Validity of telemetric-derived measures of heart rate variability: a systematic review

Heart rate variability (HRV) is a widely accepted indirect measure of autonomic function with widespread application across many settings. Although traditionally measured from the 'gold standard' criterion electrocardiography (ECG), the development of wireless telemetric heart rate monitors (HRMs) extends the scope of the HRV measurement. However, the validity of telemetric-derived data against the criterion ECG data is unclear. Thus, the purpose of this study was twofold: (a) to systematically review the validity of telemetric HRM devices to detect inter-beat intervals and aberrant beats; and (b) to determine the accuracy of HRV parameters computed from HRM-derived inter-beat interval time series data against criterion ECG-derived data in healthy adults aged 19 to 62 yrs. A systematic review of research evidence was conducted. Four electronic databases were accessed to obtain relevant articles (PubMed, EMBASE, MEDLINE and SPORTDiscus. Articles published in English between 1996 and 2016 were eligible for inclusion. Outcome measures included temporal and power spectral indices (Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology (1996). The review confirmed that modern HRMs (Polar® V800™ and Polar® RS800CX™) accurately detected inter-beat interval time-series data. The HRV parameters computed from the HRM-derived time series data were interchangeable with the ECG-derived data. The accuracy of the automatic in-built manufacturer error detection and the HRV algorithms were not established. Notwithstanding acknowledged limitations (a single reviewer, language bias, and the restricted selection of HRV parameters), we conclude that the modern Polar® HRMs offer a valid useful alternative to the ECG for the acquisition of inter-beat interval time series data, and the HRV parameters computed from Polar® HRM-derived inter-beat interval time series data accurately reflect ECG-derived HRV metrics, when inter-beat interval data are processed and analyzed using identical protocols, validated algorithms and software, particularly under controlled and stable conditions

Fast Stress Detection via ECG

Nowadays stress has become a regular part of life. Stress is difficult to measure because there has been no definition of stress that everyone accepts. Furthermore, if we do not get a handle on our stress and it becomes long term, it can seriously interfere with our health. Therefore, finding the method for stress detection could be beneficial for taking control of stress. Electrocardiogram (ECG) is the measurement of the electrical activity of the heart and represents an established standard in determining the health condition of the heart. The PQRST1[55] complex of ECG conveys information about each cardiac-cycle, where the R-peak is placed in the middle of the PQRST complex and represents the maximum value of the PQRST. Since the PQRST depicts the entire cardio-cycle, the R–peak determines half of the cardio-cycle. The distance between two adjacent R-peaks is defined as a heart rate (HR). The variation of the HR in the specific time frame, defined as heart rate variability (HRV), can reflect the state of the autonomic nervous system (ANS). The ANS has two main divisions, the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS). The SNS occurs in response to stress while the PNS results from the function of internal organs. The activity of ANS can cause an acceleration (SNS) or deceleration (PNS) of the HR. The SNS activity is associated with the low-frequency range while, the PNS activity is associated with the high frequency component of the HRV. Therefore, the power ratio of the low and high-frequency components of the spectrum of HRV can potentially show whether the subject is exposed to stress or not [48] [50]. In this research, we introduced three new indices, with one of them proposed as a proxy to provide equivalent results in the detection of stress or no-stress states while avoiding complex measurement devices as well as complex calculations. The goal was to find a more time efficient method for fast stress detection which could potentially be used in the applications that run on devices such as a wearable smartwatch in tandem with a smartphone or tablet. The experiment was established to measure the literature proposed index for stress measurement [48][50] as well as our introduced indices. In the experiment, we induced stress to the participants by using mental arithmetic as a stressor [51][53]. Theexperiment contained two kinds of trials. In the first one, the participant was exposed to different amounts of cognitive load induced by doing mental-arithmetic while, in the second one, the participant was placed in a relaxed environment. Each participant in the experiment gave feedback in which period of the experiment he/she felt stress. During the entire experiment, we recorded theparticipant‘s ECG. The ECG was used to calculate HRV which consequently was used for the calculation of the values of the index as proposed from the literature for calculating the level of the stress. The same data was used for the calculation of our introduced indices. The values of our proposed index was compared with the index and the participant‘s feedback. Finally, the data analyses showed that our proposed index is suitable to determine whether a participant is exposed to stress

Autonomic and brain morphological predictors of stress resilience

Stressful life events are an important cause of psychopathology. Humans exposed to aversive or stressful experiences show considerable inter-individual heterogeneity in their responses. However, the majority does not develop stress-related psychiatric disorders. The dynamic processes encompassing positive and functional adaptation in the face of significant adversity have been broadly defined as resilience. Traditionally, the assessment of resilience has been confined to self-report measures, both within the general community and putative high-risk populations. Although this approach has value, it is highly susceptible to subjective bias and may not capture the dynamic nature of resilience, as underlying construct. Recognizing the obvious benefits of more objective measures of resilience, research in the field has just started investigating the predictive value of several potential biological markers. This review provides an overview of theoretical views and empirical evidence suggesting that individual differences in heart rate variability (HRV), a surrogate index of resting cardiac vagal outflow, may underlie different levels of resilience toward the development of stress-related psychiatric disorders. Following this line of thought, recent studies describing associations between regional brain morphometric characteristics and resting state vagally-mediated HRV are summarized. Existing studies suggest that the structural morphology of the anterior cingulated cortex (ACC), particularly its cortical thickness, is implicated in the expression of individual differences in HRV. These findings are discussed in light of emerging structural neuroimaging research, linking morphological characteristics of the ACC to psychological traits ascribed to a high-resilient profile and abnormal structural integrity of the ACC to the psychophysiological expression of stress-related mental health consequences. We conclude that a multidisciplinary approach integrating brain structural imaging with HRV monitoring could offer novel perspectives about brain-body pathways in resilience and adaptation to psychological stres

IoT DEVELOPMENT FOR HEALTHY INDEPENDENT LIVING

The rise of internet connected devices has enabled the home with a vast amount of enhancements to make life more convenient. These internet connected devices can be used to form a community of devices known as the internet of things (IoT). There is great value in IoT devices to promote healthy independent living for older adults. Fall-related injuries has been one of the leading causes of death in older adults. For example, every year more than a third of people over 65 in the U.S. experience a fall, of which up to 30 percent result in moderate to severe injury. Therefore, this thesis proposes an IoT-based fall detection system for smart home environments that not only to send out alerts, but also launches interaction models, such as voice assistance and camera monitoring. Such connectivity could allow older adults to interact with the system without concern of a learning curve. The proposed IoT-based fall detection system will enable family and caregivers to be immediately notified of the event and remotely monitor the individual. Integrated within a smart home environment, the proposed IoT-based fall detection system can improve the quality of life among older adults. Along with the physical concerns of health, psychological stress is also a great concern among older adults. Stress has been linked to emotional and physical conditions such as depression, anxiety, heart attacks, stroke, etc. Increased susceptibility to stress may accelerate cognitive decline resulting in conversion of cognitively normal older adults to MCI (Mild Cognitive Impairment), and MCI to dementia. Thus, if stress can be measured, there can be countermeasures put in place to reduce stress and its negative effects on the psychological and physical health of older adults. This thesis presents a framework that can be used to collect and pre-process physiological data for the purpose of validating galvanic skin response (GSR), heart rate (HR), and emotional valence (EV) measurements against the cortisol and self-reporting benchmarks for stress detection. The results of this framework can be used for feature extraction to feed into a regression model for validating each combination of physiological measurement. Also, the potential of this framework to automate stress protocols like the Trier Social Stress Test (TSST) could pave the way for an IoT-based platform for automated stress detection and management

Effects of Normobaric Hypoxia on Oculomotor Dynamics of Aviator Students during a Simulated Flight Task

Hypoxia occurs when the body\u27s tissues are unable to obtain adequate oxygen supply and is the primary environmental factor present when pilots are exposed to increasing altitude levels. Hypoxia leads to impaired vision, cognition, and motor control function, which can negatively affect performance and become deadly if a pilot becomes incapacitated. Thus, objective identification of early-onset hypoxia is critical to increase the time of useful consciousness and prevent physiological episodes. Of the few studies utilizing eye-tracking, there is disagreement and mixed results concerning saccadic eye metrics as a means to measure and detect hypoxia. Therefore, the purpose of this study was to investigate saccadic velocity changes driven by acute normobaric hypoxia. Using a noninvasive infrared-based eye-tracking device, we recorded saccadic average peak velocity during flight tasks at simulated altitudes of 0 ft, 12,500 ft, and 19,000 ft. No changes were observed in saccadic average peak velocity among different altitude exposures. As time on task increased, saccadic average peak velocity decreased, suggesting that eye metrics can serve as an indicator of mental fatigue

The effects of acute exercise on plasma oxytocin

Oxytocin is a nine-amino acid peptide hormone and/or neuropeptide that has proposed mechanisms related to diminishing the effects of physical, psychological, and psychosocial stress. Exercise is often used in clinical trials to quantify stress because it is easily reproducible between subjects using relative VO2 intensities. However, trials examining plasma oxytocin in response to physical stress within exercise have shown mixed results possibly related to the varied measurement techniques. The purpose of this study is to measure plasma oxytocin changes in response to steady state exercise and graded maximal exercise and to determine if a relationship exists. Procedures were utilized to release oxytocin from the protein binding within blood and measure the oxytocin concentration through a high-performance liquid chromatography coupled to a mass spectrometer. Difficulties in the chromatography detection sensitivity forced the present study to also use an ELISA to determine plasma oxytocin concentrations. Plasma oxytocin concentrations were consistently too low to detect even after sizable spiking for both measurement techniques. Mean resting concentration derived from the ELISA was 371.75 ± 215.10 pg/ml. There was no significant difference in concentration following either exercise stimulus. These results suggest that the extraction technique utilized with the ELISA kit failed to separate protein binding from oxytocin prior to analysis

Preejection period as a sympathetic activity index: a role of confounding factors

In previous studies, one of the systolic time intervals - preejection period (PEP) - was used as an index of sympathetic activity reflecting the cardiac contractility. However, PEP could be also influenced by several other cardiovascular variables including preload, afterload and diastolic blood pressure (DBP). The aim of this study was to assess the behavior of the PEP together with other potentially confounding cardiovascular system characteristics in healthy humans during mental and orthostatic stress (head-up tilt test - HUT). Forty-nine healthy volunteers (28 females, 21 males, mean age 18.6 years (SD=1.8 years)) participated in the study. We recorded finger arterial blood pressure by volume-clamp method (Finometer Pro, FMS, Netherlands), PEP, thoracic fluid content (TFC) - a measure of preload, and cardiac output (CO) by impedance cardiography (CardioScreen (R) 2000, Medis, Germany). Systemic vascular resistance (SVR) - a measure of afterload - was calculated as a ratio of mean arterial pressure and CO. We observed that during HUT, an expected decrease in TFC was accompanied by an increase of PEP, an increase of SVR and no significant change in DBP. During mental stress, we observed a decrease of PEP and an increase of TFC, SVR and DBP. Correlating a change in assessed measures (delta values) between mental stress and previous supine rest, we found that Delta PEP correlated negatively with Delta CO and positively with Delta SVR. In orthostasis, no significant correlation between Delta PEP and Delta DBP, Delta TFC, Delta CO, Delta MBP or Delta SVR was found. We conclude that despite an expected increase of sympathetic activity during both challenges, PEP behaved differently indicating an effect of other confounding factors. To interpret PEP values properly, we recommend simultaneously to measure other variables influencing this cardiovascular measure.Web of Science66suppl. 2S275S26

Aerospace Medicine and Biology: A continuing bibliography with indexes (supplement 314)

This bibliography lists 139 reports, articles, and other documents introduced into the NASA scientific and technical information system in August, 1988

Aerospace medicine and biology: A continuing bibliography with indexes (supplement 324)

This bibliography lists 200 reports, articles and other documents introduced into the NASA Scientific and Technical Information System during May, 1989. Subject coverage includes: aerospace medicine and psychology, life support systems and controlled environments, safety equipment, exobiology and extraterrestrial life, and flight crew behavior and performance

A review of biophysiological and biochemical indicators of stress for connected and preventive healthcare

Stress is a known contributor to several life-threatening medical conditions and a risk factor for triggering acute cardiovascular events, as well as a root cause of several social problems. The burden of stress is increasing globally and, with that, is the interest in developing effective stress-monitoring solutions for preventive and connected health, particularly with the help of wearable sensing technologies. The recent development of miniaturized and flexible biosensors has enabled the development of connected wearable solutions to monitor stress and intervene in time to prevent the progression of stress-induced medical conditions. This paper presents a review of the literature on different physiological and chemical indicators of stress, which are commonly used for quantitative assessment of stress, and the associated sensing technologies