Poincaré plot indices as measures of sympathetic cardiac regulation: Responses to psychological stress and associations with pre-ejection period.

The Poincaré plot is a visual representation of the R-R time series within a Cartesian plane constructed by plotting each R-R interval as a function of the previous one. The plot can be characterized by parameters that quantify the standard deviation (SD) of short- and long-term R-R interval variability (SD1 and SD2, respectively). Claims regarding the use of Poincaré plot analysis as an alternative to conventional time-domain and spectral analytic measures of parasympathetic contributions to heart rate variability (HRV) have been evaluated somewhat extensively. However, its proposed utility for characterizing sympathetic influences on HRV during periods of acute mental stress, using SD2 and the SD1/SD2 ratio, has received minimal attention. In the present study, the electrocardiogram was used to record R-R interval variability in healthy participants during a resting baseline period, while they performed a challenging reaction time task, and then during a recovery period. Simultaneously, the thoracic impedance cardiogram was used to derive the pre-ejection period (PEP), which reflects sympathetic cardiac control. HRV was quantified using time-domain, spectral analytic, and Poincaré plot indices. Task performance elicited significant reductions in HRV and PEP parameters, indicating withdrawal of parasympathetic tone with concomitant sympathetic activation. Following cessation of task performance, all HRV and impedance measures returned to baseline levels, signaling resumption of parasympathetic dominance. Bivariate associations linking SD2 and the SD1/SD2 ratio to PEP were observed; however, these were not large in magnitude, were exceeded in size by associations between the Poincaré metrics and conventional HRV markers of parasympathetic cardiac influences, and were eliminated when the latter were controlled statistically. These observations challenge the proposal that the Poincaré SD2 and SD1/SD2 metrics are suitable markers of sympathetic cardiac regulation in research concerned with mental and physical health.

Rahman S ，Habel M ，Contrada RJ 《-》

Poincaré plot indexes of heart rate variability detect dynamic autonomic modulation during general anesthesia induction.

Beat-to-beat heart rate variability (HRV) is caused by the fluctuating balance of sympathetic and parasympathetic tone. The Poincaré plot has been used to evaluate HRV. In this study, we validate that this new method may qualitatively and quantitatively assess the sympathovagal fluctuation in patients during induction of anesthesia with sevoflurane. Twenty-eight young patients were allocated for the study. The patients received a tilt test and on the next day they sustained anesthesia induced with inhaled anesthetics. Electrocardiography signals from the patients were relayed to an analogue-digital converter. The Poincaré plot is quantified by measuring SD1, SD2, and SD1/SD2. Power spectral analyses were performed and LF, HF and HF/LF were calculated. The LF power and the SD2 of the Poincaré plot increased while subjects were tilt-up from the supine position. Additionally, a significant correlation were found between LF and SD2, HF and SD1 (p < 0.05), and LF/HF and SD2/SD1 (p < 0.01). Sevoflurane inhalation for 10 minutes had no effect on heart rate, but diminished LF, total power and SD1, SD2 of the Poincaré plot respectively. However, the LF, SD2 and LF/HF increased; the HF, SD1 and SD1/SD2 ratio decreased after intubation stimulation. Poincaré plot and power spectral analysis of HRV during tilt test and sevoflurane induction significantly correlate. Poincaré plot analysis is easier and more sensitive at evaluating the sympathovagal balance and observing the beat-to-beat HRV.

Hsu CH ，Tsai MY ，Huang GS ，Lin TC ，Chen KP ，Ho ST ，Shyu LY ，Li CY ... -  《-》

Quantitative beat-to-beat analysis of heart rate dynamics during exercise.

Tulppo MP ，Mäkikallio TH ，Takala TE ，Seppänen T ，Huikuri HV ... -  《-》

Correlation among Poincare plot and traditional heart rate variability indices in adults with different risk levels of metabolic syndrome: a cross-sectional approach from Southern India.

Heart rate variability (HRV) is an important marker of cardiac autonomic modulation. Metabolic syndrome (MetS) can alter cardiac autonomic modulation, raising the risk of cardiovascular disease (CVD). Poincaré plot analysis (PPA) is a robust scatter plot-based depiction of HRV and carries similar information to the traditional HRV measures. However, no prior studies have examined the relationship between PPA and traditional HRV measures among different risk levels of MetS. We evaluated the association between the Poincare plot and traditional heart rate variability indices among adults with different risk levels of MetS. We measured anthropometric data and collected fasting blood samples to diagnose MetS. The MetS risk was assessed in 223 participants based on the number of MetS components and was classified as control (n=64), pre-MetS (n=49), MetS (n=56), and severe MetS (n=54). We calculated the Poincaré plot (PP) and traditional HRV measures from a 5 min HRV recording. Besides the traditional HRV measures, we found that various HRV indices of PPA showed significant differences among the groups. The severe MetS group had significantly lower S (total HRV), SD1 (short-term HRV), SD2 (long-term HRV), and higher SD2/SD1. The values of S, SD1, SD2, and SD2/SD1 were significantly correlated with most traditional HRV measures. We found gradual changes in HRV patterns as lower parasympathetic and higher sympathetic activity alongside the rising number of MetS components. The HRV indices of PPA integrating the benefits of traditional HRV indices distinguish successfully between different risk levels of MetS and control subjects.

Endukuru CK ，Gaur GS ，Yerrabelli D ，Sahoo J ，Vairappan B ，Goud AC ... -  《-》

Correlations between the Poincaré plot and conventional heart rate variability parameters assessed during paced breathing.

Guzik P ，Piskorski J ，Krauze T ，Schneider R ，Wesseling KH ，Wykretowicz A ，Wysocki H ... -  《Journal of Physiological Sciences》