Study on heart rate variability in adolescent male ... - Orion Group

Original Article<strong>Study</strong> on heart rate variability in adolescent maleathletes by time domain (Short-Term) methodAlom MM, Begum N, Naher LAD, Kabir R, Faruky SB, Akhter NThe ORION Medical Journal 2010 Jan; 33(1):722-725AbstractBackground: Cardiac Autonomic NervousActivities (CANA) deteriorates with age,obesity, sedentary life style and in variouscardiac and noncardiac disease conditions.Regular physical exercise may improve CANAin health and diseases. Analysis of Heart RateVariability (HRV) by time domain method isone of the most promising newer techniques toquantify CANA. Hypothesis: Regular physicalexercise improves cardiac autonomic nervousactivities. Objective: To observe the HRVparameters by time domain method, in maleadolescent athletes in order to find out theinfluence of regular physical exercise onCANA. Method: The cross sectional study wascarried out on 62 adolescent male athletes aged12-18 years (group B), in the Department ofPhysiology, Bangabandhu Sheikh MujibMedical University from 1st July 2007 to 30thJune 2008. For comparison 30 age, sex andsocioeconomic condition matched apparentlyhealthy sedentary subjects (group A) were alsostudied. The study group was selected from theBKSP (Bangladesh Krira Shikka Prothistan,Savar, Dhaka) and the control from aresidential Madrasha (sedentary life style) ofDhaka city. HRV parameters were assessed by1. Dr. Md. Mashudul Alom, MBBS, M PhilAssistant Professor of Physiology, Sylhet Women'sMedical College, Sylhete-mail : masud_physiol@yahoo.com2. Prof. Noorzahan Begum, MBBS, M Phil, FCPS,FACP, Professor of Physiology, Department ofPhysiology, BSMMU3. Dr. Latifa Afrin Dill Nahar, MBBS, M PhilAssistant Professor, Prime Medical College, Rangpur4. Dr. Rasel Kabir, MBBS, M PhilAssistant Professor, Z.H Sikder Medical College,Dhaka5. Dr. Salma Bintey Faruky, MBBS, M PhilSenior Lecturer, Bangladesh Medical College, Dhaka6. Dr. Nilufa Akhter, MBBS, M PhilAssistant. Professor, Dhaka Shishu Hospital, DhakaThe ORION. Vol 33, Issue 1, January 2010Polygraph (Polyrite D, version 2.2). Forstatistical analysis Idependent-Samples t-testwas done as applicable. Results: Mean R-Rinterval and SDNN were significantly(P

Original ArticleCANA was also observed in disease conditionslike in Myocardial Infarction, 24,25 Coronaryartery disease, 26,27 Heart failure, 28,29,30 Obesity, 31type 2 Diabetes, 17, 32 Renal disease. 33Though, it was evident that regular physicalexercise improves CANA in health anddiseases by large number of studies; yet, a fewgroup of investigators, failed to prove thatimprovement in healthy individuals. 34,35,36Again, some other group of investigatorsshowed that physical exercise does notimprove, even in some cases deterioratesCANA in disease conditions. 37, 38,39,40 Thus, theinfluence of physical exercise on CANAremains still controversial.Analysis of HRV by time domain method toquantify CANA has now become popularworld-wide because it is independent, noninvasive,accurate, could be easily available andin some extent detailed informative. In timedomain method standard deviation of thenormal-to-normal (NN) intervals (that isintervals between adjacent QRS complexesresulting from the sinus node depolarizations)that is SDNN indicate the global variability thatis the total change in the CANA. A highervalue of SDNN indicates increased and a lowervalue indicates reduced HRV or CANA. 2In Bangladesh, the number of patients withDiabetes, Cardiac diseases and Renal failureare increasing day by day. Again, a largenumber of people in our country may found tobe affected from Autonomic Nerve Dysfunctiondue to under or over nutrition. In addition, dueto rapid urbanization and mechanization of life,sedentary life style may affect CANA in all agegroups. Therefore, people should be aware ofthe adverse effect of sedentary life and alsoabout the usefulness of physical exercise as apreventive and prognostic measure.Though, in our country, several studies weredone to assess the CANA in Diabetes, 41 aging 40and obesity 15 by conventional method; but, nostudy was undertaken to document the changesThe ORION. Vol 33, Issue 1, January 2010of HRV as a result of physical exercise bymicrocomputer based time domain method.Therefore, this study was carried out toevaluate the CANA, by analysis of HRV bytime domain method, in healthy adolescentmale athletes who perform regular physicalexercise and also in healthy adolescent malewith sedentary life style.MethodsThis cross-sectional study was carried out in thedepartment of physiology of BangabandhuSheikh Mujib Medical University from July2007 to June 2008. Departmental EthicalCommittee approved the protocol.Total 92 apparently healthy male adolescentsage ranged from 12-18 years were selected, ofwhom 30 were non-athletes sedentary taken ascontrol (Group A) and 62 were athletes selectedas experimental (Group B). Control (Group A)was selected from a Madrasha (a residentialIslamic school) in Dhaka city and the study(Group B) was from Bangladesh Krira ShikkhaProthistan ( BKSP - the top most residentialsports academy in Bangladesh). All the controlsubjects were used to maintain a sedentary lifestyle while the experimental subjects wereexposed to regular physical exercise for at leastone year. The subjects were excluded for anysystemic diseases, drug user specially drugaffecting nervous system and smoker. Allethical considerations for the subjects weretaken into account before inclusion in to thestudy. The aims and benefits of the study wereexplained to each subject and were encouragedto participate voluntarily. A written informedconsent was taken from each subjects and theirauthority. A detail physical activity, medical,personal, socio-economic history was taken andthorough clinical examination of the subjectswas done. All these information were recordedin a prepared questionnaire. The subjects wereadvised to have his meal by 9:00 p.m., toremain free from any physical and mentalstress, not to take any drugs affecting nervoussystem and to have a good sleep at night beforewww.orion-group.net/journalswww.orion-group.net/medicaljournal

Original Articlethe examination day. The subject was alsoasked to avoid tea or coffee at breakfast and toattend at the autonomic nerve functionlaboratory between 9:00 am to 11:00 am on theday of examination. On the day of examination,after detailed history and all physicalexaminations, the subject was kept undercomplete bed rest in supine position for 20minutes in a cool and calm environment at"Autonomic Nerve Function Test Laboratory"of the department of physiology. During thisperiod he was restricted to talk, eat, drink, anyphysical or mental activity and even sleep.Then all preparations for recording of the heartrate variability parameters was made byconnecting the channels i.e. the channels forECG of Polyrite-D (RMS INDIA Version-2.2).Then five minutes recording was taken inresting supine position. After recording, all thenon-sinus beats were filtered out from the ECGand the time domain parameters of the HRV(R-R interval, heart rate and SDNN) wereobtained from the time series. Then, with allaseptic precaution, 5ml of venous blood wasdrawn from the subject in order to measureserum glucose and creatinine levels to excludediabetes and kidney diseases.All datas were recorded systematically inpreformed data collection form and expressedas mean±SD. Statistical analysis was performedby using SPSS for windows version 12.0.Independent-Samples t-test was performed tocompare the data between the control and studygroup. 95% confidence limit (p

Original Articlesubjects were analyzed by microcomputerbased polygraphic recorder (Polyrite D, RMSIndia version 2.2). All these time domain HRVparameters were also studied in age and sexmatched healthy sedentary subjects for control.and also to find out their baseline data in thisgroup of population.In this study, all the time domain HRVparameters in the healthy control subjects werewithin normal ranges and are comparable withthe findings of the Task Force Guidelines. 2Serum Glucose and Creatinine levels in all thesubjects were within normal range and werestudied for exclusion of Diabetes Mellitus andkidney diseases.In the present study, Mean R-R interval wassignificantly (P

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