International Journal of Physiology

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Heart Rate Variability During Examination Stress in Medical Students


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1 Junior resident, Department of Physiology LLRM Medical College, Meerut, UP
     

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Stress has been investigated as a risk factor for cardiovascular disease and for reduced human performances. This study investigates the variations of Heart Rate Variability (HRV) due to a reallife situation of examination stress which is a known stressor to examination going students. Sixteen first year MBBS students were selected randomly to participate in the study to know heart rate variability (HRV) during the examination period. After noting all the anthropometric parameters, three recordings were performed for each student: the first assessment was done during college cultural week and it served as control, the second reading was taken on the day of their second terminal viva voce examination and the final reading was taken on the viva voce examination during professional examination. Nonlinear analysis of HRV was performed using mean RR interval, Heart rate, RMSSD, NN50, pNN50, VLF, LF, HF and LF/HF ratio. Almost all HRV features measuring heart rate complexity were decreased in the stress period results indicating a decline in HRV during stress. It is also established that non parametric HRV analysis using short term ECG recording could be effective in detecting real-life stressful conditions.

Keywords

Heart Rate Variability, LF/HF Ratio, Examination stress, RMSSD
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  • Hubert C, Lambertz M, Nelesen RA, Bardwell W, Choi JB, Dimsdale JE: Effects of stress on heart rate complexity–a comparison between short-term and chronic stress. Biol Psychol 2009, 80:325-332.

  • Kim D, Seo Y, Jaegeol C, Chul-Ho C: Detection of subjects with higher self-reporting stress scores using heart rate variability patterns during the day. Engineering in Medicine and Biology Society, 2008 EMBS 2008 30th Annual International Conference of the IEEE; 20-25 Aug, 2008 2008, 682-685.

  • Malik M, Bigger JT, Camm AJ, Kleiger RE, Malliani A, Moss AJ, Schwartz PJ: Heart rate variability: Standards of measurement, physiological interpretation, and clinical use. Eur Heart J 1996, 17:354-381.

  • Sato N, Miyake S: Cardiovascular reactivity to mental stress: relationship with menstrual cycle and gender. J Physiol Anthropol Appl Human Sci 2004, 23:215-223.

  • Yashima K, Sasaki T, Kageyama Y, Odagaki M, Hosaka H: Application of wavelet analysis to the plethysmogram for the evaluation of mental stress. Conf Proc IEEE Eng Med Biol Soc 2005, 3:2781-2784.

  • Shinba T, Kariya N, Matsui Y, Ozawa N, Matsuda Y, and Yamamoto K: Decrease in heart rate variability response to task is related to anxiety and depressiveness in normal subjects. Psychiatry Clin Neurosci 2008, 62:603-609.

  • Nakamura Y, Yamamoto Y, Muraoka I: Autonomic Control of Heart-Rate during Physical Exercise and Fractal Dimension of Heart-Rate- Variability. Journal of Applied Physiology 1993, 74:875-881.

  • Butler GC, Yamamoto Y, Hughson RL: Fractal Nature of Short-Term Systolic Bp and Hr Variability during Lower-Body Negative-Pressure. American Journal of Physiology 1994, 267:R26- R33.

  • Hagerman I, Berglund M, Lorin M, Nowak J, Sylven C: Chaos-related deterministic regulation of heart rate variability in time and frequency domains: Effects of autonomic blockade and exercise. Cardiovascular Research 1996, 31:410-418.

  • Cervantes Blasquez JC, Rodas Font G, Capdevila Ortis L: Heart-rate variability and precompetitive anxiety in swimmers. Psicothema 2009, 21:531-536.

  • Filaire E, Portier H, Massart A, Ramat L, Teixeira A: Effect of lecturing to 200 students on heart rate variability and alpha-amylase activity. Eur J Appl Physiol 2010, 108:1035-1043.

  • Waldstein SR, Neumann SA, Burns HO, Maier KJ: Role-played interpersonal interaction: ecological validity and cardiovascular reactivity. Ann Behav Med 1998, 20:302-309.

  • Anishchenko VS, Igosheva NB, Pavlov AN, Khovanov IA, Yakusheva TA: Comparative analysis of methods for classifying the cardiovascular system’s states under stress. Critical Reviews in Biomedical Engineering 2001, 29:462- 481.

  • Lucini D, Norbiato G, Clerici M, Pagani M: Hemodynamic and Autonomic Adjustments to Real Life Stress Conditions in Humans. Hypertension 2002, 39:184-188.

  • Dimitriev D, Dimitriev A, Karpenko Y, Saperova E: Influence of examination stress and psychoemotional characteristics on the blood pressure and heart rate regulation in female students. Human Physiology 2008, 34:617-624.

  • Tharion E, Parthasarathy S, Neelakantan N: Short-term heart rate variability measures in students during examinations. Natl Med J India 2009, 22:63-66.

  • Goldberger AL, Amaral LAN, Glass L, Hausdorff JM, Ivanov PC, Mark RG, Mietus JE, Moody GB, Peng C-K, Stanley HE: PhysioBank, PhysioToolkit, and PhysioNet: Components of a New Research Resource for Complex Physiologic Signals. Circulation 2000, 101:e215-220.

  • Zong W, Moody GB, Jiang D: A robust opensource algorithm to detect onset and duration of QRS complexes. Computers in Cardiology, 2003; 21-24 Sept 2003, 2003:737-740.

  • Melillo P, Fusco R, Sansone M, Bracale M, Pecchia L: Discrimination power of long-term heart rate variability measures for chronic heart failure detection. Medical and Biological Engineering and Computing 2011, 49:67-74.


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  • Heart Rate Variability During Examination Stress in Medical Students

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Authors

Savita Gautam
Junior resident, Department of Physiology LLRM Medical College, Meerut, UP

Abstract


Stress has been investigated as a risk factor for cardiovascular disease and for reduced human performances. This study investigates the variations of Heart Rate Variability (HRV) due to a reallife situation of examination stress which is a known stressor to examination going students. Sixteen first year MBBS students were selected randomly to participate in the study to know heart rate variability (HRV) during the examination period. After noting all the anthropometric parameters, three recordings were performed for each student: the first assessment was done during college cultural week and it served as control, the second reading was taken on the day of their second terminal viva voce examination and the final reading was taken on the viva voce examination during professional examination. Nonlinear analysis of HRV was performed using mean RR interval, Heart rate, RMSSD, NN50, pNN50, VLF, LF, HF and LF/HF ratio. Almost all HRV features measuring heart rate complexity were decreased in the stress period results indicating a decline in HRV during stress. It is also established that non parametric HRV analysis using short term ECG recording could be effective in detecting real-life stressful conditions.

Keywords


Heart Rate Variability, LF/HF Ratio, Examination stress, RMSSD

References