Stress and Heart Rate Variability: A Meta-Analysis and Review of the Literature

Abstract To date, there is no quantitative review examining the influence of heart rate variability biofeedback (HRV BFB) on the athlete population. Such an undertaking may provide valuable information on the autonomic and respiration responses of athletes when performing HRV BFB. Thus, purpose of this preliminary systematic review and meta-analysis on the effects of HRV BFB on HRV and respiration of athletes. Searches of Springerlink, SportDiscus, Web of Science, PROQUEST Academic Research Library, Google Scholar, and ScienceDirect were conducted for studies that met the following criteria: (1) experimental studies involving athletes that underwent randomized control trial; (2) availability of HRV BFB as a treatment compared with a control (CON)/placebo (PLA); (3) any pre and post HRV variable and/or breathing frequency as dependent variable/s; and, (4) peer-reviewed articles written in English. Four out of 660 studies involving 115 athletes (25 females and 90 males) ages 16–30 years old were assessed in this review. Preliminary findings suggest the promising ability of HRV BFB to improve respiratory mechanics in athlete population. More work is needed to determine the autonomic modulatory effect of HRV BFB in athletes.

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Heart rate variability as a strain indicator for psychological stress for emergency physicians during work and alert intervention: a systematic review

Journal of Occupational Medicine and Toxicology ◽

10.1186/s12995-021-00313-3 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Beatrice Thielmann ◽

Robert Pohl ◽

Irina Böckelmann

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Systematic Reviews ◽

Web Of Science ◽

Meta Analysis ◽

Emergency Physicians ◽

Inclusion Criteria ◽

Objective Monitoring ◽

Prisma Statement ◽

Health Studies

Abstract Background The workloads of emergency physicians are severe. The prevalence of burnout among emergency physicians is higher than with other physicians or compared to the general population. The analysis of heart rate variability (HRV) is a valid method for objective monitoring of workload. The aim of this paper is to systematically evaluate the literature on heart rate variability as an objective indicator for mental stress of emergency physicians. Methods A systematic literature review examining heart rate variability of emergency physicians in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement for reporting systematic reviews was performed. PubMed, Ovid, Cochrane Libary, Scopus, and Web of Science electronic databases were used. The methodological quality was evaluated by using a modified STARD for HRV. Results Two studies matched the inclusion criteria by using HRV between alert intervention and two other studies were considered that used HRV in other question areas. It showed an adaptation of HRV under stress. The studies were not comparable. Conclusions There is a need for occupational health studies that examine strains and stress of emergency physicians. The well-established parasympathetic mediated HRV parameters seem to be suitable parameters to objectify the stress.

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Heart Rate Variability Analyses in Parkinson’s Disease: A Systematic Review and Meta-Analysis

Brain Sciences ◽

10.3390/brainsci11080959 ◽

2021 ◽

Vol 11 (8) ◽

pp. 959

Author(s):

Konstantin G. Heimrich ◽

Thomas Lehmann ◽

Peter Schlattmann ◽

Tino Prell

Keyword(s):

Parkinson’S Disease ◽

Heart Rate ◽

Parkinson's Disease ◽

Heart Rate Variability ◽

Meta Analysis ◽

Cardiac Activity ◽

Heart Rate Variability Analysis ◽

Short Term ◽

Variability Analysis ◽

Parasympathetic Regulation

Recent evidence suggests that the vagus nerve and autonomic dysfunction play an important role in the pathogenesis of Parkinson’s disease. Using heart rate variability analysis, the autonomic modulation of cardiac activity can be investigated. This meta-analysis aims to assess if analysis of heart rate variability may indicate decreased parasympathetic tone in patients with Parkinson’s disease. The MEDLINE, EMBASE and Cochrane Central databases were searched on 31 December 2020. Studies were included if they: (1) were published in English, (2) analyzed idiopathic Parkinson’s disease and healthy adult controls, and (3) reported at least one frequency- or time-domain heart rate variability analysis parameter, which represents parasympathetic regulation. We included 47 studies with 2772 subjects. Random-effects meta-analyses revealed significantly decreased effect sizes in Parkinson patients for the high-frequency spectral component (HFms2) and the short-term measurement of the root mean square of successive normal-to-normal interval differences (RMSSD). However, heterogeneity was high, and there was evidence for publication bias regarding HFms2. There is some evidence that a more advanced disease leads to an impaired parasympathetic regulation. In conclusion, short-term measurement of RMSSD is a reliable parameter to assess parasympathetically impaired cardiac modulation in Parkinson patients. The measurement should be performed with a predefined respiratory rate.

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Effect of Acupuncture on Heart Rate Variability: A Systematic Review

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2014/819871 ◽

2014 ◽

Vol 2014 ◽

pp. 1-19 ◽

Cited By ~ 22

Author(s):

Joanne W. Y. Chung ◽

Vincent C. M. Yan ◽

Hongwei Zhang

Keyword(s):

Systematic Review ◽

Heart Rate ◽

Heart Rate Variability ◽

High Frequency ◽

Healthy Subjects ◽

Keyword Search ◽

Data Extraction ◽

Meta Analysis ◽

Low Frequency ◽

Control Group

Aim.To summarize all relevant trials and critically evaluate the effect of acupuncture on heart rate variability (HRV).Method.This was a systematic review with meta-analysis. Keyword search was conducted in 7 databases for randomized controlled trials (RCTs). Data extraction and risk of bias were done.Results.Fourteen included studies showed a decreasing effect of acupuncture on low frequency (LF) and low frequency to high frequency ratio (LF/HF ratio) of HRV for nonhealthy subjects and on normalized low frequency (LF norm) for healthy subjects. The overall effect was in favour of the sham/control group for high frequency (HF) in nonhealthy subjects and for normalized high frequency (HF norm) in healthy subjects. Significant decreasing effect on HF and LF/HF ratio of HRV when acupuncture was performed on ST36 among healthy subjects and PC6 among both healthy and nonhealthy subjects, respectively.Discussion.This study partially supports the possible effect of acupuncture in modulating the LF of HRV in both healthy and nonhealthy subjects, while previous review reported that acupuncture did not have any convincing effect on HRV in healthy subjects. More published work is needed in this area to determine if HRV can be an indicator of the therapeutic effect of acupuncture.

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The Accuracy of Acquiring Heart Rate Variability from Portable Devices: A Systematic Review and Meta-Analysis

Sports Medicine ◽

10.1007/s40279-019-01061-5 ◽

2019 ◽

Vol 49 (3) ◽

pp. 417-435 ◽

Cited By ~ 20

Author(s):

Ward C. Dobbs ◽

Michael V. Fedewa ◽

Hayley V. MacDonald ◽

Clifton J. Holmes ◽

Zackary S. Cicone ◽

...

Keyword(s):

Systematic Review ◽

Heart Rate ◽

Heart Rate Variability ◽

Meta Analysis ◽

Portable Devices

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A Review of Heart-Rate Variability and Evaluation

Perceptual and Motor Skills ◽

10.2466/pms.1978.47.1.95 ◽

1978 ◽

Vol 47 (1) ◽

pp. 95-105 ◽

Cited By ~ 5

Author(s):

J. Alan Burdick

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Review Of The Literature

A review of the literature concerning heart rate and various forms of heart-rate variability and studies of behavior associated with these variables has been presented. Emphasis has been placed on the apparent discrepancies and inconsistencies reported within the literature as well as major methodological differences which make the integration of the data presented by various researchers almost impossible.

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Does non-invasive vagus nerve stimulation affect heart rate variability? A living and interactive Bayesian meta-analysis

10.1101/2021.01.18.426704 ◽

2021 ◽

Cited By ~ 1

Author(s):

Vinzent Wolf ◽

Anne Kühnel ◽

Vanessa Teckentrup ◽

Julian Koenig ◽

Nils B. Kroemer

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Vagus Nerve ◽

Brain Stimulation ◽

Nerve Stimulation ◽

Vagus Nerve Stimulation ◽

Meta Analysis ◽

Current Evidence ◽

Beneficial Effects ◽

Non Invasive

AbstractNon-invasive brain stimulation techniques, such as transcutaneous auricular vagus nerve stimulation (taVNS), have considerable potential for clinical use. Beneficial effects of taVNS have been demonstrated on symptoms in patients with mental or neurological disorders as well as transdiagnostic dimensions, including mood and motivation. However, since taVNS research is still an emerging field, the underlying neurophysiological processes are not yet fully understood, and the replicability of findings on biomarkers of taVNS effects has been questioned. Here, we perform a living Bayesian random effects meta-analysis to synthesize the current evidence concerning the effects of taVNS on heart rate variability (HRV), a candidate biomarker that has, so far, received most attention in the field. To keep the synthesis of evidence transparent and up to date as new studies are being published, we developed a Shiny web app that regularly incorporates new results and enables users to modify study selection criteria to evaluate the robustness of the inference across potential confounds. Our analysis focuses on 17 single-blind studies comparing taVNS versus sham in healthy participants. These newly synthesized results provide strong evidence for the null hypothesis (g = 0.011, CIshortest = [−0.103, 0.125], BF01 = 25.587), indicating that acute taVNS does not alter HRV compared to sham. To conclude, based on a synthesis of the available evidence to date, there is no support for the hypothesis that HRV is a robust biomarker for acute taVNS. By increasing transparency and timeliness, we believe that the concept of living meta-analyses can lead to transformational benefits in emerging fields such as non-invasive brain stimulation.

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Heart rate variability in individuals with Down syndrome – A systematic review and meta-analysis

Autonomic Neuroscience ◽

10.1016/j.autneu.2018.05.006 ◽

2018 ◽

Vol 213 ◽

pp. 23-33 ◽

Cited By ~ 9

Author(s):

Tatiana Dias de Carvalho ◽

Thais Massetti ◽

Talita Dias da Silva ◽

Tânia Brusque Crocetta ◽

Regiani Guarnieri ◽

...

Keyword(s):

Systematic Review ◽

Heart Rate ◽

Heart Rate Variability ◽

Down Syndrome ◽

Meta Analysis

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P991Predicting arrhythmic risk in dilated cardiomyopathy: a systematic review & meta-analysis of clinical parameters

European Heart Journal ◽

10.1093/eurheartj/ehz747.0584 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

A Sammani ◽

E Kayvanpour ◽

L P Bosman ◽

F Sedaghat-Hamedani ◽

T Proctor ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

High Risk ◽

Dilated Cardiomyopathy ◽

Meta Analysis ◽

Risk Of Bias ◽

Gadolinium Enhancement ◽

T Wave ◽

History Of ◽

T Wave Alternans

Abstract Background Patients with non-ischemic dilated cardiomyopathy (NIDCM) are at increased risk of ventricular arrhythmias and sudden cardiac death (SCD). However, identifying patients at high risk for life-threatening ventricular arrhythmia (LTVA) who may benefit from an implantable cardioverter defibrillator (ICD) remains challenging. Methods We searched MEDLINE and EMBASE for prognostic studies describing predictors of LTVA (defined as sustained ventricular tachycardia (VT), haemodynamically unstable VT, ventricular fibrillation, (aborted) SCD or appropriate ICD intervention) in patients with NIDCM. We excluded articles with composite heart failure and arrhythmic endpoints but lacking (subgroup) analysis for LTVA. Study quality and risk of bias was assessed using the QUIPS-tool, and articles with high risk of bias in ≥2 areas were excluded from analysis. Univariable hazard ratios of reported predictors were pooled from the remaining studies in a meta-analysis using a random-effects model and presented with 95% confidence interval (CI). Results Out of 1996 unique citations, 51 studies were included comprising 9798 patients with 1493 arrhythmic events. 28 studies were pooled for meta-analysis (mean age 55±4.1 years, 72% male) with a mean follow-up of 3.7±1.9 years. Crude event rate was 4.3% (95% CI 4.02–4.57) per year. From our meta-analysis, hypertension (HR 1.95; CI [1.26–3.00]), history of out of hospital cardiac arrest or sustained VT (HR 4.15; CI [1.32–13.02]), T-wave alternans (HR 6.50; CI [2.46–17.14]), LVEDV per 10ml/m2 increase (HR 1.10; CI [1.10–1.10]), LVESV per 10ml/m2 increase (HR 1.10; CI [1.00–1.22]) and delayed gadolinium enhancement (HR 5.55; CI [4.02–7.67]) were significantly associated with LTVA (figure). The quality of evidence was moderate and there was significant heterogeneity (median i2 57%; IQR 76%) among studies. Additionally from data that could not be pooled, decreased LVEF, history of nsVT and decreased heart rate variability were significantly associated with LTVA. Summary of meta-analysis results Conclusion The risk of LTVA in NIDCM is 4.3% per year and is considerably higher in patients with hypertension, history of LTVA, decreased LVEF, high LVEDV, high LVESV, T-wave alternans, history of nsVT, decreased heart rate variability and delayed gadolinium enhancement. These results may help determine appropriate candidates for ICD implantation. The high heterogeneity in reported results indicate the need for future multicentre studies to further improve risk stratification in NIDCM. Acknowledgement/Funding ERA-CVD JTC2016: DETECTIN-HF, 680969 & Dutch Heart Foundation (2016T096)

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