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Temporal Analysis of Sequential Changes in Heart Rate Variability During Non-hypotensive Hypovolemia

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Abstract

Introduction

Haemorrhage is associated with changes in the cardiac autonomic drive which begins during early stages of mild haemorrhage. The knowledge of chronology of the autonomic changes at smaller timescale during the period of haemorrhage can help identify the primary autonomic parameter which signals the institution of cardiovascular reflex mechanisms.

Aim

To evaluate the heart rate variability in 2-min sequential segments with one minute overlap during and after the period of mild haemorrhage (450 ml) using blood donation as a model of acute blood loss.

Methods

47 male blood donors who had volunteered for blood donation were recruited for the study. Continuous lead II ECG was recorded before the start of the blood donation (5 min), during the period of the blood donation (~ 5–7 min) and after blood donation (5 min). The parasympathetic and sympathetic drive to heart was estimated by measures of heart rate variability in time and frequency domain.

Results

A significant decrease in the parameters assessing parasympathetic drive i.e., normalised High frequency (HFn) and NN50 (Number of pairs of adjacent NN intervals differing by more than 50 ms) and pNN50 (NN50 divided by the total number of all NN Intervals) was observed during blood donation at 3–5 min, as compared to baseline. An increase in parameters associated with sympathetic drive i.e., normalised low frequency (LFn) was observed only in the post donation period at 2–3 min. A significant rise in LF/HF ratio which is a marker of sympatho vagal balance was observed at 4–5 min during blood donation when compared to baseline.

Conclusion

The initial cardiac autonomic change during mild haemorrhage is withdrawal of parasympathetic drive, followed by an increase in sympathetic tone which occurs much later.

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Authors and Affiliations

  1. Department of Physiology, Pt. BD Sharma Post graduate Institute of Medical Sciences, 1st Floor, Rohtak, India

    Kavita Yadav

  2. Department of Physiology, All India Institute of Medical Sciences, Room no. 2017, Teaching Block, Second Floor, Ansari Nagar, New Delhi, India

    Akanksha Singh

  3. Department of Transfusion Medicine (Blood Bank), All India Institute of Medical Sciences, Ground Floor, Main Blood Bank Unit 1, Ansari Nagar, New Delhi, India

    Poonam Coshic

  4. Department of Physiology, All India Institute of Medical Sciences, Room no. 2009, Teaching Block, Second Floor, Ansari Nagar, New Delhi, India

    Ashok Kumar Jaryal & K. K. Deepak

Authors
  1. Kavita Yadav
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  2. Akanksha Singh
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  3. Ashok Kumar Jaryal
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  4. Poonam Coshic
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  5. K. K. Deepak
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Correspondence to Ashok Kumar Jaryal.

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The authors did not receive funding for the present work.

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The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the Institute Ethical Committee, All India Institute of Medical Sciences, New Delhi. All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 declaration of Helsinki and its later amendments.

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Informed written consent was obtained after explanation of the duration, type and purpose of the study.

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Yadav, K., Singh, A., Jaryal, A.K. et al. Temporal Analysis of Sequential Changes in Heart Rate Variability During Non-hypotensive Hypovolemia. High Blood Press Cardiovasc Prev 29, 385–391 (2022). https://doi.org/10.1007/s40292-022-00525-6

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  • DOI: https://doi.org/10.1007/s40292-022-00525-6

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