Heart rate variability helps to distinguish the intensity of menopausal symptoms: A prospective, observational and transversal study

Patrícia Merly Martinelli; Isabel Cristina Esposito Sorpreso; Rodrigo Daminello Raimundo; Osvaldo de Souza Leal; Juliana Zangirolami-Raimundo; Marcos Venicius Malveira de Lima; Andrés Pérez-Riera; Valdelias Xavier Pereira; Khalifa Elmusharaf; Vitor E. Valenti; Luiz Carlos de Abreu

doi:10.1371/journal.pone.0225866

Heart rate variability helps to distinguish the intensity of menopausal symptoms: A prospective, observational and transversal study

Patrícia Merly Martinelli, Isabel Cristina Esposito Sorpreso, Rodrigo Daminello Raimundo, Osvaldo de Souza Leal, Juliana Zangirolami-Raimundo, Marcos Venicius Malveira de Lima, Andrés Pérez-Riera, Valdelias Xavier Pereira, Khalifa Elmusharaf, Vitor E. Valenti, Luiz Carlos de Abreu^*

^*Corresponding author for this work

Applied Health Research

Research output: Contribution to journal › Article › peer-review

4 Citations (Scopus)

Abstract

Heart Rate Variability (HRV) represents cardiac autonomic behavior and have been related to menopausal symptoms, mainly vasomotor symptoms and their imbalance to cardiovascular risk. It is not clear in the literature which index represents this imbalance and what is their involvement with the menopausal state. The aim of this study was to evaluate HRV in menopausal transition and post-menopausal symptoms with different intensities. This cross-sectional study was conducted in Rio Branco, State of Acre, Brazil from October 2016 to July 2017. We used Kupperman-Blatt Menopausal Index (KMI) to measure menopausal symptoms intensity. HRV analysis was performed based on the guidelines of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. HRV is lower in the group with moderate/intense menopausal symptoms compared to mild symptoms. (RMSSD: p = 0.005, Cohen’s d = 0.53, pNN50: p = 0.0004, Cohen’s d = 0.68; HF: p = 0.024, Cohen’s d = 0.44). There was association between HRV and KMI (RMSSD: r = -1.248, p = 0.004; and pNN50: r = -0.615, p: 0.029) in inverse relation to the intensity of vasomotor symptoms in women in TM. In conclusion, HRV was able to distinguish menopausal symptoms, indicating reduced vagal control in women with more intense symptoms.

Original language	English
Article number	e0225866
Journal	PLoS ONE
Volume	15
Issue number	1
DOIs	https://doi.org/10.1371/journal.pone.0225866
Publication status	Published - Jan 2020

Bibliographical note

Funding Information:
This study received financial support from National Council for Scientific and Technological Development. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. We thank School of Medicine of ABC for providing support.

Publisher Copyright:
© 2020 Martinelli et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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10.1371/journal.pone.0225866

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Martinelli, P. M., Sorpreso, I. C. E., Raimundo, R. D., de Souza Leal, O., Zangirolami-Raimundo, J., de Lima, M. V. M., Pérez-Riera, A., Pereira, V. X., Elmusharaf, K., Valenti, V. E., & de Abreu, L. C. (2020). Heart rate variability helps to distinguish the intensity of menopausal symptoms: A prospective, observational and transversal study. PLoS ONE, 15(1), Article e0225866. https://doi.org/10.1371/journal.pone.0225866

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title = "Heart rate variability helps to distinguish the intensity of menopausal symptoms: A prospective, observational and transversal study",

abstract = "Heart Rate Variability (HRV) represents cardiac autonomic behavior and have been related to menopausal symptoms, mainly vasomotor symptoms and their imbalance to cardiovascular risk. It is not clear in the literature which index represents this imbalance and what is their involvement with the menopausal state. The aim of this study was to evaluate HRV in menopausal transition and post-menopausal symptoms with different intensities. This cross-sectional study was conducted in Rio Branco, State of Acre, Brazil from October 2016 to July 2017. We used Kupperman-Blatt Menopausal Index (KMI) to measure menopausal symptoms intensity. HRV analysis was performed based on the guidelines of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. HRV is lower in the group with moderate/intense menopausal symptoms compared to mild symptoms. (RMSSD: p = 0.005, Cohen{\textquoteright}s d = 0.53, pNN50: p = 0.0004, Cohen{\textquoteright}s d = 0.68; HF: p = 0.024, Cohen{\textquoteright}s d = 0.44). There was association between HRV and KMI (RMSSD: r = -1.248, p = 0.004; and pNN50: r = -0.615, p: 0.029) in inverse relation to the intensity of vasomotor symptoms in women in TM. In conclusion, HRV was able to distinguish menopausal symptoms, indicating reduced vagal control in women with more intense symptoms.",

author = "Martinelli, {Patr{\'i}cia Merly} and Sorpreso, {Isabel Cristina Esposito} and Raimundo, {Rodrigo Daminello} and {de Souza Leal}, Osvaldo and Juliana Zangirolami-Raimundo and {de Lima}, {Marcos Venicius Malveira} and Andr{\'e}s P{\'e}rez-Riera and Pereira, {Valdelias Xavier} and Khalifa Elmusharaf and Valenti, {Vitor E.} and {de Abreu}, {Luiz Carlos}",

note = "Funding Information: This study received financial support from National Council for Scientific and Technological Development. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. We thank School of Medicine of ABC for providing support. Publisher Copyright: {\textcopyright} 2020 Martinelli et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",

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month = jan,

doi = "10.1371/journal.pone.0225866",

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Martinelli, PM, Sorpreso, ICE, Raimundo, RD, de Souza Leal, O, Zangirolami-Raimundo, J, de Lima, MVM, Pérez-Riera, A, Pereira, VX, Elmusharaf, K, Valenti, VE & de Abreu, LC 2020, 'Heart rate variability helps to distinguish the intensity of menopausal symptoms: A prospective, observational and transversal study', PLoS ONE, vol. 15, no. 1, e0225866. https://doi.org/10.1371/journal.pone.0225866

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T1 - Heart rate variability helps to distinguish the intensity of menopausal symptoms

T2 - A prospective, observational and transversal study

AU - Martinelli, Patrícia Merly

AU - Sorpreso, Isabel Cristina Esposito

AU - Raimundo, Rodrigo Daminello

AU - de Souza Leal, Osvaldo

AU - Zangirolami-Raimundo, Juliana

AU - de Lima, Marcos Venicius Malveira

AU - Pérez-Riera, Andrés

AU - Pereira, Valdelias Xavier

AU - Elmusharaf, Khalifa

AU - Valenti, Vitor E.

AU - de Abreu, Luiz Carlos

N1 - Funding Information: This study received financial support from National Council for Scientific and Technological Development. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. We thank School of Medicine of ABC for providing support. Publisher Copyright: © 2020 Martinelli et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PY - 2020/1

Y1 - 2020/1

N2 - Heart Rate Variability (HRV) represents cardiac autonomic behavior and have been related to menopausal symptoms, mainly vasomotor symptoms and their imbalance to cardiovascular risk. It is not clear in the literature which index represents this imbalance and what is their involvement with the menopausal state. The aim of this study was to evaluate HRV in menopausal transition and post-menopausal symptoms with different intensities. This cross-sectional study was conducted in Rio Branco, State of Acre, Brazil from October 2016 to July 2017. We used Kupperman-Blatt Menopausal Index (KMI) to measure menopausal symptoms intensity. HRV analysis was performed based on the guidelines of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. HRV is lower in the group with moderate/intense menopausal symptoms compared to mild symptoms. (RMSSD: p = 0.005, Cohen’s d = 0.53, pNN50: p = 0.0004, Cohen’s d = 0.68; HF: p = 0.024, Cohen’s d = 0.44). There was association between HRV and KMI (RMSSD: r = -1.248, p = 0.004; and pNN50: r = -0.615, p: 0.029) in inverse relation to the intensity of vasomotor symptoms in women in TM. In conclusion, HRV was able to distinguish menopausal symptoms, indicating reduced vagal control in women with more intense symptoms.

AB - Heart Rate Variability (HRV) represents cardiac autonomic behavior and have been related to menopausal symptoms, mainly vasomotor symptoms and their imbalance to cardiovascular risk. It is not clear in the literature which index represents this imbalance and what is their involvement with the menopausal state. The aim of this study was to evaluate HRV in menopausal transition and post-menopausal symptoms with different intensities. This cross-sectional study was conducted in Rio Branco, State of Acre, Brazil from October 2016 to July 2017. We used Kupperman-Blatt Menopausal Index (KMI) to measure menopausal symptoms intensity. HRV analysis was performed based on the guidelines of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. HRV is lower in the group with moderate/intense menopausal symptoms compared to mild symptoms. (RMSSD: p = 0.005, Cohen’s d = 0.53, pNN50: p = 0.0004, Cohen’s d = 0.68; HF: p = 0.024, Cohen’s d = 0.44). There was association between HRV and KMI (RMSSD: r = -1.248, p = 0.004; and pNN50: r = -0.615, p: 0.029) in inverse relation to the intensity of vasomotor symptoms in women in TM. In conclusion, HRV was able to distinguish menopausal symptoms, indicating reduced vagal control in women with more intense symptoms.

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DO - 10.1371/journal.pone.0225866

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Heart rate variability helps to distinguish the intensity of menopausal symptoms: A prospective, observational and transversal study

Abstract

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