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      Introduction of Application of Gini Coefficient to Heart Rate Variability Spectrum for Mental Stress Evaluation

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          Abstract

          Background

          The Gini coefficient is a statistical tool generally used by economists to quantify income inequality. However, it can be applied to any kind of data with unequal distribution, including heart rate variability (HRV).

          Objectives

          To assess the application of the Gini coefficient to measure inequality in power spectral density of RR intervals, and to use this application as a psychophysiological indicator of mental stress.

          Methods

          Thirteen healthy subjects (19 ± 1.5 years) participated in this study, and their RR intervals were obtained by electrocardiogram during rest (five minutes) and during mental stress (arithmetic challenge; five minutes). These RR intervals were used to obtain the estimates of power spectral densities (PSD). The limits for the PSD bands were defined from 0.15 to 0.40 Hz for high frequency band (HF), from 0.04 to 0.15 Hz for low frequency band (LF), from 0.04 to 0.085 Hz for first low frequency sub-band (LF1) and from 0.085 to 0.15 Hz for second low frequency sub-band (LF2). The spectral Gini coefficient (SpG) was proposed to measure the inequality in the power distribution of the RR intervals in each of above-mentioned HRV bands. SpG from each band was compared with its respective traditional index of HRV during the conditions of rest and mental stress. All the differences were considered statistically significant for p < 0.05.

          Results

          There was a significant decrease in HF power (p = 0.046), as well as significant increases in heart rate (p = 0.004), LF power (p = 0.033), LF2 power (p = 0.019) and LF/HF (p = 0.002) during mental stress. There was also a significant increase in SpG(LF) (p = 0.009) and SpG(LF2) (p = 0.033) during mental stress. Coefficient of variation showed SpG has more homogeneity compared to the traditional index of HRV during mental stress.

          Conclusions

          This pilot study suggested that spectral inequality of Heart Rate Variability analyzed using the Gini coefficient seems to be an independent and homogeneous psychophysiological indicator of mental stress. Also, HR, LF/HF, SpG(LF) of HRV are possibly important, reliable and valid indicators of mental stress.

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          Most cited references26

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          Power spectrum analysis of heart rate fluctuation: a quantitative probe of beat-to-beat cardiovascular control

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            Greater cardiovascular responses to laboratory mental stress are associated with poor subsequent cardiovascular risk status: a meta-analysis of prospective evidence.

            An increasing number of studies has tested whether greater cardiovascular responses to acute mental stress predict future cardiovascular disease, but results have been variable. This review aimed quantitatively to evaluate the association between cardiovascular responses to laboratory mental stress and subsequent cardiovascular risk status in prospective cohort studies. We searched general bibliographic databases, PsycINFO, Web of Science, and PubMed, up to December 2009. Two reviewers independently extracted data on study characteristics, quality, and estimates of associations. There were 169 associations (36 articles) of stress reactivity and 30 associations (5 articles) of poststress recovery in relation to future cardiovascular risk status, including elevated blood pressure, hypertension, left ventricular mass, subclinical atherosclerosis, and clinical cardiac events. The overall meta-analyses showed that greater reactivity to and poor recovery from stress were associated longitudinally with poor cardiovascular status (r=0.091 [95% CI: 0.050 to 0.132], P<0.001, and r=0.096 [95% CI: 0.058 to 0.134], P<0.001, respectively). These findings were supported by more conservative analyses of aggregate effects and by subgroup analyses of the methodologically strong associations. Notably, incident hypertension and increased carotid intima-media thickness were more consistently predicted by greater stress reactivity and poor stress recovery, respectively, whereas both factors were associated with higher future systolic and diastolic blood pressures. In conclusion, the current meta-analysis suggests that greater responsivity to acute mental stress has an adverse effect on future cardiovascular risk status, supporting the use of methods of managing stress responsivity in the prevention and treatment of cardiovascular disease.
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              Heart rate variability: a noninvasive electrocardiographic method to measure the autonomic nervous system.

              The autonomic nervous system (ANS) plays an important role not only in physiological situations, but also in various pathological settings such as diabetic neuropathy, myocardial infarction (MI) and congestive heart failure (CHF). Autonomic imbalance associating increased sympathetic activity and reduced vagal tone has been been strongly implicated in the pathophysiology of arrhythmogenesis and sudden cardiac death. Among the different available noninvasive techniques for assessing the autonomic status heart rate variability (HRV) has emerged as a simple, noninvasive method to evaluate the sympathovagal balance at the sinoatrial level. It has been used in a variety of clinical situations including diabetic neuropathy, MI, sudden death and CHF. The standard measurements intervening in the analysis of HRV comprise time domain indices, geometric methods and components of the frequency domain. Measurements of HRV are generally performed on the basis of 24 hour Holter recordings (long-term recordings) or on shorter periods ranging from 0.5 to 5 minutes (short-term recordings). The use of long or short-term recordings depends on the type of study that has to be realised. Established clinical data based on numerous studies published during the last decade consider decreased global HRV as a strong predictor of increased all-cause cardiac and/or arrhythmic mortality, particularly in patients at risk after MI or with CHF. This article reviews the mechanism, the parameters and the use of HRV as a marker reflecting the activity of the sympathetic and vagal components of the ANS on the sinus node, and as a clinical tool for screening and identifying patients particularly at risk for cardiac mortality.
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                Author and article information

                Journal
                Arq Bras Cardiol
                Arq. Bras. Cardiol
                abc
                Arquivos Brasileiros de Cardiologia
                Sociedade Brasileira de Cardiologia - SBC
                0066-782X
                1678-4170
                October 2019
                October 2019
                : 113
                : 4
                : 725-733
                Affiliations
                [1 ] Departamento de Ciencias Básicas y Morfología - Facultad de Medicina - Universidad Católica de la Santísima Concepción, Concepción - Chile
                [2 ] Department of Kinesiology, San Francisco State University, San Francisco - USA
                [3 ] Departamento de Ciencias Basicas Biomédicas - Facultad de Medicina 1 - Universidad de Ciencias Médicas de Santiago de Cuba, Santiago de Cuba - Cuba
                [4 ] Hospital Universitario Calixto García - Universidad de Ciencias Médicas de La Habana, La Habana - Cuba
                [5 ] Centro de Simulación - Departamento de Ciencias Clínicas y Preclínicas - Facultad de Medicina - Universidad Católica de la Santísima Concepción, Concepción - Chile
                Author notes
                Mailing Address: Miguel Enrique Sánchez-Hechavarría, Alonso de Ribera, 2850. Postal Code 4090541. Concepción - Chile. Email: misanchez@ 123456ucsc.cl , miguel.sanchez881119@ 123456gmail.com
                Author information
                http://orcid.org/0000-0001-9461-203X
                http://orcid.org/0000-0001-8109-9177
                http://orcid.org/0000-0003-0298-9425
                http://orcid.org/0000-0003-0384-7883
                http://orcid.org/0000-0002-8852-4591
                http://orcid.org/0000-0003-4409-5753
                http://orcid.org/0000-0003-4407-950X
                Article
                10.5935/abc.20190185
                7020869
                31508693
                ac5108de-5488-4c7e-ba07-175a61d58a67

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 09 June 2018
                : 05 March 2019
                : 15 May 2019
                Categories
                Original Article

                gini coefficient,heart, rate,stress, psychological/physiopathology,action, spectrum,parasympathetic nervous system,simpathetic nervous system

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