Heart rate variability: An objective measure of autonomic activity and bladder sensations during urodynamics

Mehnert, Ulrich; Knapp, Peter A.; Mueller, Nicole; Reitz, André; Schurch, Brigitte

doi:10.1002/nau.20641

Cited by 29 publications

(27 citation statements)

References 31 publications

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“…Ben-Dror et al (2012) subsequently delineated a linear rise in lnLF power with acute bladder filling in healthy controls drinking water. While this may have been confounded with the osmopressor effect (as above), a similar effect was observed using filling cystometry (i.e., causing bladder distension without drinking; Mehnert et al, 2009). …”

Section: Introductionmentioning

confidence: 83%

Everything Hertz: methodological issues in short-term frequency-domain HRV

2014

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Frequency analysis of the electrocardiographic RR interval is a common method of quantifying autonomic outflow by measuring the beat-to-beat modulation of the heart (heart rate variability; HRV). This review identifies a series of problems with the methods of doing so-the interpretation of low-frequency spectral power, the multiple use of equivalent normalized low frequency (LFnu), high frequency (HFnu) and ratio (LF/HF) terms, and the lack of control over extraneous variables, and reviews research in the calendar year 2012 to determine their prevalence and severity. Results support the mathematical equivalency of ratio units across studies, a reliance on those variables to explain autonomic outflow, and insufficient control of critical experimental variables. Research measurement of HRV has a substantial need for general methodological improvement.Keywords: heart rate variability, autonomic nervous system, sympatho-vagal balance, sympathetic nervous system, parasympathetic nervous system INTRODUCTIONHeart rate variability (HRV), the fluctuation of instantaneous heart period over time, is a correlate of cardiac autonomic regulation. HRV techniques have been applied in a broad range of contexts-they have been used to predict mortality after myocardial infarction (Buccelletti et al., 2009), as a correlate of stress (Berntson and Cacioppo, 2007) and psychopathology, to stratify attention (Mulder and Mulder, 1981), and have been incorporated into biobehavioral models of self-regulation (Porges, 1995;Thayer and Lane, 2000). The idea that reliable measurement of autonomic state may be obtained cheaply and non-invasively is obviously appealing. Figure 1 illustrates a growing interest in HRV methods over time, a trend which seem likely to continue given the increasing access to heart rate data through recent technological advances-heart rate has recently been accurately calculated via smartphone (Heathers, 2013), microwave (Suzuki et al., 2008) and induction-powered indwelling device (Riistama et al., 2007). Short recordings of HRV (i.e., less than 1 h) typically show two primary patterns of oscillation which are separated into frequency bands from ≈7 to 25 s (0.04-0.15 Hz; low frequency, or LF) and 2.5 to ≈7 s (0.15-0.4 Hz; high frequency, or HF)-lower frequencies than LF are generally not meaningful over the short term. LF and HF frequency bands are widely used to quantify parasympathetic and sympathetic regulation (Akselrod et al., 1981) and their interaction (Malliani et al., 1991).As ease of access to HRV increases, establishing and maintaining correct methodology is important-redundant methodology may delay treatment, obscure valuable underlying effects, provoke Type I or II errors, and most importantly, potentially delegitimize both alternative useful results and the utility of HRV in general.However, the internal and external consistency of the methods used have received comparatively less research interest than the understanding of the autonomic, cardiac and circulatory which creates those methods (Billman, 201...

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Section: Introductionmentioning

confidence: 83%

Everything Hertz: methodological issues in short-term frequency-domain HRV

2014

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“…The alterations observed in sympathetic activity during the process of bladder filling in women with OAB may lead to a sensation of urgency. Previous studies have also shown sympathetic neural activity to increase toward the end of bladder filling in healthy women [10,11,14]. This, together with the desire to void, was also reported among healthy men, using a different method for autonomic nervous system assessment, that of sympathetic skin response [14].…”

Section: Discussionmentioning

confidence: 54%

“…In contrast, in the control group, sympathetic activity increased continuously during the entire bladder filling phase. Continual increase in sympathetic activity during bladder filling is necessary to enable the bladder to expand without detrusor contraction [4,10,11]. The alterations observed in sympathetic activity during the process of bladder filling in women with OAB may lead to a sensation of urgency.…”

Section: Discussionmentioning

confidence: 99%

“…Some consider it to represent sympathetic modulation, whereas others consider it to include both sympathetic and vagal influences [8]. However, in most reports, LF is used mainly as a representation of the effect of the sympathetic nervous system [7] Previous studies have demonstrated a relationship between HRV and autonomic nervous system activity [9][10][11][12]. Choi et al showed parameters of HRV to differ in women with OAB compared with those of normal controls [9].…”

Section: Introductionmentioning

confidence: 99%

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Alterations of heart rate variability in women with overactive bladder syndrome

et al. 2012

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“…Therefore, the International Consultation on Incontinence has suggested establishing objective data such as HR variability during urodynamic procedures. 28 The same needs to be considered for studies involvinganimals.…”

Section: Discussionmentioning

confidence: 99%

Urodynamic evaluation of female cats with idiopathic cystitis

Wu¹,

Buffington²,

Fraser³

et al. 2011

ajvr

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Objective To compare values of urodynamic measurements of cats with idiopathic cystitis (IC) with previously published data for healthy female cats. Animals 11 female cats with IC. Procedures 2 sequential cystometrograms and 2 urethral pressure profiles were obtained for each cat. All tracings were evaluated for evidence of overactive urinary bladder (OAB). Maximum urethral pressure (MUP), maximum urethral closure pressure (MUCP), and functional profile length were recorded. Results Only 3 cats had obvious micturition events. None of the 11 cats had evidence of OAB. Although not significant, threshold pressure was lower in cats with IC than in healthy cats (mean ± SD, 89.0 ± 12.0 cm H2O vs 75.7 ± 16.3 cm H2O, respectively); however, the total volume infused was significantly lower in cats with IC (4.8 ± 2.1 mL/kg vs 8.3 ± 3.2 mL/kg). The MUCP was significantly higher in cats with IC than in healthy cats (158.0 ± 47.7 cm H2O vs 88.9 ± 23.9 cm H2O, respectively). The MUP was also significantly higher in all portions of the urethra in cats with IC. Conclusions and Clinical Relevance No evidence of OAB was identified in any cat evaluated; therefore, medications used to target this abnormality did not appear justified. The high MUCP in cats with IC suggested that α1-adrenoceptor antagonists or skeletal muscle relaxants may be useful in this disease, and if these data were applicable to male cats, then α1-adrenoceptor antagonism may help prevent recurrent obstructive IC. Further studies are indicated to determine the effects, if any, these drugs might have in cats with IC.

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Heart rate variability: An objective measure of autonomic activity and bladder sensations during urodynamics

Abstract: HRV analysis seems to be a useful indicator for the general activation pattern of the sympathovagal balance during FC, correlating the intensity of the bladder filling sensation to stress and sympathetic activation.

Cited by 29 publications

References 31 publications

Everything Hertz: methodological issues in short-term frequency-domain HRV

Everything Hertz: methodological issues in short-term frequency-domain HRV

Alterations of heart rate variability in women with overactive bladder syndrome

Urodynamic evaluation of female cats with idiopathic cystitis

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