Analysis of Gender Differences in HRV of Patients with [ME/CFS] Using Mobile-Health Technology, 2021, Capdevila et al

[Andy]

Abstract

In a previous study using mobile-health technology (mHealth), we reported a robust association between chronic fatigue symptoms and heart rate variability (HRV) in female patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). This study explores HRV analysis as an objective, non-invasive and easy-to-apply marker of ME/CFS using mHealth technology, and evaluates differential gender effects on HRV and ME/CFS core symptoms.

In our methodology, participants included 77 ME/CFS patients (32 men and 45 women) and 44 age-matched healthy controls (19 men and 25 women), all self-reporting subjective scores for fatigue, sleep quality, anxiety, and depression, and neurovegetative symptoms of autonomic dysfunction. The inter-beat cardiac intervals are continuously monitored/recorded over three 5-min periods, and HRV is analyzed using a custom-made application (iOS) on a mobile device connected via Bluetooth to a wearable cardiac chest band. Male ME/CFS patients show increased scores compared with control men in all symptoms and scores of fatigue, and autonomic dysfunction, as with women in the first study. No differences in any HRV parameter appear between male ME/CFS patients and controls, in contrast to our findings in women. However, we have found negative correlations of ME/CFS symptomatology with cardiac variability (SDNN, RMSSD, pNN50, LF) in men. We have also found a significant relationship between fatigue symptomatology and HRV parameters in ME/CFS patients, but not in healthy control men. Gender effects appear in HF, LF/HF, and HFnu HRV parameters. A MANOVA analysis shows differential gender effects depending on the experimental condition in autonomic dysfunction symptoms and HF and HFnu HRV parameters. A decreased HRV pattern in ME/CFS women compared to ME/CFS men may reflect a sex-related cardiac autonomic dysfunction in ME/CFS illness that could be used as a predictive marker of disease progression. In conclusion, we show that HRV analysis using mHealth technology is an objective, non-invasive tool that can be useful for clinical prediction of fatigue severity, especially in women with ME/CFS.

Open access, https://www.mdpi.com/1424-8220/21/11/3746/htm

 

[Hutan]

In conclusion, we show that HRV analysis using mHealth technology is an objective, non-invasive tool that can be useful for clinical prediction of fatigue severity, especially in women with ME/CFS.

I haven't read the study yet, but the one below by Newton et al found that HRV was inversely correlated with activity levels. It seems possible that low HRV is just an indicator of sedentary behaviour.
Physical activity intensity but not sedentary activity is reduced in CFS and is associated with autonomic regulation, 2011, Newton et al


This study suggests that a sedentary lifestyle causes a low HRV.
The impact of sedentarism on heart rate variability (HRV) at rest and in response to mental stress in young women

We concluded that sedentary lifestyle in women induces impairment in autonomic cardiac modulation at rest and in response to physiological stress, compromising the quality of life, even before altering any cardiovascular or metabolic clinical parameters, reinforcing the potential role of HRV as early marker of cardiovascular risk in this population.

It might be that ME/CFS causes a low HRV, but it is probably more likely that ME/CFS increases the chance of a sedentary lifestyle, and that causes a low HRV. And the differences between men and women with ME/CFS found here might just be an artefact of different activity levels in these particular patient cohorts.

Like I say, I haven't read the study yet, so, there might be more to it.

 

[Snow Leopard]

I haven't read the study yet, but the one below by Newton et al found that HRV was inversely correlated with activity levels. It seems possible that low HRV is just an indicator of sedentary behaviour.

There are lots of confounding factors, unfortunately. HRV will never be a specific or sensitive biomarker.

 

[Wonko]

I may have misunderstood the abstract but what they appear to be saying is that men with ME have more symptoms than those who don't, but that women with ME also have different HRV values?

The first is so unsurprising that the only surprising thing about it is they appear to find it surprising.

Quite what they are saying with the second is unclear to me, possibly that info is contained in the paper.

 

[Wyva]

There's an article about this now.

An app to help assess the severity of symptoms in chronic fatigue syndrome

https://medicalxpress.com/news/2021-07-app-severity-symptoms-chronic-fatigue.html

Additional information I didn't know:

In this sense, Drs. José Alegre and Jesús Castro, both from Vall d'Hebron, are members for Spain in the European Network on Chronic Fatigue Syndrome / Myalgic Encephalomyelitis (EUROMENE), which includes 55 professionals from 22 European countries.​

 

[Sly Saint]

Merged thread

NEWS RELEASE
1-JUL-2021
An app to help assess the severity of symptoms in chronic fatigue syndrome

To better understand and promote follow-up, as well as stratify fatigue in these patients, Vall d'Hebron, the Universitat Autònoma de Barcelona (UAB) and the Universitat Politècnica de Catalunya · BarcelonaTech (UPC) have developed a mobile application that could be useful in the assessment of the severity of fatigue in this syndrome, especially in women. The results of the study in which this technology has been tested have been published in the journal Sensors.

The technology developed by the UAB and UPC researchers consists of a chest strap with a sensor capable of measuring certain cardiac hemodynamic variables, connected via Bluetooth to a mobile app. The mobile application allows you to record and monitor heart rate variability and share the analyzed results with the medical staff who supervise patients.

Specifically, this study analyzed the relationship between heart rate variability and severity of symptoms among women and men with CFS/ME. This parameter is closely related to heart rate, that is, the number of beats per minute of the heart. However, the time that passes between two consecutive beats is not always exactly the same, but small differences that fall within normality can be detected: this is what is known as heart rate variability (HRV).

In previous studies published in the Journal of Translational Medicine, HRV had already been related to the assessment of the severity of fatigue in women with CFS/ME. "Specifically, we had observed that this variability was lower in patients with CFS/ME, especially in the most disabling cases", explains Dr. Jesús Castro, coordinator of the laboratory in Chronic Fatigue Syndrome / Myalgic Encephalomyelitis of the Rheumatology group of the Vall d'Hebron Research Institute (VHIR). A priori, it is considered positive to have a high variability, as it is an indicator of the proper functioning of the autonomic nervous system. "In this work we wanted to verify the relationship between HRV and the syndrome in both women and men with CFS/ME compared to healthy controls and its usefulness for monitoring patients", adds Dr. Castro.

full article
https://www.eurekalert.org/pub_releases/2021-07/uadb-aat070121.php

 

[InitialConditions]

I've just got a Polar H10. I hope to track HRV and see if the hype is justified.

 

[kilfinnan]

I've just got a Polar H10. I hope to track HRV and see if the hype is justified.

It's been the most useful piece of kit I've come across. I see definite trends from the readings.

The apps I've tried are all geared towards sports activity. Unfortunately, I'm not well enough to be disciplined or clever enough to use the strap to it's full potential.

With regard to inactivity, I'm inactive. However, my HRV's change, and the more extreme values mirror the severity of my illness.

I would have expected that living, such a constant, sedentary life would produce HRV's within a set band of values. It doesn't.

 

[Hoopoe]

It's been the most useful piece of kit I've come across. I see definite trends from the readings.

Can you say more? I've been thinking about starting to document my heart rate and heart rate variability over longer periods of time but lack motivation to start since I'm not sure this exercise will actually be useful. It would take at least six months to get enough data in my opinion.

 

[Midnattsol]

My pulse can reduce a lot in a crash, with an accompanying higher HRV. Other times it will increase. I've heard the same from others. Mine is also clearly affected by my period which I've mentioned on here a few times already I might get some information if it doesn't reduce/increase by the amount I'm expecting following my cycle, but that's not always a clear sign either that anything is amiss.

 

[kilfinnan]

Can you say more? I've been thinking about starting to document my heart rate and heart rate variability over longer periods of time but lack motivation to start since I'm not sure this exercise will actually be useful. It would take at least six months to get enough data in my opinion.

This is the most useful app.

https://www.hrv4training.com/faq.html

The designer.

https://www.marcoaltini.com

Quiet an interesting guy.

• PhD cum laude in Data Science
• MSc cum laude in Computer Science Engineering
• MSc cum laude in Human Movement Sciences, High-Performance Coaching

It's all geared towards performance. I'm geared for lack of performance.

I'm loathed to discuss my condition. Broadly.

The app would tell me HRV high. I do feel unwell. Bed with eye mask on etc. Fasciculations. At the same time my heart rate is at the very lowest.

This happens during 'attacks' dipping in and coming out, over a period of days. Could last as long as 3 weeks.

The app does two things. I use it as an alarm. It makes me stop everything when the HRV readings are high. It also shows in digits that something isn't right. Before when I was bedbound, I could hear the psychologists voice in my head. The app has silenced that.

I believe that by using HRV I have lessened the severity of the bouts and they are easier to deal with.

Away from HRV, using an HR alarm has been very beneficial.

But like everyone else, I'm on my own. The illness has evolved over time. And with so many contradictions. For me fasciculations have been the constant barometer of my condition. So I'm loathed to speak about anything because it's all just vibes, and like everyone else it's frustrating knowing this could be better managed. Thank you for all your efforts.

 

[Mithriel]

I can't use chest straps so I have had a fitbit for about 4 years now and I have worked out my own patterns. It amazed me at first that when I felt I could not go on my HR was high. I can't avoid high readings as I need to do things but I try to keep them down to a few minutes then rest until it is more normal

After a while I realised that my HR was low when I was particularly bad. It is obviously not because I am fitter so it must be my heart struggling to keep up.

It was also useful when my POTS became much worse a few years ago but those readings were not associated with doing too much.

When I was more moderate it could have helped with pacing but I have found that now I can become fatigued or rather less focussed and shaky, before my HR goes up so it is not a simple relationship.

 

[Andy]

Media article about this study.

Chest Strap System Monitors Severity of Chronic Fatigue Syndrome

"Researchers at the Universitat Autònoma de Barcelona in Catalonia, Spain, have developed a system to monitor the severity of myalgic encephalomyelitis (ME), also known as chronic fatigue syndrome. The system includes a commercial chest strap sensor that measures heart rate variability and a paired app that collects, collates, and presents these data, allowing patients to monitor their condition and share information with their clinician."

https://www.medgadget.com/2021/07/c...ors-severity-of-chronic-fatigue-syndrome.html