STANDARDIZED TESTS OF HEART RATE VARIABILITY FOR AUTONOMIC FUNCTION TESTS IN HEALTHY KOREANS

Heart rate variability (HRV) is a noninvasive measure of autonomic input to heart rate that has been successfully used to estimate modulation of autonomic tone. The authors investigated to determine the normal ranges as a standardized tests of heart rate variability (HRV) for autonomic function tests in a large sample of healthy Koreans. The study also evaluated the effects of age, sex, and heart rate (HR) on the results of HRV and the values of HRV in hypertension, diabetes, and obesity group. Six hundred and thirty-seven healthy subjects who visited the health improvement center for medical examination were evaluated. A standardized 5-min resting study, including spectral analysis of HR, was used to all participants after an overnight fast. HRV (SA-2000E, Medicore, Korea) was spectrally determined by three components: total-frequency (TF) component (0.01 to 0.5 Hz), low-frequency (LF) component (0.04 to 0.15 Hz), and high-frequency (HF) component (0.15 to 0.5 Hz). Also two component ratio (LF/HF) was calculated. Routine laboratory and physical examinations were used to eliminate cardiovascular diseases and neurological disorders. The determinants of short-period HRV in a random sample of 366 men and 271 women from healthy subjects were assessed. The mean age of these subjects was 45.1 ± 10.7 years. The mean value of total power was 1106.9 ± 1109.1 ms2; SDNN was 35.9 ± 15.5 ms; rMSSD was 27.3 ± 15.6 ms for time domain analysis. The mean value of LF was 287.5 ± 384.1 ms2; HF was 227.0 ± 284.4 ms2; LF/HF was 2.2 ± 3.4 for frequency domain analysis. Additionally, men showed that their TP, LF, and LF/HF values were significantly higher than women whereas SDNN, rMSSD, HF showed no significant differences between sexes. With increasing age, there was no significant decrease in HR. TP, SDNN, LF, and HF were significantly decreased when getting older. On the contrary, LF/HF had no significant difference related to age. The study confirmed that SDNN and rMSSD were significantly lower in hypertension and diabetes group. In conclusion, middle-aged men had more pronounced sympathetic influence than women in cardiac regulation, and HRV declined linearly with age. In addition, HRV reflecting the function of autonomic nervous system was decreased in hypertension and diabetes group.

[1]  H Ector,et al.  Heart rate variability and heart rate in healthy volunteers. Is the female autonomic nervous system cardioprotective? , 1998, European heart journal.

[2]  Ong Wai Sing,et al.  Heart rate analysis in normal subjects of various age groups , 2004, Biomedical engineering online.

[3]  P. Palatini.  Heart rate as a cardiovascular risk factor , 1999 .

[4]  D Sapoznikov,et al.  Five minute recordings of heart rate variability for population studies: repeatability and age–sex characteristics , 1998, Heart.

[5]  A. Malliani,et al.  Spectral analysis of heart rate variability in the assessment of autonomic diabetic neuropathy. , 1988, Journal of the autonomic nervous system.

[6]  A. Folsom,et al.  Multiple Metabolic Syndrome Is Associated With Lower Heart Rate Variability: The Atherosclerosis Risk in Communities Study , 1998, Diabetes Care.

[7]  G. Breithardt,et al.  Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. , 1996 .

[8]  H V Huikuri,et al.  Sex-related differences in autonomic modulation of heart rate in middle-aged subjects. , 1996, Circulation.

[9]  W. Kannel,et al.  Sudden death: lessons from subsets in population studies. , 1985, Journal of the American College of Cardiology.

[10]  M. White,et al.  Aging and cardiovascular responsiveness to β‐agonist in humans: Role of changes in β‐receptor responses versus baroreflex activity , 1994 .

[11]  F. Drago,et al.  Heart rate variability in healthy children and adolescents is partially related to age and gender. , 2001, International journal of cardiology.

[12]  N. Ohte,et al.  Severity of coronary atherosclerosis correlates with the respiratory component of heart rate variability. , 1991, American heart journal.

[13]  M. Cárdenas,et al.  Age, body mass index, and menstrual cycle influence young women’s heart rate variability , 2005, Clinical Autonomic Research.

[14]  J D Best,et al.  Differential changes of autonomic nervous system function with age in man. , 1983, The American journal of medicine.

[15]  Duanping Liao,et al.  Correlates of the shift in heart rate variability with an active postural change in a healthy population sample: The Atherosclerosis Risk In Communities study. , 2002, American heart journal.

[16]  A L Goldberger,et al.  Gender- and age-related differences in heart rate dynamics: are women more complex than men? , 1994, Journal of the American College of Cardiology.

[17]  M. Supiano,et al.  Arterial alpha-adrenergic responsiveness is decreased and SNS activity is increased in older humans. , 1994, The American journal of physiology.

[18]  Neil R. Powe,et al.  The Atherosclerosis Risk in Communities Study , 2006 .

[19]  A. Malliani,et al.  Heart rate variability. Standards of measurement, physiological interpretation, and clinical use , 1996 .

[20]  D. Seals,et al.  Augmented cardiopulmonary and integrative sympathetic baroreflexes but attenuated peripheral vasoconstriction with age. , 1998, Hypertension.

[21]  D. Seals,et al.  Human ageing and the sympathoadrenal system , 2000, The Journal of physiology.

[22]  G. Reaven,et al.  Hypertension and associated metabolic abnormalities--the role of insulin resistance and the sympathoadrenal system. , 1996, The New England journal of medicine.

[23]  S Cerutti,et al.  Sympathetic predominance in essential hypertension: a study employing spectral analysis of heart rate variability. , 1988, Journal of hypertension.