title: Circadian Patterns of Heart Rate Turbulence, Heart Rate Variability and Their Relationship.
abstract: BACKGROUND
  Heart rate variability (HRV) is an established tool for studying cardiac autonomic activity over time, while heart rate turbulence (HRT) is a recent method used to assess autonomic dysfunction. However, there are different autonomic tones at different times of a day. This study aimed to examine the effect of circadian change of autonomic tone on heart rate turbulence and variability, and determine any relationship between them based on circadian variations.
  
  
  METHODS
  Twenty-four-hour Holter recordings from 35 subjects with structurally normal heart were done, and HRV and HRT parameters of turbulence onset (TO) and turbulence slope (TS) were calculated. The 24-hour circadian patterns of these parameters and correlation analysis between them were performed.
  
  
  RESULTS
  There were conspicuous diurnal oscillations in TS and HRV parameters, with less prominent variation in TO. TS and high frequency power (HF) shared the similar oscillation patterns in a day. Comparing HRT and HRV based on circadian variation, TS showed positive correlations with HF and low frequency power (LF) to a reasonable degree, while there was an inverse correlation between TS and LF/HF.
  
  
  CONCLUSIONS
  Circadian change of TS values throughout the day is more prominent than TO. It also presents as an autonomic activity more than TO. The relationships between HRV and HRT persist independently on the time of a day.
authors.affiliation: Department of Cardiology, Taipei City Hospital-Heping Branch, No. 33, Sec. 2, Zhonghua Rd., Taipei City 100, Taiwan. Email: anigi426@ms24.hinet.net ; dae28@tpech.gov.tw.
authors.forename: Hung Yi
authors.initials: HY
authors.lastname: Chen
keywords: Circadian variation; Heart rate turbulence; Heart rate variability