The validity and reliability of ultra-short-term heart rate variability parameters and the influence of physiological covariates

Author: Joel S Burma1, Sarah Graver1, Lauren N Miutz1, Alannah Macaulay2, Paige V Copeland3, Jonathan David Smirl1
Affiliation: <sup>1</sup> Faculty of Kinesiology, University of Calgary, Canada. <sup>2</sup> Faculty of Health and Exercise Science, University of British Columbia, Canada. <sup>3</sup> Faculty of Health and Social Development, University of British Columbia, Canada.
Conference/Journal: J Appl Physiol (1985)
Date published: 2021 Apr 15
Other: Special Notes: doi: 10.1152/japplphysiol.00955.2020. , Word Count: 261


Background:
Ultra-short-term (UST) heart rate variability (HRV) metrics have increasingly been proposed as surrogates for short-term HRV metrics. However, the concurrent validity, within-day reliability, and between-day reliability of UST HRV have yet to be comprehensively documented.

Methods:
Thirty-six adults (18 males, age: 26 ± 5 years, BMI: 24 ± 3 kg/m2)were recruited. Measures of HRV were quantified in a quiet-stance upright orthostatic position via three-lead electrocardiogram (ADInstruments, FE232 BioAmp). All short-term data recordings were 300-seconds in length and five UST time points (i.e., 30-seconds, 60-seconds, 120-seconds, 180-seconds, and 240-seconds) were extracted from the original 300-second recording. Bland-Altman plots with 95% limits of agreement, repeated measures ANOVA, and two-tailed paired t-tests demarcated differences between UST and short-term recordings. Linear regressions, coefficient of variation, intraclass correlation coefficients, and other tests examined the validity and reliability in both time- and frequency-domains.

Results:
No group differences were noted between all short-term and UST measures, for either time- (all p>0.202) or frequency-domain metrics (all p>0.086). A longer recording duration was associated with augmented validity and reliability, that was less impacted by confounding influences from physiological variables (e.g., respiration rate, carbon dioxide end-tidals, and blood pressure). Conclusively, heart rate, time-domain, and relative frequency-domain HRV metrics were acceptable with recordings greater or equal to 60s, 240s, and 300s, respectively.

Conclusions:
Future studies employing UST HRV metrics, should thoroughly understand the methodological requirements to obtain accurate results. Moreover, a conservative approach should be utilized regarding the minimum acceptable recording duration, which ensures valid/reliable HRV estimates are obtained.

Keywords: autonomic function; heart rate variability; physiological confounding; reliability; validity.

PMID: 33856258 DOI: 10.1152/japplphysiol.00955.2020