Heart rate variability in patients with major depression disorder during a clinical autonomic test

Chen, Xiuwen; Yang, Rongqian; Kuang, Danni; Zhang, Lei; Lv, Ruixue; Xiong, Hui; Wu, Fengchun; Lao, Guohui; Ou, Shanxing

doi:10.1016/j.psychres.2017.06.041

Cited by 34 publications

(29 citation statements)

References 22 publications

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“…We also found an elevation in IOP in phase 2 of the VM in young healthy adults compared with baseline. Significantly decreased AOD500, ARA750, TIA500 and TISA500 during the VM may also contribute to the elevated IOP, because a narrowed anterior chamber may lead to higher outflow resistance of the aqueous humor [24]. In the present study, IOP rapidly returned to baseline in phase 4, as expected given that the physiological indices normalize and the resistance resolves during this phase.…”

Section: Discussionsupporting

confidence: 79%

Dual effect of the Valsalva maneuver on autonomic nervous system activity, intraocular pressure, Schlemm’s canal, and iridocorneal angle morphology

Sun

Chen

et al. 2020

BMC Ophthalmol

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Background: The Valsalva maneuver (VM) is widely used in daily life, and has been reported to cause high intraocular pressure (IOP). This study aimed to assess changes in IOP, the Schlemm's canal (SC), autonomic nervous system activity, and iridocorneal angle morphology in healthy individuals during different phases of the VM. Methods: The high frequency (HF) of heart rate (HR) variability, the ratio of low frequency power (LF) and HF (LF/HF), heart rate (HR), IOP, systolic (SBP) and diastolic blood pressure (DBP), the area of SC (SCAR), pupil diameter (PD), and some iridocorneal angle parameters (AOD500, ARA750, TIA500 and TISA500) were measured in 29 young healthy individuals at baseline, phase 2, and phase 4 of the VM. SBP and DBP were measured to calculate mean arterial pressure (MAP) and mean ocular perfusion pressure (MOPP). HF and the LF/HF ratio were recorded using Kubios HR variability premium software to evaluate autonomic nervous system activity. The profiles of the anterior chamber were captured by a Spectralis optical coherence tomography device (anterior segment module). Results: Compared with baseline values, in phase 2 of the VM, HR, LF/HF, IOP (15.1 ± 2.7 vs. 18.8 ± 3.5 mmHg, P < 0.001), SCAR (mean) (7712.112 ± 2992.14 vs. 8921.12 ± 4482.79 μm 2 , P = 0.039), and PD increased significantly, whereas MOPP, AOD500, TIA500, and TISA500 decreased significantly. In phase 4, DBP, MAP, AOD500, ARA750, TIA500and TISA500 were significantly lower than baseline value, while PD and HF were remarkably larger than baseline. The comparison between phase 2 and phase 4 showed that HR, IOP (18.8 ± 3.5 vs. 14.7 ± 2.9 mmHg, P < 0.001) and PD decreased significantly from phase 2 to phase 4, but there were no significant differences in other parameters. Conclusions: The expansion and collapse of the SC in different phases of the VM may arise from changes in autonomic nervous system activity. Further, the effects of the VM on IOP may be attributed to changes in blood flow and ocular anatomy. Trial registration: This observational study was approved by the ethics committee of Tongji Hospital (Registration Number: ChiCTR-OON-16007850, Date: 01.28.2016).

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Section: Discussionsupporting

confidence: 79%

Dual effect of the Valsalva maneuver on autonomic nervous system activity, intraocular pressure, Schlemm’s canal, and iridocorneal angle morphology

Sun

Chen

et al. 2020

BMC Ophthalmol

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“…Li et al reported thickening of the anterior choroid and the ciliary body, but not of the posterior choroid, during forced exhalation against a closed airway in phase 2 [23].We also found an elevation in IOP in phase 2 of the VM in young healthy adults compared with baseline. Significantly decreased AOD500, ARA750, TIA500 and TISA500 during the VM may also contribute to the elevated IOP, because a narrowed anterior chamber may lead to higher outflow resistance of the aqueous humor [24]. In the present study, IOP rapidly returned to baseline in phase 4, as expected given that the physiological indices normalize and the resistance resolves during this phase.…”

Section: Discussionsupporting

confidence: 79%

Dual effect of the Valsalva maneuver on autonomic nervous system activity, intraocular pressure, Schlemm’s canal, and iridocorneal angle morphology

Sun

Chen

et al. 2019

Preprint

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Background: The Valsalva maneuver (VM) is widely used in daily life, and has been reported to cause high intraocular pressure (IOP). This study aimed to assess changes in IOP, the Schlemm’s canal (SC), autonomic nervous system activity, and iridocorneal angle morphology in healthy individuals during different phases of the VM. Methods: The high frequency (HF) of heart rate (HR) variability, the ratio of low frequency power (LF) and HF (LF/HF), heart rate (HR), IOP, systolic (SBP) and diastolic blood pressure (DBP), the area of SC (SCAR), pupil diameter (PD), and some iridocorneal angle parameters (AOD500, ARA750, TIA500 and TISA500) were measured in 29 young healthy individuals at baseline, phase 2, and phase 4 of the VM. SBP and DBP were measured to calculate mean arterial pressure (MAP) and mean ocular perfusion pressure (MOPP). HF and the LF/HF ratio were recorded using Kubios HR variability premium software to evaluate autonomic nervous system activity. The profiles of the anterior chamber were captured by a Spectralis optical coherence tomography device (anterior segment module). Results: Compared with baseline values, in phase 2 of the VM, HR, LF/HF, IOP (15.1±2.7 vs. 18.8±3.5 mmHg, P < 0.001), SCAR(mean) (7712.112±2992.14 vs. 8921.12±4482.79 μm2, P = 0.039), and PD increased significantly, whereas MOPP, AOD500, TIA500, and TISA500 decreased significantly. In phase 4, DBP, MAP, AOD500, ARA750, TIA500and TISA500 were significantly lower than baseline value, while PD and HF were remarkably larger than baseline. The comparison between phase 2 and phase 4 showed that HR, IOP (18.8±3.5 vs. 14.7±2.9 mmHg, P < 0.001) and PD decreased significantly from phase 2 to phase 4, but there were no significant differences in other parameters. Conclusions: The expansion and collapse of the SC in different phases of the VM may arise from changes in autonomic nervous system activity. Further, the effects of the VM on IOP may be attributed to changes in blood flow and ocular anatomy.

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“…Adaptation to stress is characterized by an increase in sympathetic activity and a decrease in parasympathetic activity, inducing a state of alertness [ 17 ]. Interestingly, common diseases such as rheumatoid arthritis [ 67 ], depression [ 68 ], schizophrenia [ 69 ], multiple sclerosis [ 70 ], active ulcerative colitis [ 71 ], obesity and metabolic syndrome [ 72 , 73 ], myocardial infarctions [ 74 ], high blood pressure [ 75 ], smoking [ 76 ], and cancer [ 77 ], are associated with a decrease in parasympathetic activity and an activation of sympathetic activity. However, we demonstrated that T2DM patients had a decrease in both parasympathetic and sympathetic activity.…”

Section: Discussionmentioning

confidence: 99%

Heart rate variability in type 2 diabetes mellitus: A systematic review and meta–analysis

et al. 2018

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BackgroundCardiac autonomic neuropathy in type 2 dibetes mellitus (T2DM) patients is frequent and associated with high cardiovascular mortality. Heart rate variability (HRV) is the gold standard to measure cardiac autonomic neuropathy. We aimed to conduct a systematic review and meta–analysis to evaluate the impact of T2DM on HRV parameters.MethodsThe PubMed, Cochrane Library, Embase and Science Direct databases were searched on 1st October 2017 using the keywords “diabetes” AND (“heart rate variability” OR “HRV”). Included articles had to report HRV parameters in T2DM patients and healthy controls measured during 24 hours with a Holter–electrocardiogram. Measurements of HRV retieved were: RR–intervals (or Normal to Normal intervals—NN), standard deviation of RR intervals (SDNN), percetange of adjacent NN intervals differing by more than 50 milliseconds (pNN50), square root of the mean squared difference of successive RR intervals (RMSSD), total power, Low Frequency (LF), High Frequency (HF) and LF/HF ratio, as per Task Force recommendations.ResultsWe included twenty-five case-control studies with 2,932 patients: 1,356 with T2DM and 1,576 healthy controls. T2DM patients had significantly (P<0.01) lower RR–intervals (effect size = –0.61; 95%CI –1.21 to –0.01), lower SDNN (–0.65; –0.83 to –0.47), lower RMSSD (–0.92; –1.37 to –0.47), lower pNN50 (–0.46; –0.84 to –0.09), lower total power (–1.52; –2.13 to –0.91), lower LF (–1.08; –1.46 to –0.69]), and lower HF (–0.79; –1.09 to –0.50). LF/HF did not differ between groups. Levels of blood glucose and HbA1c were associated with several HRV parameters, as well as Time from diagnosis of T2DMConclusionsT2DM was associated with an overall decrease in the HRV of T2DM patients. Both sympathetic and parasympathetic activity were decreased, which can be explained by the deleterious effects of altered glucose metabolism on HRV, leading to cardiac autonomic neuropathy.

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Heart rate variability in patients with major depression disorder during a clinical autonomic test

Cited by 34 publications

References 22 publications

Dual effect of the Valsalva maneuver on autonomic nervous system activity, intraocular pressure, Schlemm’s canal, and iridocorneal angle morphology

Dual effect of the Valsalva maneuver on autonomic nervous system activity, intraocular pressure, Schlemm’s canal, and iridocorneal angle morphology

Dual effect of the Valsalva maneuver on autonomic nervous system activity, intraocular pressure, Schlemm’s canal, and iridocorneal angle morphology

Heart rate variability in type 2 diabetes mellitus: A systematic review and meta–analysis

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