Intra- and inter-rater reliability of linear and nonlinear measures of short-term heart rate variability following combat-related traumatic injury
Author(s)
Type
Journal Article
Abstract
BACKGROUND: Heart rate variability (HRV) is a marker of autonomic function. However, the reliability of short-term HRV measurement in individuals with combat-related traumatic injury (CRTI) remains undetermined. METHODS: An intra- and inter-rater reliability study was conducted using a subsample (n = 35) of British servicemen with CRTI enrolled in the ongoing ADVANCE study. A five-minute epoch of single-lead electrocardiogram data collected during spontaneous breathing was used to measure HRV. HRV analyses were independently performed by two examiners using Kubios. Intraclass correlation coefficient (ICC), standard error of measurement (SEM), minimum detectable change (MDC), and coefficient of variance were calculated for linear [root mean square of successive difference (RMSSD), standard deviation of NN interval, low-frequency, high-frequency, total power] and nonlinear (SD1-2, acceleration and deceleration capacities, sample entropy) measures. Bland-Altman %plots were used to assess bias in intra- and inter-rater HRV data. RESULTS: The mean age of participants was 39.3 ± 6.3 years. An excellent ICC score of 0.9998 (95% CI 0.9997, 0.9999) was observed for intra-rater analyses of RMSSD, and similar excellent ICC scores were seen for all other HRV measures. The inter-rater reliability analyses produced an excellent ICC score (range 0.97-1.00). Comparatively, frequency-domain measures produced higher MDC% and SEM% scores than time-domain and nonlinear measures in both inter- and intra-rater analyses. The Bland-Altman plots revealed relatively higher bias for frequency-domain and nonlinear measures than time-domain measures. CONCLUSION: ECG-related short-term HRV measures were reliable in injured servicemen under spontaneous breathing. However, the reliability appeared better with the time-domain measure than frequency-domain and nonlinear measures in this sample.
Date Issued
2024-09
Date Acceptance
2024-08-02
Citation
Annals of Noninvasive Electrocardiology, 2024, 29 (5)
ISSN
1082-720X
Publisher
Wiley
Journal / Book Title
Annals of Noninvasive Electrocardiology
Volume
29
Issue
5
Copyright Statement
© 2024 The Author(s). Annals of Noninvasive Electrocardiology published by Wiley Periodicals LLC.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/39194165
Subjects
Adult
Electrocardiography
Heart Rate
Humans
Male
Military Personnel
Observer Variation
Reproducibility of Results
United Kingdom
Wounds and Injuries
combat injury
HRV
military
reliability
RMSSD
Publication Status
Published
Coverage Spatial
United States
Article Number
e70008
Date Publish Online
2024-08-28