A snoring classifier based on heart rate variability analysis

The effect of snoring on the cardiovascular system is not well-known. In this study we analyzed the Heart Rate Variability (HRV) differences between light and heavy snorers. The experiments are done on the full-whole-night polysomnography (PSG) with ECG and audio channels from patient group (heavy snorer) and control group (light snorer), which are gender- and age-paired, totally 30 subjects. A feature Snoring Density (SND) of audio signal as classification criterion and HRV features are computed. Mann-Whitney statistical test and Support Vector Machine (SVM) classification are done to see the correlation. The result of this study shows that snoring has close impact on the HRV features. This result can provide a deeper insight into the physiological understand of snoring. © 2011 CCAL.

Sensitivity, specificity and predictive values of linear and nonlinear indices of heart rate variability in stable angina patients

Background: Decreased heart rate variability (HRV) is related to higher morbidity and mortality. In this study we evaluated the linear and nonlinear indices of the HRV in stable angina patients submitted to coronary angiography. Methods. We studied 77 unselected patients for elective coronary angiography, which were divided into two groups: coronary artery disease (CAD) and non-CAD groups. For analysis of HRV indices, HRV was recorded beat by beat with the volunteers in the supine position for 40 minutes. We analyzed the linear indices in the time (SDNN [standard deviation of normal to normal], NN50 [total number of adjacent RR intervals with a difference of duration greater than 50ms] and RMSSD [root-mean square of differences]) and frequency domains ultra-low frequency (ULF) ≤ 0,003 Hz, very low frequency (VLF) 0,003 - 0,04 Hz, low frequency (LF) (0.04-0.15 Hz), and high frequency (HF) (0.15-0.40 Hz) as well as the ratio between LF and HF components (LF/HF). In relation to the nonlinear indices we evaluated SD1, SD2, SD1/SD2, approximate entropy (-ApEn), α1, α2, Lyapunov Exponent, Hurst Exponent, autocorrelation and dimension correlation. The definition of the cutoff point of the variables for predictive tests was obtained by the Receiver Operating Characteristic curve (ROC). The area under the ROC curve was calculated by the extended trapezoidal rule, assuming as relevant areas under the curve ≥ 0.650. Results: Coronary arterial disease patients presented reduced values of SDNN, RMSSD, NN50, HF, SD1, SD2 and -ApEn. HF ≤ 66 ms§ssup§2§esup§, RMSSD ≤ 23.9 ms, ApEn ≤-0.296 and NN50 ≤ 16 presented the best discriminatory power for the presence of significant coronary obstruction. Conclusion: We suggest the use of Heart Rate Variability Analysis in linear and nonlinear domains, for prognostic purposes in patients with stable angina pectoris, in view of their overall impairment. © 2012 Pivatelli et al.; licensee BioMed Central Ltd.

Heart rate variability in healthy adolescents at rest

Objective: to describe the cardiac autonomic function in healthy adolescents between 13 and 18 years old. Methods: data from 93 adolescents, of both sexes, were analyzed; they were divided into three groups according to age. Group A 13-14 years old (n=26), Group B 15-16 years old (n = 30) and Group C 17-18 years old (n = 17). The protocol consisted of raising the heart rate, beat by beat for twenty minutes of rest in supine position with spontaneous breathing. The cardiac autonomic behavior analysis was performed by the method of heart rate variability (HRV) through the indices of the Poincaré plot (SD1, SD2 and ratio SD1/SD2) and its qualitative analysis and indices in linear time domain (RMSSD and SDNN) and frequency (LFnu, HFnu and LF/HF). One-way ANOVA test or Kruskal-Wallis test was used for comparison between groups, with a significance level of 5%. Results: there was no significant difference in none of the indices compared the three groups. In addition,visual analysis of Poincaré plot has observed for all age groups large dispersion of RR intervals, indicating that these groups have good HRV. Conclusion: there were no changes in HRV in the different age groups analyzed, however the result allowed to establish a standard for each group that was studied, becomes an important tool for comparison of cardiac autonomic function between healthy and patients subjects or in different areas.

Auditory stimulation with music influences the geometric indices of heart rate variability in response to the postural change maneuver

It is poor in the literature the behavior of the geometric indices of heart rate variability (HRV) during the musical auditory stimulation. The objective is to investigate the acute effects of classic musical auditory stimulation on the geometric indexes of HRV in women in response to the postural change maneuver (PCM). We evaluated 11 healthy women between 18 and 25 years old. We analyzed the following indices: Triangular index, Triangular interpolation of RR intervals and Poincar plot (standard deviation of the instantaneous variability of the beat-to beat heart rate [SD1], standard deviation of long-term continuous RR interval variability and Ratio between the short - and long-term variations of RR intervals [SD1/SD2] ratio). HRV was recorded at seated rest for 10 min. The women quickly stood up from a seated position in up to 3 s and remained standing still for 15 min. HRV was recorded at the following periods: Rest, 0-5 min, 5-10 min and 10-15 min during standing. In the second protocol, the subject was exposed to auditory musical stimulation (Pachelbel-Canon in D) for 10 min at seated position before standing position. Shapiro-Wilk to verify normality of data and ANOVA for repeated measures followed by the Bonferroni test for parametric variables and Friedmans followed by the Dunns posttest for non-parametric distributions. In the first protocol, all indices were reduced at 10-15 min after the volunteers stood up. In the protocol musical auditory stimulation, the SD1 index was reduced at 5-10 min after the volunteers stood up compared with the music period. The SD1/SD2 ratio was decreased at control and music period compared with 5-10 min after the volunteers stood up. Musical auditory stimulation attenuates the cardiac autonomic responses to the PCM.

Influence of the resistance training on heart rate variability, functional capacity and muscle strength in the chronic obstructive pulmonary disease

Background. The chronic obstructive pulmonary disease (COPD) is associated with the strength and resistance decreasing in addition to the dysfunction on autonomic nervous system (ANS). The aerobic training isolated or in association with the resistance training showed evidence of beneficial effects on an autonomic modulation of COPD; however, there are no studies addressing the effect of isolated resistance training.Aims. This study aims at investigating the influence of resistance training on an autonomic modulation through heart rate variability (HRV), functional capacity and muscle strength in individuals with COPD.Design. Clinical series study.Setting. Outpatients.Population. The study involved 13 individuals with COPD.Methods. The experimental protocol was composed by an initial and final evaluation that consisted in autonomic evaluations (HRV), cardiopulmonary functional capacity evaluation (6-minute walk test) and strength evaluation (dynamometry) in addition by the resistance training performed by 24 sessions lasted 60 minutes each one and on a frequency of three times a week. The intensity was determined initially with 60% of one maximum repetition and was progressively increased in each five sessions until 80%.Results. The HRV temporal and spectral indexes analysis demonstrates improvement of autonomic modulation, with significant statistical increases to sympathetic and parasympathetic components of ANS representing by SDNN, LF and HF. In addition, it was observed significant statistical increases to shoulder abduction and. knee flexion strength and functional capacity.Conclusion. The exclusive resistance training performed was able to positively influence the autonomic modulation; in addition it promoted benefits on cardiorespiratory functional capacity and strength benefits in individuals with COPD.Clinical Rehabilitation Impact. This study could contribute to clinical and professionals researchers that act with COPD, even though the resistance component of pulmonary rehabilitation presents consensual benefits on several healthy indicators parameters. There is no evidence about the effects on HRV before. Moreover, this study showed, on clinical practice, the HRV uses as an ANS activity on sinus node evaluation and highlights further importance on scientific context.

Musical auditory stimulation at different intensities and its effects on the geometric indices of heart-rate variability

Introduction: Previous studies have shown that relaxation music increases the heart's parasympathetic modulation as well as reducing its sympathetic activity. However, what is lacking in the literature is information on the acute effects of different intensities of music on cardiac autonomic regulation. We aimed to evaluate the acute effects of baroque and heavy-metal music on cardiac autonomic regulation at different intensities. Method The study was performed in 16 healthy men aged between 18 and 25 years. The main outcomes were the geometric indices of heart-rate variability (HRV) [i.e. triangular index (RRtri); triangular interpolation of RR intervals (TINN) and Poincaré plot: SD1, SD2 and SD1/SD2 ratio]. First, HRV was recorded at rest for 10 min. The volunteers were then exposed to baroque or heavy-metal music for 5 min through an earphone; subjects were exposed to each song at three different sound levels (60–70, 70–80 and 80–90 decibels). After the first song, subjects remained at rest for 5 min before being exposed to the next song. The sequence of songs and sound intensity were randomised for each individual. Results Musical auditory stimulation with baroque music did not influence the geometric indices of HRV. The same was observed with heavy-metal musical auditory stimulation at the three sound-level ranges. Conclusion Musical auditory stimulation at different sound intensities did not influence the geometric indices of HRV in men.

Fractal scaling exponents of heart rate variability association with linear indices and Poincaré Plot

The literature indicated that the fractal analysis of heart rate variability (HRV) is related to the chaos theory. However, it is not clear if the both short and long-term fractal scaling exponents of HRV are reliable for short period analysis in women. We evaluated the association of the fractal exponents of HRV with the time and frequency domain and geometric indices of HRV. We evaluated 65 healthy women between 18 and 30 years old. HRV was analyzed with a minimal number of 256 RR intervals in the time (SDNN, RMSSD, NN50 and pNN50) and frequency (LF, HF and LF/HF ratio) domains, the geometric index were also analyzed (triangular indexRRtri, triangular interpolation of RR intervals-TINN and Poincaré plot-SD1, SD2 and SD1/SD2) as well as short and long-term fractal exponents (alpha-1 and alpha-2) of the detrended fluctuation analysis (DFA). No significant correlation was observed for alpha-2 exponent with all indices. There was significant correlation of the alpha-1 exponent with RMSSD, pNN50, SDNN/RMSSD, LF (nu), HF (nu and ms2 ), LF/HF ratio, SD1 and SD1/SD2 ratio. Our data does not indicate the alpha-2 exponent to be used for 256 RR intervals and we support the alpha-1 exponent to be used for HRV analysis in this condition.

Fractal dynamics of heart rate variability for short term

The fractal analysis of heart rate variability (HRV) has been associated to the chaos theory. We evaluated the association of the fractal exponents of HRV with the time and frequency domain and geometric indices of HRV for short period. HRV was analyzed with a minimal number of 256 RR intervals in the time (SDNN-standard deviation of normal-to-normal R-R intervals, pNN50-percentage of adjacent RR intervals with a difference of duration greater than 50ms and RMSSD-root-mean square of differences between adjacent normal RR intervals in a time interval) and frequency (LF-low frequency, HF-high frequency and LF/HF ratio) domains. The geometric indexes were also analyzed (RRtri-triangular index, TINN-triangular interpolation of RR intervals and Poincaré plot) as well as short and long-term fractal exponents (alpha-1 and alpha-2) of the detrended fluctuation analysis (DFA). We observed strong correlation of the alpha-1 exponent with RMSSD, pNN50, SDNN/RMSSD, LF (nu), HF (nu), LF/HF ratio, SD1 and SD1/Sd2 ratio. In conclusion, we suggest that the alpha-1 exponent could be applied for HRV analysis with a minimal number of 256 RR intervals.

Chronic obstructive pulmonary disease and heart rate variability: a literature update

Background: The literature indicates that chronic obstructive pulmonary disease (COPD) affects cardiac autonomic control. In this study, we conducted a literature review in order to investigate the heart rate variability (HRV) in COPD subjects. Methods: A search was performed in Medline database, using the link between the keywords: “autonomic nervous system”, “cardiovascular system”, “COPD” and “heart rate variability”. Results: The search resulted in a total of 40 references. Amongst these references, the first exclusion resulted in the barring of 29 titles and abstracts, which were not clearly related to the purpose of review. This resulted in a total of 11 articles that were then read and utilized in the review. The selected studies indicated that there is significant reduction of HRV in patients with COPD, characterized by reduction of indices that assess parasympathetic activity in addition to dealing with the global autonomic modulation. We also established that supervised exercise can reduce these harmful effects in COPD patients. Also, it was reported that the use of non-invasive ventilation in these patients may contribute to the improvement of respiratory symptoms, with no impairing, and may even induce positive responses in cardiac autonomic regulation. Conclusion: The studies indicate a need for further investigations to guide future therapies to improve the treatment of cardiovascular system in the respiratory diseases.

Auditory stimulation with music influences the geometric indices of heart rate variability in men

Background: Chronic classical music was reported to increase parasympathetic activitywhen evaluating heart rate variability (HRV). It is poor in the literature investigation of the acute effects of baroque and heavy metal styles of musical auditory stimulation on HRV. In this study we evaluated the acute effects of relaxant baroque and excitatory heavy metal music on the geometric indices of HRV in healthy men. Method: The study was performed in 12 healthy men between 18 and 30 years old. We excluded persons with previous experience with music instrument and those who had affinity with the song styles. We analyzed the following indices: RRtri, TINN and Poincaré plot (SD1, SD2 and SD1/SD2 ratio). HRV was recorded at rest for ten minutes. Subsequently they were exposed to relaxant baroque or excitatory heavy metal music for five minutes through an earphone. After the first music exposure they remained at rest for more five minutes and them they were exposed again to Baroque or Heavy Metal music (65–80 dB). The sequence of songs was randomized for each individual. Results: The RRTri and SD2 indices were reduced during the heavy metal musical auditory stimulation (p < 0.05). No changes were observed regarding TINN, SD1 and SD1/SD2 ratio (p > 0.05).The qualitative Poincaré plot analysis indicated that during relaxant classical baroque music there was observed a higher beat-to-beat dispersion of RR intervals compared with no music exposure and during excitatory heavy metal musical auditory stimulation, showing higher HRV. Conclusion: We suggest that excitatory heavy metal music acutely decreases global HRV.

Correlation between heart rate variability indexes and aerobic physiological variables in patients with COPD

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Comparison of Polar(®) RS800G3(™) heart rate monitor with Polar(®) S810i(™) and electrocardiogram to obtain the series of RR intervals and analysis of heart rate variability at rest

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Can geometric indices of heart rate variability predict improvement in autonomic modulation after resistance training in chronic obstructive pulmonary disease?

Chronic obstructive pulmonary disease (COPD) is associated with autonomic dysfunctions that can be evaluated through heart rate variability (HRV). Resistance training promotes improvement in autonomic modulation; however, studies that evaluate this scenario using geometric indices, which include nonlinear evaluation, thus providing more accurate information for physiological interpretation of HRV, are unknown. This study aimed to investigate the influence of resistance training on autonomic modulation, using geometric indices of HRV, and peripheral muscle strength in individuals with COPD. Fourteen volunteers with COPD were submitted to resistance training consisting of 24 sessions lasting 60 min each, with a frequency of three times a week. The intensity was determined as 60% of one maximum repetition and was progressively increased until 80% for the upper and lower limbs. The HRV and dynamometry were performed at two moments, the beginning and the end of the experimental protocol. Significant increases were observed in the RRtri (4·81 ± 1·60 versus 6·55 ± 2·69, P = 0·033), TINN (65·36 ± 35·49 versus 101·07 ± 63·34, P = 0·028), SD1 (7·48 ± 3·17 versus 11·04 ± 6·45, P = 0·038) and SD2 (22·30 ± 8·56 versus 32·92 ± 18·78, P = 0·022) indices after the resistance training. Visual analysis of the Poincare plot demonstrated greater dispersion beat-to-beat and in the long-term interval between consecutive heart beats. Regarding muscle strength, there was a significant increase in the shoulder abduction and knee flexion. In conclusion, geometric indices of HRV can predict improvement in autonomic modulation after resistance training in individuals with COPD; improvement in peripheral muscle strength in patients with COPD was also observed.

Sensitivity, specificity and predictive values of linear and nonlinear indices of heart rate variability in stable angina patients

Abstract Background Decreased heart rate variability (HRV) is related to higher morbidity and mortality. In this study we evaluated the linear and nonlinear indices of the HRV in stable angina patients submitted to coronary angiography. Methods We studied 77 unselected patients for elective coronary angiography, which were divided into two groups: coronary artery disease (CAD) and non-CAD groups. For analysis of HRV indices, HRV was recorded beat by beat with the volunteers in the supine position for 40 minutes. We analyzed the linear indices in the time (SDNN [standard deviation of normal to normal], NN50 [total number of adjacent RR intervals with a difference of duration greater than 50ms] and RMSSD [root-mean square of differences]) and frequency domains ultra-low frequency (ULF) ≤ 0,003 Hz, very low frequency (VLF) 0,003 – 0,04 Hz, low frequency (LF) (0.04–0.15 Hz), and high frequency (HF) (0.15–0.40 Hz) as well as the ratio between LF and HF components (LF/HF). In relation to the nonlinear indices we evaluated SD1, SD2, SD1/SD2, approximate entropy (−ApEn), α1, α2, Lyapunov Exponent, Hurst Exponent, autocorrelation and dimension correlation. The definition of the cutoff point of the variables for predictive tests was obtained by the Receiver Operating Characteristic curve (ROC). The area under the ROC curve was calculated by the extended trapezoidal rule, assuming as relevant areas under the curve ≥ 0.650. Results Coronary arterial disease patients presented reduced values of SDNN, RMSSD, NN50, HF, SD1, SD2 and -ApEn. HF ≤ 66 ms2, RMSSD ≤ 23.9 ms, ApEn ≤−0.296 and NN50 ≤ 16 presented the best discriminatory power for the presence of significant coronary obstruction. Conclusion We suggest the use of Heart Rate Variability Analysis in linear and nonlinear domains, for prognostic purposes in patients with stable angina pectoris, in view of their overall impairment.

Heart rate variability and biomarkers of systemic inflammation in patients with stable coronary heart disease: findings from the Heart and Soul Study

Chronic low-grade systemic inflammation is a key component in atherogenesis. Decreased heart rate variability (HRV), a strong predictor of cardiovascular events, has been associated with elevations in circulating levels of C-reactive protein (CRP), interleukin (IL)-6, and fibrinogen in apparently healthy individuals. We investigated whether decreased HRV is associated with inflammatory markers in patients with coronary heart disease (CHD).