Heart Rate Variability: A Measure of Cardiovascular Health and Possible Therapeutic Target in Dysautonomic Mental and Neurological Disorders

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Abstract

Mental illness such as depression and anxiety as well as cerebrovascular disease are linked to impairment of neurocardiac function mediated by changes to the autonomic nervous system with increased sympathetic and decreased parasympathetic activity. Autonomic neurocardiac function can be evaluated by computing heart rate variability (HRV). Over the past decades, research has demonstrated the diagnostic value of HRV as independent predictor of cardiovascular mortality and as disease marker in progressive autonomic nervous system disorders such as Parkinson’s disease. Here we summarize our studies on HRV and its therapeutic modulation in the context of psychopharmacology as well as psychiatric and neurological disorders to honor the life of Professor Evgeny Vaschillo, the true pioneer of HRV research who sadly passed away on November 21st, 2020.

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Most cited references 128

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Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study.

Salim Yusuf, Steven Hawken, Stephanie Ounpuu … (2004)

Although more than 80% of the global burden of cardiovascular disease occurs in low-income and middle-income countries, knowledge of the importance of risk factors is largely derived from developed countries. Therefore, the effect of such factors on risk of coronary heart disease in most regions of the world is unknown. We established a standardised case-control study of acute myocardial infarction in 52 countries, representing every inhabited continent. 15152 cases and 14820 controls were enrolled. The relation of smoking, history of hypertension or diabetes, waist/hip ratio, dietary patterns, physical activity, consumption of alcohol, blood apolipoproteins (Apo), and psychosocial factors to myocardial infarction are reported here. Odds ratios and their 99% CIs for the association of risk factors to myocardial infarction and their population attributable risks (PAR) were calculated. Smoking (odds ratio 2.87 for current vs never, PAR 35.7% for current and former vs never), raised ApoB/ApoA1 ratio (3.25 for top vs lowest quintile, PAR 49.2% for top four quintiles vs lowest quintile), history of hypertension (1.91, PAR 17.9%), diabetes (2.37, PAR 9.9%), abdominal obesity (1.12 for top vs lowest tertile and 1.62 for middle vs lowest tertile, PAR 20.1% for top two tertiles vs lowest tertile), psychosocial factors (2.67, PAR 32.5%), daily consumption of fruits and vegetables (0.70, PAR 13.7% for lack of daily consumption), regular alcohol consumption (0.91, PAR 6.7%), and regular physical activity (0.86, PAR 12.2%), were all significantly related to acute myocardial infarction (p<0.0001 for all risk factors and p=0.03 for alcohol). These associations were noted in men and women, old and young, and in all regions of the world. Collectively, these nine risk factors accounted for 90% of the PAR in men and 94% in women. Abnormal lipids, smoking, hypertension, diabetes, abdominal obesity, psychosocial factors, consumption of fruits, vegetables, and alcohol, and regular physical activity account for most of the risk of myocardial infarction worldwide in both sexes and at all ages in all regions. This finding suggests that approaches to prevention can be based on similar principles worldwide and have the potential to prevent most premature cases of myocardial infarction.

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Heart Rate Variability : Standards of Measurement, Physiological Interpretation, and Clinical Use

T. F. o. t. E. S. o. C. t. N. A. S. Electrophysiology, Peter J. Schwartz (1996)

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The ‘Trier Social Stress Test’ – A Tool for Investigating Psychobiological Stress Responses in a Laboratory Setting

Dirk Hellhammer, Karl-Martin Pirke, Clemens Kirschbaum (2004)

This paper describes a protocol for induction of moderate psychological stress in a laboratory setting and evaluates its effects on physiological responses. The 'Trier Social Stress Test' (TSST) mainly consists of an anticipation period (10 min) and a test period (10 min) in which the subjects have to deliver a free speech and perform mental arithmetic in front of an audience. In six independent studies this protocol has been found to induce considerable changes in the concentration of ACTH, cortisol (serum and saliva), GH, prolactin as well as significant increases in heart rate. As for salivary cortisol levels, the TSST reliably led to 2- to 4-fold elevations above baseline with similar peak cortisol concentrations. Studies are summarized in which TSST-induced cortisol increases elucidated some of the multiple variables contributing to the interindividual variation in adrenocortical stress responses. The results suggest that gender, genetics and nicotine consumption can influence the individual's stress responsiveness to psychological stress while personality traits showed no correlation with cortisol responses to TSST stimulation. From these data we conclude that the TSST can serve as a tool for psychobiological research.

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Author and article information

Contributors

Martin Siepmann: martin.siepmann@uniklinikum-dresden.de

Journal

Journal ID (nlm-ta): Appl Psychophysiol Biofeedback

Journal ID (iso-abbrev): Appl Psychophysiol Biofeedback

Title: Applied Psychophysiology and Biofeedback

Publisher: Springer US (New York )

ISSN (Print): 1090-0586

ISSN (Electronic): 1573-3270

Publication date (Electronic): 22 November 2022

Publication date PMC-release: 22 November 2022

Publication date (Print): 2022

Volume: 47

Issue: 4

Pages: 273-287

Affiliations

[1 ]GRID grid.412282.f, ISNI 0000 0001 1091 2917, Department of Psychotherapy and Psychosomatic Medicine, , University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, ; Fetscherstr. 74, 01307 Dresden, Germany

[2 ]Graefliche Kliniken, Bad Driburg, Germany

[3 ]GRID grid.410607.4, Medical Psychology and Medical Sociology, , University Medical Center of the Johannes Gutenberg - University Mainz, ; Mainz, Germany

[4 ]GRID grid.4488.0, ISNI 0000 0001 2111 7257, Department of Neurology, , University Hospital Carl Gustav Carus, Technische Universität Dresden, ; Dresden, Germany

Article

Publisher ID: 9572

DOI: 10.1007/s10484-022-09572-0

PMC ID: 9718704

PubMed ID: 36417141

SO-VID: da7054e4-b2b4-4b0d-89fd-4091a84af48b

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date accepted : 4 November 2022

Funding

Funded by: Technische Universität Dresden (1019)

Open Access :

Open Access funding enabled and organized by Projekt DEAL.

Custom metadata

ScienceOpen disciplines: Neurology

Keywords: neurocardiac,autonomic,heart,psychosomatic,psychocardiology

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ScienceOpen disciplines: Neurology

Keywords: neurocardiac, autonomic, heart, psychosomatic, psychocardiology

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Heart Rate Variability: A Measure of Cardiovascular Health and Possible Therapeutic Target in Dysautonomic Mental and Neurological Disorders

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Karger: Cardiovascular System

Most cited references 128

Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study.

Heart Rate Variability : Standards of Measurement, Physiological Interpretation, and Clinical Use

The ‘Trier Social Stress Test’ – A Tool for Investigating Psychobiological Stress Responses in a Laboratory Setting

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