Phenomenological modeling of cell-to-cell and beat-to-beat variability in isolated Guinea Pig ventricular myocytes

Experimental action potential (AP) recordings in isolated ventricular myoctes display significant temporal beat-to-beat variability in morphology and duration. Furthermore, significant cell-to-cell differences in AP also exist even for isolated cells originating from the same region of the same heart. However, current mathematical models of ventricular AP fail to replicate the temporal and cell-to-cell variability in AP observed experimentally. In this study, we propose a novel mathematical framework for the development of phenomenological AP models capable of capturing cell-to-cell and temporal variabilty in cardiac APs. A novel stochastic phenomenological model of the AP is developed, based on the deterministic Bueno-Orovio/Fentonmodel. Experimental recordings of AP are fit to the model to produce AP models of individual cells from the apex and the base of the guinea-pig ventricles. Our results show that the phenomenological model is able to capture the considerable differences in AP recorded from isolated cells originating from the location. We demonstrate the closeness of fit to the available experimental data which may be achieved using a phenomenological model, and also demonstrate the ability of the stochastic form of the model to capture the observed beat-to-beat variablity in action potential duration.

Effect of nortriptyline and paroxetine on measures of chaos of heart rate time series in patients with panic disorder

Tricyclic antidepressants have notable cardiac side effects, and this issue has become important due to the recent reports of increased cardiovascular mortality in patients with depression and anxiety. Several previous studies indicate that serotonin reuptake inhibitors (SRIs) do not appear to have such adverse effects. Apart from the effects of these drugs on routine 12-lead ECG, the effects on beat-to-beat heart rate (HR) and QT interval time series provide more information on the side effects related to cardiac autonomic function. In this study, we evaluated the effects of two antidepressants, nortriptyline (n = 13), a tricyclic, and paroxetine (n = 16), an SRI inhibitor, on HR variability in patients with panic disorder, using a measure of chaos, the largest Lyapunov exponent (LLE) using pre- and posttreatment HR time series. Our results show that nortriptyline is associated with a decrease in LLE of high frequency (HF: 0.15-0.5 Hz) filtered series, which is most likely due to its anticholinergic effect, while paroxetine had no such effect. Paroxetine significantly decreased sympathovagal ratios as measured by a decrease in LLE of LF/HF. These results suggest that paroxetine appears to be safer in regards to cardiovascular effects compared to nortriptyline in this group of patients. (C) 2003 Elsevier Inc. All rights reserved.

The autonomic control and functional significance of the changes in heart rate associated with air breathing in the jeju, Hoplerythrinus unitaeniatus

The jeju is a teleost fish with bimodal respiration that utilizes a modified swim bladder as an air-breathing organ (ABO). Like all air-breathing fish studied to date, jeju exhibit pronounced changes in heart rate (f(H)) during air-breathing events, and it is believed that these may facilitate oxygen uptake (M-O2) from the ABO. The current study employed power spectral analysis (PSA) of f(H) patterns, coupled with instantaneous respirometry, to investigate the autonomic control of these phenomena and their functional significance for the efficacy of air breathing. The jeju obtained less than 5% of total M-O2 (M-tO2) from air breathing in normoxia at 26 degrees C, and PSA of beat-to-beat variability in fH revealed a pattern similar to that of unimodal water-breathing fish. In deep aquatic hypoxia (water P-O2=1 kPa) the jeju increased the frequency of air breathing (f(AB)) tenfold and maintained M-tO2 unchanged from normoxia. This was associated with a significant increase in heart rate variability (HRV), each air breath (AB) being preceded by a brief bradycardia and then followed by a brief tachycardia. These f(H) changes are qualitatively similar to those associated with breathing in unimodal air-breathing vertebrates. Within 20 heartbeats after the AB, however, a beat-to-beat variability in f(H) typical of water-breathing fish was re-established. Pharmacological blockade revealed that both adrenergic and cholinergic tone increased simultaneously prior to each AB, and then decreased after it. However, modulation of inhibitory cholinergic tone was responsible for the major proportion of HRV, including the precise beat-to-beat modulation of f(H) around each AB. Pharmacological blockade of all variations in f(H) associated with air breathing in deep hypoxia did not, however, have a significant effect upon f(AB) or the regulation of M-tO2. Thus, the functional significance of the profound HRV during air breathing remains a mystery.

Fractal correlation of heart rate variability in obese children

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

Influence of pursed-lip breathing on heart rate variability and cardiorespiratory parameters in subjects with chronic obstructive pulmonary disease (COPD)

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

Fractal correlation property of heart rate variability in chronic obstructive pulmonary disease

Background: It was reported that autonomic nervous system function is altered in subjects with chronic obstructive pulmonary disease (COPD). We evaluated short-and long-term fractal exponents of heart rate variability (HRV) in COPD subjects.Patients and methods: We analyzed data from 30 volunteers, who were divided into two groups according to spirometric values: COPD (n = 15) and control (n = 15). For analysis of HRV indices, HRV was recorded beat by beat with the volunteers in the supine position for 30 minutes. We analyzed the linear indices in the time (SDNN [standard deviation of normal to normal] and RMSSD [root-mean square of differences]) and frequency domains (low frequency [LF], high frequency [HF], and LF/HF), and the short-and long-term fractal exponents were obtained by detrended fluctuation analysis. We considered P < 0.05 to be a significant difference.Results: COPD patients presented reduced levels of all linear exponents and decreased short-term fractal exponent (alpha-1: 0.899 +/- 0.18 versus 1.025 +/- 0.09, P = 0.026). There was no significant difference between COPD and control groups in alpha-2 and alpha-1/alpha-2 ratio.Conclusion: COPD subjects present reduced short-term fractal correlation properties of HRV, which indicates that this index can be used for risk stratification, assessment of systemic disease manifestations, and therapeutic procedures to monitor those patients.

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.

The effects of auditory stimulation with music on heart rate variability in healthy women

OBJECTIVES: There are no data in the literature with regard to the acute effects of different styles of music on the geometric indices of heart rate variability. In this study, we evaluated the acute effects of relaxant baroque and excitatory heavy metal music on the geometric indices of heart rate variability in women. METHODS: We conducted this study in 21 healthy women ranging in age from 18 to 35 years. We excluded persons with previous experience with musical instruments and persons who had an affinity for the song styles. We evaluated two groups: Group 1 (n = 21), who were exposed to relaxant classical baroque musical and excitatory heavy metal auditory stimulation; and Group 2 (n = 19), who were exposed to both styles of music and white noise auditory stimulation. Using earphones, the volunteers were exposed to baroque or heavy metal music for five minutes. After the first music exposure to baroque or heavy metal music, they remained at rest for five minutes; subsequently, they were re-exposed to the opposite music (70-80 dB). A different group of women were exposed to the same music styles plus white noise auditory stimulation (90 dB). The sequence of the songs was randomized for each individual. We analyzed the following indices: triangular index, triangular interpolation of RR intervals and Poincaré plot (standard deviation of instantaneous beat-by-beat variability, standard deviation of the long-term RR interval, standard deviation of instantaneous beat-by-beat variability and standard deviation of the long-term RR interval ratio), low frequency, high frequency, low frequency/high frequency ratio, standard deviation of all the normal RR intervals, root-mean square of differences between the adjacent normal RR intervals and the percentage of adjacent RR intervals with a difference of duration greater than 50 ms. Heart rate variability was recorded at rest for 10 minutes. RESULTS: The triangular index and the standard deviation of the long-term RR interval indices were reduced during exposure to both music styles in the first group and tended to decrease in the second group whereas the white noise exposure decreased the high frequency index. We observed no changes regarding the triangular interpolation of RR intervals, standard deviation of instantaneous beat-by-beat variability and standard deviation of instantaneous beat-by-beat variability/standard deviation in the long-term RR interval ratio. CONCLUSION: We suggest that relaxant baroque and excitatory heavy metal music slightly decrease global heart rate variability because of the equivalent sound level.

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.

The phylogeny and ontogeny of autonomic control of the heart and cardiorespiratory interactions in vertebrates

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Responses of the geometric indices of heart rate variability to the active orthostatic test in women

OBJECTIVES: The effects of the orthostatic test on the cardiovascular system have been investigated, but there are no data on the behavior of the geometric indices of heart rate variability. We evaluated the effects of the active orthostatic test on the geometric indices of heart rate variability in women. METHOD: The study was performed on 12 healthy women between ages 18 and 30. For the analysis of heart rate variability, heart rate was recorded beat-to-beat. The RR intervals were transformed into geometric figures, and from these we calculated the triangular index, the triangular interpolation of RR intervals, the SD1, SD2 indexes and the SD1/SD2 ratio, which were obtained from the Poincaré plot. Visual analysis of the plot was also performed. For the test, participants quickly stood up from a seated position in 3 seconds or less, and remained standing still for 15 minutes. Heart rate variability samples were collected at four moments: rest, 0-5 minutes, 5-10 minutes and 10-15 minutes at standing position. RESULTS: The triangular index, the triangular interpolation of RR intervals, the SD1 and SD2 indices were reduced (p < 0.05) at 10-15 minutes after the volunteers stood up from seated position. The SD1/SD2 ratio was decreased at 0-15 minutes after the subjects changed from seated to orthostatic position.

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.

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.