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

2019 ◽  
Author(s):  
Joel Dominic Swai ◽  
Zixuan Hu ◽  
Xiexiong Zhao ◽  
Tibera Rugambwa ◽  
Gui Ming

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.

2019 ◽  
Author(s):  
Joel Dominic Swai ◽  
Zixuan Hu ◽  
Xiexiong Zhao ◽  
Tibera Rugambwa ◽  
Gui Ming

Abstract Background: A number of published literature has reported that, physiologically, heart rate variability (HRV) in patients with postural orthostatic tachycardia syndrome (POTS) to be greatly confounded by age, sex, race, physical fitness, and circadian rhythm. The purpose of this study was to compare between POTS patients versus healthy participants, in terms of heart rate (HR) and HRV after Head-Up tilt test (HUTT), 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 POTS patients versus healthy patients, in terms of HR and HRV. HRV was grouped into Time and frequency domain outcome measurements. The time domain was measured as mean RR- interval and mean the square root of the mean of squares of successive R-R waves (rMSSD) in milliseconds. The 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 an overall outcome measure. Computer software, RevMan 5.3 was utilized, at a 95% significance level. Results: Twenty (20) eligible studies were found to report 717 POTS and 641 healthy participants. POTS group had a higher mean HR (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 a higher HR than healthy patients after HUTT and lower HRV in terms of time domain measure but not in terms of frequency domain measure. HR and time domain analyses of HRV are more reliable than frequency domain analysis in differentiating POTS patients from the healthy participants. We call upon sensitivity and specificity studies.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Joel Swai ◽  
Zixuan Hu ◽  
Xiexiong Zhao ◽  
Tibera Rugambwa ◽  
Gui Ming

Abstract Background A number of published literature has reported that, physiologically, heart rate variability (HRV) in patients with postural orthostatic tachycardia syndrome (POTS) to be greatly confounded by age, sex, race, physical fitness, and circadian rhythm. The purpose of this study was to compare between POTS patients versus healthy participants, in terms of heart rate (HR) and HRV after Head-Up tilt test (HUTT), 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 POTS patients versus healthy patients, in terms of HR and HRV. HRV was grouped into Time and frequency domain outcome measurements. The time domain was measured as mean RR- interval and mean the square root of the mean of squares of successive R-R waves (rMSSD) in milliseconds. The 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 an overall outcome measure. Computer software, RevMan 5.3 was utilized, at a 95% significance level. Results Twenty (20) eligible studies were found to report 717 POTS and 641 healthy participants. POTS group had a higher mean HR (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 a higher HR than healthy patients after HUTT and lower HRV in terms of time domain measure but not in terms of frequency domain measure. HR and time domain analyses of HRV are more reliable than frequency domain analysis in differentiating POTS patients from the healthy participants. We call upon sensitivity and specificity studies.


2019 ◽  
Author(s):  
Joel Dominic Swai ◽  
Zixuan Hu ◽  
Xiexiong Zhao ◽  
Tibera Rugambwa ◽  
Gui Ming

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.


Intrioution. The heart rate variability (HRV) is based on measuring (time) intervals between R-peaks (of RR-intervals) of an electrocardiogram (ECG) and plotting a rhythmogram on their basis with its subsequent analysis by various mathematical methods that are classified as Time Domain (TD), Frequency Domain (FD) and Nonlinear (NM) [1, 2]. Diversity of methods and approaches to analysis of HRV is stemming from complexity and nonlinearity of the phenomenon itself, as well as from greater diversity of physiological reactions of an organism, both in normal and pathological states. Therefore, it appears relevant and important to incorporate currently existing HRV indicators and norms into a unified Fuzzy Logic (FL) methodology, which in turn will allow to integrally assess each metric and HRV results as a whole. Objective. We propose a Fuzzy Logic algorithm for incorporating into a single view of each metric, – Time Domain, Frequency Domain, Nonlinear Methods and HRV as a whole. Materials and methods. We define by FL the extent of belonging to normal state both for each distinct HRV metric – TD, FD and NM, and for a patient's HRV in general. Membership functions of any HRV index and defuzzification rules for FL scores was defined. In order to implement the proposed algorithm, specified parameters of mean values of HRV (М) indicators and their standard deviation (σ) have been found in scientific publications on HRV [1, 3, 7, 8, 9, 10]. We use for FL algorithm demonstration a long-term HRV records by Massachusetts Institute of Technology - Boston’s Beth Israel Hospital (MIT-BIH) from [11], a free-access, on-line archive of physiological signals for Normal Sinus Rhythm (NSR) RR Interval, Congestive Heart Failure (CHF) RR Interval and Atrial Fibrillation (AF) Databases [12]. Conclusion. In this article, we have presented a comprehensive view of HRV by Fuzzy Logic technology and thoroughly examined the peculiarities of its application and interpretation. Of all considered examples of FL analysis, the worst result is demonstrated by a patient from the AF group, while the best one belongs to a patient from the NSR group. Difference in FL Scores between these patients from NSR and CHF groups is almost 4 times, while between patients from NSR and АF groups it is almost 6 times. It appears especially important to implement such a design in portable medical devices for quick and easy interpretation of numerous parameters measured by them.


2019 ◽  
Vol 10 ◽  
Author(s):  
Emma Karey ◽  
Shiyue Pan ◽  
Amber N. Morris ◽  
Donald A. Bruun ◽  
Pamela J. Lein ◽  
...  

Author(s):  
Chao Zeng ◽  
Wenjun Wang ◽  
Chaoyang Chen ◽  
Chaofei Zhang ◽  
Bo Cheng

The effects of fatigue on a driver’s autonomic nervous system (ANS) were investigated through heart rate variability (HRV) measures considering the difference of sex. Electrocardiogram (ECG) data from 18 drivers were recorded during a simulator-based driving experiment. Thirteen short-term HRV measures were extracted through time-domain and frequency-domain methods. First, differences in HRV measures related to mental state (alert or fatigued) were analyzed in all subjects. Then, sex-specific changes between alert and fatigued states were investigated. Finally, sex differences between alert and fatigued states were compared. For all subjects, ten measures showed significant differences (Mann-Whitney U test, p < 0.01) between different mental states. In male and female drivers, eight and four measures, respectively, showed significant differences between different mental states. Six measures showed significant differences between males and females in an alert state, while ten measures showed significant sex differences in a fatigued state. In conclusion, fatigue impacts drivers’ ANS activity, and this impact differs by sex; more differences exist between male and female drivers’ ANS activity in a fatigued state than in an alert state.


2022 ◽  
Vol 12 ◽  
Author(s):  
Chenbin Ma ◽  
Haoran Xu ◽  
Muyang Yan ◽  
Jie Huang ◽  
Wei Yan ◽  
...  

Background: The autonomic nervous system (ANS) is crucial for acclimatization. Investigating the responses of acute exposure to a hypoxic environment may provide some knowledge of the cardiopulmonary system’s adjustment mechanism.Objective: The present study investigates the longitudinal changes and recovery in heart rate variability (HRV) in a young healthy population when exposed to a simulated plateau environment.Methods: The study followed a strict experimental paradigm in which physiological signals were collected from 33 healthy college students (26 ± 2 years, 171 cm ± 7 cm, 64 ± 11 kg) using a medical-grade wearable device. The subjects were asked to sit in normoxic (approximately 101 kPa) and hypoxic (4,000 m above sea level, about 62 kPa) environments. The whole experimental process was divided into four stable resting measurement segments in chronological order to analyze the longitudinal changes of physical stress and recovery phases. Seventy-six time-domain, frequency-domain, and non-linear indicators characterizing rhythm variability were analyzed in the four groups.Results: Compared to normobaric normoxia, participants in hypobaric hypoxia had significantly lower HRV time-domain metrics, such as RMSSD, MeanNN, and MedianNN (p &lt; 0.01), substantially higher frequency domain metrics such as LF/HF ratio (p &lt; 0.05), significantly lower Poincaré plot parameters such as SD1/SD2 ratio and other Poincaré plot parameters are reduced considerably (p &lt; 0.01), and Refined Composite Multi-Scale Entropy (RCMSE) curves are reduced significantly (p &lt; 0.01).Conclusion: The present study shows that elevated heart rates, sympathetic activation, and reduced overall complexity were observed in healthy subjects exposed to a hypobaric and hypoxic environment. Moreover, the results indicated that Multiscale Entropy (MSE) analysis of RR interval series could characterize the degree of minor physiological changes. This novel index of HRV can better explain changes in the human ANS.


2006 ◽  
Vol 34 (3) ◽  
pp. 291-296 ◽  
Author(s):  
H Kudat ◽  
V Akkaya ◽  
AB Sozen ◽  
S Salman ◽  
S Demirel ◽  
...  

Diabetes mellitus can cause cardiovascular autonomic neuropathy and is associated with increased cardiovascular deaths. We investigated cardiovascular autonomic neuropathy in diabetics and healthy controls by analysis of heart rate variability. Thirty-one diabetics and 30 age- and sex-matched controls were included. In the time domain we measured the mean R-R interval (NN), the standard deviation of the R-R interval index (SDNN), the standard deviation of the 5-min R - R interval mean (SDANN), the root mean square of successive R - R interval differences (RMSSD) and the percentage of beats with a consecutive R - R interval difference > 50 ms (pNN50). In the frequency domain we measured high-frequency power (HF), low-frequency power (LF) and the LF/HF ratio. Diabetes patients had lower values for time-domain and frequency-domain parameters than controls. Most heart rate variability parameters were lower in diabetes patients with chronic complications than in those without chronic complications.


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