Short- and long-term reproducibility of autonomic measures in supine and standing positions

Abstract

Autonomic nervous tests and heart rate variability (HRV) have been used to assess cardiac autonomic function and to evaluate long-term prognosis. The aim of this study was to evaluate the short- and long-term reproducibility of HRV parameters and autonomic nervous tests according to body position (supine or standing). The study group consisted of 26 healthy subjects. Autonomic nervous tests and HRV were performed twice during the day and the results were averaged. The protocol was then repeated 3 days after each examination and also after 6 and 24 months. Autonomic nervous tests included deep breathing, Valsalva manoeuvre and isometric muscle exercise (handgrip), as well as blood pressure and heart rate in response to standing. ECG recordings were taken for 10 min during spontaneous breathing for HRV analysis. We found that the reproducibility of some parameters of the autonomic nervous test were independent of body position [E/I ratio (heart rate response to deep breathing)], whereas other parameters were dependent on body position (Valsalva manoeuvre and blood pressure response to sustained handgrip). In addition, within-day measurements of those parameters varied from non-reproducible (Valsalva ratio, handgrip and blood pressure response to standing) to moderately reproducible [E/I ratio and 30/15 ratio (heart rate response to standing)]. Among the HRV parameters, we found that total power (TP), low (LF)- and high (HF)-frequency were reproducible not only for measurements made within the same day, but also during short- and long-term observations, and only the LF/HF ratio was dependent on body position. We conclude that only a few autonomic nervous tests are reproducible in the short- and long-term. Because HRV parameters obtained during spontaneous respiration showed high reproducibility for measurements made within the same day as well as in the short- and long-term, they should be used instead of autonomic nervous tests when long-term observations are carried out in a healthy population.

Heart rate variability in the standing position reflects training adaptation in professional soccer players

“…Therefore, the training might have led to a heterogeneous group that included players well adapted and players with several fatigue patterns. As expected, HRV spectral analysis in the supine position did not provide additional information and remained unchanged despite a good reproducibility of this method over several weeks (Kowalewski and Urban 2004).…”

Reliability and accuracy of heart rate variability metrics versus ECG segment duration

“…Some studies concluded that their examined HRV metrics were reliable [2,5,8,13,14,18,19,25,29,31,34,35,39,41,50,55,58,59,60,61], while others found the reliability to be moderate or low [6,23,33,51,56,62]. This discrepancy of results may be due, in part, to the fact that these studies examined distinct subject populations, and their conclusions on HRV reliability apply only to the specific HRV metrics studied.…”

“…In general, the objective of previous works has been to assess the reproducibility of a subset of the HRV metrics used to study a specific patient population or condition of interest. These studies include research on the shortand long-term reproducibility of autonomic measures in supine and standing positions [31], reproducibility of HRV responses to graded lower body negative pressure [20,34], reliability of short-term HRV measures during exercise [3,28,30,62], reproducibility of measures of cardiovascular autonomic nervous function in middle age and elderly subjects [23], reproducibility of frequency domain HRV metrics before and after a standardized meal [18], HRV analysis reproducibility in the chronic phase of myocardial infarction [5], reproducibility of HRV from short-term recording during manoeuvres in normal subjects [9], stability of short recordings in time [54] and reproducibility of HRV metrics obtained from short-term sampling records [21,37]. In addition to the reproducibility of 24 h and 5 min records, assessing the reproducibility of HRV metrics calculated from very short records has significant practical importance [25], since it is not always possible to obtain 5 min records due to instrumentation constraints or study design [17].…”

Influence of peripheral arterial disease and supervised walking on heart rate variability

“…29,30 Linear and nonlinear HRV measures have previously been reported to be reproducible during short-term recordings of supine rest. 31,32 Walking capacity. Distance to the onset of claudication pain (ICD), maximal walking distance (MWD), and peak aerobic capacity (VO 2peak ) were recorded as previously described.…”