Abstract
Analysis of heart rate variability—the magnitude and subtle patterns of variation in length of the cardiac cycle from one heartbeat to the next—continues to yield new insights into the role of regulatory mechanisms in acute inflammation and other pathophysiology of critical illness. However, diverse methods of calculating heart rate variability and a large body of literature spanning many application domains can make selection of a particular technique and interpretation of results difficult for newcomers to the field. This chapter serves as a brief introduction for those beginning to undertake heart rate variability analyses, with emphasis on applications to the study of inflammation and critical care. It covers the biological basis and rationale for measuring heart rate variability in these domains and introduces several popular analytic methods and freely available tools for implementing these techniques. Finally, ongoing research efforts are briefly reviewed that may lead to novel diagnostic and therapeutic opportunities for improving the management of acute inflammation and other aspects of critically ill patient care.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Billman GE (2011) Heart rate variability – a historical perspective. Front Physiol 2:86
Moorman JR, Carlo WA, Kattwinkel J, Schelonka RL, Porcelli PJ, Navarrete CT et al (2011) Mortality reduction by heart rate characteristic monitoring in very low birth weight neonates: a randomized trial. J Pediatr 159(6):900–906
Gleik J (1988) Chaos: making a new science. Penguin, New York
Kamath M, Watanabe M, Upton A (eds) (2012) Heart rate variability (HRV) signal analysis: clinical applications. CRC, Boca Raton, FL
Malik M, Camm AJ (eds) (1995) Heart rate variability. Wiley-Blackwell, Hoboken, NJ
Bruner S. Physiology models. http://www.physiologymodels.info/. Accessed 10 Oct 2012
Stauss HM (2003) Heart rate variability. Am J Physiol Regul Integr Comp Physiol 285(5):R927–R931
Beck W, Barnard CN, Schrire V (1969) Heart rate after cardiac transplantation. Circulation 40(4):437–445
Bengel FM, Ueberfuhr P, Karja J, Schreiber K, Nekolla SG, Reichart B et al (2004) Sympathetic reinnervation, exercise performance and effects of beta-adrenergic blockade in cardiac transplant recipients. Eur Heart J 25(19):1726–1733
Murphy DA, Thompson GW, Ardell JL, McCraty R, Stevenson RS, Sangalang VE et al (2000) The heart reinnervates after transplantation. Ann Thorac Surg 69(6):1769–1781
Uberfuhr P, Frey AW, Reichart B (2000) Vagal reinnervation in the long term after orthotopic heart transplantation. J Heart Lung Transplant 19(10):946–950
Toledo E, Pinhas I, Aravot D, Almog Y, Akselrod S (2002) Functional restitution of cardiac control in heart transplant patients. Am J Physiol Regul Integr Comp Physiol 282(3): R900–R908
Hoyer D, Frank B, Gotze C, Stein PK, Zebrowski JJ, Baranowski R et al (2007) Interactions between short-term and long-term cardiovascular control mechanisms. Chaos 17(1):015110
Kotani K, Struzik ZR, Takamasu K, Stanley HE, Yamamoto Y (2005) Model for complex heart rate dynamics in health and diseases. Phys Rev E Stat Nonlin Soft Matter Phys 72(4 Pt 1):041904
Berntson GG, Bigger JT Jr, Eckberg DL, Grossman P, Kaufmann PG, Malik M et al (1997) Heart rate variability: origins, methods, and interpretive caveats. Psychophysiology 34(6): 623–648
(1996) Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation 93(5):1043–1065
Sandercock GR, Bromley PD, Brodie DA (2005) The reliability of short-term measurements of heart rate variability. Int J Cardiol 103(3):238–247
Kleiger RE, Stein PK, Bigger JT Jr (2005) Heart rate variability: measurement and clinical utility. Ann Noninvasive Electrocardiol 10(1):88–101
Parati G, Mancia G, Di RM, Castiglioni P (2006) Point: cardiovascular variability is/is not an index of autonomic control of circulation. J Appl Physiol 101(2):676–678
Jokinen V. Longitudinal changes and prognostic significance of cardiovascular autonomic regulation assessed by heart rate variability and analysis of non-linear heart rate dynamics. http://herkules.oulu.fi/isbn9514272005/html/index.html. Accessed 14 Oct 2012
Goldstein B, McNames J, McDonald BA, Ellenby M, Lai S, Sun Z et al (2003) Physiologic data acquisition system and database for the study of disease dynamics in the intensive care unit. Crit Care Med 31(2):433–441
Korhonen I, Ojaniemi J, Nieminen K, van Gils M, Heikela A, Kari A (1997) Building the IMPROVE Data Library. IEEE Eng Med Biol Mag 16(6):25–32
Norris PR, Riordan WP Jr, Dawant BM, Kleymeer CJ, Jenkins JM, Williams AE et al (2010) SIMON: a decade of physiological data research and development in trauma intensive care. J Healthc Eng 1(3):315–335
Saeed M, Villarroel M, Reisner AT, Clifford G, Lehman LW, Moody G et al (2011) Multiparameter intelligent monitoring in intensive care II (MIMIC-II): a public-access intensive care unit database. Crit Care Med 39(5):952–960
Goldberger AL, Amaral LAN, Glass L, Hausdorff JM, Ivanov PC, Mark RG et al (2000) PhysioBank, PhysioToolkit, and PhysioNet: components of a new research resource for complex physiologic signals. Circulation 101(23):e215–e220
Moody GB, Mark RG, Goldberger AL (2001) PhysioNet: a Web-based resource for the study of physiologic signals. IEEE Eng Med Biol Mag 20(3):70–75
Norris PR, Morris JA Jr, Ozdas A, Grogan EL, Williams AE (2005) Heart rate variability predicts trauma patient outcome as early as 12 h: implications for military and civilian triage. J Surg Res 129(1):122–128
Grogan EL, Morris JA Jr, Norris PR, France DJ, Ozdas A, Stiles RA et al (2004) Reduced heart rate volatility: an early predictor of death in trauma patients. Ann Surg 240(3): 547–554
Bigger JT Jr, Kleiger RE, Fleiss JL, Rolnitzky LM, Steinman RC, Miller JP (1988) Components of heart rate variability measured during healing of acute myocardial infarction. Am J Cardiol 61(4):208–215
Perkiomaki JS, Makikallio TH, Huikuri HV (2005) Fractal and complexity measures of heart rate variability. Clin Exp Hypertens 27(2–3):149–158
Peng CK, Havlin S, Hausdorff JM, Mietus JE, Stanley HE, Goldberger AL (1995) Fractal mechanisms and heart rate dynamics. Long-range correlations and their breakdown with disease. J Electrocardiol 28(Suppl):59–65
Goldberger AL (1997) Fractal variability versus pathologic periodicity: complexity loss and stereotypy in disease. Perspect Biol Med 40(4):543–561
Huikuri HV, Perkiomaki JS, Maestri R, Pinna GD (2009) Clinical impact of evaluation of cardiovascular control by novel methods of heart rate dynamics. Philos Transact A Math Phys Eng Sci 367(1892):1223–1238
Peng CK, Havlin S, Stanley HE, Goldberger AL (1995) Quantification of scaling exponents and crossover phenomena in nonstationary heartbeat time series. Chaos 5(1):82–87
Costa M, Goldberger AL, Peng CK (2005) Multiscale entropy analysis of biological signals. Phys Rev E Stat Nonlin Soft Matter Phys 71(2 Pt 1):021906
Yeragani VK, Srinivasan K, Vempati S, Pohl R, Balon R (1993) Fractal dimension of heart rate time series: an effective measure of autonomic function. J Appl Physiol 75(6):2429–2438
Pincus SM, Gladstone IM, Ehrenkranz RA (1991) A regularity statistic for medical data analysis. J Clin Monit 7(4):335–345
Pincus SM (1991) Approximate entropy as a measure of system complexity. Proc Natl Acad Sci USA 88(6):2297–2301
Ganz RE, Weibels G, Stacker KH, Faustmann PM, Zimmermann CW (1993) The Lyapunov exponent of heart rate dynamics as a sensitive marker of central autonomic organization: an exemplary study of early multiple sclerosis. Int J Neurosci 71(1–4):29–36
Casaleggio A, Cerutti S, Signorini MG (1997) Study of the Lyapunov exponents in heart rate variability signals. Methods Inf Med 36(4–5):274–277
Norris PR, Anderson SM, Jenkins JM, Williams AE, Morris JA Jr (2008) Heart rate multiscale entropy at three hours predicts hospital mortality in 3,154 trauma patients. Shock 30(1):17–22
Trunkvalterova Z, Javorka M, Tonhajzerova I, Javorkova J, Lazarova Z, Javorka K et al (2008) Reduced short-term complexity of heart rate and blood pressure dynamics in patients with diabetes mellitus type 1: multiscale entropy analysis. Physiol Meas 29(7):817–828
Ahmad S, Ramsay T, Huebsch L, Flanagan S, McDiarmid S, Batkin I et al (2009) Continuous multi-parameter heart rate variability analysis heralds onset of sepsis in adults. PLoS One 4(8):e6642
Riordan WP Jr, Norris PR, Jenkins JM, Morris JA Jr (2009) Early loss of heart rate complexity predicts mortality regardless of mechanism, anatomic location, or severity of injury in 2178 trauma patients. J Surg Res 156(2):283–289
Papaioannou VE, Chouvarda I, Maglaveras N, Dragoumanis C, Pneumatikos I (2011) Changes of heart and respiratory rate dynamics during weaning from mechanical ventilation: a study of physiologic complexity in surgical critically ill patients. J Crit Care 26(3): 262–272
Ho YL, Lin C, Lin YH, Lo MT (2011) The prognostic value of non-linear analysis of heart rate variability in patients with congestive heart failure – a pilot study of multiscale entropy. PLoS One 6(4):e18699
Norris PR, Stein PK, Morris JA Jr (2008) Reduced heart rate multiscale entropy predicts death in critical illness: a study of physiologic complexity in 285 trauma patients. J Crit Care 23(3):399–405
Shannon CE (1948) A mathematical theory of communication. Bell Syst Tech J 27(3): 379–423
Lake DE, Richman JS, Griffin MP, Moorman JR (2002) Sample entropy analysis of neonatal heart rate variability. Am J Physiol Regul Integr Comp Physiol 283(3):R789–R797
Richman JS, Moorman JR (2000) Physiological time-series analysis using approximate entropy and sample entropy. Am J Physiol Heart Circ Physiol 278(6):H2039–H2049
Reynolds EW Jr, Muller BF, Anderson GJ, Muller BT (1967) High-frequency components in the electrocardiogram. A comparative study of normals and patients with myocardial disease. Circulation 35(1):195–206
Akselrod S, Gordon D, Ubel FA, Shannon DC, Berger AC, Cohen RJ (1981) Power spectrum analysis of heart rate fluctuation: a quantitative probe of beat-to-beat cardiovascular control. Science 213(4504):220–222
Peters CH, Vullings R, Rooijakkers MJ, Bergmans JW, Oei SG, Wijn PF (2011) A continuous wavelet transform-based method for time-frequency analysis of artefact-corrected heart rate variability data. Physiol Meas 32(10):1517–1527
Belova NY, Mihaylov SV, Piryova BG (2007) Wavelet transform: a better approach for the evaluation of instantaneous changes in heart rate variability. Auton Neurosci 131(1–2):107–122
Crowe JA, Gibson NM, Woolfson MS, Somekh MG (1992) Wavelet transform as a potential tool for ECG analysis and compression. J Biomed Eng 14(3):268–272
Mietus JE and Goldberger AL. Heart rate variability analysis with the HRV toolkit. http://physionet.org/tutorials/hrv-toolkit/. Accessed 12 Oct 2012
Clifford GD, Tarassenko L (2005) Quantifying errors in spectral estimates of HRV due to beat replacement and resampling. IEEE Trans Biomed Eng 52(4):630–638
KUBIOS-HRV. http://kubios.uku.fi/. Accessed 10 Oct 2012
Niskanen JP, Tarvainen MP, Ranta-Aho PO, Karjalainen PA (2004) Software for advanced HRV analysis. Comput Methods Programs Biomed 76(1):73–81
Perakakis P, Joffily M, Taylor M, Guerra P, Vila J (2010) KARDIA: a Matlab software for the analysis of cardiac interbeat intervals. Comput Methods Programs Biomed 98(1):83–89
de Carvalho JLA, da Rocha AF, de Oliveira Nascimento FA, Neto JS, Junqueira LF Jr (2002) Development of a Matlab software for analysis of heart rate variability. In: Proceedings of the 6th IEEE International conference on signal processing, vol 2, pp 1488–1491
Maestri R, Pinna GD (1998) POLYAN: a computer program for polyparametric analysis of cardio-respiratory variability signals. Comput Methods Programs Biomed 56(1):37–48
Lado M, Mendez A, Olivieri D, Rodriguez-Linares L, Vila X. R-Package RHRV: Heart rate variability analysis of ECG data. http://cran.r-project.org/web/packages/RHRV/. Accessed 20 Oct 2012
Seely AJ, Green GC, Bravi A (2011) Continuous multiorgan variability monitoring in critically ill patients – complexity science at the bedside. Conf Proc IEEE Eng Med Biol Soc 2011:5503–5506
Ghuran A, Reid F, La Rovere MT, Schmidt G, Bigger JT Jr, Camm AJ et al (2002) Heart rate turbulence-based predictors of fatal and nonfatal cardiac arrest (The Autonomic Tone and Reflexes After Myocardial Infarction substudy). Am J Cardiol 89(2):184–190
Huikuri HV, Stein PK (2012) Clinical application of heart rate variability after acute myocardial infarction. Front Physiol 3:41
Borovikova LV, Ivanova S, Zhang M, Yang H, Botchkina GI, Watkins LR et al (2000) Vagus nerve stimulation attenuates the systemic inflammatory response to endotoxin. Nature 405(6785):458–462
Huang J, Wang Y, Jiang D, Zhou J, Huang X (2010) The sympathetic-vagal balance against endotoxemia. J Neural Transm 117(6):729–735
Zhang Y, Popovic ZB, Bibevski S, Fakhry I, Sica DA, Van Wagoner DR et al (2009) Chronic vagus nerve stimulation improves autonomic control and attenuates systemic inflammation and heart failure progression in a canine high-rate pacing model. Circ Heart Fail 2(6):692–699
Hoeger S, Bergstraesser C, Selhorst J, Fontana J, Birck R, Waldherr R et al (2010) Modulation of brain dead induced inflammation by vagus nerve stimulation. Am J Transplant 10(3): 477–489
Tracey KJ (2002) The inflammatory reflex. Nature 420(6917):853–859
Olofsson PS, Rosas-Ballina M, Levine YA, Tracey KJ (2012) Rethinking inflammation: neural circuits in the regulation of immunity. Immunol Rev 248(1):188–204
Huston JM, Tracey KJ (2011) The pulse of inflammation: heart rate variability, the cholinergic anti-inflammatory pathway and implications for therapy. J Intern Med 269(1):45–53
Pavlov VA, Ochani M, Gallowitsch-Puerta M, Ochani K, Huston JM, Czura CJ et al (2006) Central muscarinic cholinergic regulation of the systemic inflammatory response during endotoxemia. Proc Natl Acad Sci USA 103(13):5219–5223
Kox M, Pompe JC, van der Hoeven JG, Hoedemaekers CW, Pickkers P (2011) Influence of different breathing patterns on heart rate variability indices and reproducibility during experimental endotoxaemia in human subjects. Clin Sci (Lond) 121(5):215–222
Kox M, Ramakers BP, Pompe JC, van der Hoeven JG, Hoedemaekers CW, Pickkers P (2011) Interplay between the acute inflammatory response and heart rate variability in healthy human volunteers. Shock 36(2):115–120
Lehrer P, Karavidas MK, Lu SE, Coyle SM, Oikawa LO, Macor M et al (2010) Voluntarily produced increases in heart rate variability modulate autonomic effects of endotoxin induced systemic inflammation: an exploratory study. Appl Psychophysiol Biofeedback 35(4):303–315
Marsland AL, Gianaros PJ, Prather AA, Jennings JR, Neumann SA, Manuck SB (2007) Stimulated production of proinflammatory cytokines covaries inversely with heart rate variability. Psychosom Med 69(8):709–716
Rassias AJ, Holzberger PT, Givan AL, Fahrner SL, Yeager MP (2005) Decreased physiologic variability as a generalized response to human endotoxemia. Crit Care Med 33(3):512–519
Rassias AJ, Guyre PM, Yeager MP (2011) Hydrocortisone at stress-associated concentrations helps maintain human heart rate variability during subsequent endotoxin challenge. J Crit Care 26(6):636.e1–636.e5
Fairchild KD, Saucerman JJ, Raynor LL, Sivak JA, Xiao Y, Lake DE et al (2009) Endotoxin depresses heart rate variability in mice: cytokine and steroid effects. Am J Physiol Regul Integr Comp Physiol 297(4):R1019–R1027
Gholami M, Mazaheri P, Mohamadi A, Dehpour T, Safari F, Hajizadeh S et al (2012) Endotoxemia is associated with partial uncoupling of cardiac pacemaker from cholinergic neural control in rats. Shock 37(2):219–227
Huang W, Zhu T, Pan X, Hu M, Lu SE, Lin Y et al (2012) Air pollution and autonomic and vascular dysfunction in patients with cardiovascular disease: interactions of systemic inflammation, overweight, and gender. Am J Epidemiol 176(2):117–126
Luttmann-Gibson H, Suh HH, Coull BA, Dockery DW, Sarnat SE, Schwartz J et al (2010) Systemic inflammation, heart rate variability and air pollution in a cohort of senior adults. Occup Environ Med 67(9):625–630
Fang SC, Cavallari JM, Eisen EA, Chen JC, Mittleman MA, Christiani DC (2009) Vascular function, inflammation, and variations in cardiac autonomic responses to particulate matter among welders. Am J Epidemiol 169(7):848–856
Lanza GA, Barone L, Scalone G, Pitocco D, Sgueglia GA, Mollo R et al (2011) Inflammation-related effects of adjuvant influenza A vaccination on platelet activation and cardiac autonomic function. J Intern Med 269(1):118–125
Hamaad A, Sosin M, Blann AD, Patel J, Lip GY, MacFadyen RJ (2005) Markers of inflammation in acute coronary syndromes: association with increased heart rate and reductions in heart rate variability. Clin Cardiol 28(12):570–576
Kon H, Nagano M, Tanaka F, Satoh K, Segawa T, Nakamura M (2006) Association of decreased variation of R-R interval and elevated serum C-reactive protein level in a general population in Japan. Int Heart J 47(6):867–876
Frasure-Smith N, Lesperance F, Irwin MR, Talajic M, Pollock BG (2009) The relationships among heart rate variability, inflammatory markers and depression in coronary heart disease patients. Brain Behav Immun 23(8):1140–1147
Haarala A, Kahonen M, Eklund C, Jylhava J, Koskinen T, Taittonen L et al (2011) Heart rate variability is independently associated with C-reactive protein but not with Serum amyloid A. The Cardiovascular Risk in Young Finns Study. Eur J Clin Invest 41(9):951–957
Lampert R, Bremner JD, Su S, Miller A, Lee F, Cheema F et al (2008) Decreased heart rate variability is associated with higher levels of inflammation in middle-aged men. Am Heart J 156(4):759 e1–759 e7
Papaioannou VE, Dragoumanis C, Theodorou V, Gargaretas C, Pneumatikos I (2009) Relation of heart rate variability to serum levels of C-reactive protein, interleukin 6, and 10 in patients with sepsis and septic shock. J Crit Care 24(4):625–627
Singh P, Hawkley LC, McDade TW, Cacioppo JT, Masi CM (2009) Autonomic tone and C-reactive protein: a prospective population-based study. Clin Auton Res 19(6):367–374
Sloan RP, McCreath H, Tracey KJ, Sidney S, Liu K, Seeman T (2007) RR interval variability is inversely related to inflammatory markers: the CARDIA study. Mol Med 13(3–4): 178–184
Thayer JF, Fischer JE (2009) Heart rate variability, overnight urinary norepinephrine and C-reactive protein: evidence for the cholinergic anti-inflammatory pathway in healthy human adults. J Intern Med 265(4):439–447
von Känel R, Carney RM, Zhao S, Whooley MA (2011) Heart rate variability and biomarkers of systemic inflammation in patients with stable coronary heart disease: findings from the Heart and Soul Study. Clin Res Cardiol 100(3):241–247
Lowensohn RI, Weiss M, Hon EH (1977) Heart-rate variability in brain-damaged adults. Lancet 1(8012):626–628
Winchell RJ, Hoyt DB (1997) Analysis of heart-rate variability: a noninvasive predictor of death and poor outcome in patients with severe head injury. J Trauma 43(6):927–933
Riordan WP Jr, Cotton BA, Norris PR, Waitman LR, Jenkins JM, Morris JA Jr (2007) Beta-blocker exposure in patients with severe traumatic brain injury (TBI) and cardiac uncoupling. J Trauma 63(3):503–510
Baguley IJ, Heriseanu RE, Felmingham KL, Cameron ID (2006) Dysautonomia and heart rate variability following severe traumatic brain injury. Brain Inj 20(4):437–444
Goldstein B, Kempski MH, DeKing D, Cox C, DeLong DJ, Kelly MM et al (1996) Autonomic control of heart rate after brain injury in children. Crit Care Med 24(2):234–240
Proctor KG, Atapattu SA, Duncan RC (2007) Heart rate variability index in trauma patients. J Trauma 63(1):33–43
Fathizadeh P, Shoemaker WC, Wo CC, Colombo J (2004) Autonomic activity in trauma patients based on variability of heart rate and respiratory rate. Crit Care Med 32(6): 1300–1305
Norris PR, Ozdas A, Cao H, Williams AE, Harrell FE, Jenkins JM et al (2006) Cardiac uncoupling and heart rate variability stratify ICU patients by mortality: a study of 2088 trauma patients. Ann Surg 243(6):804–812
Cooke WH, Salinas J, Convertino VA, Ludwig DA, Hinds D, Duke JH et al (2006) Heart rate variability and its association with mortality in prehospital trauma patients. J Trauma 60(2): 363–370
Batchinsky AI, Cancio LC, Salinas J, Kuusela T, Cooke WH, Wang JJ et al (2007) Prehospital loss of R-to-R interval complexity is associated with mortality in trauma patients. J Trauma 63(3):512–518
Batchinsky AI, Skinner JE, Necsoiu C, Jordan BS, Weiss D, Cancio LC (2010) New measures of heart-rate complexity: effect of chest trauma and hemorrhage. J Trauma 68(5):1178–1185
Batchinsky AI, Cooke WH, Kuusela TA, Jordan BS, Wang JJ, Cancio LC (2007) Sympathetic nerve activity and heart rate variability during severe hemorrhagic shock in sheep. Auton Neurosci 136(1–2):43–51
Batchinsky AI, Cooke WH, Kuusela T, Cancio LC (2007) Loss of complexity characterizes the heart rate response to experimental hemorrhagic shock in swine. Crit Care Med 35(2): 519–525
Hinojosa-Laborde C, Rickards CA, Ryan KL, Convertino VA (2011) Heart rate variability during simulated hemorrhage with lower body negative pressure in high and low tolerant subjects. Front Physiol 2:85
Rickards CA, Ryan KL, Convertino VA (2010) Characterization of common measures of heart period variability in healthy human subjects: implications for patient monitoring. J Clin Monit Comput 24(1):61–70
Kox M, Vrouwenvelder MQ, Pompe JC, van der Hoeven JG, Pickkers P, Hoedemaekers CW (2012) The effects of brain injury on heart rate variability and the innate immune response in critically ill patients. J Neurotrauma 29(5):747–755
Ahmad S, Tejuja A, Newman KD, Zarychanski R, Seely AJ (2009) Clinical review: a review and analysis of heart rate variability and the diagnosis and prognosis of infection. Crit Care 13(6):232
Werdan K, Schmidt H, Ebelt H, Zorn-Pauly K, Koidl B, Hoke RS et al (2009) Impaired regulation of cardiac function in sepsis, SIRS, and MODS. Can J Physiol Pharmacol 87(4): 266–274
Chen WL, Kuo CD (2007) Characteristics of heart rate variability can predict impending septic shock in emergency department patients with sepsis. Acad Emerg Med 14(5): 392–397
Chen WL, Chen JH, Huang CC, Kuo CD, Huang CI, Lee LS (2008) Heart rate variability measures as predictors of in-hospital mortality in ED patients with sepsis. Am J Emerg Med 26(4):395–401
Bravi A, Green G, Longtin A, Seely AJ (2012) Monitoring and identification of sepsis development through a composite measure of heart rate variability. PLoS One 7(9):e45666
Korach M, Sharshar T, Jarrin I, Fouillot JP, Raphael JC, Gajdos P et al (2001) Cardiac variability in critically ill adults: influence of sepsis. Crit Care Med 29(7):1380–1385
Papaioannou VE, Maglaveras N, Houvarda I, Antoniadou E, Vretzakis G (2006) Investigation of altered heart rate variability, nonlinear properties of heart rate signals, and organ dysfunction longitudinally over time in intensive care unit patients. J Crit Care 21(1):95–103
Morris JA Jr, Norris PR, Waitman LR, Ozdas A, Guillamondegui OD, Jenkins JM (2007) Adrenal insufficiency, heart rate variability, and complex biologic systems: a study of 1,871 critically ill trauma patients. J Am Coll Surg 204(5):885–892
Griffin MP, Scollan DF, Moorman JR (1994) The dynamic range of neonatal heart rate variability. J Cardiovasc Electrophysiol 5(2):112–124
Griffin MP, Lake DE, O’Shea TM, Moorman JR (2007) Heart rate characteristics and clinical signs in neonatal sepsis. Pediatr Res 61(2):222–227
Moorman JR, Lake DE, Griffin MP (2006) Heart rate characteristics monitoring for neonatal sepsis. IEEE Trans Biomed Eng 53(1):126–132
Cao H, Lake DE, Griffin MP, Moorman JR (2004) Increased nonstationarity of neonatal heart rate before the clinical diagnosis of sepsis. Ann Biomed Eng 32(2):233–244
Stein PK, Domitrovich PP, Hui N, Rautaharju P, Gottdiener J (2005) Sometimes higher heart rate variability is not better heart rate variability: results of graphical and nonlinear analyses. J Cardiovasc Electrophysiol 16(9):954–959
Fairchild KD, Srinivasan V, Moorman JR, Gaykema RP, Goehler LE (2011) Pathogen-induced heart rate changes associated with cholinergic nervous system activation. Am J Physiol Regul Integr Comp Physiol 300(2):R330–R339
Tran TY, Dunne IE, German JW (2008) Beta blockers exposure and traumatic brain injury: a literature review. Neurosurg Focus 25(4):E8
Van de Louw A, Medigue C, Papelier Y, Cottin F (2010) Positive end-expiratory pressure may alter breathing cardiovascular variability and baroreflex gain in mechanically ventilated patients. Respir Res 11:38
Borghi-Silva A, Reis MS, Mendes RG, Pantoni CB, Simoes RP, Martins LE et al (2008) Noninvasive ventilation acutely modifies heart rate variability in chronic obstructive pulmonary disease patients. Respir Med 102(8):1117–1123
Pantoni CB, Di TL, Mendes RG, Catai AM, Luzzi S, Amaral NO et al (2011) Effects of different levels of positive airway pressure on breathing pattern and heart rate variability after coronary artery bypass grafting surgery. Braz J Med Biol Res 44(1):38–45
Ng J, Sundaram S, Kadish AH, Goldberger JJ (2009) Autonomic effects on the spectral analysis of heart rate variability after exercise. Am J Physiol Heart Circ Physiol 297(4): H1421–H1428
Tarvainen MP, Georgiadis S, Laitio T, Lipponen JA, Karjalainen PA, Kaskinoro K et al (2012) Heart rate variability dynamics during low-dose propofol and dexmedetomidine anesthesia. Ann Biomed Eng 40(8):1802–1813
Bourgault AM, Brown CA, Hains SM, Parlow JL (2006) Effects of endotracheal tube suctioning on arterial oxygen tension and heart rate variability. Biol Res Nurs 7(4):268–278
Newton-Cheh C, Guo CY, Wang TJ, O’donnell CJ, Levy D, Larson MG (2007) Genome-wide association study of electrocardiographic and heart rate variability traits: the Framingham Heart Study. BMC Med Genet 8(Suppl 1):S7
Norris PR, Canter JA, Jenkins JM, Moore JH, Williams AE, Morris JA Jr (2009) Personalized medicine: genetic variation and loss of physiologic complexity are associated with mortality in 644 trauma patients. Ann Surg 250(4):524–530
Bidargaddi N, Sarela A, Korhonen I (2008) Physiological state characterization by clustering heart rate, heart rate variability and movement activity information. Conf Proc IEEE Eng Med Biol Soc 2008:1749–1752
Kiyono K, Struzik ZR, Aoyagi N, Togo F, Yamamoto Y (2005) Phase transition in a healthy human heart rate. Phys Rev Lett 95(5):058101
Godin PJ, Buchman TG (1996) Uncoupling of biological oscillators: a complementary hypothesis concerning the pathogenesis of multiple organ dysfunction syndrome. Crit Care Med 24(7):1107–1116
Buchman TG (2004) Nonlinear dynamics, complex systems, and the pathobiology of critical illness. Curr Opin Crit Care 10(5):378–382
Seely AJ, Christou NV (2000) Multiple organ dysfunction syndrome: exploring the paradigm of complex nonlinear systems. Crit Care Med 28(7):2193–2200
Dick TE, Molkov YI, Nieman G, Hsieh YH, Jacono FJ, Doyle J et al (2012) Linking inflammation, cardiorespiratory variability, and neural control in acute inflammation via computational modeling. Front Physiol 3:222
An G, Nieman G, Vodovotz Y (2012) Toward computational identification of multiscale “tipping points” in acute inflammation and multiple organ failure. Ann Biomed Eng 40(11): 2414–2424
Xiao X, Mullen TJ, Mukkamala R (2005) System identification: a multi-signal approach for probing neural cardiovascular regulation. Physiol Meas 26(3):R41–R71
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer Science+Business Media New York
About this chapter
Cite this chapter
Norris, P.R. (2013). Analysis of Heart Rate Variability. In: Vodovotz, Y., An, G. (eds) Complex Systems and Computational Biology Approaches to Acute Inflammation. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8008-2_4
Download citation
DOI: https://doi.org/10.1007/978-1-4614-8008-2_4
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-8007-5
Online ISBN: 978-1-4614-8008-2
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)