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Age changes in the physiological maintenance of tension in the functioning of the heart muscle of military servicemen with the diagnosis of "post-traumatic stress disorder" or "adaptation disorders"

Age changes in the physiological maintenance of tension in the functioning of the heart muscle of military servicemen with the diagnosis of "post-traumatic stress disorder" or "adaptation disorders"

ISSN 2223-6775 Ukrainian Journal of Occupational Health, Vol. 19, 2023, Supplement

https://doi.org/10.33573/ujoh2023.Suppl.384

Age changes in the physiological maintenance of tension in the functioning of the heart muscle of military servicemen with the diagnosis of "post-traumatic stress disorder" or "adaptation disorders"

Bobko N. A.1, Zaitsev D. V.1, 2

1State Institution "Kundiiev Institute of Occupational Health of National Academy of Medical Sciences of Ukraine", Kyiv, Ukraine

2Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine


Introduction.

"Post-traumatic stress disorder" or "adaptation disorders" arise as a result of experienced stressful events that act as the factors to form a stress and increased tension in the body, including the circulatory system. At the same time, with age, physiological stress under objectively identical loads increases.

Objective. To reveal the age-related changes in the physiological maintenance of tension in the functioning of the heart muscle of servicemen with a diagnosis of "post-traumatic stress disorder" or "adaptation disorders" based on indicators of heart rate variability (HRV).

Materials and methods.83 servicemen – men aged 19–60 years (36 ± 9) – were examined using a 5-minute HRV registration. A total of 1.504 human studies. There were 4 age groups: 19–29 years (n = 30, N = 414), 30–39 years (n = 29, N = 501), 40–49 years (n = 19, N = 486), 50–60 years (n = 5, N = 103). Statistical data analysis was performed at p < 0.05.

The results. The mean group values of heart rate and tension index of regulatory systems (TI) did not go beyond the physiological norm and increased with age. The values of RMSSD and pNN50 were outside the normal range in both directions and decreased with age. Analysis of the histogram of the distribution of the duration of intersystolic intervals (RRNN): SDNN was less than normal and decreased with age, mode decreased with age, mode amplitude was at or above the upper part of the physiological norm and increased with age, ΔX was within or below physiological norm and decreased with age. Spectral analysis: TP corresponded to moderate to low levels and decreased with age; VLF and LF were lower than norm and decreased with age. HF was at or below the lower part of the norm and decreased with age. LFnorm and HFnorm were almost within normal limits and changed with age: LFnorm increased, HFnorm decreased; the sympathovagal index (LF/HF) exceeded the upper limit of norm and increased with age. An increase in TI was accompanied by an increase in heart rate, the amplitude of the mode of the RRNN distribution, and indices characterizing the predominance of the power of sympathetic influences on heart rhythm regulation. An increase in TI was accompanied by a decrease in RRNN, their mode, dispersion, variability and indicators characterizing the overall power of HRV oscillations (TP), their components (VLF, LF, HF) and parasympathetic influences (RMSSD, pNN50). The relative contribution of sympathetic influences to the regulation of heart rate (LFnorm) was positively correlated with TI in the group under 30 years of age (p < 0.001), positively at the level of a pronounced tendency (p < 0.07) in the groups of 30-39 and 40-49 years, and negatively – in the group over 50 years old (p < 0.05). The relative contribution of the vagus to heart rate regulation (HFnorm) was strictly opposite. The correlation of the sympathovagal index LF/HF with TI was positive in groups under 50 years of age (p < 0.001...0.01) and had a pronounced negative trend in the group over 50 years of age (p < 0.07).

Conclusions. With age of military personnel, the tension index of heart rhythm increases, which reflects the predominance of central regulatory influences over autonomous ones in the regulation of heart rhythm. The values of indicators characterizing the intensity of sympathetic influences and their derivatives also increase, and the values of indicators characterizing the intensity of parasympathetic influences and their derivatives, as well as the overall power of heart rate fluctuations (the activity of neurohumoral and metabolic influences on the heart), decrease. With an increase in the tension index of the heart rhythm, changes in its regulation by the nervous system, neurohumoral and metabolic effects are mostly observed, similar to age-related changes, which may indicate accelerated aging under the increased body tension. At the same time, if up to the age of 50, the increase in the intensity of the heart rhythm is ensured by increasing the share of sympathetic influences in its regulation, and even more so, the younger the body, then after 50 years – by increasing the share of parasympathetic influences.

Keywords:heart rate variability, tension index of regulatory systems, sympathovagal index, military personnel, post-traumatic stress disorder, adaptation disorders

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