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CC BY-NC-ND 4.0 · Journal of Health and Allied Sciences NU 2014; 04(01): 004-008
DOI: 10.1055/s-0040-1703722
Original Article

A CORRELATIVE STUDY ON DETERMINANTS OF TIME DOMAIN MEASURES OF CARDIAC VAGAL FUNCTION IN HEALTHY SUBJECTS

Subbalakshmi N. K.
1   Associate Professor, Department of Physiology, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
,
Jeganathan P. S.
2   Professor, Department of Physiology, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
,
Sathyanarayana Rao K. N.
3   Professor, Department of Pharmacology, K.S. Hegde Medical Academy, Nitte University, Mangalore, Karnataka, India
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Abstract:

Introduction: E: I ratio and r-MSSD are known indicators of cardiac vagal activity. But their determinants are unclear.

Objective: To evaluate the determinants of E: I ratio and r-MSSD in healthy subjects.

Materials and Methods: 141 healthy subjects were studied. In them body mass index (BMI), Q-T interval, heart rate (HR), systolic, diastolic, pulse and mean arterial blood pressure (MABP) were measured. Age and sex of the subjects were noted. E: I ratio and r-MSSD was estimated from one minute lead II electrocardiogram in supine position. E: I ratio was recorded while breathing at 6 respiratory cycles per minute and r-MSSD was quantified during normal breathing. Data was analyzed by Pearson Correlation Coefficient and unpaired t test. p value less than 0.05 was considered significant.

Results: There was positive correlation between E: I ratio and r-MSSD (p = 0.006). E: I ratio and r-MSSD were negatively correlating with age (p < 0.01). r-MSSD was negatively correlating with HR, systolic, diastolic, pulse and MABP (p = 0.0001, 0.01, 0.03, 0.04, 0.01 respectively). r-MSSD did not correlate with BMI and Q-T interval. E: I ratio did not correlate with blood pressure, BMI and Q-T interval. Mean E: I ratio and r-MSSD of males did not differ compared to females.

Conclusion: E: I ratio and r-MSSD are correlated. Age is an influencing factor of E: I ratio and r-MSSD. Blood pressure and HR are the other determinants of r-MSSD but not of E: I ratio in healthy subjects.

Keywords:

E: I ratio - r-MSSD - blood pressure - heart rate - vagal function - healthy subjects


Publication History

Article published online:
24 April 2020

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  • References:

  • 1 Ewing DJ, Campbell IW, Clark BF. The natural history of diabetic autonomic neuropathy. Q. J. Med. 1980; 193: 95-108.
  • 2 Malpas SC, Maling TJB. Heart rate variability and cardiac autonomic function in diabetes. Diabetes 1990; 39: 1177-1181.
  • 3 Pipilis A, Flather M, Ormerod O, Sleight P. Heart rate variability in acute myocardial infarction and its association with infarct site and clinical course. Am J Cardiol 1991; 67: 1137-1139.
  • 4 Rothschild M, Rothschild A, Pfeifer M. Temporary decrease in cardiac parasympathetic tone after acute myocardial infarction. Am J Cardiol 1988; 18: 637-639.
  • 5 Casolo G, Balli E, Taddei T, Amuhasi J, Gori C. Decreased spontaneous heart rate variability in congestive heart failure. Am J Cardiol 1989; 64: 1162-1167.
  • 6 Cohn JN. Abnormalities of peripheral sympathetic nervous system control in congestive heart failure. Circulation 1990; 82: 159-167 (suppl.).
  • 7 Corr PB, Yamada KA, Witkowski F.X. Mechanisms controlling cardiac autonomic function and their relation to arrhythmogenesis. In The Heart and Cardiovascular System (eds. Fozzard HA, Haber E, Jenning, RB, Katz AM). Raven Press, Newyork, 1986: 1343.
  • 8 Nakagawa M, Saikawa T, Ito M. Progressive reduction of heart rate variability with eventual sudden death in two patients. Br. Heart J 1994; 71: 87-88.
  • 9 Miller IF, Yeates DB, Wong LB. Heart Rate Variability Analysis – Promise and Fulfillment. Business Briefing: Global Health Care – Advanced medical technologies 2004; 1- 4.
  • 10 Ewing DJ, Clarke B.F. Diagnosis and management of diabetic autonomic neuropathy. Br Med J 1982; 285: 916-918.
  • 11 Freeman R. Noninvasive evaluation of heart rate variability. In (ed. Low PA) Clinical Autonomic Disorders. Lippincott-Raven, Philadelphia, 1997; 297-307.
  • 12 Ewing DJ, Borsey DQ, Bellavere F, Clarke BF. Cardiac autonomic neuropathy in diabetes: comparison of measures of R-R interval variation. Diabetologia.1981; 21:18-24.
  • 13 Sundkvist G, Almer LO, Lilja B. Respiratory influence on heart rate in diabetes mellitus. British Medical Journal, 1979; 1: 924-925.
  • 14 Kleiger RE, Stein PK, Bosner MS, Rotman JN. Time domain measurements of heart rate variability. Cardiol Clin 1992; 10:487–498.
  • 15 Sztajzel J. Heart rate variability: a noninvasive electrocardiographic method to measure the autonomic nervous system. Swiss Med Wkly 2004; 134:514–522.
  • 16 Subbalakshmi N.K, Adhikari PMR, Sathyanarayana Rao KN, Jeganathan PS. Deterioration of cardiac autonomic function over a period of one year in relation to cardiovascular and somatic neuropathy complications in type 2 diabetes mellitus. diabetes research and clinical practice 2012; 97 : 313-321.
  • 17 Bazett HC. An analysis of the time relations of electrocardiograms. Heart 1920; 7: 353 -370.
  • 18 Ziegler D, Laux G, Dannehl K, Spüler M, Mühlen H, Mayer P, Gries FA. Assessment of cardiovascular autonomic function: age-related normal ranges and reproducibility of spectral analysis, vector analysis, and standard tests of heart rate variation and blood pressure responses. Diabet Med 1992 9(2):166-175.
  • 19 Hulegar A. Abhishekh, Palgun Nisarga, Ravikiran Kisan, Adoor Meghana, Sajish Chandran, Trichur Raju, Talakad N. Sathyaprabha. Influence of age and gender on autonomic regulation of heart. Journal of Clinical Monitoring and Computing 2013; 27: 259-264.
  • 20 O'Brien IA, O'Hare JP, Lewin IG, Corrall RJ. The prevalence of autonomic neuropathy in insulin-dependent diabetes mellitus: a controlled study based on heart rate variability. Q J Med 1986; 61:957-967.
  • 21 Smith SA. Reduced sinus arrhythmia in diabetic autonomic neuropathy: diagnostic value of an age-related normal range. Br Med J (Clin Res Ed) 1982; 285:1599-601.
  • 22 Cowvell. Cardiovascular control and integrated responses. In (ed. West JB) Best and Taylor's Physiological Basis of Medical Practice. Williams and Wilkins, Baltimore/London. 1984; 263-282.
  • 23 Talman WT, Benaroch EE. Neural control of cardiac function. In (eds. Dyck PJ, Thomas PK, Lambert EH, Bunge R). Peripheral Neuropathy. W.B Saunders, Philadelphia 1992: 177-185.