Heart Rate Variability Indices Research Articles

Relationship between dust allergen sensitization and cardiac autonomic function in patients with chronic obstructive pulmonary disease.

Cardiac autonomic function predicts cardiovascular disease risk. The aim of this study was to investigate the relationship between sensitization to dust allergens and cardiac autonomic dysfunction in patients with chronic obstructive pulmonary disease (COPD), and to provide new ideas for the prevention of cardiovascular complications in these patients. Immunoassays for sensitization to cats/dogs, cockroaches and dust mites were performed in 840 patients with COPD. Indicators of heart rate variability in these patients were used to assess cardiac autonomic function, including standard deviation of normal-to-normal intervals (SDNN), root-mean square of successive differences between normal-to-normal intervals (RMSSD), low-frequency power (LF), high-frequency power (HF), and LF/HF ratios, which were obtained based on ambulatory electrocardiographic monitoring data. The relationship between sensitization to these dust allergens and heart rate variability was explored using multivariate logistic regression. The multivariate analyses showed that sensitization to total allergens was associated with reduced levels of SDNN, RMSSD, LF and HF and with increased levels of the LF/HF ratio in the patients with COPD (p < .05). Dust allergen sensitization may be associated with cardiac autonomic dysfunction in patients with COPD. Whether desensitization can prevent cardiovascular complications in these patients should be further explored.

Structural analysis of prognostic diagnostics of cardiovascular system adaptive capacity and assessment of psycho physiological resistance to stressоgenic cognitive loads.

Aim: To conduct a structural analysis of cardiological signs of adaptation to stressogenic cognitive loads by identifying factor features of correlations between heart rate variability (HRV) and coping-testing data indicators. Materials and Methods: 43 people aged 19.7±1.8 years (23 boys and 20 girls) were monitored for their HRV. Methods included DC-06000 portable ECG recorder, 3X series "badge" type (single channel) and COPE Test. The study process includes four stages. Results: As a result of further factor correlation analysis, it was revealed that Factor 1 "HRV Stress Indicators" has a negative correlation (p<0.05) of "moderate" strength ρs= -0.363 with Factor 2 "Strategies to avoid problems and stresses" and a positive correlation of "weak" strength ρs=0.167 with Factor 3 "Psychoemotional Indicators". If two factors correlate with each other, it indicates they are related and can interact, which is important for adequate interpretation of the results of factor analysis. Conclusions: Structural analysis of the complex of cardiological signs of adaptivity to stressogenic cognitive loads and coping-testing data revealed the existence of three correlated factors: Factor 1 "HRV Stress Scores", Factor 2 "Strategies to avoid problems and stress", Factor 3 "Psychoemotional indicators". The revealed negative correlation of Factors 1 and 2 may indicate that in case the impact of Factor 2 "Strategies to avoid problems and stress" increases, the intensity of Factor 1 "HRV Stress Scores" (i.e., stress signs according to the indicators of heart rate variability) may decrease.

The Influence of Autonomic Nervous System during Resting State on the Peripheral Pulse Wave Velocity in Young Adult Males

Abstract Background: The association between the activity of autonomic nervous systems (ANS) and pulse wave velocity (PWV) was commonly deduced after adjusting for confounding factors. The relationship between the ANS and PWV was either maintained, but attenuated, or no longer statistically connected after controlling for confounding variables. Research in young healthy individuals showed that the ANS does not control aortic stiffness (indexed by PWV) in a pressure-independent manner. Therefore, the role of the ANS in controlling PWV is debatable. Objectives: The objective of this study was to examine the possibility that ANS directly affects PWV independent of blood pressure (BP) and heart rate (HR). Subjects and Methods: Thirty-four healthy male volunteers (19 years old) were recruited. Stable brachial systolic BP (SBP)/diastolic BP (DBP) and HR were measured in semi-supine position after a 15-min rest. During the last 5 min, fingertip digital pulse wave (DPW) and lead II electrocardiogram (ECG) signals were recorded. The pulse transit time, and consequently PWV, was calculated by measuring the duration between the ECG R wave climax and a reference point on the DPW in the same cardiac cycle. The ANS activity was assessed by calculating the HR variability (HRV) indices obtained from the ECG record of 5-min R-R intervals (RRIs). Results: HRV indices low-frequency (LF)/high-frequency (HF) (LF band power measured in the 0.04–0.15 Hz)/the HF band power measured in the 0.15–0.4 Hz band) and SD2/SD1 ratios (SD1 and SD2 represent the dispersion along the minor and major axis of the fitted ellipse of the Poincaré plot) (sympathovagal balance) were significantly and positively correlated with PWV. In addition, the standard deviation of RRI, or normal-to-normal “NN” (SDNN) interval, after excluding ectopic beats, the square root of the mean squared differences of successive NN intervals (RMSSD) were significantly and negatively correlated with the PWV. No correlation was obtained between PWV and HR, SBP, or DBP. Conclusion: Peripheral PWV during rest or inactivity is affected directly by the sympathovagal balance independent of BP.

Vagal predominance correlates with mood state changes of winter-over expeditioners during prolonged Antarctic residence.

Winter-over expeditioners in Antarctica are challenged by various environmental and psycho-social stress factors, which may induce psychophysiological changes. The autonomic nervous system (ANS) plays a crucial role in the adaptation process under stress. However, the relationship between ANS activity and the mood states of expeditioners remains largely unexplored. This study aims to uncover the pattern of ANS adjustment under extreme Antarctic environments and provide new insights into the correlations between ANS activity and mood state changes, which may provide scientific data for medical interventions. Fourteen expeditioners at Zhongshan Station participated in this study. The study was conducted during four representative periods: pre-Antarctica, Antarctica-1 (pre-winter), Antarctica-2 (winter), and Antarctica-3 (summer). The heart rate variability (HRV) of the expeditioners was continuously measured for 24 hours to evaluate ANS activity. Plasma levels of catecholamines were tested by ELISA. Mood states were assessed by the Profile of Mood States (POMS) scale. HRV analysis showed a disturbance of ANS during winter and summer periods. For frequency domain parameters, very low frequency (VLF), low frequency (LF), high frequency (HF), and total power (TP) significantly increased during the second half of the mission. Especially, LF/HF ratio decreased during summer, indicating the predominance of vagal tone. Results of the time domain analysis showed increased heart rate variability during the austral winter and summer. Plasma epinephrine (E) significantly increased during residence in Antarctica. Compared with pre-Antarctica, the vigor, depression, and anger scores of the expeditioners decreased significantly during the austral summer. Notably, the depression score showed a moderate positive correlation with LF/HF, while weak negative correlations with other HRV indicators, including TP, VLF, and LF. Anger score showed a moderate positive correlation with LF/HF and weak negative correlations with the average normal-to-normal (NN) interval, and the root mean square of differences between adjacent RR intervals (RMSSD). Plasma E level weakly correlated with the average NN interval. Prolonged residence in Antarctica increased the ANS activities and shifted the cardiac autonomic modulation towards vagal predominance. The alteration of HRV correlated with mood states and plasma epinephrine levels.

ПРОГНОЗИРОВАНИЕ РАЗВИТИЯ АРТЕРИАЛЬНОЙ ГИПЕРТЕНЗИИ У МОЛОДЫХ МУЖЧИН С ВЫСОКИМ НОРМАЛЬНЫМ АРТЕРИАЛЬНЫМ ДАВЛЕНИЕМ

High normal blood pressure (HNBP) is known to be associated with an increased risk of arterial hypertension (AH) development. The purpose of the study is to identify predictors of the development of AH in young men with HNBP, to assess their prognostic significance. Materials and methods. From a sample of 50 men aged 18-29 years with registered HNBP, groups were formed: group 1 – 18 patients with AH diagnosed within 10 years, group 2 – 32 patients in whom AH was not diagnosed. Cardiovascular risk factors, indicators of 24-hour blood pressure monitoring, bicycle ergometry, heart rate variability (HRV) during an active orthostatic test, echocardiography, and pulse wave velocity were analyzed. Results. Predictors of the development of AH in young men with HNBP are HRV indicators during active orthostatic test (ΔSDNN, ΔHF) and bicycle ergometry indicators (heart rate (HR) at the end of the physical load, diastolic BP (DBP) at the end of the recovery period). Conclusions. Predictors of the development of AH in young men with HNBP are ΔSDNN and ΔHF during active orthostatic test, HR in peak physical load and the level of DBP in the recovery period of bicycle ergometry (sensitivity – 88.89%, specificity – 93.75%, accuracy – 92.0%). The resulting prognostic model can be used as a method for determining the individual risk of AH development.

Effect of combined Zhuang medicine treatment on tricuspid annular displacement and heart rate variability in rheumatoid arthritis patients.

This retrospective study analyzed echocardiographic data and HRV of 30 healthy subjects and 60 RA patients. RA patients were divided into two groups for a 6-month treatment: 30 received iguratimod (control group), and 30 underwent combined Zhuang medicine and needle-pricking therapy (test group). Echocardiographic assessments and HRV measures were recorded both before and after treatment. Compared to the healthy group, RA patients showed increased late diastolic tricuspid annular velocity. However, early diastolic tricuspid annular velocity to late diastolic tricuspid annular velocity ratios, tricuspid annular plane systolic excursion (TAPSE), and the standard deviation of average normal RR intervals (SDANN) were significantly lower (all P<0.05). After treatment, the test group exhibited higher clinical efficacy (90% vs. 56.67% in the control group). Significant improvements were observed in TAPSE and HRV indices [SDANN, standard deviation of the RR intervals (SDNN), root mean square of successive RR interval differences (RMSSD), and the percentage of adjacent RR interval differences greater than 50 milliseconds (PNN50)] in the test group (all P<0.05). Additionally, a positive correlation was noted among these measurments. Zhuang medicine significantly enhances right ventricular function and autonomic balance in RA patients, thus affirming its therapeutic potential.

Nomogram model based on clinical factors and autonomic nervous system activity for predicting residual renal function decline in patients undergoing peritoneal dialysis.

Several heart rate variability (HRV) parameters were reported to be associated with residual renal function (RRF) in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). However, it is unclear whether using HRV or other autonomic nervous system (ANS) activity indexes can predict RRF decline in CAPD patients. Patients undergoing CAPD in 2022 from the First Affiliated Hospital of Nanjing Medical University were enrolled in this study. Their clinical characteristics, 5-min HRV parameters and average voltage of 5-min skin sympathetic nerve activity (aSKNA) were collected. According to the 12-month glomerular filtration rate (GFR) decline rate compared with the upper quartile, these patients were categorized into two groups: RRF decline (RRF-D) group and RRF stable (RRF-S) group. Clinical factors and ANS activity indexes for predicting 1-year RRF decline were analyzed using logistic regression, and a nomogram model was further established. The relationships between volume load related indexes and aSKNA were displayed by Spearman's correlation graphs. Ninety-eight patients (53 women, average age of 46.7 ± 13.0 years old) with a median dialysis vintage of 24.5 months were enrolled in this study. Seventy-three patients were categorized into the RRF-S group and 25 patients into the RRF-D group. Compared with RRF-S group, patients in the RRF-D group had higher systolic blood pressure (BP; p = 0.019), higher GFR (p = 0.016), higher serum phosphorous level (p = 0.030), lower total Kt/V (p = 0.001), and lower levels of hemoglobin (p = 0.007) and albumin (p = 0.010). The RRF-D group generally exhibited lower HRV parameters and aSKNA compared with the RRF-S group. A nomogram model included clinical factors (sex, systolic BP, hemoglobin, GFR, and total Kt/V) and aSKNA showed the largest AUC of 0.940 (95% CI: 0.890-0.990) for predicting 1-year RRF decline. The nomogram model included clinical factors (sex, systolic BP, hemoglobin, GFR and total Kt/V) and ANS activity index (aSKNA) might be a promising tool for predicting 1-year RRF decline in CAPD patients.

Visually assessing work performance using a smartwatch via day-to-day fluctuations in heart rate variability.

To optimize workplace health promotion, a simple method for quantifying allostatic load response is needed. This study examines the feasibility of optimizing objective anxiety and presenteeism monitoring using daily smartwatch-measured ultra-short heart rate variability (HRV). Office workers without diagnosed disease prospectively performed 30 s HRV self-measurement each morning for two months and responded to the State-Trait Anxiety Inventory (STAI) and Work Limitation Questionnaire (WLQ). Logistic regression analysis examined daily HRV parameters in the high-trait anxiety group (HTA, STAI ≥ 40) using mean and variance HRV, age, self-reported gender, and body mass index (BMI). The ideal cutoff value enabled comparison of WLQ using the Mann-Whitney U test. Heart rate variability data were collected for 279 participants (male ratio, 83.9%; age, 42 ± 10 years) who completed questionnaires and monitored HRV for 30+ days. Compared to the low-trait anxiety group, HTA exhibited higher variance of the log-transformed coefficient of component variance of high-frequency component (LnccvHF) and low-frequency per HF (Lnccv L/H), in addition to differences in the means of these HRV parameters. In addition to BMI (odds ratio [OR] = 0.92, p = 0.02) and mean LnccvL/H (OR = 10.75, p < 0.01), the variance of Lnccv L/H was an independent predictor of HTA (OR = 2.39E + 8, p = 0.011). The daily Lnccv L/H dispersion group had a lower WLQ productivity loss score (p = 0.02, r = 0.17). By focusing on HRV dispersion status, this simple and instantly applicable daily HRV monitoring system enables optimized quantitative monitoring of anxiety and productivity.

Effect of nadanusandhana on heart rate variability in individuals with insomnia – A randomized controlled trial

ABSTRACT Background: Insomnia is a common sleep disorder characterized by difficulty initiating or maintaining sleep or sleep that is unrefreshing or of poor quality. It is a serious public health concern where pharmacological insomnia treatments are often only advised for short term. Nadanusandana relaxation can be a safe, simple, and most effective treatment for insomnia as an adjuvant yogic treatment. Aim: The aim of this study was to assess the effect of Nadanusandana relaxation on autonomic variables in patients with insomnia. Settings and Design: A prospective randomized controlled trial conducted on subjects who fulfilled the inclusion criteria were divided equally into two groups. Group 1 along with naturopathy and yogic intervention practiced Nadanusandana relaxation (n = 50) and Group 2 underwent only naturopathic and yogic practices (n = 50). Subjects and Methods: Subjects were assessed for heart rate variability (HRV), blood pressure, and Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) scores before and after treatment. Statistical Analysis Used: SPSS 21.0 was used for statistical analysis. Results: The Nadanusandana relaxation group observed a significant increase in average RR interval, the square root of the mean squared difference between adjacent N-N intervals, the fraction of consecutive RR intervals that differ by more than 50 ms, and high frequency (HF), and a significant decrease in low frequency (LF) and LF/HF ratio was observed in HRV.. A very substantial drop in both the diastolic and systolic blood pressure during blood pressure readings. Sleep quality questionnaire analyzed a significant decrease in ISI score and in PSQI. Conclusion: Nadanusandana relaxation reduces sympathetic tone and shifts sympathovagal balance toward vagal dominance in regular practice. Hence, the result claims that this technique can be effective in reducing sleep disturbances, lowering blood pressure, and improving sleep quality in insomnia.

Assessment of Heart Rate Variability and Energy Expenditure Index during Ambulation on Uneven Surface Among Young Adults of Aged 18–30 years

Context: Walking on uneven surfaces is a common daily activity that presents unique challenges to the human body’s energy expenditure and cardiovascular system. This research delves into the unique demands of navigating such surfaces, focusing on two key metrics: energy expenditure index (EEI) and heart rate variability (HRV). Understanding how these physiological parameters are affected during ambulation on irregular terrain is crucial for various fields, including sports science, rehabilitation, and occupational health. Aim: Despite the ubiquity of uneven terrain ambulation in low- and middle-income countries, the physiological responses to such terrain remain understudied. This external pilot study addresses this gap by investigating HRV and EEI during ambulation on various uneven surfaces in healthy young adults. Objectives: The objectives of this study were to evaluate how HRV parameters and EEI respond to ambulation on various uneven surfaces such as roads, grass, sand, and pebbles. Methods and Material: This observational cross-sectional study employed a convenience sample of 35 healthy young adults aged 18–30 years. Participants completed 5-min walks on various surfaces (level, road, grass, sand, and pebbles), whereas HRV and EEI were measured using a polar H10 HR monitor and the elite HRV mobile application and EEI through standard formula. Results: Data were analyzed using descriptive statistics, Shapiro–Wilk tests for normality, and one-way analysis of variance with Bonferroni post hoc tests. No statistically significant differences in HRV or EEI were found between level, sand, pebbles, road, or grass surfaces in healthy young adults (P &gt; 0.05 for all comparisons). Conclusions: While healthy young adults adapted readily to navigating diverse uneven terrain, showing no significant changes in HRV or EEI, research with larger, diverse samples, and longer exposure is needed to confirm clinical implications for populations with lower adaptability or facing more challenging surfaces.

Construction of nomogram prediction model using heart rate and pulse perfusion variability index as predictors for hypotension in cervical cancer patients with spinal epidural anesthesia.

The prevention and treatment strategies for cervical cancer patients undergoing spinal epidural anesthesia have increasingly focused on early screening for high-risk factors associated with potential hypotension. We analyze the general conditions and preoperative examination results of 312 cervical cancer patients who received spinal epidural anesthesia, in order to identify independent risk factors for hypotension, assess their predictive efficacy, and construct a nomogram. 312 patients with cervical cancer received spinal epidural anesthesia were included in this study. Among them, 164 patients with hypotension after hysterectomy with spinal epidural anesthesia were in a hypotension group. Important risk predictors of hypotension after hysterectomy with spinal epidural anesthesia were identified using univariate and multivariate analyses, then a clinical nomogram was constructed. The predictive accuracy was assessed by unadjusted concordance index (C-index) and calibration plot. Univariate and multivariate regression analysis identified basal HR (≥95) (95% CI 0.831-0.900; P = 0.000) and basal PVI (95% CI 0.679-0.877; P = 0.000) were the independent risk factors for hypotension in cervical cancer patients with spinal epidural anesthesia. Those risk factors were used to construct a clinical predictive nomogram. The regression equation model based on the above factors was logit (P) = -6.820 + 0.216 * basal HR + basic PVI * 0.312. The calibration curves for hypotension risk revealed excellent accuracy of the predictive nomogram model. Decision curve analysis showed that the predictive model could be applied clinically when the threshold probability was 20 to 75%. We surmised that the basal HR values and PVI values are the independent risk factors for hypotension in cervical cancer patients with spinal epidural anesthesia. The construction of nomograms is beneficial in predicting the risk of hypotension in these patients.

Data Analysis of Heart Rate Variability and Arrhythmia in Patients with Paroxysmal Atrial Fibrillation.

Atrial fibrillation (AF) is the most common type of arrhythmia. Heart rate variability (HRV) may be associated with AF risk. The aim of this study was to test HRV indices and arrhythmias as predictors of paroxysmal AF based on 24-hour dynamic electrocardiogram recordings of patients. A total of 199 patients with paroxysmal AF (AF group) and 204 elderly volunteers over 60 years old (Control group) who underwent a 24-hour dynamic electrocardiogram from August 2022 to March 2023 were included. Time-domain indices, frequency-domain indices, and arrhythmia data of the two groups were classified and measured. Binary logistic regression analysis was performed on variables with significant differences to identify independent risk factors. A nomogram prediction model was established, and the sum of individual scores of each variable was calculated. Gender, age, body mass index and low-density lipoprotein (LDL) did not differ significantly between AF and Control groups (p > 0.05), whereas significant group differences were found for smoking, hypertension, diabetes, and high-density lipoprotein (HDL) (p < 0.05). The standard deviation of all normal to normal (NN) R-R intervals (SDNN), standard deviation of 5-minute average NN intervals (SDANN), root mean square of successive NN interval differences (rMSSD), 50 ms from the preceding interval (pNN50), low-frequency/high-frequency (LF/HF), LF, premature atrial contractions (PACs), atrial tachycardia (AT), T-wave index, and ST-segment index differed significantly between the two groups. Logistic regression analysis identified rMSSD, PACs, and AT as independent predictors of AF. For each unit increase in rMSSD and PACs, the odds of developing AF increased by 1.0357 and 1.0005 times, respectively. For each unit increase in AT, the odds of developing AF decreased by 0.9976 times. The total score of the nomogram prediction model ranged from 0 to 110. The autonomic nervous system (ANS) plays a pivotal role in the occurrence and development of AF. The individualized nomogram prediction model of AF occurrence contributes to the early identification of high-risk patients with AF.

Confiabilidade e Concordância Intra-Avaliador das Avaliações da Pressão Arterial, Rigidez Arterial e Variabilidade da Frequência Cardíaca em Pacientes com Doença de Parkinson

Abstract To assess the intrarater reliability and agreement of blood pressure (BP), arterial stiffness, and heart rate variability (HRV) assessments in patients with Parkinson`s disease (PD). Twenty patients with PD visited the laboratory three times, during which brachial and central BP (auscultatory and applanation tonometry, respectively), arterial stiffness (carotid-femoral pulse wave velocity and augmentation index), and HRV assessments were performed at rest. Brachial and central systolic BP presented greater values on visit 1 when compared to visits 2 and 3 (122±13 vs. 116±16 vs. 120±15, p=0.029). There were no significant differences (p&gt;0.05) among the experimental visits for other parameters. Brachial and central BP showed an intraclass correlation coefficient (ICC) above 0.842 and a standard error of measurement (SEM) lower than 5.0%. Bland–Altman plots indicated low agreement between visits 1 and 2 and good agreement between visits 2 and 3. Arterial stiffness indices exhibited ICC values between 0.781 and 0.886, and SEM ranged from 7.3% to 25.2%. Bland–Altman plots indicated moderate to good agreement among visits for arterial stiffness parameters. HRV indices presented ICC values ranging from 0.558 to 0.854 and SEM values ranging from 5.1% to 76.0%. Bland–Altman plots indicated moderate agreement among visits for HRV parameters. In PD patients, brachial and central BP present low intrarater reliability and agreement between visits 1 and 2 and good intrarater reliability and agreement between visits 2 and 3. In general, arterial stiffness and HRV assessments present acceptable intrarater reliability and agreement among visits, except for cardiac sympathovagal balance.

Exploring factors associated with heart rate variability in newly injured traumatic cervical spinal cord injury patients

Background: Assessment of heart rate variability (HRV) in traumatic cervical spinal cord injury (SCI) patients is widely reported, but few studies have examined the HRV in the newly injured. Further, there is paucity of data relating HRV to factors that might have a bearing on the extent of variability in them. Aim and Objectives: The current study explored the factors associated with the HRV of newly injured cervical SCI American Spinal Injury Association (ASIA) Impairment Scale (AIS) grade A/B patients. Materials and Methods: A secondary analysis of HRV data acquired from 24 newly injured tetraplegic patients in a previously published study compared the HRV between AIS grade A and B patients, and across cervical levels of lesion. In addition, the correlation of HRV indices with duration since injury and the patients’ age was examined. Results: The ratio of low to high frequency power was significantly lower in AIS B compared to AIS A patients, and significantly negatively correlated with duration since injury. Conclusion: The ratio of modulations of cardiac sympatho-vagal supply was lower in AIS B patients and reduced with increasing duration since injury. AIS grade and duration since injury need to be considered when interpreting the HRV data of newly injured tetraplegic patients.

Cardio-Metabolic Indices in Relation to Serum Vitamin D Levels among Middle-Aged Adults

A plethora of research showed that vitamin D deficiency is one of the most prevalent dietary inadequacies in India. The condition is addressed as hypovitaminosis-D and often intervenes with the occurrence of diseases like cardio-metabolic disease. Though several epidemiological studies have supported this fact, there is an insufficiency of rational data to support the fact. Hence the current study investigates the relationship between vitamin D levels and markers of cardio-metabolic diseases among middle-aged adults. This study recruited 100 healthy middle-aged adults, and the participants underwent evaluation of their anthropometric measurements, Heart Rate Variability (HRV), and serum vitamin D levels. Analysis was done by taking consideration of total power (TP), absolute, and normalized power of high-frequency (HF), and low-frequency (LF) power spectrum including their ratio (LF/HF) as HRV indices. Data analysis was performed using the Pearson correlation test. Data analysis showed a negative correlation between vitamin D and anthropometric measurements and a positive correlation with cardiac sympathovagal balance as determined by waist circumference and LF/HF ratio. However, there was no discernible correlation between vitamin D levels and the BMI, fat percentage, Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), absolute power spectrum of HRV. The results of this study conclude that serum vitamin D levels affect central obesity and cardiac sympathovagal balance, indicating low levels of serum vitamin D might contribute higher risk for cardiovascular diseases.

Targeted ablation of the left middle cervical ganglion prevents ventricular arrhythmias and cardiac injury induced by AMI.

Cardiac sympathetic overactivation is a critical driver in the progression of acute myocardial infarction (AMI). The left middle cervical ganglion (LMCG) is an important extracardiac sympathetic ganglion. However, the regulatory effects of LMCG on AMI have not yet been fully documented. In the present study, we detected that the LMCG was innervated by abundant sympathetic components and exerted an excitatory effect on the cardiac sympathetic nervous system in response to stimulation. In canine models of AMI, targeted ablation of LMCG reduced the sympathetic indexes of heart rate variability and serum norepinephrine, resulting in suppressed cardiac sympathetic activity. Moreover, LMCG ablation could improve ventricular electrophysiological stability, evidenced by the prolonged ventricular effective refractory period, elevated action potential duration, increased ventricular fibrillation threshold, and enhanced connexin43 expression, consequently showing antiarrhythmic effects. Additionally, compared with the control group, myocardial infarction size, circulating cardiac troponin I, and myocardial apoptosis were significantly reduced, accompanied by preserved cardiac function in canines subjected to LMCG ablation. Finally, we performed the left stellate ganglion (LSG) ablation and compared its effects with LMCG destruction. The results indicated that LMCG ablation prevented ventricular electrophysiological instability, cardiac sympathetic activation, and AMI-induced ventricular arrhythmias with similar efficiency as LSG denervation. In conclusion, this study demonstrated that LMCG ablation suppressed cardiac sympathetic activity, stabilized ventricular electrophysiological properties and mitigated cardiomyocyte death, resultantly preventing ischemia-induced ventricular arrhythmias, myocardial injury, and cardiac dysfunction. Neuromodulation therapytargeting LMCG represented a promising strategy for the treatment of AMI.

Pilot Randomized Controlled Trial of Multi-Disciplinary Community-Based Biofeedback Vs Health Promotion Programs on Mental Health And Drug Use Among People Experiencing Homelessness

Background: PEH are most vulnerable to COVID-19 due to high levels of chronic disease and social isolation. However, in Skid Row Los Angeles, there are limited resources for mental health and drug treatment services. Biofeedback (BF) has been found to decrease depression and substance use among drug users; however, no studies have assessed the impact of BF on PEH during the COVID-19 pandemic.&#x0D; Aim: Our multi-disciplinary team designed and pilot tested an 8-week Heart Rate Variability-Biofeedback (HRV-BF) intervention, utilizing a nurse-led, Community Health Worker model of care with 50 people experiencing homelessness (PEH) as compared with a Health Promotion (HP) program. Our goal was to establish feasibility of the program, and to assess effects HRV-BF on measures of HRV, mental health and drug use as compared to HP.&#x0D; Methods: Utilizing Community Based Participatory Research (CBPR) principles, a community advisory board was established to refine the HRV-BF intervention and assess acceptability and feasibility. We enrolled 40 PEH and randomized into HRV-BF vs HP program and assessed a) impact on anxiety and depression; b) HRV and cortisol indices; and c) drug and alcohol use among all participants.&#x0D; Results: In total, 40 PEH were enrolled with 36 completing the intervention; 17 HRV-BF and 19 HP. Majority were male (80%) and were equally Black (37.5%) or Hispanic (35%). The mean age of PEH was 49 (SD 16.7), median age 53. The HRV measure RMSSD (root mean square of successive differences between normal heart beats, a time-based variable reflecting vagally mediated HRV), assessed during the resting 5-minute period, showed significant increases in 71% of participants (75% among HRV-BF and 68% among HP), using paired t-tests with natural log transformed variables, p=0.004, and by non-parametric tests, p= 0.006 (p values one-sided). Across the sample, PHQ-9 (depressive symptoms) showed marginally significant improvement (p= 0.09). Anxiety and Mental Health Inventory scores showed improvement, though not significant. Between-group analysis showed the HRV-BF group had better GAD-7 and MHI scores at 8 weeks (post-intervention), though not statistically significant. Chronic disease was found to be high in both groups (67% among HRV-BF and 82% among HP). No significant differences were found in terms of substance use.&#x0D; Conclusions: As the first known study to date examining the role of a biofeedback self-regulation training on biomarkers of stress/mental health measures among PEH, our study shows feasibility and acceptability among the study population and positive initial results for both arms of the study. We plan to extend the follow-up period beyond the intervention period of 8 weeks to establish the sustainability of the intervention.&#x0D; Funding: Susan Samueli Integrative Health Institute Pilot Studies Award&#x0D;

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.

Heart Rate Variability during Online Video Game Playing in Habitual Gamers: Effects of Internet Addiction Scale, Ranking Score and Gaming Performance.

Previous studies have demonstrated that individuals with internet gaming disorder (IGD) display abnormal autonomic activities at rest and during gameplay. Here, we examined whether and how in-game autonomic activity is modulated by human characteristics and behavioral performance of the player. We measured heart rate variability (HRV) in 42 male university student habitual gamers (HGs) when they played a round of League of Legends game online. Short-term HRV indices measured in early, middle and late phases of the game were compared between the players at high risk of developing IGD and those at low risk, as assessed by the revised Chen Internet addiction scale (CIAS-R). Multiple linear regression (MLR) was used to identify significant predictors of HRV measured over the whole gameplay period (WG), among CIAS-R, ranking score, hours of weekly playing and selected in-game performance parameters. The high-risk players showed a significantly higher low-frequency power/high-frequency power ratio (LF/HF) relative to the low-risk players, regardless of game phase. MLR analysis revealed that LF/HF measured in WG was predicted by, and only by, CIAS-R. The HRV indicators of sympathetic activity were found to be predicted only by the number of slain in WG (NSlain), and the indicators of parasympathetic activity were predicted by both CIAS-R and NSlain. Collectively, the results demonstrated that risk of developing IGD is associated with dysregulated autonomic balance during gameplay, and in-game autonomic activities are modulated by complex interactions among personal attributes and in-game behavioral performance of the player, as well as situational factors embedded in game mechanics.

New opportunities for optimizing the treatment of supraventricular heart rhythm disorders in patients with arterial hypertension under conditions of chronic stress

The aim was to determine the effects of Carvelis (Dr Gustav Klein GmbH Co KG, Germany) in patients with arterial hypertension (AH) and supraventricular arrhythmias on the state of psycho‑vegetative disorders in combination with the analysis of heart rate variability (HRV) and manifestations of arrhythmia.&#x0D; Materials and methods. Investigation involved 50 patients with АН of ІІ stage 2 degree with supraventricular extrasystole and paroxysmal atrial fibrillation (AF). The first group (26 patients) took standard therapy and Carvelis 30 drops 3 times a day; 24 patients of the second group received the standard therapy only. The examinations were performed before and after 3 months of treatment and included general clinical laboratory examination, questionnaires with psychometric scales, 24‑hours ECG monitoring, daily blood pressure monitoring (DMAT), exercise test (ET), echocardiography.&#x0D; Results. At baseline, Hospital Anxiety and Depression Scale (HADS) demonstrated clinically (≥ 11 points) and sub‑clinically (8–10 points) manifested anxiety and depression in all study participants. After 3 months, patients of the 1 group showed significant decrease in the manifestations of anxiety and depression, especially in the most severe cases of psycho‑emotional state. In comparison with the group 2, Carvelis administration was associated with the normalization of HRV indices and an additional 10.8% reduction in the number of AF paroxysms. According to the DMAT data, an almost 2‑fold increase in the number of patients with physiological blood pressure profile and normalization of blood pressure variability indicators was observed in group 1. The treadmill test results demonstrated an increase in power (12.5%) and time (9.5%) of the physical load performed in group 1.&#x0D; Conclusions. The use of psychometric scales in patients with arterial hypertension and atrial fibrillation makes it possible to identify psycho‑emotional disorders. Correction of these disorders by addition of Carvelis for 3 months associated with the HRV normalization, increase in the effectiveness of antiarrhythmic therapy, restoration of the physiological daily profile of blood pressure, and increase in the indicators of test with physical load.&#x0D;