Features of Changes in Heart Rate Variability among Medical Students during the Education Process
-
Ainura Manasovna Satarkulova
,
Asel Abdumomunovna Usenova
,
Shirin Syrgakovna Bakirova
,
Shadiya Yusupdjanovna Aisaeva
,
Kanykei Sadyrbekovna Keneshova
,
Meerim Turdubekovna Turdubekova
Abstract
Background: We investigated the changes of Heart Rate Variability (HRV) parameters, which reflect the state of the regulatory mechanisms of cardiovascular system, among medical students during routine academic period and examination session.
Methods: The study was conducted in Jan-Feb 2024, at the IHSM in Bishkek, Kyrgyz Republic, among the healthy 70 students (mean age 19.71 ± 1.54 years) from India and Pakistan. For each student, two ECG recordings were performed: one 3 weeks before the exam and one 10-15 minutes after exam.
Results: The results of study demonstrated that after the exam, students presented significantly higher HR, AMo, SI, VLF, LF and lower SDNN, TP, HF compared before the exam (P<0.05). Distribution of students showed that on a routine academic period 53% of students belonged to sympathotonic, 14% to vagotonic and 33% to normotonic. During the examination period the number of sympathotonic increased to 74%, but the number of vagotonic and normotonic decreased to 4% and 22% respectively.
Conclusion: Each type revealed an individual reaction to exam stress: in the group of vagotonic there was a slight activation of the SNS; in sympathotonic students there was a tension of regulatory mechanisms, leading to depletion of adaptive mechanisms; in the group of normotonic there was a shift in the vegetative balance towards the sympathetic link of ANS.
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2. Malik M (1996). Guidelines Heart rate vari-ability. Eur Heart J, 17:354–381.
3. Baevsky RM, Ivanov GG (2001). Heart rate variability: theoretical aspects and pos-sibilities of clinical application. Ultra-sound and functional diagnostics, 3:108–127.
4. Schubert C, Lambertz M, Nelesen RA, et al (2009). Effects of stress on heart rate complexity–a comparison between short-term and chronic stress. Biol Psy-chol, 80:325-332.
5. Traina M, Gataldo A, Galullo F, Russo G (2011). Effects of anxiety due to mental stress on heart rate variability in healthy subjects. Minerva Psichiatrica, 52:227–231.
6. Sato N, Miyake S (2004). Cardiovascular re-activity to mental stress: relationship with menstrual cycle and gender. J Phys-iol Anthropol Appl Human Sci, 23:215-223.
7. Yashima K, Sasaki T, Kageyama Y, Odagaki M, Hosaka H (2005). Applica-tion of wavelet analysis to the plethys-mogram for the evaluation of mental stress. Conf Proc IEEE Eng Med Biol Soc, 2005:2781-4.
8. Shinba T, Kariya N, Matsui Y, Ozawa N, Matsuda Y, Yamamoto K (2008). De-crease in heart rate variability response to task is related to anxiety and depres-siveness in normal subjects. Psychiatry Clin Neurosci, 62:603-609.
9. Nakamura Y, Yamamoto Y, Muraoka I (1993). Autonomic Control of Heart-Rate during Physical Exercise and Fractal Dimension of Heart-Rate-Variability. J Appl Physiol (1985), 74:875-881.
10. Butler GC, Yamamoto Y, Hughson RL (1994). Fractal Nature of Short-Term Systolic Bp and Hr Variability during Lower-Body Negative-Pressure. Am J Physiol, 267:R26-R33.
11. Hagerman I, Berglund M, Lorin M, Nowak J, Sylven C (1996). Chaos-related deter-ministic regulation of heart rate variabil-ity in time and frequency domains: Ef-fects of autonomic blockade and exer-cise. Cardiovasc Res, 31:410-418.
12. Cervantes Blasquez JC, Rodas Font G, Capdevila Ortis L (2009). Heart-rate var-iability and precompetitive anxiety in swimmers. Psicothema, 21:531-536.
13. Filaire E, Portier H, Massart A, Ramat L, Teixeira A (2010). Effect of lecturing to 200 students on heart rate variability and alpha-amylase activity. Eur J Appl Physiol, 108:1035-1043.
14. Waldstein SR, Neumann SA, Burns HO, Maier KJ (1998). Role-played interper-sonal interaction: ecological validity and cardiovascular reactivity. Ann Behav Med, 20:302-309.
15. Kim D, Seo Y, Jaegeol C, Chul-Ho C (2008). Detection of subjects with higher self-reporting stress scores using heart rate variability patterns during the day. Annu Int Conf IEEE Eng Med Biol Soc, 2008:682-5.
16. Anishchenko VS, Igosheva NB, Pavlov AN, Khovanov IA, Yakusheva TA (2001). Comparative analysis of methods for classifying the cardiovascular system’s states under stress. Crit Rev Biomed Eng, 29:462-481.
17. -Lucini D, Norbiato G, Clerici M, Pagani M (2002). Hemodynamic and Autonomic Adjustments to Real Life Stress Condi-tions in Humans. Hypertension, 39:184-188.
18. Dimitriev D, Dimitriev A, Karpenko Y, Saperova E (2008). Influence of exami-nation stress and psychoemotional characteristics on the blood pressure and heart rate regulation in female stu-dents. Fiziol Cheloveka, 34(5):89-96.
19. Tharion E, Parthasarathy S, Neelakantan N (2009). Short-term heart rate variability measures in students during examina-tions. Natl Med J India, 22:63-66.
20. Simic N, Manenica I (2011). Cardiovascular reactions to exam situations. Rev Psychol, 18:37–44.
21. Guimarães T, Patrícia A, Monteiro I, Gomes R (2014). Stress in university stu-dents and cardiovascular response to academic stressors. Rev Saude Publica, 48(sp. no.):274.
22. Hammoud S, Karam R, Mourad R, Saad I, Kurdi M (2018). Stress and Heart Rate Variability during University Final Ex-amination among Lebanese Students. Behav Sci (Basel), 9 (1):3.
23. Melillo P, Bracale M, Pecchia L (2011). Nonlinear Heart Rate Variability fea-tures for real-life stress detection. Case study: Students under stress due to uni-versity examination. Biomed Eng Online, 10:96.
24. Mironova OI (2021). Approaches to study-ing exam stress in students. Pedagogy and Psychology of Education. 159-170.
25. Shukurov FA, Halimova FT (2021). Health levels in students with emotional stress. Biol Integr Med, 467-471.
26. Zaripov VN, Barinova MO (2008). Changes in parameters of tachography and heart rate variability in students differing in the level of psychoemotional stress and type of temperament during an academ-ic test week. Hum Physiol, 34:454–460.
27. Fleishman AN (1999). Slow fluctuations of hemodynamics. Theory, practical appli-cation in clinical medicine and preven-tion. Novosibirsk Science, 264.
28. Alekseeva EA, Shantanova LN, Petunova AN, Ivanova IK (2010). Estimation of the functional state of student’s organ-ism during the examination stress. BSU Bulletin, 12:108–113.
29. Yogesh K, Vinay A, Savita G (2013). Heart Rate Variability during Examination Stress in Medical Students. Int J Physiol, 1:83–86.
30. Mikhailov VM (2002). Heart rate variability: the experience of practical application of the method. Ivan State Med Academy, 290.
31. Kamath MV, Fallen EL (1993). Power spec-tral analysis of heart rate variability: a noninvasive signature of cardiac auto-nomic function. Crit Rev Biomed Eng, 21: 245–311.
32. Malliani A, Pagani M, Lombardi F, Cerutti S (1991). Cardiovascular neural regulation explored in the frequency domain. Circu-lation, 84: 482–92
33. Agelink MW, Malessa R, Baumann B, et al (2001). Standardized tests of heart rate variability: Normal ranges obtained from 309 healthy humans, and effects of age, gender, and heart rate. Clin Auton Res, 11:99–108.
34. Shokr S (2015). Effect of Exam Stress on Heart Rate Variability Parameters in Healthy Students. Egypt Acad J Biol Sci, 7: 75–81.
35. Karpenko YuD (2010). Functional states in students under examination stress. Gig Sanit, (1):78–80.
36. Safonova VR, Shalamova EYu (2013). Heart rate variability parameters of female students at a northern medical university under exam stress. Hum Ecology, 8:11–16.
37. Srinivasan K, Vaz M, Sucharita S (2006). Study of stress and autonomic nervous function in first year undergraduate medical students. Indian J Physiol Phar-macol, 50 (3): 257–264.
38. Sudakov KV (1998). Individual resistance to emotional stress. Horizon, 267.
39. Baevsky RM (2003). The physiological norm and the concept of health. Ross Fiziol Zh Im I M Sechenova, 89 (4):473-89.
40. Shlyk NI, Gavrilova EA (2015). Heart rate variability in the rapid assessment to the functional state of the athlete. Appl Sports Sci, 2: 115-125.
2. Malik M (1996). Guidelines Heart rate vari-ability. Eur Heart J, 17:354–381.
3. Baevsky RM, Ivanov GG (2001). Heart rate variability: theoretical aspects and pos-sibilities of clinical application. Ultra-sound and functional diagnostics, 3:108–127.
4. Schubert C, Lambertz M, Nelesen RA, et al (2009). Effects of stress on heart rate complexity–a comparison between short-term and chronic stress. Biol Psy-chol, 80:325-332.
5. Traina M, Gataldo A, Galullo F, Russo G (2011). Effects of anxiety due to mental stress on heart rate variability in healthy subjects. Minerva Psichiatrica, 52:227–231.
6. Sato N, Miyake S (2004). Cardiovascular re-activity to mental stress: relationship with menstrual cycle and gender. J Phys-iol Anthropol Appl Human Sci, 23:215-223.
7. Yashima K, Sasaki T, Kageyama Y, Odagaki M, Hosaka H (2005). Applica-tion of wavelet analysis to the plethys-mogram for the evaluation of mental stress. Conf Proc IEEE Eng Med Biol Soc, 2005:2781-4.
8. Shinba T, Kariya N, Matsui Y, Ozawa N, Matsuda Y, Yamamoto K (2008). De-crease in heart rate variability response to task is related to anxiety and depres-siveness in normal subjects. Psychiatry Clin Neurosci, 62:603-609.
9. Nakamura Y, Yamamoto Y, Muraoka I (1993). Autonomic Control of Heart-Rate during Physical Exercise and Fractal Dimension of Heart-Rate-Variability. J Appl Physiol (1985), 74:875-881.
10. Butler GC, Yamamoto Y, Hughson RL (1994). Fractal Nature of Short-Term Systolic Bp and Hr Variability during Lower-Body Negative-Pressure. Am J Physiol, 267:R26-R33.
11. Hagerman I, Berglund M, Lorin M, Nowak J, Sylven C (1996). Chaos-related deter-ministic regulation of heart rate variabil-ity in time and frequency domains: Ef-fects of autonomic blockade and exer-cise. Cardiovasc Res, 31:410-418.
12. Cervantes Blasquez JC, Rodas Font G, Capdevila Ortis L (2009). Heart-rate var-iability and precompetitive anxiety in swimmers. Psicothema, 21:531-536.
13. Filaire E, Portier H, Massart A, Ramat L, Teixeira A (2010). Effect of lecturing to 200 students on heart rate variability and alpha-amylase activity. Eur J Appl Physiol, 108:1035-1043.
14. Waldstein SR, Neumann SA, Burns HO, Maier KJ (1998). Role-played interper-sonal interaction: ecological validity and cardiovascular reactivity. Ann Behav Med, 20:302-309.
15. Kim D, Seo Y, Jaegeol C, Chul-Ho C (2008). Detection of subjects with higher self-reporting stress scores using heart rate variability patterns during the day. Annu Int Conf IEEE Eng Med Biol Soc, 2008:682-5.
16. Anishchenko VS, Igosheva NB, Pavlov AN, Khovanov IA, Yakusheva TA (2001). Comparative analysis of methods for classifying the cardiovascular system’s states under stress. Crit Rev Biomed Eng, 29:462-481.
17. -Lucini D, Norbiato G, Clerici M, Pagani M (2002). Hemodynamic and Autonomic Adjustments to Real Life Stress Condi-tions in Humans. Hypertension, 39:184-188.
18. Dimitriev D, Dimitriev A, Karpenko Y, Saperova E (2008). Influence of exami-nation stress and psychoemotional characteristics on the blood pressure and heart rate regulation in female stu-dents. Fiziol Cheloveka, 34(5):89-96.
19. Tharion E, Parthasarathy S, Neelakantan N (2009). Short-term heart rate variability measures in students during examina-tions. Natl Med J India, 22:63-66.
20. Simic N, Manenica I (2011). Cardiovascular reactions to exam situations. Rev Psychol, 18:37–44.
21. Guimarães T, Patrícia A, Monteiro I, Gomes R (2014). Stress in university stu-dents and cardiovascular response to academic stressors. Rev Saude Publica, 48(sp. no.):274.
22. Hammoud S, Karam R, Mourad R, Saad I, Kurdi M (2018). Stress and Heart Rate Variability during University Final Ex-amination among Lebanese Students. Behav Sci (Basel), 9 (1):3.
23. Melillo P, Bracale M, Pecchia L (2011). Nonlinear Heart Rate Variability fea-tures for real-life stress detection. Case study: Students under stress due to uni-versity examination. Biomed Eng Online, 10:96.
24. Mironova OI (2021). Approaches to study-ing exam stress in students. Pedagogy and Psychology of Education. 159-170.
25. Shukurov FA, Halimova FT (2021). Health levels in students with emotional stress. Biol Integr Med, 467-471.
26. Zaripov VN, Barinova MO (2008). Changes in parameters of tachography and heart rate variability in students differing in the level of psychoemotional stress and type of temperament during an academ-ic test week. Hum Physiol, 34:454–460.
27. Fleishman AN (1999). Slow fluctuations of hemodynamics. Theory, practical appli-cation in clinical medicine and preven-tion. Novosibirsk Science, 264.
28. Alekseeva EA, Shantanova LN, Petunova AN, Ivanova IK (2010). Estimation of the functional state of student’s organ-ism during the examination stress. BSU Bulletin, 12:108–113.
29. Yogesh K, Vinay A, Savita G (2013). Heart Rate Variability during Examination Stress in Medical Students. Int J Physiol, 1:83–86.
30. Mikhailov VM (2002). Heart rate variability: the experience of practical application of the method. Ivan State Med Academy, 290.
31. Kamath MV, Fallen EL (1993). Power spec-tral analysis of heart rate variability: a noninvasive signature of cardiac auto-nomic function. Crit Rev Biomed Eng, 21: 245–311.
32. Malliani A, Pagani M, Lombardi F, Cerutti S (1991). Cardiovascular neural regulation explored in the frequency domain. Circu-lation, 84: 482–92
33. Agelink MW, Malessa R, Baumann B, et al (2001). Standardized tests of heart rate variability: Normal ranges obtained from 309 healthy humans, and effects of age, gender, and heart rate. Clin Auton Res, 11:99–108.
34. Shokr S (2015). Effect of Exam Stress on Heart Rate Variability Parameters in Healthy Students. Egypt Acad J Biol Sci, 7: 75–81.
35. Karpenko YuD (2010). Functional states in students under examination stress. Gig Sanit, (1):78–80.
36. Safonova VR, Shalamova EYu (2013). Heart rate variability parameters of female students at a northern medical university under exam stress. Hum Ecology, 8:11–16.
37. Srinivasan K, Vaz M, Sucharita S (2006). Study of stress and autonomic nervous function in first year undergraduate medical students. Indian J Physiol Phar-macol, 50 (3): 257–264.
38. Sudakov KV (1998). Individual resistance to emotional stress. Horizon, 267.
39. Baevsky RM (2003). The physiological norm and the concept of health. Ross Fiziol Zh Im I M Sechenova, 89 (4):473-89.
40. Shlyk NI, Gavrilova EA (2015). Heart rate variability in the rapid assessment to the functional state of the athlete. Appl Sports Sci, 2: 115-125.
| Files | ||
| Issue | Vol 53 No 11 (2024) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v53i11.16959 | |
| Keywords | ||
| Heart rate variability Examination stress Vegetative regulation Autonomic nervous system | ||
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How to Cite
1.
Manasovna Satarkulova A, Abdumomunovna Usenova A, Syrgakovna Bakirova S, Yusupdjanovna Aisaeva S, Sadyrbekovna Keneshova K, Turdubekovna Turdubekova M. Features of Changes in Heart Rate Variability among Medical Students during the Education Process. Iran J Public Health. 2024;53(11):2551-2562.
