammation. Ten healthy volunteers received an intravenous LPS challenge and were monitored for 24 h using the VitalConnect VitalPatch (VitalPatch). VitalPatch measurements included heart rate (HR), heart rate variability (HRV), respiratory rate (RR), and skin temperature (TEMP). Conventional episodic inpatient vital signs and serum proteins were measured pre- and post-LPS challenge. The VitalPatch provided vital signs that were comparable to conventional methods for assessing HR, RR, and TEMP. A pronounced increase was observed in HR, RR, and TEMP as well as a decrease in HRV 1-4 h post-LPS challenge. The ordering of participants by magnitude of inflammatory cytokine response 2 h post-LPS challenge was consistent with ordering of participants by change from baseline in vital signs when measured by VitalPatch (r = 0.73) but not when measured by conventional methods (r = -0.04). A machine learning model trained on VitalPatch data predicted change from baseline in inflammatory protein response (R2 = 0.67). DHTs, such as VitalPatch, can improve upon existing episodic measurements of vital signs by enabling continuous sensing and have the potential for future use as tools to remotely monitor inflammation.

A cross-sectional comparative assessment of diabetic autonomic neuropathy using heart rate variability and galvanic skin response – Effect of disease progression

Background: Type 2 diabetes mellitus (T2DM) poses a significant health-care challenge and is a primary contributor to both mortality and morbidity. Diabetic autonomic neuropathy (DAN) is a frequently occurring complication associated with diabetes mellitus. Autonomic nerve damage leading to cardiac autonomic dysfunction and peripheral sympathetic neuropathy can lead to changes in heart rate variability (HRV) and galvanic skin resistance (GSR), respectively. Aims and Objectives: The study was designed and done to evaluate the impact of T2DM on HRV and GSR for assessing DAN. Materials and Methods: A total of 100 individuals diagnosed with T2DM (cases) and 100 healthy individuals (controls) participated in this study. Physio Pac (PC-2004) was used to record the necessary data. Statistical analysis was performed using the non-parametric Mann–Whitney test to see the comparison of the cases and controls. In addition, to measure the statistical relationship between the duration of the disease and the HRV and GSR parameters, Spearman’s rank correlation coefficient was utilized. The study received approval from the Ethical and Research Committee at the Government Medical College, Patiala. Results: Significant statistical differences were observed between the cases and controls in all time domain measures, as well as GSR and the majority of frequency domain measures of HRV. The correlation analysis revealed a strong association between the duration of T2DM and a decrease in HRV as well as an increase in GSR. Conclusion: The findings from the present study provide evidence that T2DM has an impact on HRV, which suggests the presence of cardiac autonomic neuropathy among diabetic patients, leading to an increased risk of cardiovascular morbidity. In addition, the study indicates that reduced sudomotor function, as assessed by Galvanic Skin Resistance (GSR), serves as a predictive measure for autonomic neuropathy. Therefore, these tests can serve as valuable tools in facilitating the assessment of DAN.

Partial Exchange Transfusion in the Management of a Preterm Neonate with Severe Anaemia from Acute Foetomaternal Haemorrhage: A Case Report

Foetomaternal Haemorrhage (FMH) refers to the passage of foetal blood into the maternal circulation. FMH is rarely diagnosed antenatally as clinical findings are subtle and non specific. Massive FMH is suspected when foetal movements are decreased, and Cardiotocographic (CTG) findings are abnormal with decreased heart rate variability, saw-tooth or a sinusoidal pattern. Massive FMH can lead to foetal demise, stillbirth, hydrops, or the birth of a severely anaemic infant with hypovolaemic shock. A 35-week pregnant woman presented with decreased foetal movements, and an emergency caesarean section was performed due to late deceleration on the cardiotocograph. The baby was very pale at birth and in shock. The Kleihauer-Betke (KB) test performed on the mother’s blood shortly after delivery showed 2.7% foetal red cells, suggesting 135 cc of FMH. The clinical features and outcome of FMH depend on the gestational age, volume, and rapidity of FMH, as well as, whether it is acute or chronic. Packed cell transfusion is recommended, but in babies with severe anaemia and cardiac failure, partial exchange transfusion is performed. The baby was managed with a fluid bolus, inotropic support, respiratory support, and partial exchange transfusion, resulting in a successful outcome. A high index of suspicion enables the obstetrician to undertake diagnostic tests, cordocentesis, plan for intrauterine transfusion or delivery, and alert the neonatal team for a better outcome.

Retracted: Substance Misuse Decreases Heart Rate Variability

Retracted: Substance Misuse Decreases Heart Rate Variability

Autonomic nervous system function assessed by heart rate variability and the presence of symptoms affecting activities of daily living in community-dwelling residents with chronic pain: The Hisayama Study.

Autonomic nervous system dysfunction has been reported to be associated with impaired activities of daily living (ADL) among patients with chronic pain, but the association has not been fully addressed in general populations. This study cross-sectionally investigated the association between autonomic nervous system function and the presence of subjective symptoms affecting ADL in community-dwelling residents with chronic pain. A total of 888 residents with chronic pain, aged 40-79 years, who underwent a health examination in 2017-2018 were included. Based on heart rate variability measured by fingertip pulse wave, the standard deviation of normal-to-normal intervals (SDNN), root mean square of successive RR interval differences (RMSSD), low frequency (LF) power, and high frequency (HF) power were calculated. Symptoms affecting ADL were defined as those scoring ≥1 on the modified Rankin Scale. Odds ratios (ORs) and their 95% confidence intervals (CIs) for symptoms affecting ADL were estimated using a logistic regression analysis. The overall prevalence of symptoms affecting ADL was 39.4%. The ORs for symptoms affecting ADL increased significantly per 1-standard-deviation decrement in log-transformed SDNN (OR 1.23 [95% CI 1.06-1.44]), RMSSD (1.25 [1.08-1.45]), LF power (1.29 [1.11-1.52]), and HF power (1.29 [1.11-1.51]) after adjusting for age, sex, education, hypertension, diabetes, serum total cholesterol level, body mass index, past medical history, current smoking, current drinking, exercise, depressive symptoms, and pain intensity. Decreased heart rate variability was associated with the presence of symptoms affecting ADL among individuals with chronic pain in a Japanese community. Decrease in heart rate variability was associated with the presence of symptoms affecting ADL among individuals with chronic pain in a Japanese community. This article could help scientists understand the significance of autonomic nervous system dysfunction in the pathology of chronic pain. Approaches that target autonomic nervous system dysfunction may be an option to relieve or prevent symptoms affecting ADL for chronic pain sufferers.

Heart rate variability as an indicator of stress in women during wartime

The impact of post-traumatic stress related to the war was analyzed in 91 women who were in Kyiv or the Kyiv region during active combat in February and March 2022. Some of the examined women had been under occupation for an extended period. In contrast, others, from May 2022 to May 2023, experienced the strong influence of war factors such as missile and artillery shelling, staying in bomb shelters, or other shelters. Due to the military actions, the examined individuals were subjected to significant stress factors, which inevitably affected their psychoemotional state. To compare, data from 79 women examined before the Russian-Ukrainian war were used as a control group. The groups of women examined before and during the war did not differ in anthropometric indicators. To understand the age-related characteristics of civilian women, they were distributed into age groups of 30-44, 45-59, and 60-74 years. ECG registration was carried out using the ECG-recorder DiaCard (Solvaig, Ukraine). The analysis of heart rate variability (HRV) was performed by application DiaCard v. 1.0.0.73. ECG measurements were taken from 10:00 a.m. to 12:00 p.m., in the supine and standing positions (5 min). The study of HRV in women during wartime and the comparison of obtained results with the pre-war period revealed that war-related stress induces changes in HRV characteristics of various types of stress. In the examined women during wartime, there is a decrease in overall HRV, primarily due to HF oscillations, indicating a reduction in parasympathetic activity of the autonomic nervous system (ANS). Such changes are typical for mild stress. Changes in HRV under conditions of military stress depend on the age of individuals and are more pronounced in young and elderly women. No significant shifts in heart rate variability were observed in individuals of average age. _________________________________________________________________________________________ Keywords: heart rate variability; woman; stress; war

Analysis of heart rate indices at different levels of sleepiness

The objective detection of sleepiness through physiological indices is crucial for ensuring transportation and industrial safety. As gadgets become more commonplace for measuring heart rate, it is important to identify valid indices that correlate with the level of sleepiness. Research indicates that time-domain and frequency-domain heart rate indices align with levels of alertness and sleepiness [e.g., 1, 2]. The aim of this paper is to identify heart rate indices that correlate with varying degrees of evening sleepiness in vivo, whether low or high. The data analyzed in this paper was obtained from 32 recordings from the SSDD (Subjective Sleepiness Dynamics Dataset) collected at the UNN Cyberpsychology Laboratory since 2022. The experiment was designed in the following manner: participants put on a heart rhythm sensor (Polar H10) at 7:40 PM in their homes and connected it to a smartphone app. Participants then completed a self-reported questionnaire in the electronic system. Starting at 8:00 PM, and every 30 minutes thereafter, the participant recorded data on the subjective level of sleepiness via the Karolinska (KSS) and Stanford (SSS) sleepiness scales up until the time of the participant’s bedtime. The selection of 32 recordings met specific criteria: all participants went to bed between 10:30 and 11:00 PM and completed both the KSS and SSS on time at each time point (08:00, 08:30, 09:00, 09:30, and 10:00 PM). For each time point, an integral sleepiness score was calculated according to the formula: sl=(KSS/10+SSS/7)/2. The 4-minute rhythmogram recordings corresponding to the time points of KSS and SSS filling were chosen for analysis. Data were processed in Jupyter Notebook. Heart rhythm indices, including time-domain, frequency-domain, and nonlinear indices, were computed for each time point from the rhythmogram — NN-interval sequence — using the “hrv-analysis” package. The study employed Student’s t-test to compare indices for varying levels of sleepiness based on integral scores, where “low level” was defined as sl 0.45 and “high level” was defined as sl 0.55. Additionally, the Pearson criterion was used to evaluate the correlation between sl and heart rate indices at each time interval. The indices responsible for the variability of the NN-interval sequence, namely NNi_50 (p=0.027), NNi_20 (p=0.007), and pNNi_20 (p=0.024), exhibited lower values during periods of “low” sleepiness (N=54) as compared to “high” sleepiness (N=58). Moreover, we observed that the autonomic balance index, i.e., the ratio of the power of the heart rate variability spectrum in the low-frequency band to that in the high-frequency band, was higher during ‘high’ sleepiness (p=0.015). Analysis revealed that correlations between integral sleepiness score and heart rate indices were present only for the 08:30 PM time point. Correlations of sl with the NN-interval range (R=–0.388; p=0.028), the severity of sympathetic regulatory circuit activity (R=–0.383; p=0.031), and the nonlinear cardiovagal index (R=–0.359; p=0.043) were found. Thus, it can be inferred that increased sleepiness is associated with decreased heart rate variability indices, along with decreased functioning of the autonomic nervous system overall.

To what degree patient-reported symptoms of central sensitization, kinesiophobia, disability, sleep, and life quality associated with 24-h heart rate variability and actigraphy measurements?

Chronic musculoskeletal pain is associated with decreased parasympathetic and increased sympathetic activity in the autonomic nervous system. The objective of this study was to determine the associations between objective measures of heart rate variability (a measure of autonomic nervous system function), actigraphy (a measure of activity and sleep quality), respiration rates, and subjective patient-reported outcome measures (PROMs) of central sensitization, kinesiophobia, disability, the effect of pain on sleep, and life quality. Thirty-eight study subjects were divided into two subgroups, including low symptoms of central sensitization (n = 18) and high symptoms of central sensitization (n = 20), based on patient-reported scores on the Central Sensitization Inventory (CSI). Heart rate variability (HRV) and actigraphy measurements were carried out simultaneously in 24 h measurement during wakefulness and sleep. A decrease in HRV during the first 2 h of sleep was stronger in the low CSI subgroup compared to the high CSI subgroup. Otherwise, all other HRV and actigraphy parameters and subjective measures of central sensitization, disability, kinesiophobia, the effect of pain on sleep, and quality of life showed only little associations. The high CSI subgroup reported significantly more severe symptoms of disability, kinesiophobia, sleep, and quality of life compared to the low CSI subgroup. However, there were only small and nonsignificant trend in increased sympathetic nervous system activity and poorer sleep quality on the high central sensitization subgroup. Moreover, very little differences in respiratory rates were found between the groups.

Stress Response Pattern of Heart Rate Variability in Patients with Functional Somatic Syndromes.

Functional somatic syndromes (FSSs) represent a clinically important group of disorders that are often stress-related. Their autonomic pathophysiology, including reduced heart rate variability (HRV), has been reported. However, the response pattern to mental stress and recovery in FSSs remains unclear. Thus, we aimed to clarify the pattern of autonomic stress response and recovery to mental arithmetic stress in patients with FSS compared to that in healthy controls. This cross-sectional study included 79 patients with FSS who visited the Department of Psychosomatic Medicine at a university hospital in Japan and 39 healthy controls. Following a mood questionnaire and obtaining epidemiologic information, HRV was measured during three periods (5 min each): relaxation baseline resting, stress (mental arithmetic task), and post-stress recovery period. The HRV analysis included inter-beat interval, low frequency power, and high frequency power. Compared to healthy controls, patients with FSS exhibited significantly higher scores on the mood questionnaire, prolonged duration of illness, and decreased functionality in daily activities. While the healthy control group showed a pronounced stress response pattern with a significant decrease in vagal HRV and recovery, the FSS group showed a "flat" vagal stress response pattern, and the HRV in the FSS group was lower at relaxation baseline, remained low during the stress, and did not change post stress. Patients with severe FSS exhibit an altered stress response pattern. Our results could provide significant clues for the diagnosis and treatment of such patients, as well as useful insights into the relationship between stress and illness.

The peculiarities of changes in myocardial electrical activity and heart rate variability in patients with coronary artery disease depending on the stage of concomitant iron deficiency

The aim of the study: to assess changes in myocardial electrical activity and heart rate variability (HRV) in patients with coronary artery disease (CAD) depending on the stage of iron deficiency (ID) and identify their relationship with ferrokinetic parameters. Materials and methods. In total, 90 patients with CAD, stable angina II–III FC were examined (men – 35, women – 55, age – 69 (61; 72) years). The patients were divided into 4 groups: the 1st group (n = 16) consisted of patients with concomitant ID anemia (IDA) of mild and moderate severity, the 2nd (n = 15) – with latent ID, the 3rd (n = 14) – with functional ID, the 4th (n = 45) – patients with CAD without iron metabolism disorders. The HRV features during 24 hours, daytime and nighttime as well as their relationships with ferrokinetic and hematological parameters were analyzed. The data analysis was performed using Statistica 13.0. Results. CAD patients with concomitant IDA demonstrated a tendency to have a higher average daytime heart rate value (U = 14.0; p ≈ 0.08), a longer duration of tachycardia (U = 20.0; p ≈ 0.06), and a significantly greater number (2.4 times) of ventricular extrasystoles (VE) (U = 7.0; p < 0.05) compared to patients without iron metabolism disorders. There were no statistically significant differences in heart rate, episodes of tachycardia, and the number of arrhythmic events in CAD patients with different stages of ID. During the temporal analysis of HRV indicators, patients with different stages of concomitant ID demonstrated a decrease in overall HRV due to SDNN-index, rMSSD (%) and HRVT triangular index both in active and passive periods as compared to patients without iron metabolism disorders. Spectral analysis of HRV has revealed reduced parasympathetic activity of the autonomic nervous system due to HF indicator in patients of the 1st–3rd groups. The presence of concomitant IDA was characterized by maximum changes in HRV indicators and the predominance of central mechanisms of HRV regulation over autonomic ones, which was confirmed by a significant increase in the centralization index (IC) and stress index (SI). For CAD patients with concomitant IDA and latent ID, a number of relationships between ferrokinetic and HRV parameters was found. There were no statistically significant correlations between indicators of iron metabolism and HRV in patients with CAD and functional ID. Conclusions. The decrease in iron stores in the body due to its tissue and transport reserves is accompanied by changes in the myocardial electrical activity, a progressive reduction in heart rate variability, autonomic dysfunction towards a suppression of the parasympathetic domain activity, confirming the relevant correlations with the ferrokinetic parameters.

Relationship between dynamic electrocardiogram and CRP, IL-6, ET-1 expression in myocardial ischemia patients with coronary heart disease.

This study aimed to observe the relationship between dynamic electrocardiogram and CRP, IL-6, and ET-1 expression in individuals with myocardial ischemia and Coronary Heart Disease (CHD). For this purpose, from January 2021 to December 2022, 80 patients with CHD were admitted to the hospital to determine the presence of myocardial ischemia according to coronary angiography. The individuals were separated into a myocardial ischemia group and a no myocardial ischemia group. Dynamic electrocardiogram (DCG), serum CRP, IL-6, and ET-1 were used in the two groups, respectively. The association between dynamic electrocardiogram indexes and serum CRP, IL-6, and ET-1 levels was discovered using a Pearson correlation analysis. Results showed that the SDNN, SDANNI, rMSSD and PNN50 of Patients with Myocardial Ischemia (PWMI) were lower than individuals with CHD without myocardial ischemia (P<0.05). CRP and IL-6 were negatively correlated with SDNN, SDANNI, rMSSD and PNN50 (P<0.001). ET-1 had a bad relationship with rMSSD and PNN50 (P<0.001). Correlation heat map analysis showed that the color difference of IL-6 was the most obvious between PWMI and Patients Without Myocardial Ischemia (POMI), and IL-6 was more strongly correlated with dynamic electrocardiogram-related indexes of myocardial ischemia. In individuals with CHD myocardial ischemia, there is a negative connection between the DCG index and the production of the inflammatory cytokines CRP, IL-6, and ET-1. In conclusion, CRP, IL-6, and ET-1 levels should be monitored in patients with decreased heart rate variability, so as to further determine the level of micro-inflammation and endothelial function.

The Link between Major Depressive Disorder &amp; Chronic Coronary Syndrome - A Literature Review

Depression is prevalent among patients with coronary artery disease and has significant consequences. Occurrence of depression after a new diagnosis of stable angina is common and affects nearly 1 in 5 individuals. There have been several biological mechanisms by which depression may be related to coronary artery disease. As compared with nondepressed patients, those with depression have increased catecholamine levels,elevated resting heart rate, and decreased heart rate variability. . Behavioral characteristics of patients with depression include poor medication adherence, lower exercise tolerance,physical inactivity, poor dietary habits,and tobacco use. Although depression and its impact have been well documented in post-MI patients, much less is known about its significance in patients with chronic coronary syndrome(CCS).Despite the fact that CCS is the most common manifestation of coronary artery disease,sothere is a huge gap in the field of knowledge correlating CCS and depression. University Heart Journal 2023; 19(1): 26-30