1
|
Sato T, Aoki T, Ito Y, Oishi K, Fujishima M, Okumura E, Ishii K. Effects of continuous supplementation of Acanthopanax senticosus Harms on the cardiac autonomic function of community-dwelling elderly individuals during resting and standing tests: a randomized controlled trial. Front Cardiovasc Med 2024; 11:1336676. [PMID: 38525193 PMCID: PMC10957529 DOI: 10.3389/fcvm.2024.1336676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/26/2024] [Indexed: 03/26/2024] Open
Abstract
Background Cardiac autonomic function (CAF) decreases with aging, and Acanthopanax senticosus Harms (ASH) consumption reportedly induces anti-stress effects. This study aimed to assess the effect of continuous supplementation of ASH on CAF during resting and standing tests in the elderly population. Methods This double-blind, randomized controlled trial was conducted in the morning in a laboratory setting and was carried out between June 2017 and July 2017 at Kambaikan, Doshisha University (Karasuma-higashi-iru, Imadegawa-dori, Kamigyo-ku, Kyoto 602-8580, Japan). In total, 28 community-dwelling elderly individuals (mean ± standard deviation = 72.5 ± 4.5 years) were included. Each subject was instructed to consume ASH or placebo supplements twice daily for 4 weeks. An autonomic reflex orthostatic tolerance recorder was used to measure CAF in pre- and post-intervention phases. Parameters were measured in a seated position and included coefficient of variation of R-R intervals (CVRR), low frequency (LF), high frequency (HF), LF/HF ratio, blood pressure, and heart rate (HR). Changes in each parameter were evaluated before and after standing. All parameters were defined as the difference between the mean value obtained in a standing position for 2 min and that obtained in a 2-min seated position. Results A two-way analysis of variance revealed a significant group-time interaction effect on CVRR, HF, and ΔLF/HF ratio. Following the intervention, CVRR, HF, LF/HF ratio, systolic blood pressure (SBP), HR, ΔLF/HF ratio, ΔSBP, and ΔHR improved significantly in the ASH group only. Conclusions Four-week supplementation of ASH improved CAF in community-dwelling elderly individuals during resting and standing tests. Clinical Trial Registration https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000031218, UMIN Clinical Trials Registry (UMIN000027251).
Collapse
Affiliation(s)
- Takeru Sato
- Graduate School of Health and Sports Science, Doshisha University, Kyo-Tanabe, Japan
| | - Takumi Aoki
- Faculty of Education, Miyagi Gakuin Women’s University, Sendai, Japan
| | - Yuki Ito
- College of Life and Health Sciences, Chubu University, Kasugai, Japan
| | - Kan Oishi
- Graduate School of Health and Sports Science, Doshisha University, Kyo-Tanabe, Japan
| | | | | | - Kojiro Ishii
- Faculty of Health and Sports Science, Doshisha University, Kyo-Tanabe, Japan
| |
Collapse
|
2
|
Martín-González S, Ravelo-García AG, Navarro-Mesa JL, Hernández-Pérez E. Combining Heart Rate Variability and Oximetry to Improve Apneic Event Screening in Non-Desaturating Patients. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23094267. [PMID: 37177472 PMCID: PMC10181515 DOI: 10.3390/s23094267] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 05/15/2023]
Abstract
In this paper, we thoroughly analyze the detection of sleep apnea events in the context of Obstructive Sleep Apnea (OSA), which is considered a public health problem because of its high prevalence and serious health implications. We especially evaluate patients who do not always show desaturations during apneic episodes (non-desaturating patients). For this purpose, we use a database (HuGCDN2014-OXI) that includes desaturating and non-desaturating patients, and we use the widely used Physionet Apnea Dataset for a meaningful comparison with prior work. Our system combines features extracted from the Heart-Rate Variability (HRV) and SpO2, and it explores their potential to characterize desaturating and non-desaturating events. The HRV-based features include spectral, cepstral, and nonlinear information (Detrended Fluctuation Analysis (DFA) and Recurrence Quantification Analysis (RQA)). SpO2-based features include temporal (variance) and spectral information. The features feed a Linear Discriminant Analysis (LDA) classifier. The goal is to evaluate the effect of using these features either individually or in combination, especially in non-desaturating patients. The main results for the detection of apneic events are: (a) Physionet success rate of 96.19%, sensitivity of 95.74% and specificity of 95.25% (Area Under Curve (AUC): 0.99); (b) HuGCDN2014-OXI of 87.32%, 83.81% and 88.55% (AUC: 0.934), respectively. The best results for the global diagnosis of OSA patients (HuGCDN2014-OXI) are: success rate of 95.74%, sensitivity of 100%, and specificity of 89.47%. We conclude that combining both features is the most accurate option, especially when there are non-desaturating patterns among the recordings under study.
Collapse
Affiliation(s)
- Sofía Martín-González
- Institute for Technological Development and Innovation in Communications, Universidad de Las Palmas de Gran Canaria, 35017 Las Palmas de Gran Canaria, Spain
| | - Antonio G Ravelo-García
- Institute for Technological Development and Innovation in Communications, Universidad de Las Palmas de Gran Canaria, 35017 Las Palmas de Gran Canaria, Spain
- Interactive Technologies Institute (ITI/LARSyS and ARDITI), 9020-105 Funchal, Portugal
| | - Juan L Navarro-Mesa
- Institute for Technological Development and Innovation in Communications, Universidad de Las Palmas de Gran Canaria, 35017 Las Palmas de Gran Canaria, Spain
| | - Eduardo Hernández-Pérez
- Institute for Technological Development and Innovation in Communications, Universidad de Las Palmas de Gran Canaria, 35017 Las Palmas de Gran Canaria, Spain
| |
Collapse
|
3
|
Nashiro K, Yoo HJ, Cho C, Min J, Feng T, Nasseri P, Bachman SL, Lehrer P, Thayer JF, Mather M. Effects of a Randomised Trial of 5-Week Heart Rate Variability Biofeedback Intervention on Cognitive Function: Possible Benefits for Inhibitory Control. Appl Psychophysiol Biofeedback 2023; 48:35-48. [PMID: 36030457 PMCID: PMC9420180 DOI: 10.1007/s10484-022-09558-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2022] [Indexed: 12/01/2022]
Abstract
Previous research suggests that higher heart rate variability (HRV) is associated with better cognitive function. However, since most previous findings on the relationship between HRV and cognitive function were correlational in nature, it is unclear whether individual differences in HRV play a causal role in cognitive performance. To investigate whether there are causal relationships, we used a simple breathing manipulation that increases HRV through a 5-week HRV biofeedback intervention and examined whether this manipulation improves cognitive performance in younger and older adults (N = 165). The 5-week HRV biofeedback intervention did not significantly improve inhibitory control, working memory and processing speed across age groups. However, improvement in the Flanker score (a measure of inhibition) was associated with the amplitude of heart rate oscillations during practice sessions in the younger and older intervention groups. Our results suggest that daily practice to increase heart rate oscillations may improve inhibitory control, but future studies using longer intervention periods are warranted to replicate the present finding.
Collapse
Affiliation(s)
- Kaoru Nashiro
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA.
| | - Hyun Joo Yoo
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA
| | - Christine Cho
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA
| | - Jungwon Min
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA
| | - Tiantian Feng
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA
| | - Padideh Nasseri
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA
| | - Shelby L Bachman
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA
| | | | | | - Mara Mather
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA
| |
Collapse
|
4
|
Lin LLC, Chen YJ, Lin TY, Weng TC. Effects of Resistance Training Intensity on Heart Rate Variability at Rest and in Response to Orthostasis in Middle-Aged and Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10579. [PMID: 36078296 PMCID: PMC9517804 DOI: 10.3390/ijerph191710579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 08/10/2022] [Accepted: 08/15/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Aging and deficits related to decreased physical activity can lead to higher risks of autonomic nervous system (ANS) dysfunction. The aim of this study was to evaluate the effects of 24 weeks of resistance training (RT) at various intensities on hemodynamics as well as heart rate variability (HRV) at rest and in response to orthostatic tests in middle-aged and older adults. METHODS Forty adults were randomized into three groups: high-intensity (HEX) (80% 1-RM) (11 female, 4 male; 60 ± 4 years); low-moderate-intensity (LEX) (50% 1-RM) (nine female, four male; 61 ± 5 years); and a control group (CON) (eight female, four male; 60 ± 4 years). The RT program consisted of nine exercises, with two sets performed of each exercise two times per week for 24 weeks. Data collected included 1-RM, heart rate, and blood pressure and HRV at rest and in response to orthostasis. RESULTS Both the HEX (42-94%) and LEX (31.3-51.7%) groups showed increases in 1-RM (p < 0.01). The HEX group showed decreases in resting heart rate (-4.0%), diastolic blood pressure (-3.2 mmHg (-4.2%)), and low frequency/high frequency (LF/HF) (Ln ratio) (p < 0.05). Post-study, the HEX group had higher HF (Ln ms2) than the CON, adjusted for pre-study value and age (p < 0.05). Post-study, the supine-standing ratio (SSR) of LFn (normalized unit) in the HEX group was greater than that in the LEX and CON groups, while the SSR of LF/HF in the HEX group was greater than the CON (p < 0.05). In conclusion, high-intensity RT can improve resting heart rate and HRV by enhancing cardiac vagal control. High-intensity RT might also improve the orthostatic response in terms of HRV. High intensity RT might assist ANS modification and could perhaps decrease the risks of cardiovascular disease and orthostatic intolerance.
Collapse
Affiliation(s)
- Linda Li-Chuan Lin
- Institute of Physical Education, Health and Leisure Studies, National Cheng Kung University, No. 1, Ta-Hsueh Road, Tainan 701, Taiwan
| | - Yi-Ju Chen
- Institute of Physical Education, Health and Leisure Studies, National Cheng Kung University, No. 1, Ta-Hsueh Road, Tainan 701, Taiwan
| | - Tai-You Lin
- National Sports Training Center, No. 399, Shiyun Blvd., Zuoying Dist., Kaohsiung City 813, Taiwan
| | - Ting-Chun Weng
- Institute of Physical Education, Health and Leisure Studies, National Cheng Kung University, No. 1, Ta-Hsueh Road, Tainan 701, Taiwan
| |
Collapse
|
5
|
Evaluation of Heart Rate Variability and Application of Heart Rate Variability Biofeedback: Toward Further Research on Slow-Paced Abdominal Breathing in Zen Meditation. Appl Psychophysiol Biofeedback 2022; 47:345-356. [PMID: 35579767 DOI: 10.1007/s10484-022-09546-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2022] [Indexed: 11/02/2022]
Abstract
This review summarizes my own involvement in heart rate variability (HRV) and HRV biofeedback studies, as a tribute to the late Dr. Evgeny Vaschillo. I first review psychophysiological studies on behavioral stress and relaxation performed in my laboratory using an assessment of cardiac parasympathetic activity. Although magnitude of high-frequency (HF) component of HRV corresponding respiratory sinus arrhythmia (RSA) is widely used as an index of cardiac parasympathetic function, a respiratory confound during stress or relaxation may have interfered with the proper assessment of the HF HRV. An enhanced method under frequency-controlled respiration at 0.25 Hz provided a reliable assessment of cardiac parasympathetic activity. I then review findings from HRV biofeedback research in my laboratory. Based on the hypothesis that RSA measured as an HF component of HRV represents cardiorespiratory resting function, it was demonstrated that HRV biofeedback before sleep enhanced the magnitude of HF HRV during sleep, a cardiorespiratory resting function. Moreover, by focusing on the spectral peak of the low-frequency (LF) component of HRV, paced breathing at the LF-peak frequency was shown to increase baroreflex sensitivity. Finally, I describe the potential of slow-paced abdominal breathing (i.e., Tanden breathing) performed in Zen meditation. The concept of Tanden breathing as described in a regimen from early modern Japan is introduced, and recent research findings on slow-paced abdominal breathing are summarized. Future research directions of slow-paced abdominal breathing are also discussed.
Collapse
|
6
|
Hayano J, Yuda E. Assessment of autonomic function by long-term heart rate variability: beyond the classical framework of LF and HF measurements. J Physiol Anthropol 2021; 40:21. [PMID: 34847967 PMCID: PMC8630879 DOI: 10.1186/s40101-021-00272-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 11/12/2021] [Indexed: 12/16/2022] Open
Abstract
In the assessment of autonomic function by heart rate variability (HRV), the framework that the power of high-frequency component or its surrogate indices reflects parasympathetic activity, while the power of low-frequency component or LF/HF reflects sympathetic activity has been used as the theoretical basis for the interpretation of HRV. Although this classical framework has contributed greatly to the widespread use of HRV for the assessment of autonomic function, it was obtained from studies of short-term HRV (typically 5‑10 min) under tightly controlled conditions. If it is applied to long-term HRV (typically 24 h) under free-running conditions in daily life, erroneous conclusions could be drawn. Also, long-term HRV could contain untapped useful information that is not revealed in the classical framework. In this review, we discuss the limitations of the classical framework and present studies that extracted autonomic function indicators and other useful biomedical information from long-term HRV using novel approaches beyond the classical framework. Those methods include non-Gaussianity index, HRV sleep index, heart rate turbulence, and the frequency and amplitude of cyclic variation of heart rate.
Collapse
Affiliation(s)
- Junichiro Hayano
- Heart Beat Science Lab, Co., Ltd., Aoba 6-6-40 Aramaki Aoba-ku, Sendai, 980-0845 Japan
- Nagoya City University, Kawasumi 1, Mizuho-cho Mizuho-ku, Nagoya, 467-8602 Japan
| | - Emi Yuda
- Heart Beat Science Lab, Co., Ltd., Aoba 6-6-40 Aramaki Aoba-ku, Sendai, 980-0845 Japan
- Center for Data-Driven Science and Artificial Intelligence, Tohoku University, 41 Kawauchi, Aoba-ku, Sendai, 980-8576 Japan
| |
Collapse
|
7
|
Takahashi N, Takahashi Y, Tabara Y, Kawaguchi T, Kuriyama A, Ueshima K, Kosugi S, Sekine A, Yamada R, Matsuda F, Nakayama T. Descriptive epidemiology of high frequency component based on heart rate variability from 10-second ECG data and daily physical activity among community adult residents: the Nagahama Study. Biosci Trends 2020; 14:241-247. [PMID: 32624526 DOI: 10.5582/bst.2020.03146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Characteristics of high frequency (HF) component based on heart rate variability (HRV) in a large general population remain unclear, particularly on the relationship with daily physical activity. We aimed to characterize the distribution of HF component and examine the association with daily physical activity among community residents. We performed spectral analysis of HRV from 10-second ECG recordings among 9135 residents aged 30 to 74 years in Nagahama City, Japan. HF components were log-transformed to consider the distribution. Simple correlations between HF and age were determined. Age-adjusted mean values of HF component were calculated for each questionnaire item related to daily physical activity. Multiple regression analysis was performed to examine the effect of daily physical activity on HF component value. Mean values of logarithmically-transformed HF component (lnHF) were higher in women than in men (p < 0.001). lnHF was inversely associated with age (r = -0.40, -0.49 for men, women, respectively). Adjusted mean lnHF for physically active people was significantly higher than that in inactive people (p < 0.001). HF components from 10-second ECG recordings were moderately and negatively correlated with age in both sexes, and positively correlated with daily physical activity in the general adult population. Maintaining the level of daily physical activity, especially to exercise regularly could keep the parasympathetic function high.
Collapse
Affiliation(s)
- Naomi Takahashi
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Yoshimitsu Takahashi
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Yasuharu Tabara
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takahisa Kawaguchi
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akira Kuriyama
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Kenji Ueshima
- Department of EBM Research, Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital, Kyoto, Japan
| | - Shinji Kosugi
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - Akihiro Sekine
- Department of Omics-based Medicine, Clinical Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Ryo Yamada
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | | |
Collapse
|
8
|
Monfredi O, Lakatta EG. Complexities in cardiovascular rhythmicity: perspectives on circadian normality, ageing and disease. Cardiovasc Res 2020; 115:1576-1595. [PMID: 31150049 DOI: 10.1093/cvr/cvz112] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 02/06/2019] [Accepted: 05/25/2019] [Indexed: 12/13/2022] Open
Abstract
Biological rhythms exist in organisms at all levels of complexity, in most organs and at myriad time scales. Our own biological rhythms are driven by energy emitted by the sun, interacting via our retinas with brain stem centres, which then send out complex messages designed to synchronize the behaviour of peripheral non-light sensing organs, to ensure optimal physiological responsiveness and performance of the organism based on the time of day. Peripheral organs themselves have autonomous rhythmic behaviours that can act independently from central nervous system control but is entrainable. Dysregulation of biological rhythms either through environment or disease has far-reaching consequences on health that we are only now beginning to appreciate. In this review, we focus on cardiovascular rhythms in health, with ageing and under disease conditions.
Collapse
Affiliation(s)
- Oliver Monfredi
- Division of Medicine, Department of Cardiology, The Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD, USA.,Laboratory of Cardiovascular Sciences, Intramural Research Program, National Institute on Aging, National Institutes of Health, 251 Bayview Blvd, Baltimore, MD, USA
| | - Edward G Lakatta
- Laboratory of Cardiovascular Sciences, Intramural Research Program, National Institute on Aging, National Institutes of Health, 251 Bayview Blvd, Baltimore, MD, USA
| |
Collapse
|
9
|
Non-REM Sleep Marker for Wearable Monitoring: Power Concentration of Respiratory Heart Rate Fluctuation. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10093336] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A variety of heart rate variability (HRV) indices have been reported to estimate sleep stages, but the associations are modest and lacking solid physiological basis. Non-REM (NREM) sleep is associated with increased regularity of respiratory frequency, which results in the concentration of high frequency (HF) HRV power into a narrow frequency range. Using this physiological feature, we developed a new HRV sleep index named Hsi to quantify the degree of HF power concentration. We analyzed 11,636 consecutive 5-min segments of electrocardiographic (ECG) signal of polysomnographic data in 141 subjects and calculated Hsi and conventional HRV indices for each segment. Hsi was greater during NREM (mean [SD], 75.1 [8.3]%) than wake (61.0 [10.3]%) and REM (62.0 [8.4]%) stages. Receiver-operating characteristic curve analysis revealed that Hsi discriminated NREM from wake and REM segments with an area under the curve of 0.86, which was greater than those of heart rate (0.642), peak HF power (0.75), low-to-high frequency ratio (0.77), and scaling exponent α (0.77). With a cutoff >70%, Hsi detected NREM segments with 77% sensitivity, 80% specificity, and a Cohen’s kappa coefficient of 0.57. Hsi may provide an accurate NREM sleep maker for ECG and pulse wave signals obtained from wearable sensors.
Collapse
|
10
|
Chikamoto A, Sekizawa SI, Tochinai R, Kuwahara M. Early attenuation of autonomic nervous function in senescence accelerated mouse-prone 8 (SAMP8). Exp Anim 2019; 68:511-517. [PMID: 31168043 PMCID: PMC6842801 DOI: 10.1538/expanim.19-0032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The senescence-accelerated mouse (SAM) strain has been established as an inbred strain with an accelerated aging phenotype. SAM prone-8 (SAMP8), one of the SAM strain, exhibits learning disability, immune deficiency, and circadian rhythm loss at a relatively young age. However, it has not been clarified whether aging affects the autonomic nervous activity in SAMP8. The aim of this study was to clarify the utility of SAMP8 in age-related studies of autonomic nervous function. Electrocardiogram (ECG), body temperature, and locomotor activity were recorded to evaluate bio-behavioral activities. Autonomic nervous activity was evaluated via power spectral analysis of heart rate variability from ECG recordings. SAMP8 significantly decreased both biological and autonomic nervous functions, and the animals exhibited circadian rhythm loss of locomotive activity at as early as 40 weeks of age compared with a control strain at the same age. We concluded that the SAMP8 strain can be used as an animal model for age-related studies of autonomic nervous function.
Collapse
Affiliation(s)
- Akitoshi Chikamoto
- Laboratory of Veterinary Pathophysiology and Animal Health, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Shin-Ichi Sekizawa
- Laboratory of Veterinary Pathophysiology and Animal Health, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Ryota Tochinai
- Laboratory of Veterinary Pathophysiology and Animal Health, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Masayoshi Kuwahara
- Laboratory of Veterinary Pathophysiology and Animal Health, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| |
Collapse
|
11
|
Hayano J, Yuda E. Pitfalls of assessment of autonomic function by heart rate variability. J Physiol Anthropol 2019; 38:3. [PMID: 30867063 PMCID: PMC6416928 DOI: 10.1186/s40101-019-0193-2] [Citation(s) in RCA: 152] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 03/05/2019] [Indexed: 12/16/2022] Open
Abstract
Although analysis of heart rate variability is widely used for the assessment of autonomic function, its fundamental framework linking low-frequency and high-frequency components of heart rate variability with sympathetic and parasympathetic autonomic divisions has developed in the 1980s. This simplified framework is no longer able to deal with much evidence about heart rate variability accumulated over the past half-century. This review addresses the pitfalls caused by the old framework and discusses the points that need attention in autonomic assessment by heart rate variability.
Collapse
Affiliation(s)
- Junichiro Hayano
- Department of Medical Education, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi Mizuho-cho Mizuho-ku, Nagoya, 467-8602, Japan.
| | - Emi Yuda
- Department of Medical Education, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi Mizuho-cho Mizuho-ku, Nagoya, 467-8602, Japan
| |
Collapse
|
12
|
Clinical factors associated with the recovery of cardiovascular autonomic neuropathy in patients with type 2 diabetes mellitus. Cardiovasc Diabetol 2019; 18:29. [PMID: 30857534 PMCID: PMC6410519 DOI: 10.1186/s12933-019-0830-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 02/19/2019] [Indexed: 02/07/2023] Open
Abstract
Background Cardiovascular autonomic neuropathy (CAN) is a major cause of morbidity and mortality in diabetes patients. Although several risk factors for CAN progression have been established, whether CAN is reversible remains unclear and the clinical factors associated with CAN recovery have not been identified. This study aimed to determine clinical factors related to CAN recovery. Methods Type 2 diabetes patients with CAN but free of cardiovascular disease at baseline were enrolled and followed for 2–3 years in this retrospective longitudinal study. CAN was classified as early (one abnormal parasympathetic test), definite (two or more abnormal parasympathetic tests), severe (definite plus orthostatic hypotension), or atypical (early plus orthostatic hypotension or orthostatic hypotension alone) based on Ewing’s method. CAN recovery was classified as partial or complete: Partial recovery was defined as one-step improvement in CAN stage (early to normal, definite to early, or severe to definite), including the disappearance of only one abnormal result in any stage. Complete recovery was defined as normalization from definite or severe CAN. Results Among 759 subjects with CAN, 29.9% (n = 227) experienced CAN recovery, and 1.2% (n = 9) recovered completely. In a multivariate model, younger age (odds ratio [OR] per 5-year decrease 1.49; 95% confidence interval [CI] 1.25–1.78, P < 0.001), shorter duration of diabetes (OR per 5-year decrease 1.33; 95% CI 1.05–1.67, P = 0.016), presence of micro/macroalbuminuria (OR 0.34; 95% CI 0.15–0.78, P = 0.011), body weight reduction (OR per 1-kg decrease 1.11; 95% CI 1.02–1.21, P = 0.016), and HbA1c reduction (OR per 1% decrease 1.32; 95% CI 1.05–1.67, P = 0.019) were significantly associated with composite events of partial and complete CAN recovery. Age had the highest relative significance among the associated clinical factors. In addition, younger age was the only significant factor in complete CAN recovery. Conclusions Younger age was the most important factor in CAN recovery in subjects with type 2 diabetes, including recovery from the definite or severe stage. HbA1c reduction, body weight reduction, no concurrent micro/macroalbuminuria, and shorter duration of diabetes were also significantly associated with CAN recovery. Electronic supplementary material The online version of this article (10.1186/s12933-019-0830-4) contains supplementary material, which is available to authorized users.
Collapse
|
13
|
Kubota S, Endo Y, Kubota M, Shigemasa T. Assessment of effects of differences in trunk posture during Fowler's position on hemodynamics and cardiovascular regulation in older and younger subjects. Clin Interv Aging 2017; 12:603-610. [PMID: 28408809 PMCID: PMC5384695 DOI: 10.2147/cia.s132399] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background Downward shifts in blood volume with changing position generally cause tachycardic responses. Age-related decreases in vagal nerve activity could contribute to orthostatic hypotension in older individuals. Fowler’s position is a reclined position with the back between 30° and 60°, used to facilitate breathing, eating, and other routine daily activities in frail and elderly patients. Objective This study examined whether stroke volume (SV) was higher and heart rate (HR) lower in Fowler’s position with an upright upper trunk than in Fowler’s position with the whole trunk upright in both older and younger subjects, based on the assumption that lower HR would result from reduced sympathetic activation in older individuals. Methods We assessed hemodynamics and HR variability from electrocardiography, noninvasive arterial pressure and impedance cardiography in 11 younger male subjects (age range, 20–22 years) and 11 older male subjects (age range, 64–79 years), using three positions: supine, or Fowler’s positions with either 30° of lower trunk inclination and 60° of upper trunk inclination (UT60) or 60° of whole trunk inclination (WT60). Comparisons were then made between age groups and between positions. Results Reductions in SV and tachycardic response were smaller with UT60 than with WT60, in both younger and older subjects. In addition, reduced tachycardic response with upright upper trunk appeared attributable to decreased vagal withdrawal in younger subjects and to reduced sympathetic activation in older subjects. Conclusion Our findings indicate that an upright upper trunk during Fowler’s position allowed maintenance of SV and inhibited tachycardic response compared to an upright whole trunk regardless of age, although the autonomic mechanisms underlying tachycardic responses differed between younger and older adults. An upright upper trunk in Fowler’s position might help to reduce orthostatic stress and facilitate routine activities and conversation in frail patients.
Collapse
Affiliation(s)
- Satoshi Kubota
- School of Nursing and Rehabilitation Sciences at Odawara, International University of Health and Welfare, Odawara, Kanagawa, Japan
| | - Yutaka Endo
- School of Nursing and Rehabilitation Sciences at Odawara, International University of Health and Welfare, Odawara, Kanagawa, Japan
| | - Mitsue Kubota
- School of Nursing and Rehabilitation Sciences at Odawara, International University of Health and Welfare, Odawara, Kanagawa, Japan
| | - Tomohiko Shigemasa
- Department of Cardiology, International University of Health and Welfare Atami Hospital, Atami, Shizuoka, Japan
| |
Collapse
|
14
|
Dennis PA, Weinberg JB, Calhoun PS, Watkins LL, Sherwood A, Dennis MF, Beckham JC. An investigation of vago-regulatory and health-behavior accounts for increased inflammation in posttraumatic stress disorder. J Psychosom Res 2016; 83:33-9. [PMID: 27020074 PMCID: PMC4813329 DOI: 10.1016/j.jpsychores.2016.02.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 02/18/2016] [Accepted: 02/24/2016] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Posttraumatic stress disorder (PTSD) has been linked to chronic inflammation, a condition that poses a risk for cardiovascular disease. Attenuated vagal activity has been proposed as a potential mediator of PTSD and inflammation, although associated behavioral health risks-namely cigarette smoking and alcohol dependence-might also account for that link. METHODS Inflammation was quantified by fasting serum concentrations of C-reactive protein (CRP), tumor necrosis factor (TNF)-α, interleukin (IL)-10, and thymus- and activation-regulated chemokine (TARC)/CCL17 collected from 85 participants with PTSD and 82 without PTSD. Latent variable modeling was used to assess the relationship between PTSD symptom severity and inflammation along with potential mediators vagal activity (respiratory sinus arrhythmia; RSA), smoking status, and lifetime alcohol dependence. RESULTS PTSD symptom severity was associated with increased inflammation (β=.18, p=.02). However, this association was reduced in models that adjusted for RSA, smoking status, and lifetime alcohol dependence. Independent mediation effects were deemed significant via bootstrapping analyses. Together, RSA, smoking status, and lifetime alcohol dependence accounted for 95% of the effect of PTSD symptom severity on inflammation. CONCLUSION Although RSA accounted for a modest proportion of the association between posttraumatic stress and pro-inflammatory responses, behavioral factors-specifically cigarette smoking and alcohol dependence-proved to be larger mediators. The benefits of PTSD treatment may be enhanced by additional interventions aimed at modifying these health behaviors.
Collapse
Affiliation(s)
- Paul A. Dennis
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
| | - J. B. Weinberg
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA,Department of Medicine, Duke University Medical Center, Durham, NC 27705, USA
| | - Patrick S. Calhoun
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA,Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA,Veterans Affairs Center for Health Services Research in Primary Care, Durham, NC, 27705, USA
| | - Lana L. Watkins
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
| | - Andrew Sherwood
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
| | - Michelle F. Dennis
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
| | - Jean C. Beckham
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA,Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA
| |
Collapse
|
15
|
Zhao R, Li D, Zuo P, Bai R, Zhou Q, Fan J, Li C, Wang L, Yang X. Influences of age, gender, and circadian rhythm on deceleration capacity in subjects without evident heart diseases. Ann Noninvasive Electrocardiol 2014; 20:158-66. [PMID: 25112779 PMCID: PMC4407920 DOI: 10.1111/anec.12189] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background Deceleration capacity (DC) is a newly found predictor of mortality after myocardial infarction. Age‐, gender‐, and circadian rhythm–related differences in DC may limit its predictive value, which should be considered in clinical settings. Methods DC, average heart rate, and HRV parameters, including 24 hours, awaking state (15:00–20:00) and sleeping mode (00:00–05:00) strips from 24 hours Holter recordings in 636 subjects without heart diseases were examined. Heart rate variability was analyzed in time domains (standard deviation of all normal‐to‐normal intervals [SDNN], normal‐to‐normal RR intervals in all 5‐minute segments [SDANN], and root mean square successive difference [RMSSD]). Results The DC, SDNN, SDANN, RMSSD, and heart rate decreased with age. Deceleration capacity was significantly lower in patients greater than 50 years of age. The largest decrease of SDNN, SDANN, and RMSSD occurred in patients 30–39 years of age. The values of SDNN, SDANN, and DC of women were lower than that of men in the young and middle‐aged groups, but age‐related decrease of DC in men was greater than that in women. Heart rate of women was significantly higher than that of men in younger subjects, especially in a sleeping mode. There were higher values of DC and RMSSD during sleeping than that during a waking state. Conclusions The age, gender, and circadian rhythm may be useful when evaluating cardiac autonomic function and need to be considered when evaluating DC and HRV in clinical and scientific researches.
Collapse
Affiliation(s)
- Ruifu Zhao
- Department of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Yamaguchi K, Inoue Y, Ohki N, Satoya N, Inoue F, Maeda Y, Sekiguchi H, Suzuki M, Tsuji T, Aoshiba K, Nagai A. Gender-specific impacts of apnea, age, and BMI on parasympathetic nerve dysfunction during sleep in patients with obstructive sleep apnea. PLoS One 2014; 9:e92808. [PMID: 24667894 PMCID: PMC3965452 DOI: 10.1371/journal.pone.0092808] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 02/26/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The gender-specific influences of various confounding factors, including apnea, age, BMI, and cigarette consumption, on the function of the parasympathetic nerve system (PNS) during sleep in OSA patients has never been investigated. METHODS One hundred ninety-seven males and 63 females with OSA were subjected to full PSG examinations including assessment of R-R intervals (RRIs) during an overnight ECG. The PNS-derived modulatory effect on the RRIs and the variability of this effect were quantified during REM and NREM using instantaneous time-frequency analysis with complex demodulation. The spectral domain with the maximum instantaneous amplitude in the high-frequency band between 0.15 and 0.4 Hz was defined as the main HF peak and used as a surrogate marker of PNS discharge. Based on density-spectrum-array maps of the main HF peaks (HF-DSA map), shifts in the central frequency of the main HF peak over time were continuously observed. When the main HF peaks on the HF-DSA maps maintained the same central frequency for more than 20 sec or 5 min, the PNS functions were considered to be "stable" or "very stable", respectively. RESULTS Apneas enhanced PNS-derived cardiac-modulation during REM in males, but more importantly, they made PNS-function unstable during both REM and NREM in males and during NREM in females. Aging blunted the PNS-derived cardiac-modulation during both REM and NREM regardless of gender, but aging had no impact on the stability of PNS-function. BMI blunted PNS-eliciting cardiac-modulation during REM in males and during NREM in both males and females. BMI made the PNS unstable during REM in females. Neither height nor cigarette consumption influenced any PNS-related parameter. CONCLUSIONS The PNS-derived cardiac-modulation was generally inhibited by aging and obesity, in which the effect of obesity was gender-specific. The PNS instability at nighttime was mainly induced by apneas but by obesity particularly during REM in females.
Collapse
Affiliation(s)
- Kazuhiro Yamaguchi
- Comprehensive Medical Center of Sleep Disorders, Aoyama Hospital, Tokyo Women’s Medical University, Minato-ku, Tokyo, Japan
- * E-mail:
| | - Yuji Inoue
- Comprehensive Medical Center of Sleep Disorders, Aoyama Hospital, Tokyo Women’s Medical University, Minato-ku, Tokyo, Japan
| | - Noboru Ohki
- NoruPro Light Systems Incorporation, Kokubunji-shi, Tokyo, Japan
| | - Natsumi Satoya
- Comprehensive Medical Center of Sleep Disorders, Aoyama Hospital, Tokyo Women’s Medical University, Minato-ku, Tokyo, Japan
| | - Fukumi Inoue
- Comprehensive Medical Center of Sleep Disorders, Aoyama Hospital, Tokyo Women’s Medical University, Minato-ku, Tokyo, Japan
| | - Yoshiko Maeda
- Department of Urology, Aoyama Hospital, Tokyo Women’s Medical University, Minato-ku, Tokyo, Japan
| | - Haruki Sekiguchi
- Department of Cardiology, Aoyama Hospital, Tokyo Women’s Medical University, Minato-ku, Tokyo, Japan
| | - Mayumi Suzuki
- Comprehensive Medical Center of Sleep Disorders, Aoyama Hospital, Tokyo Women’s Medical University, Minato-ku, Tokyo, Japan
| | - Takao Tsuji
- Department of Respiratory Medicine, Tokyo Medical University Ibaraki Medical Center, Inashiki, Ibaraki, Japan
| | - Kazutetsu Aoshiba
- Department of Respiratory Medicine, Tokyo Medical University Ibaraki Medical Center, Inashiki, Ibaraki, Japan
| | - Atsushi Nagai
- The First Department of Medicine, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan
| |
Collapse
|
17
|
Russoniello CV, Zhirnov YN, Pougatchev VI, Gribkov EN. Heart rate variability and biological age: implications for health and gaming. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2013; 16:302-8. [PMID: 23574369 DOI: 10.1089/cyber.2013.1505] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Accurate and inexpensive psychophysiological equipment and software are needed to measure and monitor the autonomic nervous system for gaming and therapeutic purposes. The purpose of this study was to determine whether heart rate variability (HRV) derived from photoplethesmography (PPG) technology was predictive of autonomic nervous system (ANS) aging or biological age. Second, we sought to determine which HRV variable was most predictive of ANS change and aging. To test our hypotheses, we first conducted a criterion related validity study by comparing parameters of a 5 minute resting HRV test obtained from electrocardiography (ECG), the current "gold standard," with PPG technologies, and found them to be significantly correlated (r≥0.92) on all parameters during a resting state. PPG was strongly correlated to ECG on all HRV parameters during a paced six breaths per minute deep breathing test (r≥0.98). Further analysis revealed that maximum variation of heart rate had the highest negative correlation (r=-0.67) with age. We conclude that PPG is comparable to ECG in accuracy, and maximum variation of heart rate derived from a paced breathing test can be considered a marker of biological aging. Therapeutic interventions and games designed to reduce dysfunction in the ANS can now be developed using accurate physiological data.
Collapse
Affiliation(s)
- Carmen V Russoniello
- Psychophysiology Lab and Biofeedback Clinic, Department of Recreation and Leisure Studies, College of Health and Human Performance, East Carolina University, Greenville, NC 27858, USA.
| | | | | | | |
Collapse
|
18
|
Nemati S, Edwards BA, Lee J, Pittman-Polletta B, Butler JP, Malhotra A. Respiration and heart rate complexity: effects of age and gender assessed by band-limited transfer entropy. Respir Physiol Neurobiol 2013; 189:27-33. [PMID: 23811194 DOI: 10.1016/j.resp.2013.06.016] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 06/19/2013] [Accepted: 06/20/2013] [Indexed: 12/19/2022]
Abstract
Aging and disease are accompanied with a reduction of complex variability in the temporal patterns of heart rate. This reduction has been attributed to a break down of the underlying regulatory feedback mechanisms that maintain a homeodynamic state. Previous work has established the utility of entropy as an index of disorder, for quantification of changes in heart rate complexity. However, questions remain regarding the origin of heart rate complexity and the mechanisms involved in its reduction with aging and disease. In this work we use a newly developed technique based on the concept of band-limited transfer entropy to assess the aging-related changes in contribution of respiration and blood pressure to entropy of heart rate at different frequency bands. Noninvasive measurements of heart beat interval, respiration, and systolic blood pressure were recorded from 20 young (21-34 years) and 20 older (68-85 years) healthy adults. Band-limited transfer entropy analysis revealed a reduction in high-frequency contribution of respiration to heart rate complexity (p<0.001) with normal aging, particularly in men. These results have the potential for dissecting the relative contributions of respiration and blood pressure-related reflexes to heart rate complexity and their degeneration with normal aging.
Collapse
Affiliation(s)
- Shamim Nemati
- Harvard Medical School, Division of Sleep Medicine, Brigham and Women's Hospital, 221 Longwood Avenue, Suite 438, Boston, MA 02115, USA.
| | | | | | | | | | | |
Collapse
|
19
|
Pieters N, Plusquin M, Cox B, Kicinski M, Vangronsveld J, Nawrot TS. An epidemiological appraisal of the association between heart rate variability and particulate air pollution: a meta-analysis. Heart 2012; 98:1127-35. [PMID: 22628541 PMCID: PMC3392690 DOI: 10.1136/heartjnl-2011-301505] [Citation(s) in RCA: 123] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Objective Studies on the association between short-term exposure to ambient air pollution and heart rate variability (HRV) suggest that particulate matter (PM) exposure is associated with reductions in measures of HRV, but there is heterogeneity in the nature and magnitude of this association between studies. The authors performed a meta-analysis to determine how consistent this association is. Data source The authors searched the Pubmed citation database and Web of Knowledge to identify studies on HRV and PM. Study selection Of the epidemiologic studies reviewed, 29 provided sufficient details to be considered. The meta-analysis included 18667 subjects recruited from the population in surveys, studies from patient groups, and from occupationally exposed groups. Data extraction Two investigators read all papers and computerised all relevant information. Results The authors computed pooled estimates from a random-effects model. In the combined studies, an increase of 10 μg/m3 in PM2.5 was associated with significant reductions in the time-domain measurements, including low frequency (−1.66%, 95% CI −2.58% to −0.74%) and high frequency (−2.44%, 95% CI −3.76% to −1.12%) and in frequency-domain measurements, for SDNN (−0.12%, 95% CI −0.22% to −0.03%) and for rMSSD (−2.18%, 95% CI −3.33% to −1.03%). Funnel plots suggested that no publication bias was present and a sensitivity analysis confirmed the robustness of our combined estimates. Conclusion The meta-analysis supports an inverse relationship between HRV, a marker for a worse cardiovascular prognosis, and particulate air pollution.
Collapse
Affiliation(s)
- Nicky Pieters
- Hasselt University, Agoralaan Gebouw D, Diepenbeek, Belgium
| | | | | | | | | | | |
Collapse
|
20
|
Accuracy of ECG-based screening for sleep-disordered breathing: a survey of all male workers in a transport company. Sleep Breath 2012; 17:243-51. [PMID: 22430527 PMCID: PMC3575561 DOI: 10.1007/s11325-012-0681-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2012] [Revised: 02/08/2012] [Accepted: 03/05/2012] [Indexed: 01/26/2023]
Abstract
Purpose Sleep-disordered breathing (SDB) is associated with increased risk for cardiovascular morbidity and mortality and for sleepiness-related accidents, but >75 % of the patients remain undiagnosed. We sought to determine the diagnostic accuracy of ECG-based detection of SDB when used for population-based screening. Methods All male workers, mostly truck drivers, of a transport company (n = 165; age, 43 ± 12 years) underwent standard attended overnight polysomnography. Cyclic variation of heart rate (CVHR), a characteristic pattern of heart rate associated with SDB, was detected from single-lead ECG signals during the polysomnography by a newly developed automated algorithm of autocorrelated wave detection with adaptive threshold (ACAT). Results Among 165 subjects, the apnea–hypopnea index (AHI) was ≥5 in 62 (38 %), ≥15 in 26 (16 %), and ≥30 in 16 (10 %). The number of CVHR per hour (CVHR index) closely correlated with AHI [r = 0.868 (95 % CI, 0.825–0.901)]. The areas under the receiver operating characteristic curves for detecting subjects with AHI ≥5, ≥15, and ≥30 were 0.796 (95 % CI, 0.727–0.855), 0.974 (0.937–0.993), and 0.997 (0.971–0.999), respectively. With a predetermined criterion of CVHR index ≥15, subjects with AHI ≥15 were identified with 88 % sensitivity and 97 % specificity (likelihood ratios for positive and negative test, 30.7 and 0.12). The classification performance was retained in subgroups of subjects with obesity, hypertension, diabetes mellitus, dyslipidemia, and decreased autonomic function. Conclusions The CVHR obtained by the ACAT algorithm may provide a useful marker for screening for moderate-to-severe SDB among apparently healthy male workers.
Collapse
|
21
|
Gender differences in age-related changes in cardiac autonomic nervous function. J Aging Res 2011; 2012:679345. [PMID: 22187649 PMCID: PMC3236491 DOI: 10.1155/2012/679345] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Revised: 10/20/2011] [Accepted: 10/23/2011] [Indexed: 12/18/2022] Open
Abstract
Ageing is associated with changes in cardiac autonomic control as measured by Heart Rate Variability (HRV). Not many studies have explored the influence of gender on age-related changes in cardiac autonomic regulation. This study evaluated the gender differences in age-associated changes in cardiac autonomic nervous activity by assessing HRV using frequency domain analysis of short-term stationary R-R intervals. HRV was studied in healthy males and females ranging in age from 6 to 55 years. Total power and absolute power in High-Frequency (HF) and Low-Frequency (LF) components as well as HF in normalized unit declined significantly with ageing. The HF/LF ratio was significantly higher in the adolescent and adult females compared to male of these age groups. This study suggests that gender differences exist in age-related changes in HRV. The finding that gender differences are limited to adolescent and adult age groups may indicate a role for female sex hormones in cardiac autonomic modulation.
Collapse
|
22
|
McLachlan CS, Ocsan R, Spence I, Hambly B, Matthews S, Wang L, Jelinek HF. Increased total heart rate variability and enhanced cardiac vagal autonomic activity in healthy humans with sinus bradycardia. Proc (Bayl Univ Med Cent) 2011; 23:368-70. [PMID: 20944759 DOI: 10.1080/08998280.2010.11928655] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Sinus bradycardia can be defined as a sinus rhythm with a resting heart rate of 60 beats per minute or less. While it is assumed that increased autonomic parasympathetic activity is associated with sinus bradycardia, such an association has yet to be proven. The aims of this study were to compute a number of heart rate variability (HRV) parameters in healthy individuals with sinus bradycardia and determine whether there was a significant vagal component to sinus bradycardia. Forty-three healthy adults with normal sinus rhythm and 25 healthy adults with sinus bradycardia had an electrocardiogram recorded for 20 minutes, from which HRV indices were calculated. Results showed significant increases in SDNN (standard deviation of NN intervals) (P < 0.05), RMSDD (square root of the mean squared differences of successive NN intervals) (P < 0.05), and DFA32 (detrended fluctuation analysis) (P < 0.05) in bradycardic subjects compared with subjects with normal sinus rhythm. There were no significant differences in sympathetic frequency domain indices between the two groups. In conclusion, there were significant increases in total heart variability and increased parasympathetic drive in subjects with bradycardia. Clinically, bradycardia is likely to be cardioprotective in aging populations based upon these HRV findings.
Collapse
Affiliation(s)
- Craig S McLachlan
- Department of Physiology, National University of Singapore, Singapore (McLachlan); the Kolling Institute, the Sydney Medical School, the University of Sydney, Australia (McLachlan); the Departments of Pharmacology (Spence, Matthews) and Pathology (Ocsan, Hambly), the University of Sydney, Sydney, Australia; the School of Biomedical Sciences, Charles Sturt University, Wagga Wagga, Australia (Wang); and the School of Community Health, Charles Sturt University, Albury, Australia (Jelinek)
| | | | | | | | | | | | | |
Collapse
|
23
|
Kai S, Nakahara M, Murakami S, Yoshimoto R, Watari K, Ooura Y, Nakatomi K, Takahashi S. Heart Rate Variability during Two-Leg to One-Leg Standing Shift in the Elderly. J Phys Ther Sci 2008. [DOI: 10.1589/jpts.20.67] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Satoru Kai
- The School of Fukuoka Rehabilitation Sciences, International University of Health and Welfare
- International University of Health and Welfare Graduate School
| | | | | | | | - Kazuo Watari
- Fukuoka International College of Health and Welfare
| | - Yuko Ooura
- International University of Health and Welfare Graduate School
| | | | - Seiichiro Takahashi
- The School of Fukuoka Rehabilitation Sciences, International University of Health and Welfare
- International University of Health and Welfare Graduate School
| |
Collapse
|
24
|
Yoshida N, Nozawa T, Igawa A, Fujii N, Kato B, Mizumaki K, Fujiki A, Asanoi H, Seto H, Inoue H. Modulation of ventricular repolarization and R-R interval is altered in patients with globally impaired cardiac 123I-MIBG uptake. Ann Noninvasive Electrocardiol 2006; 6:55-63. [PMID: 11174864 PMCID: PMC7027723 DOI: 10.1111/j.1542-474x.2001.tb00087.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Cardiac (123)I-metaiodobenzylguanidine (MIBG) imaging is widely used to assess cardiac sympathetic neuronal function. However, physiologic significance of impaired cardiac MIBG uptake is not fully elucidated. The purpose of the present study was to determine influences of abnormal cardiac sympathetic neuronal function on heart rate variability (HRV) and ventricular repolarization process. METHODS Twenty-nine patients with prior myocardial infarction were divided into two groups by a heart-to-mediastinum ratio (H/M) of MIBG scintigraphy. Ten patients with globally decreased MIBG uptake (group I: H/M < 1.5), 19 patients with partially decreased MIBG uptake (group II: H/M >or= 1.5), and 17 control subjects with normal MIBG uptake (group III) were studied. Holter recording and a standard 12-lead electrocardiography were used for evaluation of HRV, QT-RR relation, and QT dispersion. RESULTS Low, high, and total frequency components decreased in groups I and II, as compared to that of group III. The reduction of these frequency domain measures was more severe in group I than in group II, but the differences did not reach statistical significance. Circadian variation of frequency domain measures disappeared in group I. The slope of QT-RR relation was significantly greater in group I than in groups II and III. QT dispersion was also greater in group I (64 +/- 25 msec) than in group II (43 +/- 19 msec) and group III (28 +/- 9 msec). CONCLUSION These results suggest that patients with sympathetic neuronal dysfunction inferred from globally impaired cardiac MIBG uptake have an altered modulation of ventricular repolarization process as well as decreased HRV.
Collapse
Affiliation(s)
- Naohiro Yoshida
- 2nd Department of Internal Medicine, Toyama Medical and Pharmaceutical University, Toyama, Japan
| | - Takashi Nozawa
- 2nd Department of Internal Medicine, Toyama Medical and Pharmaceutical University, Toyama, Japan
| | - Akihiko Igawa
- 2nd Department of Internal Medicine, Toyama Medical and Pharmaceutical University, Toyama, Japan
| | - Nozomu Fujii
- 2nd Department of Internal Medicine, Toyama Medical and Pharmaceutical University, Toyama, Japan
| | - Bun‐ichi Kato
- 2nd Department of Internal Medicine, Toyama Medical and Pharmaceutical University, Toyama, Japan
| | - Koichi Mizumaki
- 2nd Department of Internal Medicine, Toyama Medical and Pharmaceutical University, Toyama, Japan
| | - Akira Fujiki
- 2nd Department of Internal Medicine, Toyama Medical and Pharmaceutical University, Toyama, Japan
| | - Hidetsugu Asanoi
- 2nd Department of Internal Medicine, Toyama Medical and Pharmaceutical University, Toyama, Japan
| | - Hikaru Seto
- Department of Radiology, Toyama Medical and Pharmaceutical University, Toyama, Japan
| | - Hiroshi Inoue
- 2nd Department of Internal Medicine, Toyama Medical and Pharmaceutical University, Toyama, Japan
| |
Collapse
|
25
|
Sroka K. On the genesis of myocardial ischemia. ACTA ACUST UNITED AC 2005; 93:768-83. [PMID: 15492892 DOI: 10.1007/s00392-004-0137-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2003] [Accepted: 11/27/2003] [Indexed: 12/19/2022]
Abstract
About three quarters of myocardial ischemic events are triggered by the autonomic nervous system. The pathognomonic constellation is a combination of an almost complete withdrawal of tonic vagal activity with increased sympathetic activity. The reduction of tonic vagal activity, which is characteristic for ischemic heart disease, and the acute withdrawal of vagal drive preceding the onset of ischemia are not dependent on coronary artery disease. In this paper, the pathophysiological steps that lead from sympathetic-parasympathetic imbalance to myocardial ischemia shall be discussed. A considerable increase of aerobic glycolysis within the myocardium as a result of the autonomic imbalance is of special importance in this process.
Collapse
Affiliation(s)
- K Sroka
- Stellinger Weg 47, 20255 Hamburg, Germany.
| |
Collapse
|
26
|
Abstract
QT interval on the surface electrocardiogram (ECG) reflects the time for repolarization of myocardium and prolongation of QTc is strongly associated with sudden cardiac death. Studies using novel techniques on beat-to-beat QT interval variability (QTV) have shown that it is influenced by the autonomic nervous system and is a predictor of sudden cardiac death. In this study, we examined the awake and sleep changes in QTV in 39 normal adults (mean age, 35 years) and 10 children (mean age, 11 years) using 24-hour ECG records. We obtained eight 5-minute segments of ECG sampled at 1000 Hz from the 24-hour records. Our results show that there is a diurnal variation of QTvm, detrended QT interval variance corrected for mean QT, and QTvi, an index of QTvm divided by heart rate variability corrected for mean heart rate. There was a significant increase in mean QT during sleep, whereas there was a significant decrease in QTvm and QTvi. QTvi significantly increased during the early morning hours. There were significant but modest correlations between the average 24-hour and awake QTvi and age (p < 0.01). There were also decreased low-frequency and high-frequency powers of QT during sleep. Coherence between heart rate and QT interval fluctuations in the range of 0-0.5 Hz, and especially in the high-frequency range (0.15-0.5 Hz), was significantly lower in adults than in children (p < 0.0002). These findings demonstrate diurnal fluctuations in ventricular repolarization lability. We speculate that these effects may relate to changes in cardiac autonomic function and may contribute to the well-known diurnal variation in the incidence of ventricular arrhythmias.
Collapse
Affiliation(s)
- V K Yeragani
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan 48207, USA.
| | | | | | | |
Collapse
|
27
|
Giardino ND, Glenny RW, Borson S, Chan L. Respiratory sinus arrhythmia is associated with efficiency of pulmonary gas exchange in healthy humans. Am J Physiol Heart Circ Physiol 2003; 284:H1585-91. [PMID: 12543637 DOI: 10.1152/ajpheart.00893.2002] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Respiratory sinus arrhythmia (RSA) may be associated with improved efficiency of pulmonary gas exchange by matching ventilation to perfusion within each respiratory cycle. Respiration rate, tidal volume, minute ventilation (.VE), exhaled carbon dioxide (.VCO(2)), oxygen consumption (.VO(2)), and heart rate were measured in 10 healthy human volunteers during paced breathing to test the hypothesis that RSA contributes to pulmonary gas exchange efficiency. Cross-spectral analysis of heart rate and respiration was computed to calculate RSA and the coherence and phase between these variables. Pulmonary gas exchange efficiency was measured as the average ventilatory equivalent of CO(2) (.VE/.VCO(2)) and O(2) (.VE/.VO(2)). Across subjects and paced breathing periods, RSA was significantly associated with CO(2) (partial r = -0.53, P = 0.002) and O(2) (partial r = -0.49, P = 0.005) exchange efficiency after controlling for the effects of age, respiration rate, tidal volume, and average heart rate. Phase between heart rate and respiration was significantly associated with CO(2) exchange efficiency (partial r = 0.40, P = 0.03). These results are consistent with previous studies and further support the theory that RSA may improve the efficiency of pulmonary gas exchange.
Collapse
Affiliation(s)
- Nicholas D Giardino
- Department of Rehabilitation Medicine, University of Washington, 1959 SE Pacific Street, Seattle, WA 98195, USA.
| | | | | | | |
Collapse
|
28
|
Scheuermann BW, Bell C, Paterson DH, Barstow TJ, Kowalchuk JM. Oxygen uptake kinetics for moderate exercise are speeded in older humans by prior heavy exercise. J Appl Physiol (1985) 2002; 92:609-16. [PMID: 11796671 DOI: 10.1152/japplphysiol.00186.2001] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study examined the effect of heavy-intensity warm-up exercise on O(2) uptake (VO(2)) kinetics at the onset of moderate-intensity (80% ventilation threshold), constant-work rate exercise in eight older (65 +/- 2 yr) and seven younger adults (26 +/- 1 yr). Step increases in work rate from loadless cycling to moderate exercise (Mod(1)), heavy exercise, and moderate exercise (Mod(2)) were performed. Each exercise bout was 6 min in duration and separated by 6 min of loadless cycling. VO(2) kinetics were modeled from the onset of exercise by use of a two-component exponential model. Heart rate (HR) kinetics were modeled from the onset of exercise using a single exponential model. During Mod(1), the time constant (tau) for the predominant rise in VO(2) (tau VO(2)) was slower (P < 0.05) in the older adults (50 +/- 10 s) than in young adults (19 +/- 5 s). The older adults demonstrated a speeding (P < 0.05) of VO(2) kinetics when moderate-intensity exercise (Mod(2)) was preceded by high-intensity warm-up exercise (tau VO(2), 27 +/- 3 s), whereas young adults showed no speeding of VO(2) kinetics (tau VO(2), 17 +/- 3 s). In the older and younger adults, baseline HR preceding Mod(2) was elevated compared with Mod(1), but the tau for HR kinetics was slowed (P < 0.05) in Mod(2) only for the older adults. Prior heavy-intensity exercise in old, but not young, adults speeded VO(2) kinetics during Mod(2). Despite slowed HR kinetics in Mod(2) in the older adults, an elevated baseline HR before the onset of Mod(2) may have led to sufficient muscle perfusion and O(2) delivery. These results suggest that, when muscle blood flow and O(2) delivery are adequate, muscle O(2) consumption in both old and young adults is limited by intracellular processes within the exercising muscle.
Collapse
Affiliation(s)
- Barry W Scheuermann
- Centre for Activity and Aging, School of Kinesiology, The University of Western Ontario, London, Ontario, Canada N6A 3K7
| | | | | | | | | |
Collapse
|
29
|
Abstract
OBJECTIVE Previous literature has shown that the psychological trait of defensiveness is related to elevated sympathetic reactivity to stress and to several cardiac risk factors. The aim of this study was to examine whether these previous findings on defensiveness extend to an asthmatic population. METHODS Defensiveness was measured by the Marlowe-Crowne Social Desirability Scale using a quartile split: high (upper 25%) and low (bottom 75%). Twenty-two defensive and 66 nondefensive participants with asthma were exposed to laboratory tasks (initial baseline rest period, reaction time task, and a shop accident film). RESULTS During the tasks there was evidence of lower skin conductance levels and greater respiratory sinus arrhythmia amplitudes among defensive patients with asthma. After exposure to the tasks, defensive patients with asthma showed a decline on spirometry test measures compared with nondefensive asthmatic patients, who displayed an increase. CONCLUSIONS These data confirm individual response stereotypy and suggest that defensiveness may be characterized by sympathetic hypoarousal and parasympathetic hyperarousal among patients with asthma. Future studies are needed to determine whether defensiveness is a risk factor for stress-induced bronchoconstriction.
Collapse
Affiliation(s)
- Jonathan M Feldman
- Department of Psychology, Rutgers University, New Brunswick, New Jersey, USA
| | | | | | | |
Collapse
|
30
|
Goldberger JJ, Challapalli S, Tung R, Parker MA, Kadish AH. Relationship of heart rate variability to parasympathetic effect. Circulation 2001; 103:1977-83. [PMID: 11306527 DOI: 10.1161/01.cir.103.15.1977] [Citation(s) in RCA: 196] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Baroreflex-mediated parasympathetic stimulation has variable effects on heart rate variability (HRV). We postulated that a quadratic function would describe the relationship between HRV and parasympathetic effect better than a linear function. METHODS AND RESULTS Twenty-nine normal volunteers (15 women; mean age 39+/-12 years) were studied after beta-adrenergic blockade with intravenous propranolol. Five-minute ECG recordings were made during graded infusions of phenylephrine and nitroprusside to achieve baroreflex-mediated increases and decreases in parasympathetic effect, respectively. Time- and frequency-domain measures of HRV were calculated from the R-R interval tachograms. The R-R interval and the vagal-sympathetic effect (VSE=R-R interval/intrinsic R-R interval) were used as indices of parasympathetic effect. The data were fit to both quadratic and linear models. In each case, the quadratic model (with a negative coefficient for the squared term) was superior to the linear model. There was some evidence that age influenced the responsiveness of the HRV parameters with changing parasympathetic effect, although the regression analysis was significant only in the models for MSSD (P<0.03) and pNN50 (P<0.001). CONCLUSIONS The relationship between HRV and parasympathetic effect is best described by a function in which there is an ascending limb where HRV increases as parasympathetic effect increases until it reaches a plateau level; HRV then decreases as parasympathetic effect increases. Because there is marked interindividual variation in this relationship, differences in HRV between individuals may reflect differences in this relationship and/or differences in autonomic effects.
Collapse
Affiliation(s)
- J J Goldberger
- Division of Cardiology, Department of Medicine, Northwestern University, Chicago, Illinois, USA.
| | | | | | | | | |
Collapse
|
31
|
Jinbo Y, Kobayashi Y, Miyata A, Chiyoda K, Nakagawa H, Tanno K, Kurano K, Kikushima S, Baba T, Katagiri T. Decreasing parasympathetic tone activity and proarrhythmic effect after radiofrequency catheter ablation--differences in ablation site. JAPANESE CIRCULATION JOURNAL 1998; 62:733-40. [PMID: 9805253 DOI: 10.1253/jcj.62.733] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Holter ECG was used to evaluate changes in heart rate variability (HRV), indicators of the autonomic nervous system, and arrhythmia before and after radiofrequency (RF) catheter ablation in patients with symptomatic supraventricular tachycardia. Ablation targets in 43 patients included the atrioventricular (AV) nodal pathway (AVNRT, n = 17), a right free wall accessory pathway (n = 10), a septal accessory pathway (n = 6), and a left free wall accessory pathway (n = 10). The High frequency component (0.15 - 0.40 Hz) or pNN50 of HRV analysis, indicating parasympathetic activity, significantly decreased immediately after RF ablation in the AVNRT and septal accessory pathway groups, but not in the right or left wall groups. In contrast, in all four groups, ventricular premature contractions (VPCs) significantly increased in most of the patients, and ventricular tachycardia occurred in a few of the patients immediately after RF ablation. There was no serious arrhythmia. These alterations in HRV analysis and arrhythmia returned to the control level after 1 week or more. VPCs after RF ablation did not consistently increase as a result of the reduced parasympathetic tone activity, but at the lesion near the conduction system, the increase in VPCs was inhibited by higher parasympathetic tone activity, because the parasympathetic nerve fibers and receptors were distributed in these lesions.
Collapse
Affiliation(s)
- Y Jinbo
- Third Department of Internal Medicine, Showa University, School of Medicine, Tokyo, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Sinnreich R, Kark JD, Friedlander Y, Sapoznikov D, Luria MH. Five minute recordings of heart rate variability for population studies: repeatability and age-sex characteristics. Heart 1998; 80:156-62. [PMID: 9813562 PMCID: PMC1728778 DOI: 10.1136/hrt.80.2.156] [Citation(s) in RCA: 184] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To evaluate the stability of short recordings of heart rate variability (HRV) with time, and the association of HRV with age and sex. DESIGN Five minute Holter recordings were made twice over a two month interval (tracking study). In addition, HRV was measured in a cross sectional study. SETTING Residents of 11 Israeli kibbutzim were examined in their settlements. SUBJECTS 32 men and 38 women (aged 31-67) participated in the tracking study and 294 (aged 35-65) were involved in the cross sectional study. MAIN OUTCOME MEASURES Time and frequency domain analyses on Holter recordings were undertaken in two breathing conditions: spontaneous and controlled breathing (15 respirations per minute). Regression was used to assess the relations of sex, age, heart rate, and logarithmically transformed HRV indices. RESULTS HRV measures were highly consistent with time with correlations of 0.76-0.80 for high frequency and total power. Geometric mean total power declined with age by 45% in men and 32% in women, and was lower by 24% among women than among men (all p < or = 0.005). Men had a 34% higher very low and low frequency power and a higher ratio of low to high frequency power (p < 0.001). Conversely, high frequency power in women represents a greater proportion of total power than in men. CONCLUSION Short recordings of HRV in a non-laboratory setting are stable over months and therefore characteristic of an individual. Strong age and sex effects were evident. HRV derived from short recordings can be informative in population based studies.
Collapse
Affiliation(s)
- R Sinnreich
- Department of Social Medicine, Hadassah Medical Organization, Ein Kerem, Jerusalem, Israel
| | | | | | | | | |
Collapse
|
33
|
Jartti TT, Kuusela TA, Kaila TJ, Tahvanainen KU, Välimäki IA. The dose-response effects of terbutaline on the variability, approximate entropy and fractal dimension of heart rate and blood pressure. Br J Clin Pharmacol 1998; 45:277-85. [PMID: 9517372 PMCID: PMC1873370 DOI: 10.1046/j.1365-2125.1998.00674.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIMS To study the dose-response effects of intravenous terbutaline on the cardiovascular and respiratory autonomic nervous regulation. METHODS The study followed a randomized, placebo-controlled crossover design in six healthy adult volunteers. The terbutaline dose ranged from 10 to 30 microg min(-1) We continuously measured electrocardiogram, finger systolic arterial pressure (SAP) and flow-volume spirometry in supine and upright positions at baseline and during 3 h drug infusion. The periodic variability components of R-R intervals (time between successive heart beats) and SAP in relation to respiration were assessed using spectral analysis techniques. The regularity of the time series was assessed by approximate entropy (ApEn) and the convolutedness by fractal dimension (FD). RESULTS Terbutaline dose-dependently decreased total variability of R-R intervals, low frequency (LF) variability of R-R intervals (10 s waves), high frequency (HF) variability of R-R intervals (respiratory variability), total variability of SAP, HF variability of SAP, baroreflex sensitivity, plasma potassium concentration, approximate entropy of R-R interval and of SAP as well as fractal dimension of R-R interval. Terbutaline dose-dependently increased heart rate, LF/HF ratios of R-R intervals and of SAP, LF variability of SAP, minute ventilation and plasma terbutaline concentration. CONCLUSIONS Terbutaline infusion decreases parasympathetic cardiovascular reactivity, baroreflex sensitivity, dimensionality of heart rate and plasma potassium concentration; it increases sympathetic dominance in cardiovascular autonomic balance, minute ventilation, and the regularity of heart rate and blood pressure time series.
Collapse
Affiliation(s)
- T T Jartti
- Department of Paediatrics, Turku University Hospital, Finland
| | | | | | | | | |
Collapse
|
34
|
Hayano J, Kimura K, Hosaka T, Shibata N, Fukunishi I, Yamasaki K, Mono H, Maeda S. Coronary disease-prone behavior among Japanese men: job-centered lifestyle and social dominance. Type A Behavior Pattern Conference. Am Heart J 1997; 134:1029-36. [PMID: 9424062 DOI: 10.1016/s0002-8703(97)70022-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In Japan the type A behavior pattern, particularly its component of hostility, is known to have less value as a risk for coronary artery disease (CAD) than in the United States. We developed a questionnaire (Japanese Coronary-prone Behavior Scale [JCBS]) to investigate the behavioral correlates with CAD among contemporary Japanese persons. The JCBS was administered to 419 Japanese men undergoing coronary angiography; 310 of them had angiographic or clinical evidence or both of CAD, and 109 had no evidence of CAD. The group with CAD had more coronary risk factors than the group without CAD, but the two groups did not differ in type A behavior pattern as assessed with the Jenkins Activity Survey. Stepwise discriminant analysis, in which standard coronary risk factors were forced into the model, revealed that inclusion of nine JCBS items (scale C) in the model resulted in the best discrimination between the two groups. Cross-validation results showed that the error-rate estimates for the discriminant models that consisted only of standard coronary risk factors, only of scale C items, and of their combination were 34.7, 32.4, and 27.0%, respectively. The scale C items represented a job-centered lifestyle, social dominance, and suppressed overt type A behaviors. These results indicate that an independent behavior pattern prone to CAD is discernible among Japanese men and suggest that the behavior pattern may contain characteristics that can be differentiated from those that constitute the type A behavior pattern.
Collapse
Affiliation(s)
- J Hayano
- Third Department of Internal Medicine, Nagoya City University Medical School, Nagoya, Japan
| | | | | | | | | | | | | | | |
Collapse
|
35
|
Tsuji H, Venditti FJ, Manders ES, Evans JC, Larson MG, Feldman CL, Levy D. Reduced heart rate variability and mortality risk in an elderly cohort. The Framingham Heart Study. Circulation 1994; 90:878-83. [PMID: 8044959 DOI: 10.1161/01.cir.90.2.878] [Citation(s) in RCA: 688] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND The prognostic implications of alterations in heart rate variability have not been studied in a large community-based population. METHODS AND RESULTS The first 2 hours of ambulatory ECG recordings obtained on original subjects of the Framingham Heart Study attending the 18th biennial examination were reprocessed to assess heart rate variability. Subjects with transient or persistent nonsinus rhythm, premature beats > 10% of total beats, < 1 hour of recording time, processed time < 50% of recorded time, and those taking antiarrhythmic medications were excluded. The associations between heart rate variability measures and all-cause mortality during 4 years of follow-up were assessed. There were 736 eligible subjects with a mean age (+/- SD) of 72 +/- 6 years. The following five frequency domain measures and three time domain measures were obtained: very-low-frequency power (0.01 to 0.04 Hz), low-frequency power (0.04 to 0.15 Hz), high-frequency power (0.15 to 0.40 Hz), total power (0.01 to 0.40 Hz), the ratio of low-frequency to high-frequency power, the standard deviation of total normal RR intervals, the percentage of differences between adjacent normal RR intervals that are > 50 milliseconds, and the square root of the mean of the squared differences between adjacent normal RR intervals. During follow-up, 74 subjects died. In separate proportional hazards regression analyses that adjusted for relevant risk factors, very-low-frequency power (P < .0001), low-frequency power (P < .0001), high-frequency power (P = .0014), total power (P < .0001), and the standard deviation of total normal RR intervals (P = .0019) were significantly associated with all-cause mortality. When all eight heart rate variability measures were assessed in a stepwise analysis that included other risk factors, low-frequency power entered the model first (P < .0001); thereafter, none of the other measures of heart rate variability significantly contributed to the prediction of all-cause mortality. A 1 SD decrement in low-frequency power (natural log transformed) was associated with 1.70 times greater hazard for all-cause mortality (95% confidence interval of 1.37 to 2.09). CONCLUSIONS The estimation of heart rate variability by ambulatory monitoring offers prognostic information beyond that provided by the evaluation of traditional risk factors.
Collapse
Affiliation(s)
- H Tsuji
- Lahey Clinic Medical Center, Burlington, Mass
| | | | | | | | | | | | | |
Collapse
|
36
|
Walsh BT, Giardina EG, Sloan RP, Greenhill L, Goldfein J. Effects of desipramine on autonomic control of the heart. J Am Acad Child Adolesc Psychiatry 1994; 33:191-7. [PMID: 8150790 DOI: 10.1097/00004583-199402000-00006] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To assess the effects of desipramine (DMI) on autonomic control of the heart. METHODS Blood pressure, RR interval (the time between successive heart beats), and RR interval variability, a noninvasive measure of autonomic control of the heart, were assessed in 13 subjects younger than 30 years old. RESULTS DMI treatment was associated with an increase in blood pressure, a decrease in RR interval, and a decline in low and high frequency RR interval variability. CONCLUSIONS These preliminary data suggest that, in young people, DMI treatment produces a substantial decrease in parasympathetic input to the heart and an increase in the ratio of sympathetic to parasympathetic input, changes that in certain circumstances have been associated with an increased risk of arrhythmia. In exploring the cardiac effects of the tricyclic antidepressants (TCAs) in young people, the impact of TCAs on autonomic input to the heart should be examined.
Collapse
Affiliation(s)
- B T Walsh
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY
| | | | | | | | | |
Collapse
|
37
|
Affiliation(s)
- S Oppenheimer
- Cerebrovascular Program, Johns Hopkins Hospital, Baltimore, MD 21205
| |
Collapse
|
38
|
|
39
|
Garrard CS, Seidler A, McKibben A, McAlpine LE, Gordon D. Spectral analysis of heart rate variability in bronchial asthma. Clin Auton Res 1992; 2:105-11. [PMID: 1638105 DOI: 10.1007/bf01819665] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Sympathetic and parasympathetic activity was evaluated in ten healthy controls, nine asymptomatic, untreated asthmatic subjects and ten asthmatic patients during treatment for acute asthma, by measurement of the variation in resting heart rate using frequency spectrum analysis. Heart rate was recorded by ECG and respiratory rate by impedance plethysmography. Spectral density of the beat-to-beat heart rate was measured within the low frequency band 0.04 to 0.10 Hz (low frequency power) modulated by sympathetic and parasympathetic activity, and within a 0.12 Hz band width at the respiratory frequency mode (respiratory frequency power) modulated by parasympathetic activity. Acute asthmatics had higher heart rates than either of the other two groups; this was probably related to the effects of beta-adrenoceptor agonist medication. Sympathetically mediated heart rate variability (normalized low frequency power) was significantly lower in both asymptomatic (p less than 0.002) and acute (p less than 0.02) asthma subjects compared to controls. This is consistent with altered sympathetic/parasympathetic regulation of heart rate in subjects with bronchial asthma.
Collapse
Affiliation(s)
- C S Garrard
- Intensive Therapy Unit, John Radcliffe Hospital, Oxford, UK
| | | | | | | | | |
Collapse
|