Circadian changes of influence of swallowing on heart rate variability with respiratory-phase domain analysis

Effect of spontaneous saliva swallowing on short-term heart rate variability (HRV) and reliability of HRV analysis

The effects of effortful swallowing and solid meal ingestions on heart rate variability (HRV) have been examined previously. The effects of spontaneous saliva swallowing on short-term HRV and reliability of HRV analysis have not been studied before. The effect of saliva swallowing on HRV analyses parameters [meanRRI, SDNN (standard deviation of normal-to-normal), LF (low frequency), HF (high frequency) powers, LH/HF] and the reliability of LF and HF powers were investigated by frequency, time-frequency and intraclass correlation coefficient (ICC) analyses. Electrocardiogram and swallowing signal that obtained from an electronic stethoscope placed on the necks of subjects were recorded simultaneously from 30 healthy and young volunteers in sitting position during 15 min. Spontaneous swallowing has been shown to significantly alter some HRV parameters (SDNN, LF power and LF/HF ratio). Time-frequency analysis results showed that the contribution of saliva swallowing to LF (1-58%) and HF (2-42%) powers could change significantly depending on the number of swallowing. The ICC of the LF and HF powers for the successive 5-min signal segments were found 0·89, 0·92, respectively. These values decreased to 0·73 and 0·90 in the subjects with more swallowing rate. When the analyses were made for 2-min signal periods, these values decreased to 0·63 and 0·67. We concluded that spontaneous saliva swallowing can change HRV parameters. We have also seen that changes in swallowing rate and use of short signal segments may reduce the reliability of HRV analyses.

Effects of Effortful Swallow on Cardiac Autonomic Regulation

Swallowing-induced changes in heart rate have been recently reported. However, it is not apparent the responses of heart rate variability (HRV) elicited by effortful swallow maneuver. We investigated the acute effects of effortful swallowing maneuver on HRV. This study was performed on 34 healthy women between 18 and 35 years old. We assessed heart rate variability in the time (SDNN, RMSSD, and pNN50) and frequency (HF, LF, and LF/HF ratio) domains and, visual analysis through the Poincaré plot. The subjects remained at rest for 5 min during spontaneous swallowing and then performed effortful swallowing for 5 min. HRV was analyzed during spontaneous and effortful swallowing. We found no significant differences for SDNN, pNN50, RMSSD, HF in absolute units (ms(2)). There is a trend for increase of LF in absolute (p = 0.05) and normalized (p = 0.08) units during effortful swallowing. HF in normalized units reduced (p = 0.02) during effortful swallowing and LF/HF ratio (p = 0.03) increased during effortful swallowing. In conclusion effortful swallow maneuver in healthy women increased sympathetic cardiac modulation, indicating a cardiac overload.

Extraction of response waveforms of heartbeat and blood pressure to swallowing. Using mixed signal processing of time domain and respiratory phase domain

BACKGROUND

Evaluating the accurate responses of the cardiovascular system to external stimuli is important for a deeper understanding of cardiovascular homeostasis. However, the responses should be distorted by the conventional time domain analysis when a frequency of the effect of external stimuli matches that of intrinsic fluctuations.

OBJECTIVES

The purpose of this study is to propose a mixed signal processing of time domain and respiratory phase domain to extract the response waveforms of heartbeat and blood pressure (BP) to external stimuli and to clarify the physiological mechanisms of swallowing effects on the cardiovascular system.

METHODS

Measurements were conducted on 12 healthy humans in the sitting and standing positions, with each subject requested to swallow every 30 s between expiration and inspiration. Waveforms of respiratory sinus arrhythmia (RSA) and respiratory-related BP variations were extracted as functions of the respiratory phase. Then, respiratory effects were subtracted from response waveforms with reference to the respiratory phase in the time domain.

RESULTS

As a result, swallowing induced tachycardia, which peaked within 3 s and recovered within 8 s. Tachycardia was greater in the sitting position than during standing. Furthermore, systolic BP and pulse pressure immediately decreased and diastolic BP increased coincident with the occurrence of tachycardia. Subsequently, systolic BP and pulse pressure recovered faster than the R-R interval.

CONCLUSIONS

We conclude that swallowing-induced tachycardia arises largely from the decrease of vagal activity and the baroreflex would yield fast oscillatory responses in recovery.