Standard Deviation Of Normal-to-normal Research Articles

Circadian changes of autonomic function in patients with zoster-associated pain: A heart rate variability analysis.

To investigate the circadian changes of the autonomic function in patients with zoster-associated pain (ZAP). A total of 37 patients with ZAP from April 2022 to October 2022 were enrolled as the observation group, and 37 normal volunteers at the same time were selected as the control group. All participants were required to wear a 24-h Holter, which was used to compare the heart rate variability (HRV) between the two groups. HRV analysis involved time- and frequency-domain parameters. There was no statistically significant difference in general information between two groups. Patients with ZAP had an increased mean heart rate and decreased the standard deviation of normal-to-normal (SDNN) R-R interval, the root mean square of the differences (RMSSD) in successive RR interval, low frequency (LF), and high frequency (HF) compared with control groups in all periods (p<.05). The ratio of LF/HF between two groups had no significant difference (p=.245). SDNN had no significant difference between day and night in the control group (p>.05), whereas SDNN of ZAP patients in night period was reduced than that in day period (p<.001). The level of RMSSD during the day was lower than those at night in the control group (p<.05), whereas no significant difference of RMSSD between two periods was observed in patients with ZAP (p>.05). The results of this study indicated that ZAP contributes to the decline of autonomic nervous system (ANS) function, especially parasympathetic components. The patients with ZAP lost parasympathetic advantage and had a worse ANS during the night.

The value of circadian heart rate variability for the estimation of obstructive sleep apnea severity in adult males.

Heart rate variability (HRV) is becoming more prevalent as a measurable parameter in wearable sleep-monitoring devices, which are simple and effective instruments for illness evaluation. Currently, most studies on investigating OSA severity and HRV have measured heart rates during wakefulness or sleep. Therefore, the objective of this study was to investigate the circadian rhythm of HRV in male patients with OSA and its value for the estimation of OSA severity using group-based trajectory modeling. Patients with complaints of snoring were enrolled from the Sleep Center of Shandong Qianfoshan Hospital. Patients were divided into 3 groups according to apnea hypopnea index (AHI inevents/h), as follows: (<15, 15≤AHI<30, and ≥30). HRV parameters were calculated using 24 h Holter monitoring, which included time-domain and frequency-domain indices. Circadian differences in the standard deviation of normal to normal (SDNN) were evaluated for OSA severity using analysis of variance, trajectory analysis, and multinomial logistic regression. A total of 228 patients were enrolled, 47 with mild OSA, 48 moderate, and 133 severe.Patients with severe OSA exhibited reduced triangular index and higher very low frequency than those in the other groups. Circadian HRV showed that nocturnal SDNN was considerably higher than daytime SDNN in patients with severe OSA. The difference among the OSA groups was significant at 23, 24, 2, and 3 o'clock sharp between the severe and moderate OSA groups (all P<0.05). The heterogeneity of circadian HRV trajectories in OSA was strongly associated with OSA severity, including sleep structure and hypoxia-related parameters. Among the low-to-low, low-to-high, high-to-low, and high-to-high groups, OSA severity in the low-to-high group was the most severe, especially compared with the low-to-low and high-to-low SDNN groups, respectively. Circadian HRV in patients with OSA emerged as low daytime and high nocturnal in SDNN, particularly in men with severe OSA. The heterogeneity of circadian HRV revealed that trajectories with low daytime and significantly high nighttime were more strongly associated with severe OSA. Thus, circadian HRV trajectories may be useful to identify the severity of OSA.

Analysis of Heart Rate Variability in Young Male Adults with Depression and Anxiety during Warm-water Footbath

Abstract Background: Heart rate variability (HRV) modulates both the sympathetic nervous system and the parasympathetic nervous system (PNS) of the autonomic nervous system. Mood disorder is one of the contributing factors to influence HRV. The warm-water footbath as a relaxing way is used to enhance the PNS. In this study, we intended to explore the association between HRV and a footbath in the mood disorder group. Methods: We recruited 14 young male study participants to receive a 30-minute warm-water footbath three times a week. Furthermore, we monitored the heart rates electrocardiographically before, during, and after the intervention. Results: This study showed that the footbath not only significantly enhanced standard deviation of NN (SDNN) intervals, high-frequency (HF) power, and low-frequency (LF) power during the first five minutes footbath (p &lt; 0.01) but also increased all the parameters in five minutes after finishing the footbath. SDNN intervals, HF power, and LF power remained significantly upward in the next five minutes (p &lt; 0.05). Conclusion: In line with previous studies, this study showed that a footbath elevated the PNS-related HRV parameters. We suggest that a warm-water footbath improves the PNS modulation possibly through baroreflex. In addition, those with cardiac conditions and depression should be particularly attentive to their condition during and following a footbath.

Effect of cardiac rehabilitation therapy on depressed patients with cardiac insufficiency after cardiac surgery.

This study aims to analyze the effect of cardiac rehabilitation therapy on cardiac autonomic nervous function in patients with cardiac insufficiency complicated with anxiety depression after cardiac operation to provide a reference for clinical practice. A total of 109 patients subject to cardiac operation in our hospital from January 2020 to March 2023 were enrolled as study subjects, including 50 patients who received conventional rehabilitation therapy (control group) and 69 patients who received cardiac rehabilitation therapy (research group). Before and after treatment, the left ventricular ejection fraction (LVEF) and central venous pressure (CVP) were determined, and the level of N-terminal pro-B-type natriuretic peptide (NT-proBNP) was measured. Low frequency/high frequency (LF/HF), standard deviation of normal to normal (SDNN), and root mean of successive square differences (RMSSD) were measured by a multi-lead ECG system. Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI), Activity of daily living (ADL), and Barthel Index (BI) were applied for corresponding investigations, as well as the 6-min walk test (6MWT). After treatment, the research group showed higher LVEF, CVP, LF/HF, SDNN, and RMSSD, and lower NT-proBNP, SAS, and SDS than the control group (P < 0.05). Significantly elevated ADL score, BI, and 6MWT and reduced PSQI were observed in both groups after treatment, with more remarkable changes in the research group (P < 0.05). In conclusion, cardiac rehabilitation therapy effectively improved the cardiac function of patients with cardiac insufficiency complicated with anxiety and depression after the cardiac operation and alleviated their negative emotions.

Post-exercise heart rate variability recovery after 800-m endurance run load among Cameroonian adolescent's males

The 800-m (m) run is part of Physical Education classes in Cameroon, after which arrhythmias may occur during recovery. Hence, this study aimed at determining relationship between 800-m run loads on cardiac autonomic recovery among school adolescents.Forty-two male adolescents (aged [17 ​± ​1] years) performed 800-m. Post-exercise heart rate variability (HRV) was recorded during 5-min (min) (HRV5-min) and 15-min (HRV15-min) in time: Standard deviation of normal to normal (SDNN); Root mean square of successive differences (RMSSD) and frequency domain (LH: Low frequency, HF: High frequency, TP: Total power). Rating of Perceived Exertion (RPE) and blood lactate concentration (BLa) were measured after exercise. In HRV5-min, RPE was associated with SDNN (r ​= ​−0.44, p ​< ​0.01) and RMSSD (r ​= ​−0.38, p ​< ​0.05). BLa was correlated with SDNN (r ​= ​−0.38, p ​< ​0.05) and RMSSD (r ​= ​−0.56, p ​< ​0.001) in the time-domain, LF (r ​= ​−0.64, p ​< ​0.001), HF (r ​= ​−0.58, p ​< ​0.001) and TP (r ​= ​−0.61, p ​< ​0.001) in frequency-domain. Moreover, RPE was correlated with LF (r ​= ​−0.44, p ​< ​0.01), TP (r ​= ​−0.49, p ​< ​0.01) while exercise duration with HF (r ​= ​−0.38, p ​< ​0.05). In HRV15-min, BLa was correlated with RMSSD (r ​= ​−0.53, p ​< ​0.001) and SDNN (r ​= ​−0.68, p ​< ​0.001). RPE was negatively correlated SDNN (r ​= ​−0.53, p ​< ​0.01) and RMSSD (r ​= ​−0.44, p ​< ​0.01). BLa was associated with HF (r ​= ​−0.55, p ​< ​0.001), TP (r ​= ​−0.50, p ​< ​0.01) and RPE with LF (r ​= ​−0.51, p ​< ​0.01), HF (r ​= ​−0.50, p ​< ​0.01), TP (r ​= ​−0.49, p ​< ​0.01). In addition, exercise duration was negatively linked to HF (r ​= ​−0.36, p ​< ​0.05). This study outlined that in untrained adolescents an increase of 800-m loads is associated with a slow vagal indexes of HRV during the recovery.

Machine learning analysis of primary hyperhidrosis for classification of hyperhidrosis type and prediction of compensatory hyperhidrosis.

Although sympathectomy is highly effective for improving symptom, compensatory hyperhidrosis (CH) is a major issue. In this study, characteristics of primary hyperhidrosis were investigated in terms of the heart rate variability (HRV) parameters. Classification of hyperhidrosis type and prediction of CH after sympathicotomy were also determined using machine learning analysis. From March 2017 to December 2021, 128 subjects who underwent HRV tests before sympathicotomy were analyzed. T2 and T3 bilateral endoscopic sympathicotomy were routinely performed in patients with craniofacial and palmar hyperhidrosis, respectively. Data collected age, sex, body mass index (BMI), hyperhidrosis type, symptom improvement after sympathicotomy, the degrees of CH after sympathicotomy, and preoperative HRV findings. The independent risk factors associated with the degree of CH after sympathicotomy were investigated. Machine learning analysis was used to determine classification of hyperhidrosis type and prediction of the degree of CH. Preoperatively, patients with palmar hyperhidrosis presented with significantly larger standard deviation of normal-to-normal (SDNN), root mean square of successive differences (RMSSD), total power (TP), and low frequency (LF) than patients with craniofacial hyperhidrosis after controlling for age and sex (P=0.030, P=0.004, P=0.041, and P=0.022, respectively). More sympathetic nervous predominance was found in craniofacial type (P=0.019). Low degree of CH had significantly greater RMSSD (P=0.047), and high degree of CH showed more sympathetic nervous predominance (P=0.006). Multivariate analysis showed the type and expansion of sympathicotomy were significant factors for CH (P=0.001 and P=0.028, respectively). The neural network (NN) algorithm outperformed and showed a 0.961 accuracy, 0.961 F1 score, 0.961 precision, 0.961 recall, and 0.972 area under the curve (AUC) for classification of hyperhidrosis type. The random forest (RF) model outperformed showed a 0.852 accuracy, 0.853 F1 score, 0.856 precision, 0.852 recall, and 0.914 AUC for prediction of the degree of CH. The present study showed the machine learning algorithm can classify types and predict CH after sympathicotomy for primary hyperhidrosis with considerable accuracy. Further large-scale studies are needed to validate the findings and provide management guidelines for primary hyperhidrosis.

A Real-Time Evaluation Algorithm for Noncontact Heart Rate Variability Monitoring.

Noncontact vital sign monitoring based on radar has attracted great interest in many fields. Heart Rate Variability (HRV), which measures the fluctuation of heartbeat intervals, has been considered as an important indicator for general health evaluation. This paper proposes a new algorithm for HRV monitoring in which frequency-modulated continuous-wave (FMCW) radar is used to separate echo signals from different distances, and the beamforming technique is adopted to improve signal quality. After the phase reflecting the chest wall motion is demodulated, the acceleration is calculated to enhance the heartbeat and suppress the impact of respiration. The time interval of each heartbeat is estimated based on the smoothed acceleration waveform. Finally, a joint optimization algorithm was developed and is used to precisely segment the acceleration signal for analyzing HRV. Experimental results from 10 participants show the potential of the proposed algorithm for obtaining a noncontact HRV estimation with high accuracy. The proposed algorithm can measure the interbeat interval (IBI) with a root mean square error (RMSE) of 14.9 ms and accurately estimate HRV parameters with an RMSE of 3.24 ms for MEAN (the average value of the IBI), 4.91 ms for the standard deviation of normal to normal (SDNN), and 9.10 ms for the root mean square of successive differences (RMSSD). These results demonstrate the effectiveness and feasibility of the proposed method in emotion recognition, sleep monitoring, and heart disease diagnosis.

The effect of being married on heart rate variability, an indicator of autonomic dysfunction: A retrospective study.

Heart rate variability (HRV) is a noninvasive assessment that reflects the autonomic functions of the heart and is known to be impaired in many diseases. In our study, we aimed to investigate the relationship between HRV and being married. The study included 104 patients, between the aged 20 to 40 years were included in the study. The patients were divided into 2 groups as 53 healthy married (group 1) and 51 healthy unmarried (group 2). 24-hour rhythm Holter recordings were performed on all married and unmarried patients. Group 1 had a mean age of 32 ± 5 years and 47.2% men, and group 2 had a mean age of 30 ± 5 years and 54.9% men. Standard deviation of normal to normal (SDNN) was 150 ± 40 versus 128 ± 30 ( P = .003), SDNN index was 66 ± 20 versus 56 ± 12 ( P = .004), the square root of the mean of the squares of the differences of the adjacent root mean square of successive differences (RMSSD) was 37 ± 10 versus 30 ± 10 ( P < .001), percentage of successive R-R intervals that differ by more than 50 milliseconds (PNN50) was 13.5 ± 7 versus 8.5 ± 7 ( P = .001), HF was 450 ± 270 versus 225 ± 130 ( P < .001) found to be significantly less in the group 2. LF/HF ratio was 1.68 ± 0.65 versus 3.31 ± 1.56 ( P < .001) found to be significantly higher in the group 2. In our study, it is possible to say that the sympathetic system effect on the heart was more dominant and the HRV was lower in the unmarried group.

Statistical heart rate variability analysis for healthy person: Influence of gender and body posture.

Short-term ECG-derived heart rate variability can assess autonomic function non-invasively. The purpose of this study is to investigate the influence of body posture and gender on parasympathetic-sympathetic balance by utilising electrocardiogram (ECG). A total of sixty participants including thirty males (95% CI: 23.34-26.32years old) and thirty females (95% CI: 23.33-26.07years old) voluntarily executed three sets of 5-min ECG recordings in supine, sitting and standing posture. A nonparametric Friedman test followed by Bonferroni post-hoc test was carried out to find the statistical differences between the group. A significant difference was observed for RR mean, low frequency (LF), high frequency (HF), ratio LF/HF and the ratio long term variability to short term variability (SD2/SD1) for p<0.01 while respiration rate (Resp Rate), standard deviation of heart rate (STD_HR), long term variability (SD2), approximate entropy (ApEn), correlation dimension (CD) are non-significant (p>0.01) for supine, sitting and standing. HRV indices such as standard deviation of NN (SDNN), HRV triangular index (HRVi), and triangular interpolation of NN interval (TINN) are statistically not significant for males but there are significant differences for females at a significance level 1%. Relative reliability and relatedness were evaluated through the interclass coefficient (ICC) and spearman correlation coefficient. The experimental results advocate that there is a posture-specific difference in HRV indices while the correlational studies suggest no such significant differences.

Abstract 13772: The Cardiac Autonomic Reactivity in Long-Term Female Yoga Practitioners: A Comparison With Runners and Sedentary Individuals

Introduction: Yoga practice, a means of stress management, has been reported to optimize psychophysiological health; however, its underlying mechanisms remain unclear. The purpose of the present study was to examine the cardiac autonomic reactivity in long-term yoga practitioners and compared that to runners and sedentary individuals. Hypothesis: The level of cardiac autonomic reactivity in yoga practitioners would be greater than that in the sedentary individuals but similar to that in the runners. Methods: Female individuals aged 20-50 years old with BMI 18.5-30 kg/m 2 were recruited. Participants in the yoga (or running) group regularly performed yoga (or running) for ≥ 90 minutes/week, for at least 2 years. Participants who did not regularly perform any type of physical activity were assigned to the sedentary group. Blood pressure (BP), heart rate (HR), respiration rate (RR) and heart rate variability (HRV) parameters (e.g., high frequency normalized unit (HFnu), the square root of the mean squared differences of successive normal-to-normal intervals (RMSSD), total power (TP) and standard deviation of normal-to-normal (SDNN)) were recorded at rest, during and following psychological stress, which was elicited by the Stroop color-and-word test (SCWT) and the mental arithmetic task (MAT). Outcome variables in the 3 groups were compared at multiple phases using Group x Time mixed design ANOVA and Bonferroni post-hoc comparison. Results: Yoga group demonstrated a lower RR (10.4±2.1 bpm) as compared to the other 2 groups, and a lower HR (66.6±7.6 bpm) and diastolic BP (67.8±8.4 mmHg) at rest as compared to the sedentary group (all p&lt;0.05). HFnu following mental stress returned to the baseline in yoga (35.7±16.0 vs. 43.5±20.5) and running groups (44.7±17.1 vs. 52.0±18.0), but not in the sedentary group (29.9±22.0 vs. 43.1±18.3, p&lt; 0.05). Similar results were observed in RMSSD and TP, where the level of outcome variables at the recovery phase returned to baseline in the yoga and running group, but not in the sedentary group. Conclusions: Yoga practitioners may have a greater homeostatic capacity and autonomic resilience than do sedentary individuals. The level of autonomic reactivity in long-term yoga practitioners was similar to that in the runners.

RF02 | PMON308 Hyperglycemia Is the Main Determinant of Cardiac Autonomic Dysfunction in Youth With Obesity Across the Spectrum of Glycemic Regulation.

Abstract Heart Rate Variability (HRV) results from the autonomic nervous system activity, it is a non-invasive marker of cardiac autonomic function. Loss of parasympathetic function (PNS) and sympathetic (SNS) override, reflected in decreased HRV, is one of the earliest subclinical manifestations of cardiac autonomic dysfunction. Lower HRV is associated with increased risk of cardiac events in adults. We aimed to characterize HRV in normal weight and overweight children with and without dysglycemia and to investigate the determinants of HRV in these youth, including body composition, glycemia measures, beta-cell function and inflammatory markers. We evaluated 94 adolescents (50 males/44 females), age 15 ± 2.1 years; 21 normal weight with normal glucose tolerance (NW-NGT), 23 overweight with NGT (OW-NGT) and 50 overweight with impaired glucose regulation (OW-IGR) including prediabetes (n= 27) and type 2 diabetes (n= 23). They underwent assessment of anthropometrics, body composition (DXA scan), inflammatory markers (hs-CRP and TNF-α), fasting labs and 2-hour oral glucose tolerance test (OGTT) with determination of glucose and insulin concentration. EndoPat was used to measure HRV: frequency-domain indices [high-frequency (HF) reflecting PNS, low-frequency (LF) reflecting both PNS and SNS, and LF/HF (higher is worse) estimating the ratio between SNS and PNS] and time-domain indices [the inter-beat interval of normal sinus beats (NN) and the standard deviation of NN (SDNN) measuring overall HRV, the square root of the mean squared difference of successive NN (RMSSD) and the NN intervals differing by more than 50 milliseconds (NN50) measuring PNS activity]. LF/HF was higher in the OW-IGR group compared with NW and OW-NGT (p=0.005). After controlling for sex, race and Tanner stage, fasting glucose (FBG) negatively correlated with NN (r=-0.22,p=0.04), SDNN (r=-0.21,p=0.05), RMSSD (r=-0.3,p=0.004), NN50 (r=-0.27,p=0.01) and HF (r=-0.26,p=0.02). LF/HF was positively related to FBG (r=0.39,p&amp;lt;0.001), 2hr-glucose (r=0.31,p=0.004) and HbA1c (r=0.22,p=0.04), and negatively with the insulinogenic index (r=-0.27,p=0.02), but not fasting insulin or HOMA-IR; LF/HF also correlated with percent body fat (r=0.22,p=0.04), hs-CRP (r=0.33,p=0.002) and TNF-α (r=0.38,p=0.006). In a linear regression model with LnLF/HF as the dependent variable and percent body fat, hs-CRP, FBG and HOMA-IR as the independent variables, FBG (beta=0.39,p=0.003) and hs-CRP (beta=0.21,p=0.09) were the significant determinants of LnLF/HF independent of age, sex, race and Tanner stage as covariates (R2= 0.23,p=0.013). Youth with impaired glucose metabolism have evidence of early subclinical cardiac autonomic dysfunction with decreased HRV, loss of parasympathetic function and sympathetic overdrive as reflected by lower time-domain indices, lower HF and higher LF/HF, related to glycemia and systemic inflammation. Presentation: Saturday, June 11, 2022 1:00 p.m. - 2:00 p.m., Saturday, June 11, 2022 1:12 p.m. - 1:17 p.m., Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.

Acute effects of singing on cardiovascular biomarkers.

BackgroundSinging is a physical activity involving components of the vagal nerves manifested as changes in cardiac autonomic regulation.AimsThe aim of this pilot study is to investigate the acute effects of singing on biomarkers of cardiovascular health.MethodsAdult subjects were recruited from cardiology clinics to participate in a single 90-min study visit. Vascular function was measured at the fingertips with peripheral arterial tonometry (PAT) before and after singing to a 14-min video led by a voice expert. Heart rate variability (HRV) was measured with a chest strap sensor at baseline, during, and after singing. PAT measurements were expressed as reactive hyperemia index (RHI) and Framingham reactive hyperemia index (fRHI). Measures of HRV included root mean square of successive RR interval differences (RMSSD) and standard deviation of NN (or RR) intervals (SDNN).ResultsSixty subjects completed the study (68% female, mean age 61 ±13 years, mean BMI 32 ± 8). There was a significant increase in fRHI (1.88 ± 0.14 to 2.10 ± 0.14, p = 0.02) after singing with no significant change in the RHI (1.99 ± 0.10 to 2.12 ± 0.09, p = 0.22). There was a reduction in HRV during singing (compared to baseline) (RMSSD: 42.0 ± 5 to 32.6 ± 4, p = 0.004 and SDNN: 54 ± 4 to 33.5 ± 3, p = 0.009). HRV measures trended back toward baseline after singing.ConclusionsA short duration of singing improved vascular function acutely. Improvements were more substantial in subjects with abnormal baseline endothelial function. HRV patterns were similar to that of light-intensity exercise. Future studies should confirm favorable vascular adaptation to more sustained singing interventions.Clinical trial registrationClinicalTrials.gov, identifer: NCT03805529.

Characteristics of heart rate variability in patients with vestibular migraine

Objective: To analyze the characteristics of heart rate variability (HRV) in patients with vestibular migraine (VM) and to explore its possible mechanism. Methods: Forty-eight patients with VM [17 males and 31 females, age (36.2±9.2) years], 44 patients with migraine [15 males and 29 females, age (34.4±9.0) years], and 30 patients with health check-ups during the same period [12 males and 18 females, age (34.6±6.5) years old] were selected as study subjects. Ambulatory ECG monitoring was performed in all subjects, and the HRV characteristics of each group were analyzed from both daytime and nighttime time phases. Time domain parameters were analyzed: standard deviation of normal to normal (SDNN), root mean square of successive differences (RMSSD), and percentage of normal to normal intervals differing by more than 50 ms (pNN50). The parameters in the frequency domain were analyzed: high frequency power (HF), low frequency power (LF), and the ratio of low frequency to high frequency power (LF/HF). Statistical analysis of the data was performed using SPSS 26.0 software. Results: At night, RMSSD (F=6.694) and HF (F=9.434) were lower in the VM and migraine groups compared to the control group, while LF/HF (F=16.049) and LF (F=9.434) were elevated compared to the control group, with statistically significant differences (P<0.05 or P<0.01), while LF was significantly elevated in the VM group compared to the migraine group, with a statistically significant (P<0.05). On the daytime measurements, mainly LF was elevated in the vestibular migraine group compared with the control group, while RMSSD was decreased compared with the control group, with statistically significant differences (P<0.05). Conclusion: Autonomic dysfunction characterized by sympathetic hyperfunction and vagal hypofunction is present in VM patients and is more pronounced at night. In addition, the degree of autonomic dysfunction may be more pronounced in VM patients than in migraine patients.

Using Mobile Technology to Construct a Network Medical Health Care System

In this study, a multisensory physiological measurement system was built with wireless transmission technology, using a DSPIC30F4011 as the master control center and equipped with physiological signal acquisition modules such as an electrocardiogram module, blood pressure module, blood oxygen concentration module, and respiratory rate module. The physiological data were transmitted wirelessly to Android-based mobile applications via the TCP/IP or Bluetooth serial ports of Wi-Fi. The Android applications displayed the acquired physiological signals in real time and performed a preliminary abnormity diagnosis based on the measured physiological data and built-in index diagnostic data provided by doctors, such as blood oxygen concentration, systolic pressure, and diastolic pressure. In addition, in this study, the R waves, which are the highest peaks of the PQRST waves in electrocardiograms, were analyzed and detected using the heart rate variability (HRV) for time-frequency analysis and calculation of the RR interval time series. In this study, the heart rate data in the same age group were collected, and the optimal value of the standard deviation of normal to normal (SDNN) during the time domain of a normal heartbeat was found using the particle swarm optimization (PSO) algorithm and set as the risk level of the SDNN time domain analysis. A spectral analysis on the activity of the autonomic nervous system (ANS) was performed and the preliminary analysis results were displayed on the Android handheld devices for comprehensive physiological data analysis and HRV time-frequency analysis. Healthcare needs are distributed at all levels, therefore user-friendly software interfaces have been written to meet the healthcare needs at all ages.

Effect of a mobile application and smart devices on heart rate variability in diabetic patients with high cardiovascular risk: A sub-study of the LIGHT randomized clinical trial.

This investigation aims to evaluate the effect of a mobile application and smart devices on frequency and time domains of heart rate variability (HRV) in diabetic patients in 1-year follow-up. This is post-hoc analysis of a diabetic subgroup of "Lifestyle Intervention usinG mobile technology in patients with high cardiovascular risk: a pragmatic randomized clinical Trial" (LIGHT). One hundred and nine and 118 patients were enrolled in two arms: the intervention plus usual care and the usual care arm. The study outcome was the 1-year HRV parameters adjusted to the baseline HRV parameters. HRV measures were recorded for every patient at the randomization and final visits with 24-hour Holter monitoring. There was an improvement in the standard deviation of normal to normal (SDNN) R-R intervals 24-hour by 4.8 (adjusted treatment effect 4.8, 95% confidence interval [CI], 0.1-9.5; P = 0.044) in the intervention-plus-usual-care arm compared to usual care after a 1-year follow-up. The improvement was also experienced in other HRV time domains including standard deviation of the mean R-R intervals calculated over a 5-minute period, SDNN, square root of the mean squared difference of successive R-R intervals, and the percentage of the differences between adjacent normal R-R intervals exceeding 50 milliseconds. A significant enhancement was also detected in HRV frequency domains of total power low frequency and high frequency in the intervention plus usual care compared to usual care after a 1-year follow-up. The mobile application and smart device technology compared to usual care alone improved HRV parameters in diabetic patients at 1-year follow-up.

Effects of Acute-Partial Sleep Deprivation on High-Intensity Exercise Performance and Cardiac Autonomic Activity in Healthy Adolescents

Performing high-intensity exercise (HIE) in the morning under sleep deprivation may harm the health benefits related to sufficient sleep and HIE. Therefore, the aim of this study was to explore the effects of acute-partial sleep deprivation on HIE performance and cardiac autonomic activity by monitoring heart rate variability (HRV) indices. Twenty-nine healthy male adolescents in college were recruited to perform a one-time HIE session on the treadmill (Bruce protocol) after ≥7 h of normal control sleep (control) and after ≤4 h of acute-partial sleep deprivation (SD). At the beginning of control and SD periods and after exercising under the two sleep conditions, heart rate (HR), standard deviation of normal to normal (SDNN), square root of the mean squared differences of successive NN intervals (RMSSD), normalized low frequency power (LFn), normalized high frequency power (HFn), number of pairs adjacent NN intervals differing by ≥50 ms in the entire recording count divided by the total number of all NN intervals (pNN50), and short axis and long axis value in Poincaré plot (SD1 and SD2) were measured at rest in an upright sitting position. The participants slept 7.63 ± 0.52 and 3.78 ± 0.69 h during control and SD periods, respectively (p &lt; 0.001). Compared with the control participants, those suffering sleep deprivation experienced a significant decrease in exercise duration, RMSSD, HFn, SD1, and pNN50 as well as a significant increase in maximum heart rate during exercise (p &lt; 0.05). SDNN, RMSSD, HFn, SD1, and pNN50 decreased significantly after exercise (p &lt; 0.05 and 0.01 and 0.001, respectively). In summary, acute-partial sleep deprivation affected aerobic exercise performance the next morning and led to decreased cardiac vagus activity and cardiac autonomic dysfunction.

Autonomic Activity and Surgical Flow Disruptions in Healthcare Providers during Cardiac Surgery.

Cardiac surgery represents a complex sociotechnical environment relying on a combination of technical and non-technical team-based expertise. Surgical flow disruptions (SFDs) may be influenced by a variety of sources, including social, environmental, and emotional factors affecting healthcare providers (HCPs). Many of these factors can be readily observed, except for emotional factors (i.e. distress), which represents an underappreciated yet critical source of SFDs. The aim of this study was to demonstrate the sensitivity of autonomic activity metrics to detect an SFD during cardiac surgery. We integrated heart rate variability (HRV) analysis with observation-based annotations to allow data triangulation. Following a critical medication administration error by the anesthesiologist in-training, data sources were consulted to identify events precipitating this near-miss event. Using pyphysio, an open-source physiological signal processing package, we analyzed the attending anesthesiologists' HRV, specifically the low frequency (LF) power, high frequency (HF) power, LF/HF ratio, standard deviation of normal-to-normal (SDNN), and root mean square of the successive differences (RMSSD) as indicators of ANS activity. A heightened SNS response in the attending anesthesiologists' physiological arousal was observed as elevations in LF power and LF/HF ratio, as well as depressions in HF power, SDNN, and RMSSD prior to the near-miss event. The attending anesthesiologist subjectively confirmed a state of high distress induced by task-irrelevant environmental factors during this time. Qualitative analysis of audio/video recordings objectively revealed that the autonomic nervous system (ANS) activation detected was temporally associated with an argument over operating room management. This study confirms that it is possible to recognize detrimental psychophysiological influences in cardiac surgery procedures via advanced HRV analysis. To our knowledge, ours is the first such case demonstrating ANS activity coinciding with strong self-reported emotion during live surgery using HRV. Despite extensive experience in the cardiac OR, transient but intense emotional changes may have the potential to disrupt attention processes in even the most experienced HCP. A primary implication of this work is the possibility to detect real-time ANS activity, which could enable personalized interventions to proactively mitigate downstream adverse events. Additional studies on our large database of surgical cases are underway and new studies are actively being planned to confirm this preliminary observation.

Autonomic Influences Related to Early Repolarization in Patients Without Structural Heart Disease

This cross-sectional study focused on the association between heart rate variability (HRV) and early repolarization pattern (ERP). It included 1236 patients categorized into three groups: ERP type 1: J-point elevation with notched/slurred QRS; ERP type 2: ST elevation without dominant J-wave; and non-ERP group. Analyzing time-domain indexes include standard deviation of NN (normal-to-normal) RR intervals (SDNN), root mean square of successive difference in NN RR intervals (RMSSD), and proportion of consecutive NN intervals that differ by more than 50ms (PNN50), there were significant differences between any two groups (all P < 0.01). All time-domain indexes showed: ERP type 2 > ERP type 1 > non-ERP. Multivariate logistic regression analysis revealed that SDNN at nighttime and gender were independently associated with the maximum magnitude of J-point elevation ≧0.2mV. The findings strongly suggested that based on electrocardiogram characteristics, parasympathetic tone denoted by HRV may be related to different types of ERP.

Association between PM2.5 exposure and heart rate variability for the patients with cardiac problems in Japan

A reduction in heart rate variability (HRV) is reportedly associated with an increased risk of cardiovascular mortality and morbidity. In previous studies, an inverse association was noted between HRV and particulate air pollution, but the sample populations were small and most consisted only of elderly individuals. We examined the association between 24-h HRV and fine particulate matter (PM2.5) in a large study population spanning 7 prefectures in Japan from April 2010 through March 2013. Meta-analysis was also performed. In total, 59,493 records of 24-h HRV for patients aged 20–90 years with symptoms/signs suggestive of heart disease were included in this analysis. Air pollution data were obtained from the National Institute for Environmental Studies. Regression models were used to examine the association between daily concentration of PM2.5 and HRV indices (e.g., standard deviation of normal-to-normal (SDNN), SD of average NN internals calculated over short periods (SDANN), very low frequency (VLF), and ultra-low frequency (ULF)). The model was adjusted for age, sex, temperature, and relative humidity. We examined the lagged association for single (up to lag3) and moving average (up to lag03). We found that decreases in HRV indices, especially for SDNN, SDANN, VLF, and ULF, were associated with PM2.5 in Hokkaido, Chiba, Tokyo, and Kanagawa. In contrast, there was no clear association between HRV with PM2.5 in Saitama and Aichi. Meta-analysis revealed significant decreases in SDNN, SDANN, VLF, and ULF were associated with PM2.5. Short-term exposure to PM2.5 was associated with lower 24-h HRV in patients with symptoms/signs suggestive of heart disease.

Associations between Personal Exposure to Metals in Fine Particulate Matter and Autonomic Nervous System Dysfunction among Healthy Adults

ABSTRACT The impact of airborne particulate matter and its metal components on autonomic nervous system (ANS) dysfunction in healthy subjects remains unclear. The aim of this study was to examine the effects of personal exposure to airborne particulate matter on the ANS in young, healthy adults. This longitudinal study recruited 82 adults aged 20 to 35 years from districts A and B. District A had lower ambient PM2.5 levels than district B. Personal exposure to fine particulate matter and metals in PM2.5 was collected every two months. The heart rate variability (HRV) indices of each participant were measured three times. The relationship among the PM2.5 concentration, metals in PM2.5 and HRV level was investigated by a generalized estimating equation with an autoregression of order 1. The average age of the participants was 26.4 ± 3.6 years in district A and 21.9 ± 1.5 years in district B (p < 0.001). After adjusting for covariables, significant changes in Log10 standard deviation of normal to normal (SDNN) intervals and Log10 square root of the mean of the sum of the squares of differences (r-MSSDs) were related to unit changes in Log10 iron in PM2.5 (β = –0.033, 95% CI = –0.060 to –0.0056, p < 0.05 and β = –0.041, 95% CI = –0.075 to –0.0076, p < 0.05, respectively). The Log10 SDNN levels were significantly positively related to Log10 gallium in PM2.5 (β = 0.054, 95% CI = 0.0064 to 0.10, p < 0.05). Exposure to heavy metals in airborne particulate matter was associated with ANS dysfunction.