Poincaré plot indexes of heart rate variability: Relationships with other nonlinear variables

Hoshi, Rosângela Akemi; Pastre, Carlos Marcelo; Vanderlei, Luiz Carlos Marques; Godoy, Moacir Fernandes de

doi:10.1016/j.autneu.2013.05.004

Cited by 155 publications

(120 citation statements)

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“…For quantitative analysis of the plot an ellipse will be adjusted to the points of the graph where the indices SD1 and SD2 are obtained. SD1 is an instantaneous index of beat-to-beat variability and represents the parasympathetic modulation [24], while the SD2 Index represents the HRV in long-term records, and reflects the overall variability [24]. …”

Section: Methodsmentioning

confidence: 99%

Effects of massage as a recuperative technique on autonomic modulation of heart rate and cardiorespiratory parameters: a study protocol for a randomized clinical trial

Mantovani

Pizzo

Siqueira

et al. 2018

Trials

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BackgroundRecuperative techniques have been used to anticipate and potentiate recovery. The massage is one of the most widely used in sports. Among the ways to demonstrate the recovery of the organism is the resumption of autonomic modulation of heart rate, which can be analyzed in situations that cause disturbances in the behavior of the cardiovascular system with the objective of verifying the responsiveness of the autonomic nervous system (ANS). Recovery can be assessed through heart rate variability (HRV) which analyzes the oscillations in consecutive heartbeats, thus allowing an important non-invasive alternative for the study of modulation of the ANS. The objective of the study will be to measure the effects of massage as a recuperative technique on the autonomic modulation of heart rate and cardiorespiratory parameters at different moments of application.MethodsThis is a randomized, cross-over clinical trial. Forty men aged 18 to 30 years, healthy and physically active according to the International Physical Activity Questionnaire will participate in the study. Participants will be randomized into groups, which will perform the five interventions of the study at randomized moments, one intervention per session: Intervention 1: control; Intervention 2: participants will receive the massage protocol; Intervention 3: performance of the stress protocol; Intervention 4: participants will perform the stress protocol and immediately after receive the massage; Intervention 5: participants will perform the stress protocol and 1 h after conclusion of the protocol will receive the massage. The sessions will occur with an interval of 1 week between them and, due to the technique used, blinding participants and therapists is not possible. The primary outcome measure is HRV that will be measured 2 h after the conclusion of each intervention, and secondary outcome measures, which include heart rate, respiratory rate, blood pressure, oxygen saturation, and individual touch perception, will be measured at specific moments in the course of each intervention.DiscussionThe implementation and use of this standardized protocol should provide important and reliable information regarding the use of massage in post-exercise recovery, with the identification of its effects on the ANS and the best timing and form of massage application. The data obtained in the present study will provide subsidies for the best management of application of the technique in sports clinical practice, considering periods of training and, mainly, of competitions.Trial registrationClinicalTrials.gov, ID:NCT03094676. Pre-results. 12 March 2018.Electronic supplementary materialThe online version of this article (10.1186/s13063-018-2830-1) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Effects of massage as a recuperative technique on autonomic modulation of heart rate and cardiorespiratory parameters: a study protocol for a randomized clinical trial

Mantovani

Pizzo

Siqueira

et al. 2018

Trials

Self Cite

View full text Add to dashboard Cite

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“…Since the ANS is not a linear system, it has been argued that non-linear analysis would be informative for HRV (33) and nonlinear measures have also been proposed to be more accurate at predicting cardiac dysfunction, including ventricular tachycardia and sudden cardiac death (34, 35) when compared to traditional time and frequency domain analyses. Poincare analyses are commonly used as a nonlinear measures of HRV (36), including SD1, which represents a measure of rapid changes in R–R intervals. Because vagal effects on the sinus node are known to develop faster than sympathetically mediated effects, it is considered a parasympathetic index of sinus node control (37, 38).…”

Section: Methodsmentioning

confidence: 99%

Pilot Randomized Study of a Gratitude Journaling Intervention on Heart Rate Variability and Inflammatory Biomarkers in Patients With Stage B Heart Failure

et al. 2016

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Objective Stage B, asymptomatic heart failure (HF) presents a therapeutic window for attenuating disease progression and development of HF symptoms, and improving quality of life. Gratitude, the practice of appreciating positive life features, is highly related to quality of life, leading to development of promising clinical interventions. However, few gratitude studies have investigated objective measures of physical health; most relied on self-report measures. We conducted a pilot study in Stage B HF patients to examine whether gratitude journaling improved biomarkers related to HF prognosis. Methods Patients (N = 70; mean age = 66.2 years, SD = 7.6) were randomized to an 8-week gratitude journaling intervention or treatment as usual (TAU). Baseline (T1) assessments included 6-item Gratitude Questionnaire (GQ-6), resting heart rate variability (HRV), and an inflammatory biomarker index. At T2 (mid-intervention) GQ6 was measured. At T3 (post-intervention), T1 measures were repeated but also included a gratitude journaling task. Results The gratitude intervention was associated with improved trait gratitude scores (F = 6.0, p = .017, η2 = .10), reduced inflammatory biomarker index score over time (F = 9.7, p = .004, η2 = .21) and increased parasympathetic HRV responses during the gratitude journaling task (F = 4.2, p = .036, η2 = .15), compared with TAU. However, there were no resting pre- to post-intervention group differences in HRV (p's > .10). Conclusions Gratitude journaling may improve biomarkers related to HF morbidity, such as reduced inflammation; large-scale studies with active control conditions are needed to confirm these findings.

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“…23 Five time-domain parameters were computed from the PPIs: (1) the mean of the PPIs: representing the RR interval or the time interval between two consecutive R waves in the ECG, (2) the SD of PPIs: representing SDNN or the SD of the so-called normal-to-normal (NN) intervals, (3) the root mean square of the successive differences (RMSSD) between adjacent PPIs: representing RMSSD or the RMSSD between adjacent NN intervals and (4 and 5) two standard descriptors to evaluate non-linear short-term and long-term variability (SD1 and SD2) based on the Poincaré plot of PPIs. 24 For the frequency analysis, each segment of PPIs was resampled into an equivalent, uniformly spaced time series (sampling rate of 4 Hz), and the power spectral density was computed. The power in each frequency band was computed by integrating the area under the power spectral density curve bound by the band of interest: very low frequency (0.01-0.04 Hz), low frequency (LF; 0.04-0.15 Hz) and high frequency (HF; 0.15-0.4 Hz).…”

Section: Prv Characterisationmentioning

confidence: 99%

Respiratory rate and pulse oximetry derived information as predictors of hospital admission in young children in Bangladesh: a prospective observational study

et al. 2016

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ObjectiveHypoxaemia is a strong predictor of mortality in children. Early detection of deteriorating condition is vital to timely intervention. We hypothesise that measures of pulse oximetry dynamics may identify children requiring hospitalisation. Our aim was to develop a predictive tool using only objective data derived from pulse oximetry and observed respiratory rate to identify children at increased risk of hospital admission.SettingTertiary-level hospital emergency department in Bangladesh.ParticipantsChildren under 5 years (n=3374) presenting at the facility (October 2012–April 2013) without documented chronic diseases were recruited. 1-minute segments of pulse oximetry (photoplethysmogram (PPG), blood oxygen saturation (SpO2) and heart rate (HR)) and respiratory rate were collected with a mobile app.Primary outcomeThe need for hospitalisation based on expert physician review and follow-up.MethodsPulse rate variability (PRV) using pulse peak intervals of the PPG signal and features extracted from the SpO2 signal, all derived from pulse oximetry recordings, were studied. A univariate age-adjusted logistic regression was applied to evaluate differences between admitted and non-admitted children. A multivariate logistic regression model was developed using a stepwise selection of predictors and was internally validated using bootstrapping.ResultsChildren admitted to hospital showed significantly (p<0.01) decreased PRV and higher SpO2 variability compared to non-admitted children. The strongest predictors of hospitalisation were reduced PRV-power in the low frequency band (OR associated with a 0.01 unit increase, 0.93; 95% CI 0.89 to 0.98), greater time spent below an SpO2 of 98% and 94% (OR associated with 10 s increase, 1.4; 95% CI 1.3 to 1.4 and 1.5; 95% CI 1.4 to 1.6, respectively), high respiratory rate, high HR, low SpO2, young age and male sex. These variables provided a bootstrap-corrected AUC of the receiver operating characteristic of 0.76.ConclusionsObjective measurements, easily obtained using a mobile device in low-resource settings, can predict the need for hospitalisation. External validation will be required before clinical adoption.

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Poincaré plot indexes of heart rate variability: Relationships with other nonlinear variables

Cited by 155 publications

References 40 publications

Effects of massage as a recuperative technique on autonomic modulation of heart rate and cardiorespiratory parameters: a study protocol for a randomized clinical trial

Effects of massage as a recuperative technique on autonomic modulation of heart rate and cardiorespiratory parameters: a study protocol for a randomized clinical trial

Pilot Randomized Study of a Gratitude Journaling Intervention on Heart Rate Variability and Inflammatory Biomarkers in Patients With Stage B Heart Failure

Respiratory rate and pulse oximetry derived information as predictors of hospital admission in young children in Bangladesh: a prospective observational study

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