Should heart rate variability be “corrected” for heart rate? Biological, quantitative, and interpretive considerations

Eco J.C. de Geus*, Peter J. Gianaros, Ryan C. Brindle, J. Richard Jennings, Gary G. Berntson

*Corresponding author for this work

Research output: Contribution to JournalReview articleAcademicpeer-review

Abstract

Metrics of heart period variability are widely used in the behavioral and biomedical sciences, although somewhat confusingly labeled as heart rate variability (HRV). Despite their wide use, HRV metrics are usually analyzed and interpreted without reference to prevailing levels of cardiac chronotropic state (i.e., mean heart rate or mean heart period). This isolated treatment of HRV metrics is nontrivial. All HRV metrics routinely used in the literature exhibit a known and positive relationship with the mean duration of the interval between two beats (heart period): as the heart period increases, so does its variability. This raises the question of whether HRV metrics should be “corrected” for the mean heart period (or its inverse, the heart rate). Here, we outline biological, quantitative, and interpretive issues engendered by this question. We provide arguments that HRV is neither uniformly nor simply a surrogate for heart period. We also identify knowledge gaps that remain to be satisfactorily addressed with respect to assumptions underlying existing HRV correction approaches. In doing so, we aim to stimulate further progress toward the rigorous use and disciplined interpretation of HRV. We close with provisional guidance on HRV reporting that acknowledges the complex interplay between the mean and variability of the heart period.

Original languageEnglish
Article numbere13287
Pages (from-to)1-26
Number of pages26
JournalPsychophysiology
Volume56
Issue number2
Early online date25 Oct 2018
DOIs
Publication statusPublished - Feb 2019

Funding

NIH grant (HL089850) (to P.J.G.), NIH grant (HL101959) (to J.R.J.), NIH grant (F32 HL137227) to R.C.B., Ohio State University Emeritus Academy grant (to G.G.B.), John D. and Catherine T. MacArthur Foundation Research Network National Institute on Aging (P01‐ AG020166), National Institute on Aging (U19‐AG051426), NIH National Center for Advancing Translational Sciences (NCATS) Clinical and Translational Science Award (CTSA) program (UL1TR001409) (Georgetown), (UL1TR001881) (UCLA), (1UL1RR025011) (UW), Netherlands Organization for Scientific Research (NWO), The Netherlands Organization for Health Research and Development (ZonMW), Biobanking and Biomolecular Resources Research Infrastructure (BBMRI–NL), Vrije Universiteit’s VU‐ AMS research fund. This work was supported by NIH grant HL089850 to P.J.G., NIH grant HL101959 to J.R.J., NIH grant F32 HL137227 to R.C.B., and an Ohio State University Emeritus Academy grant to G.G.B. Since 1995, the MIDUS study has been funded by the following: John D. and Catherine T. MacArthur Foundation Research Network National Institute on Aging (P01‐AG020166), National Institute on Aging (U19‐AG051426). Biomarker data collection was further supported by the NIH National Center for Advancing Translational Sciences (NCATS) Clinical and Translational Science Award (CTSA) program as follows: UL1TR001409 (Georgetown), UL1TR001881 (UCLA), 1UL1RR025011 (UW). Data collection on the autonomic nervous system in the Netherlands Twin Register (NTR) was supported by the Netherlands Organization for Scientific Research (NWO) and The Netherlands Organization for Health Research and Development (ZonMW), the Biobanking and Biomolecular Resources Research Infrastructure (BBMRI–NL), and the Vrije Universiteit’s VU‐AMS research fund. Data management and access was supported by the Netherlands Organization for Scientific Research (NWO) grant 480‐15‐001/674 (NWO‐Groot). The authors declare no conflicts of interest with respect to their authorship or the publication of this article.

FundersFunder number
BBMRI
Biobanking and Biomolecular Resources Research Infrastructure
John D. and Catherine T. MacArthur Foundation Research Network National Institute on AgingP01‐ AG020166
Netherlands Organization for Health Research and Development
Ohio State University Emeritus Academy
Vrije Universiteit’s VU‐ AMS
National Institutes of HealthHL089850, HL101959, F32 HL137227
National Institute on AgingU19AG051426
National Center for Advancing Translational SciencesUL1TR001881, UL1TR001409
University of California, Los Angeles1UL1RR025011
ZonMw
Nederlandse Organisatie voor Wetenschappelijk Onderzoek

    Keywords

    • autonomic
    • behavioral medicine
    • heart rate
    • heart rate variability

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