Differences In Heart Rate Variability Indices Research Articles

Indices Of Heart Rate Variability Are Not Associated With Obesity In Patients 30-60 Years Of Age Without Chronic Noncommunicable Diseases

Objective –– to compare heart rate variability (HRV) in patients aged 30-60 years without chronic noncommunicable diseases (CNCDs) with and without obesity. Methods –– The groups of obese (n=43) and nonobese (n=28) patients without CNCDs ranged 30 through 60 years of age. We assessed the conventional HRV indices according to the clinical guidelines, as well as the synchronization index (S) for low-frequency (LF) oscillations evaluated from HRV and photoplethysmogram (PPG). Results –– No statistically significant differences in HRV indices and S index were detected between the study groups. Conclusion –– HRV indices and synchronization of LF oscillations detected from HRV and PPG were not significantly associated with obesity in patients aged 30-60 years without CNCDs.

Exploring Autonomic Alterations during Seizures in Temporal Lobe Epilepsy: Insights from a Heart-Rate Variability Analysis

Epilepsy’s impact on cardiovascular function and autonomic regulation, including heart-rate variability, is complex and may contribute to sudden unexpected death in epilepsy (SUDEP). Lateralization of autonomic control in the brain remains the subject of debate; nevertheless, ultra-short-term heart-rate variability (HRV) analysis is a useful tool for understanding the pathophysiology of autonomic dysfunction in epilepsy patients. A retrospective study reviewed medical records of patients with temporal lobe epilepsy who underwent presurgical evaluations. Data from 75 patients were analyzed and HRV indices were extracted from electrocardiogram recordings of preictal, ictal, and postictal intervals. Various HRV indices were calculated, including time domain, frequency domain, and nonlinear indices, to assess autonomic function during different seizure intervals. The study found significant differences in HRV indices based on hemispheric laterality, language dominancy, hippocampal atrophy, amygdala enlargement, sustained theta activity, and seizure frequency. HRV indices such as the root mean square of successive differences between heartbeats, pNN50, normalized low-frequency, normalized high-frequency, and the low-frequency/high-frequency ratio exhibited significant differences during the ictal period. Language dominancy, hippocampal atrophy, amygdala enlargement, and sustained theta activity were also found to affect HRV. Seizure frequency was correlated with HRV indices, suggesting a potential relationship with the risk of SUDEP.

Psychological skills training impacts autonomic nervous system responses to stress during sport-specific imagery: An exploratory study in junior elite shooters.

This study investigated the effects of psychological skills training (PST) in shooters psychophysiologically using heart rate variability (HRV) in addition to psychological questionnaires and participant interviews. Five junior pistol shooters participated in an 8-week PST program consisting of a group session per week followed by individual counseling. Before and after PST, we collected electrocardiography data during rest, mental imagery of sport-related crisis situations, and successful performance, to analyze differences in HRV indices. Participants also responded to the Psychological Skills Inventory for Archery and Shooting (PSIAS), Intrinsic Motivation Inventory (IMI), Sports Anxiety Scale (SAS), and Trait Sport Confidence Inventory (TSCI). Results showed that the perceived competence (pre: 2.52 ± 0.95, post: 3.36 ± 0.73, p = 0.049) and trait sport confidence (pre: 4.94 ± 1.17, post: 6.60 ± 0.65, p = 0.049) significantly improved after PST. The analysis of HRV indicated that the ratio of low-frequency power to high-frequency power (LF/HF ratio) decreased significantly during imagery of crisis (pre: 3.4 ± 2.3, post: 1.014 ± 0.71, p = 0.038) and success (pre: 1.933 ± 0.917, post: 0.988 ± 0.572, p = 0.046), reflecting a strengthened autonomic nervous system's responsiveness to stress. Our findings illustrate that PST can help athletes better cope with psychologically disturbed situations during competition, by providing psychophysiological evidence through HRV changes.

Does length of time since diagnosis in Parkinson's disease influence heart rate variability? A cross-sectional study.

Intrinsic changes in Parkinson's disease (PD) affect the autonomic nervous system, and the disease course can aggravate the initial condition. Although the impact of time since disease onset on autonomic modulation has already been studied in other populations, this has not yet been investigated in PD. To investigate the impact of the length of time since diagnosis on the cardiac autonomic modulation of individuals with PD and compare with healthy individuals. Fifty participants were divided into three groups: a control group (CG; n = 24) and two groups with PD, divided according to the median length of time since diagnosis (median = 5.5 years): below the median (PG1; n = 13) and above the median (PG2; n = 13). To evaluate cardiac autonomic modulation, heart rate was obtained beat-to-beat in the supine position over a 30-min period, and heart rate variability (HRV) indices were calculated using linear methods in the time and frequency domains. There were no significant differences in HRV indices between the PG groups, or between the three groups regarding Mean RR, LFun, HFun and LF/HF ratio. Significant reductions in the RMSSD, SDNN, pNN50, LFms2 and HFms2 indices were observed in PG1 and PG2, compared with CG. The cardiac autonomic modulation of individuals with PD was not influenced by the time since diagnosis. However, reduced parasympathetic and global modulation were observed in these individuals, compared with controls. These results emphasize the importance of aerobic exercise for improving autonomic modulation among individuals with PD.

Green Exercise: Can Nature Video Benefit Isometric Exercise?

Green exercise is the combination of physical activity and nature exposure, which has been associated with positive effects on psychophysiological health. This study aimed to investigate the effects of nature video viewing on isometric exercise and find a useful practice for green exercise in urban living. In the current study, 18 male subjects were recruited in a randomized crossover trial and underwent a sequence of wall squat exercises. The whole experiment contained three periods of baseline (before exercise), exercise, and recovery (after exercise), and each period lasted for 2 min. A video of forest walking was played in the exercise and recovery periods as treatment, while a black screen was set as control. The Rate of Perceived Exertion Scale (RPE) and Feeling Scale (FS) were employed to measure perceived exertion and affective responses in the exercise period; heart rate (HR) and heart rate variability (HRV) including the standard deviation of normal-to-normal RR intervals (SDNN), the root mean square of successive differences (RMSSD), and the standard deviations of the Poincaré plot (SD1), were recorded in the three periods. Heart rate recovery (HRR) in the recovery period was further calculated based on 30 s and 60 s time frames. Results demonstrated that during the exercise period nature video viewing was associated with better affective responses (median of 1.00 and an interquartile (IQR) of 2.00, p = 0.017), lower perceived exertion (median = 6.00, IQR = 2.00, p = 0.021), and lower HR (median = 89.60, IQR = 20.94, p = 0.01), but the differences in HRV indices between the experimental settings were not statistically significant. In the recovery period, significantly higher values of RMSSD (median = 34.88, IQR = 24.52, p = 0.004), SD1 (median = 24.75, IQR = 17.41, p = 0.003), and HR (median = 84.18, IQR = 16.58, p = 0.001) were observed in the treatment setting, whereas no statistically significant difference was found for HRR. In general, our findings support that nature video viewing may help reduce perceived exertion, increase exercise pleasure, buffer heart rate, and improve cardiac autonomic recovery for wall squat exercising, which implies the potential of nature-based stimuli in green exercise. However, due to the limited research sample, further study may need to include female participants and focus on various populations to confirm the effectiveness of using virtual and environments depicting nature at home or in public exercise places to promote positive exercise experience.

Ambulatory heart rate variability in overweight and obese men after high-intensity interval exercise versus moderate-intensity continuous exercise

ABSTRACT Despite the growing evidence for the beneficial effects of high-intensity interval exercise (HIIE) on vascular health of overweight and obese individuals, it is not clear whether the autonomic stress promoted by HIIE during the ambulatory period is higher than that by moderate-intensity continuous exercise (MICE). Therefore, this study compares the 24 hour (h) ambulatory heart rate variability (HRV) following HIIE and MICE in young overweight and obese men. Eleven untrained men aged 23.2 ± 1.9 years, with average body mass index (BMI) of 31.6 ± 3.9 kg/m² (three overweight and eight obese), underwent three exercise sessions: HIIE, MICE and Control (CT). HRV was recorded in the laboratory and for the next 24 h following laboratory recovery. There were no differences in HRV indices in the rest period between the sessions (p > .05). During the ambulatory period, the area under the curve (AUC) of the low-frequency band transformed into natural logarithm (Ln-LF) during sleep was higher after HIIE than after CT (43.31 ± 8.59 vs. 41.11 ± 7.28 ms²*h, p = .034). The HRV followed by MICE did not differ from other sessions (p > .05). In conclusion, the 24 h ambulatory HRV did not differ after HIIE and MICE. However, despite the small effect, HIIE increased the cardiac autonomic modulation during the sleep period, as a protector of cardiovascular system. Highlights 24 h ambulatory HRV could add important information about the cardiovascular safety of the exercise protocols in overweight and obese individuals. There was no disturbances in the cardiac autonomic modulation during the awake period, regardless of the exercise protocol. LnLF index was higher in HIIE compared to CT in the sleep period. 24 h ambulatory HRV did not differ between the HIIE and MICE sessions.

Autonomic dysfunction in posttraumatic stress disorder indexed by heart rate variability: a meta-analysis.

Changes in autonomic nervous system (ANS) function have been observed in a variety of psychological disorders, including posttraumatic stress disorder (PTSD). Analysis of heart rate variability (HRV) provides insight into the functioning of the ANS. Previous research on PTSD found lower HRV in PTSD patients compared to controls, indicating altered sympathetic and parasympathetic activity, but findings are inconsistent. The purpose of this meta-analysis was to examine differences in HRV indices between individuals with PTSD and healthy controls at baseline and during stress. The included primary studies present an aggregate of studies analyzing different HRV indices. Examined HRV indices were standard deviation of the normalized NN-intervals (SDNN), root mean square of successive differences (RMSSD), low-frequency (LF) and high-frequency (HF) spectral components, LF/HF ratio, and heart rate (HR). Moderating effects of study design, HRV and PTSD assessment, and sample characteristics were examined via subgroup-analyses and meta-regressions. Random-effects meta-analyses for HRV parameters at rest revealed significant group differences for RMSSD and HF-HRV, suggesting lower parasympathetic activity in PTSD. The aggregated effect size for SDNN was medium, suggesting diminished total variability in PTSD. A small effect was found for LF-HRV. A higher LF/HF ratio was found in the PTSD sample as compared to controls. Individuals with PTSD showed significantly higher HR. During stress, individuals with PTSD showed higher HR and lower HF-HRV, both indicated by small effect sizes. Findings suggest that PTSD is associated with ANS dysfunction.

Frequency Domain Indices of Heart Rate Variability are Useful for Differentiating Vasovagal Syncope and Postural Tachycardia Syndrome in Children

To explore the value of frequency domain indices of heart rate variability (HRV) in the differential diagnosis between pediatric vasovagal syncope and postural tachycardia syndrome (POTS). Eighty-five patients aged 7-16 years with either vasovagal syncope or POTS were enrolled in the experimental group; 18 healthy children served as controls. Holter electrocardiography was used to detect HRV frequency-domain indices in patients with vasovagal syncope, patients with POTS, and control subjects. The differences in HRV indices were compared between the vasovagal syncope and POTS groups. The receiver operating characteristic (ROC) curve was calculated to analyze the predictive value of HRV for the differential diagnosis between vasovagal syncope and POTS in children. In addition, 37 children aged 7-17 years with either vasovagal syncope or POTS were recruited as an external validation group. The daytime ultra-low frequency (dULF), nighttime ULF (nULF), daytime very low frequency (dVLF), and nighttime VLF (nVLF) were higher in the vasovagal syncope group compared with the POTS group (P < .01 for dULF, dVLF, and nVLF; P < .05 for nULF). The dULF, nULF, dVLF, and nVLF yielded a sensitivity of 73.3%, 71.1%, 68.9%, and 62.2%, respectively, and a specificity of 72.5%, 62.5%, 60.0%, and 60.0%, respectively, to differentiate vasovagal syncope from POTS. The external validation with clinical diagnostic standard showed that a dULF cutoff value of 36.2 ms2 for differentiating POTS from vasovagal syncope yielded a sensitivity of 71.4%, a specificity of 75.0%, and an accuracy of 73.0%. dULF may be a useful measure for the differential diagnosis between vasovagal syncope and POTS in adolescents.

Impact of heart rate on reproducibility of heart rate variability analysis in the supine and standing positions in healthy men

OBJECTIVE:The reliability of heart rate variability (HRV) analysis is not yet fully understood, especially considering different body positions and the mathematical influence of heart rate. The aim of this study was to evaluate the reliability of HRV in supine and standing positions, with and without mathematical adjustment of HRV by the average R-R interval (iRR).METHODS:We evaluated 37 young males (23.1±4 years; 25.1±3 kg/m2). A 5-min segment of the iRR was collected in the supine and standing positions on three occasions separated by 48-hour intervals. Absolute and relative reliability of temporal and spectral indices were assessed by the coefficient of variation (CV) and the intraclass correlation coefficient (ICC), respectively.RESULTS:We did not observe differences in HRV indices in the three occasions in the supine or standing position (p>0.05). Moderate to good reproducibility was observed for temporal and spectral indices of HRV in the supine position (ICC: 0.65-0.89; CV: 0.9-19.8). In the orthostatic position, low to good reproducibility was observed (ICC: 0.35-0.89; CV: 1.1-34.8), with higher ICCs for temporal indices. After mathematical adjustment, only a small modification in HRV reliability was observed in both positions.CONCLUSIONS:In young adult males, the mathematical adjustment of HRV by the average iRR led to a nonsignificant effect on HRV reliability. Additionally, HRV reliability is dependent on body position and the index analyzed. Promising measures in both supine and standing positions include r-MSSD and the HF band (parasympathetic indices).

Association of physical capacity with heart rate variability based on a short-duration measurement of resting pulse rate in older adults with obesity.

BackgroundObesity can limit physical capacity and lower physical activity levels in elderly people. Low physical activity levels may be mediated by autonomic dysfunction with decreased heart rate variability (HRV). However, the relationship between autonomic dysfunction and low physical capability remains unclear. This cross-sectional study investigated the association of low physical capability with HRV in older adults with obesity.Materials and methodsWe recruited 231 old man and 210 old women with a mean (range) age of 65.5 (51−78) and 62.9 (52−76) years, respectively. Physical capability was measured using mobility tasks, including functional reach, single-leg stance (SLS), gait speed (GS), timed up and go, and timed chair rise (TCR), and the scores on these tasks were merged and transformed into a global physical capability score (GPCS). HRV was measured using a 7-min resting pulse-based technique, and the time- and frequency-domain indices of HRV were obtained including standard deviation of normal-to-normal intervals (SDNN), root mean square of successive differences at rest (rMSSD), and high-frequency (HF) power. All HRV indices were natural log (ln) transformed for analysis. Participants were divided into high, moderate, and low physical-capability groups according to their physical performance. Multivariate analysis of covariance was performed to test differences in HRV indices among physical-capability groups with participants’ characteristics serving as covariates. A stepwise regression model was established to identify the determinants of HRV indices. We used hierarchical regression analysis to identify the association of the GPCS with HRV indices.ResultsIn both men and women, the low physical-capability group exhibited significantly increased heart rate (P <0.05) and decreased HRV in terms of a decreased ln[SDNN] (P <0.001), ln[rMSSD] (P <0.05) and ln[HF] (P <0.05), compared with the high physical-capability group. GS positively predicted ln[SDNN], whereas SLS, GS, and TCR were determinants of ln[HF], regardless of gender. The GPCS in older men and women independently accounted for 29.9% (P <0.001) and 23.7% (P <0.001), respectively, in variance in ln[SDNN].ConclusionsA low physical-capability level is an independent determinant of decreased HRV in older adults with obesity.

Different autonomic responses to occupational and leisure time physical activities among blue-collar workers

PurposeThe differential effect of occupational and leisure time physical activity on cardiovascular health is termed the physical activity health paradox. Cardiac autonomic modulation could bring insights about the underlying mechanism behind this differential effect. The aim was to compare heart rate variability (HRV) during different activities (sitting, standing and moving) at work and leisure among blue-collar workers.MethodsOne hundred thirty-eight workers from the NOMAD cohort were included. Data from physical activity and HRV were obtained for 3–4 days using tri-axial accelerometers (Actigraph GT3X+) and a heart rate monitor (Actiheart). HRV indices were determined during sitting, standing and moving both at work and leisure. Linear mixed-models with two fixed factors (activities and domains) were applied to investigate differences in HRV indices adjusting for individual and occupational factors.ResultsThe results showed significant effects of domain (p < 0.01), physical activity type (p < 0.01) and interaction between domain and activity type (p < 0.01) on HRV indices. Mean heart rate (IBI) and parasympathetic measures of HRV (RMSSD and HF) were lower for sitting (p < 0.01) and higher for moving (p < 0.01) during work compared with leisure, while no difference between domains was found for standing (p > 0.05). Sympathovagal balance (LF/HF) was higher during work for sitting and moving (p < 0.01), but showed no difference for standing (p = 0.62).ConclusionsDifferences in cardiac autonomic modulation between work and leisure were found, indicating sympathetic predominance during work and parasympathetic predominance during leisure for sitting. Autonomic responses can be part of the mechanism that explains the differential effect of occupational and leisure time physical activity on health.

Heart Rate Variability and the Efficacy of Biofeedback in Heroin Users with Depressive Symptoms.

ObjectiveLow heart rate variability (HRV) has been confirmed in heroin users, but the effects of heart-rate-variability–biofeedback in heroin users remain unknown. This study examined (1) correlations between depression and HRV indices; (2) group differences in HRV indices among a heroin-user group, a group with major depressive disorder but no heroin use, and healthy controls; and (3) the effects of heart-rate-variability–biofeedback on depressive symptoms, HRV indices, and respiratory rates within the heroin group.MethodsAll participants completed a depression questionnaire and underwent electrocardiogram measurements, and group differences in baseline HRV indices were examined. The heroin group underwent electrocardiogram and respiration rate measurements at baseline, during a depressive condition, and during a happiness condition, before and after which they took part in the heart-rate-variability–biofeedback program. The effects of heart-rate-variability–biofeedback on depressive symptoms, HRV indices, and respiration rates were examined.ResultsThere was a negative correlation between depression and high frequency of HRV, and a positive correlation between depression and low frequency to high frequency ratio of HRV. The heroin group had a lower overall and high frequency of HRV, and a higher low frequency/high frequency ratio than healthy controls. The heart-rate-variability–biofeedback intervention increased HRV indices and decreased respiratory rates from pre-intervention to post-intervention.ConclusionReduced parasympathetic and increased sympathetic activations were found in heroin users. Heart-rate-variability–biofeedback was an effective non-pharmacological intervention to restore autonomic balance.

Towards an objective measurement of emotional stress: Preliminary analysis based on heart rate variability.

This paper presents a study performed in 25 young healthy subjects measuring the evolution of heart rate variability (HRV) indices during emotional stress. Acute emotional stress was generated with a modified version of Trier Social Stress Test (TSST). The TSST comprises several tasks which include a memory test, anticipation of stress, public exposition, and an arithmetic task. Each task has different demanding conditions, carrying subjects' emotional stress to different states. An autogenic relaxation was done before TSST. Significant differences in HRV indices were observed in the arithmetic and memory task with respect to the relaxation stage. In particular during the arithmetic task, mean heart rate increased 22% (p-value <0.00001) the power in the very low frequency band increased 47% (p-value <0.00001 and normalized power in the low frequency (LF) band increased 19% (p-value <0.04). These results support a sympathetic activation during these tasks.

Autonomic dysfunction in mild cognitive impairment: evidence from power spectral analysis of heart rate variability in a cross-sectional case-control study.

BackgroundMild cognitive impairment (MCI) is set to become a major health problem with the exponential ageing of the world's population. The association between MCI and autonomic dysfunction, supported by indirect evidence and rich with clinical implications in terms of progression to dementia and increased risk of mortality and falls, has never been specifically demonstrated.AimTo conduct a comprehensive assessment of autonomic function in subjects with MCI by means of power spectral analysis (PSA) of heart rate variability (HRV) at rest and during provocative manoeuvres.MethodsThis cross-sectional study involved 80 older outpatients (aged ≥65) consecutively referred to a geriatric unit and diagnosed with MCI or normal cognition (controls) based on neuropsychological testing. PSA was performed on 5-minute electrocardiographic recordings under three conditions—supine rest with free breathing (baseline), supine rest with paced breathing at 12 breaths/minute (parasympathetic stimulation), and active standing (orthosympathetic stimulation)—with particular focus on the changes from baseline to stimulation of indices of sympathovagal balance: normalized low frequency (LFn) and high frequency (HFn) powers and the LF/HF ratio. Blood pressure (BP) was measured at baseline and during standing. Given its exploratory nature in a clinical population the study included subjects on medications with a potential to affect HRV.ResultsThere were no significant differences in HRV indices between the two groups at baseline. MCI subjects exhibited smaller physiological changes in all three HRV indices during active standing, consistently with a dysfunction of the orthosympathetic system. Systolic BP after 10 minutes of standing was lower in MCI subjects, suggesting dysautonomia-related orthostatic BP dysregulation.ConclusionsOur study is novel in providing evidence of autonomic dysfunction in MCI. This is associated with orthostatic BP dysregulation and the ongoing follow-up of the study population will determine its prognostic relevance as a predictor of adverse health outcomes.

Breathing at a rate of 5.5 breaths per minute with equal inhalation-to-exhalation ratio increases heart rate variability

ObjectivesPrior studies have found that a breathing pattern of 6 or 5.5breaths per minute (bpm) was associated with greater heart rate variability (HRV) than that of spontaneous breathing rate. However, the effects of combining the breathing rate with the inhalation-to-exhalation ratio (I:E ratio) on HRV indices are inconsistent. This study aimed to examine the differences in HRV indices and subjective feelings of anxiety and relaxation among four different breathing patterns. MethodsForty-seven healthy college students were recruited for the study, and a Latin square experimental design with a counterbalance in random sequences was applied. Participants were instructed to breathe at two different breathing rates (6 and 5.5 breaths) and two different I:E ratios (5:5 and 4:6). The HRV indices as well as anxiety and relaxation levels were measured at baseline (spontaneous breathing) and for the four different breathing patterns. ResultsThe results revealed that a pattern of 5.5bpm with an I:E ratio of 5:5 produced a higher NN interval standard deviation and higher low frequency power than the other breathing patterns. Moreover, the four different breathing patterns were associated with significantly increased feeling of relaxation compared with baseline. ConclusionThe study confirmed that a breathing pattern of 5.5bpm with an I:E ratio of 5:5 achieved greater HRV than the other breathing patterns. This finding can be applied to HRV biofeedback or breathing training in the future.

Automatic filtering of outliers in RR intervals before analysis of heart rate variability in Holter recordings: a comparison with carefully edited data

BackgroundUndetected arrhythmic beats seriously affect the power spectrum of the heart rate variability (HRV). Therefore, the series of RR intervals are normally carefully edited before HRV is analysed, but this is a time consuming procedure when 24-hours recordings are analysed. Alternatively, different methods can be used for automatic removal of arrhythmic beats and artefacts. This study compared common frequency domain indices of HRV when determined from manually edited and automatically filtered RR intervals.Methods and ResultsTwenty-four hours Holter recordings were available from 140 healthy subjects of age 1-75 years. An experienced technician carefully edited all recordings. Automatic filtering was performed using a recursive procedure where RR intervals were removed if they differed from the mean of the surrounding RR intervals with more than a predetermined limit (ranging from 10% to 50%). The filtering algorithm was evaluated by replacing 1% of the beats with synthesised ectopic beats. Power spectral analysis was performed before and after filtering of both the original edited data and the noisy data set. The results from the analysis using the noisy data were used to define an age-based filtering threshold. The age-based filtration was evaluated with completely unedited data, generated by removing all annotations from the series of RR intervals, and then comparing the resulting HRV indices with those obtained using edited data. The results showed equivalent results after age-based filtration of both the edited and unedited data sets, where the differences in HRV indices obtained by different preprocessing methods were small compared to the mean values within each age group.ConclusionsThe study showed that it might not be necessary to perform the time-consuming careful editing of all detected heartbeats before HRV is analysed in Holter recordings.In most subjects, it is sufficient to perform the regular editing needed for valid arrhythmia analyses, and then remove undetected ectopic beats and artefacts by age-based filtration of the series of RR intervals, particularly in subjects older than 30 years.

The changes of heart rate variability after unilateral stellate ganglion block

BackgroundThe effect of the unilateral stellate ganglion block (SGB) on cardiovascular regulation remains controversial. We wished to evaluate the changes in heart rate variability (HRV) after a unilateral stellate ganglion block in patients with head and neck pain in the present study.MethodsPatients with head and neck pain (n = 89) were studied. HRV was determined before and after a C6 unilateral stellate ganglion block (right-sided SGB, 40; left-sided SGB, 49) using a paratracheal technique with 1% mepivacaine (6 ml).ResultsThere were no significant differences in HRV indices before and after right-sided SGB. The log scale of power in the high frequency range (lnHF) was increased and ratio of power in the low frequency range (LF) to power in the high frequency range (HF) ratio was decreased after left-sided SGB.ConclusionsThese results demonstrated that left-sided SGB increased parasympathetic activities in patients with head and neck pain.

Evaluation of Heart Rate Variability Indices Using a Real-Time Handheld Remote ECG Monitor

Studies on retrospective electrocardiogram (ECG) recordings of patients during cardiac arrest have shown significant changes in heart rate variability (HRV) indices prior to the onset of cardiac arrhythmia. The early detection of these changes in HRV indices increases the chances for a successful medical intervention by increasing the response time window. A portable, handheld remote ECG monitor designed in this research detects the QRS complex and calculates short-term HRV indices in real-time. The QRS detection of the ECG recordings of subjects from the MIT-Arrhythmia database yielded a mean sensitivity of 99.34% and a specificity of 99.31%. ECG recordings from normal subjects and subjects with congestive heart failure were used to identify the differences in HRV indices. An increase in heart rate, high-frequency spectral power (HFP), total spectral power, the ratio of HFP to low-frequency spectral power (LFP), and a decrease in root mean square sum of RR differences were observed. No difference was found on comparison of the standard deviation of normal to normal interval between adjacent R-waves, LFP, and very-low-frequency spectral power. Based on these, additional analytical calculations could be made to provide early warnings of impending cardiac conditions.

The relationship of heart rate and heart rate variability to non‐diabetic fasting glucose levels and the metabolic syndrome: The Cardiovascular Health Study

Increased heart rate (HR) and diminished heart rate variability (HRV) are signs of early cardiovascular autonomic neuropathy. We tested the hypotheses that increased HR and diminished HRV are present in people: (i) with increased fasting glucose (FG) levels not in the range of diabetes mellitus (DM), and (ii) in people with the metabolic syndrome (MetS) independent of elevated FG levels. HR and HRV were determined in 1267 adults (mean age 72 years) who had Holter monitoring and FG measures: 536 had normal FG levels (NORM, FG 4.5-5.5 mmol/l), 363 had mildly impaired FG (IFG-1, FG 5.6-6.0 mmol/l), 182 had significantly impaired FG (IFG-2, FG 6.1-6.9 mmol/l) and 178 had DM (FG > 6.9 mmol/l or use of glucose-lowering agents/insulin). HR and HRV in NORM/IFG-1 was further compared by the number of components of the MetS and compared by the presence or absence of MetS in IFG-2/DM. HRV indices were more impaired in IFG-2 and DM than in NORM or IFG-1. There were few differences in HRV indices between NORM and IFG-1 or between IFG-2 and DM. In NORM/IFG-1 participants, having > or = 2 components of the MetS was associated with a greater decrease in HRV compared with having no or one components. In IFG-2/DM participants, MetS was associated with decreased HRV compared with no MetS. Increased HR and diminished HRV occur in the non-diabetic FG range. Diminished HRV is associated with the MetS, independent of FG levels. Both these results suggest that factors associated with increasing non-diabetic FG levels and the MetS play a role in the onset of cardiac autonomic impairment.

Heart rate variability in coronary artery disease patients with and without panic disorder

Panic disorder (PD) and coronary artery disease (CAD) often co-occur, and CAD patients with comorbid PD suffer greater cardiovascular morbidity and mortality relative to CAD patients without PD. However, the mechanisms underlying these associations are still unknown. Reduced heart rate variability (HRV), a non-invasive measure of cardiac autonomic modulation, is an important predictor of adverse cardiac events. Interestingly, reduced HRV has been observed in patients with panic-like anxiety and PD, as well as in various CAD populations. However, the extent to which HRV is altered in patients with both PD and CAD is unknown. This study evaluated HRV in 42 CAD patients with ( n=20) and without ( n=22) PD. Patients underwent 48-h electrocardiographic monitoring. Power spectral analysis of HRV indicated that CAD patients with PD exhibited significantly lower LF/HF ratios, which may reflect lower sympathetic modulation, compared with non-PD patients. Additionally, total power in PD patients was made up of a significantly higher proportion of HF power and a significantly lower proportion of VLF power than in non-PD patients. No other significant differences in HRV indices were observed. Results suggest that contrary to what has been observed in the majority of PD-only and CAD-only populations; patients with both PD and CAD appear to exhibit lower sympathetic modulation during ordinary daily life conditions. Though preliminary, these findings suggest that changes in HRV may not be the mechanism underlying greater cardiovascular morbidity and mortality among CAD patients with PD.