Relaxation training assisted by heart rate variability biofeedback: Implication for a military predeployment stress inoculation protocol

Decreased heart rate variability (HRV) is associated with posttraumatic stress disorder (PTSD) and depression symptoms, but PTSD's effects on the autonomic stress response and the potential influence of HRV biofeedback in stress relaxation training on improving PTSD symptoms are not well understood. The objective of this study was to examine the impact of a predeployment stress inoculation training (PRESTINT) protocol on physiologic measures of HRV in a large sample of the military population randomly assigned to experimental HRV biofeedback‐assisted relaxation training versus a control condition. PRESTINT altered the parasympathetic regulation of cardiac activity, with experimental subjects exhibiting greater HRV, that is, less arousal, during a posttraining combat simulation designed to heighten arousal. Autonomic reactivity was also found to be related to PTSD and self‐reported use of mental health services. Future PRESTINT training could be appropriate for efficiently teaching self‐help skills to reduce the psychological harm following trauma exposure by increasing the capacity for parasympathetically modulated reactions to stress and providing a coping tool (i.e., relaxation method) for use following a stressful situation.     

Inclusion of a rest period in diaphragmatic breathing increases high frequency heart rate variability: Implications for behavioral therapy

Heart rate variability (HRV) is associated with positive physiological and psychological effects. HRV is affected by breathing parameters, yet debate remains regarding the best breathing interventions for strengthening HRV. The objective of the current study was to test whether the inclusion of a postexhalation rest period was effective at increasing HRV, while controlling for breathing rate. A within‐subject crossover design was used with 40 participants who were assigned randomly to a breathing pattern including a postexhalation rest period or a breathing pattern that omitted the postexhalation rest period. Participants completed training on each breathing pattern, practiced for 6 min, and sat quietly during a 5‐min washout period between practices. Participants were given instructions for diaphragmatic breathing at a pace of six breaths/minute with or without a postexhalation rest period. Recordings of heart rate, breathing rate, HF‐HRV, RMSSD, LF‐HRV, and SDNN were collected before and during each of the breathing trials. HRV indices were derived from Lead 1 ECG recordings. Pairwise contrasts showed that inclusion of a postexhalation rest period significantly decreased heart rate (p < .001) and increased HF‐HRV (p < .05). No differences were found for breathing rates (p > .05), RMSSD (p > .05), and SDNN (p > .05). Results indicated that omission of the postexhalation rest period resulted in higher LF‐HRV (p < .05). A postexhalation rest period improves HF‐HRV, commonly associated with self‐regulatory control, yet the importance of a postexhalation rest period requires further exploration.     

Heart rate and heart rate variability during a novel object test and a handling test in young horses

Forty-one Dutch Warmblood immature horses were used in a study to quantify temperamental traits on the basis of heart rate (HR) and heart rate variability (HRV) measures. Half of the horses received additional training from the age of 5 months onwards; the other half did not. Horses were tested at 9, 10, 21 and 22 months of age in a novel object and a handling test. During the tests, mean HR and two heart variability indices, e.g. standard deviation of beat-to-beat intervals (SDRR) and root mean square of successive beat-to-beat differences (rMSSD), were calculated and expressed as response values to baseline measures. In both tests, horses showed at all ages a significant increase in mean HR and decrease in HRV measures, which suggests a marked shift of the balance of the autonomic nervous system towards a sympathetic dominance. In the novel object test, this shift was more pronounced in horses that had not been trained. Furthermore, statistical analysis showed that the increase in mean HR could not be entirely explained by the physical activity. The additional increase in HR, the nonmotor HR, was more pronounced in the untrained horses compared to the trained. Hence, it is suggested that this nonmotor HR might be due to the level of emotionality. HR variables showed consistency between years, as well as within the second year. These tests bring about a HR response in horses, part of which may indicate a higher level of emotionality; and horses show individual consistency of these HR variables over ages. Therefore, it is concluded that mean HR and HRV measures used with these tests quantify certain aspects of a horse's temperament.     

Circadian rhythm changes in heart rate variability during chronic sound stress

To study the circadian rhythm changes of the heart rate variability (HRV) during chronic sound stress, Wistar rats were implanted with telemetry transmitters and exposed to chronic ultrasound stress for 14 days. The heart rate, mean R-R intervals (mean R-R) and body temperature were monitored hourly. The spectra of five-minute heart rate variability were plotted on a log-log scale of frequency versus power spectral density, and the spectral exponent β of the regression line of this plot was calculated. The exponent β, heart rate (HR) and body temperature recorded hourly were plotted and fitted to sine curves to observe the circadian rhythm of these parameters. The correlation coefficient of the fitted sine curves in β decreased from 0.644 in the control period to 0.105 in the stress period, indicating that the rhythm of β deceased during stress. This did not occur in the other two parameters, demonstrating that the HRV exponent can assess chronic stress.     

Genetic influences on heart rate variability at rest and during stress

We tested whether the heritability of heart rate variability (HRV) under stress is different from rest and its dependency on ethnicity or gender. HRV indexed by root mean square of successive differences (RMSSD) and high-frequency (HF) power was measured at rest and during 3 stressors in 427 European and 308 African American twins. No ethnic or gender differences were found for any measures. There was a nonsignificant increase in heritability of RMSSD (from 0.48 to 0.58) and HF (from 0.50 to 0.58) under stress. Up to 81% and 60% of the heritabilities of RMSSD and HF under stress could be attributed to genes influencing rest levels. The heritabilities due to genes expressed under stress were 0.11 for RMSSD and 0.23 for HF. The findings suggest that, independent of ethnicity and gender, HRV regulation at rest and under stress is largely influenced by the same genes with a small but significant contribution of stress-specific genetic effects.     

Women with posttraumatic stress disorder have larger decreases in heart rate variability during stress tasks

The relationship between posttraumatic stress disorder (PTSD) and high frequency heart rate variability (HF-HRV) was investigated during a resting baseline period and two 4-minute laboratory speech tasks. Participants were 20 women with PTSD and 20 age- and gender-matched controls. Parasympathetic nervous system (PNS) cardiac control was measured as HF-HRV (0.12–0.40 Hz) using power spectrum analysis. Participants with PTSD had significantly greater reductions in HF-HRV during two speech tasks (trauma recall and mental arithmetic) than control. These results suggest that PTSD is related to the magnitude of decrease in parasympathetic cardiac control during stress in women. Health implications of altered PNS activity associated with PTSD deserve further study.     

Effects of low ambient temperature on heart rate variability during sleep in humans

The effects of cold exposure on heart rate variability (HRV) during sleep were examined. Eight male subjects slept under three different conditions: 3°C, 50–80% relative humidity (RH) [3]; 10°C, 50% RH [10]; and 17°C 50% RH [17]. No significant differences were observed in HRV during rapid eye movement sleep (REM) and wakefulness. The ratio of the low frequency (LF) to high frequency component (HF) of HRV (LF/HF) significantly differed among the conditions during stage 2 and slow wave sleep (SWS) that decreased as the ambient temperature decreased. The normalized LF [LF/(LF + HF)] significantly decreased in 3 and 10 than in 17 during SWS. In low ambient temperature, predominant cardiac parasympathetic activity during stage 2 with no significant difference during REM and wakefulness may cause variations in HRV at transition from stage 2 to REM and wakefulness. These results may partly explain the peak in adverse cardiac events during winter.     

The effect of mental stress on heart rate variability and blood pressure during computer work

The aim was to evaluate the cardiovascular and subjective stress response to a combined physical and mental workload, and the effect of rest. Twelve females who had no prior experience of laboratory experiments participated in the study. Computer-work-related mental stressors were either added to or removed from a standardized computer work session in the laboratory. Beat-to-beat blood pressure and electrocardiogram (ECG) were recorded continuously during the experiment. The participants reported subjective experiences of stress in six categories using an 11-point scale before and at the end of the work. Heart rate variability (HRV) variables were calculated from the ECG recordings, and a reduction in the high-frequency component of HRV and an increase in the low- to high-frequency ratio were observed in the stress situation compared to the control session. No changes were seen in the low-frequency component of HRV. The stressors induced an increase in blood pressure compared to baseline that persisted, and for the diastolic pressure it even increased in the subsequent control session. No differences were observed for subjective experience of stress with the exception of a time trend in the exhaustion scale, i.e. a progression in reported exhaustion with time. The results—and the dissociation between HRV and blood pressure variables—indicate that HRV is a more sensitive and selective measure of mental stress. It could be speculated that heart rate-derived variables reflect a central pathway in cardiovascular control mechanisms (central command), while the blood pressure response is more influenced by local conditions in the working muscles that partly mask the effect of changes in mental workloads. In the rest period after each work session, HRV and blood pressure variables were partly normalized as expected. However, an 8-min period of rest was insufficient to restore blood pressure to resting values.     

The regulation of heart rate during sleep

Summary One group of the experiments was carried out on cats using encéphale isolé preparations, a second group was performed on cats with chronically implanted electrodes. Cortical EEG, electromyogram, ocular movements and electrocardiogram were recorded simultaneously.Different kinds of heart denervation have been performed in order to study separately the action of the sympathetic and parasympathetic nervous system. The following results have been obtained:The changes in heart rate associated with the different states of sleep and wakefulness are controled by both the sympathetic and parasympathetic section of the autonomic nervous system.The tonic fall in heart rate during a shift from wakefulness to synchronized sleep is prepondantly caused by an increase in the vagal tonus, whereas the further decrease in heart rate during desynchronized sleep is mainly brought about by a tonically reduced sympathetic discharge.The phasic increase in heart rate following an arousal is only due to a phasic inhibition of the parasympathetic cardioinhibitory center. The phasic changes in heart rate associated with the bursts of rapid eye movements occuring during desynchronized sleep are caused by changes in the sympathetic and vagal activity as well. A detailed analysis shows that the phasic acceleration is prepondantly due to an inhibition of the vagal activity, whereas the following bradycardia is brought about by a phasic inhibition of the sympathetic output and a simultaneous increase in the vagal discharge.The results clearly demonstrate that the changes in heart rate related with the different states of sleep and wakefulness are not caused by quantitatively equal antagonistic changes in the activity of the two sections of the autonomic nervous system.This work was supported by grants from the Deutsche Forschungsgemeinschaft.     

Excess heart rate and systolic blood pressure during psychological stress in relation to metabolic demand in adolescents

Cardiovascular responses during exercise are matched to the increased metabolic demand, but this may not be the case during psychological stress. No studies to date have tested this hypothesis in youth. Fifty-four youth, ages 13-16 years completed two visits. Heart rate (HR), systolic blood pressure (SBP), and oxygen (O(2)) consumption were measured during a graded exercise test on one day and during psychological stress reactivity (star tracing, speech) on another day. Predicted HR and SBP values during psychological stress were calculated based on HR-O(2) and SBP-O(2) relationships calculated during graded exercise. At a given O(2) consumption, actual HR was greater (p<0.02) than predicted for all stress tasks. Actual SBP was greater (p<0.001) than predicted for all stress tasks. This was the first study to demonstrate that cardiovascular responses were in excess of what would be expected based on metabolic demand in youth.     

Reproducibility of heart rate variability and baroreflex sensitivity measurements in children

Despite their extensive use, the reproducibility of cardiac autonomic measurements in children is not well-known. We investigated the reproducibility of short-term continuous measurements of heart rate (HR), heart rate variability (HRV, time and frequency domain), and spontaneous baroreflex sensitivity (BRS, frequency domain) in the supine and standing position in 57 children (11.2 ± 0.7 years, 52.6% boys). Reproducibility between two sessions within a two-week interval was evaluated by intraclass correlation coefficients (ICCs), standard error of measurement, coefficients of variation (CVs), limits of agreement, and Bland-Altman plots. HR and HRV were moderately-to-highly (ICC = .63-.79; CV = 5.7%-9.7%) and BRS moderately (ICC = .49-.63; CV = 11.4%-14.0%) reproducible. While the BRS measurements were slightly less reproducible than the HR and HRV measurements, all can be reliably applied in research, thus implicating sufficient capacity to detect real differences between children. Still, clinical studies focusing on individual changes in cardiac autonomic functioning need to address the considerable random variations that may occur between test-retest measurements.     

Wavelet transform analysis of heart rate variability during myocardial ischaemia

Analysis of heart rate variability (HRV) is a valuable, non-invasive method for quantifying autonomic cardiac control in humans. Frequency-domain analysis of HRV involving myocardial ischaemic episodes should take into account its non-stationary behaviour. The wavelet transform is an alternative tool for the analysis of non-stationary signals. Fourteen patients have been analysed, ranging from 40 to 64 years old and selected from the European Electrocardiographic ST-T Database (ESDB). These records contain 33 ST episodes, according to the notation of the ESDB, with durations of between 40s and 12min. A method for analysing HRV signals using the wavelet transform was applied to obtain a time-scale representation for very low-frequency (VLF), low-frequency (LF) and high-frequency (HF) bands using the orthogonal multiresolution pyramidal algorithm. The design and implementation using fast algorithms included a specially adapted decomposition quadrature mirror filter bank for the frequency bands of interest. Comparing a normality zone against the ischaemic episode in the same record, increases in LF (0.0112±0.0101 against 0.0175±0.0208s²Hz⁻¹; p<0.1) and HF (0.0011±0.0008 against 0.0017±0.0020s²Hz⁻¹; p<0.05) were obtained. The possibility of using these indexes to develop an ischaemic-episode classifier was also tested. Results suggest that wavelet analysis provides useful information for the assessment of dynamic changes and patterns of HRV during myocardial ischaemia.     

Visual discrimination learning in dwarf goats and associated changes in heart rate and heart rate variability

We studied visual discrimination learning in a group of Nigerian dwarf goats using a computer-based learning device which was integrated in the animals' home pen. We conducted three consecutive learning tasks (T1, T2 and T3), each of which lasted for 13 days. In each task, a different set of four visual stimuli was presented on a computer screen in a four-choice design. Predefined sequences of stimulus combinations were presented in a pseudorandom order. Animals were rewarded with drinking water when they chose the positive stimulus by pressing a button next to it. Noninvasive measurements of goats' heartbeat intervals were carried out on the first and the last 2 days of each learning task. We analysed heart rate (HR) and heart rate variability (HRV) of resting animals to study sustained physiological effects related to general learning challenge rather than acute excitement during an actual learning session. The number of trials to reach the learning criterion was 1000 in T1, when visual stimuli were presented to the goats for the first time, but decreased to 210 in T2 and 240 in T3, respectively. A stable plateau of correct choices between 70% and 80% was reached on Day 10 in T1, on Day 8 in T2 and on Day 6 in T3. We found a significant influence of the task and of the interaction between task and day on learning success. Whereas HR increased throughout T1, this relationship was inverted in T2 and T3, indicating different effects on the HR depending on how familiar goats were with the learning task. We found a significant influence of the task and the interaction between task and time within the task on HRV parameters, indicating changes of vagal activity at the heart. The results suggest that changes in HR related to learning were predominantly caused by a withdrawal of vagal activity at the heart. With regard to nonlinear processes in heartbeat regulation, increased deterministic shares of HRV indicated that the animals did not really relax until the end of T3. Comparing changes of HR and HRV in T3 and in a subsequent postexperiment (PE), we assume a positive effect of such cognitive challenges once the task had been learned by the animals.     

Enhanced cardiac and attentional responding to fearful faces in 7-month-old infants

Orienting of attention to emotionally negative stimuli is accompanied by rapid heart rate (HR) deceleration, reflecting enhanced attentional and sensory processing. We studied whether similar emotional modulation of cardiac responding is observed in infants. HR and eye movements were recorded from 7-month-old infants while they observed a fearful or happy face that was flanked after 700 ms by a peripheral distractor for 2000 ms. An attentional bias for fearful faces was indicated by less frequent and longer latency saccades toward the distractors during fearful than happy trials. HR deceleration was significantly larger during fearful than happy trials on which infants did not make a distractor-directed saccade. For trials with a distractor-directed saccade, no difference between fearful and happy faces emerged. Thus, the bias to attend preferentially to fearful faces is accompanied by a concomitant increase in the cardiac orienting response.     

The effect of eccentric strength training on heart rate and on its variability during isometric exercise in healthy older men

The purpose of this study was to investigate if chronic eccentric strength training (ST) affects heart rate (HR) and heart rate variability (HRV) during sub-maximal isometric voluntary contractions (SIVC). The training group (TG) (9 men, 62 ± 2) was submitted to ST (12 weeks, 2 days/week, 2–4 sets of 8–12 repetitions at 75–80% peak torque (PT). The control group (CG) (8 men, 64 ± 4) did not perform ST. The HR and the HRV (RMSSD index) were evaluated during SIVC of the knee extension (15, 30 and 40% of PT). ST increased the eccentric torque only in TG, but did not change the isometric PT and the duration of SIVC. During SIVC, the HR response pattern and the RMSSD index were similar for both groups in pre- and post-training evaluations. Although ST increased the eccentric torque in the TG, it did not generate changes in HR or HRV.     

微机心率变异功率谱测量系统

本文报道在在IBM—PC/XT微型计算机上开发的心率变异(HRV)功率谱测量系统技术,用于无创伤性定量测量心脏植物性神经的活动。系统软件采用菜单方式设计,用8088汇编语言和FORTRAN语言编写。系统在程控下,通过对连续心电信号(ECG)的R—R间期采样计数,并利用傅利叶变换的数字技术,计算出心率变异的时域和频域参数。     

正常家兔心率变异特点

目的:记录测定正常家兔在体和离体短程心率变异情况,探讨心脏自主神经功能的变化情况,为进一步研究家兔冠状动脉粥样硬化、冠脉痉挛时自主神经变化反映在心率变异性上的特点提供基础数据.方法:在体组用正交法记录胸前心电;离体组,采用兰氏(Langendorff)心脏灌流系统基础上,用正交悬浮电极法记录心电.采用Powerlab/8sp多道生理仪采集心电波.利用Chart模块对电信号进行短程心率变异分析.结果:正常家兔在体和离体组,短程心率变异分析结果值有明显不同.结论:正常家兔短程HRV特征较人体有明显区别,其频段取值范围有明显差异;在体与离体组HRV差异与神经体液调节因素有关.     

Continuous and online analysis of heart rate variability

Spectral analysis of heart rate variability provides a probe to assess the function of the sympathetic and parasympathetic nervous systems. Time-frequency analysis of heart rate variability is useful for investigating autonomic nervous function in patients with syncope or non-sustained ventricular tachycardia, or in anaesthesia, etc. In this paper, we developed an algorithm for continuous and online analysis of heart rate variability. The algorithm was simulated and evaluated in MATLAB, and implemented on the digital signal processor. The electrocardiogram signals from MIT/BIH arrhythmia database and one patient with syncope demonstrate the capability of the proposed method in the continuous and online analysis of heart rate variability.     

Cortical thickness,resting state heart rate,and heart rate variability in female adolescents

Resting state heart rate variability (HRV) is a psychophysiological marker that has gained increasing research interest, in particular in developmental neuroscience. HRV has been shown to be associated with mental and physical health, beyond simple measures of heart rate (HR) and shows inter‐ and intraindividual variance across aging. Recently, three studies reported on a positive correlation between resting state HRV and cortical thickness in selected regions of interest (ROIs) in adult samples. Structural thickness, HRV, and HR change during the sensitive period of adolescence. Previously, no study has addressed the structural concomitants of resting HR and HRV in adolescents. Cortical thickness (3‐T MRI), HR, and HRV were recorded in 20 healthy, female adolescents (mean age: 15.92 years; SD = 1.06; range: 14–17). In line with existing research in adults, cortical thickness in a number of ROIs was associated with resting state HRV but not HR. The comparison of regression analyses using the Bayes factor revealed evidence for a correlation between HRV and cortical thickness of the bilateral rostral anterior cingulate cortex. However, unlike in adults, greater cortical thickness was associated with reduced HRV in female adolescents. Analyses on HR showed no superior model fit. Results suggest that greater HRV might be beneficial for cortical development during adolescence (cortical thinning). On the other hand, cortical development might determine changes in autonomic nervous system function in adolescents. Future studies are needed to replicate these findings in larger samples including boys and to test these hypotheses in longitudinal designs.