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Does the Heart Fall Asleep?—Diurnal Variations in Heart Rate Variability in Patients with Disorders of Consciousness

The current study investigated heart rate (HR) and heart rate variability (HRV) across day and night in patients with disorders of consciousness (DOC). We recorded 24-h electrocardiography in 26 patients with DOC (i.e., unresponsive wakefulness syndrome (UWS; n = 16) and (exit) minimally conscious s...

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Autores principales: Angerer, Monika, Wilhelm, Frank H., Liedlgruber, Michael, Pichler, Gerald, Angerer, Birgit, Scarpatetti, Monika, Blume, Christine, Schabus, Manuel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8946070/
https://www.ncbi.nlm.nih.gov/pubmed/35326331
http://dx.doi.org/10.3390/brainsci12030375
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author Angerer, Monika
Wilhelm, Frank H.
Liedlgruber, Michael
Pichler, Gerald
Angerer, Birgit
Scarpatetti, Monika
Blume, Christine
Schabus, Manuel
author_facet Angerer, Monika
Wilhelm, Frank H.
Liedlgruber, Michael
Pichler, Gerald
Angerer, Birgit
Scarpatetti, Monika
Blume, Christine
Schabus, Manuel
author_sort Angerer, Monika
collection PubMed
description The current study investigated heart rate (HR) and heart rate variability (HRV) across day and night in patients with disorders of consciousness (DOC). We recorded 24-h electrocardiography in 26 patients with DOC (i.e., unresponsive wakefulness syndrome (UWS; n = 16) and (exit) minimally conscious state ((E)MCS; n = 10)). To examine diurnal variations, HR and HRV indices in the time, frequency, and entropy domains were computed for periods of clear day- (forenoon: 8 a.m.–2 p.m.; afternoon: 2 p.m.–8 p.m.) and nighttime (11 p.m.–5 a.m.). The results indicate that patients’ interbeat intervals (IBIs) were larger during the night than during the day, indicating HR slowing. The patients in UWS showed larger IBIs compared to the patients in (E)MCS, and the patients with non-traumatic brain injury showed lower HRV entropy than the patients with traumatic brain injury. Additionally, higher HRV entropy was associated with higher EEG entropy during the night. Thus, cardiac activity varies with a diurnal pattern in patients with DOC and can differentiate between patients’ diagnoses and etiologies. Moreover, the interaction of heart and brain appears to follow a diurnal rhythm. Thus, HR and HRV seem to mirror the integrity of brain functioning and, consequently, might serve as supplementary measures for improving the validity of assessments in patients with DOC.
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spelling pubmed-89460702022-03-25 Does the Heart Fall Asleep?—Diurnal Variations in Heart Rate Variability in Patients with Disorders of Consciousness Angerer, Monika Wilhelm, Frank H. Liedlgruber, Michael Pichler, Gerald Angerer, Birgit Scarpatetti, Monika Blume, Christine Schabus, Manuel Brain Sci Article The current study investigated heart rate (HR) and heart rate variability (HRV) across day and night in patients with disorders of consciousness (DOC). We recorded 24-h electrocardiography in 26 patients with DOC (i.e., unresponsive wakefulness syndrome (UWS; n = 16) and (exit) minimally conscious state ((E)MCS; n = 10)). To examine diurnal variations, HR and HRV indices in the time, frequency, and entropy domains were computed for periods of clear day- (forenoon: 8 a.m.–2 p.m.; afternoon: 2 p.m.–8 p.m.) and nighttime (11 p.m.–5 a.m.). The results indicate that patients’ interbeat intervals (IBIs) were larger during the night than during the day, indicating HR slowing. The patients in UWS showed larger IBIs compared to the patients in (E)MCS, and the patients with non-traumatic brain injury showed lower HRV entropy than the patients with traumatic brain injury. Additionally, higher HRV entropy was associated with higher EEG entropy during the night. Thus, cardiac activity varies with a diurnal pattern in patients with DOC and can differentiate between patients’ diagnoses and etiologies. Moreover, the interaction of heart and brain appears to follow a diurnal rhythm. Thus, HR and HRV seem to mirror the integrity of brain functioning and, consequently, might serve as supplementary measures for improving the validity of assessments in patients with DOC. MDPI 2022-03-11 /pmc/articles/PMC8946070/ /pubmed/35326331 http://dx.doi.org/10.3390/brainsci12030375 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/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 (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Angerer, Monika
Wilhelm, Frank H.
Liedlgruber, Michael
Pichler, Gerald
Angerer, Birgit
Scarpatetti, Monika
Blume, Christine
Schabus, Manuel
Does the Heart Fall Asleep?—Diurnal Variations in Heart Rate Variability in Patients with Disorders of Consciousness
title Does the Heart Fall Asleep?—Diurnal Variations in Heart Rate Variability in Patients with Disorders of Consciousness
title_full Does the Heart Fall Asleep?—Diurnal Variations in Heart Rate Variability in Patients with Disorders of Consciousness
title_fullStr Does the Heart Fall Asleep?—Diurnal Variations in Heart Rate Variability in Patients with Disorders of Consciousness
title_full_unstemmed Does the Heart Fall Asleep?—Diurnal Variations in Heart Rate Variability in Patients with Disorders of Consciousness
title_short Does the Heart Fall Asleep?—Diurnal Variations in Heart Rate Variability in Patients with Disorders of Consciousness
title_sort does the heart fall asleep?—diurnal variations in heart rate variability in patients with disorders of consciousness
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8946070/
https://www.ncbi.nlm.nih.gov/pubmed/35326331
http://dx.doi.org/10.3390/brainsci12030375
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