Heart rate variability: for real doctors. Translation from the Russian version of the book, published at Kharkiv, 2010, 131 p.
The basics and practice of the clinical use of the technology of heart rate variability are outlined for doctors of all specialties and students of medical faculties of universities.
What generates and reflects HRV
HRV is generated by regulation
• regulation is multi-loop hierarchical non-linear,
• regulation through sensors is open to the (external and internal) world and interacts with it,
• regulation is dynamic and is determined by the current interaction with the world,
• HRV reflects multi-contour hierarchical nonlinear dynamic regulation,
• the higher the level of regulation, the longer the reaction times it is characterized
• the lower the level of regulation, the shorter the reaction times it will be,
• any link of regulation is represented and acts at its different levels,
• any regulation link is characterized by a spectrum (long and short) reaction times,
• no regulation link can only have a characteristic (particular, isolated) spectrum of reaction times,
• regulation reacts to influences (external, internal stress of any nature and intensity) as an integral system,
• it is impossible to create an artificial effect that isolates anyone link of regulation in isolation,
• HRV with any influences (and any study protocols) reflects systemic regulation reactions,
• any HRV protocols should be considered for regulation reactions as an integral system,
• the contribution of regular links to the general regulation is estimated in functional samples.
Nevertheless, methods for indirect assessment of the quality of sympathetic (baroreflex control) and vagal (parasympathetic activity) activity and their significance in the general state of regulation exist. These methods are functional tests, the most important among which are the orthostatic test and metronized breath. The orthostatic test is implemented through baroreflex control, and metronomized respiration through the stimulation of vagal nuclei, and, therefore, allow us to evaluate their contribution to the regulation as a whole, as well as to its links (the corresponding spectra are high, medium, some frequencies).
Complementing the definition of HRV in the basal conditions with the definition in functional tests, the doctor gets an opportunity to get quite a complete picture of the state of regulation as a whole.
But the diversity of functional tests and their value in the assessment of regulation we will discuss slightly lower.