Heart Rate Variability Research Articles

Heart rate variability biofeedback for critical illness polyneuropathy: a randomized sham-controlled study.

Critical illness polyneuropathy (CIP) has been linked to neurocardiac dysfunction mediated by autonomic nervous system dysregulation, which increases mortality. We aimed to assess if heart rate variability (HRV) biofeedback could improve neurocardiac function in CIP. We randomly allocated (1:1) patients with electrophysiologically confirmed CIP undergoing early inpatient neurological rehabilitation to additional HRV or sham biofeedback over 14 days. We evaluated neurocardiac function via standard deviation of normal-to-normal intervals (SDNN) as the primary outcome, as well as HRV frequency domains, sympathetic cutaneous sudomotor and vasomotor functions and disability at baseline, post intervention and 4 weeks later. The study is registered on the German Clinical Trials Register (DRKS00028911). We included 30 patients with CIP (40% females, median [interquartile range] age 64.6 [56, 72] years). We observed an increase in SDNN and the predominantly parasympathetic high frequency domain post intervention (ß = 16.4, 95% confidence interval [CI] 0.2, 32.6 [p = 0.047] and ß = 1179.2, 95% CI 119.9, 2158.5 [p = 0.018]), which was sustained at the 4-week follow-up (ß = 25.7, 95% CI 6.0, 45.4 [p = 0.011] and ß = 25.7, 95% CI 6.0, 45.4 [p = 0.011]). Patients who underwent HRV biofeedback displayed a higher adjusted Barthel index, indicating less severe disability 4 weeks after the intervention compared to those in the sham group (ß = 23.3, 95% CI 5.5, 41.1 [p = 0.014]). Low frequency and sympathetic skin functions did not differ between groups (p = nonsignificant). Our study provides pilot data suggesting that, in patients with CIP, HRV biofeedback can improve neurocardiac function with a predominant effect on the parasympathetic nervous system and has a beneficial effect on functional recovery.

The recovery of decreased executive attention in Tibetan migrants at high-altitude.

Attention is one of the basic cognitive functions sensitive to high altitude, and most studies have focussed on exposure times of approximately 3 years; however, it is unclear how attention changes in migrants who have lived and worked at high altitude for nearly 20 years. We explored the dynamics of attentional networks and neurophysiological mechanisms in migrants over 3-20 years using the Attentional Network Test combined with Electrocardiograph and Electroencephalography and found a consistent quadratic correlation between exposure and executive control efficiency, P3 amplitude and heart rate variability (HRV), with a decrease followed by an increase/relative stability, with approximately 10 years being the breakpoint. However, neither linear nor quadratic trajectories were observed for the alerting and orienting network. Mediation analysis revealed that the P3 amplitude mediated the decrease and increase in executive control efficiency with exposure time depends on the breakpoint. Correlations between HRV and executive control efficiency and P3 amplitude suggest that U-shaped changes in executive control in migrants may be related to body homeostasis maintained by the autonomic nervous system, and that P3 amplitude may serve as a neurophysiological marker of migrants' adaptation/recovery from high-altitude exposure.

Heart rate variability indices for predicting cardiorenal outcomes: A lesson from the PERL and ACCORD cohorts.

This commentary highlights the role of heart rate variability (HRV) indices in predicting diabetic kidney disease (DKD) progression, based on findings from the PERL and ACCORD trials. HRV-derived measures from routine ECGs are shown to be strong predictors of rapid kidney function decline in both type 1 and type 2 diabetes, suggesting their potential utility in identifying individuals at high risk for DKD and guiding early preventive interventions.

A higher peak heart rate during head-up tilt test predicts the therapeutic efficacy of metoprolol in vasovagal syncope

BackgroundAlthough beta blockers, such as metoprolol, have been widely used in the management of vasovagal syncope (VVS), their efficacy remains debated, with larger studies showing limited benefit. Identifying patient-specific characteristics that predict a positive response to metoprolol could optimize its use. This study aims to investigate the key factors that may determine which VVS patients are suitable candidates for metoprolol treatment.MethodsThis retrospective study was conducted at a single center. Patients diagnosed with VVS and treated with metoprolol for a minimum of three months were included. A 50% reduction in syncope symptom score (SS) after three months of metoprolol treatment was used to define metoprolol responders, while those who did not achieve this reduction were classified as non-responders. After a three-month follow-up, patients were divided into two groups: responders and non-responders. Baseline data—including age, gender, comorbidities, laboratory tests, and the type of VVS—were analyzed for each patient. Changes in heart rate (HR) and blood pressure during the head-up tilt test (HUTT) were also evaluated between the two groups. Logistic regression analysis was performed to identify potential predictors of metoprolol response, and receiver operating characteristic (ROC) curve analysis was used to assess the value of these predictors in selecting potential responders.ResultsA total of 168 VVS patients were enrolled between January 2016 and December 2020. Of these, 100 patients responded positively to metoprolol, while 68 did not. No significant differences in baseline characteristics or HUTT results were observed between the two groups (p > 0.05). However, responders exhibited a significantly higher peak HR compared to non-responders during the HUTT (120.13 ± 19.33 vs. 106.60 ± 22.32, p < 0.001). The increase in HR was also more pronounced in responders (0.60 ± 0.23 vs. 0.41 ± 0.25, p < 0.001). Additionally, HR variability was significantly greater in responders than in non-responders (16.18 ± 5.51 vs. 12.61 ± 5.50, p < 0.001).ConclusionHigher peak HR, larger increases in HR, and greater HR variability during the HUTT may serve as reliable predictors of a positive response to metoprolol in patients with VVS.

Dynamic evolution of high-speed railway driver fatigue across scheduling shifts – a simulator study in China

ABSTRACT Scheduling significantly contributes to fatigue among high-speed rail (HSR) drivers, impacting both driving performance and safety. This study aims to analyse distinctiveness and evolutionary patterns of driver fatigue across different scheduling shifts, leveraging an HSR simulator and wearable devices. Through an extensive statistical examination, differences in most heart rate variability features were identified across shifts. The evolution of self-reported fatigue and physiological fatigue was investigated using a Markov chain and a hidden Markov model (HMM) that is extended using softmax regression, respectively. Results indicated a similarity in the initial fatigue state distribution and evolution trends across shifts, albeit with varying degrees of fluctuation. Morning shifts exhibited a higher likelihood of fatigue accumulation. The study revealed that even adequate pre-rest did not entirely counterbalance the impact of circadian rhythms. These findings may contribute to comprehending the temporal dynamics of driver fatigue evolution and offer insights for optimizing driver scheduling practices.

The cardiac, vasomotor and myocardial branches of the baroreflex in hypotension: indications of reduced venous return to the heart.

Alterations of autonomic cardiovascular control are implicated in the origin of chronic low blood pressure (BP) (hypotension), but comprehensive analysis of baroreflex function is still lacking. This study explored baroreflex function in its cardiac, vascular and myocardial branches METHODS: Continuous BP was recorded at rest and during a mental arithmetic task in 40 hypotensive and 40 normotensive participants. Assessed cardiovascular variables included stroke volume (SV) (calculated by the Modelflow method), heart rate (HR), cardiac output (CO), total peripheral resistance (TPR) and heart rate variability (HRV). Baroreflex sensitivity (BRS) was calculated using the spontaneous sequence method. Hypotensive participants exhibited greater BRS in the three baroreflex branches, in addition to lower SV, HR and CO and higher HRV and TPR. Reactivity for BP, HRV and CO during the stress task was reduced in hypotensive individuals. The greater cardiac BRS can explain the lower HR and higher HRV observed in hypotension, suggestive of increased vagal cardiac influences. The higher vasomotor BRS may contribute to the greater TPR observed in the hypotensive participants. Abnormal associations between myocardial BRS and SV arose, suggesting aberrant autonomic control of myocardial contractility in hypotension. The results indicate that hemodynamic deficits in hypotension are related to preload factors, probably triggered by hypovolemia and reduced unstressed blood reserves, resulting in lower venous return, ventricular preload and SV. In contrast, afterload mechanisms seem to work appropriately.

Normative data on measures of cardiovascular autonomic neuropathy and the effect of pretest conditions in a large Danish non-diabetic CVD-free population from the Lolland-Falster Health Study.

Cardiovascular autonomic neuropathy (CAN) is a common diabetic complication associated with excess morbidity and mortality. CAN is also seen in conditions such as Parkinson's disease. Normative reference data for cardiovascular autonomic function are used to stratify individuals into those with and without CAN. However, reference thresholds for both cardiovascular autonomic reflex tests (CARTs) and heart rate variability (HRV) are scarce and based on small sample sizes. The aim of the study was to establish contemporary normative reference thresholds based on a large non-diabetic population free of cardiovascular disease (CVD). Cardiovascular autonomic function, CARTs and 5-min HRV indices were assessed in individuals without diabetes and CVD from the Lolland-Falster Health Study (2018-2020) by applying the point-of-care device Vagus™. Age-specific normative reference thresholds were estimated by using log-transformed quantile regression models at the 5th and 10th percentile, with adjustments made for sex. Models assessing the association between age and HRV indices were further adjusted for heart rate. We present age-specific normative reference thresholds for cardiovascular autonomic function, including CARTs and HRV, for 875 individuals (48% females) aged 15-85years. The reference thresholds are presented for both the 5th and 10th lower percentile. Higher age was inversely associated with all outcomes. Females tended to have a higher parasympathetic drive compared to males. Pre-test conditions did not affect CARTs significantly. The presented age-related normative reference thresholds for both CARTs and HRV indices based on a large Danish cohort may facilitate improved quality of research and treatment.

Quran memorisation and heart rate variability: How do they correlate?

BACKGROUND Heart rate variability (HRV) was shown to be affected by performing religious activities. AIM To examine the relationship between the level of Quran (the holy book of Muslims) memorisation and HRV among teenagers. METHODS This experimental study included 16 Tahfiz students and 16 non-Tahfiz students (n = 32). The HRV was measured in three tasks: Recalling familiar verses, memorising new verses, and recalling the newly memorised verses of the Quran. HRV analysis was done using these parameters: Standard deviation of N-N (heartbeat peak) interval; low frequency (LF); high frequency (HF) and LF/HF ratio. RESULTS There were significant differences between tasks for all parameters (P &lt; 0.05). However, between the groups, only the LF/HF ratio had significant differences, with F = 5.04, P &lt; 0.05. Pearson correlation showed a moderate positive correlation between the number of pages memorised and the LF/HF ratio (r = 0.61, P &lt; 0.05). CONCLUSION Quran memorisation increased the HRV and our results suggested that this activity could be developed as an effective sympathovagal modulation training activity.

Executive functions in older adults with generalised anxiety disorder and healthy controls: Associations with heart rate variability, brain-derived neurotrophic factor, and physical fitness

Executive functions (EF) decline with age and this decline in older adults with generalised anxiety disorder (GAD) may be influenced by heart rate variability (HRV), brain-derived neurotrophic factor (BDNF), and physical fitness. Understanding these relationships is important for tailored treatments in this population. In this study, 51 adults with GAD (M age = 66.46, SD = 4.08) and 51 healthy controls (M age = 67.67, SD = 4.04) were assessed on cognitive inhibition (Stroop task), shifting (Trails part 4), flexibility (Wisconsin Card Sorting Test – Perseverative errors), working memory (Digit Span Backwards), IQ (Wechsler Abbreviated Scale of Intelligence), high frequency HRV, serum mature BDNF levels, and VO2 max. Results indicated that participants with GAD exhibited better cognitive inhibition compared to controls, with no general reduction in EF. Cognitive inhibition was predicted by gender, HRV, and BDNF levels, while cognitive shifting was predicted by gender and IQ, and cognitive flexibility and working memory by IQ. The enhanced cognitive inhibition in GAD participants might stem from maladaptive use of this function, characteristic of GAD, or protection from EF decline due to normal HRV. Increased BDNF levels, possibly due to good fitness, or compensatory mechanisms related to the disorder, might also play a role. These findings highlight the complexity of EF and related mechanisms in GAD, highlighting the need for interventions that consider both cognitive and physiological factors for optimal outcomes.

Hardware-accelerated neural network model for early prediction of sudden cardiac arrest based on heart rate variability metrics

AbstractSudden Cardiac Arrest (SCA) constitutes a dire medical condition, marked by the abrupt cessation of effective blood circulation due to the heart's failure to contract properly. This leads to acute circulatory collapse, often culminating in loss of consciousness within an hour and potentially resulting in fatality within minutes if left unattended. Heart rate variability (HRV) serves as a critical biometric, derived from electrocardiogram (ECG) signals with ventricular depolarization waves to further calculate the R-R Intervals (RRIs). These intervals provide the basis for extracting various characteristics of cardiac rhythm, encompassing time-domain, frequency-domain, and nonlinear features. This study presents a neural network-based classification algorithm that leverages HRV metrics to categorize patients into SCA and Normal Sinus Rhythm (NSR) cohorts. The proposed neural network (NN) model showcased impressive results, achieving an accuracy of 96.23%, a sensitivity of 94.35%, and a specificity of 98.12% in detecting SCA, as evaluated through leave-one-subject-out analysis. In order to harness the benefits of hardware acceleration, the algorithm is implemented on a Field-Programmable Gate Array (FPGA). Its computational efficiency is subsequently benchmarked against traditional software-based methodologies. The hardware-level implementation is made possible in Verilog hardware description language (HDL) and was verified successfully with expected performance by register-transfer level (RTL) simulation via Vivado 2020.2.

Improvement of heart rate variability after metabolic bariatric surgery in Korean subjects with obesity.

Cardiovascular autonomic neuropathy (CAN) is a chronic complication of diabetes. As obesity is a major risk factor for CAN, we hypothesized that metabolic bariatric surgery (MBS) could improve CAN indices in Korean patients with obesity. Patients who underwent bariatric surgery between February 2020 and June 2022 were prospectively recruited. CAN was conducted once before surgery and again after surgery, using the Ewing method and heart rate variability (HRV) analysis (standard deviation of the NN interval [SDNN], root mean square of successive RR interval difference [RMSSD], and spectral analysis). A total of 47 patients were included. The mean age was 39.8 ± 8.7 years, 15 (31.9%) were male, and 26 (55.3%) had diabetes. Resting HR before surgery was 81.0 ± 12.3 bpm, which decreased significantly to 68.0 ± 9.3 bpm after surgery (P < 0.001). Changes in HR and BP according to the Valsalva maneuver, postural changes, and handgrip were not significantly different before and after surgery. However, SDNN significantly increased from 25.2 [15.1, 33.5] to 38.0 [25.4, 45.0] ms (P < 0.001), and RMSSD also significantly increased from 17.0 [9.2, 31.8] to 28.2 [15.3, 45.6] ms (P = 0.001). Both low-frequency power (LF) and high-frequency power (HF) increased significantly, and the LF/HF ratio significantly decreased from 2.1 ± 1.6 to 1.3 ± 1.3 (P = 0.010). Loss of weight, fat mass, and lean body mass were independently associated with improving the HRV variables. MBS improved HRV variables, and these changes were mainly associated with postoperative weight loss.

Stretchable Ag/AgCl Nanowire Dry Electrodes for High-Quality Multimodal Bioelectronic Sensing.

Bioelectrical signal measurements play a crucial role in clinical diagnosis and continuous health monitoring. Conventional wet electrodes, however, present limitations as they are conductive gel for skin irritation and/or have inflexibility. Here, we developed a cost-effective and user-friendly stretchable dry electrode constructed with a flexible network of Ag/AgCl nanowires embedded in polydimethylsiloxane (PDMS). We compared the performance of the stretched Ag/AgCl nanowire electrode with commonly used commercial wet electrodes to measure electrocardiogram (ECG), electromyogram (EMG), and electroencephalogram (EEG) signals. All the signal-to-noise ratios (SNRs) of the as-fabricated or stretched (50% tensile strain) Ag/AgCl nanowire electrodes are higher than that measured by commercial wet electrodes as well as other dry electrodes. The evaluation of ECG signal quality through waveform segmentation, the signal quality index (SQI), and heart rate variability (HRV) reveal that both the as-fabricated and stretched Ag/AgCl nanowire electrode produce high-quality signals similar to those obtained from commercial wet electrodes. The stretchable electrode exhibits high sensitivity and dependability in measuring EMG and EEG data, successfully capturing EMG signals associated with muscle activity and clearly recording α-waves in EEG signals during eye closure. Our stretchable dry electrode shows enhanced comfort, high sensitivity, and convenience for curved surface biosignal monitoring in clinical contexts.

Postpartum Blood Pressure Variability and Heart Rate Variability in Preeclampsia.

Preeclampsia is associated with autonomic dysregulation during pregnancy; however, less is known about autonomic function in the first week postpartum after preeclampsia. We retrospectively analyzed data from a prospective cohort of women with and without preeclampsia. Continuous blood pressure and heart rate were measured with finger plethysmography within 7 days postpartum. Frequency-domain blood pressure and heart rate variability (HRV) were calculated using spectral analysis. Time-domain HRV was calculated as the root mean square of successive RR interval differences. We compared results between those with and without preeclampsia, as well as between those with new-onset preeclampsia, chronic hypertension with superimposed preeclampsia, and normotensive participants. A total of 70 postpartum women were enrolled: 20 normotensive, 29 new-onset preeclampsia, and 21 superimposed preeclampsia. Both low- and high-frequency blood pressure variabilities were higher in those with preeclampsia compared with controls (P=0.04 and P=0.02, respectively). This difference was driven by those with new-onset preeclampsia. The preeclampsia group had lower high-frequency HRV (P<0.005), a higher low-/high-frequency ratio of HRV (P<0.005), and lower time-domain HRV (P=0.01); this difference was seen in those with and without chronic hypertension. Postpartum patients with preeclampsia with and without chronic hypertension had lower HRV compared with normotensive postpartum controls. Higher blood pressure variability was observed only in those with nonsuperimposed preeclampsia, suggesting that the autonomic profile of preeclampsia may differ in patients with chronic hypertension.

Autonomic Reactivity to Mental Stress is Associated with Cardiovascular Mortality

Abstract Background and Aims The mechanisms linking acute psychological stress to cardiovascular disease (CVD) mortality are incompletely understood. We studied the relationship of electrocardiographic measures of autonomic dysfunction during acute mental stress provocation and CVD death. Methods In a pooled cohort of 765 participants with stable CVD from two related studies, we collected Holter data during standardized laboratory-based mental stress testing with a speech task and followed them for events. We assessed autonomic function using low frequency (LF) heart rate variability (HRV) in five-minute intervals before, during, and after stress induction, and specifically examined changes from rest to stress. We employed cause-specific survival models to examine its association with CVD and all-cause mortality, controlling for demographic and CVD risk factors. Results The mean (SD) age was 58 (10) years, 35% were women, and 44% self-identified as Black. After a median follow-up of 5.6 years, 37 (5%) died from CVD causes. A stress-induced low frequency (LF) HRV decrease (67% of sample), versus increase, was associated with a hazard ratio (HR) of 3.48 (95% confidence interval, 3.25, 3.73) for CVD mortality. Low rest LF HRV (bottom quartile) was also independently associated with CVD mortality, HR = 1.75 (1.58, 1.94), versus normal rest LF HRV (upper three quartiles). The combination of stress-induced LF HRV decrease and low rest LF HRV was associated with HR = 5.73 (5.33, 6.15) versus the normal stress/rest LF HRV reference. We found similar results with HF HRV. Conclusions Stress-induced LF HRV decrease and low rest LF HRV are both independently and additively associated with a higher CVD mortality risk. Additional research is needed to assess whether targeting autonomic dysfunction may improve CVD outcomes.

Physiological monitoring of movement and manoeuvrability during a military skiing exercise

IntroductionMilitary forces receive training in various high-altitude warfare techniques to safeguard border regions and lives. Skiing is one of such practices where research evidences are limited. Therefore, a study was...

Effect of Yoga Therapy on Hypothyroidism: A Systematic Review

Background Hypothyroidism (HT) is the most prevalent endocrine disorder, affecting approximately one in 10 out of 35 adults, with a higher prevalence in females and the elderly. Purpose This systematic review (SR) aimed to discuss the effects of yoga on markers and comorbid conditions of HT. Methods The SR was registered with the PROSPERO (PROSPERO 2022 CRD42022312990). Google Scholar, PubMed, Cochrane, and EMBASE were searched for the relevant English language interventional studies published from 31 December 1947 to 31 December 2023 by using the keywords ‘meditation OR breath regulation OR yoga OR yoga nidra AND hypothyroidism OR hypothyreosis OR underactive thyroid OR low thyroid’. Of the 4078 screened studies, eight eligible studies (three RCTs, two pilot studies, two pre-post trials, and one case study) with 421 HT patients (392 females and 29 males) and three to six-month yoga interventions were included. Two independent review authors extracted study characteristics and synthesised them descriptively. RCTs and NRSIs were assessed for risk-of-bias (RoB) using Cochrane tools RoB2 and ROBINS-1. Results The findings suggest that yoga effectively improves the thyroid profile, lipid profile, heart rate variability, pulmonary functions, anxiety, depression, and quality of life among HT patients. Conclusion Yoga may be an inexpensive add-on preventive and therapeutic option for HT. The clinical and methodological heterogeneity among the studies did not allow for meta-analysis (MA). Well-designed MAs are warranted by including rigorous RCTs to draw valid conclusions and defined mechanisms regarding the efficacy of yoga practices/interventions on HT.

Safety in the application of high-velocity low-amplitude technique in upper cervical in elderly: Preliminary study

Background: The literature is still controversial regarding the safety of applying high-velocity, low-amplitude (HVLA) techniques to the upper cervical spine, as well as the effects on heart rate variability (HRV) in the elderly. To date, there are no studies reporting the safety of applying these techniques to elderly. Objective: To verify the safety and immediate effects on HRV after applying an HVLA technique to elderly, for the purpose of conducting a future clinical trial. Materials and Methods: This is a preliminary, randomized, crossover study. Six physically active elderly individuals without cardiovascular disease were recruited. The subjects underwent two interventions, with a seven-day interval between them: intervention one consisted of an HVLA technique to the upper cervical spine, while intervention two was a simulated (sham) technique. Data on self-reported symptoms after applying the techniques were collected, in addition to HRV, to assess autonomic function. Results: There were no records of immediate adverse effects after applying the intervention techniques. However, a significant increase in the root means square difference between adjacent normal RR intervals over a time interval (RMSSD) and in the instantaneous beat-to-beat heart rate recording (SD1) was observed in the HVLA group when compared to the sham group. Conclusion: The application of the HVLA technique in the upper cervical spine did not produce self-reported adverse effects in elderly. The HVLA technique increased the activity of the parasympathetic nervous system, producing adjustments in HRV, thus indicating that there may be a significant parasympathetic stimulation in elderly.

Heart Rate Variability and Interoception in Periodic Limb Movements in Sleep: Interference with Psychiatric Disorders?

Periodic limb movements in sleep (PLMS) are a prevalent disorder characterized by rhythmic, involuntary movements of the lower limbs, such as dorsiflexion of the ankle and extension of the big toe, occurring in periodic intervals during sleep. These movements are often linked to disrupted autonomic nervous system (ANS) activity and altered interoception. Interoception involves perceiving internal bodily states, like heartbeat, breathing, hunger, and temperature, and plays a crucial role in maintaining homeostasis and the mind-body connection. This review explores the complex relationships between PLMS, heart rate variability (HRV), ANS dysregulation, and their impact on psychiatric disorders. By synthesizing the existing literature, it provides insights into how ANS dysregulation and altered interoceptive processes, alongside PLMS, contribute to psychiatric conditions. The review highlights the potential for integrated diagnostic and therapeutic approaches and presents a cause-and-effect model illustrating the mutual influence of psychiatric disorders, ANS dysregulation, PLMS, and interoception.

Self-Immersed Expressive Writing Increases LF/HF Ratio and Decreases Expressive Suppression

Abstract: Expressive writing helps the disclosure of an emotionally charged event, in a safe and nonthreatening environment, while focusing on the feelings and emotions associated with a traumatic experience. Studies have proposed that expressive writing improves both mental and physical health, and that writing perspective might influence expressive writing outcomes. However, no studies have compared both emotion regulation outcomes and Heart-Rate Variability between self-immersed (I) and self-distancing expressive writing (She/He). Two hundred and one college students at a university were randomly assigned to either an expressive group, writing about their most upsetting life experience (using either a self-immersed or distanced perspective), or a control group (using either a self-immersed or distanced perspective), writing about their daily routine. Positive and negative affect, emotion regulation, anxiety and alexithymia were measured before and after writing. Heart-rate variability was recorded during the experiment to examine the effects of the writing exercise on the autonomous nervous system. We found that suppression decreased at follow-up (η2p = .023) and LF/HF ratio increased after writing (η2 p = .031) in the self-immersed expressive group, in comparison to the self-immersed control group. These are promising results as they suggest that self-immersed expressive writing might be used to foster emotion regulation.

Efficacy and Safety of Ciprofol Versus Propofol as Anesthetic for Patients Undergoing Painless Colonoscopy.

Ciprofol is a novel propofol analogue with a characteristic of hemodynamic stability. At present, there is a lack of research comparing the hemodynamic stability of ciprofol and propofol during painless colonoscopy. In this study, we aim to test the hypothesis that ciprofol is superior to propofol in terms of hemodynamic stability for sedation anesthesia in patients undergoing colonoscopy. A total of 222 patients were randomized into two groups. Patients in group P (n=112) and group C (n=110) received propofol and ciprofol sedation, respectively. Noninvasive blood pressure were monitored starting from induction (T0) to the end of the procedure, at 2-min intervals (T1 to T10). Heart rate variability (HRV), pain injection, Modified Observer's Assessment of Alertness and Sedation(MOAA/S) score, body movement, doses of norepinephrine, modified Aldrete score, drug-related adverse reactions, and patient satisfaction and endoscopist satisfaction were recorded. In group C, fewer patients experienced a decrease in blood pressure with a higher HRV after induction sedation, the incidence of pain injection was reduced, the amount of norepinephrine dose was decreased, patient satisfaction was increased compared with group P (all P<0.05). There were no significant differences in induction time, modified Aldrete score, alertness time, drug-related adverse reactions, and endoscopist satisfaction. Our study indicated intravenous induction with ciprofol was superior, with regard to hemodynamic stability and reduced injection pain, than induction with propofol for anesthesia in patients undergoing painless colonoscopy. Chinese Clinical Trial Registry (ChiCTR2200061814).