Does the Temporal Asymmetry of Short-Term Heart Rate Variability Change during Regular Walking? A Pilot Study of Healthy Young Subjects
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The acceleration and deceleration patterns in heartbeat fluctuations distribute asymmetrically, which is known as heart rate asymmetry (HRA). It is hypothesized that HRA reflects the balancing regulation of the sympathetic and parasympathetic nervous systems. This study was designed to examine whether altered autonomic balance during exercise can lead to HRA changes. Sixteen healthy college students were enrolled, and each student undertook two 5-min ECG measurements: one in a resting seated position and another while walking on a treadmill at a regular speed of 5 km/h. The two measurements were conducted in a randomized order, and a 30-min rest was required between them. RR interval time series were extracted from the 5-min ECG data, and HRA (short-term) was estimated using four established metrics, that is, Porta's index (PI), Guzik's index (GI), slope index (SI), and area index (AI), from both raw RR interval time series and the time series after wavelet detrending that removes the low-frequency component of <~0.03 Hz. Our pilot data showed a reduced PI but unchanged GI, SI, and AI during walking compared to resting seated position based on the raw data. Based on the wavelet-detrended data, reduced PI, SI, and AI were observed while GI still showed no significant changes. The reduced PI during walking based on both raw and detrended data which suggests less short-term HRA may underline the belief that vagal tone is withdrawn during low-intensity exercise. GI may not be sensitive to short-term HRA. The reduced SI and AI based on detrended data suggest that they may capture both short- and long-term HRA features and that the expected change in short-term HRA is amplified after removing the trend that is supposed to link to long-term component. Further studies with more subjects and longer measurements are warranted to validate our observations and to examine these additional hypotheses.Introduction: Heart Rate Variability (HRV) and Pulse Rate Variability (PRV), are non-invasive techniques for monitoring changes in the cardiac cycle. Both techniques have been used for assessing the autonomic activity. Although highly correlated in healthy subjects, differences in HRV and PRV have been observed under various physiological conditions. The reasons for their disparities in assessing the degree of autonomic activity remains unknown. Methods: To investigate the differences between HRV and PRV, a whole-body cold exposure (CE) study was conducted on 20 healthy volunteers (11 male and 9 female, 30.3 $\pm$ 10.4 years old), where PRV indices were measured from red photoplethysmography signals acquired from central (ear canal, ear lobe) and peripheral sites (finger and toe), and HRV indices from the ECG signal. PRV and HRV indices were used to assess the effects of CE upon the autonomic control in peripheral and core vasculature, and on the relationship between HRV and PRV. The hypotheses underlying the experiment were that PRV from central vasculature is less affected by CE than PRV from the peripheries, and that PRV from peripheral and central vasculature differ with HRV to a different extent, especially during CE. Results: Most of the PRV time-domain and Poincaré plot indices increased during cold exposure. Frequency-domain parameters also showed differences except for relative-power frequency-domain parameters, which remained unchanged. HRV-derived parameters showed a similar behaviour but were less affected than PRV. When PRV and HRV parameters were compared, time-domain, absolute-power frequency-domain, and non-linear indices showed differences among stages from most of the locations. Bland-Altman analysis showed that the relationship between HRV and PRV was affected by CE, and that it recovered faster in the core vasculature after CE. Conclusion: PRV responds to cold exposure differently to HRV, especially in peripheral sites such as the finger and the toe, and may have different information not available in HRV due to its non-localised nature. Hence, multi-site PRV shows promise for assessing the autonomic activity on different body locations and under different circumstances, which could allow for further understanding of the localised responses of the autonomic nervous system.
Photoplethysmogram
Vagal Tone
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신경심장학의 발전으로 중추신경 활성이 심장의 전기적 활동도에 미치는 영향이 밝혀지고 있고, 심박동수변이(Heart rate variability, HRV)가 정신적 스트레스와 심혈관질환의 기계적 연관성을 나타내는 중요한 지표로 제기되고 있다. HRV란 자율신경계의 정상적 상호작용에 의해 나타나는 생리적인 심박수 변동을 타나내며, 자율신경 기능을 정량화하여 측정할 수 있는 방법론이다. 분석 방법은 시간 영역 분석과 주파수 영역 분석으로 나눌 수 있으며, 측정 시간대에 따라 단기간 측정과 24시간 측정 등의 방법이 확립되어 있다. 임상적으로는 변이 정도, 교감신경과 부교감신경의 활성과 균형도를 파악하여 다양한 질환과 스트레스 등의 진단과 치료 및 예후 판정에 활용되고 있다. HRV를 이용한 바이오피드백도 최근 자율신경 관련 질환의 치료에 활용되고 있다. 향후 다양한 프로토콜의 개발과 임상적 적용이 필요할 것으로 보인다. 【In this article, the effects of stress on central nerve system and heart function and the concept of heart rate variability were reviewed. HRV(Heart Rate Variability), the periodical change of the heart rate, is indicated larger in the healthier because they respond flexibly to various sorts of facts influencing on HR. HRV analysis is largely composed of the time domain analysis and the frequency analysis. In the former the flexibility of heart function is analysed, while in the latter autonomic nerve function is examined, which is the degree of sympathetic and parasympathetic nerve activity and the state of balance. Furthermore, existence or nonexistence of disease and/or level of stress can be estimated by measuring the variability and normality of heart rate, and balance of autonomic nerve system, and through HRV biofeedback the symptoms of anxiety disorder or asthma can be reduced.】
Autonomic nerve
Autonomic function
Biofeedback
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Heart rate variability (HRV) is a noninvasive marker of cardiac autonomic activity and has been used in different circumstances to assess the autonomic responses of the body. Pulse rate variability (PRV), a similar variable obtained from pulse waves, has been used in recent years as a valid surrogate of HRV. However, the effect that localized changes in autonomic activity have in the relationship between HRV and PRV has not been entirely understood. In this study, a whole-body cold exposure protocol was performed to generate localized changes in autonomic activity, and HRV and PRV from different body sites were obtained. PRV measured from the earlobe and the finger was shown to differ from HRV, and the correlation between these variables was affected by the cold. Also, it was found that PRV from the finger was more affected by cold exposure than PRV from the earlobe. In conclusion, PRV is affected differently to HRV when localized changes in autonomic activity occur. Hence, PRV should not be considered as a valid surrogate of HRV under certain circumstances.Clinical Relevance- This indicates that pulse rate variability is affected differently to heart rate variability when autonomic activity is modified and suggests that pulse rate variability is not always a valid surrogate of heart rate variability.
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Aims: Autonomic nervous system (ANS) dysregulation is associated with various symptoms of depressive disorder. The beat-to-beat pattern of heart rate (Heart Rate Variability) (HRV) provides a noninvasive portal to ANS function through the quantification of periodic heart rate patterns. In this study we quantified two components of HRV: Respiratory Sinus Arrhythmia (RSA), and Low Frequency HRV (LF-HRV). Both of these components have been extensively reported in studies of depression and have been at least partially associated with reduction in vagal nerve tone. We quantified RSA and LF-HRV in patients with Major Depressive Disorder (MDD) as measures of ANS regulation seeking to establish the utility of components of HRV as potential diagnostic and prognostic biomarkers for treatment outcome. Methods: Sixty-six MDD patients were enrolled. In two separate and consecutively run studies they received either Escitalopram or Quetiapine fumarate ER over 12 weeks. Forty-one patients completed the studies. RSA and LF-HRV were assessed at pretreatment and end of study. Thirty-six healthy subjects served as controls. RSA and LF-HRV were quantified using an algorithm that incorporates time and frequency domains to address the non-stationarity of the beat-to-beat heart rate pattern. Results: No significant differences in baseline RSA or LF-HRV were found between MDD and healthy controls. However, baseline RSA and LF-HRV were significantly higher in treatment responders (lnRSA = 6.20, lnLF-HRV = 5.76) than non-responders (lnRSA = 4.75, lnLF-HRV = 4.53) (p = 0.005, p = 0.006). No significant changes in RSA or LF-HRV were detected over the course of either treatment. Conclusions: Components of HRV may be predictive of antidepressant response in MDD patients.
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Escitalopram
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Heart rate variability (HRV) is a useful measure to evaluate activity of the autonomic nervous system (ANS) and monitor both pathological and psychological conditions. However, HRV analysis still has difficulties with changes in HRV parameters due to an increase or decrease in the average heart rate. At present, the interpretation of the average changes in HRV datasets and their HRV parameters is not fully understood. Therefore, this study aimed to analyze how much deviation in HRV parameters occurs from rescaling tachograms and normalizing HRV datasets. Four rescaled tachograms and their corresponding normalized HRV datasets were created by increasing the average heartbeat from 50 to 110 bpm in 20 bpm steps. The difference in low frequency powers (Ln LFs) calculated between two successive rescaled groups was 0.89, 1.03, and 1.04, as the average heartbeat increased from slow to fast, while the difference in high frequency powers (Ln HFs) was 1.06, 1.53, and 1.37. However, in the four normalized HRV datasets, the difference in Ln LFs and Ln HFs between two successive normalized groups was -0.28 and -0.12, 0.31 and 0.27, and 0.31 and 0.37, respectively. The results suggest that the normalized HRV datasets are more valuable than the individual rescaled-tachogram HRV dataset for obtaining measurements using frequency-domain HRV parameters for HRV analysis in clinical applications.
Heart beat
Normalization
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بررسی تغییرات طیف توان فرکانس سیگنال( Heart HRV Rate variability ) در بیماری شریان کرونری( CAD ) و مقایسه با نتیجه تست ورزش , بررسی تغییرات طیف توان فرکانس سیگنال( Heart HRV Rate variability ) در بیماری شریان کرونری( CAD )... , کتابخانه الکترونیک و دیجیتال - آذرسا
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A prospective evaluation of 37 kidney and 20 kidney-pancreas transplant recipients was conducted to assess the relationship between pre-to posttransplant changes in heart rate variability (HRV) and quality of life (QoL). Assessments of 24-hour interbeat variability (pNN50 and rMSSD, SDNN, SDANN) and power spectral analysis of total, low (sympathetic), and high (parasympathetic) frequency components of HRV were performed. The Sickness Impact Profile was used to assess three dimensions of QoL (physical, psychosocial, and total functioning) prior to and at 6 months following transplantation. Changes in vagally mediated time domain measures of HRV were related to changes in physical and total functioning. Stronger correlations occurred between biobehavioral measures in kidney-pancreas recipients, with the strongest relationships occurring between changes in HRV frequency domain measures and changes in physical functioning. Findings indicate that changes in HRV and QoL are related, suggesting that interventions that enhance transplant recipients’ HRV may also enhance their QoL.
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Η χρόνια νεφρική ανεπάρκεια αποτελεί μια από τις κύριες αιτίες νοσηρότητας και θνητότητας. Η επίπτωση της χρόνιας νεφρικής νόσου είναι μεγαλύτερη σε διαβητικά σε σχέση με μη διαβητικά άτομα. Σε ασθενείς με χρόνια νεφρική ανεπάρκεια τελικού σταδίου τα καρδιαγγειακά νοσήματα αποτελούν την κύρια αιτία θανάτου. Τις τελευταίες δυο δεκαετίες έχει καταδειχθεί μια σημαντική συσχέτιση μεταξύ της δυσλειτουργίας του ΑΝΣ και της καρδιαγγειακής θνησιμότητας. Η HRV είναι ένας μη επεμβατικός ηλεκτροκαρδιογραφικός δείκτης που αντικατοπτρίζει τη δραστηριότητα του συμπαθητικού και παρασυμπαθητικού τμήματος του ΑΝΣ στο επίπεδο του καρδιακού φλεβοκόμβου. Η ελαττωμένη HRV έχει καθιερωθεί ως σημαντικός ανεξάρτητος παράγοντας κινδύνου για υψηλότερη ολική και καρδιαγγειακή θνησιμότητα στην καρδιαγγειακή νόσο αλλά και σε υγιείς πληθυσμούς. Οι μελέτες ασθενών με χρόνια νεφρική ανεπάρκεια τελικού σταδίου έδειξαν μείωση της HRV, η οποία συνδέεται με αυξημένο κίνδυνο ολικής θνησιμότητας και αιφνίδιου καρδιακού θανάτου. Παραδόξως μέχρι σήμερα δεν υπάρχουν μελέτες που να αναφέρονται στην μακροχρόνια επίδραση της χρόνιας περιοδικής αιμοκάθαρσης στη HRV σε ασθενείς με χρόνια νεφρική ανεπάρκεια τελικού σταδίου, διαβητικούς ή μη. Στην παρούσα μελέτη 1) εξετάσθηκε κατά πόσον η εφαρμογή τρισεβδομαδιαίας τετράωρης περιοδικής αιμοκάθαρσης επί τρίμηνο, σε διαβητικούς και μη ασθενείς με χρόνια νεφρική ανεπάρκεια τελικού σταδίου, επηρέασε τις time- και frequency-domain παραμέτρους της HRV, 2) διερευνήθηκε η ύπαρξη συσχετίσεων μεταξύ των time- και frequency- domain παραμέτρων της HRV αφενός με κλινικοεργαστηριακά ευρήματα και αφετέρου με κλασσικούς και νεότερους παράγοντες καρδιαγγειακού κινδύνου στον ανωτέρω πληθυσμό και 3) έγινε προσπάθεια διαμόρφωσης ενός μοντέλου πρόγνωσης διαταραχών της HRV βάσει των δεδομένων του ατομικού αναμνηστικού και των κλινικοεργαστηριακών ευρημάτων των ανωτέρω ασθενών. Στους νεφροπαθείς ασθενείς με ή χωρίς ΣΔ και στους διαβητικούς ασθενείς χωρίς νεφρική ανεπάρκεια διαπιστώθηκε σημαντικά μειωμένη HRV, με τη δραματικότερη μείωση να παρατηρείται στους ασθενείς με συνυπάρχουσα χρόνια νεφρική ανεπάρκεια και ΣΔ. Οι νεφροπαθείς ασθενείς με ή χωρίς ΣΔ, μετά την ένταξή τους σε χρόνιο πρόγραμμα περιοδικής αιμοκάθαρσης, βελτίωσαν σημαντικά τις time-domain παραμέτρους της HRV, με τη μεγαλύτερη βελτίωση να παρατηρείται στους νεφροπαθείς χωρίς ΣΔ, ενώ οι frequency-domain παράμετροι παρέμειναν αμετάβλητες. Στη μελέτη μας διαπιστώθηκε σημαντική συσχέτιση των παραμέτρων της HRV αφενός μεν με κλασσικούς παράγοντες καρδιαγγειακού κινδύνου όπως η ηλικία, το ιστορικό αρτηριακής υπέρτασης και καρδιακής νόσου, ο ΣΔ, η νεφρική νόσος και η δυσλιπιδαιμία, αφετέρου δε με νεότερους παράγοντες καρδιαγγειακόυ κινδύνου όπως τα λευκά αιμοσφαίρια, η αντίσταση στην ινσουλίνη, η hs-CRP, το NT-proBNP, η MGP και το οξειδωτικό stress. Διαπιστώθηκε θετική σημαντική συσχέτιση των παραμέτρων της HRV με τα ολικά λευκώματα και την λευκωματίνη ορού και με τα επίπεδα νατρίου και ασβεστίου ορού, ενώ διαπιστώθηκε αρνητική σημαντική συσχέτιση με την περίμετρο μέσης, τη HbA1c, με τα επίπεδα καλίου και φωσφόρου ορού και το ουρικό οξύ.
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RR interval
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This study is an instantaneous heart rate variability (HRV) signal cloud portable flat panel observation. HRV applications reflect the heart and cardiovascular disease. Patients with essential hypertension and myocardial infarction, vagal decay are reflected in the heart rate variability. Heart rate variability is also used as a predictor. Neurology, heart rate variability can reflect a variety of central nervous autonomic disorders. Such as Parkinson's disease, chronic alcoholism, limb paralysis and so on. Cardiomyopathy caused by diabetes mellitus and diabetes mellitus will reduce heart rate variability. The decrease in heart rate variability is before the onset of clinical conditions.
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