Hemodynamic profile and heart rate variability in hyperadrenergic versus non-hyperadrenergic postural orthostatic tachycardia syndrome

Introduction and aim. Bispectral index (BIS) and heart rate variability (HRV) can be monitored in real time, along with the standard hemodynamic parameters: blood pressure (BP) and heart rate (HR). It is interesting to assess the interrelationship between these parameters during anesthesia. In this work, the objective was to evaluate the changes of HRV, depending on the level of sedation for outpatient endoscopic procedures and to develop a mathematical model of their relationship. Materials and methods. In the first phase of the study, comparative and staged assessment of hemodynamic parameters, BIS and HRV was performed in 26 patients, including 11 men and 15 women aged from 18 to 74 (46±14) years. In the second stage, in order to test the operability of the model, the study was conducted in 12 patients aged from 20 to 72 (44±15) years. All patients were subjected to endoscopic surgery (colonoscopy). The assessment of HRV, hemodynamic profile, and the BIS was carried out in three stages of the study. Depending on the BIS values, all patients were allocated to three levels of sedation. Results and discussion. As a result, the models for HRV-based BIS determination were obtained, giving a high degree of objectivity in determining the status of anesthesia in patients based on HRV-derived BIS. Conclusions. The results of the study revealed the parameters that together reflect the level of sedation. Suggested mathematical model based on discriminant analysis allows to assess the level of light sedation with accuracy of 85.7 %, and the level of adequate sedation with accuracy of 93.3 %. The accuracy of a classification matrix was 89.1 %. The developed software allows to visually assess the level of sedation.

Download Full-text

Heart Rate Variability Analysis in Postural Orthostatic Tachycardia Syndrome: A Case Report

Heart International ◽

10.1177/182618680600200208 ◽

2006 ◽

Vol 2 (2) ◽

pp. 182618680600200

Author(s):

Vincenzo Russo ◽

Ilaria De Crescenzo ◽

Ernesto Ammendola ◽

Carolina Pagano ◽

Cristina Savarese ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Case Report ◽

Heart Rate Variability Analysis ◽

Postural Orthostatic Tachycardia Syndrome ◽

Variability Analysis

Download Full-text

Heart rate and heart rate variability comparison between postural orthostatic tachycardia syndrome versus healthy participants; a systematic review and meta-analysis.

10.21203/rs.2.16519/v2 ◽

2019 ◽

Author(s):

Joel Dominic Swai ◽

Zixuan Hu ◽

Xiexiong Zhao ◽

Tibera Rugambwa ◽

Gui Ming

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Frequency Domain ◽

Time Domain ◽

Meta Analysis ◽

Postural Orthostatic Tachycardia Syndrome ◽

Mean Values ◽

Rr Interval ◽

Normalized Units ◽

Healthy Participants

Abstract Background: A number of published literatures have reported that, physiologically, heart rate variability in patients with postural orthostatic tachycardia (POTS) to be greatly confounded by age, sex, race, physical fitness and circadian rhythm. The purpose of this study was to compare between postural orthostatic tachycardia syndrome (POTS) patients versus healthy patients , in terms of heart rate (HR) and heart rate variability (HRV) after Head-Up tilt test, by systematic review and meta-analysis of available published literature. Methods: MEDLINE (using PubMed interphase), EMBASE and SCOPUS were systematically searched for observational studies comparing between POTS patients versus healthy patients, in terms of heart rate (HR) and heart rate variability (HRV). HRV was grouped into Time and frequency domain outcome measurements. Time domain was measured as mean RR- interval and mean square root of mean of squares of successive R-R waves (rMSSD) in milliseconds. Frequency domain was measured as mean values of Low frequency power (LF), High frequency power (HF), LF/HF-ratio, LF-normalized units (LF(n.u)) and HF-normalized units (HF(n.u)). Demographic data, comorbidities, and mean values of HR, RR- interval, rMSSD, LF, HF, LF/HF-ratio, LF-(n.u) and H.F-n.u were extracted from each group and compared, by their mean differences as overall outcome measure. Computer software, RevMan 5.3 was utilized, at 95% significance level. Results: Twenty (20) eligible studies were found to report 717 POTS and 641 healthy participant s. POTS group had higher mean heart rate (p<0.05), lower mean RR-Interval (p<0.05), lower rMSSD (p<0.05) than healthy participants. Furthermore, POTS group had lower mean HF (p>0.05), lower mean LF(p>0.05), and lower mean HF(n.u) (p>0.05), higher LF/HF-Ratio (p>0.05) and higher LF(n.u) (p>0.05) as compared to healthy participants. Conclusion: POTS patients have higher heart rate than healthy patients after HUTT and and lower HRV in terms of time domain measure but not in terms of frequency domain measure. Heart rate and time domain analyses of HRV are more reliable than frequency domain analysis in differentiating POTS patient from healthy participant. We call upon sensitivity and specificity studies.

Download Full-text

Heart rate and heart rate variability comparison between postural orthostatic tachycardia syndrome versus healthy participants; a systematic review and meta-analysis.

10.21203/rs.2.16519/v1 ◽

2019 ◽

Author(s):

Joel Dominic Swai ◽

Zixuan Hu ◽

Xiexiong Zhao ◽

Tibera Rugambwa ◽

Gui Ming

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Frequency Domain ◽

Meta Analysis ◽

Postural Orthostatic Tachycardia Syndrome ◽

Mean Values ◽

Rr Interval ◽

Normalized Units ◽

Healthy Participants ◽

Frequency Power

Abstract Background A number of published literatures have reported that, physiologically, heart rate variability in patients with postural orthostatic tachycardia (POTS) to be greatly confounded by age, sex, race, physical fitness and circadian rhythm. The purpose of this study was to compare between postural orthostatic tachycardia syndrome (POTS) patients versus healthy patients, in terms of heart rate (HR) and heart rate variability (HRV) after Head-Up tilt test, by systematic review and meta-analysis of available published literature.Methods MEDLINE (using PubMed interphase), EMBASE and SCOPUS were systematically searched for observational studies comparing between POTS patients versus healthy patients, in terms of heart rate (HR) and heart rate variability (HRV). HRV was grouped into Time and frequency domain outcome measurements. Time domain was measured as mean RR- interval and mean square root of mean of squares of successive R-R waves (rMSSD) in milliseconds. Frequency domain was measured as mean values of Low frequency power (LF), High frequency power (HF), LF/HF-ratio, LF-normalized units (LF(n.u)) and HF-normalized units (HF(n.u)). Demographic data, comorbidities, and mean values of HR, RR- interval, rMSSD, LF, HF, LF/HF-ratio, LF-(n.u) and H.F-n.u were extracted from each group and compared, by their mean differences as overall outcome measure. Computer software, RevMan 5.3 was utilized, at 95% significance level.Results Twenty (20) eligible studies were found to report 717 POTS and 641 healthy participants. POTS group had higher mean heart rate (p<0.05), lower mean RR-Interval (p<0.05), lower rMSSD (p<0.05) than healthy participants. Furthermore, POTS group had lower mean HF(p>0.05), lower mean LF(p>0.05), and lower mean HF(n.u) (p>0.05), higher LF/HF-Ratio (p>0.05) and higher LF(n.u) (p>0.05) as compared to healthy participants.Conclusion Despite massively supported fact that POTS patients have higher heart rate than healthy patients after HUTT, POTS patients have lower heart rate variability in terms of time domain measure but not in terms of frequency domain measure.

Download Full-text