Influence of Basic Heart Rate and Sex on Heart Rate Turbulence in Healthy Subjects

Schwab, Jörg O.; Eichner, Gerrit; Veit, G.; Schmitt, H; Lewalter, Thorsten; Lüderitz, Berndt

doi:10.1111/j.1540-8159.2004.00695.x

Cited by 15 publications

(16 citation statements)

References 11 publications

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“…When we analysed only TO and TS we stated that there is no significant gender-related difference between women and men in these HRT parameters (TO: -0.6 ± 2.7 vs. -0.7 ± 2.4, p = NS and TS: 5.6 ± 5.6 vs. 6.4 ± 6.7 ms/RR interval, p = NS). Similar conclusions were presented in numerous previous studies in healthy and post-MI patients [4,3,12,[22][23][24][25]. Moreover, Schwab et al…”

Section: Discussionsupporting

confidence: 78%

“…Furthermore, the results of another study conducted by the same authors in healthy volunteers showed that there was no gender-related difference regarding TO or TS values. These authors reported that the abnormal TO was observed in 24% of the population (18% of women vs. 29% of men, p = 0.28), while the incidence of pathological TS was reported in 5% of patients (5% of women vs. 6% of men, p = 0.87) [12]. However, they confirmed that an increased heart rate before a ventricular premature contraction (VPC) was associated with a decreased TO (p < 0.0001), but again there was no significant difference between women and men (p = 0.28).…”

Section: Discussionmentioning

confidence: 99%

“…In many published studies, HRT was investigated only in terms of such parameters (as their combinations) as turbulence onset (TO) or turbulence slope (TS), and very little attention in the literature has been paid to evaluate turbulence timing (TT) [5,11,12].…”

Section: Introductionmentioning

confidence: 99%

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Gender-dependent profile of heart rate turbulence parameters in patients after acute myocardial infarction treated invasively

et al. 2016

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A b s t r a c t Background and aim:The aim of this study was to determine whether gender is related to differences in heart rate turbulence (HRT) parameters and the authors' own predefined HRT categories comprising turbulence timing (TT) in patients at the early stage of acute myocardial infarction (AMI) treated invasively. Methods:We analysed 489 consecutive patients (147 females and 342 males, aged 63.9 ± 11.7 years) with AMI admitted to our department and treated invasively on admission to the hospital. On the fifth day after MI 24-h digital Holter recordings were performed to assess HRT, and the following HRT parameters were calculated in all patients using the HRTView program: turbulence onset (TO, %), slope (TS, ms/RR interval), and TT. The following values of HRT parameters were considered abnormal: TO ≥ 0, TS ≤ 2.5, and TT ≥ 10. Based on the abovementioned parameters, the authors defined their own HRT categories (A, B, C): A -comprising three normal parameters, B -one abnormal parameter, C -three abnormal parameters. Results:TT was significantly later in women than in men: 7.5 ± 3.1 vs. 6.8 ± 3.1 (p < 0.05), respectively. When analysing the authors' own predefined HRT categories, significant differences between women and men were present in the occurrence of the category C, including all three abnormal HRT parameters: TO, TS, and TT. Conclusions:In women worse TT was present and all three abnormal HRT parameters occurred more frequently. HRT in women after AMI is profoundly altered compared to in men. This indicates greater autonomic dysfunction and higher risk for sudden cardiac death in women after AMI.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

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Gender-dependent profile of heart rate turbulence parameters in patients after acute myocardial infarction treated invasively

et al. 2016

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“…The reasons are caused by the different sample age and reported diseases. Moreover, Grimm et al (6) and Schwab et al (7) described an incidence of false positive results in healthy middle-aged subjects when Schmidt's criteria were used as a cut-off values (6,19). The incidence of 3% of abnormal results in our research is concordant with other population-based distribution indices, i.e.…”

supporting

confidence: 81%

Heart Rate Turbulence in Children—Age and Heart Rate Relationships

Kowalewski¹,

Adam

Bochen

et al. 2007

Pediatr Res

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Heart rate turbulence (HRT) is a chronotropic response of the sinus heart rhythm to ventricular premature beat (VPB). Children show decreasing heart rate together with the maturation of the autonomic nervous system. The aim of the research was to assess the relationship between HRT parameters, age, and heart rate and time domain heart rate variability (HRV) parameters in healthy children. Twenty-four-hour ECG Holter recording was performed on 398 healthy children. The mean RR interval preceding VPB, number of VPBs, and HRT parameters-turbulence onset (TO) and turbulence slope (TS)-were determined. We observed significant correlation among TS and mean RR and age. Children with prepubertal status have lower values of TS compared with those during puberty. According to given quartiles, upper for TO was Ն-0.8%, lower for TS was Յ4.56 ms/RR, 13 patients (3%) obtained abnormal both TO and TS. The correlations between HRT and HRV parameters were observed among the youngest children. Age and heart rate preceding VPB have no effect on HRT onset in children, whereas HRT slope is highly dependent on these variables. Our results support hypothesis that in older children HRT is dependent on autonomic tone and also determined by other intrinsic modulators. T he term "heart rate turbulence" (HRT) was first used by Schmidt et al. (1) and refers to changes in the sinus heart rhythm after ventricular premature beat (VPB). The response consists of a short phase of early heart rate acceleration followed by heart rate deceleration. HRT can be quantified by two parameters, turbulence onset (TO) and turbulence slope (TS), which are strong and independent markers of a sudden cardiac death risk in various patients' cohorts (1,2). The underlying mechanism of described parameters is connected with compensatory activation of baroreceptor reflex triggered by a decreased stroke volume following a VPB. The HRT response is believed to be under strong dependence on parasympathetic activity and heart rate preceding VPB (3). Recent studies have shown that HRT phenomenon can be used as an alternative measure of baroreflex sensitivity (4,5).A few studies demonstrate that in healthy subjects increasing age is associated with a decrease of HRT slope (6,7), likewise an increase in heart rate is relevant to TO decrease. However, there is a lack of information about heart rate turbulence behavior after VPB and the potential influence of age and pubertal status on healthy subjects within first two decades of life. Changes in basic heart rhythm during child's development are influenced by breathing frequency, sleeping periods and maturation of sympathetic and parasympathetic systems (8). We hypothesized that in such population age heart rhythm may significantly influence the heart rate turbulence parameters.The aim of this study was to determine the correlation among the HRT parameters, age, heart rate, heart rate variability (HRV) parameters and pubertal status in healthy children. MATERIALSAll the participants had a documented history of vent...

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“…HRT is reduced at a high heart rate (7,11,(63)(64)(65). The mechanisms responsible for heart rate modulation of HRT are not completely understood.…”

Section: Figure 3 Normal Post-ectopic Blood Pressure and R-r Intervalmentioning

confidence: 99%

Heart Rate Turbulence: Standards of Measurement, Physiological Interpretation, and Clinical Use

Bauer¹,

Malík

Schmidt³

et al. 2008

Journal of the American College of Cardiology

388

422

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This consensus statement has been compiled on behalf of the International Society for Holter and Noninvasive Electrophysiology. It reviews the topic of heart rate turbulence (HRT) and concentrates on technologies for measurement, physiologic background and interpretation, and clinical use of HRT. It also lists suggestions for future research. The phenomenon of HRT refers to sinus rhythm cycle-length perturbations after isolated premature ventricular complexes. The physiologic pattern of HRT consists of brief heart rate acceleration (quantified by the so-called turbulence onset) followed by more gradual heart rate deceleration (quantified by the so-called turbulence slope) before the rate returns to a pre-ectopic level. Available physiologic investigations confirm that the initial heart rate acceleration is triggered by transient vagal inhibition in response to the missed baroreflex afferent input caused by hemodynamically inefficient ventricular contraction. A sympathetically mediated overshoot of arterial pressure is responsible for the subsequent heart rate deceleration through vagal recruitment. Hence, the HRT pattern is blunted in patients with reduced baroreflex. The HRT pattern is influenced by a number of factors, provocations, treatments, and pathologies reviewed in this consensus. As HRT measurement provides an indirect assessment of baroreflex, it is useful in those clinical situations that benefit from baroreflex evaluation. The HRT evaluation has thus been found appropriate in risk stratification after acute myocardial infarction, risk prediction, and monitoring of disease progression in heart failure, as well as in several other pathologies.

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Influence of Basic Heart Rate and Sex on Heart Rate Turbulence in Healthy Subjects

Cited by 15 publications

References 11 publications

Gender-dependent profile of heart rate turbulence parameters in patients after acute myocardial infarction treated invasively

Gender-dependent profile of heart rate turbulence parameters in patients after acute myocardial infarction treated invasively

Heart Rate Turbulence in Children—Age and Heart Rate Relationships

Heart Rate Turbulence: Standards of Measurement, Physiological Interpretation, and Clinical Use

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