Heart Rate Oscillations Research Articles

The entrainment of action potential duration and contraction amplitude by recapitulation of respiratory sinus arrhythmia in isolated cardiac myocytes

Abstract Introduction Respiratory sinus arrhythmia (RSA) is the oscillation of heart rate in phase with ventilation and represents the high frequency component of heart rate variability. RSA is prevalent in the young and the endurance-trained and its loss is considered a prognostic indicator for sudden cardiac death. The recapitulation of RSA improves cardiac function in animal models of heart failure1,2. However, the precise mechanisms by which RSA affects cardiac function are unknown. Hypothesis: We examined the hypothesis that the recapitulation of RSA in isolated ventricular myocytes affects the stimulus interval-dependence of action potential duration (APD) and sarcomere shortening through mechanisms involving sarcoplasmic reticulum (SR) Ca2+ release. Methods Hearts were excised from adult male guinea pigs under general anaesthesia (140 mg/kg bodyweight euthatal, i.p.) and left ventricular myocytes isolated. Isolated myocytes were superfused with Tyrode’s solution for perforated patch whole-cell current clamp recording and action potentials and sarcomere length measured simultaneously. Sample sizes are presented as n/N (cell/animal number) and nested hierarchical analysis applied using a generalized linear mixed model (P<0.05). Results Pacing at a basic cycle length (CL, 350 ms) induced APD, Ca2+ transient amplitude (CaT) and sarcomere shortening alternans. The recapitulation of RSA through oscillatory pacing (OP), in which CL was set to 20% below and 20% above the corresponding basic CL in a 2-short, 2-long stimulus train, reduced the incidence of alternans. Furthermore, OP entrained APD, CaT and sarcomere shortening and this entrainment persisted in voltage clamp experiments with fixed APD. Using a three-step protocol to examine the dependence of APD and sarcomere shortening on both preceding (CLn-1) and anteceding (CLn-2) stimulus intervals, both APD and sarcomere shortening were found to depend directly on the preceding cycle length (CLn-1, P<0.001). In contrast, sarcomere shortening depended inversely on the anteceding CL (CLn-2, P<0.001; n/N = 24/4). Following treatment of the cells with caffeine (50 µM) to sensitise ryanodine receptors, the dependence of APD and sarcomere shortening on CLn-1 was markedly suppressed, and the inverse dependence of sarcomere shortening on CLn-2 was lost (P<0.001, n/N = 6/3). The effects of OP are akin to post-extrasystolic potentiation3 and mathematical simulation4 supports the involvement of changes in the sarcoplasmic reticulum Ca2+ content. Conclusion These data are consistent with an obligatory role for the SR in the entrainment of APD, CaT and sarcomere shortening and the suppression of alternans by the recapitulation of RSA. We hypothesise that recapitulation of RSA would be protective against ventricular tachyarrhythmia and further work is required to test this.

Oscillatory Coupling Between Neural and Cardiac Rhythms.

Oscillations serve a critical role in organizing biological systems. In the brain, oscillatory coupling is a fundamental mechanism of communication. The possibility that neural oscillations interact directly with slower physiological rhythms (e.g., heart rate, respiration) is largely unexplored and may have important implications for psychological functioning. Oscillations in heart rate, an aspect of heart rate variability (HRV), show remarkably robust associations with psychological health. Mather and Thayer proposed coupling between high-frequency HRV (HF-HRV) and neural oscillations as a mechanism that partially accounts for such relationships. We tested this hypothesis by measuring phase-amplitude coupling between HF-HRV and neural oscillations in 37 healthy adults at rest. Robust coupling was detected in all frequency bands. Granger causality analyses indicated stronger heart-to-brain than brain-to-heart effects in all frequency bands except gamma. These findings suggest that cardiac rhythms play a causal role in modulating neural oscillations, which may have important implications for mental health.

Heart rate and breathing effects on attention and memory (HeartBEAM): study protocol for a randomized controlled trial in older adults

BackgroundIn healthy people, the “fight-or-flight” sympathetic system is counterbalanced by the “rest-and-digest” parasympathetic system. As we grow older, the parasympathetic system declines as the sympathetic system becomes hyperactive. In our prior heart rate variability biofeedback and emotion regulation (HRV-ER) clinical trial, we found that increasing parasympathetic activity through daily practice of slow-paced breathing significantly decreased plasma amyloid-β (Aβ) in healthy younger and older adults. In healthy adults, higher plasma Aβ is associated with greater risk of Alzheimer’s disease (AD). Our primary goal of this trial is to reproduce and extend our initial findings regarding effects of slow-paced breathing on Aβ. Our secondary objectives are to examine the effects of daily slow-paced breathing on brain structure and the rate of learning.MethodsAdults aged 50–70 have been randomized to practice one of two breathing protocols twice daily for 9 weeks: (1) “slow-paced breathing condition” involving daily cognitive training followed by slow-paced breathing designed to maximize heart rate oscillations or (2) “random-paced breathing condition” involving daily cognitive training followed by random-paced breathing to avoid increasing heart rate oscillations. The primary outcomes are plasma Aβ40 and Aβ42 levels and plasma Aβ42/40 ratio. The secondary outcomes are brain perivascular space volume, hippocampal volume, and learning rates measured by cognitive training performance. Other pre-registered outcomes include plasma pTau-181/tTau ratio and urine Aβ42. Recruitment began in January 2023. Interventions are ongoing and will be completed by the end of 2023.DiscussionOur HRV-ER trial was groundbreaking in demonstrating that a behavioral intervention can reduce plasma Aβ levels relative to a randomized control group. We aim to reproduce these findings while testing effects on brain clearance pathways and cognition.Trial registration ClinicalTrials.gov NCT05602220. Registered on January 12, 2023.

Ultradian rhythms in accelerometric and autonomic data vary based on seizure occurrence in paediatric epilepsy patients.

Ultradian rhythms are physiological oscillations that resonate with period lengths shorter than 24 hours. This study examined the expression of ultradian rhythms in patients with epilepsy, a disease defined by an enduring seizure risk that may vary cyclically. Using a wearable device, we recorded heart rate, body temperature, electrodermal activity and limb accelerometry in patients admitted to the paediatric epilepsy monitoring unit. In our case-control design, we included recordings from 29 patients with tonic-clonic seizures and 29 non-seizing controls. We spectrally decomposed each signal to identify cycle lengths of interest and compared average spectral power- and period-related markers between groups. Additionally, we related seizure occurrence to the phase of ultradian rhythm in patients with recorded seizures. We observed prominent 2- and 4-hour-long ultradian rhythms of accelerometry, as well as 4-hour-long oscillations in heart rate. Patients with seizures displayed a higher peak power in the 2-hour accelerometry rhythm (U = 287, P = 0.038) and a period-lengthened 4-hour heart rate rhythm (U = 291.5, P = 0.037). Those that seized also displayed greater mean rhythmic electrodermal activity (U = 261; P = 0.013). Most seizures occurred during the falling-to-trough quarter phase of accelerometric rhythms (13 out of 27, χ2 = 8.41, P = 0.038). Fluctuations in seizure risk or the occurrence of seizures may interrelate with ultradian rhythms of movement and autonomic function. Longitudinal assessments of ultradian patterns in larger patient samples may enable us to understand how such rhythms may improve the temporal precision of seizure forecasting models.

POTENTIAL MECHANISMS THROUGH WHICH INDUCING HEART RATE OSCILLATIONS AFFECTS PLASMA AMYLOID BETA LEVELS

Abstract Alzheimer’s disease-related protein amyloid beta (Aβ) plasma levels increase with age, and Aβ40 levels are associated with greater mortality. Most plasma Aβ40 is produced via platelets. Platelet activity is regulated by endothelial cells, which are stimulated by blood flow. Slow paced breathing with a 10-second cycle maximizes heart rate oscillations, which may stimulate endothelial-platelet interactions that affect Aβ production. We investigated this idea by randomizing healthy adults (54 younger and 54 older adults) into two groups with the opposite goals: increasing (Osc+) or decreasing (Osc-) heart rate oscillations. Four weeks of daily practice (20-40 min) resulted in large changes in plasma Aβ40 and Aβ42 levels. We also found that changes in Aβ were not associated with changes in resting-state physiology including heart rate variability. But the Aβ changes were associated with a frequency measure of heart rate oscillations induced during practice, suggesting that the Aβ changes were more driven by blood flow changes during practice. P-selectin is an indicator of endothelial activity. We found a significant intervention effect where the Osc+ intervention increased p-selectin and the Osc- intervention decreased p-selectin in older adults. Changes in p-selectin also showed strong negative correlations with changes in Aβ40 and Aβ42 in older adults. The results suggest that blood flow oscillations caused by high amplitude heart rate oscillations stimulated endothelial cells, which suppressed platelet activity and consequently reduced the production of Aβ in older adults. In follow-up research, we are investigating relationships between plasma Ab changes and changes in brain and cognition.

AUTONOMIC ACTIVITY AND THE AGING BRAIN

Abstract Aging affects both autonomic activity and the brain regions that help modulate autonomic activity. In this symposium, we present new findings on how the relationships between autonomic activity and the brain change in aging. In addition, we demonstrate that modulating autonomic activity can affect the aging brain and emotional and cognitive functions controlled by the brain. Kathy Liu will present research from over 600 participants showing that, unlike younger adults who show the expected positive relationship between heart rate variability (HRV) and brain and behavioral indicators of emotion regulation, older adults showed a negative relationship between HRV and emotion regulation. Julian Thayer will present findings on how blood pressure and total peripheral resistance relate to brain structure. Richard Song will present functional MRI data revealing that the older brain shows less blood oxygen level dependent (BOLD) response to physiological fluctuations than younger brains. Jungwon Min will present findings that random assignment to daily biofeedback to either increase or decrease heart rate oscillations had a large effect on plasma amyloid-β. Mara Mather will present a new theoretical model positing that older brains attempt to compensate for hyperactive peripheral sympathetic activity, and that this ventromedial prefrontal compensatory activity leads to the biases in attention and memory known as the age-related positivity effect. Together, the empirical findings and theoretical perspectives presented in this symposium indicate that the autonomic system exerts important influences over the aging brain and that this provides a significant opportunity for intervening to improve brain health.

Analysis of oscillatory processes in the cardiovascular system in response to local heating in patients with type 2 diabetes mellitus

A comprehensive spectral analysis was used to assess heart rate variability and skin perfusion pattern of limbs in patients with type 2 diabetes mellitus in response to local heating and to identify significant predictors of physiological and pathological changes in the cardiovascular system. An electrocardiogram and skin perfusion on the forearm and foot were measured using Laser Doppler flowmetry at rest and during local heating in both healthy volunteers and patients with type 2 diabetes. The wavelet analysis was applied to Laser Doppler signals and heart rate variability (based on electrocardiogram signals). ROC analysis was used to evaluate significant predictors. The analysis results of patients with type 2 diabetes were compared with healthy controls. The following changes were observed in patients 1) impairment of skin blood flow reserve on the foot during heating, 2) lower amplitude oscillations in heart rate at rest and during heating, 3) an increase in amplitude of oscillations in the skin blood flow from the forearm in intervals related to respiration and heart activity at rest and during heating, 4) a decrease in amplitude of oscillations in the skin blood flow on the foot in the interval related to myogenic activity at rest and in cardiointerval during heating. The parameters of cardiovascular system (energies of heart rate variability at low-frequencies recorded by laser Doppler flowmetry on forearm in intervals related to respiration activity) with high discriminative power were revealed to distinguish patients from healthy subjects in response to local heating; these parameters can be used as markers for early diagnosis of microvascular disorders.

Daily biofeedback to modulate heart rate oscillations affects structural volume in hippocampal subregions targeted by the locus coeruleus in older adults but not younger adults

Using data from a clinical trial, we tested the hypothesis that daily sessions modulating heart rate oscillations affect older adults' volume of a region-of-interest (ROI) comprised of adjacent hippocampal subregions with relatively strong locus coeruleus (LC) noradrenergic input. Younger and older adults were randomly assigned to one of two daily biofeedback practices for 5 weeks: (1) engage in slow-paced breathing to increase the amplitude of oscillations in heart rate at their breathing frequency (Osc+); (2) engage in self-selected strategies to decrease heart rate oscillations (Osc-). The interventions did not significantly affect younger adults’ hippocampal volume. Among older adults, the two conditions affected volume in the LC-targeted hippocampal ROI differentially as reflected in a significant condition × time-point interaction on ROI volume. These condition differences were driven by opposing changes in the two conditions (increased volume in Osc+ and decreased volume in Osc-) and were mediated by the degree of heart rate oscillation during training sessions.

Daily heart rate variability biofeedback training decreases locus coeruleus MRI contrast in younger adults in a randomized clinical trial

As an arousal hub region in the brain, the locus coeruleus (LC) has bidirectional connections with the autonomic nervous system. Magnetic resonance imaging (MRI)-based measures of LC structural integrity have been linked to cognition and arousal, but less is known about factors that influence LC structure and function across time. Here, we tested the effects of heart rate variability (HRV) biofeedback, an intervention targeting the autonomic nervous system, on LC MRI contrast and sympathetic activity. Younger and older participants completed daily HRV biofeedback training for five weeks. Those assigned to an experimental condition performed biofeedback involving slow, paced breathing designed to increase heart rate oscillations, whereas those assigned to a control condition performed biofeedback to decrease heart rate oscillations. At the pre- and post-training timepoints, LC contrast was assessed using turbo spin echo MRI scans, and RNA sequencing was used to assess cAMP-responsive element binding protein (CREB)-regulated gene expression in circulating blood cells, an index of sympathetic nervous system signaling. We found that left LC contrast decreased in younger participants in the experimental group, and across younger participants, decreases in left LC contrast were related to the extent to which participants increased their heart rate oscillations during training. Furthermore, decreases in left LC contrast were associated with decreased expression of CREB-associated gene transcripts. On the contrary, there were no effects of biofeedback on LC contrast among older participants in the experimental group. These findings provide novel evidence that in younger adults, HRV biofeedback involving slow, paced breathing can decrease both LC contrast and sympathetic nervous system signaling.

Multimodal neuroimaging data from a 5-week heart rate variability biofeedback randomized clinical trial

We present data from the Heart Rate Variability and Emotion Regulation (HRV-ER) randomized clinical trial testing effects of HRV biofeedback. Younger (N = 121) and older (N = 72) participants completed baseline magnetic resonance imaging (MRI) including T1-weighted, resting and emotion regulation task functional MRI (fMRI), pulsed continuous arterial spin labeling (PCASL), and proton magnetic resonance spectroscopy (1H MRS). During fMRI scans, physiological measures (blood pressure, pulse, respiration, and end-tidal CO2) were continuously acquired. Participants were randomized to either increase heart rate oscillations or decrease heart rate oscillations during daily sessions. After 5 weeks of HRV biofeedback, they repeated the baseline measurements in addition to new measures (ultimatum game fMRI, training mimicking during blood oxygen level dependent (BOLD) and PCASL fMRI). Participants also wore a wristband sensor to estimate sleep time. Psychological assessment comprised three cognitive tests and ten questionnaires related to emotional well-being. A subset (N = 104) provided plasma samples pre- and post-intervention that were assayed for amyloid and tau. Data is publicly available via the OpenNeuro data sharing platform.

Daily heart rate variability biofeedback practice sessions affect plasma Αβ40 and Αβ42 levels in healthy younger and older adults: A randomized clinical trial (N = 108)

AbstractBackgroundGenetic mutations affecting β‐amyloid (Αβ) production suggest that decreasing Αβ levels in healthy adults could prevent AD. However, evidence for behavioral interventions that decrease Αβ levels is lacking. The current study examined whether heart rate variability (HRV) biofeedback affects plasma Αβ levels. This intervention involves breathing slowly at a pace that maximizes the amplitude of heart rate oscillations. During slow paced breathing, the vagus nerve receives strong signals from stretch receptors in blood vessels and the lungs. These afferent signals stimulate ascending vagus nerve signaling that activate ‘safety’ signaling pathways, suppressing stress and arousal pathways in the brain and body. Experiencing adversity increases production of Aβ and risk of AD. We hypothesized that, in healthy adults, daily sessions involving slow paced breathing during HRV biofeedback could decrease Aβ by suppressing these adversity‐related processes.MethodHealthy adults (N = 54 age 18‐35; N = 54 age 55‐80) practiced HRV biofeedback daily for five weeks. They were randomized to use slow paced breathing and HRV biofeedback to increase heart rate oscillations (Osc+ condition) or to use personalized strategies and HRV biofeedback to try to decrease heart rate oscillations (Osc‐ condition). Pre‐ and post‐intervention plasma Aβ40 and Aβ42 levels were quantified blind to condition. Gene expression analysis of peripheral blood samples of the 54 younger adults using bioinformatics‐based analyses of genome‐wide RNA profiles examined activity of pro‐inflammatory, neuroendocrine, and antiviral transcription control pathways relevant to the conserved transcriptional response to adversity (CTRA). We predicted that reductions in the CTRA across the 5‐week trial would be associated with reduced plasma Aβ.ResultBoth younger and older adults showed significant differences between Osc+ and Osc‐ conditions in change in plasma Aβ40 and Aβ42 levels (Figure 1). The Osc+ condition decreased Αβ while the Osc‐ condition increased Αβ. Individual changes in plasma Aβ from pre‐ to post‐intervention were associated with changes in expression of the CTRA in the predicted direction.ConclusionHRV biofeedback affects plasma Aβ and these effects are associated with changes in expression of genes upregulated during adversity. Future longer‐term studies should test whether reducing plasma Αβ via the Osc+ intervention reduces risk of developing AD.

Autonomic control of heart and vessels in patients with very early stage of Parkinson disease

Objective. Non-motor symptoms including those reflecting autonomic cardiovascular dysregulation are often present in Parkinson disease. It is unclear whether it is possible to detect cardiovascular autonomic dysregulation in the very early stage of Parkinson disease potentially supporting the concept of the upstream propagation of nervous system damage through autonomic nerves. We hypothesized that cardiovascular dysregulation should precede the motor symptoms and at the time of their occurrence autonomic dysregulation should be clearly demonstrable. Therefore, the aim of this study was to assess the various aspects of autonomic cardiovascular control in the very early stage of Parkinson disease. Approach. We performed prospective case-control study on 19 patients with Parkinson disease (<6 months after motor signs occurrence) and 19 healthy control subjects. For each phase of study protocol (supine, head-up tilt, supine recovery), we calculated a wide array of cardiovascular control related parameters reflecting cardiac chronotropic, cardiac inotropic and vasomotor control and baroreflex mediated cardiovascular response. Main results. We observed the well-preserved heart rate and blood pressure control in patients with early stage of Parkinson disease. However, causal analysis of interactions between heart rate and blood pressure oscillations revealed subtle differences in baroreflex function and baroreflex mediated vasoconstriction response to orthostasis. Furthermore, a tendency towards a decreased contraction strength in Parkinson disease was observed. Significance. Considering only subtle cardiovascular control impairment in our study employing a wide array of sensitive methods at the time when motor signs were clearly expressed, we suggest that motor signs dominated in this stage of Parkinson disease.

ECG-Based Semi-Supervised Anomaly Detection for Early Detection and Monitoring of Epileptic Seizures

Epilepsy is one of the most common brain diseases, characterized by frequent recurrent seizures or "ictal" states. A patient experiences uncontrollable muscular contractions, inducing loss of mobility and balance, which may result in injury or even death during these ictal states. Extensive investigation is vital to establish a systematic approach for predicting and informing patients about oncoming seizures ahead of time. Most methodologies developed are focused on the detection of abnormalities using mostly electroencephalogram (EEG) recordings. In this regard, research has indicated that certain pre-ictal alterations in the Autonomic Nervous System (ANS) can be detected in patient electrocardiogram (ECG) signals. The latter could potentially provide the basis for a robust seizure prediction approach. The recently proposed ECG-based seizure warning systems utilize machine learning models to classify a patient's condition. Such approaches require the incorporation of large, diverse, and thoroughly annotated ECG datasets, limiting their application potential. In this work, we investigate anomaly detection models in a patient-specific context with low supervision requirements. Specifically, we consider One-Class SVM (OCSVM), Minimum Covariance Determinant (MCD) Estimator, and Local Outlier Factor (LOF) models to quantify the novelty or abnormality of pre-ictal short-term (2-3 min) Heart Rate Variability (HRV) features of patients, trained on a reference interval considered to contain stable heart rate as the only form of supervision. Our models are evaluated against labels that were either hand-picked or automatically generated (weak labels) by a two-phase clustering procedure for samples of the "Post-Ictal Heart Rate Oscillations in Partial Epilepsy" (PIHROPE) dataset recorded by the Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, achieving detection in 9 out of 10 cases, with average AUCs of over 93% across all models and warning times ranging from 6 to 30 min prior to seizure. The proposed anomaly detection and monitoring approach can potentially pave the way for early detection and warning of seizure incidents based on body sensor inputs.

Modulating heart rate oscillation affects plasma amyloid beta and tau levels in younger and older adults

Slow paced breathing via heart rate variability (HRV) biofeedback stimulates vagus-nerve pathways that counter noradrenergic stress and arousal pathways that can influence production and clearance of Alzheimer's disease (AD)-related proteins. Thus, we examined whether HRV biofeedback intervention affects plasma Αβ40, Αβ42, total tau (tTau), and phosphorylated tau-181 (pTau-181) levels. We randomized healthy adults (N = 108) to use slow-paced breathing with HRV biofeedback to increase heart rate oscillations (Osc+) or to use personalized strategies with HRV biofeedback to decrease heart rate oscillations (Osc−). They practiced 20–40 min daily. Four weeks of practicing the Osc+ and Osc− conditions produced large effect size differences in change in plasma Aβ40 and Aβ42 levels. The Osc+ condition decreased plasma Αβ while the Osc− condition increased Αβ. Decreases in Αβ were associated with decreases in gene transcription indicators of β-adrenergic signaling, linking effects to the noradrenergic system. There were also opposing effects of the Osc+ and Osc− interventions on tTau for younger adults and pTau-181 for older adults. These results provide novel data supporting a causal role of autonomic activity in modulating plasma AD-related biomarkers.Trial registration: NCT03458910 (ClinicalTrials.gov); first posted on 03/08/2018.

Changes in Medial Prefrontal Cortex Mediate Effects of Heart Rate Variability Biofeedback on Positive Emotional Memory Biases

Previous research suggests that implicit automatic emotion regulation relies on the medial prefrontal cortex (mPFC). However, most of the human studies supporting this hypothesis have been correlational in nature. In the current study, we examine how changes in mPFC-left amygdala functional connectivity relate to emotional memory biases. In a randomized clinical trial examining the effects of heart rate variability (HRV) biofeedback on brain mechanisms of emotion regulation, we randomly assigned participants to increase or decrease heart rate oscillations while receiving biofeedback. After several weeks of daily biofeedback sessions, younger and older participants completed an emotional picture memory task involving encoding, recall, and recognition phases as an additional measure in this clinical trial. Participants assigned to increase HRV (Osc+) (n = 84) showed a relatively higher rate of false alarms for positive than negative images than participants assigned to decrease HRV (Osc−) (n = 81). Osc+ participants also recalled relatively more positive compared with negative items than Osc− participants, but this difference was not significant. However, a summary bias score reflecting positive emotional memory bias across recall and recognition was significantly higher in the Osc+ than Osc− condition. As previously reported, the Osc+ manipulation increased left amygdala-mPFC resting-state functional connectivity significantly more than the Osc− manipulation. This increased functional connectivity significantly mediated the effects of the Osc+ condition on emotional bias. These findings suggest that, by increasing mPFC coordination of emotion-related circuits, daily practice increasing heart rate oscillations can increase implicit emotion regulation.

The relationship between heart rate and barrel oscillation in rifle shooters VIFK

The relationship between heart rate and barrel oscillation in rifle shooters VIFK

Combined thickness of uterus and placenta, foetal heart rate oscillations and progesterone concentration in last week of canine gestation

This study aimed to evaluate the combined thickness of uterus and placenta, foetal heart rate and serum progesterone concentration in prepartum bitches. Eighteen pregnant female dogs in the last week of gestation were subjected to ultrasonographic examination and progesterone assay to evaluate changes prior to impending whelping. No significant difference was found in the combined thickness of uterus and placenta measurements in the last week of gestation. However, foetal heart rate showed oscillations and progesterone declined 12h prior to whelping.

Is it Feasible to Use a Low-Cost Wearable Sensor for Heart Rate Monitoring within an Upper Limb Training in Spinal Cord Injured Patients?: A Pilot Study.

(1) Background: Cervical spinal cord injury (SCI) patients have impairment in the autonomic nervous system, reflected in the cardiovascular adaption level during the performance of upper limb (UL) activities carried out in the rehabilitation process. This adaption level could be measured from the heart rate (HR) by means of wearable technologies. Therefore, the objective was to analyze the feasibility of using Xiaomi Mi Band 5 wristband (XMB5) for HR monitoring in these patients during the performance of UL activities; (2) Methods: The HR measurements obtained from XMB5 were compared to those obtained by the professional medical equipment Nonin LifeSense II capnograph and pulse oximeter (NLII) in static and dynamic conditions. Then, four healthy people and four cervical SCI patients performed a UL training based on six experimental sessions; (3) Results: the correlation between the HR measurements from XMB5 and NLII devices was strong and positive in healthy people (r = 0.921 and r = 0.941 (p &lt; 0.01) in the static and dynamic conditions, respectively). Then, XMB5 was used within the experimental sessions, and the HR oscillation range measured was significantly higher in healthy individuals than in patients; (4) Conclusions: The XMB5 seems to be feasible for measuring the HR in this biomedical application in SCI patients.

Screening of obstructive sleep apnea syndrome by the deep breathing technique.

Obstructive sleep apnea syndrome (OSAS) is associated with alterations in heart rate variability (HRV) in relation to chronic autonomic dysfunction. We tested the ability of the deep breathing technique-a simple way to evaluate HRV-to identify patients with OSAS. Consecutive patients referred for suspected OSAS (without obesity, diabetes, and heart diseases) were included. They underwent a measure of HRV at rest and of heart rate oscillations during expiration vs inspiration (DeltaHRDB) when breathing deeply at the resonant frequency of 6 cycles per minute (deep breathing technique) while sitting awake, followed by a nighttime polysomnography. We measured DeltaHRDB and performed temporal and spectral HRV analysis. Of 31 included participants (77% male), 14 had mild to moderate OSAS (apnea-hypopnea index median [IQR]: 18 [12]) and 17 had no OSAS. The conventional HRV analysis did not reveal any difference between the groups with vs without OSAS. However, the DeltaHRDB was lower in those with than without OSAS. Lower DeltaHRDB correlated with higher apnea-hypopnea index, arousal index, and desaturation degree. A DeltaHRDB below 11 beats per minute (bpm) predicted OSAS with a sensitivity of 100% and specificity of 86%. The deep breathing technique accurately identifies a reduction in cardiac changes in patients with mild to moderate OSAS. It could be used as a simple screening tool to select patients for polysomnography. Onanga M, Joanny S, Rivals I, etal. Screening of obstructive sleep apnea syndrome by the deep breathing technique. J Clin Sleep Med. 2023;19(2):293-302.

Heart rate monitoring of physical fitness training load based on wavelet transform

The detection of fluctuations is a crucial step in the process of isolating heart rate oscillation signals. This is necessary to circumvent the issue wherein a variety of auditory signals will invariably interfere with the collection of centre velocity signals during physical activity, which has a significant impact on the detection efficiency of automated testing. To obtain heart rate fluctuation signals that are more precise, the paper proposes a method of R-wave identification that is based on heartbeat conversion while the athlete is exercising. The proposed model relies heavily on the technique of wave analysis to filter out the background noise of the heartbeat when the athlete exercises and isolates the R-wave signal of the heartbeat from the background noise. The proposed algorithm is evaluated in terms of noise interference that removes approximately 90% of noise, the heart rate data which is obtained after the noise is normally distributed, the average detection rate of the R-wave algorithm is 98.65%. It has been demonstrated that the detection accuracy of the proposed algorithm is sufficient to meet the requirements of generating heart rate oscillatory signals.