Reference ranges of circadian variation parameters of cardiac autonomic modulation in healthy employees: The Mannheim Industrial Cohort Studies
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1 Reference ranges of circadian variation parameters of cardiac autonomic modulation in healthy employees: The Mannheim Industrial Cohort Studies Symposium 1031: Chronobiology Meets Psychophysiology: Revisiting Circadian Rhythms Underlying 24-h Ambulatory Data Dr. Marc N. Jarczok, Ann-Katrin Rohr-Kräutle, Julian F. Thayer, Joachim E. Fischer March 8th 2018
2 Slide 2 Aim & Methods Ø Aim: to provide age and sex specific reference values of the circadian pattern of HRV in a healthy working population Ø Voluntary on-site health assessment from 21 company sites across Germany (Industrial engineering, manufacturing, pharmaceutical, automobile, aeronautic and electricity companies) Ø Participation rates: 46% - 58% (years ) Ø Online questionnaire (e.g. Health behavior, demography, diagnosis) Ø Objectively measured clinical data Ø Blood draw & ambulatory long-term heart rate recording (Suunto T6 Memory Belt at 1000Hz) Ø HRV parameters obtained at the Centre for Neuroscience Research (Trier, Germany) per 5.35-minute segments of IBI
3 Slide 3 Ø Healthy is defined rigorously. Participants were excluded not indicating explicitly No (vs. Yes, or unknown ) to any of the following conditions: Ø Hypertension, dyslipidemia, hyperglycemia, Ø Respiratory diseases (e.g. Asthma, COPD), Ø Angina pectoris, stroke, infarction, CHD, Ø Depression, burnout, other chronic diseases, cancer and Ø Taking beta blockers Analysis Sample Ø In addition, objectively measured clinical data had to be unobtrusive (Fasting Plasma Glucose, Hba1c, HDL, LDL, TRIG, Blood Pressure) Ø Aim: Get close to the prototypical circadian variation pattern in healthy population
4 Slide Analysis Sample Recruited N=19,734 With HR-Recording: N=12,418 N=6,880 Included N=5,538 Exclusion Criteria <20h rec. length (N=4,229) >20% missing 5min intervals (N=796) >6 consecutive 5min intervals with artifact rate >5.4%(N=294) Not defined as healthy (N=1,361) M (79%) F (21%)
5 Slide 5 Individual Example of a Cosine Function N= 264 Intervals 24h Mean= msec 5.35 Minute Interval RMSSD Self-reported Sleep period 1x Male Person 20 years BMI 21 Never Smoker Moving Average (local polynomial smoothing function)
6 Slide 6 Individual Example of a Cosine Function N= 264 Intervals 24h Mean= msec R 2 =51% Cosine function
7 Slide 7 Individual Example of a Cosine Function N= 264 Intervals 24h Mean= msec Acrophase = 23:45h R 2 =51% Amplitude = 13.7 msec Cosine function MESOR = 44.2 msec
8 Slide 8 Reference Ranges by Age Group & Sex Ø Expected relationships: Higher ratio in elderly & Men LF/HF ratio Men LF/HF ratio Women
9 Slide 9 Reference Ranges by Age Group & Sex Ø Expected relationships: Decrease in SDRR by age group Ø Women show diminished profile LF/HF ratio Men SDRR Men SDRR Women
10 Slide 10 Reference Ranges by Age Group & Sex Ø Expected relationships: Decrease in RMSSD by age group RMSSD Men RMSSD Women
11 Slide 11 Effect (Hedges s D) of Sex on HRV Parameters Higher in Men Higher in Women Higher in Men Higher in Women Figure 2 from Koenig, Thayer: Sex differences in healthy human heart rate variability: A meta-analysis Neuros. & Biobehav. Reviews 64 (2016)
12 Slide 12 Effect (Hedges s D) of Sex on HRV Parameters Higher in Men Higher in Women Higher in Men Higher in Women Figure 2 from Koenig, Thayer: Sex differences in healthy human heart rate variability: A meta-analysis Neuros. & Biobehav. Reviews 64 (2016)
13 Slide 13 ØP-values for Wilcoxon Rank test for sex difference within age group ØSimilar pattern for parametric tests & CI of Hedges s D HRV RR SDRR RMSS RMSSD D HF LF LF/HF TOTAL Quinquennium MESOR Amplitude Acrophase MESOR Amplitude Acrophase MESOR Amplitude Acrophase MESOR Amplitude Acrophase MESOR Amplitude Acrophase MESOR Amplitude Acrophase MESOR Amplitude Acrophase
14 Slide 14 ØP-values from ANOVA PostHoc Test testing between age-group differences (Sidak adjusted) RMSSD SDRR (1) (1) (2) (2) (3) (3) (4) (4) (5) (5) (6) (6) (7) (7) (8) (8) (9) (9) HF TP LF (1) (1) (1) (2) (2) (2) (3) (3) (3) (4) (4) (4) (5) (5) (5) (6) (6) (6) (7) (7) (7) (8) (8) (8) (9) (9) (9)
15 Slide 15 ØP-values for Men from ANOVA PostHoc Test testing between agegroup differences (Sidak adjusted) RMSSD SDRR (1) (1) (2) (2) p< (3) (3) (4) (4) (5) (5) (6) (6) (7) (7) (8) (8) (9) (9) HF TP LF (1) (1) (1) (2) (2) (2) (3) (3) (3) (4) (4) (4) (5) (5) (5) (6) (6) (6) (7) (7) (7) (8) (8) (8) (9) (9) (9)
16 Slide 16 ØP-values for Women from ANOVA PostHoc Test testing between age-group differences (Sidak adjusted) RMSSD SDRR (1) (1) (2) (2) p< (3) (3) (4) (4) (5) (5) (6) (6) (7) (7) (8) (8) (9) (9) HF TP LF (1) (1) (1) (2) (2) (2) (3) (3) (3) (4) (4) (4) (5) (5) (5) (6) (6) (6) (7) (7) (7) (8) (8) (8) (9) (9) (9)
17 Slide 17 Summary Ø Circadian variation patterns of HRV diminish by age Ø Women show lower variation patterns Ø Sex differences apparent in most HRV measures Ø but only up to age group in this sample
18 Slide 18 Conflict of interest: none to declare Acknowledgement: MNJs position was funded through the Physician Scientist Program (Medical Faculty Heidelberg, Heidelberg University) from 9/15 to 3/17 Find me on:
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