• Journal of Biomedical Engineering Research
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• v.24 no.1
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• pp.1-8
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• 2003

The job of long distance driving is likely to be fatiguing and requires long period alertness and attention, which make considerable demands of the driver. Driving fatigue contributes to driver related with accidents and fatalities. In this study, we investigated the relationship between the number of hours of driving and driving fatigue using heart rate variability(HRV) signal. With a more traditional measure of overall variability (standard deviation, mean, spectral values of heart rate). Nonlinear characteristics of HRV signal were analyzed using Approximate Entropy (ApEn) and Poincare plot. Five subjects drive the four passenger vehicle twice. All experiment number was 40. The test route was about 300Km continuous long highway circuit and driving time was about 3 hours. During the driving, measures of electrocardiogram(ECG) were performed at intervals of 30min. HRV signal, derived from the ECG, was analyzed using time, frequency domain parameters and nonlinear characteristic. The significance of differences on the response to driving fatigue was determined by Student's t-test. Differences were considered significant when a p value < 0.05 was observed. In the results, mean heart rate(HRmean) decreased consistently with driving time, standard deviation of RR intervals(SDRR), standard deviation of the successive difference of the RR intervals(SDSD) increased until 90min. Hereafter, they were almost unchanging until the end of the test. Normalized low frequency component $(LF_{norm})$, ratio of low to high frequency component (LF/HF) increased. We used the Approximate Entropy(ApEn), Poincare plot method to describe the nonlinear characteristics of HRV signal. Nonlinear characteristics of HRV signals decreased with driving time. Statistical significant is appeared after 60 min in all parameters.

• Korean Journal of Psychosomatic Medicine
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• v.28 no.1
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• pp.89-97
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• 2020

Objectives : We investigated heart rate variability (HRV) patterns in patients with somatic symptom disorder (SSD) and the relationships of these patterns with alexithymia. Methods : In total, 42 patients with SSD and 33 healthy controls were enrolled in this study. Demographic, psychological, and HRV data were assessed at baseline, and 24 patients with SSD were reassessed after 6 months of treatment. The psychological data included somatic symptoms and levels of depression, anxiety, and alexithymia as indicated by the somatic symptom subscale of the Symptom Checklist 90-Revision (SCL-12), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and the Toronto Alexithymia Scale 20 (TAS-20), respectively. Results : Patients with SSD had a lower standard deviation of normal-to-normal R-R intervals (SDNN) and lower proportions of adjacent R-R intervals greater than 50 milliseconds (pNN50) compared with controls. These HRV parameters were negatively correlated with alexithymia severity. After treatment, patients exhibited significantly decreased levels of somatic symptoms and reduced anxiety and depression, but there were no significant differences in the HRV parameters. In patients with alexithymia, a high baseline SDNN and pNN50 were associated with a decrease in somatic symptoms. Conclusions : Patients with SSD have different HRV patterns, and several HRV parameters are associated with alexithymia severity. These findings suggest that ANS regulation is involved in the pathophysiology of SSD, mediated by alexithymia. Furthermore, these results suggest that certain HRV parameters may be associated with clinical outcomes of SSD.

• Journal of Physiology & Pathology in Korean Medicine
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• v.34 no.1
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• pp.30-36
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• 2020

This study aimed to investigate heart rate variability (HRV) characteristics of cold pattern with repeated measurement data. Participants were taken from a Daejeon University cohort study from 2015 to 2018. Forty-seven of the participants studied displayed cold pattern while 23 showed signs of non-cold pattern. HRV was measured in supine position for 5 minutes at each year, and an 8-item cold pattern questionnaire was used for the diagnosis of cold pattern. SDNN (standard deviation of the NN intervals) and RMSSD (the square root of the mean squared differences of successive NN intervals) were used as time domain analysis, and TP (total power), VLF (power in very low frequency range), LF (power in low frequency range), HF (power in high frequency range), LF norm (LF power in normalized units), HF norm (HF power in normalized units) and LF/HF were used as frequency domain analysis. In the Mann-Whitney U test, LF norm, HF norm, and LF/HF showed differences between the cold pattern group and non-cold pattern group at every measurement, and in the independent t-test, the differences were also observed at three points except for the baseline (2015). In the repeated measures ANOVA, the interaction effects were not observed in all HRV parameters, but the time period effects were observed in SDNN, RMSSD, TP, VLF, LF and HF. There were significant differences between those two groups in LF norm, HF norm and LF/HF. This study suggests that LF norm, HF norm and LF/HF might be a useful indicator of cold pattern properties.

• Journal of Biomedical Engineering Research
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• v.33 no.3
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• pp.141-147
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• 2012

In this paper, we have investigated effects of two specific meditations (Chinese qigong meditation and Kundalini yoga meditation) on the heart rate variability (HRV), which is a well-known quantitative measure of autonomic balance, of skilled students. To analyze the effects, the MIT/BIH physionet database was utilized. The database includes RR intervals of eight skilled Chinese qigong meditators (5 women and 3 men; age range 26-35) and four skilled Kundalini yoga meditators (2 women and 2 men; age range 20-52). RR intervals of each subject were measured before and during the meditations. For HRV analysis, we have used typical four HRV parameters - the low frequency to high frequency power ratio (LF/HF ratio), SD2/SD1 ratio, sample entropy, and fractal dimension. The LF/HF ratio was calculated by the autoregressive spectrum and the SD2/SD1 ratio was derived from the Poincar$\grave{e}$ plot. The sample entropy was computed from the phase space plot and the fractal dimension was estimated by the Higuchi's algorithm. In the experiments, the Wilcoxon signed rank test was employed because we used small datasets and compared HRV parameters before and during the meditations. As a result, we have found increment of the LF/HF and SD2/SD1 ratios in both meditations; whereas the sample entropy is decreased during the meditations. In addition, the fractal dimension is increased during the Chinese qigong meditation; whereas it is decreased during the Kundalini yoga meditation. The results show that the sympathetic nervous system is generally more activated in skilled Chinese qigong and Kundalini yoga meditators, but the activation of the parasympathetic nervous tone is suppressed.

• Journal of Korean Medicine Rehabilitation
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• v.31 no.2
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• pp.81-97
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• 2021

Objectives This study was designed to identify the changes of autonomic nervous system (ANS) which was induced by acupuncture at the field of the auricular branch of the vagus nerve. Methods 30 healthy adults were selected and classified into two groups; experimental group, control group. After providing mental stress, acupuncture was applied at external ear in experimental group and no treatment executed in control group. The evaluation of ANS function was measured by heart rate variability (HRV). We statically analyzed the difference of HRV parameters which include mean heart rate (MHRT), standard deviation of all N-N intervals (SDNN), square root of the mean of the sum of the squares of differences between adjacent N-N intervals (RMSSD), total power (TP), low frequency power (LF), high frequency power (HF), LF/HF ratio. Results All subjects showed significant increase in SDNN, LF after stress stimulation (p<0.05). Immediately after intervention, MHRT was significantly decreased (p<0.001) and RMSSD, HF were significantly increased in experimental group (p<0.05). After the end of intervention, SDNN, HF, RMSSD, TP, LF were significantly increased in experimental group (p<0.01, p<0.05). And when comparing baseline HRV, SDNN, LF were significantly increased in control group (p<0.01) and SDNN, RMSSD, TP, LF were significantly increased in experimental group (p<0.05). In the subgroup analysis, normal balance of ANS group showed significant increase in TP, LF, SDNN, HF (p<0.01, p<0.05). Conclusions We suggested that acupuncture at external ear, region of the vagus nerve distribution could increase parasympathetic activity and cause changes and reregulation of the ANS.

• Journal of Chest Surgery
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• v.28 no.1
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• pp.23-30
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• 1995

From January 1985 to December 1992, of 1257 patients who underwent a heart valve replacement 210 [16.8% underwent reoperation on prosthetic heart valves, and 6 of them had a second valve reoperation. The indications for reoperation were structural deterioration [176 cases, 81.5% , prosthetic valve endocarditis [25 cases, 11.6% , paravalvular leak [12 cases, 5.6% , valve thrombosis [2 cases, 0.9% and ascending aortic aneurysm [1 case, 0.4% . Prosthetic valve failure developed most frequently in mitral position [57.9% and prosthetic valve endocarditis and paravalvular leak developed significantly in the aortic valve [40%, 75% [P<0.02 . Mean intervals between the primary valve operation and reoperation were 105.3$\pm$28.4 months in the case of prosthetic valve failure, 61.5$\pm$38.5 months in prosthetic valve endocarditis, 26.8$\pm$31.2 months in paravalvualr leak, and 25.0$\pm$7.0 months in valve thrombosis. In bioprostheses, the intervals were in 102.0$\pm$23.9 months in the aortic valve, and 103.6$\pm$30.8 months in the mitral valve. The overall hospital mortality rate was 7.9% [17/26 : 15% in aortic valve reoperation [6/40 , 6.5% in reoperation on the mitral prostheses [9/135 and 5.7% in multiple valve replacement [2.35 . Low cardiac output syndrome was the most common cause of death [70.6% . Advanced New York Heart Association class [P=0.00298 , explant period [P=0.0031 , aortic cross-clamp time [P=0.0070 , prosthetic valve endocarditis [P=0.0101 , paravalvularr leak [P=0.0096 , and second reoperation [P=0.00036 were the independent risk factors, but age, sex, valve position and multiple valve replacement did not have any influence on operative mortality. Mean follow up period was 38.6$\pm$24.5 months and total patient follow up period was 633.3 patient year. Actuarial survival at 8 year was 97.3$\pm$3.0% and 5 year event-free survival was 80.0$\pm$13.7%. The surgical risk of reoperation on heart valve prostheses in the advanced NYHA class patients is higher, so reoperation before severe hemodynamic impairment occurs is recommended.

• Science of Emotion and Sensibility
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• v.8 no.2
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• pp.95-101
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• 2005

This study is based on previous information regarding reduced cardiac vagal activity in patients with coronary artery disease(CAD), on reduced variance(SDNN : standard deviation of all normal RR intervals), low-frequency power(LF), and the complexity of heart rate variability(HRV) in patients with chronic heart failure(CHF), and on the normalized high-frequency power of HRV is the highest in the right lateral decubitus position among 3 recumbent postures in patients with CAD, However, nothing is known about the nonlinear dynamics of HRV for the 3 recumbent postures in patients with CAD. To investigate the linear and non-linear characteristics of HRV in patients with CAD, 29 patients as CAD group and 23 patients as control group were studied. Electrocardiogram(ECG) with lead II channel was measured on these patients for 3 recumbent postures in random order. The HRV from ECG was analyzed with linear method(for time and frequency domains) and nonlinear method. The lower the high-frequency power in normalized unit(nHF) in the supine or left lateral decubitous position, the higher the increase in nHF when the position was changed from supine or left lateral decubitous to right lateral decubitous. Among the 3 recumbent postures in patients with severe CAD, the right lateral decubitus position was observed to induce the highest vagal modulation, the lowest sympathetic modulation, and the highest complexity of human physiology system.

• The Transactions of The Korean Institute of Electrical Engineers
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• v.57 no.6
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• pp.1109-1115
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• 2008

In the ubiquitous health monitoring environments, it is quite important not only to evaluate the physiological health condition but also mental stress condition. In order to achieve this goal, a heart activity monitoring system utilizing a wearable bipolar electrode is devised and the heart rate variability(HRV) is extracted and interpreted in both frequency and time feature domains. Consequently, to evaluate the emotional stress condition of the subjects, a stress-induced experimental protocol was applied to healthy subjects and the time and frequency features of heart activity were analyzed in terms of the ratio of low frequency components v.s., high frequency components and the relevant the moving average distributions compromising the successive RR peaks intervals in the ambulatory ECG measurement system.

• Korean Journal of Psychosomatic Medicine
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• v.28 no.1
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• pp.81-88
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• 2020

Objectives : This study aimed to compare autonomic nervous system (ANS) dysregulation and differential relationships with clinical severities between anxiety disorder, depressive disorder, and trauma·stressor related disorder using heart rate variability (HRV) parameters. Methods : We conducted a retrospective chart review of outpatients from 2017 to 2018 in Stress Clinic of National Center for Mental Health. Total 473 patients were included; 166 anxiety disorder; 184 depressive disorder ; 123 trauma·stressor related disorder. Parameters of 5-min analysis of HRV were compared in three groups. Additionally, we investigated the differential association of each parameters with Clinical Global Impression-Severity Scale (CGI-S) across each group. Results : No significant differences were found in all HRV parameters between the three groups. However, significant group interactions by CGI-S were found in standard deviation of all RR intervals (SDNN) and the square root of the mean squared differences of successive normal-to-normal intervals (RMSSD) (SDNN, p=0.017 ; RMSSD, p=0.034). A negative relationship between CGI-S and SDNN, RMSSD has been found in anxiety disorder and depressive disorder. However, a positive relationship between CGI-S and SDNN, RMSSD has been found in trauma·stressor related disorder. Conclusions : Despite of no significant differences of each HRV parameter, our findings suggested the differential associations of HRV parameters with clinical severity among anxiety disorder, depressive disorder and trauma·stressor related disorder. In trauma·stressor related disorder, the clinical severity and degree of ANS dysregulation may differ, so more aggressive treatment is suggested.

• Horticultural Science & Technology
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• v.28 no.6
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• pp.1066-1071
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• 2010

To evaluate the effect of horticultural therapy (HT) on the emotional improvement of depressed patients, computer-based heart rate variability (HRV) was compared with self-report scale (SRS) known as existing subjective evaluation method. SRS included four test areas: mental stress scale (MSS), physical stress scale (PSS), Beck anxiety inventory (BAI), and Beck depression inventory (BDI). HRV was itemized into four parameters: standard deviation of the N-N intervals (SDNN), square root of mean squared difference of successive N-N intervals (RMSSD), total power (TP), and low-frequency/high-frequency ratio (LF/HF ratio). Thirty patients with depression at the same mental hospital participated in this study. 15 patients of the treatment group received HT once a week for three months, but the control group did not during the same period. As a result, the emotional improvement in treatment group was clearly identified through HRV as well as SRS. The significant difference was shown at three test areas (MSS, BAI, and BDI, $p$ < 0.001) in SRS and at one parameter (total power, $p$ < 0.05) in HRV. There was noticeable increase in SDNN, RMSSD, and LF/HF ratio in treatment group after HT activity, but no significant difference. Although all parameters of HRV did not show significance, the possibility of HRV as an objective evaluation method to HT was recognized in this study. These results also implied that HT was efficient in the mental and physical regeneration of the depressed patients in both subjective and objective evaluation methods.