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

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.

Clinical characterization of dysautonomia in long COVID-19 patients

“…Characteristics of the participants were described in Table 1. Median average for age was 48 [12] years for patients with long COVID-19 with fatigue, 39 [10] years for patients with long COVID-19 without fatigue and 43 [9] years for the control group. Few patients of our study group presented comorbidities, only 3 patients with hypertension for long COVID-19 groups and one patient for control group, and only one patient with diabetes in long COVID-19 groups.…”

“…HRV is mainly related to emotional, social, cognitive and health levels 11 . HRV is the main marker of the modulation of the sympathetic and parasympathetic branches of the ANS, and thus, of dysautonomia 12 . The low-frequency band reflects the modulation of sympathetic and parasympathetic branches on the heart 13 and has been considered as an index of the sympathovagal imbalance 14 .…”

Dysautonomia in post-COVID-19 patients: new insights

“…We observed that HRV, reflected by the NOL index, was significant different in post-COVID-19 participants with fatigue compared to control participants. HRV is one of the main marker of dysautonomia 12 . Some etiologies may explain dysautonomia in post-COVID-19 patients including hypoxia, neurotropism and inflammation.…”

Disturbances of Autonomic Regulation of Cardiovascular System at Different Working Regimes with Night Shifts

“…Ранее выполненные исследования свидетельствуют об информативности показателей состояния ВНС в определении дизрегуляционной патологии, которые получают посредством анализа ВРС. Определено, что у работающих с ночными сменами регистрируются изменения временных и спектральных показателей ВРС в покое [24,29,30], которые объясняют комплексным влиянием измененной циркадной ритмичности, изменениями времени и продолжительности сна [9,29,[31][32][33]. В нашем исследовании получены данные, подтверждающие статистически значимые изменения основных показателей у работников этой категории, которые выражаются в снижении общей мощности регуляции (ТР, SDNN) и парасимпатического звена (HF, pNN50).…”

“…Так, в мета-анализе J. Swai и соавт. [33], в котором объединены результаты 20 исследований ВРС с ортостатической пробой, включивших 717 пациентов с синдромом постуральной ортостатической тахикардии и 641 здорового участника, анализировали возраст, коморбидные состояния и другие факторы, потенциально связанные с изменениями ВРС, но не фактор сменной ночной работы. В исследовании N. M. Monteze и соавт.…”