Heart Rate Variability and Heart Rate Recovery as prognostic factors

Abstract

Background and aimHeart rate (HR) can appear static and regular at rest, during exercise or recovery after exercise. However, HR is constantly adjusted due to factors such as breathing, blood pressure control, thermoregulation and the renin-angiotensin system, leading to a more dynamic response that can be quantified using HRV (heart rate variability). HRV is defined as the deviation in time between successive normal heart beat and is a noninvasive method to measure the total variation in a number of HR interval. HRV can serve as measure of autonomic activity of sino-atrial node. The aim of the study was to determine the influence of certain clinical and paraclinical parameters on heart rate recovery after exercise in patients with ischemic heart disease and the relation with HRV using 24 h Holter monitoring.MethodsThe study included 46 patients who were submitted to cardiovascular exercise stress test and also to 24 h Holter EKG monitoring. Subjects had a mean age of 56.2±11.2 years, with a minimum of 25 and a maximum of 79 years. The study included 22 (47.8%) men and 24 (52.2%) women. Statistical analysis was performed using MedCalc software version 14.8.1. Multivariate analysis consisted of the construction of several multiple linear regression models. A p value of 0.05 was considered statistically significant.ResultsThe HRV values (time domain) were all lower in the IHD compared with the group without coronary heart disease, even if the difference is not statistically significant. Also rest and maximal HR values were similar but during the test varies in the sense that those with IHD had higher values of rest and maximal HR and lower HRR, but not statistically significant.ConclusionsHRV is a very easy and safe method if there is an available device and it is used for evaluation of the autonomic nervous system in many cardiovascular diseases, but also in other pathologies.In uncomplicated ischemic heart disease HRV is depressed, but not significant. HRR, which is also considered an indicator of the parasympathetic activity after exercise termination, is also non-significantlly decreased in ischemic patients and the correlation between them is weak. Both HRV and HRR parameters can be easily measured, but the best algorithm of this issue requires further studies, conducted in larger patient populations. Although HRR and HRV are tools to measure the autonomic nervous system activity the relation between them need more studies to be able to quantify the arrhythmogenic risk.

Influence of waterpipe smoking on cardiac autonomic function at rest and following high-intensity anaerobic exercise

“…Depressed HRV has been established as a powerful independent predictor of increased mortality following myocardial infarction and signifies a shift in sympathovagal balance towards sympathetic predominance and decreased vagal activity (Middlekauff, Park, & Moheimani, 2014). Likewise, heart rate recovery (HRR) after exercise has become a valuable, non-invasive procedure to assess cardiac parasympathetic reactivation with a small HRR indicating poor reactivation and greater risk of future cardiovascular mortality and morbidity (Grad, 2015). Monitoring of HRV and HRR may therefore provide a simple, non-invasive indication of cardiac autonomic activity to assist in identification of normal and abnormal cardiac function and subsequent health status (Currie, Rosen, Millar, McKelvie, & MacDonald, 2013).…”

"Stress Level of Critical Care Nurses: Evaluation by Heart Rate Variability"

“…It is known that the autonomic nervous system (ANS) makes tonic and reflexively influence on blood pressure, peripheral resistance and cardiac output through the parasympathetic and sympathetic nerves that innervate the heart, promoting acceleration (nice influence) or decrease (parasympathetic influence) of cardiovascular activity [17,18,20,21]. Studies say that one of the most affordable and reliable sources of information of the effects of the ANS on the cardiovascular system is HRV, which is represented by the oscillations of the intervals between successive heartbeats, called R-R intervals [20][21][22]. Thus, the HRV has been studied as a non-invasive to evaluate the stress level for its relationship with cardiac autonomous regulation [23][24][25][26][27][28].…”

Physiological Characteristics and Reserves of the Cardiovascular System in Professional Female Athletes During the Pre-Involution Period

“…Для обработки КИГ применяли статистический анализ следующих показателей: частота сердечных сокращений (ЧСС, уд/мин); SDNN -стандартное отклонение средних значений NN интервалов; квад-ратный корень из суммы разностей последовательного ряда кардиоинтервалов (RMSSD, мс); число пар кардиоинтервалов с разностью более 50 мс в % к общему числу кардиоинтервалов в массиве (pNN50, n). Также анализ ВСР проводили путем построения гистограмм распределения R-R-интервалов и определения показателей: моды (Мо) -наиболее часто встречающееся значение R-R (мс), амплитуды моды (АМо) -количество R-R, соответствующих значению моды (n), расчета индекса напряжения регуляторных систем (ИН) [10,11]. Спектральный анализ волновой структуры ритма сердца применяли для определения мощности и соотношения трех видов волн различной частотной характеристики: с высокочастотными колебаниями (HF) в границах от 0,15 до 0,4 Гц, низкочастотными колебаниями (LF) в границах от 0,04 до 0,15 Гц и колебаниями очень низкой частоты (VLF) в границах от 0 до 0,04 Гц.…”

“…В частности, у спортсменок данного возрастного диапазона в in vitro тесте OVUPLAN LUX был установлен отрицательный результат в 72 % случаях, что свидетельствовало о преимущественно ановуляторном характере менструального цикла. Также у спортсменок 37-45 лет регистрировали уровень ФСГ на 2-3-й день менструации -25,4 ± 1,42 мМЕ/мл и содержание ЛГ в межменструальный период -70, 9 ± 4, Оценка вегетативной регуляции спортсменок в исходном состоянии, проведенная путем статистического анализа ВСР, показала, что величина SDАNN, характеризующая уровень интегральной нейрогуморальной регуляторной активности, в диапазоне 37-45 лет была сравнительно низкой, что говорит о тенденции снижения регуляторных резервов [11]. При этом достоверное снижение SDАNN до значений 36,8 ± 2,09 (р < 0,01) определено в период с 13-го по 16-й день.…”