Heart Rate Variability: Clinical Applications and Interaction between HRV and Heart Rate


Book Description

Over the last decades, assessment of heart rate variability (HRV) has increased in various fields of research. HRV describes changes in heartbeat intervals, which are caused by autonomic neural regulation, i.e. by the interplay of the sympathetic and the parasympathetic nervous systems. The most frequent application of HRV is connected to cardiological issues, most importantly to the monitoring of post-myocardial infarction patients and the prediction of sudden cardiac death. Analysis of HRV is also frequently applied in relation to diabetes, renal failure, neurological and psychiatric conditions, sleep disorders, psychological phenomena such as stress, as well as drug and addiction research including alcohol and smoking. The widespread application of HRV measurements is based on the fact that they are noninvasive, easy to perform, and in general reproducible – if carried out under standardized conditions. However, the amount of parameters to be analysed is still rising. Well-established time domain and frequency domain parameters are discussed controversially when it comes to their physiological interpretation and their psychometric properties like reliability and validity, and the sensitivity to cardiovascular properties of the variety of parameters seems to be a topic for further research. Recently introduced parameters like pNNxx and new dynamic methods such as approximate entropy and detrended fluctuation analysis offer new potentials and warrant standardization. However, HRV is significantly associated with average heart rate (HR) and one can conclude that HRV actually provides information on two quantities, i.e. on HR and its variability. It is hard to determine which of these two plays a principal role in the clinical value of HRV. The association between HRV and HR is not only a physiological phenomenon but also a mathematical one which is due to non-linear (mathematical) relationship between RR interval and HR. If one normalizes HRV to its average RR interval, one may get ‘pure’ variability free from the mathematical bias. Recently, a new modification method of the association between HRV and HR has been developed which enables us to completely remove the HRV dependence on HR (even the physiological one), or conversely enhance this dependence. Such an approach allows us to explore the HR contribution to the clinical significance of HRV, i.e. whether HR or its variability plays a main role in the HRV clinical value. This Research Topic covers recent advances in the application of HRV, methodological issues, basic underlying mechanisms as well as all aspects of the interaction between HRV and HR.







Heart Rate Variability (HRV)


Book Description

Heart rate variability (HRV) has become a popular method to study autonomic modulation of the cardiovascular system. Cardiovascular health depends on the proper functioning of several physiological systems, including the autonomic nervous system, which exerts its function via a complex interaction between its two branches: sympathetic and parasympathetic. Additionally, heart rate variability has been widely applied in basic and clinical research studies for describing the extent of sinus arrhythmia, and for assessing the function of cardiac autonomic regulation quantitatively. In other words, it is a mirror of the balance of sympathetic and vagal activity. This book discusses the prognostic significance, risk factors and clinical applications of heart rate variability.




Heart Rate Variability, Health and Well-being: A Systems Perspective


Book Description

The development of a new tool, analytic device, or approach frequently facilitates rapid growth in scientific understanding, although the process is seldom linear. The study of heart rate variability (HRV) defined as the extent to which beat-to-beat variation in heart rate varies, is a rapidly maturing paradigm that integrates health and wellness observations across a wide variety of biomedical and psychosocial phenomena and illustrates this nonlinear path of development. The utility of HRV as an analytic and interventive technique goes far beyond its original application as a robust predictor of sudden cardiac death. This Research Topic aims to provide a conceptual framework to use in exploring the utility of HRV as a robust parameter of health status, using a broad and inclusive definition of ‘health’ and ‘well-being’. From the broadest perspective, current biomedical science emerged from shamanistic and religious healing practices and empirically observed interventions made as humans emerged from other hominins. The exponential growth of physics, chemistry and biology provided scientific support for the model emphasizing pathology and disorders. Even before the momentous discovery of germ theory, sanitation and other preventive strategies brought about great declines in mortality and morbidity. The revolution that is currently expanding the biomedical model is an integrative approach that includes the wide variety of non-physio/chemical factors that contribute to health. In the integrative approach, health is understood to be more than the absence of disease and emphasis is placed on optimal overall functioning, within the ecological niche occupied by the organism. This approach also includes not just interventive techniques and procedures, but also those social and cultural structures that provide access to safe and effective caring for sufferers. Beyond the typical drug and surgical interventions - which many identify with the Western biomedical model that currently enjoys an unstable hegemony - such factors also include cognitive-behavioral, social and cultural practices such as have been shown to be major contributors to the prevention and treatment of disease and the promotion of health and optimal functioning. This Integrative Model of Health and Well-being also derives additional conceptual power by recognizing the role played by evolutionary processes in which conserved, adaptive human traits and response tendencies are not congruent with current industrial and postindustrial global environmental demands and characteristics. This mismatch contributes to an increasing incidence of chronic conditions related to lifestyle and health behavior. Such a comprehensive model will make possible a truly personalized approach to health and well-being, including and going far beyond the current emphasis on genomic analysis, which has promised more that it has currently delivered. HRV offers an inexpensive and easily obtained measure of neurovisceral functioning which has been found to relate to the occurrence and severity of numerous physical disease states, as well as many cognitive-behavioral health disorders. This use of the term neurovisceral refers to the relationships between the nervous system and the viscera, providing a more focused and specific conceptual alternative to the now nearly archaic “mind-body” distinction. This awareness has led to the recent and growing use of HRV as a health biomarker or health status measure of neurovisceral functioning. It facilitates studying the complex two way interaction between the central nervous system and other key systems such as the cardiac, gastroenterological, pulmonary and immune systems. The utility of HRV as a broad spectrum health indicator with possible application both clinically and to population health has only begun to be explored. Interventions based on HRV have been demonstrated to be effective evidence-based interventions, with HRV biofeedback treatment for PTSD representing an empirically supported modality for this complex and highly visible affliction. As an integral measure of stress, HRV can be used to objectively assess the functioning of the central, enteric and cardiac nervous systems, all of which are largely mediated by the vagal nervous complex. HRV has also been found to be a measure of central neurobiological concepts such as executive functioning and cognitive load. The relatively simple and inexpensive acquisition of HRV data and its ease of network transmission and analysis make possible a promising digital epidemiology which can facilitate objective population health studies, as well as web based clinical applications. An intriguing example is the use of HRV data obtained at motor vehicle crash sites in decision support regarding life flight evacuations to improve triage to critical care facilities. This Research Topic critically addresses the issues of appropriate scientific and analytic methods to capture the concept of the Integrative Health and Well-being Model. The true nature of this approach can be appreciated only by using both traditional linear quantitative statistics and nonlinear systems dynamics metrics, which tend to be qualitative. The Research Topic also provides support for further development of new and robust methods for evaluating the safety and effectiveness of interventions and practices, going beyond the sometimes tepid and misleading “gold standard” randomized controlled clinical trial.




Comprehensive Electrocardiology


Book Description

New edition of the classic complete reference book for cardiologists and trainee cardiologists on the theory and practice of electrocardiography, one of the key modalities used for evaluating cardiology patients and deciding on appropriate management strategies.




Organizational Neuroscience


Book Description

This volume aims to introduce organizational researchers and practitioners to the role of neuroscience in building theory, research methodologies and practical applications. The volume introduces the field of organizational neuroscience and explores its influence on topics such as leadership, ethics and moral reasoning.







EMBEC & NBC 2017


Book Description

This volume presents the proceedings of the joint conference of the European Medical and Biological Engineering Conference (EMBEC) and the Nordic-Baltic Conference on Biomedical Engineering and Medical Physics (NBC), held in Tampere, Finland, in June 2017. The proceedings present all traditional biomedical engineering areas, but also highlight new emerging fields, such as tissue engineering, bioinformatics, biosensing, neurotechnology, additive manufacturing technologies for medicine and biology, and bioimaging, to name a few. Moreover, it emphasizes the role of education, translational research, and commercialization.




Clinical Assessment of the Autonomic Nervous System


Book Description

This book describes newly developed methods of assessing the autonomic nervous system. Up-to-date information on microneurographic analysis of human cardiovascular and thermoregulatory function in humans, heart rate variability, and 131I-metaiodobenzylguanidine (MIBG) scintigraphy are provided. Microneurography, which was originally developed as a technique to analyze the afferent muscle spindle, came to be used to analyze sympathetic nerve activity in the mid-1980s. In the twenty-first century, this technique has become prevalent all over the world especially in investigating the pathophysiology of human cardiovascular function. It is also now used in researching human thermoregulatory function. Heart rate variability is another valuable tool in investigating the current status of human vagal function and in predicting future cardiovascular disease. MIBG is also used to assess cardiac noradrenergic function, especially decreases associated with Parkinson’s disease, Lewy body disease, and multisystem atrophy. Overviews of recent advances in these three important assessments are provided by leading experts.Clinical Assessment of the Autonomic Nervous System is a useful resource for neurologists and researchers of clinical neurophysiology.




Human Baroreflexes in Health and Disease


Book Description

Nerve endings in the walls of the carotid sinuses and the aortic arch transduce arterial pressure changes and provide the central nervous system with a steady stream of encoded information. On the basis of this information, efferent autonomic neural activity is modulated finely, and the neurohumoral milieu of the heart and the blood vessels is adjusted on a second-to-second basis. The arterial baroreflex may be the most important of the cardiovascular control mechanisms, because the baroreflex, above all other reflex mechanisms, is the one whose speed is most adequate to respond rapidly to the abrupt transients of arterial pressure that occur in daily life. This volume presents the many experimental methods available for use in humans that have been recently developed. Some are ingenious and yield results that earlier might have been thought impossible to obtain from human volunteers. Development of these new methods has increased the scientific credibility of human baroreflex research, and this work discusses the advances made in these studies. It clearly describes the existing deficiencies in the understanding of baroreflex mechanisms, and suggests methods for future research in this developing field.