Key result
Time domain parameters of heart rate variability showed greater utility than frequency parameters in autonomic disorders, with healthy young having lower resting HR than POTS (61.4 vs 76.8 bpm; P<0.001).
Why the study?
Do time or frequency domain parameters of heart rate variability have greater utility in distinguishing healthy individuals from those with autonomic dysfunction?
Cross-Sectional (n=225)
Do time or frequency domain parameters of heart rate variability have greater utility in distinguishing healthy individuals from those with autonomic dysfunction?
Time domain parameters of heart rate variability are more useful than frequency parameters for evaluating patients with autonomic disorders such as postural tachycardia syndrome and neurogenic orthostatic hypotension.
HRV time-domain metrics may aid autonomic assessment in POTS; leaves open prospective validation before clinical adoption.
PURPOSE: The clinical significance of heart rate variability in the context of autonomic dysfunction continues to be a matter of debate. A consensus is lacking on the best heart rate variability measures for clinical purposes. Therefore, the purpose of this study was to investigate the utility of heart rate variability parameters in healthy versus autonomic dysfunction. METHODS: Healthy young (n = 134), healthy older (n = 32), and patients with mild (postural tachycardia syndrome; n = 25) and severe (neurogenic orthostatic hypotension; n = 34) autonomic dysfunction were included. Time and frequency parameters during baseline, head-up tilt (HUT), and heart rate response to deep breathing (HRDB) were compared. RESULTS: Cardiovagal time parameters were significantly reduced during HUT in healthy young and postural tachycardia syndrome (P < 0.001). Healthy young had significantly higher time parameters during baseline, HUT, and HRDB (P < 0.01). This was reflected by a significantly lower resting heart rate (HR) (61.4 ± 9.0 bpm vs. 76.8 ± 13.6 bpm; P < 0.001) and a smaller [INCREMENT]HR during HUT (32.8 ± 10.5 bpm vs. 44.4 ± 13.3 bpm; P < 0.001). Time parameters increased in young and postural tachycardia syndrome during HRDB, which was characterized by a nonsignificant difference in [INCREMENT]HR between both groups. Time parameters were significantly higher in healthy old versus neurogenic orthostatic hypotension at rest and during HRDB (P < 0.05). During HUT, only the SD of all normal RR intervals remained significantly higher. Heart rate changes corroborated these findings. Resting HR was significantly lower in healthy older (62.6 ± 11.0 bpm vs. 70.7 ± 12.4 bpm), and [INCREMENT]HR during HRDB was significantly higher (15.9 ± 9.2 bpm vs. 3.9 ± 4.2 bpm; P < 0.001). During HUT, [INCREMENT]HR showed no significant differences. CONCLUSIONS: Time domain parameters of heart rate variability have a greater utility than frequency parameters in clinical autonomic disorders.
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Baker et al. (2018) conducted a cross-sectional in Autonomic dysfunction (postural tachycardia syndrome, neurogenic orthostatic hypotension) (n=225). Autonomic dysfunction vs. Healthy controls was evaluated on Time and frequency parameters of heart rate variability during baseline, head-up tilt, and heart rate response to deep breathing. Time domain parameters of heart rate variability showed greater utility than frequency parameters in autonomic disorders, with healthy young having lower resting HR than POTS (61.4 vs 76.8 bpm; P<0.001).
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