Nocturnal Difference in the Ultra Low Frequency Band of Heart Rate Variability in Patients Stratified by Kampo Medicine Prescription

Kainuma, Mosaburo; Furusyo, Norihiro; Ando, Shin Ichi; Mukae, Haru; Ogawa, Eiichi; Toyoda, Kazuhiro; Murata, Masayuki; Hayashi, Jun

doi:10.1253/circj.cj-14-0362

Cited by 5 publications

(2 citation statements)

References 19 publications

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“…Previous studies have shown that time domain indices of HRV are useful measures of the changes in HR over time or the intervals between successive normal cardiac cycles, and they reflect alterations in autonomic tone that are predominantly vagally mediated (Young and Benton, 2018). The ULF and VLF component was proposed as an auxiliary marker for sympathetic modulation (Kainuma et al, 2014). The interpretation of the LF component is controversial.…”

Section: Discussionmentioning

confidence: 99%

Heart Rate Variability Predicts Therapeutic Response to Metoprolol in Children With Postural Tachycardia Syndrome

et al. 2019

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PurposeTo improve the metoprolol therapeutic effectiveness, we aimed to explore whether baseline heart rate variability (HRV) indicators before metoprolol treatment were useful for predicting its efficacy for postural tachycardia syndrome (POTS).MethodsWe recruited 45 children with POTS who received metoprolol and 17 healthy controls. All children underwent a standing test or basic head-up tilt test and 24-h dynamic electrocardiography before treatment. After 3 months of metoprolol, therapeutic responsiveness was evaluated. The usefulness of baseline HRV parameters in predicting the effectiveness of metoprolol was studied and the long-term cumulative symptom rate was analyzed.ResultsThe baseline HRV frequency domain indicators for power, ultra-low frequency, very-low frequency, low frequency (LF), high frequency (HF), and total power (TP) as well as time domain indicators were significantly lower for responders than non-responders to metoprolol; however, low-frequency normalized units and LF/HF ratio were markedly greater for responders than non-responders. On series-parallel analysis, combined baseline triangular (TR) index ≤ 33.7 and standard deviation of all normal-to-normal intervals (SDNN) index ≤ 79.0 ms as cut-off values yielded sensitivity, specificity and accuracy of 85.3, 81.8, and 84.4%, respectively, to predict therapeutic responsiveness to metoprolol. On long-term follow-up, the cumulative symptom rate was significantly higher with TR index > 33.7 and SDNN index ≤ 79.0 ms, TR index ≤ 33.7 and SDNN index > 79.0 ms or TR index > 33.7 and SDNN index > 79.0 ms than TR index ≤ 33.7 and SDNN index ≤ 79.0 ms (P < 0.05).ConclusionCombined TR index ≤ 33.7 and SDNN index ≤ 79.0 ms were useful preliminary measures to predict therapeutic response to metoprolol in pediatric POTS.

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Section: Discussionmentioning

confidence: 99%