Age, sex and underlying heart rate as determinants of nocturnal heart rate variability among wearable smart ring users

Abstract Background Heart rate variability (HRV) is an important marker of overall health and especially cardiovascular health. Decreased HRV has been associated with reduced vagal control of heart rate and with adverse outcome in several studies. Purpose The purpose of this study was to investigate the impact of demographic factors (age and sex) and underlying heart rate on nocturnal HRV among wearable smart ring users. Methods De-identified data was gathered from 104,431 wearable smart ring users over the course of one week (640,911 nights; 65% men and 35% women; age 42.6±12.1 years). Inclusion criteria included self-reported age of ≥20 years and sleep duration ≥4 hours. The ring estimates heart rate and HRV with photoplethysmographic (PPG) sensors and calculates the root mean square of successive differences (rMSSD) between adjacent inter-beat-intervals (IBI) for 5-minute segments throughout each night. The average HRV in these segments was then taken to represent the cardiac parasympathetic activity among each user. In addition, rate-corrected HRV was calculated by dividing the rMSSD value with mean IBI (crMSSD = 100 * rMSSD/IBI). Results Nocturnal HRV was significantly dependent on age and underlying heart rate (Figure). The observed rMSSD values declined with age (P<0.001) in both men and women. Concomitant decrease in rMSSD was observed with increasing heart rate in each age group (P<0.001). Statistically significant sex-related differences were observed in HRV. Men had higher crMSSD during the early decades of life (<40 years) than women. This difference diminished with age and women ≥50 years had higher crMSSD than their male coevals. The average resting heart rate decreased with age and was lower among men throughout the age groups (P<0.001). Conclusions Normal aging is associated with reduced cardiac vagal modulation and is reflected as decreased nocturnal HRV values among male and female wearable smart ring users. The underlying heart rate is a significant factor for the degree of HRV throughout life. In this population, the sex-related differences observed during the early decades of life diminish on the verge of midlife and are reversed later in life with women showing higher HRV during and after midlife. Effects of age and HR on HRV Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Oura Health Ltd

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Impact of maternal obesity on neonatal heart rate and cardiac size

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2021-322860 ◽

2021 ◽

pp. fetalneonatal-2021-322860

Author(s):

Alan M Groves ◽

Anthony N Price ◽

Tamarind Russell-Webster ◽

Simone Jhaveri ◽

Yang Yang ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Cardiovascular Health ◽

Maternal Obesity ◽

Left Ventricular ◽

Causal Mechanism ◽

Left Ventricular Volumes ◽

Healthy Weight ◽

Systolic Volume ◽

The Impact

BackgroundMaternal obesity may increase offspring risk of cardiovascular disease. We assessed the impact of maternal obesity on cardiac structure and function in newborns as a marker of fetal cardiac growth.MethodsNeonates born to mothers of healthy weight (body mass index (BMI) 20–25 kg/m2, n=56) and to mothers who were obese (BMI ≥30 kg/m2, n=31) underwent 25-minute continuous ECG recording and non-sedated, free-breathing cardiac MRI within 72 hours of birth.ResultsMean (SD) heart rate during sleep was higher in infants born to mothers who were versus were not obese (123 (12.6) vs 114 (9.8) beats/min, p=0.002). Heart rate variability during sleep was lower in infants born to mothers who were versus were not obese (SD of normal-to-normal R-R interval 34.6 (16.8) vs 43.9 (16.5) ms, p=0.05). Similar heart rate changes were seen during wakefulness. Left ventricular end-diastolic volume (2.35 (0.14) vs 2.54 (0.29) mL/kg, p=0.03) and stroke volume (1.50 (0.09) vs 1.60 (0.14), p=0.04) were decreased in infants born to mothers who were versus were not obese. There were no differences in left ventricular end-systolic volume, ejection fraction, output or myocardial mass between the groups.ConclusionMaternal obesity was associated with increased heart rate, decreased heart rate variability and decreased left ventricular volumes in newborns. If persistent, these changes may provide a causal mechanism for the increased cardiovascular risk in adult offspring of mothers with obesity. In turn, modifying antenatal and perinatal maternal health may have the potential to optimise long-term cardiovascular health in offspring.

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Projecting the long-term benefits of single pill combination therapy for patients with hypertension in five countries

European Heart Journal ◽

10.1093/ehjci/ehaa946.2781 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

C Borghi ◽

J.G Wang ◽

A.V Rodionov ◽

M Rosas ◽

I.S Sohn ◽

...

Keyword(s):

Combination Therapy ◽

South Korea ◽

Health Outcomes ◽

Clinical Outcomes ◽

Funding Source ◽

Combination Therapies ◽

Private Company ◽

Treatment Pathways ◽

Single Pill ◽

The Impact

Abstract Background It is well established that single pill combination (SPC) therapies have the potential to improve patient adherence versus multi-pill regimens, thereby improving blood pressure control and clinical outcomes in populations with hypertension. Purpose To develop a microsimulation model, capturing different treatment pathways, to project the impact on clinical outcomes of using single pill combination therapies for the management of hypertension in five countries (Italy, Russia, China, South Korea and Mexico). Methods The model was designed to project health outcomes between 2020 and 2030 for populations with hypertension managed according to four different treatment pathways: current treatment practices [CTP], single drug with dosage titration first then sequential addition of other agents [start low and go slow, SLGS], free choice combination with multiple pills [FCC] and combination therapy in the form of a single pill [SPC]. Model inputs were derived from Global Burden of Disease 2017 dataset, including demographics, health status/risk factors, transition probabilities and treatment attributes/healthcare utilization, and the model incorporated real-world challenges to healthcare delivery such as access to care, SBP measurement error, adherence and therapeutic inertia. Simulated outcomes of mortality, incidence of chronic kidney disease (CKD), stroke and ischemic heart disease (IHD), and disability-adjusted life years (DALYs) due to these conditions were estimated for population of 1,000,000 simulated patients for each treatment pathway and country. Results SPC therapy was projected to improve health outcomes over SLGS, FCC and CTP over 10 years in all five countries. SPC was forecast to reduce mortality by 5.4% (Italy), 4.9% (Russia), 4.5% (China), 2.3% (South Korea) and 3.6% (Mexico) versus CTP and showed greater projected reductions in mortality than SLGS and FCC. DALYs were projected to be reduced with SPC therapy by between 5.7% (Italy) and 2.2% (South Korea) compared with CTP and reductions in the incidence of clinical events were also projected with SPC therapy, with decreases in the range of 11.5% (Italy) to 4.9% (South Korea) versus CTP. Conclusions Ten-year projections of clinical outcomes associated with different anti-hypertensive treatment pathways in five countries indicated that both combination therapies (FCC and SPC) are likely to reduce the disease burden of hypertension compared with conventional management approaches, with SPC showing the greatest overall benefits due to improved adherence. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Sanofi, Gentilly, France

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Artificial intelligence-guided image acquisition on patients with implanted electrophysiological devices: results from a pivotal prospective multi-center clinical trial

European Heart Journal ◽

10.1093/ehjci/ehaa946.0006 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

S Surette ◽

A Narang ◽

R Bae ◽

H Hong ◽

Y Thomas ◽

...

Keyword(s):

Qualitative Assessment ◽

Funding Source ◽

Software Performance ◽

Private Company ◽

Diagnostic Quality ◽

Icd Leads ◽

Significant Difference ◽

Level 3 ◽

And Function ◽

The Impact

Abstract Background A novel, recently FDA-authorized software uses deep learning (DL) to provide prescriptive transthoracic echocardiography (TTE) guidance, allowing novices to acquire standard TTE views. The DL model was trained by >5,000,000 observations of the impact of probe motion on image orientation/quality. This study evaluated whether novice-acquired TTE images guided by this software were of diagnostic quality in patients with and without implanted electrophysiological (EP) devices, focusing on RV size and function, which were thought to be sensitive to EP devices. Some aspects of the study have previously been presented. Methods 240 patients (61±16 years old, 58% male, 33% BMI >30 kg/m2, 91% with cardiac pathology) were recruited. 8 nurses without echo experience each acquired 10 view TTEs in 30 patients guided by the software. 235 of the patients were also scanned by a trained sonographer without assistance from the software. 5 Level 3 echocardiographers independently assessed the diagnostic quality of the TTEs acquired by the nurses and sonographers to evaluate the effect of EP devices on DL software performance. Results Nurses using the AI-guided acquisition software acquired TTEs of sufficient quality to make qualitative assessments of right ventricular (RV) size and function in greater than 80% of cases for patients with and without implanted EP devices (Table). There was no significant difference between nurse- and sonographer-acquired scans. Conclusion These results indicate that new DL software can guide novices to obtain TTEs that enable qualitative assessment of RV size even in the presence of implanted EP devices. The results of the comparison to sonographer-acquired exams indicate the software performance is robust to presence of pacemaker/ICD leads visible in the images (Figure). Nurse-acquired TTE with visible ICD lead Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Caption Health, Inc.

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Dohsa‐hou Relaxation Enhances Cardiac Parasympathetic Activity Assessed by Analysis of Heart Rate Variability

Japanese Psychological Research ◽

10.1111/jpr.12364 ◽

2021 ◽

Author(s):

Ryuji Kuwashima ◽

Masahito Sakakibara ◽

Yoshimi Yoshikawa

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Parasympathetic Activity ◽

Cardiac Parasympathetic Activity

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Liraglutide increases 24-h heart rate by reducing the cardiac parasympathetic activity of patients with type 2 diabetes: power spectral analysis of heart rate variability on 24-h Holter ECG recordings

Diabetology International ◽

10.1007/s13340-014-0170-2 ◽

2014 ◽

Vol 6 (1) ◽

pp. 26-32 ◽

Cited By ~ 2

Author(s):

Kenji Hara ◽

Yoshimasa Aso ◽

Takaaki Komatsu ◽

Takafumi Nakamachi ◽

Yoshihiko Sakai ◽

...

Keyword(s):

Type 2 Diabetes ◽

Heart Rate ◽

Heart Rate Variability ◽

Spectral Analysis ◽

Power Spectral Analysis ◽

Parasympathetic Activity ◽

Holter Ecg ◽

Power Spectral ◽

Cardiac Parasympathetic Activity

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Mindfulness meditation, well-being, and heart rate variability: A preliminary investigation into the impact of intensive Vipassana meditation

International Journal of Psychophysiology ◽

10.1016/j.ijpsycho.2013.06.017 ◽

2013 ◽

Vol 89 (3) ◽

pp. 305-313 ◽

Cited By ~ 122

Author(s):

Jonathan R. Krygier ◽

James A.J. Heathers ◽

Sara Shahrestani ◽

Maree Abbott ◽

James J. Gross ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Mindfulness Meditation ◽

Preliminary Investigation ◽

Well Being ◽

Vipassana Meditation ◽

The Impact

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THE IMPACT OF STRESS ON HEART RATE VARIABILITY OF ON-CALL PHYSICIANS

CHEST Journal ◽

10.1378/chest.128.4_meetingabstracts.277s-a ◽

2005 ◽

Vol 128 (4) ◽

pp. 277S

Author(s):

Stavros E. Mountantonakis ◽

Dimitrios A. Moutzouris ◽

Craig McPherson

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

The Impact

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Abstract P315: Increase in Stress May Contribute to Lower Heart Rate Variability in Healthy Young Subjects

Circulation ◽

10.1161/circ.125.suppl_10.ap315 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Amanda C Costa ◽

Ana Gabriela C Silva ◽

Cibele T Ribeiro ◽

Guilherme A Fregonezi ◽

Fernando A Dias

Keyword(s):

Cardiovascular Disease ◽

Heart Rate ◽

Heart Rate Variability ◽

Healthy Volunteers ◽

Perceived Stress ◽

Low Frequency ◽

Statistical Correlation ◽

Total Power ◽

The Impact ◽

Nonparametric Correlation

Background: Stress is one of the risk factors for cardiovascular disease and decreased heart rate variability is associated to increased mortality in some cardiac diseases. The aim of the study was to assess the impact of perceived stress on cardiac autonomic regulation in young healthy volunteers. Methods: 35 young healthy volunteers (19 to 29 years old, 6 men) from a Brazilian population were assessed for perceived stress by the translated and validated Perceived Stress Scale (PSS, 14 questions) and had the R-R intervals recorded at rest on supine position (POLAR RS800CX) and analyzed (5 minutes, Kubius HRV software) by Fast-Fourier Transform for quantification of Heart Rate Variability (HRV). Results: Average data (±SD) for age, heart rate, BMI, waist circumference and percentage of body fat (%BF) were: 21.3±2.7 years; 65.5±7.9 bpm; 22.3±1.9 Kg/m 2 ; 76.0±6.1 cm and 32.1±6.6%; respectively. The mean score for the PSS-14 was 23.5±7.2 and for the HRV parameter as follow: SSDN=54.8±21.2ms; rMSSD=55.9±32.2ms; low-frequency (LF)= 794.8±579.7ms 2 ; High-frequency (HF)= 1508.0±1783.0 ms 2 ; LF(n.u.)= 41.1±16.2; HF(n.u.)= 58.9±16.2; LF/HF=0.89±0.80 and Total power (TP)= 3151±2570ms 2 . Spearman nonparametric correlation was calculated and there was a significant correlation of PSS-14 scores and LF (ms 2 ) (r=−0.343; p= 0.044). Other HRV variables did not shown significant correlation but also had negative values for Spearman r (TP r=−0.265, p=0.124; HF r=−0.158; SSDN r=−0.207; rMSSD r=−0.243, p=0.160). LF/HF and LF(n.u.) did not correlate to PSS-14 having Spearman r very close to zero (LF/HF r=−0.007, p=0.969; LF(n.u.) r=−0.005, p=0.976). No correlation was found for HRV parameters and BMI and there was a trend for statistical correlation of %BF and LF (ms 2 ) (r=−0.309, p=0.071). Conclusions: These data demonstrate a possible association of perceived stress level and HRV at rest. Changes in LF can be a consequence of both sympathetic and parasympathetic activity, however, analyzing the other variables HF, TP, SSDN and rMSSD (all negative Spearman r) and due to the lack of changes in LF/HF ratio and LF(n.u.) we interpret that increased stress may be associated to decrease in overall heart rate variability. These changes were seen in healthy individuals and may point out an important mechanism in cardiovascular disease development.

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