Nonstationarity and duration of the R-R-segment in the diagnostics of functional states of operators

The effect of the nonstationarity of R-R interval series on the diagnostics of functional states of operators has been analyzed. The functional states were diagnosed by means of a factor model of heart rate variability. The heart rate was recorded in the supine position, before the performance of an important task, and after its completion. A high resistance of the diagnostics of functional states to nonstationarity was found for all periods. Indices of heart rate variability resistant to nonstationarity were defined. Also, the effect of R-R segment duration on functional states diagnostics was explored. The results obtained allow one to conclude that the diagnostics of functional states based on the three-factor model of heart rate variability can be used on short segments within a range of 256 divided 32 R-R intervals. The indices of the factor model of heart rate variability must be normalized for corresponding R-R segment duration before diagnostics. In addition, the effect of the duration of R-R segment on the indices of heart rate variability was analyzed for different functional states. The indices resistant to the duration of R-R segments and conditions necessary for heart rate recording were defined.     

The variability of the heart rhythm and the nature of the feedback as a result of operator activity in man]

In a memory task which required sustained attention, the positive or negative emotional state of an operator was created by introduction of two different types of feedback in accordance with the number of correct or wrong solutions. Standard and original indices were used for evaluation of the short-term variability of the heart rate (HRV) during performance. Changes in the HRV were observed only in the periods of performance with the failure type of the feedback. These changes reflected stabilization of heart bit-to-bit intervals. The original index of the fast HRV turned to be the most sensitive for testing HRV changes. Human autonomic reactions of such a kind during operator-like activity are known as a predictor for the functional state of dissatisfaction. This confirms the practical importance of application of the HRV indices for testing the ergonomic properties of the systems which control the operator-computer interaction.     

Comparative Evaluation of Heart Rate Variability Based on the Data of ECG and Blood Pressure Measurements

The development of new approaches to the assessment of heart rate variability (HRV) is an important problem, since HRV reflects the functioning of cardiovascular control and is affected by various diseases. The purpose of this study was to evaluate the informative value of statistical and spectral HRV parameters calculated from pulse interval (PI) data of blood pressure as compared with those calculated from RR-interval data of electrocardiograms (ECG). We recorded ECG in conscious rats using skin adhesive electrodes simultaneously with blood pressure signal obtained through a catheter in the femoral artery. It has been found that the PI sequence can be used to calculate the statistical HRV indices that describe the HRV at time intervals about 1 min or longer, but statistical indices of the PI and RR intervals may differ in the analysis of beat-tobeat variations. The power spectra of the RR intervals and PI coincide in the low-frequency region, including the band of baroreflex cardiac rhythm oscillation. However, they can differ in the high-frequency region (at respiration frequency and above).     

Automatic filtering of outliers in RR intervals before analysis of heart rate variability in Holter recordings: a comparison with carefully edited data

Background  

Undetected arrhythmic beats seriously affect the power spectrum of the heart rate variability (HRV). Therefore, the series of RR intervals are normally carefully edited before HRV is analysed, but this is a time consuming procedure when 24-hours recordings are analysed. Alternatively, different methods can be used for automatic removal of arrhythmic beats and artefacts. This study compared common frequency domain indices of HRV when determined from manually edited and automatically filtered RR intervals.     

Influence of 50 Hz magnetic field on human heart rate variability: linear and nonlinear analysis

This study investigated the problem of the influence of 50 Hz magnetic field (MF) on human heart rate variability (HRV). The exposure system was a commercial device for magnetotherapy, generating field of the strength of 500 microT at the center of the coil, 150-200 microT at the position of human subjects' heart and 20-30 microT at the position of subjects' head. The exposure protocols, applied randomly, were either "half hour MF-off/half hour MF-on" or "half hour MF-off/half hour MF-off." The phonocardiographic (PhCG) signal of 15 volunteers were obtained during exposure and used for calculation of time-domain HRV parameters (mean time between heart beats (N-N), standard deviation of time between heart beats (SDNN), and the number of differences of successive beat-to-beat intervals greater than 50 ms, divided by the total number of beat-to-beat intervals (pNN50)) and nonlinear HRV measures (approximate entropy (ApEn), detrended fluctuation scaling exponents). The protocol MF-off/MF-on was applied in nine subjects. Repeated measures ANOVA (RMANOVA) performed for Mf-off/MF-off protocol indicated no statistical difference among four 15 min intervals of HRV data (P value >20% for all parameters except for N-N, where P = 3.7%). RMANOVA followed by the post hoc Tukey test performed for Mf-off/MF-on protocol indicated a statistically significant difference during MF on for N-N (8% increase, P <.1%), SDNN (40% increase, P = 1.1%), and pNN50 (110% increase, P <.1%). The results of the analysis indicate that the changes of these parameters could be associated with the influence of MF.     

Identification of development and autonomic nerve activity from heart rate variability in preterm infants

Heartbeat intervals, which are determined basically by regular excitations of the sinoatrial node, show significant fluctuation referred to as the heart rate variability (HRV). The HRV is mostly due to nerve activities through the sympathetic and parasympathetic branches of the autonomic nervous system (ANS). In recent years, it has been recognized that the HRV shows a greater complexity than ever expected, suggesting that it includes much information about ANS activities. In this study, we investigated relationship between HRV and development in preterm infants. To this end, heartbeat intervals were continuously recorded from 11 preterm infants in NICU. The recording periods were ranging from several days to weeks depending on the individuals. The HRV at various ages was then characterized by several indices. They include power spectrum as well as the mean and standard deviation of the series. For the power spectrum, the low-frequency band power (LF), high-frequency band power (HF), LF/HF (the ratio between LF and HF), beta (scaling exponent of the spectrum) were estimated. The detrended fluctuation analysis (DFA) was also employed to obtain short- and long-range scaling exponents. Each of these indices showed a correlation with the age. We showed that the long-range scaling exponent, derived from the DFA, was most significantly correlated with the age, suggesting that it could be a robust index to characterize the development of preterm infants.     

Inheritance of heart rate variability: the kibbutzim family study

Heart rate variability (HRV) measures are associated with coronary heart disease incidence and mortality. Therefore insight into the genetic and environmental determinants of these measures may have clinical relevance. We assessed the role of genetic and environmental factors of time domain and frequency domain HRV indices. Participants were 451 kibbutz members, aged 15 and up, belonging to 80 families. HRV indices were calculated from Holter recordings measured over 5 min. Our data indicate that for the two time- and four frequency domain indices, a mixture of two normal distributions fit the data significantly better than a single normal distribution (P<0.05). We used complex segregation analysis to infer the modes of inheritance of these HRV measures. We found evidence for possible involvement of a recessive major gene in the inheritance of the root mean square of successive differences in RR intervals (RMSSD), which is predominantly vagally mediated. A putative major gene explains 28%-34% of the adjusted inter-individual variability. The SD, determined by a mixture of mechanisms, is influenced by environmental and polygenic effects, but not by a major gene. The findings regarding the heritability of the frequency domain indices were not conclusive. However, the involvement of genetic factors was not rejected. Additional studies in extended families are needed to confirm the involvement of major genes in the determination of the autonomic activity.     

Influence of Non-Alcoholic Fatty Liver Disease on Autonomic Changes Evaluated by the Time Domain,Frequency Domain,and Symbolic Dynamics of Heart Rate Variability

Background

Non-alcoholic fatty liver disease (NAFLD) is associated with cardiovascular atherosclerosis independent of classical risk factors. This study investigated the influence of NAFLD on autonomic changes, which is currently unknown.

Methods

Subjects without an overt history of cardiovascular disease were enrolled during health checkups. The subjects diagnosed for NAFLD using ultrasonography underwent 5-min heart rate variability (HRV) measurements that was analyzed using the following indices: (1) the time domain with the standard deviation of N-N (SDNN) intervals and root mean square of successive differences between adjacent N-N intervals (rMSSD); (2) the frequency domain with low frequency (LF) and high frequency (HF) components; and (3) symbolic dynamics analysis. Routine blood biochemistry data and serum leptin levels were analyzed. Homeostasis model assessment of insulin resistance (HOMA-IR) was measured.

Results

Of the 497 subjects (mean age, 46.2 years), 176 (35.4%) had NAFLD. The HRV indices (Ln SDNN, Ln rMSSD, Ln LF, and Ln HF) were significantly decreased in the NAFLD group (3.51 vs 3.62 ms, 3.06 vs 3.22 ms, 5.26 vs 5.49 ms², 4.49 vs 5.21 ms², respectively, all P<0.05). Ln SDNN was significantly lower in the NAFLD group after adjustment for age, sex, hypertension, dyslipidemia, metabolic syndrome, body mass index, smoking, estimated glomerular filtration rate, HOMA-IR, and leptin (P<0.05). In the symbolic dynamic analysis, 0 V percentage was significantly higher in the NAFLD group (33.8% vs 28.7%, P = 0.001) and significantly correlated with linear HRV indices (Ln SDNN, Ln rMSSD, and Ln HF).

Conclusions

NAFLD is associated with decreased Ln SDNN and increased 0 V percentage. The former association was independent of conventional cardiovascular risk factors and serum biomarkers (insulin resistance and leptin). Further risk stratification of autonomic dysfunction with falls or cardiovascular diseases by these HRV parameters is required in patients with NAFLD.     

Kinetographic assessment of the functional state of healthy humans: A pilot study

An original method for assessing the human functional state (FS) is described. The method is based on stabilography in a sitting position. Changes in the position of the total center of pressure on a stabilographic support were monitored in 32 healthy subjects who were in an arbitrary sitting position, in the state of quiet wakefulness with the eyes open or closed. The obtained data were analyzed in terms of the theory of complex systems. The recorded signal was considered as an output of a complex, half-open biomechanical system responding to numerous external and internal stimuli. The necessary and sufficient set of parameters for qualifying the FS has been determined, and the ranges of normal values of these parameters have been estimated. The sensitivity of the method to changes in the FS and the individual stability of some calculated kinetographic parameters have been demonstrated. The method is applicable to studies in psychotherapy, perception psychology, operator performance, and neurological rehabilitation science.     

Multilevel examination of minor salivary gland biopsy for Sjogren's syndrome significantly improves diagnostic performance of AECG classification criteria

The recently observed low reproducibility of focus score (FS) assessment at different section depths in a series of single minor salivary gland biopsies highlighted the need for a standardized protocol of extensive histopathological examination of such biopsies in Sjogren's syndrome. For this purpose, a cumulative focus score (cFS) was evaluated on three slides cut at 200-mum intervals from each of a series of 120 salivary biopsies. The cFS was substituted for the baseline FS in the American-European Consensus Group (AECG) criteria set for Sjogren's syndrome classification, and then test specificity and sensitivity were assessed against clinical patient re-evaluation. Test performances of the AECG classification with the original FS and the score obtained after multilevel examination were statistically compared using receiver operating characteristic (ROC) curve analysis. The diagnostic performance of AECG classification significantly improved when the cFS was entered in the AECG classification; the improvement was mostly due to increased specificity in biopsies with a baseline FS >or= 1 but <2. The assessment of a cFS obtained at three different section levels on minor salivary gland biopsies can be useful especially in biopsies with baseline FSs between 1 and 2.     

Short-Term Heart Rate Variability—Influence of Gender and Age in Healthy Subjects

In the recent years, short-term heart rate variability (HRV) describing complex variations of beat-to-beat interval series that are mainly controlled by the autonomic nervous system (ANS) has been increasingly analyzed to assess the ANS activity in different diseases and under various conditions. In contrast to long-term HRV analysis, short-term investigations (<30 min) provide a test result almost immediately. Thus, short-term HRV analysis is suitable for ambulatory care, patient monitoring and all those applications where the result is urgently needed. In a previous study, we could show significant variations of 5-min HRV indices according to age in almost all domains (linear and nonlinear) in 1906 healthy subjects from the KORA S4 cohort. Based on the same group of subjects, general gender-related influences on HRV indices are to be determined in this study. Short-term 5-min HRV indices from linear time and frequency domain and from nonlinear methods (compression entropy, detrended fluctuation analysis, traditional and segmented Poincaré plot analysis, irreversibility analysis, symbolic dynamics, correlation and mutual information analysis) were determined from 782 females and 1124 males. First, we examined the gender differences in two age clusters (25–49 years and 50–74 years). Secondly, we investigated the gender-specific development of HRV indices in five age decade categories, namely for ages 25–34, 35–44, 45–54, 55–64 and 65–74 years. In this study, significant modifications of the indices according to gender could be obtained, especially in the frequency domain and correlation analyses. Furthermore, there were significant modifications according to age in nearly all of the domains. The gender differences disappeared within the last two age decades and the age dependencies disappeared in the last decade. To summarize gender and age influences need to be considered when performing HRV studies even if these influences only partly differ.     

Welfare implication of measuring heart rate and heart rate variability in dairy cattle: literature review and conclusions for future research

Heart rate (HR) measurements have been used to determine stress in livestock species since the beginning of the 1970s. However, according to the latest studies in veterinary and behaviour–physiological sciences, heart rate variability (HRV) proved to be more precise for studying the activity of the autonomic nervous system. In dairy cattle, HR and HRV indices have been used to detect stress caused by routine management practices, pain or milking. This review provides the significance of HR and HRV measurements in dairy cattle by summarising current knowledge and research results in this area. First, the biological background and the interrelation of the autonomic regulation of cardiovascular function, stress, HR and HRV are discussed. Equipment and methodological approaches developed to measure interbeat intervals and estimate HRV in dairy cattle are described. The methods of HRV analysis in time, frequency and non-linear domains are also explained in detail emphasising their physiological background. Finally, the most important scientific results and potential possibilities for future research are presented.     

Low to high frequency ratio of heart rate variability spectra fails to describe sympatho-vagal balance in cardiac patients

Heart rate variability (HRV) reflects an influence of autonomic nervous system on heart work. In healthy subjects, ratio between low and high frequency components (LF/HF ratio) of HRV spectra represents a measure of sympatho-vagal balance. The ratio was defined by the authorities as an useful clinical tool, but it seems that it fails to summarise sympatho-vagal balance in a clinical setting. Value of the method was re-evaluated in several categories of cardiac patients. HRV was analysed from 24-hour Holter ECGs in 132 healthy subjects, and 2159 cardiac patients dichotomised by gender, median of age, diagnosis of myocardial infarction or coronary artery surgery, left ventricular systolic function and divided by overall HRV into several categories. In healthy subjects, LF/HF ratio correlated with overall HRV negatively, as expected. The paradoxical finding was obtained in cardiac patients; the lower the overall HRV and the time-domain indices of vagal modulation activity were the lower the LF/HF ratio was. If used as a measure of sympatho-vagal balance, long-term recordings of LF/HF ratio contradict to clinical finding and time-domain HRV indices in cardiac patients. The ratio cannot therefore be used as a reliable marker of autonomic activity in a clinical setting.     

Multilevel examination of minor salivary gland biopsy for Sjögren's syndrome significantly improves diagnostic performance of AECG classification criteria

The recently observed low reproducibility of focus score (FS) assessment at different section depths in a series of single minor salivary gland biopsies highlighted the need for a standardized protocol of extensive histopathological examination of such biopsies in Sjögren's syndrome. For this purpose, a cumulative focus score (cFS) was evaluated on three slides cut at 200-μm intervals from each of a series of 120 salivary biopsies. The cFS was substituted for the baseline FS in the American–European Consensus Group (AECG) criteria set for Sjögren's syndrome classification, and then test specificity and sensitivity were assessed against clinical patient re-evaluation. Test performances of the AECG classification with the original FS and the score obtained after multilevel examination were statistically compared using receiver operating characteristic (ROC) curve analysis. The diagnostic performance of AECG classification significantly improved when the cFS was entered in the AECG classification; the improvement was mostly due to increased specificity in biopsies with a baseline FS ≥ 1 but <2. The assessment of a cFS obtained at three different section levels on minor salivary gland biopsies can be useful especially in biopsies with baseline FSs between 1 and 2.     

Attenuated autonomic function in multiple organ dysfunction syndrome across three age groups.

Multiple organ dysfunction syndrome (MODS) is the failure of several organs after a trigger event. The mortality is high, at up to 70%. We hypothesize that autonomic dysfunction may substantially contribute to the development of MODS and speculate that there is an age dependence of autonomic dysfunction in MODS. A total of 90 consecutively admitted MODS patients were assigned to this study. Three variables of autonomic function were analyzed: heart rate variability (HRV), baroreflex sensitivity (BRS) and chemoreflex sensitivity (CRS). The patient cohort was divided into three age groups. The main finding was that BRS, CRS and almost all indices of HRV were attenuated in comparison to normal range data and there was no age dependence for HRV indices or CRS, but there was for BRS. In conclusion, autonomic function in MODS is attenuated. The influence of MODS on autonomic function overwhelms the age dependence of autonomic function observed in healthy subjects.     

Effect of Chronic Training on Heart Rate Variability,Salivary IgA and Salivary Alpha-Amylase in Elite Swimmers with a Disability

The purpose of this study was to a) determine the heart rate variability (HRV) and saliva markers of immunity (salivary immunoglobulin A; sIgA) and stress (salivary alpha-amylase; sAA) responses to chronic training in elite swimmers with a disability; and b) identify the relationships between HRV, sIgA, sAA and training volume. Eight members of a high performance Paralympic swimming program were monitored for their weekly resting HRV, sIgA and sAA levels in the 14 weeks leading up to a major international competition. The 14 week training program included aerobic, anaerobic, power and speed, and taper training phases, while also incorporating two swimming step tests and two swimming competitions. Specific time (root mean square of the successive differences; RMSSD) and frequency (high frequency normalized units [HFnu]) domain measures, along with non-linear indices (standard deviation of instantaneous RR variability; SD1 and short term fractal scaling exponent; α1) of HRV were used for all analyses with effects examined using magnitude-based inferences. Relationships between HRV and saliva markers were identified by Spearman rank rho (ρ) correlation coefficients. Compared with week 1, SD1 was very likely lower (96/4/0, ES = -2.21), while sAA was very likely elevated (100/0/0, ES = 2.32) at the beginning of week 7 for all athletes. The training program did not alter HRV or saliva whereas competition did. There were also no apparent differences observed for HRV, sIgA and sAA between each of the training phases during the 14 week swimming program. Correlations were observed between sAA and SD1 (ρ = -0.212, p<0.05), along with sAA and mean HR (ρ = 0.309, p<0.05). These results show that high level national competition influences depresses HRV (SD1) and increases saliva biomarkers of stress (sAA). It appears that a well-managed and periodised swimming program can maintain these indices within normal baseline levels. The study also highlighted the parasympathetic nervous system influence on sAA.     

Heart Rate Variability During Sleep Following the Practice of Cyclic Meditation and Supine Rest

Day time activities are known to influence the sleep on the following night. Cyclic meditation (CM) has recurring cycles. Previously, the low frequency (LF) power and the ratio between low frequency and high frequency (LF/HF ratio) of the heart rate variability (HRV) decreased during and after CM but not after a comparable period of supine rest (SR). In the present study, on thirty male volunteers, CM was practiced twice in the day and after this the HRV was recorded (1) while awake and (2) during 6 h of sleep (based on EEG, EMG and EGG recordings). This was similarly recorded for the night’s sleep following the day time practice of SR. Participants were randomly assigned to the two sessions and all of them practiced both CM and SR on different days. During the night following day time CM practice there were the following changes; a decrease in heart rate, LF power (n.u.), LF/HF ratio, and an increase in the number of pairs of Normal to Normal RR intervals differing by more than 50 ms divided by total number of all NN intervals (pNN50) (P < 0.05, in all cases, comparing sleep following CM compared with sleep following SR). No change was seen on the night following SR. Hence yoga practice during the day appears to shift sympatho-vagal balance in favor of parasympathetic dominance during sleep on the following night.     

Respiratory influences on non-linear dynamics of heart rate variability in humans

 The goal of our study was to determine whether evidence for chaos in heart rate variability (HRV) can be observed when the respiratory input to the autonomic controller of heart rate is forced by the deterministic pattern associated with periodic breathing. We simultaneously recorded, in supine healthy volunteers, RR intervals and breathing volumes for 20 to 30 min (1024 data point series) during three protocols: rest (control), fixed breathing (15 breath/min) and voluntary periodic breathing (3 breaths with 2 s inspiration and 2 s expiration followed by an 8 s breath hold). On both the RR interval and breathing volume series we applied the non-linear prediction method (Sugihara and May algorithm) to the original time series and to distribution-conserved isospectral surrogate data. Our results showed that, in contrast to the control test, during both fixed and voluntary periodic breathing the variability of breathing volumes was clearly deterministic non-chaotic. During all the three protocols, the RR-interval series’ non-linear predictability was consistent with one of a chaotic series. However, at rest, no clear difference was observed between the RR-interval series and their surrogates, which means that no clear chaos was observed. During fixed breathing a difference appeared, and this difference seemed clearer during voluntary periodic breathing. We concluded that HRV dynamics were chaotic when respiration was forced with a deterministic non-chaotic pattern and that normal spontaneous respiratory influences might mask the normally chaotic pattern in HRV. Received: 7 August 1995 / Accepted in revised form: 20 March 1997     

Circadian and ultradian rhythms in heart rate variability.

AIM: Heart rate variability (HRV) patterns reflect the changing effect of sympathetic and parasympathetic modulation of the autonomic nervous system. While overall and circadian heart rate (HR) and HRV are well characterized by traditional measures, there is currently no method to measure ultradian cycles of HR and HRV. MATERIALS AND METHODS: HR/HRV for each 2-min interval was calculated using normal-to-normal interbeat intervals from overnight polysomnographic ECGs in 113 subjects, aged 58+/-10 years (65 male, 48 female). HR, SDNN2, high-frequency power (HF) and the LF (low-frequency power)/HF ratio were plotted. A curve-fitting algorithm, developed in MatLab, identified cyclic patterns of HR/HRV and extracted parameters to characterize them. Results were compared for older vs. younger patients, males vs. females, with vs. without severe sleep apnea, and for the upper and lower half of sleep efficiency. RESULTS: Ultradian patterns for different HR/HRV indices had variable correspondences with each other and none could be considered surrogates. Differences were seen for all comparison groups, but no one marker was consistently different across comparisons. CONCLUSION: Each HR/HRV parameter has its own rhythm, and the correspondence between these rhythms varies greatly across subjects. Quantification of ultradian patterns of HRV is feasible and could provide new insights into autonomic physiology.     

Reproducibility of Heart Rate Variability Indices in Children with Cystic Fibrosis

Fundamental to the potential utilisation of heart rate variability (HRV) indices as a prognostic tool is the reproducibility of these measures. The purpose of the present study was therefore to investigate the reproducibility of 24-hour derived HRV indices in a clinical paediatric population. Eighteen children (10 boys; 12.4 ± 2.8 years) with mild to moderate Cystic Fibrosis (CF; FVC: 83 ± 12% predicted; FEV₁: 80 ± 9% predicted) and eighteen age- and sex-matched controls (10 boys; 12.5 ± 2.7 years) wore a combined ECG and accelerometer for two consecutive days. Standard time and frequency domain indices of HRV were subsequently derived. Reproducibility was assessed by Bland-Altman plots, 95% limits of agreement and intra-class correlation coefficients (ICC). In both groups, there was no systematic difference between days, with the variables demonstrating a symmetrical, homoscedastic distribution around the zero line. The time domain parameters demonstrated a good to excellent reproducibility irrespective of the population considered (ICC: 0.56 to 0.86). In contrast, whilst the frequency domain parameters similarly showed excellent reproducibility in the healthy children (ICC: 0.70 to 0.96), the majority of the frequency domain parameters illustrated a poor to moderate reproducibility in those with CF (ICC: 0.22 to 0.43). The exceptions to this trend were the normalised LF and HF components which were associated with a good to excellent reproducibility. These findings thereby support the utilisation of time and relative frequency domain HRV indices as a prognostic tool in children with CF. Furthermore, the present results highlight the excellent reproducibility of HRV in healthy children, indicating that this may be a useful tool to assess intervention effectiveness in this population.