RR interval variability during galvanic vestibular stimulation correlates with arterial pressure upon head-up tilt

Abstract

RR interval variability (RRIV) in the supine position without and with galvanic vestibular stimulation (GVS (off) and GVS (on), respectively), changes in mean arterial pressure (MAP) at the onset of 60° head-up tilt (HUT) during GVS (off), and their relationship were analyzed in 25 healthy young subjects. MAP decreased by less than 5mmHg or increased upon HUT in 12 subjects (UP), but MAP decreased by more than 5mmHg in 13 subjects (DOWN). Applying sinusoidal GVS of 2mA at a random frequency of 0.2 to 10.0Hz did not change the RR intervals or MAP. However, the high frequency component (HF) of RRIV increased in both UP and DOWN subjects. The increase in DOWN subjects was larger than that in UP subjects. The ratio of the low frequency component to HF (L/H) increased in UP subjects during GVS (on), but did not reach a significant level in DOWN subjects. The changes in the HF were significantly correlated with changes in MAP at the onset of HUT; i.e., the subjects with larger increases in the HF during GVS (on) showed larger decreases in MAP. Thus, GVS or vestibular input during HUT possibly activates the vagal nerves, and the dominance of excitation in sympathetic or vagal nerves during vestibular stimulation is important for controlling MAP at the onset of HUT.

Keywords: Heart rate variability; Orthostatic hypotension; Vagal nerve activity; Vestibulo-cardiovascular reflex.