Seasonal variation in heart rate variability in asthmatic children

Asthma is a "seasonal disease" with symptoms either aggravated by environmental changes during specific seasons or prevalent at certain times of the year for other reasons. We examined whether the heart rate variability (HRV) of asthmatic children changes by season. The HRV during a portion of one night (00:00-04:00) and day (12:00-16:00) and the entire 24h period (00:00-24:00) during each of the four seasons was analyzed. The data of 95 children with asthma and 106 healthy children, as controls, were assessed. In children with asthma during the 24h period, seasonal variation in the low-frequency (LF) band (0.04-0.15 Hz) and the high-frequency (HF) band (0.15-0.4 Hz) were detected (HF: F=6.81, p=.0003; LF: F=4.18, p= .008). The HF value in the summer was significantly higher than in autumn and spring (Scheffe test: autumn vs. summer, s = 4.46, p < .001: spring vs. summer, s = 2.86, p < .05), while the LF value in autumn was significantly lower than in summer (s = 3.42, p < .01). In the control group, no seasonal variation in HF, LF, or LF/HF was detected. The findings infer the HRV, a surrogate measure of autonomic nervous system function, of asthmatic children is more susceptible to seasonal changes brought about by either endogenous annual rhythms or environmental weather phenomena.     

Heart Rate Variability During 24 Hours in Asthmatic Children

The autonomic circadian rhythm plays an important role in asthma. In recent years it has become possible to evaluate autonomic nervous function (ANF) using analysis of heart rate variability (HRV). We analyzed the HRV in the 24h period following the state without an asthma attack in order to study the relationship between asthma and ANF. The HRV was analyzed in 94 asthmatic children (ages 5–15 years). These subjects were divided into groups according to the severity of their asthma. After recording a 24h ambulatory electrocardiograph (AECG), the HRV was analyzed by a computer. Evaluation of the HRV was carried out using time-domain and frequency-domain analyses. The ANF of asthma subjects was decreased in comparison to the normal group. The severity of asthma had a significant effect on the %RR50 (the proportion of cycles during which the difference is > 50 ms), the SD (standard deviation; mean of standard deviation of all normal RR intervals for all 5-minute periods), the low-frequency (LF) band (0.04 to 0.15 Hz), and the high-frequency (HF) band (0.15 to 0.4 Hz) (%RR50: F = 4.31, p = 0.01; SD: F=3.48, p = 0.03; LF: F=3.67, p = 0.02; HF: F=3.41, p = 0.03). These values were lowest in the severe asthma group. With regard to the therapy grouping, the index that exhibited a significant difference was the NNA (mean of normal-to-normal RR intervals over 24h) (F = 4.43, p = 0.01) In conclusion, even in the normal condition in which the patient is free of an asthma attack, the ANF of asthma sufferers differs from that of normal children. It is possible that the different ANF of asthma sufferers is related to the severity of the asthma. (Chronobiology International, 14(6), 597–606, 1997)     

Seasonal Variation in the Orcadian Rhythm of Pulmonary Function in Stable Astthmatic Children who have Nearly Outgrown their Asthma

To study whether nocturnal bronchial obstruction changes during the year, we assessed the circadian FEV₁ variation during four consecutive seasons in 20 children (12 boys; aged 9–12 years) with episodic asthma who were outgrowing their asthma. FEV₁ was determined every 4 h between 10:00 and 10:00 during two consecutive days. The last six FEV₁ values were submitted to cosinor and coefficient of variation (CV) analyses. The seasonal means (SD) in the group 24 h percent predicted FEV₁ was 85.5 (11.4), 81.2 (10.6), 86.0 (11.6), and 82.2 (14.0)% during spring, summer, autumn, and winter, respectively. The difference between the summer and autumn FEV₁ values was statistically significant (p < 0.05). The mean (SD) of the circadian amplitude values was 4.1 (4.3), 6.0 (3.8), 4.9 (3.4), and 7.2 (4.1)% during spring, summer, autumn, and winter, respectively. The difference in amplitude between the spring and winter and between the autumn and winter values was statistically significant (p<0.05). CV values of 48 of the 80 (60%) circadian FEV, time series exceeded the average CV of 5% observed in non-asthmatic children studied in our laboratory. There was an unequal distribution during the year in elevated CV values; 6, 17, 10, and 15 of the high CV values occurred, respectively, in the spring, summer, autumn, and winter. These results suggest that nocturnal bronchial obstruction may change seasonally in terms of severity and amplitude in children who have nearly outgrown their asthma. (Chronobiology International, 13(4), 295–303, 1996)     

Assessment of Cardiac Autonomic Modulation during Adolescent Obesity

Objective: To investigate the cardiovascular autonomic function in pediatric obesity of different duration by using standard time domain, spectral heart rate variability (HRV), and nonlinear methods. Research Methods and Procedures: Fifty obese children (13.9 ± 1.7 years) were compared with 12 lean subjects (12.9 ± 1.6 years). Obese children were classified as recent obese (ROB) (<4 years), intermediate obese (IOB) (4 to 7 years), and long‐term obese (OB) (>7 years). In all participants, we performed blood pressure (BP) measurements, laboratory tests, and 24‐hour electrocardiogram/ambulatory BP monitoring. The spectral power was quantified in total power, very low‐frequency (LF) power, high‐frequency (HF) power, and LF to HF ratio. Total, long‐term, and short‐term time domain HRV were calculated. Poincaré plot and quadrant methods were used as nonlinear techniques. Results: All obese groups had higher casual and ambulatory BP and higher glucose, homeostasis model assessment, and triglyceride levels. All parameters reflecting parasympathetic tone (HF band, root mean square successive difference, proportion of successive normal‐to‐normal intervals, and scatterplot width) were significantly and persistently reduced in all obese groups in comparison with lean controls. LF normalized units, LF/HF, and cardiac acceleration (reflecting sympathetic activation) were significantly increased in the ROB group. In IOB and OB groups, LF, but not nonlinear, measures were similar to lean controls, suggesting biphasic behavior of sympathetic tone, whereas nonlinear analysis showed a decreasing trend with the duration of obesity. Long‐term HRV measures were significantly reduced in ROB and IOB. Discussion: Autonomic nervous system changes in adolescent obesity seem to be related to its duration. Nonlinear methods of scatterplot and quadrant analysis permit assessment of autonomic balance, despite measuring different aspects of HRV.     

Autonomic Nervous System Activity and the State and Development of Obesity in Japanese School Children

Objective: The autonomic nervous system (ANS) plays an important role in regulating energy expenditure and body fat content; however, the extent to which the ANS contributes to pediatric obesity remains inconclusive. The aim of this study was to evaluate whether sympathetic and/or the parasympathetic nerve activities were altered in an obese pediatric population. We further examined a physiological association between the duration of obesity and the sympatho‐vagal activities to scrutinize the nature of ANS alteration as a possible etiologic factor of childhood obesity. Research Methods and Procedures: Forty‐two obese and 42 non‐obese healthy sedentary school children were carefully selected from 1080 participants initially recruited to this study. The two groups were matched in age, gender, and height. The clinical records of physical characteristics and development of the obese children were retrospectively reviewed to investigate the onset and progression of obesity. The ANS activities were assessed during a resting condition by means of heart rate variability power spectral analysis, which enables us to identify separate frequency components, i.e., total power (TP), low‐frequency (LF) power, and high‐frequency (HF) power. The spectral powers were then logarithmically transformed for statistical testing. Results: The obese children demonstrated a significantly lower TP (6.77 ± 0.12 vs. 7.11 ± 0.04 ln ms², p < 0.05), LF power (6.16 ± 0.12 vs. 6.42 ± 0.05 ln ms², p < 0.05), and HF power (5.84 ± 0.15 vs. 6.34 ± 0.07 ln ms², p < 0.01) compared with the non‐obese children. A partial correlation analysis revealed that the LF and HF powers among 42 obese children were negatively associated with the duration of obesity independent of age (LF: partial r = ?0.55, p < 0.001; HF: partial r = ?0.40, p < 0.01). The obese children were further subdivided into two groups based on the length of their obesity. All three spectral powers were significantly reduced in the obese group with obesity of >3 years (n = 18) compared to the group with obesity of <3 years. Discussion: Our data indicate that obese children possess reduced sympathetic as well as parasympathetic nerve activities. Such autonomic depression, which is associated with the duration of obesity, could be a physiological factor promoting the state and development of obesity. These findings further imply that preventing and treating obesity beginning in the childhood years could be an urgent and crucial pediatric public health issue.     

Effects of Dinner Composition on Postprandial Macronutrient Oxidation in Prepubertal Girls

Objective: To see whether a fat‐rich (50%) evening meal promoted fat oxidation and a different spontaneous food intake on the following day at breakfast than a meal with a lower fat content (20%) in 10 prepubertal obese girls. Research Methods and Procedures: The postabsorptive and postprandial (10.5 hours) energy expenditure after a low‐fat (LF) (20% fat, 68% carbohydrate, 12% protein) and an isocaloric (2.1 MJ) and isoproteic high‐fat (HF; 50% fat, 38% carbohydrate, 12% protein) meal were measured by in direct calorimetry. Results: Fat oxidation was not significantly different after the two meals [LF, 31 ± 9 vs. HF, 35 ± 9 g/10.5 hours, p = not significant (NS)]. The girls oxidized 1.8 ± 0.9 times more fat than that ingested (11.1 grams) with the LF meal vs. 0.3 ± 0.3 times more fat than that ingested (27.1 grams) with the HF meal (p < 0.001). Carbohydrate oxidation was significantly higher after an LF than an HF meal (39 ± 12 vs. 29 ± 9 g/10.5 hours, p < 0, 05). At breakfast, the girls spontaneously ingested a similar amount of energy (1.5 ± 0.7 vs. 1.5 ± 0.6 MJ, p = NS) and macronutrient proportions (fat, 23% vs. 26%, p = NS; protein, 9% vs. 10%; carbohydrate, 68% vs. 64%,) independently of their having eaten an HF or an LF dinner. Discussion: An HF dinner did not stimulate fat oxidation, and no compensatory effect in spontaneous food intake was observed during breakfast the following morning. Cumulated total fat oxidation after dinner was higher than total fat ingested at dinner, but a much larger negative fat balance was observed after the LF meal. Spontaneous energy and nutrient intakes at breakfast were similar after LF and HF isocaloric, isoproteic dinners. This study points out the lack of sensitivity of short‐term fat balance to subsequently readjust fat intake and emphasizes the importance of an LF meal to avoid transient positive fat imbalance.     

Associations between Heart Rate Variability Parameters and Housing- and Individual-Related Variables in Dairy Cows Using Canonical Correspondence Analysis

We investigated the associations between heart rate variability (HRV) parameters and some housing- and individual-related variables using the canonical correspondence analysis (CCOA) method in lactating Holstein-Friesian dairy cows. We collected a total of 5200 5-min interbeat interval (IBI) samples from 260 animals on five commercial dairy farms [smaller-scale farms with 70 (Farm 1, n = 50) and 80 cows per farm (Farm 2, n = 40), and larger-scale farms with 850 (Farm 3, n = 66), 1900 (Farm 4, n = 60) and 1200 (Farm 5, n = 45) cows. Dependent variables included HRV parameters, which reflect the activity of the autonomic nervous system: heart rate (HR), the root mean square of successive differences (RMSSD) in IBIs, the standard deviation 1 (SD1), the high frequency (HF) component of HRV and the ratio between the low frequency (LF) and the HF parameter (LF/HF). Explanatory variables were group size, space allowance, milking frequency, parity, daily milk yield, body condition score, locomotion score, farm, season and physical activity (lying, lying and rumination, standing, standing and rumination and feeding). Physical activity involved in standing, feeding and in rumination was associated with HRV parameters, indicating a decreasing sympathetic and an increasing vagal tone in the following order: feeding, standing, standing and rumination, lying and rumination, lying. Objects representing summer positioned close to HR and LF and far from SD1, RMSSD and HF indicate a higher sympathetic and a lower vagal activity. Objects representing autumn, spring and winter associated with increasing vagal activity, in this order. Time-domain measures of HRV were associated with most of the housing- and individual-related explanatory variables. Higher HR and lower RMSSD and SD1 were associated with higher group size, milking frequency, parity and milk yield, and low space allowance. Higher parity and milk yield were associated with higher sympathetic activity as well (higher LF/HF), while individuals with lower locomotion scores (lower degree of lameness) were characterized with a higher sympathetic and a lower vagal tone (higher HR and LF/HF and lower RMSSD and SD1). Our findings indicate that the CCOA method is useful in demonstrating associations between HRV and selected explanatory variables. We consider physical activity, space allowance, group size, milking frequency, parity, daily milk yield, locomotion score and season to be the most important variables in further HRV studies on dairy cows.     

HEART-RATE VARIABILITY IN WOMEN DURING 40-HOUR PROLONGED WAKEFULNESS

Heart-rate variability patterns of 18 women during a 40-h constant routine of prolonged wakefulness under controlled laboratory conditions were analyzed. The authors tested the circadian timing of the autonomic nervous system and the relationship between the sympathetic and vagal branches in women with both a functional disorder of vascular regulation (main symptom: cold hands and feet) and prolonged sleep onset and controls without these symptoms. Spectral analysis of R-R intervals during paced breathing episodes revealed significantly lower power values in the high-frequency band (HF; 0.15–0.4?Hz) but not in the low-frequency band (LF; 0.04–0.15?Hz), leading to a significantly elevated LF/HF ratio in the former group. A significant circadian rhythm in LF power and heart rate occurred in both groups, and a significant correlation was found between sleepiness and sympathovagal balance (r?=?.53, p?<?.05). These findings indicate not only an autonomic imbalance in the first group compared with controls, but also two strategies of the autonomic nervous system to fight against fatigue in women. One implies circadian control and the other homeostatic control, and both are reflected by the LF/HF ratio. (Author correspondence: Kurt.Kraeuchi@upkbs.ch)     

Relationships of cardiac autonomic function with metabolic abnormalities in childhood obesity

Objective: The objective was to examine cardiovascular autonomic (cANS) function and its potential relationships with leptin resistance, insulin resistance, oxidative stress, and inflammation in a pediatric sample with varying levels of obesity. Research Methods and Procedures: Participants were normal‐weight (NW; BMI <85th percentile, 6 male, 4 female), overweight (OW; 85th percentile < BMI <95th percentile, 6 male, 4 female), and obese children (OB; BMI >95th percentile, 6 male, 10 female) who had cANS function assessed via heart rate variability (HRV) methods during resting conditions. Standard time‐domain and frequency‐domain measures [high‐frequency normalized units (HFnu; measure of parasympathetic nervous system activity) and low frequency:high‐frequency ratio (LF:HF; overall sympathovagal balance)] of HRV were calculated. Fasting blood samples were drawn for measurement of glucose, insulin, lipids, 8‐isoprostane, leptin, soluble leptin‐receptor (sOB‐R), C‐reactive protein (CRP), interleukin‐6 (IL‐6), and tumor necrosis factor‐α (TNF‐α). Results were reported as mean ± standard error of the mean. Results: OB had significantly elevated LF:HF and decreased HFnu when compared with NW (p < 0.05), but no differences between OW and NW were observed. Measures of HRV were significantly related to leptin, insulin resistance, 8‐isoprostane, and CRP (p < 0.05), but these relationships were not significant after adjustment for fat mass. Discussion: When compared with NW, OB but not OW children are characterized by cANS dysfunction and increased leptin, insulin resistance, oxidative stress, and inflammation (CRP). The relationships between these factors seem to be dependent on quantity of fat mass and/or other factors associated with being obese.     

Effects of Serum Calcium and Magnesium on Heart Rate Variability in Adult Women

The present study was designed to evaluate the association of serum calcium (Ca) and magnesium (Mg) levels with heart rate variability (HRV). One hundred and sixteen adult women were recruited in this cross-sectional study. Serum Ca and Mg levels were measured, and HRV in each time and frequency domain was recorded for 5?min. Mean heart rate and standard deviation of the normal to normal interval (SDNN) and root mean square of differences of successive RR interval (RMSSD) in time domain and total power (TP), low-frequency power (LF), high-frequency power (HF), and LF/HF ratio in frequency domain were compared according to the tertiles of serum Ca and Mg levels and Ca/Mg ratio. The associations between serum Ca and Mg levels and Ca/Mg ratio with HRV were evaluated using regression analyses. Mean heart rate tended to increase from the lowest to the highest tertile of Ca levels (p?=?0.081), whereas it decreased significantly with higher Mg levels (p?=?0.026). Increasing SDNN value was observed from the lowest to the highest tertile of Mg levels (p?=?0.009). SDNN value decreased significantly from the lowest to the highest tertile of Ca/Mg ratio (p?=?0.030). Participants in the lowest tertile of Ca/Mg ratio had significantly higher TP and LF values compared to those in the middle and highest tertiles (p?<?0.05). Decreasing SDNN, TP, and LF values were significantly associated with higher Ca/Mg ratios (p?<?0.05). Associations of serum Mg level and Ca/Mg ratio with HRV could be one of the mechanisms involved in cardiovascular diseases.     

Insulin Sensitivity Determines the Effectiveness of Dietary Macronutrient Composition on Weight Loss in Obese Women

Objective: To determine whether macronutrient composition of a hypocaloric diet can enhance its effectiveness and whether insulin sensitivity (Si) affects the response to hypocaloric diets. Research Methods and Procedures: Obese nondiabetic insulin‐sensitive (fasting insulin < 10 μU/mL; n = 12) and obese nondiabetic insulin‐resistant (fasting insulin > 15 μU/mL; n = 9) women (23 to 53 years old) were randomized to either a high carbohydrate (CHO) (HC)/low fat (LF) (60% CHO, 20% fat) or low CHO (LC)/high fat (HF) (40% CHO, 40% fat) hypocaloric diet. Primary outcome measures after a 16‐week dietary intervention were: changes in body weight (BW), Si, resting metabolic rate, and fasting lipids. Results: Insulin‐sensitive women on the HC/LF diet lost 13.5 ± 1.2% (p < 0.001) of their initial BW, whereas those on the LC/HF diet lost 6.8 ± 1.2% (p < 0.001; p < 0.002 between the groups). In contrast, among the insulin‐resistant women, those on the LC/HF diet lost 13.4 ± 1.3% (p < 0.001) of their initial BW as compared with 8.5 ± 1.4% (p < 0.001) lost by those on the HC/LF diet (p < 0.04 between two groups). These differences could not be explained by changes in resting metabolic rate, activity, or intake. Overall, changes in Si were associated with the degree of weight loss (r = ?0.57, p < 0.05). Discussion: The state of Si determines the effectiveness of macronutrient composition of hypocaloric diets in obese women. For maximal benefit, the macronutrient composition of a hypocaloric diet may need to be adjusted to correspond to the state of Si.     

The influence of hydration status on heart rate variability after exercise heat stress

While exercise heat stress and hydration status are known to independently influence heart rate variability (HRV), the combined effect of these physiological stressors is unknown. Thus, heat-acclimated subjects (n=5) performed exercise heat trials (40 °C, 20% relative humidity) in the euhydrated and hypohydrated state (3.9±0.7% body weight loss). During each trial, cardiac cycle R–R interval data were collected for 45 min at rest (pre-) and after (post-) completing 90 min of cycle ergometer exercise. Pre- and post-exercise RRI data were analyzed by Fast Fourier Power Spectral analysis to determine the high-frequency (HF), low-frequency (LF), very low-frequency (VLF), and total power (TP) components of HRV. Overall HRV was decreased by both hypohydration and exercise heat stress. Hypohydration reduced TP, LF, VLF, and LF:HF ratio $(P<0.05)$ while HF was significantly higher. The change in both LF and HF power (pre- vs. post-exercise) were blunted during hypohydration compared to euhydration. These data suggest that dehydration alone positively influences the parasympathetic (HF) control of HRV, but the reduction in overall HRV and the blunted oscillations in LF and HF power following exercise heat stress support an overall deleterious effect of dehydration on autonomic cardiac stability.     

先天性心脏病患儿介入封堵术治疗前后CRP、NT-proBNP、心率变异性的变化及与术后心功能的关系研究

摘要 目的：探讨先天性心脏病（CHD）患儿介入封堵术治疗前后C-反应蛋白（CRP）、N末端B型利钠肽原（NT-proBNP）、心率变异性（HRV）的变化及与术后心功能的关系。方法：选择2020年10月至2021年6月在本院行介入封堵术治疗的95例CHD患儿为研究对象,采用化学发光法检测血清CRP水平,采用电化学发光免疫技术检测血清NT-proBNP水平,采用24 h动态心电图及12导联同步心电图分析HRV指标,观察手术前后患儿的血清CRP、NT-proBNP水平及HRV指标变化,比较术后不同NYHA心功能分级患儿的血清CRP、NT-proBNP水平和HRV指标,分析患儿术前血清CRP水平、血清NT-proBNP水平、HRV指标与术后NYHA心功能分级的相关性。结果：介入封堵术后患儿血清CRP、NT-proBNP、LF/HF水平逐渐降低,术后3 d、术后1个月时均低于术前,术后1个月时均低于术后3 d时（P<0.025）;而TP、HF、LF、R-R、PNN50%、ASDNN、SDANN、SDNN、rMSSD水平逐渐升高,术后3 d、术后1个月时均高于术前,术后1个月时均高于术后3 d 时（P<0.025）。患儿术后3 d的血清CRP、NT-proBNP水平及LF/HF水平随着NYHA心功能分级的升高而升高,TP、HF、LF、R-R、PNN50%、ASDNN、SDANN、SDNN、rMSSD水平随着NYHA心功能分级的升高而降低（多有P＜0.05）。患儿术后3 d的NYHA心功能分级与治疗前血清CRP、NT-proBNP及LF/HF水平呈负相关,与TP、HF、LF、R-R、PNN50%、ASDNN、SDANN、SDNN、rMSSD水平呈正相关（P＜0.05）。结论：CHD患儿经介入封堵术治疗后,血清CRP、NT-proBNP及HRV指标变化明显,与术后NYHA心功能分级显著相关,血清CRP、NT-proBNP及HRV指标有望成为评估CHD患儿介入封堵术后预后的较敏感性指标。     

Intentional Weight Loss Reduces Mortality Rate in a Rodent Model of Dietary Obesity

Objective: We used a rodent model of dietary obesity to evaluate effects of caloric restriction‐induced weight loss on mortality rate. Research Measures and Procedures: In a randomized parallel‐groups design, 312 outbred Sprague‐Dawley rats (one‐half males) were assigned at age 10 weeks to one of three diets: low fat (LF; 18.7% calories as fat) with caloric intake adjusted to maintain body weight 10% below that for ad libitum (AL)‐fed rat food, high fat (HF; 45% calories as fat) fed at the same level, or HF fed AL. At age 46 weeks, the lightest one‐third of the AL group was discarded to ensure a more obese group; the remaining animals were randomly assigned to one of three diets: HF‐AL, HF with energy restricted to produce body weights of animals restricted on the HF diet throughout life, or LF with energy restricted to produce the body weights of animals restricted on the LF diet throughout life. Life span, body weight, and leptin levels were measured. Results: Animals restricted throughout life lived the longest (p < 0.001). Life span was not different among animals that had been obese and then lost weight and animals that had been nonobese throughout life (p = 0.18). Animals that were obese and lost weight lived substantially longer than animals that remained obese throughout life (p = 0.002). Diet composition had no effect on life span (p = 0.52). Discussion: Weight loss after the onset of obesity during adulthood leads to a substantial increase in longevity in rats.     

WORKING THE NIGHT SHIFT CAUSES INCREASED VASCULAR STRESS AND DELAYED RECOVERY IN YOUNG WOMEN

Shiftwork has been associated with elevated blood pressure (BP) and decreased heart-rate variability (HRV), factors that may increase the long-term risk of cardiovascular-related mortality and morbidity. This study explored the effect of shiftwork on dynamic changes in autonomic control of HRV (cardiac stress), systolic BP and diastolic BP, i.e., SBP and DBP (vascular stress), and recovery in the same subjects working different shifts. By studying the same subjects, the authors could reduce the effect of possible contribution of between-subject variation from genetic predisposition and environmental factors. The authors recruited 16 young female nurses working rotating shifts—day (08:00–16:00 h), evening (16:00–00:00 h), and night (00:00–08:00 h)—and 6 others working the regular day shift. Each nurse received simultaneous and repeated 48-h ambulatory electrocardiography and BP monitoring during their work day and the following off-duty day. Using a linear mixed-effect model to adjust for day shift, the results of the repeated-measurements and self-comparisons found significant shift differences in vascular stress. While working the night shift, the nurses showed significant increases in vascular stress, with increased SBP of 9.7 mm Hg. The changes of SBP and DBP seemed to peak during waking time at the same time on the day off as they did on the working day. Whereas HRV profiles usually returned to baseline level after each shift, the SBP and DBP of night-shift workers did not completely return to baseline levels the following off-duty day (p?<?.001). The authors concluded that although the nurses may recover from cardiac stress the first day off following a night shift, they do not completely recover from increases in vascular stress on that day. (Author correspondence: jdwang@ntu.edu.tw)     

Effect on HRV of archer athletes one day before competition after three different abdominal respiratory frequency

PurposeTo study the effect on HRV of archer athletes one day before competition after three different abdominal respiratory frequencies.MethodsEight elite archers performed three different respiratory frequency tests, HRV were recorded in pre-, during, and post-frequency control in frequency 16 (F16 group, n = 8), 8 (F8 group, n = 8), and 5 (F5 group, n = 8) times per minute, and hoped to find a respiratory adjust way to reduce stress. RMSSD, RR_triangular index, TP, VLF, LF, HF and LF/HF were analyzed to describe the effect of respiratory frequency.ResultThe average RR separate, RR_triangular index and HF showed no significant change in three respiratory frequency (P > 0.05); LF increased significantly in F16 group, but LP of F8 and F5 group increased first then reduced (P < .05); VLF rose in F8 and F5 group (P < .05, respectively), the LF/HF has the similar change as the LF in all the groups.ConclusionThe F16 group increased equilibrium of sympathetic and pneumogastric nerve system; F8 increase excitability of sympathetic nerve; mental fatigue remission in F5.     

Normal ranges and reproducibility of statistical, geometric, frequency domain, and non-linear measures of 24-hour heart rate variability.

Diabetic cardiovascular autonomic neuropathy (CAN) carries an increased risk of mortality. The early detection and characterization of CAN has traditionally been based on the results of autonomic reflex tests (AFTs). A variety of different measures to quantify 24-hour heart rate variability (HRV) have recently been introduced, but their normal ranges, reliability, and validity in patients with CAN have not been adequately studied. We established the normal ranges of statistical (SDNN index, CV, SNN50, RMSSD), geometric (triangular index (TI), triangular interpolation (TINN), top angle index [TAI]), frequency domain (spectral power in the VLF, LF, and HF bands, LF/HF ratio, LF in normalized units [NU]), and non-linear measures (CV1 and CV2 of the Poincaré plot) of 24-hour HRV in 94 healthy control subjects. Day-to-day reproducibility was evaluated on two occasions in 17 healthy subjects and 9 diabetic patients. The parameters of HRV were computed over time periods representing the day (6:00-24:00 hours), night (00:00-6:00 hours), and 24 hours in total. The results of all indexes, except for the LF/HF ratio and LF-NU, declined significantly with increasing age (p<0.05), but were independent of sex and BMI. The statistical, geometric, and non-linear measures (p<0.05), but not the frequency-domain parameters decreased significantly with increasing heart rate. Since the HRV data showed log normal distribution, log transformation was used to define the age-related lower limits of normal at the 2.5th centile. Intraindividual reproducibility was highest for the geometric measures. The nonlinear and statistical parameters also showed high reliability, except for the SNN50. The repeatability of the frequency domain measures was somewhat lower but still satisfactory. Reproducibility was lower in the diabetic than in the control group, higher during the day than during the night, and better than that reported previously for the AFTs. In conclusion, in healthy subjects the measures of 24-h HRV are not related to sex or BMI, but strongly dependent on age and heart rate, the latter except for the frequency domain measures. The majority of the HRV measures, in particular the geometric parameters, show a relatively high intraindividual reproducibility which underlines their suitability for the use in prospective studies.     

Central hemodynamic and heart rate variability parameters in athletes during different training programs

Central hemodynamic and heart rate variability (HRV) parameters were assessed in highly qualified athletes differing in the types of their training programs at relative rest. During endurance (the endurance group, n = 27) and strength (the strength group, n = 17) trainings, the total peripheral resistance (TPR) was decreased by 15% (p = 0.003) in the endurance group and by 16% (p = 0.011) in the strength group, and the stroke volume increased by 31% (p < 0.0001) in the endurance group and by 19% (p = 0.024) in the strength group. In the strength group, the cardiac output (Q) was higher (p = 0.012) and the temporal and spectral parameters of HRV (RMSSD, pNN ₅₀, and HF) were lower (p < 0.05) than those in the control group (n = 56). Some of these differences can be explained by an increased body mass index (p = 0.005) in the strength group. In the endurance group, the HRV parameters (RMSSD, pNN₅₀, HF, VLF, and TP) were higher (p ≤ 0.02), and the mean blood pressure was lower (p < 0.003) than those in the control group, with no significant differences in the Q from the control group. Our findings suggest that, in the strength-training athletes, resting hemodynamics were characterized by a greater Q level and a greater tension of mechanisms regulating cardiac activity. In the endurance-training athletes, a low Q level was associated with a lower tension of the mechanisms regulating cardiac activity (an increased vagal tone).     

Sleep and Sleepiness among Working and Non‐Working High School Evening Students

The aim of this study was to evaluate patterns of sleepiness, comparing working and non‐working students. The study was conducted on high school students attending evening classes (19:00–22:30 h) at a public school in São Paulo, Brazil. The study group consisted of working (n=51) and non‐working (n=41) students, aged 14–21 yrs. The students answered a questionnaire about working and living conditions and reported health symptoms and diseases. For seven consecutive days, actigraphy measurements were recorded, and the students also filled in a sleep diary. Sleepiness ratings were given six times per day, including upon waking and at bedtime, using the Karolinska Sleepiness Scale. Statistical analyses included three‐way ANOVA and t‐test. The mean sleep duration during weekdays was shorter among workers (7.2 h) than non‐workers (8.8 h) (t=4.34; p<.01). The mean duration of night awakenings was longer among workers on Tuesdays and Wednesdays (28.2 min) and shorter on Mondays (24.2 min) (t=2.57; p=.03). Among workers, mean napping duration was longer on Mondays and Tuesdays (89.9 min) (t=2.27; p=.03) but shorter on Fridays and Sundays (31.4 min) (t=3.13; p=.03). Sleep efficiency was lower on Fridays among non‐workers. Working students were moderately sleepier than non‐workers during the week and also during class on specific days: Mondays (13:00–15:00 h), Wednesdays (19:00–22:00 h), and Fridays (22:00–00:59 h). The study found that daytime sleepiness of workers is moderately higher in the evening. This might be due to a work effect, reducing the available time for sleep and shortening the sleep duration. Sleepiness and shorter sleep duration can have a negative impact on the quality of life and school development of high school students.     

Link between Peripheral Artery Disease and Heart Rate Variability in Hemodialysis Patients

Peripheral artery disease (PAD) and low heart rate variability (HRV) are highly prevalent in hemodialysis patients, and both are associated with increased cardiovascular morbidity and mortality. This study aims to examine the suggested relationship between PAD and HRV, and the relationship of parameters before and after hemodialysis. This study enrolled 161 maintenance hemodialysis patients. PAD was defined as ABI < 0.9 in either leg. HRV was performed to assess changes before and after hemodialysis. The change in HRV (△HRV) was defined as post-hemodialysis HRV minus pre-hemodialysis HRV. Patients’ clinical parameters were collected from the dialysis records. All HRV parameters except high frequency (HF) % were lower in patients with PAD than patients without PAD, though not achieving significant level. In patients without PAD, HF (P = 0.013), low frequency (LF) % (P = 0.028) and LF/HF (P = 0.034) were significantly elevated after hemodialysis, whereas no significant HRV parameters change was noted in patients with PAD. Serum intact parathyroid hormone was independently associated with △HF (β = -0.970, P = 0.032) and △LF% (β = -12.609, P = 0.049). Uric acid level (β = -0.154, P = 0.027) was negatively associated with △LF/HF in patients without PAD. Our results demonstrated that some of the HRV parameters were significantly increased after hemodialysis in patients without PAD, but not in patients with PAD, reflecting a state of impaired sympatho-vagal equilibrium. Severity of secondary hyperparathyroidism and hyperuricemia contributed to lesser HRV parameters increase after hemodialysis in patients without PAD.