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"heart rate variability"

Original Articles

The Relationship between Heart Rate Variability and Aortic Knob Width
Si-Yeun Sung, Jee-Hye Han, Jung-Hwan Kim, Kil-Young Kwon, Seong-Wook Park
Korean J Fam Med 2019;40(1):39-44.   Published online January 9, 2019
DOI: https://doi.org/10.4082/kjfm.18.0077
Background
The aortic knob width (AKW) and the heart rate variability (HRV) were suggested to be related to development of cardiovascular diseases. However, the relationship between them has not been investigated; thus, this study aimed to determine this relationship.
Methods
This study included 587 Koreans aged 18–79 years. Their physical measurements, medical and social histories, blood test findings, and chest radiographs were obtained. The HRV parameters included the standard deviation of the N-N interval (SDNN), root mean square of successive differences (RMSSD), approximate entropy (ApEn), total power (TP), very low frequency (VLF), low frequency (LF), high frequency (HF), and LF/HF ratio, which were measured for 5 minutes. The AKW was measured on chest radiographs by a single reviewer.
Results
The AKW was significantly correlated with the HRV parameters, except for the LF/HF ratio. However, RMSSD and ApEn were not significantly related to the AKW in women. After dividing the participants into quartile groups, the AKW was significantly related to the SDNN, RMSSD, TP, VLF, LF, and HF. The HRV parameter values decreased in the higher AKW quartile groups, the HRV parameter values decreased. After adjusting for sex, drinking status, exercise habits, smoking status, waist circumference, and triglyceride, low-density lipoprotein cholesterol, fasting blood sugar, and glycated hemoglobin levels, the AKW showed significant negative associations with the HRV parameters, except for the LF/HF ratio.
Conclusion
The AKW is significantly associated with the HRV parameters of SDNN, RMSSD, ApEn, TP, VLF, LF, and HF.
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  • 2 Web of Science
The Relationship among Pulse Wave Velocity, Ankle-Brachial Pressure Index and Heart Rate Variability in Adult Males
Jeong-Hwan Ahn, Mihee Kong
Korean J Fam Med 2011;32(7):406-411.   Published online November 30, 2011
DOI: https://doi.org/10.4082/kjfm.2011.32.7.406
Background

Pulse wave velocity (PWV) and ankle-brachial pressure index (ABI) are non-invasive tools to measure atherosclerosis and arterial stiffness. Heart rate variability (HRV) has proven to be a non-invasive powerful tool in the investigation of the autonomic cardiovascular control. Therefore, the purpose of this study was to determine the relationship among PWV, ABI, and HRV parameters in adult males.

Methods

The study was carried out with 117 males who visited a health care center from April, 2009 to May, 2010. We conducted blood sampling (total cholesterol, triglyceride, high density lipoprotein, cholesterol, fasting glucose) and physical examination. We studied brachial-ankle PWV (baPWV) and ABI. We examined HRV parameters including standard deviation of NN interval (SDNN), low frequency (LF), high frequency (HF), LF/HF ratio. We analyzed the relationship among baPWV, ABI, and HRV parameters.

Results

SDNN had a significant negative correlation with age, systolic blood pressure and heart rate. LF and HF had a significant negative correlation with age, and age and heart rate, respectively. baPWV was significantly and positively associated with age, systolic and diastolic blood pressures, total cholesterol, fasting glucose and heart rate. ABI was negative correlated significantly with systolic and diastolic blood pressures and heart rate. After adjusting for all associated variables, baPWV was not correlated with HRV parameters, but there was a significant positive association between SDNN and ABI (r = 0.195, P = 0.014).

Conclusion

SDNN of HRV parameters had a significant positive correlation with ABI.

Citations

Citations to this article as recorded by  
  • The Influence of Autonomic Nervous System during Resting State on the Peripheral Pulse Wave Velocity in Young Adult Males
    Zainab Nazar Al-Wahab, Ali Fouad Saleem, Bassam Talib Al-Gailani
    Mustansiriya Medical Journal.2024; 23(1): 34.     CrossRef
  • Pulse Wave Velocity: Methodology, Clinical Applications, and Interplay with Heart Rate Variability
    Niklas Pilz, Viktor Heinz, Timon Ax, Leon Fesseler, Andreas Patzak, Tomas Lucca Bothe
    Reviews in Cardiovascular Medicine.2024;[Epub]     CrossRef
  • Brachial-ankle pulse wave velocity increasing with heart rate accelerates
    Qian Wang, Xinxin Xu, Xue Geng, Haijuan Hu, Wei Cui
    Frontiers in Cardiovascular Medicine.2023;[Epub]     CrossRef
  • Acute psychological stress, autonomic function, and arterial stiffness among women
    Jeongok G. Logan, Bethany A. Teachman, Xiaoyue Liu, Charles R. Farber, Zhenqi Liu, Brian H. Annex
    International Journal of Psychophysiology.2020; 155: 219.     CrossRef
  • Pulse rate variability in cardiovascular health: a review on its applications and relationship with heart rate variability
    Elisa Mejía-Mejía, James M May, Robinson Torres, Panayiotis A Kyriacou
    Physiological Measurement.2020; 41(7): 07TR01.     CrossRef
  • Fed and fasted states on heart rate variability, hemodynamic heart rate and blood pressure in adults submitted to moderate aerobic exercise
    J.A.L. Rodrigues, A.C. Yamane, T.C.P. Gonçalves, C. Kalva-Filho, M. Papoti, C.R.B. Júnior
    IJC Heart & Vasculature.2019; 23: 100378.     CrossRef
  • Complex nonlinear autonomic nervous system modulation link cardiac autonomic neuropathy and peripheral vascular disease
    Kinda Khalaf, Herbert F. Jelinek, Caroline Robinson, David J. Cornforth, Mika P. Tarvainen, Hayder Al-Aubaidy
    Frontiers in Physiology.2015;[Epub]     CrossRef
  • Noninvasive Technique for the Diagnosis of Patent Ductus Arteriosus in Premature Infants by Analyzing Pulse Wave Phases on Photoplethysmography Signals Measured in the Right Hand and the Left Foot
    Sabrina Goudjil, Fatiha Imestouren, Aurelie Armougon, Lucie Razafimanantsoa, Mahdi Mahmoudzadeh, Fabrice Wallois, André Leke, Guy Kongolo, Vincenzo Lionetti
    PLoS ONE.2014; 9(6): e98763.     CrossRef
  • 4,246 View
  • 29 Download
  • 8 Crossref
The Relationship between Menopausal Symptoms and Heart Rate Variability in Middle Aged Women
Jin Oh Lee, Sung Goo Kang, Se Hong Kim, Seo Jin Park, Sang Wook Song
Korean J Fam Med 2011;32(5):299-305.   Published online July 28, 2011
DOI: https://doi.org/10.4082/kjfm.2011.32.5.299
Background

The study of the correlation of menopausal symptoms with heart rate variability (HRV) has not been adequate. The aim of this study was to investigate the relationship between postmenopausal symptoms measured by the menopause rating scale (MRS) and HRV.

Methods

We assessed postmenopausal symptoms (using MRS) with age, BMI, educational status, occupation, marital status, alcohol and caffeine consumption, smoking history, exercise, duration of sleep and amenorrhea, degree of anxiety and depression, menarcheal age, and heart rate variability. For evaluation of HRV, the record of electrocardiogram for 5 minutes in the resting state was divided into temporal categories and frequency categories, and analyzed.

Results

No significant differences in age, BMI, duration of amenorrhea, heart rate, systolic blood pressure, diastolic blood pressure, fasting blood sugar, triglyceride, and high-density lipoprotein were observed between two groups, which were divided according to menopausal symptoms. Low frequency/high frequency (LF/HF) ratio was significantly higher in symptomatic women, compared with asymptomatic women (P < 0.05). No significant differences of HRV index by the severity of postmenopausal symptoms were observed. LF/HF ratio of HRV parameters showed a significant increase in moderate or severe degree of "hot flashes" and "sleep problem" score (P < 0.05). Anxiety scale in symptomatic women was significantly higher than in asymptomatic women (P < 0.05).

Conclusion

The above data suggest that postmenopausal symptoms are associated with altered autonomic control of heart rate. In particular, hot flashes and sleep problems in moderate or severe degree are related to increase of sympathetic nerve activity.

Citations

Citations to this article as recorded by  
  • Association of cardiac autonomic modulation with different intensities of physical activity in a small Brazilian inner city: A gender analysis
    Diego G.D. Christofaro, William R. Tebar, Luiz Carlos M. Vanderlei, Rômulo A. Fernandes, Jorge Mota, Gregore I. Mielke, Raphael M. Ritti‐Dias
    European Journal of Sport Science.2023; 23(4): 649.     CrossRef
  • Heart rate variability in patients with dementia or neurocognitive disorders: A systematic review and meta-analysis
    Ying-Chih Cheng, Yu-Chen Huang, Wei-Lieh Huang
    Australian & New Zealand Journal of Psychiatry.2022; 56(1): 16.     CrossRef
  • Decreased Frequency of Mental Workload-Induced Subjective Hot Flashes Through Gum Massage: An Open-Label, Self-Controlled Crossover Trial
    Kanako Ichinose, Riho Tateyama-Makino, Asami Miyajima, Satoru Morishita, Taku Iwamoto, Yukio Yamamoto
    Women's Health Reports.2022; 3(1): 335.     CrossRef
  • Heart rate behavior on the menopause stages
    Dulce Madagleno-Arroyo, Mauricio Sanchez-Barajas, Marysol Garcia-Perez, Teodoro Cordova-Fraga
    Revista de Fisioterapia y Tecnología Médica.2022; : 14.     CrossRef
  • Decreased baroreflex sensitivity is associated with cardiometabolic risks and prehypertension status in early-postmenopausal women
    Soundirarajan Subhashri, Pravati Pal, Gopal Krushna Pal, Dasari Papa, Nivedita Nanda
    Clinical and Experimental Hypertension.2021; 43(2): 112.     CrossRef
  • Menopausal symptoms are associated with oral sensory complaints in perimenopausal women: an observational study
    Tomoharu Taga, Kayoko Ito, Kiyoshi Takamatsu, Mariko Ogawa, Saori Funayama, Makoto Inoue
    BMC Women's Health.2021;[Epub]     CrossRef
  • Estrogen Deprivation and Myocardial Infarction: Role of Aerobic Exercise Training, Inflammation and Metabolomics
    Olívia M. Ruberti, Bruno Rodrigues
    Current Cardiology Reviews.2021; 16(4): 292.     CrossRef
  • The influence of autogenic training on the physical properties of skin and cardiac autonomic activity in postmenopausal women: an exploratory study
    Shingo Sakai, Mayumi Inoue‐Sato, Rei Amemiya, Motoko Murakami, Kazuki Inagaki, Yosuke Sakairi
    International Journal of Dermatology.2020; 59(1): 103.     CrossRef
  • Heart rate variability helps to distinguish the intensity of menopausal symptoms: A prospective, observational and transversal study
    Patrícia Merly Martinelli, Isabel Cristina Esposito Sorpreso, Rodrigo Daminello Raimundo, Osvaldo de Souza Leal Junior, Juliana Zangirolami-Raimundo, Marcos Venicius Malveira de Lima, Andrés Pérez-Riera, Valdelias Xavier Pereira, Khalifa Elmusharaf, Vitor
    PLOS ONE.2020; 15(1): e0225866.     CrossRef
  • Isoflavone does not promote additional effects on heart rate variability of postmenopausal women performing combined exercise training: a clinical, controlled, randomized, double-blind study
    Igor Moraes Mariano, Victor Hugo de Freitas, Juliene Gonçalves Costa Dechichi, Jaqueline Pontes Batista, Tállita Cristina Ferreira de Souza, Ana Luiza Amaral, Mateus de Lima Rodrigues, Victor Hugo Vilarinho Carrijo, Guilherme Morais Puga
    Applied Physiology, Nutrition, and Metabolism.2020; 45(4): 362.     CrossRef
  • Sex differences in cardiovascular responses to orthostatic challenge in healthy older persons: A pilot study
    C Sachse, I Trozic, B Brix, A Roessler, N Goswami
    Physiology International.2019; 106(3): 236.     CrossRef
  • Electrodermal response to auditory stimuli in relation to menopausal transition period
    Ashwini Kishan, Nikitha Marakur, Shailaja Moodithaya, Amrit M. Mirajkar
    Journal of Basic and Clinical Physiology and Pharmacology.2018; 29(2): 123.     CrossRef
  • Cardiac autonomic function and hot flashes among perimenopausal and postmenopausal women
    Carolyn J. Gibson, Wendy Berry Mendes, Michael Schembri, Deborah Grady, Alison J. Huang
    Menopause.2017; 24(7): 756.     CrossRef
  • The application of yin-yang concept on heart rate variability patterns in menopausal women with insomnia
    Yen-ying Kung, Cheryl C. H. Yang, Jen-hwey Chiu, Terry B. J. Kuo
    Chinese Journal of Integrative Medicine.2016;[Epub]     CrossRef
  • Is heart rate variability associated with frequency and intensity of vasomotor symptoms among healthy perimenopausal and postmenopausal women?
    Salene M. W. Jones, Katherine A. Guthrie, Andrea Z. LaCroix, Barbara Sternfeld, Carol A. Landis, Susan D. Reed, Andrea Dunn, Bette Caan, Lee S. Cohen, Julie Hunt, Katherine M. Newton
    Clinical Autonomic Research.2016; 26(1): 7.     CrossRef
  • Elevated resting heart rate predisposes metabolic syndrome in women rather than in men: a 15-year prospective study
    Si Wang, Kai Liu, Xin Zhang, Qingtao Meng, Yong Wang, Shixi Wan, Xiaoping Chen
    BMC Cardiovascular Disorders.2015;[Epub]     CrossRef
  • A Hyperlipidic Diet Combined with Short‐Term Ovariectomy Increases Adiposity and Hyperleptinemia and Decreases Cytokine Content in Mesenteric Adipose Tissue
    Nelson Inacio Pinto Neto, Maria Elizabeth Sousa Rodrigues, Ana Claudia Losinskas Hachul, Mayara Franzoi Moreno, Valter Tadeu Boldarine, Eliane Beraldi Ribeiro, Lila Missae Oyama, Claudia Maria Oller do Nascimento, Kaijun Niu
    Mediators of Inflammation.2015;[Epub]     CrossRef
  • Hot Flashes and Hypogonadism Symptoms in Patients with Prostate Cancer Receiving Hormone Replacement Therapy
    Hyun Hye Park, Jeong Sook Park
    Korean Journal of Adult Nursing.2014; 26(2): 159.     CrossRef
  • Impact of Caffeine on Heart Rate Variability: A Systematic Review
    Julian Koenig, Marc N. Jarczok, Wolfgang Kuhn, Katharina Morsch, Alexander Schäfer, Thomas K. Hillecke, Julian F. Thayer
    Journal of Caffeine Research.2013; 3(1): 22.     CrossRef
  • Relationships between oriental medical pattern diagnosis and cardiovascular autonomic function
    Young-Jae Park, Jin-Moo Lee, Young-Bae Park
    European Journal of Integrative Medicine.2013; 5(6): 506.     CrossRef
  • Herzfrequenzvariabilität in der Postmenopause
    G. Capaldo, M. Wilhelm, P. Stute
    Gynäkologische Endokrinologie.2013; 11(2): 140.     CrossRef
  • Comparison of Heart Rate Variability between Mild and Severe Depression in Menopausal Women with Low Exercise Behavior
    Wen-Dien Chang, Chia-Lun Lee, Chien-Tsung Tsai
    Journal of Physical Therapy Science.2013; 25(1): 69.     CrossRef
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  • 22 Crossref
The Association between Symptoms of Autonomic Neuropathy and the Heart Rate Variability in Diabetics
Min-Young Chun, Hoon-Ki Park, Hwan-Sik Hwang, Jae-Il Han, Young-Joon Chee, Jong-Sill Lee
Korean J Fam Med 2011;32(5):292-298.   Published online July 28, 2011
DOI: https://doi.org/10.4082/kjfm.2011.32.5.292
Background

There are few tools to detect the diabetic autonomic neuropathy at an earlier stage. This study was conducted to investigate the association between symptoms of autonomic neuropathy and the heart rate variability (HRV) in diabetics.

Methods

Study subjects consisted of 50 diabetic patients and 30 outpatient hospital control patients at a university family medicine department. The patients completed a Korean version of composite autonomic symptom scale (COMPASS). Electrocardiography was recorded in the supine position, on standing, and during deep breathing, for 5 minutes each. HRV of frequency domain was calculated by power spectral analysis.

Results

The COMPASS score was higher in female diabetic patients compared with that in controls. Among 50 diabetic patients, the total COMPASS score correlated positively with normalized low frequency (LF) score (normalized units, n.u.) (r = 0.62, P < 0 .001) and low frequency/high frequency (LF/HF) (r = 0.77, P < 0.001), negatively with normalized HF score (n.u.) (r = -0.59, P < 0.001) and RMSSD (square root of the mean of the sum of the square of differences between adjacent NN interval; r = -0.33, P = 0.031). The decrease in LF (n.u) and the increase in HF (n.u) by deep breathing from the supine position were higher in diabetic patients compared with those in controls. The increase in LF (n.u) and the decrease in HF (n.u) by standing from the supine position were lower in diabetic patients compared with those in controls.

Conclusion

The COMPASS score correlated with some component score of the HRV in diabetics. The HRV may be used as a tool to detect diabetic autonomic neuropathy by augmentation with position change.

Citations

Citations to this article as recorded by  
  • Multifractal Heart Rate Value Analysis: A Novel Approach for Diabetic Neuropathy Diagnosis
    Andrea Coppola, Sergio Conte, Donatella Pastore, Francesca Chiereghin, Giulia Donadel
    Healthcare.2024; 12(2): 234.     CrossRef
  • Screening Cardiovascular Autonomic Neuropathy in Diabetic Patients With Microvascular Complications Using Machine Learning: A 24-Hour Heart Rate Variability Study
    Mohanad Alkhodari, Mamunur Rashid, Mohammad Abdul Mukit, Khawza I. Ahmed, Raqibul Mostafa, Sharmin Parveen, Ahsan H. Khandoker
    IEEE Access.2021; 9: 119171.     CrossRef
  • Evaluation of the Degree of Agreement of Four Methods for Diagnosing Diabetic Autonomic Neuropathy
    Yu Peng, Ying-shan Liu, Min-yi Wu, Chu-na Chen, Chu-qiao Li, An-qi Jiang, Chong-xin Li, Yao Wang, Ge Tian, Su-yue Pan, Ling-ling Xu
    Frontiers in Neurology.2021;[Epub]     CrossRef
  • Assessment of heart rate variability (HRV) in subjects with type 2 diabetes mellitus with and without diabetic foot: correlations with endothelial dysfunction indices and markers of adipo-inflammatory dysfunction
    Antonino Tuttolomondo, Alessandro Del Cuore, Alessandro La Malfa, Alessandra Casuccio, Mario Daidone, Carlo Domenico Maida, Domenico Di Raimondo, Tiziana Di Chiara, Maria Grazia Puleo, Rosario Norrito, Giovanni Guercio, Antonio Pinto
    Cardiovascular Diabetology.2021;[Epub]     CrossRef
  • Manifestazioni cliniche della neuropatia autonomica diabetica: valutazione dei sintomi
    Carla Greco, Chiara Pacchioni, Manuela Simoni
    L'Endocrinologo.2021; 22(6): 514.     CrossRef
  • Different Clinical Expression of Anxiety Disorders in Children and Adolescents: Assessment and Treatment
    Nada Pop-Jordanova
    PRILOZI.2019; 40(1): 5.     CrossRef
  • Validation of the Composite Autonomic Symptom Score 31 (COMPASS 31) for the assessment of symptoms of autonomic neuropathy in people with diabetes
    C. Greco, F. Di Gennaro, C. D'Amato, R. Morganti, D. Corradini, A. Sun, S. Longo, D. Lauro, G. Pierangeli, P. Cortelli, V. Spallone
    Diabetic Medicine.2017; 34(6): 834.     CrossRef
  • Changes before and after improvement of subjective sleep state of a man diagnosed with pre-diabetes and sleep disorder
    Miki Sato, Yuko Yasuhara, Tetsuya Tanioka, Yukie Iwasa, Toshiyuki Yasui, Masafumi Miyake, Haruo Kobayashi, Waraporn Kongsuwan, Rozzano C. Locsin
    Health.2013; 05(03): 504.     CrossRef
  • 4,047 View
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  • 8 Crossref
The Changes in Heart Rate Variability between Morning and Afternoon.
Chang Jin Choi, Whan Seok Choi, Kyung Soo Kim
J Korean Acad Fam Med 2008;29(8):579-584.   Published online August 10, 2008
Background
Short-term measurement of heart rate variability is known to be a non-invasive technique to examine autonomic nerve system. Heart rate variability exhibits circadian rhythm according to work/sleep cycle and biological clock. In primary practice, short-term measurement of heart rate variability is usually used during the day. Therefore the aims of this study were to investigate the possibility of differences in heart rate variability between morning and afternoon and also to examine the relationship among associated factors. Methods: Sixty-eight healthy volunteers underwent short- term measurement of heart rate variability on two occasions: in the morning (08:30∼11:00) and in the afternoon (13:30∼16:00). A structured questionnaire was used to access general characteristics, emotion, fatigue and sleeping hours. Results: The mean heart rate was significantly increased and SDNN, RMSSD, TP, HF and VLF were significantly decreased in the afternoon compared to the morning. LF and LF/HF were not changed. The anxiety group, the depression group and the fatigue group showed significantly greater reduction in TP and RMDDS than the control group. Conclusion: In the afternoon, parasympathetic activity and total power were decreased significantly compared to the morning. Short-term heart rate variability should be measured in the same time zone and need to consider food intake effect. Those who complained of anxiety, depression or fatigue were related to much decrease in TP and RMSSD in the afternoon. (J Korean Acad Fam Med 2008;29:579-584)
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Changes in Heart Rate Variability after Weight Reduction in the Obese.
Nam Seok Joo, Soo Bum Park, Kwang Min Kim, Sang Man Kim, Duk Joo Lee, Bom Taeck Kim
J Korean Acad Fam Med 2005;26(11):693-698.   Published online November 10, 2005
Background
: Obesity increases morbidities and mortalities due to cardiovascular diseases. In previous studies, decrease in heart rate variability was associated with cardiovascular death and reduced heart rate variability in the obese had been reported. The authors investigated immediate changes in the heart rate variability after weight reduction in obese individuals.

Methods : The subjects for this study were 39 Korean adults (35 female, 4 male), who visited obesity clinic in a university hospital from January 2002 to July 2003. At first visit, weight, height, body mass index (BMI) and waist circumference of the subjects were measured. We also measured parameters of heart rate variability: Mean Heart Rate (MHR), Standard Deviation of N-N interval (SDNN), The Square Root of the Mean Squared Difference of successive NN intervals (RMSSD), Total Power (TP), Low Frequency (LF), High Frequency (HF), and LF/HF ratio. Weight reduction protocol included nutritional counseling, exercise, behavioral modification and anti-obesity medications, if needed.

Results : At 12 weeks of intervention, weight, BMI, waist circumference, fat mass, and lean body mass significantly decreased (3.90±3.11 kg, -1.50±1.21 kg/m2, -4.45±5.61 cm, -3.03±2.45 kg, -1.32±1.16 kg, P<0.01, respectively). MHR (-6.17±9.65 bpm, P<0.01) and LF/ HF (-0.61±1.56, P<0.05) showed significant reduction. Changes of weight and LF were positively correlated (r=0.338, P<0.01). Changes of waist circumference was correlated with changes of SDNN (r= 0.331, P<0.05). Changes of BMI showed positive correlation with changes in TP (r=0.327, P<0.05) and LF (r=0.345, P<0.05).

Conclusion : Short term intervention for obese people decreased sympathetic nervous activity.
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Effects of Aerobic Exercise on Heart Rate Variability(HRV).
Whan Seok Choi, Sun Myeong Ock, Churl Min Kim, Byung Chae Lee, Kee Sam Jeong, Sun Ju Lee
J Korean Acad Fam Med 2005;26(9):561-566.   Published online September 10, 2005
Background
: This study was conducted to find out the difference of heart rate variability between practicing Tai Chi and walking at 6 km/hr.

Methods : Twelve healthy volunteers aged 25 to 35 were recruited through advertisement. All the subjects gave their informed consent, and the study was approved by the Institutional Review Board of the Catholic Medical Center Research Foundation. The subjects either practised Tai Chi or walked at 6 km/ hr on a treadmill machine, maintaining 5-minute rest, 20-minute exercise, and 30-minute rest. After 1 week, they switched and performed the other form of exercise. During the exercise, beat-to-beat HRV data was recorded by Polar S-810. We calculated HRV indices using Matlab software program and analyzed the mean value of HRV indices.

Results : The differences of the mean value of HRV indices of pre-exercise resting period were not significant. However, repeated ANOVA revealed that there were significant differences of change in the mean of SDNN (-14.27±13.03 ms, -33.67±20.23 ms; P=0.023), RMSSD (-10.17±9.59 ms, -21.90±12.60 ms; P=0.087), and STIDX (171.60±196.84, 1003.49±812.56; P=0.003) between practising Tai Chi and walking. The differences of change in mean heat rate, LF/HF ratio, LF, HF and TP were not significant. The differences of the mean value of HRV indices of the post-exercise resting period were not significant compared to the pre-exercise period.

Conclusion : The result of this study suggest that exertional intensity of practising Tai Chi is similar to that of walking. Moreover, practising Tai Chi may be more profitable than walking in the aspect of HRV.
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The Relationship between Heart Rate Variability and Illness Severity.
Sang Hwan Kim, Hee Jin Hwang, Jae Won Kim, Jae Yong Shim, Hye Ree Lee
J Korean Acad Fam Med 2005;26(3):152-157.   Published online March 10, 2005
Background
: In severity of illness index, there is an acute physiologic and chronic health evaluation (APACHE) scoring system which was modified to APACHE III in 1990. Heart rate variability (HRV) studies for the intensive care unit (ICU) patients provides an indirect but noninvasive probe of autonomic cardiovascular control. Therefore, we intended to find out the relationship between the APACHE III score and the HRV variables in ICU patients.

Methods : We examined 22 patients in medical ICU of one college hospital from April to May of 2003, excluding patients with cardiac disorders, neurologic disorders or surgical diseases. We also examined 22 patients in general wards of family medicine. We checked the APACHE III during the 24 hours of admission, and examined the HRV on the second day of admission and then the total power (TP), normalized low frequency (LFnorm), low frequency/ high frequency ratio (LF/HF ratio) and approximate entropy (ApEn).

Results : The average of TP (msec2) were 538.9±896.7 in ICU patients and 1605.3±3091.8 in patients of general ward. The average APACHE III score was 35.9±18.5 and by Pearson correlation analysis, the correlation coefficient between the APACHE III score and the log (TP) was -0.58 (P=0.005).

Conclusion : We found that the medical ICU patients had more decreased autonomic function than the patients of general ward, and there was a negative correlation with the APACHE III score and the disease severity.
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The Influence of Depression on Cardiac Autonomous Control in the Thirties Male Workers.
Yong Chan Kim, Sang Wook Song, Jin Hee Shin, Seong Hyun Kim, Sung Goo Kang, Su Hwa Lee
J Korean Acad Fam Med 2004;25(11):809-817.   Published online November 10, 2004
Background
: The purpose of this study was to investigate the relationship between depression and heart rate variability in the thirties male workers.

Methods : Subjects were 85 thirties male workers who had routine health examination from June to July in 2002. They were classified as the depressed group (n=15) or the non-depressed group (n=70) on the basis of Zung Self-rating Depression Scale (SDS) index. 5- minute electrocardiographic (ECG) recordings were analyzed with time and frequency domain methods of heart rate variability (HRV). Standard Deviation of NN intervals (SDNN), Root-Mean-Square of Successive Differences (RMSSD), Total Power (TP), Low Frequency (LF: 0.04∼0.15 Hz) power, High Frequency (HF: 0.15∼0.4 Hz) power, LF/HF ratio were used as the indices of HRV. The data were analyzed using SPSS 11.0/PC program.

Results : There were no significant differences among the groups in drinking, smoking, body mass index (BMI), or exercise. Heart rate variability (SDNN, rMSSD, TP, LF, HF) was significantly lower in the depressed group than in the non-depressed group. Mean heart rate was also higher in the depressed group compared with the non-depressed group, but these differences did not attain statistical significance.

Conclusion : The association of depressed mood with reduced heart rate variability in the thirties male workers reflect dysregulation of cardiac autonomous control and may explain their increased risk for cardiovascular disease. However, we should confirm those effects through the well-designed prospective study.
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The Relationship between Autonomous Function and Fatigue Rating in Patients with Fatigue.
Jeong Min Kim, Min Ju Shin, Sun Hee Lee, Whan Seok Choi, Sun Myeong Ock, Churl Min Kim, Kee Sam Jeong
J Korean Acad Fam Med 2004;25(1):52-58.   Published online January 10, 2004
Background
: This study was conducted to find out the relationship between autonomous function and fatigue rating. The subjects were patients with complaints of fatigue who visited the department of family medicine in a general hospital.

Methods : We conducted this study from April to December 2002 in patients complaining of fatigue. The subjects were categorized into low, intermediate, and high fatigue groups. Heart rate variability was measured for five minutes at rest, followed by a five minute mental arithmetic test. We analyzed the relationship between fatigue ratings and autonomous function with SPSS 10.0.

Results : There was a statistically significant increase in the mean heart rate variability in the all three groups at rest and with stress. There was a statistically significant increase in LF norm increase in the low and high fatigue groups. HF norm showed a statistically significant decrease in the intermediate and high fatigue group. The variation in LF norms was highest in the low fatigue group and lowest. With the mental arithmetic test, the low fatigue group showed decreased rMSSD, HF and HF norm values compared to the intermediate group. The above values showed decrease in the high fatigue group compared to the low group.

Conclusion : Overactivity of the sympathetic nervous system was observed as fatigue ratings increased. The cadiovascular autonomic response tended to decrease as fatigue ratings increased.
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Case Report

Heart Rate Variability in Major Depressive Disorder.
Jeong A Kim, Youn Seun Choi, Kyung Hwan Cho, Myung Ho Hong
J Korean Acad Fam Med 2003;24(12):1117-1122.   Published online December 10, 2003
In foreign country, lots of studies were reported about the relationship between heart rate variability (HRV) and cardiac mortality. Lower HRV has been identified as a independent risk factor for sudden death. By the time, the study of HRV is confined to physically diseased state such as myocardial infarction or diabetic neuropathy. However recently the tendency of HRV has been toward to make clear the relationship of HRV and psychological problem. It is well known that depressed person is affected frequently by cardiovascular disease compared with normal people. However the mechanism that depression increases cardiovascular disease is not definitely found even though the autonomic dysfunction measured in HRV is suggested a factor for this mechanism. Depressed person has decreased HRV, decreased low frequency which reflects sympathetic activity, decreased high frequency which reflects parasympathetic activity. It means they have lower autonomic activity, so they have high cardiac mortality.

Few physician knows about the utility of heart rate variability and in my thought, especially short time analysis and frequency domain method is first introduced in Korea.

So we introduce this case for as many as physician know the utility of HRV.

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Original Article
Heart Rate Variability in Metabolic Syndrome.
Yong Jae Lee, Mun Sung Kim, Bum Taek Kim, Tae Hwan Kwak, Jae Yong Shim, Hye Ree Lee
J Korean Acad Fam Med 2002;23(12):1432-1439.   Published online December 10, 2002
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