title: Correlation between health-related quality of life in the physical domain and heart rate variability in asymptomatic adults.
abstract: BACKGROUND
  Reduced health-related quality of life in the physical domain (HRQOLphysical) has been reported to increase risks for cardiovascular disease (CVD); however, the mechanism underlying this phenomenon is still unclear. The autonomic nervous system (ANS) that connects the body and mind is a biologically plausible candidate to investigate this mechanism. The aim of our study is to examine whether the HRQOLphysicalindependently contributes to heart rate variability (HRV), which reflects ANS activity.
  
  
  METHODS
  We recruited 329 physically and mentally healthy adults. All participants completed Beck Anxiety Inventory, Beck Depression Inventory and World Health Organization Questionnaire on Quality of Life: Short Form-Taiwanese version (WHOQOL-BREF). They were divided into groups of individuals having high or low scores of HRQOLphysicalas discriminated by the quartile value of WHOQOL-BREF. We obtained the time and frequency-domain indices of HRV, namely variance (total HRV), the low-frequency power (LF; 0.05-0.15 Hz), which may reflect baroreflex function, the high-frequency power (HF; 0.15-0.40 Hz), which reflects cardiac parasympathetic activity, and the LF/HF ratio.
  
  
  RESULTS
  There was an independent contribution of HRQOLphysicalto explaining the variance in HRV after excluding potential confounding factors (gender, age, physical activity, alcohol use, depression and anxiety). Compared with the participants with high levels of HRQOLphysical, those with low levels of HRQOLphysicaldisplayed significant reductions in variance and LF.
  
  
  CONCLUSIONS
  This study highlights the independent role of low HRQOLphysicalin contributing to the reduced HRV in healthy adults and points to a potential underlying mechanism for HRQOLphysicalto confer increased risks for CVD.
authors.affiliation: Department of Psychiatry, Tri-Service General Hospital National Defense Medical Center, No. 325, Cheng-Kung Road, Sec. 2, Nei-Hu District, 114, Taipei, Taiwan.
authors.forename: Wan-Chun
authors.initials: WC
authors.lastname: Lu
authors.affiliation: Department of Psychiatry, Tri-Service General Hospital National Defense Medical Center, No. 325, Cheng-Kung Road, Sec. 2, Nei-Hu District, 114, Taipei, Taiwan.|Student Counseling Center, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Nian-Sheng
authors.initials: NS
authors.lastname: Tzeng
authors.affiliation: Department of Psychiatry, Tri-Service General Hospital Songshan Branch, Taipei, Taiwan.
authors.forename: Yu-Chen
authors.initials: YC
authors.lastname: Kao
authors.affiliation: Department of Psychiatry, Tri-Service General Hospital National Defense Medical Center, No. 325, Cheng-Kung Road, Sec. 2, Nei-Hu District, 114, Taipei, Taiwan.
authors.forename: Chin-Bin
authors.initials: CB
authors.lastname: Yeh
authors.affiliation: Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Terry B J
authors.initials: TB
authors.lastname: Kuo
authors.affiliation: Department of Psychiatry, Tri-Service General Hospital National Defense Medical Center, No. 325, Cheng-Kung Road, Sec. 2, Nei-Hu District, 114, Taipei, Taiwan. changcc@mail.ndmctsgh.edu.tw.
authors.forename: Chuan-Chia
authors.initials: CC
authors.lastname: Chang
authors.affiliation: Department of Psychiatry, Tri-Service General Hospital National Defense Medical Center, No. 325, Cheng-Kung Road, Sec. 2, Nei-Hu District, 114, Taipei, Taiwan. chang.ha@mail.ndmctsgh.edu.tw.
authors.forename: Hsin-An
authors.initials: HA
authors.lastname: Chang
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000150:complications / Q000523:psychology*; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000523:psychology*; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013624:Taiwan; D055815:Young Adult
keywords: Autonomic nervous system; Cardiovascular disease; Quality of life