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PTU-121 Normal Values and Reproducibility of the Real Time Beat-To-Beat Index of Cardiac Vagal Tone in Healthy Humans
  1. A D Farmer1,
  2. S J Coen1,
  3. M Kano1,
  4. Q Aziz1
  1. 1Wingate Institute of Neurogastroenterology, Barts & The London School of Medicine, London, UK

Abstract

Introduction The vagus nerve is the primary neuroanatomical substrate within the brain gut axis (1). In humans, surrogate measures of vagal tone are most commonly evaluated using heart rate variability (HRV) albeit with considerable methodological limitations, particularly with respect to temporal resolution. However, recent advances have allowed the measurement of a novel non-invasive validated measure of efferent vagal activity from the brainstem, known as cardiac vagal tone (CVT). CVT is measured on a linear vagal scale (LVS) where 0 represents full atropinization and has improved temporal resolution compared to HRV. CVT is increasingly being utilised in a diverse array of GI research (3.4.5). However, its normal values and reproducibility are, to date, incompletely understood. The aim of this study was to address these knowledge gaps.

Methods 120 healthy subjects (68 males, median age 29 years, range 19–55 years) were studied in a temperature controlled, constantly lit, quiet laboratory. After attachment of CVT recording equipment (Neuroscope), 20 minutes of CVT data (resting/no stimulation) was acquired. 30 subjects, selected at random, were restudied after 1 year. Reproducibility was assessed using a two-way, random effects, single measure intra-class correlational coefficients (ICC) model and Bland Altman plots.

Results The mean CVT was 8.2 LVS with a standard deviation of 3.0. Thus, the normal range (mean +/- 2 standard deviations (SD)) for CVT based on this data is therefore 2.2 LVS to 14.2 LVS. Age correlated negatively with CVT (r = –0.36, p < 0.0001) but there was no discernable effect of gender, body mass index or ethnicity. The ICC for CVT was 0.81 (95% confidence interval 0.64–0.91), indicating excellent reproducibility. Figure 1 shows the Bland-Altman plot that demonstrate that 29 out of the 30 measurements lie within +/- 2 SDs of the differences between measurements suggesting that there was no bias or systematic error and that the parameter of CVT is reproducible at a period of 1 year.

Conclusion The normal range for CVT should be considered to be 2.2 – 14.2 LVS. CVT is a reproducible measure over the period of 1 year. Future research utilising CVT should refer to these values

Disclosure of Interest None Declared

References

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  2. Spainzi et al. NGM 2010.

  3. Paine et al. Pain 2011.

  4. Chua et al. APT 2012.

  5. Sharma et al. Psychosomatic Medicine 2012.

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