Long-term parameters of heart rate variability in patients with insulin-resistance

Novo, Giuseppina; Manno, Girolamo; Levantino, Piero; Evola, Vincenzo; GiustinaVitale,; Evola, Salvatore; Luparelli, Mirko; Novo, Salvatore

doi:10.2459/jcm.0000000000000798

Cited by 3 publications

(1 citation statement)

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“…The results of the recently reported Armed Services Trauma Rehabilitation Outcome Study (ADVANCE) which examined the relative cardiovascular risk profiles of 579 injured versus 565 matched (age, sex, deployment) uninjured military personnel showed that the levels of high-sensitivity C-reactive protein (HS-CRP) were significantly greater among those with TI [ 26 ]. In the ADVANCE study it was also observed that T1 injury was associated with higher resting HR, relative obesity, dyslipidaemia, and insulin resistance among the injured [ 30 ]- which are all reported to be inversely related to HRV [ 55 , 56 ]. Another plausible mechanism to explain the lower HRV with TI may be related to the higher burden of depression, anxiety, and PTSD which are all known to reduce HRV [ 57 ].…”

Section: Discussionmentioning

confidence: 99%

Association between non-acute Traumatic Injury (TI) and Heart Rate Variability (HRV) in adults: A systematic review and meta-analysis

et al. 2023

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Heart rate variability (HRV) is a non-invasive measure of autonomic function. The relationship between unselected long-term traumatic injury (TI) and HRV has not been investigated. This systematic review examines the impact of non-acute TI (>7 days post-injury) on standard HRV indices in adults. Four electronic databases (CINAHL, Medline, Scopus, and Web of Science) were searched. The quality of studies, risk of bias (RoB), and quality of evidence (QoE) were assessed using Axis, RoBANS and GRADE, respectively. Using the random-effects model, mean difference (MD) for root mean square of successive differences (RMSSD) and standard deviation of NN-intervals (SDNN), and standardized mean difference (SMD) for Low-frequency (LF): High-Frequency (HF) were pooled in RevMan guided by the heterogeneity score (I2). 2152 records were screened followed by full-text retrieval of 72 studies. 31 studies were assessed on the inclusion and exclusion criteria. Only four studies met the inclusion criteria. Three studies demonstrated a high RoB (mean RoBANS score 14.5±3.31) with a low QoE. TI was associated with a significantly higher resting heart rate. Meta-analysis of three cross-sectional studies demonstrated a statistically significant reduction in RMSSD (MD -8.45ms, 95%CI-12.78, -4.12, p<0.0001) and SDNN (MD -9.93ms, 95%CI-14.82, -5.03, p<0.0001) (low QoE) in participants with TI relative to the uninjured control. The pooled analysis of four studies showed a higher LF: HF ratio among injured versus uninjured (SMD 0.20, 95%CI 0.01–0.39, p<0.04) (very low QoE). Albeit low QoE, non-acute TI is associated with attenuated HRV indicating autonomic imbalance. The findings might explain greater cardiovascular risk following TI. Trial registration PROSPERO registration number: CRD: CRD42021298530.

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