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      Impact of Using Different Levels of Threshold-Based Artefact Correction on the Quantification of Heart Rate Variability in Three Independent Human Cohorts

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          Abstract

          Heart rate variability (HRV) is a non-invasive indicator of autonomic nervous system function. HRV recordings show artefacts due to technical and/or biological issues. The Kubios software is one of the most used software to process HRV recordings, offering different levels of threshold-based artefact correction (i.e., Kubios filters). The aim of the study was to analyze the impact of different Kubios filters on the quantification of HRV derived parameters from short-term recordings in three independent human cohorts. A total of 312 participants were included: 107 children with overweight/obesity (10.0 ± 1.1 years, 58% men), 132 young adults (22.2 ± 2.2 years, 33% men) and 73 middle-aged adults (53.6 ± 5.2 years, 48% men). HRV was assessed using a heart rate monitor during 10–15 min, and the Kubios software was used for HRV data processing using all the Kubios filters available (i.e., 6). Repeated-measures analysis of variance indicated significant differences in HRV derived parameters in the time-domain (all p < 0.001) across the Kubios filters in all cohorts, moreover similar results were observed in the frequency-domain. When comparing two extreme Kubios filters, these statistical differences could be clinically relevant, e.g. more than 10 ms in the standard deviation of all normal R-R intervals (SDNN). In conclusion, the results of the present study suggest that the application of different Kubios filters had a significant impact on HRV derived parameters obtained from short-term recordings in both time and frequency-domains.

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          Most cited references20

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          Monitoring training status with HR measures: do all roads lead to Rome?

          Measures of resting, exercise, and recovery heart rate are receiving increasing interest for monitoring fatigue, fitness and endurance performance responses, which has direct implications for adjusting training load (1) daily during specific training blocks and (2) throughout the competitive season. However, these measures are still not widely implemented to monitor athletes' responses to training load, probably because of apparent contradictory findings in the literature. In this review I contend that most of the contradictory findings are related to methodological inconsistencies and/or misinterpretation of the data rather than to limitations of heart rate measures to accurately inform on training status. I also provide evidence that measures derived from 5-min (almost daily) recordings of resting (indices capturing beat-to-beat changes in heart rate, reflecting cardiac parasympathetic activity) and submaximal exercise (30- to 60-s average) heart rate are likely the most useful monitoring tools. For appropriate interpretation at the individual level, changes in a given measure should be interpreted by taking into account the error of measurement and the smallest important change of the measure, as well as the training context (training phase, load, and intensity distribution). The decision to use a given measure should be based upon the level of information that is required by the athlete, the marker's sensitivity to changes in training status and the practical constrains required for the measurements. However, measures of heart rate cannot inform on all aspects of wellness, fatigue, and performance, so their use in combination with daily training logs, psychometric questionnaires and non-invasive, cost-effective performance tests such as a countermovement jump may offer a complete solution to monitor training status in athletes participating in aerobic-oriented sports.
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            Software for advanced HRV analysis.

            A computer program for advanced heart rate variability (HRV) analysis is presented. The program calculates all the commonly used time- and frequency-domain measures of HRV as well as the nonlinear Poincaré plot. In frequency-domain analysis parametric and nonparametric spectrum estimates are calculated. The program generates an informative printable report sheet which can be exported to various file formats including the portable document format (PDF). Results can also be saved as an ASCII file from which they can be imported to a spreadsheet program such as the Microsoft Excel. Together with a modern heart rate monitor capable of recording RR intervals this freely distributed program forms a complete low-cost HRV measuring and analysis system.
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              Assessment of autonomic function in cardiovascular disease: physiological basis and prognostic implications.

              Certain abnormalities of autonomic function in the setting of structural cardiovascular disease have been associated with an adverse prognosis. Various markers of autonomic activity have received increased attention as methods for identifying patients at risk for sudden death. Both the sympathetic and the parasympathetic limbs can be characterized by tonic levels of activity, which are modulated by, and respond reflexively to, physiological changes. Heart rate provides an index of the net effects of autonomic tone on the sinus node, and carries prognostic significance. Heart rate variability, though related to heart rate, assesses modulation of autonomic control of heart rate and carries additional prognostic information, which in some cases is more powerful than heart rate alone. Heart rate recovery after exercise represents the changes in autonomic tone that occur immediately after cessation of exercise. This index has also been shown to have prognostic significance. Autonomic evaluation during exercise and recovery may be important prognostically, because these are high-risk periods for sudden death, and the autonomic changes that occur with exercise could modulate this high risk. These markers provide related, but not redundant information about different aspects of autonomic effects on the sinus node.
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                Author and article information

                Journal
                J Clin Med
                J Clin Med
                jcm
                Journal of Clinical Medicine
                MDPI
                2077-0383
                23 January 2020
                February 2020
                : 9
                : 2
                : 325
                Affiliations
                [1 ]PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, 18011 Granada, Spain; abeladrian@ 123456ugr.es (A.P.-F.); amarof@ 123456ugr.es (F.J.A.-G.); acostaf@ 123456ugr.es (F.M.A.); jairohm@ 123456ugr.es (J.H.M.); pablomolinag5@ 123456ugr.es (P.M.-G.); gsanchezdelgado@ 123456ugr.es (G.S.-D.)
                [2 ]EFFECTS-262 Research Group, Department of Physiology, School of Medicine, University of Granada, 18071 Granada, Spain
                [3 ]Department of Rehabilitation Sciences, KU Leuven, University of Leuven, 3000 Leuven, Belgium
                [4 ]Faculty of Physical Education and Physiotherapy, Opole University of Technology, 45-758 Opole, Poland; sacha@ 123456op.pl
                [5 ]Department of Cardiology, University Hospital in Opole, University of Opole, 45-401 Opole, Poland
                [6 ]Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA
                [7 ]Department of Medicine, division of Endocrinology, and Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, 2333 Leiden, The Netherlands
                Author notes
                [* ]Correspondence: alcantarajma@ 123456ugr.es ; Tel.: +34-958-244-353
                [†]

                These authors have made an equal contribution.

                Author information
                https://orcid.org/0000-0002-8842-374X
                https://orcid.org/0000-0002-5374-3129
                https://orcid.org/0000-0002-7207-9016
                https://orcid.org/0000-0001-7504-7506
                https://orcid.org/0000-0001-8783-1859
                Article
                jcm-09-00325
                10.3390/jcm9020325
                7074236
                31979367
                4df24c1e-bd97-4256-aa20-b38edcc7b2be
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 23 December 2019
                : 21 January 2020
                Categories
                Article

                kubios software,autonomic nervous system,data processing,children,young adults,middle-aged adults

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