Dynamics of spectral components of heart rate variability during changes in autonomic balance

Preliminary Comparison of Zero-Gravity Chair With Tilt Table in Relation to Heart Rate Variability Measurements

Heart rate variability (HRV) measurements are performed using a tilt-table (TT) to diagnose dysfunctionality in the autonomic nervous system (ANS) and the cardiovascular system. To maintain homeostasis, the ANS adapts to body position changes through alterations in sympathetic and parasympathetic responses that can be quantified by extracting time-domain and frequency-domain parameters from the heart rate signal. When body position is changed from supine to erect, a healthy subject’s response also shows changes in ANS activity. However, TT can be unsafe or uncomfortable for elderly or overweight subjects. Furthermore, it may induce anxiety which alters the HRV measurements. This study proposes an alternative strategy to replace the TT with a zero-gravity chair (ZGC). The statistical analysis between HRV parameters from the TT and the ZGC shows that ZGC can be a feasible alternative to TT. Therefore, ZGC can be used as a more convenient, secure, stable and safer option to the traditional HRV analysis with TT.

The effect of randomised exposure to different types of natural outdoor environments compared to exposure to an urban environment on people with indications of psychological distress in Catalonia

Introduction

Experimental studies have reported associations between short-term exposure to natural outdoor environments (NOE) and health benefits. However, they lack insight into mechanisms, often have low external and ecological validity, and have rarely focused on people with some psycho-physiological affection. The aim of this study was to use a randomized, case-crossover design to investigate: (i) the effects of unconstrained exposure to real natural and urban environments on psycho-physiological indicators of people with indications of psychological distress, (ii) the possible differential effects of 30 and 30+180 minutes exposures, and (iii) the possible mechanisms explaining these effects.

Material and methods

People (n = 26) with indications of psychological distress were exposed to green (Collserola Natural Park), blue (Castelldefels beach) and urban (Eixample neighbourhood) environments in Catalonia. They were exposed to all environments in groups for a period of 30+180 minutes between October 2013 and January 2014. During the exposure period, participants were instructed to do what they would usually do in that environment. Before, during (at 30 and 30+180 minutes) and after each exposure, several psycho-physiological measures were taken: mood (measured as Total Mood Disturbance, TMD), attention capacity (measured as backwards digit-span task), stress levels (measures as salivary cortisol), systolic and diastolic blood pressure, heart rate, autonomous nervous system (assessed as heart rate variability and the indicators: low frequency power (LF), high frequency power (HF), ratio between LF and HF (LF:HF), and coefficients of component variance of LF, HF, and LF:HF). We also measured several potential mediators: air pollution, noise, physical activity, social interactions, and self-perceived restoration experience.

Results

When compared with responses to urban environment, we found statistically significantly lower TMD [-4.78 (-7.77, -1.79) points difference], and salivary cortisol [-0.21 (-0.34, -0.08) log nmol/L] in the green exposure environment, and statistically significantly lower TMD [-4.53 (-7.57, -1.49) points difference], and statistically significant favourable changes in heart rate variability indicators (specifically LF:HF and CCV-LF:HF with around -0.20 points of difference of the indicators) in the blue exposure environment. Physical activity and self-perceived restoration experience partially mediated the associations between NOE and TMD. Physical activity and air pollution partially mediated the associations between NOE and heart rate variability.

Discussion and conclusions

This study extends the existing evidence on the benefits of NOE for people's health. It also suggests NOE potential as a preventive medicine, specifically focusing on people with indications of psychological distress.

Trial registration

Clinicaltrials.gov NCT02624921

Association between beat-to-beat blood pressure variability and vascular elasticity in normal young adults during the cold pressor test

The beat-to-beat blood pressure (BP) monitoring parameters, such as average beat-to-beat BP, BP variability (BPV), could have an influence on the vascular elasticity. This study hypothesized that the elevated beat-to-beat BPV could evoke the reduction of the vascular elasticity independent of BP levels. We measured the beat-to-beat BP recordings and total arterial compliance (TAC), which was used to assess the vascular elasticity, in 80 young healthy adults during the cold pressor test (CPT). The CPT included 3 phases: baseline phase, cold stimulus phase, recovery phase. Six parameters were used to estimate BPV. In bivariate correlation analysis, TAC showed a significant correlation with systolic BP (SBP) and diastolic BP (DBP) in the cold stimulus phase; and 4 indices of SBP variability (SBPV) were associated with TAC (r = 0.271∼0.331, P ≤ 0.015) in the recovery phase; similarly, 2 indices of DBP variability (DBPV) were also correlated with TAC (r = 0.221∼0.285, P ≤ 0.048) in the recovery phase. In multivariate regression analysis, DBPV (β = 0.229, P = 0.001) was a determinant of TAC independent of average DBP, sex, and weight. In addition, both beat-to-beat BP and BPV values increased in the cold stimulus phase (P < 0.01); whereas, the TAC decreased in the cold stimulus phase (P < 0.01). In conclusion, these data suggest that the beat-to-beat DBPV shows an independent association with the vascular elasticity in young normal adults during the CPT.

Cognitive behavior evaluation based on physiological parameters among young healthy subjects with yoga as intervention

Objective. To investigate the effect of yoga practice on cognitive skills, autonomic nervous system, and heart rate variability by analyzing physiological parameters. Methods. The study was conducted on 30 normal young healthy engineering students. They were randomly selected into two groups: yoga group and control group. The yoga group practiced yoga one and half hour per day for six days in a week, for a period of five months. Results. The yoga practising group showed increased α, β, and δ EEG band powers and significant reduction in θ and γ band powers. The increased α and β power can represent enhanced cognitive functions such as memory and concentration, and that of δ signifies synchronization of brain activity. The heart rate index θ/α decreased, neural activity β/θ increased, attention resource index β/(α + θ) increased, executive load index (δ + θ)/α decreased, and the ratio (δ + θ)/(α + β) decreased. The yoga practice group showed improvement in heart rate variability, increased SDNN/RMSSD, and reduction in LF/HF ratio. Conclusion. Yoga practising group showed significant improvement in various cognitive functions, such as performance enhancement, neural activity, attention, and executive function. It also resulted in increase in the heart rate variability, parasympathetic nervous system activity, and balanced autonomic nervous system reactivity.

Autonomic nervous system in the control of energy balance and body weight: personal contributions

The prevalence of obesity is increasing in the industrialized world, so that the World Health Organization considers obesity as a "pandemia" in rich populations. The autonomic nervous system plays a crucial role in the control of energy balance and body weight. This review summarizes our own data and perspectives, emphasizing the influence exerted by autonomic nervous system on energy expenditure and food intake, which are able to determine the body weight. Activation of the sympathetic discharge causes an increase in energy expenditure and a decrease in food intake, while reduction of food intake and body weight loss determines a reduction of the sympathetic activity. On the other hand, pathophysiological mechanisms of the obesity involve alterations of the sympathetic nervous system in accordance with the "Mona Lisa Hypothesis," an acronym for "most obesities known are low in sympathetic activity." Furthermore, the parasympathetic influences on the energy expenditure are analyzed in this review, showing that an increase in parasympathetic activity can induce a paradoxical enhancement of energy consumption.

Quantifying cardiac sympathetic and parasympathetic nervous activities using principal dynamic modes analysis of heart rate variability

The ratio between low-frequency (LF) and high-frequency (HF) spectral power of heart rate has been used as an approximate index for determining the autonomic nervous system (ANS) balance. An accurate assessment of the ANS balance can only be achieved if clear separation of the dynamics of the sympathetic and parasympathetic nervous activities can be obtained, which is a daunting task because they are nonlinear and have overlapping dynamics. In this study, a promising nonlinear method, termed the principal dynamic mode (PDM) method, is used to separate dynamic components of the sympathetic and parasympathetic nervous activities on the basis of ECG signal, and the results are compared with the power spectral approach to assessing the ANS balance. The PDM analysis based on the 28 subjects consistently resulted in a clear separation of the two nervous systems, which have similar frequency characteristics for parasympathetic and sympathetic activities as those reported in the literature. With the application of atropine, in 13 of 15 supine subjects there was an increase in the sympathetic-to-parasympathetic ratio (SPR) due to a greater decrease of parasympathetic than sympathetic activity ( P = 0.003), and all 13 subjects in the upright position had a decrease in SPR due to a greater decrease of sympathetic than parasympathetic activity ( P < 0.001) with the application of propranolol. The LF-to-HF ratio calculated by the power spectral density is less accurate than the PDM because it is not able to separate the dynamics of the parasympathetic and sympathetic nervous systems. The culprit is equivalent decreases in both the sympathetic and parasympathetic activities irrespective of the pharmacological blockades. These findings suggest that the PDM shows promise as a noninvasive and quantitative marker of ANS imbalance, which has been shown to be a factor in many cardiac and stress-related diseases.

Age-associated alteration of sympatho-vagal balance in a female population assessed through the tone-entropy analysis

Through our recent studies on heart rate variability (Oida et al. J Appl Physiol 82:1794-1801, 1997; J Gerontol 54A:M219-M224, 1999a; Acta Physiol Scand 165:129-134, 1999b; Acta Physiol Scand 165:421-422, 1999c), we discover that autonomic functions could be assessed quantitatively in time domain by the tone-entropy (T-E) methodology, where the tone represents sympatho-vagal balance, and the entropy, autonomic regulatory activity. The purpose of this study was then to elucidate an age-associated alteration of sympatho-vagal balance in a female population through this T-E method. ECG R-R time intervals at rest were acquired on 10 min for 73 female subjects. Ageing influence was examined by comparisons between two groups: middle-aged group (40-50), (51.5 +/- 0.7 year, n = 28) and old-aged (60-70), (69.5 +/- 0.8 year, n = 45)]. Evaluated tone: [-0.058 +/- 0.011 (40-50), and 0.027 +/- 0.003 (60-70) (P < 0.01)], and entropy: [3.46 +/- 0.11 (40-50), and 3.06 +/- 0.08 bit (60-70) (P<0.01)]. The result showed that the tone was high and the entropy was low in the old-aged compared with the middle-aged group. When the result was plotted in two-dimensional T-E space, it revealed a curvi-linear relation between the tone and the entropy, consistent with our previous studies on pharmacological blockades, on heart recovery after dynamic exercise and on a male ageing. In conclusion, the result suggested that the sympatho-vagal balance altered or the vagal predominance was impaired with age significantly in this female population. Interestingly, comparing with corresponding male, the female had better autonomic functions.

Functional changes in autonomic nervous system and baroreceptor reflex induced by 14 days of 6 degrees head-down bed rest

We studied the effects of 14 days of 6 degrees head-down bed rest (HDBR) in 16 healthy male subjects to examine the functional changes in the autonomic nervous system and cardiac baroreceptor reflex response with an emphasis on dynamic changes during HDBR. Beat-by-beat RR intervals (RRIs) and systolic arterial pressures (SAPs) were measured non-invasively from simultaneous, continuous recordings of ECG and arterial pressure waves in supine resting postures. A power spectrum analysis by the fast Fourier transform was applied to a data set composed of interpolated 512 RRIs and 512 SAPs (256 s in duration). Three indices of cardiac baroreceptor reflex sensitivity (BRS) were obtained by applying a sequence technique and a cross-spectrum analysis technique to the spontaneous RRIs and SAPs. The high-frequency band power of RRI variability (HF(RRI)) decreased significantly in the latter part of HDBR and persisted until the initial stage of the post-HDBR period (POST). The low-frequency band power of SAP variability decreased significantly only during the mid-part of HDBR. The BRS(sequence) obtained by the sequence technique showed a significant increase temporarily on the initial day of HDBR. The BRS(sequence) and the estimate of BRS obtained by the cross-spectrum analysis handling the high-frequency band were both significantly decreased on the initial day of POST. Each of the BRS estimates correlated negatively with heart rate and positively with HF(RRI) during HDBR and POST. These results suggest the following: (1) cardiac spontaneous baroreceptor reflex sensitivity might be transiently increased at the initial stage of HDBR, (2) the reduction in vagal modulation on the sinus node occurs from the latter part of HDBR to the initial stage of POST, (3) sympathetic vasomotor control is probably slightly inhibited during the mid-part of HDBR, and (4) the enhancement in cardiac sympathetic modulation and the impairment in cardiac spontaneous baroreceptor reflex sensitivity may occur in the initial stage of POST.

Effects of external periodic perturbations on short-term heart rate variability in healthy subjects and ischemic heart disease patients

AIMS

To characterise the frequency response of short-term heart rate variability to external periodic perturbations in healthy and ischemic heart disease subjects.

METHODS

Eleven healthy men and 11 ischemic heart disease patients were enrolled in this study. The frequency response of heart rate variability was assessed during periodic eyes opening test and controlled breathing at frequencies ranging from 0.08 to 0.25 Hz using autoregressive spectral analysis.

RESULTS

In subjects of both groups the mean heart rate and blood pressure were unchanged across experimental sessions. In healthy subjects eyes opening at rate of 8 and 6 times/min (0.12 and 0.10 Hz) evoked high-power peaks (P<0.05) at the same frequencies in the R-R power spectrum. The largest frequency response of heart rate variability was seen during eyes opening at 0.1 Hz (P<0.05). Ischemic heart disease patients failed to respond to periodic eyes opening with any changes in heart rate variability. During controlled breathing healthy subjects showed the highest heart rate variability frequency responses when breath frequency was 0.1 Hz (P<0.05). Comparatively, patients with ischemic heart disease had reduced frequency responses of heart rate variability at all breath rates and its magnitude did not depend on the perturbation frequency.

CONCLUSIONS

Our results demonstrate that the frequency response of short-term heart rate variability to external periodic perturbations is dependent on the perturbation frequency and the presence disease processes in the cardiovascular system.

Effect of endurance exercise on autonomic control of heart rate

Long-term endurance training significantly influences how the autonomic nervous system controls heart function. Endurance training increases parasympathetic activity and decreases sympathetic activity in the human heart at rest. These two training-induced autonomic effects, coupled with a possible reduction in intrinsic heart rate, decrease resting heart rate. Long-term endurance training also decreases submaximal exercise heart rate by reducing sympathetic activity to the heart. Physiological ageing is associated with a reduction in parasympathetic control of the heart; this decline in parasympathetic activity can be reduced by regular endurance exercise. Some research has indicated that females have increased parasympathetic and decreased sympathetic control of heart rate. These gender-specific autonomic differences probably contribute to a decreased cardiovascular risk and increased longevity observed in females.

Lower heart rate variability is associated with the development of coronary heart disease in individuals with diabetes: the atherosclerosis risk in communities (ARIC) study

The objective of this study was to test prospectively in a population sample whether individuals with impaired heart rate variability (HRV) are at increased risk of developing coronary heart disease (CHD) and of non-CHD mortality and to test whether this relationship is more pronounced among individuals with diabetes. We examined the association between HRV and incident CHD and non-CHD mortality in a cohort of 11,654 men and women aged 45-64 years at intake, from the biracial, population-based Atherosclerosis Risk in Communities Study. Supine, resting, 2-min beat-to-beat heart rate data were collected at the baseline examination. High frequency (HF; 0.15-0.40 Hz) and low frequency (LF; 0.04-0.15 Hz) spectral powers, LF/HF ratio, normalized HF and LF, the standard deviation of all normal R-R intervals (SDNN), and the mean of the sum of the squared differences between adjacent normal R-R intervals (MSSD) were used as the conventional indexes of HRV to measure cardiac autonomic control. From this cohort, 635 cases of incident CHD (including 346 cases of incident myocardial infarction [MI] and 82 cases of fatal CHD), and 623 non-CHD deaths were identified and validated after an average of 8 years of follow-up. Among individuals with diabetes, the multivariable adjusted proportional hazards ratios (95% CI) were 2.03 (1.28-3.23), 1.60 (1.12-2.27), 1.50 (0.65-3.42), and 1.27 (0.84-1.91) for incident MI, incident CHD, fatal CHD, and non-CHD deaths, respectively, comparing the lowest quartile to the upper most three quartiles of HF. A similar pattern of associations was found for LF, SDNN, and MSSD. By contrast, there was no consistent pattern of associations among individuals without diabetes. At the population level, a lower HRV (reflective of impaired cardiac autonomic control) is statistically significantly related to the development of CHD among individuals with diabetes, independent of markers of the duration/severity of the glucose metabolism impairment. These data suggest a contribution of an impaired cardiac autonomic control to the risk of CHD among individuals with diabetes.

Poincaré plot interpretation using a physiological model of HRV based on a network of oscillators

In this paper, we develop a physiological oscillator model of which the output mimics the shape of the R-R interval Poincaré plot. To validate the model, simulations of various nervous conditions are compared with heart rate variability (HRV) data obtained from subjects under each prescribed condition. For a variety of sympathovagal balances, our model generates Poincaré plots that undergo alterations strongly resembling those of actual R-R intervals. By exploiting the oscillator basis of our model, we detail the way that low- and high-frequency modulation of the sinus node translates into R-R interval Poincaré plot shape by way of simulations and analytic results. With the use of our model, we establish that the length and width of a Poincaré plot are a weighted combination of low- and high-frequency power. This provides a theoretical link between frequency-domain spectral analysis techniques and time-domain Poincaré plot analysis. We ascertain the degree to which these principles apply to real R-R intervals by testing the mathematical relationships on a set of data and establish that the principles are clearly evident in actual HRV records.