Parsimonious Correction of Heart Rate Variability for Its Dependency on Heart Rate
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To the Editor:
In their article, Monfredi et al1 addressed the relationship between mean heart rate (HR) and its variability (HRV). In their carefully conducted experiments and with clear reasoning, they demonstrated a universal exponential decay-like relationship between HRV and HR and concluded from this that HRV cannot be used in any simple way to assess autonomic nerve activity to the heart. Like Stauss,2 we tend to agree with this conclusion as it points out a highly relevant and important issue in the field of cardiovascular medicine. However, we note that the complex biophysical model presented is merely an example of a restriction-of-range phenomena, which has been acknowledged in psychophysiological research3,4. These insights were not picked-up and included in the guiding HRV Task Force paper5 and likely, therefore, largely missed.
Ceiling Effect and Restriction of Range
Thirty years ago, Akselrod et al6 elegantly explained that the nature of the interbeat interval (IBI) time series can explain the relationship between HRV and HR. In …