Short-term Heart Rate Variability Research Articles

Effects of stress management interventions on heart rate variability in adults with cardiovascular disease: a systematic review and meta-analysis.

Meta-analysis was used to investigate the potential benefits of stress management interventions (SMIs) on vagally-mediated heart rate variability (HRV) in adults with cardiovascular disease. Electronic bibliographic databases were searched through August 2022. Randomized controlled trials and quasi-experimental studies assessing effects of SMIs on HRV were included. Methodological quality was assessed with a standardized checklist. A pooled effect size was calculated for vagally-mediated HRV indices (standard deviation of normal-to-normal intervals, root mean square of the successive differences, and high frequency power) using random effects models. Fourteen studies (1202 participants, Mage: 59 ± 6.25years; 25% ± 16% women; 61% ± 22% White) were included. Ten studies (11 effects) reported short-term HRV assessment; a small between-group difference emerged for vagally-mediated HRV (d+ = .27, 95% confidence interval [CI] 0.01-0.52, k = 11). Most interventions examined biofeedback; these studies yielded a small between-group difference on vagally-mediated HRV (d+ = 0.31, 95% CI 0.09-0.53, k = 7, Q [6] = 3.82, p = .70, I2 = 11%). This is the first systematic examination of the effect of SMIs on HRV in adults with CVD. Findings suggest a small effect of SMIs on vagally-mediated HRV, with biofeedback likely driving the effect. More research is required to fully understand whether this benefit on vagally-mediated HRV applies to other SMIs.

Feasibility and determinants of short-term heart rate variability in patients using photoplethysmography-based wearable devices - data derived from TeleCheck-AF

Abstract Background Heart rate variability (HRV), especially short-term HRV, is known to be associated with development of atrial fibrillation (AF). Nevertheless, it is not known if short-term HRV can be feasibly derived from digital devices in patients at risk for AF. In this analysis, we aimed to evaluate the feasibility and determinants of short-term HRV using non-continuous photoplethysmography (PPG) recordings derived from digital hand-held device. Methods TeleCheck-AF is a project implementing an on-demand app-based infrastructure for the management of AF. Briefly, one week prior to the scheduled teleconsultation, patients were provided with a smartphone app to assess heart rate/rhythm three times a day and in case of symptoms. Patients from the project with at least one PPG recording in sinus rhythm (SR) during the study period were analyzed. For every recording in SR, the short-term HRV parameter, root mean square of successive normal-to-normal interval differences (RMSSD), was calculated. The PPG parameters, heart rate and RMSSD, were compared between groups (men vs women, presence vs absence of previous AF, atrial flutter, atrial tachycardia, pulmonary vein isolation (PVI) within 12 months). Results Overall, 855 patients [60.5% men, median age 63 (56;70) years] with a total number of 13465 recordings were included in the analysis. Median number of recordings per patient was 15 (7;20) with a median heart rate of 66 (59;75)bpm and a RMSSD of 39.7 (30.6 ;56.1)ms. Results revealed a significant difference in RMSSD for gender and previously known AF, whereas no difference was seen e.g., for patients with known atrial flutter or atrial tachycardia (table 1). In patients with previously known AF, patients who underwent PVI within the last 12 months had a reduced RMSSD in comparison to patients without previous PVI (36.7 (31.8; 47.0)ms vs 42.2 (34.4; 54.3)ms, p<0.001). Conclusion Assessing short-term HRV based on RMSSD using PPG recordings is feasible. Short-term HRV recorded by digital hand-held devices may be especially helpful in patients after PVI as such patients were shown to have a reduced HRV in this analysis. Table 1: Differences in short-term heart rate variability in patients at risk for atrial fibrillation. AF = Atrial fibrillation.Table 1

Photoplethysmography recordings preceding onset atrial fibrillation show a higher heart rate variability - a TeleCheck-AF subanalysis

Abstract Background An increased heart rate variability (HRV), mostly assessed by 12-lead electrocardiogram (ECG) or long-term Holter monitoring, can be associated with the onset of atrial fibrillation (AF). Data evaluating HRV measurements using digital devices, especially those using photoplethysmography (PPG), in patients at risk for AF are sparse. In this analysis, we aimed to assess if hand-held-based non-continuous PPG measurements can provide short-term HRV to predict AF. Methods Patients from the TeleCheck-AF project with at least one PPG measurement in AF and one measurement in sinus rhythm (SR) were analyzed. Briefly, patients were provided with a PPG-based heart rate/rhythm monitoring smartphone app. They were instructed to record a PPG measurements three times daily and in case of symptoms for seven consecutive days. Short-term HRV using root mean square of successive normal-to-normal interval differences (RMSSD) was calculated in recordings in SR and compared between those not preceding and preceding an episode of AF (figure 1). Results Overall, 136 patients [56.3% men, median age 66 (59; 72) years] were included in the analysis. Median total number of recordings per patient was 24 (19; 30) including 4 (2;7) AF episodes per 1 week recording period. RMSSD was significantly higher in PPG measurements preceding an AF episode than in PPG measurements not preceding an AF episode [42.5 (33.2;70.7)ms vs. 41.1 (32.4;54.7)ms; p<0.001]. Between-group comparison revealed no significant difference for gender, age, previous ablation or betablocker therapy (p=0.824; p=0.484; p=0.519 and p=0.624, respectively). Conclusion Short-term HRV based on RMSSD, assessed by digital hand-held devices is significantly higher in PPG recordings preceding an AF episode than in measurements not preceding a consecutive AF episode. Whether PPG-recording derived short-term HRV can help to predict onset-AF warrants further study in larger populations. Figure 1: Patient example and exemplary analysis scheme, depicting the total number of recordings (n=14). HRV of recordings in sinus rhythm (SR) not preceding an episode of atrial fibrillation (AF) (A; grey circles) were compared to recordings preceding a consecutive AF episode (B; blue circles).Figure 1

Assessing heart rate fragmentation to predict atrial fibrillation in the general population aged 65

Abstract Rationale Screening the general population aged 65 for atrial fibrillation (AF) has been proposed as a preventive measure against potential complications. The dysfunction of the autonomic nervous system (ANS) plays an important role in atrial fibrillation (AF). Short-term HRV is conceptually attributed to physiologic vagal tone modulation. But recent data suggest that a component of short-term HRV, called heart rate fragmentation (HRF), is related to ANS breakdown and may be a predictor of AF occurrence. Metrics derived from heart rate variability (HRV) that depict heart rate fragmentation (HRF) have been suggested to reflect autonomic nervous system (ANS) dysfunction. Objectives To assess the predictive capacity of HRF markers for AF occurrence over an 18-year follow-up in individuals aged 65 at the study’s inspection and to develop a predictive score for AF onset. Methods A cohort study was designed to prospectively assess the predictive value of ANS activity level among general population regarding cardiovascular events and mortality. 1011 subjects aged 65 were enrolled in the study from September 2000 to December 2002. The study population had no history of AF and a low cardiovascular risk. A median follow-up of 17.8 years was managed. HRV data were acquired by 24-h Holter electrcardiogram (ECG) monitoring at baseline and assessed by frequency domain and time domain methods. Heart rate fragmentation using the percentage of inflection points (PIP) and alpha 1-index (using fractal evaluation of NN intervals) were then calculated. The study outcome was the development of AF during follow-up, defined as a standard 12-lead ECG recording or Holter recording with ≥ 30 s of AF. Results AF was diagnosed in 123 patients during the 18-year follow-up, representing a cumulative incidence of 13.4%. Using multivariate analysis, the occurrence of AF was independently predicted by the male gender (HR=1.74, 95%CI:1.16-2.63, p<0.01), a heart rate below 70bpm (HR=1.85, 95%CI:1.18-2.90, p<0.01), an increased percentage of NN intervals that differ by more than 50 ms from the previous interval (pnn50) (HR=1.69, 95%CI:1.06-2.70, p=0.03), an increased percentage of inflection points (HR=2.80, 95%CI:1.66-4.72,p<0.01), and a reduced alpha 1 index (HR=1.61, 95%CI:1.03-2.53, p=0.04). Given these results, a predictive score was built up based on the 4 independent predictors, ranging from 0 to 6 (Graphical Abstract). The high-risk group, defined as having a PROOF-AF score of 4 or higher, exhibited a 3.3-fold higher risk of developing AF (Figure). The PROOF-AF score demonstrated superior predictive performance compared to other available risk scores for incident AF such as CHARGE-AF score, C2HEST score, FHS score, and JMC score. Conclusion HRF parameters, included in the PROOF-AF score, may be used to identify individuals aged 65 without pre-existing health conditions who are at high-risk of developing AF and assist population screening.Graphical abstractFigure

Association of sex with heart rate variability in atrial fibrillation patients

Abstract Background Sex-specific differences in cardiac autonomic tone have not been thoroughly investigated in patients with atrial fibrillation (AF) but may play a relevant role. Purpose We aimed to investigate cardiac autonomic function of female compared to male AF patients by means of short-term heart rate variability (HRV) analysis. Methods In this cross-sectional analysis, we enrolled 1150 patients from the Swiss-AF cohort study with 5-minute resting ECG recordings in sinus rhythm. We calculated the following HRV parameters: HRV triangular index (HRVI), standard deviation of NN intervals (SDNN), root mean square of successive differences, mean heart rate, power in the high frequency and low frequency range. We fitted linear regression models to analyze the association between gender and HRV variables adjusted for age, intake of betablockers, hypertension, diabetes and heart failure. Results 361 patients (29%) were female (mean age 72.9±7.8 years), 789 (68.6%) were male (mean age 69.8±8.5 years). In the multivariable adjusted models, female sex was associated with significantly lower values of HRVI (β = -0.74; 95% CI -1.44- -0 04, p=0.039) and SDNN (β = 8.95; 95% CI 0.162-17.7, p=0.046). This association persisted in all three age tertiles (<68 years, 68-75 years and ≥ 75 years of age). Conclusions In an elderly AF cohort, female sex is associated with reduced global autonomic activity. Whether this is associated with an adverse prognosis has to be investigated.

The effect of breathing hypoxic gas (15% FIO2 ) on physiological and behavioral outcomes during simulated driving in healthy subjects.

Hypoxia is mainly caused by cardiopulmonary disease or high-altitude exposure. We used a driving simulator to investigate whether breathing hypoxic gas influences driving behaviors in healthy subjects. Fifty-two healthy subjects were recruited in this study, approved by the Science and Engineering Ethical Committee. During simulated driving experiments, driving behaviors, breathing frequency, oxygen saturation (SpO2 ), and heart rate variability (HRV) were analyzed. Each subject had four driving sessions; a 10-min practice and three 20-min randomized interventions: normoxic room air (21% FIO2 ) and medical air (21% FIO2 ) and hypoxic air (equal to 15% FIO2 ), analyzed by repeated measures ANOVA. Driving behaviors and HRV frequency domains showed no significant change. Heart rate (HR; p < 0.0001), standard deviation of the RR interval (SDRR; p = 0.03), short-term HRV (SD1; p < 0.0001), breathing rate (p = 0.01), and SpO2 (p < 0.0001) were all significantly different over the three gas interventions. Pairwise comparisons showed HR increased during hypoxic gas exposure compared to both normoxic interventions, while SDRR, SD1, breathing rate, and SpO2 were lower. Breathing hypoxic gas (15% FiO2 , equivalent to 2710 m altitude) may not have a significant impact on driving behavior in healthy subjects. Furthermore, HRV was negatively affected by hypoxic gas exposure while driving suggesting further research to investigate the impact of breathing hypoxic gas on driving performance for patients with autonomic dysfunction.

Effect of psychosocial factors on autonomic nervous system activity in patients with heart failure.

Autonomic imbalance predicts worse clinical outcomes in patients with heart failure (HF). Managing the variables affecting heart rate variability (HRV) might improve the clinical outcomes of patients with HF. This study aimed to investigate variables affecting HRV. We assessed autonomic nervous system activity (low-frequency [Lf], high-frequency [Hf], and Lf/Hf ratio) in 60 patients with HF, employing standard measures to capture short-term HRV. To estimate the independent effects of variables such as well-known cardiac risk factors and psychosocial conditions on HRV, multivariate analyses were conducted. For psychosocial variables, we assessed depression and quality of life in patients and their family caregivers. We also assessed the self-care behavior of patients and their caregivers' burden. Depression in family caregivers and self-care behavior of patients were independently associated with a decreased Hf (β-coefficient = 0.309, P = .039 and β-coefficient = -0.029, P = .047, respectively). Depression of family caregivers and self-care behavior of patients may affect HRV in patients with HF.

Cardiac Autonomic and Endothelial Function in Acute Lymphoblastic Leukaemia Patients Immediately After Chemotherapy and at the Three-Month Follow-up.

Acute lymphoblastic leukemia (ALL) is a malignant uncontrolled overproduction of immature lymphoid cells in blood and bone marrow. The primary treatment of ALL is chemotherapy. Chemotherapy can have myriad systemic side effects, notably cardiovascular derangement. Autonomic derangement occurrence in cancer patients signifies cardiovascular risk in them and is a determinant of cardiovascular morbidity and mortality. Elevated soluble vascular cell adhesion molecule-1 (sVCAM-1) and soluble intercellular adhesion molecule-1 (sICAM-1) levels implicated in the regulation of inflammation indicate endothelial dysfunction. High levels of high-sensitivity C-reactive protein (hsCRP) can be indicative of low-grade inflammation. Hence, in this study the cardiac autonomic function and endothelial and inflammatory biomarker levels in adult patients with ALLwere assessed immediately and three months after chemotherapy. In this longitudinal study, 30 ALL patients (23 males, seven females) aged between 18 to 50 years, who had completed chemotherapy regimens, and 30 age and gender-matched healthy participants (controls) were recruited. Cardiac autonomic function tests (short-term heart rate variability (HRV), 30:15 ratio, synaptic excitation and inhibition (E/I) ratio, diastolic blood pressure (DBP) response to isometric hand grip), endothelial markers (sVCAM-1 and sICAM-1), and inflammatory marker (hsCRP) were assessed immediately and at three months after chemotherapy. Magnitudes of time domain and frequency domain indices, conventional autonomic function test indices, and biomarkers were deranged in ALL patients immediately after chemotherapy. After three months, cardiac autonomic function parameters were found to improve in the form of increased root mean square of successive differences between normal heartbeats (RMSSD), standard deviation of the interbeat intervals of normal sinus beats (SDNN), total power, high-frequency (HF)nu, and decreased low-frequency(LF)nu & LF-HF ratio. Endothelial (sVCAM-1) and inflammatory markers (hsCRP) were lower in the patient group as compared to the controls immediately after chemotherapy. Three months after chemotherapy, the levels of endothelial and inflammatory markers did not show much change. In this study, we found ALL patients showed higher sympathetic drive, decreased parasympathetic modulation, and sympathovagal imbalance immediately after chemotherapy as compared to the controls, indicating cardiovascular risk. After three months, improvement in cardiovascular autonomic function was observed. ALL itself is a state of inflammation with elevated endothelial and inflammatory markers; thus, the decreased endothelial and inflammatory markers could be attributed to the immediate effect of chemotherapy.

Does Osteopathic Heart-Focused Palpation Modify Heart Rate Variability in Stressed Participants with Musculoskeletal Pain? A Randomised Controlled Pilot Study.

Heart rate variability (HRV) describes fluctuations in time intervals between heartbeats and reflects autonomic activity. HRV is reduced in stressed patients with musculoskeletal pain and improved after osteopathic manipulative treatment and mind-body interventions. Heart-focused palpation (HFP) combines manual and mind-body approaches to facilitate relaxation. This randomised controlled pilot study investigated the feasibility and sample size for a future randomised controlled trial and the effect of a single treatment with HFP or sham HFP (SHAM) on short-term HRV. A total of Thirty-three adults (47.7 ± 13.5 years old) with stress and musculoskeletal pain completed the trial with acceptable rates of recruitment (8.25 subjects per site/month), retention (100%), adherence (100%), and adverse events (0%). HFP (n = 18), but not SHAM (n = 15), significantly increased the root mean square of successive RR interval differences (p = 0.036), standard deviation of the NN intervals (p = 0.009), and ratio of the low-frequency to high-frequency power band (p = 0.026). HFP and SHAM significantly decreased the heart rate (p < 0.001, p = 0.009) but not the stress index and ratio of the Poincaré plot standard deviation along and perpendicular to the line of identity (p > 0.05). A power analysis calculated 72 participants. Taken together, the study was feasible and HFP improved HRV in stressed subjects with musculoskeletal pain, suggesting a parasympathetic effect.

Comparison of time domain indices of heart rate variability between alcohol-dependent individuals and non-alcoholic subjects

Background: Alcohol dependence develops because of repeated alcohol intake. Alcohol damages the cardiac autonomic nerve fibers leading to autonomic imbalance, resulting in reduced heart rate variability (HRV). HRV refers to the complex beat-to-beat variation in the heart rate, produced by the interplay of sympathetic and parasympathetic neural activity at the Sino-atrial node. Our body works effectively in parasympathetic activity dominance. The time domain indices of HRV are specific markers of parasympathetic activity. A decrease in the time domain parameters indicates reduced parasympathetic activity in the heart, indicating cardiac autonomic dysfunction with vagal neuropathy. Aims and Objectives: The objectives of the study are as follows: (1) To assess the HRV in alcohol-dependent individuals using time domain indices. (2) To compare the HRV between alcoholic-dependent individuals and non-alcoholic subjects. Materials and Methods: A total of 110 individuals in the age group of 20–55 years were recruited for our study. Among them, 55 were alcohol-dependent individuals selected based on the diagnostic and statistical manual-IV, international classification of diseases-10 criteria, and 55 age and gender-matched volunteers were selected as healthy non-alcoholic controls. Short-term HRV was recorded in a supine posture, and the results were interpreted. Statistical analysis was done using the software SPSS version 21.0. Results: Our results showed a significant reduction in the time-domain parameters of HRV – SDNN, RMSSD, NN50, and pNN50 in the alcohol-dependent individuals compared to the controls, suggesting reduced parasympathetic activity in the heart indicating cardiac autonomic neuropathy. Conclusion: Alcohol affects the cardiac autonomic status leading to sudden death due to arrhythmias. HRV can be used as a non-invasive test to assess cardiac autonomic dysfunction and its biofeedback can help alcohol-dependent individuals to adopt healthy lifestyle measures.

Association of heart rate variability and C-reactive protein in patients with depression.

Depression has been shown to be correlated with cardiovascular (CV) morbidity and mortality. Inflammation and autonomic nervous system (ANS) dysfunction are possible causes. Numerous clinical studies have found an association between inflammatory pathways and the ANS. The aim of this study was to investigate the relationship between different heart rate variability (HRV) parameters and C-reactive protein (CRP) levels in depressed patients without concomitant diseases. Sixty-five depressed patients who were not taking medication participated in this cross-sectional study. The Tenth Revision of the International Classification of Diseases and Related Health Problems (ICD-10) categorization of mental and behavioral disorders served as the basis for the diagnosis of depression. HRV processing and analysis were performed using ADInstrument's Pro LabChart (PowerLab 8Pro) data analysis software. HRV was recorded for 5 min in an upright sitting position using a lead II electrocardiogram (ECG) (short-term HRV). CRP levels were measured using an ELISA (enzyme-linked immunosorbent assay) test. None of the measures of HRV showed a significant relationship with pulse rate, systolic blood pressure, diastolic blood pressure, or body mass index (BMI). Weight and BMI were strongly positively related (r = 0.420, P = 0.003) to pRR50 (percentage of successive RR intervals differing by more than 50 ms). Very low frequency (VLF), low frequency (LF), and the LF/HF (high frequency) ratio were all strongly positively correlated with CRP (r = 0.595, P = 0.001), whereas HF was also significantly negatively correlated (r = 0.383, P = 0.007). CRP had a significant negative correlation with the logarithm (ln) HF and a significant positive correlation with lnVLF, lnLF, and lnLF/HF. Measurement of resting HRV and CRP may be helpful in detecting CV disease in depressed patients. Low HRV and elevated serum CRP should prompt physicians to begin treatment for risk CV as soon as possible.

Reliability and Validity of Kubios HRV Smart Phone Application as Measures of Heart Rate Variability

Introduction: Heart rate variability (HRV) analysis has given a non-invasive way for assessing cardiac autonomic control. Reduced HRV is an independent indicator of poor prognosis in both heart disease patients and the general population. Aim/Objective: To establish reliability and validity for Kubios HRV smart phone application. Materials and methods: Fifty (n =50) office workers volunteered for the study, with 10 females and 40 males ranging in age from 30 to 50 years (Mean age =38.4±5.6). To evaluate Intra and Inter-rater reliability and validity the of HRV parameter, R-R intervals comparing simultaneous recording from ECG and Kubios HRV app, at different three times (day1,day2 &amp;day3) one day apart and by two different trained examiners in the same participants. Each participants rested in supine for 10 minutes prior to the assessment and was instructed to remain relaxed, breathe properly, and refrain from talking and sleeping during the measurement. The RR intervals (R-R) were recorded during a 5 min period in supine position using ECG and polar H10 monitor with Kubios HRV smartphone application. Results: Kubios HRV smart phone application shows excellent reliability, Intra-rater (α =0.868) and Inter-rater (α =0.890) and Validity (r = 0.94) with R-R intervals calculated from ECG. Conclusion: The Kubios HRV smart phone application provides an accurate and reliable alternative to the ECG for acquiring inter-beat interval time series data. The Kubios HRV app gives an R-R interval that can be used for short term HRV analysis in office workers from steady resting conditions, supporting the selection of this approach of evaluation in research and clinical practise.

Non-Contact Short-Term Heart Rate Variability Analysis Under Paced Respiration Based on a Robust Fiber Optic Sensor System

Non-Contact Short-Term Heart Rate Variability Analysis Under Paced Respiration Based on a Robust Fiber Optic Sensor System

Assessment of heart rate variability among healthy 1st year medical students in a Government Medical College of Kolkata: A cross-sectional observational study

Background: Heart rate variability (HRV) means the beat-to-beat variations of cardiac rhythm which is influenced by the interplay of sympathetic and parasympathetic nerves. At present, cardiovascular morbidity and mortality have become a matter of great concern in the young population. Such complications may arise from cardiac dysautonomia. HRV analysis may be considered an efficient tool to detect this derangement as early as possible. Moreover, normative data on HRV should be established among the young population of India considering other demographic parameters such as gender, height, weight, and BMI. Aim and Objective: Our study intends to establish normative data for short-term HRV parameters among medical students of a tertiary care hospital in West Bengal. Materials and Methods: After obtaining approval from the Institutional Ethics Committee, 250 apparently healthy medical students were assessed and HRV parameters such as mean RR, mean HR, SDNN, NN50, pNN50, root mean square of successive differences (RMSSD), high frequency (HF), low frequency (LF), and LF/HF ratio were recorded. Results: In time domain parameters, values were significantly higher in males for mean HR and significantly higher in females for mean RR, NN50, and pNN50. In frequency domain parameters, significantly higher values were found for LF and LF/HF ratio in males and HF in females. Conclusion: We have established gender-based normative values of HRV parameters in the young population.

Heart rate variability and perception of mental stress among medical students and residents at an emergency department

BackgroundWhen Medical Residents (MR) and Medical Students (MS) are assigned to the demanding environment of an Emergency they inevitably encounter stress. The aims of this study are to measure short-term heart rate variability (HRV) before and after shifts, estimate perceived stress levels, and assess the recovery patterns after their shifts. MethodsWe assessed HRV parameters in MS and MR using the wristband physiological monitor Polar® Verify Sense before and after day (DS) and night shifts (NS). Perceived stress levels were evaluated using the simplified State Trait Anxiety Inventory (STAI-S6) and the Subjective Units of Distress Scale. ResultsThis study included 60 participants of which 55% were female with a mean age of 26 years. MS presented significant reduction in sympathetic nervous system index after DS [0.68 (0.01–2.42) vs −0.22 (−0.75–1.13), p < 0.01] and NS [0.87 (−0.28–1.45) vs 0.06 (−0.70–1.04), p < 0.01], while MR maintained the same levels of sympathetic activity [DS: 1.17 (0.04 –2.88) vs 0.93 (0.50–1.41), p = 0.14; NS: 1.37 (0.76–2.21) vs 1.29 (0.35–2.18), p = 0.40]. Psychological data from STAI-S6 showed statistically significant differences when comparing before and after DS in both groups, with more perceived stress after than before DS (MS: 12 ± 4 vs 14 ± 4, p = 0.04; MR: 14 ± 4 vs 16 ± 4, p = 0.04), which was not observed at NS (MS: 12 ± 3 vs 12 ± 3, p = 0.84; MR: 15 ± 3 vs 15 ± 4, p = 0.40). ConclusionsShort-term HRV recordings before and after day or night shifts among MR and MS revealed heightened sympathetic activity preceding each shift, with a more sustained increase observed in the MR population and more perceived stress after day shifts in both groups.

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.

Retracted: Changes of Short-Term Heart Rate Variability and Vertebral Artery Magnetic Resonance Angiography in Patients with Cervical Vertigo

Retracted: Changes of Short-Term Heart Rate Variability and Vertebral Artery Magnetic Resonance Angiography in Patients with Cervical Vertigo

Effect of Selected Music Soundtracks on Cardiac Vagal Control and Complexity Assessed by Heart Rate Variability.

The aim of our study was to investigate the effect of selected passive music therapy frequencies without vocals on selected cardio-vagal and complexity indices of short-term heart rate variability (HRV) in healthy youth, in terms of calming the human. 30 probands (15 male, averaged age: 19.7+/-1.4 years, BMI: 23.3+/-3.8 kg/m2) were examined during protocol (Silence baseline, Music 1 (20-1000 Hz), Silence 1, Music 2 (250-2000 Hz), Silence 2, Music 3 (1000-16000 Hz), and Silence 3). Evaluated HRV parameters in time, spectral, and geometrical domains represent indices of cardio-vagal and emotional regulation. Additionally, HRV complexity was calculated by approximate entropy and sample entropy (SampEn) and subjective characteristics of each phase by Likert scale. the distance between subsequent R-waves in the electrocardiogram (RR intervals [ms]) and SampEn were significantly higher during Music 3 compared to Silence 3 (p=0.015, p=0.021, respectively). Geometrical cardio-vagal index was significantly higher during Music 2 than during Silence 2 (p=0.006). In the subjective perception of the healthy youths evaluated statistically through a Likert scale, the phases of music were perceived significantly more pleasant than the silent phases (p<0.001, p=0.008, p=0.003, respectively). Our findings revealed a rise of cardio-vagal modulation and higher complexity assessed by short-term HRV indices suggesting positive relaxing effect music especially of higher frequency on human organism.

Modifications of short-term heart rate variability in metabolic syndrome: a systematic review and meta-analysis

Abstract Introduction Metabolic syndrome (MS) is a clinical condition in which different non-communicable chronic diseases converge, such as hypertension, diabetes, dyslipidemia and obesity. MS has been related to dysregulation of the autonomic nervous system (ANS). Heart rate variability (HRV) has been widely used as a tool to assess the activity of autonomic function, which could be very useful for diagnosis or monitoring in patients with MS; however, to date, no quantitative analysis of ANS dysfunction in MS has been performed. For this reason, the objective of this systematic review and meta-analysis (MA) is to determine the impact that MS produces in short-term HRV, characterizing the cardiac autonomic dysfunction induced by this pathological condition and the most frequently reported explanatory variables. Methods We searched PubMed, Web of Science and Scopus electronic databases for original works with short-term HRV recordings (15 minutes or shorter) that compared people with MS (MS+) versus healthy people as a control group (MS-). The search was carried out between June 25th, 2022 and September 1st, 2022. Within these databases, the terms used were "metabolic syndrome" linked to "heart rate variability" (HRV), "cardiac autonomic control", "cardiac autonomic function", or "cardiac autonomic modulation". This systematic review and MA was performed according with PRISMA guidelines and registered at the International Prospective Register of Systematic Reviews. Results are reported as standard mean difference [95% CI]. Results Twenty-eight articles were included in the qualitative synthesis and nineteen of them met required criteria to be included in the MA. MS decreased SDNN (-0.40 [-0.5, -0.3], p&amp;lt;0.001), rMSSD (-7.59 [-9.98, -5.19], p&amp;lt;0.001), HF (-0.32 [-0.46, -0.18], p&amp;lt;0.001) and LF (-0.22 [-0.39, -0.06], p&amp;lt;0.01). The ratio LF/HF did not change (0.24 [-0.22, 0.69]). In subsequent subanalyses, we found a decreased in SDNN (-0.99 (-1.45, -0.52], p&amp;lt;0.001), rMSSD (-10.18 [-16.85, -3.52], p&amp;lt;0.01) and HF (-1.04 [-1.97, -0.1] p&amp;lt;0.05) in women. In men, only LF showed a significant decrease (-0.26 [-0.5, -0.2], p&amp;lt;0.05). We could not perform MA for the non-linear variables, but the qualitative analyses showed a decrease in SD1 and increase in SD2 of the Poincare-plot for the MS group. Conclusions MS produced changes in short-term HRV in the time-domain analyses, showing a decrease of SDNN and rMSSD. Regarding the frequency-domain analyses, MS induced a decrease in HF and LF, with the exception of the LF/HF relationship, which was not modified. When gender was taken into account, the MA was only possible in one of both genders (men or women) in rMSSD and LF/HF. Lastly, when data for both men and women were available, gender subanalyses showed a different behavior than the mixed analyses for SDNN, HF and LF, which might point towards a different impact of MS in men and women.

Prognostic role of short-term heart rate variability and deceleration/acceleration capacities of heart rate in extensive-stage small cell lung cancer.

Background: Prior research suggests that autonomic modulation investigated by heart rate variability (HRV) might act as a novel predictive biomarker for cancer prognosis, such as in breast cancer and pancreatic cancer. It is not clear whether there is a correlation between autonomic modulation and prognosis in patients with extensive-stage small cell lung cancer (ES-SCLC). Therefore, the purpose of the study was to examine the association between short-term HRV, deceleration capacity (DC) and acceleration capacity (AC) of heart rate and overall survival in patients with ES-SCLC. Methods: We recruited 40 patients with ES-SCLC, and 39 were included in the final analysis. A 5-min resting electrocardiogram of patients with ES-SCLC was collected using a microelectrocardiogram recorder to analyse short-term HRV, DC and AC. The following HRV parameters were used: standard deviation of the normal-normal intervals (SDNN) and root mean square of successive interval differences (RMSSD). Overall survival of patients with ES-SCLC was defined as time from the date of electrocardiogram measurement to the date of death or the last follow-up. Follow-up was last performed on 07 June 2023. There was a median follow-up time of 42.2months. Results: Univariate analysis revealed that the HRV parameter SDNN, as well as DC significantly predicted the overall survival of ES-SCLC patients (all p < 0.05). Multivariate analysis showed that the HRV parameters SDNN (hazard ratio = 5.254, 95% CI: 1.817-15.189, p = 0.002), RMSSD (hazard ratio = 3.024, 95% CI: 1.093-8.372, p = 0.033), as well as DC (hazard ratio = 3.909, 95% CI: 1.353-11.293, p = 0.012) were independent prognostic factors in ES-SCLC patients. Conclusion: Decreased HRV parameters (SDNN, RMSSD) and DC are independently associated with shorter overall survival in ES-SCLC patients. Autonomic nervous system function (assessed based on HRV and DC) may be a new biomarker for evaluating the prognosis of patients with ES-SCLC.