Heart Rate Asymmetry Analysis During Head-Up Tilt Test in Healthy Men

Abstract

The purpose of this study is to assess the cardiovascular system response to orthostatic stress in a group of 133 healthy men using heart rate asymmetry (HRA) methods. HRA is a feature of variability in human heart rate which is dependent upon external and internal body conditions. The initial phases of head-up tilt test (HUTT), namely, supine and tilt, were chosen as the external body affecting factors. Various calculation methods of HRA, such as Porta’s index (PI), Guzik’s index (GI), and its variance based components, were used to assess the heart rate variability (HRV) and its asymmetry. We compared 5-min ECG recordings from both supine and tilt phases of HUT test. Short-term HRA was observed in 54.1% of men in supine phase and 65.4% of men in tilt phase. The study revealed significant increase of GI (from 0.50 to 0.52, p < 0.001) in the tilt phase as well as significant changes in HRV descriptors between HUTT phases. Our results showed that the variability of human heart rate and its asymmetry are sensitive to orthostatic stress. The study of short-term HRA is a potential additional tool to increase sensitivity in conditions where HUTT is a diagnostic tool, such as vasovagal syncope.

Heart rate variability during head‐up tilt shows inter‐individual differences among healthy individuals of extreme Prakriti types

“…The SD1 reflects parasympathetic activity and SD2 reflects sympathetic modulation on the sinus node (Mourot et al, 2004 ; Shaffer & Ginsberg, 2017 ). Our result of a decrease in SD1 during tilt position is consistent with previous results (Karmakar et al, 2011 ; Pawłowski et al, 2021 ). Likewise, CSI represents the cardiac sympathetic activity which also increased in tilt position & CVI which represents cardiac parasympathetic activity decreased in the tilt position.…”

Autonomic response to early head‐up tilt in patients with severe traumatic brain injury: Analysis from a randomized feasibility trial

“…To the best of our knowledge, this is the first study to report on the autonomic response to an orthostatic challenge in the acute phase after TBI. The observed tilt‐induced reductions in SDNN, RMSDD, and total power in short‐term recordings corresponded qualitatively to those of the included group of healthy volunteers and those which have been previously reported in healthy individuals (Montano et al, 1994 ; Pawłowski et al, 2021 ; Piccirillo et al, 1995 ; Sharma et al, 2009 ; Stewart, 2000 ). The findings probably reflect increased sympathetic drive before and during the head‐up tilt.…”

An assessment of heart rate and blood pressure asymmetry in the diagnosis of vasovagal syncope in females

“…The observed property of HRV response to tilt in healthy women manifests as a change only between supine and tilt in beat-to-beat HRV, unlike in our previous study which was conducted on a larger group of healthy men where the changes of both beat-to-beat and slow HRV have been noted (Pawłowski et al, 2021). The increase of SD2 in HRV during the tilt phase only in males may be a signal of weaker adaptation to the upright position by the female cardiovascular system and explains why women are more affected by VVS than males (Alboni et al, 2021).…”

“…This result shows that the occurrence of HRA considered as a health indicator should be developed and applied to a larger group. The time spent by the subject in asymmetry is another factor that could have had an impact on this-it is possible to extract non-HRA heartbeat subsequence from longer ones which manifest asymmetrical tendencies (Piskorski et al, 2019;Pawłowski et al, 2021). The same consideration applies in the case of low occurrence of BPA in our study (36.8% in healthy females in supine) despite the independence of both phenomena (HRA and BPA) revealed by Guzik et al (2010b).…”