{Lying-Standing (during rest) Non-Smokers Research}

1. {Lying-Standing
(during rest) Non-
Smokers Research}
By/ DR. Z.

2. Introduction
 Since 1965, and the Scientists and Doctors In clinics
thinking and observing the variation of the heart
rhythm.
 Until early sixties the clinicians was ignoring the
variation in heart rhythm in practical cardiology. It was
even believed that heart rhythm variation is a negative
prognosis .
 The first appreciation of variation in heart rhythm was in
1965, It was noted that there were changes in interbeat
intervals in fetal distress, in utero, before any
considerable change occurred in heart rate itself. The
Scientists and Doctors tried more experiments In 1970,
short term HRV measurments used on a Diabetic
Autonomic Neuropathy.
 Late 1980, it was Cofirmed that HRV is a firm reliable
and independent predictor of death after an acute
myocardial infarction. The Clinical importance of HRV
then was appreciated (Nakagawa, et al. 1994, sited in
Task Force, 1996).

3. o We were able to quantify the vagal withdrawal (reflected
in the high frequency component of the time-dependent
spectrum of Heart Rate fluctuations) in the immediate
response to Changing position from supine to standing
and the more slowly following sympathetic increase
(reflected in the low frequency component of Arterial
Blood Pressure). (Akselrod S, et al. 1997).
o A postural change from supine to standing, the low to
high frequency power ratio was significantly increased,
indicating the augmentation of sympathetic activity or
the reduction of parasympathetic activity, or both. Thus,
It was suggested that a postural change from supine to
standing causes the predominance of sympathetic
activity. (OsakaM, et al. 1993).
o Our Results showed reproducibiliby of HRV parameters
when recorded in the same individual with a short time
between two exams, The increase sympathetic activity
occurring in the orthostatic position probably facilitates
reproducibility of the HRV indexes. (Andreao, et al.
2010).

4. Heart rate variability is the oscillation in the
interval between consecutive heart beats as well as
the oscillations between consecutive instantaneous
heart rates (sited in Task Force, 1996). It could
also be defined as the degree of fluctuation in the
length of intervals between heart beats (Callahan,
2001). Another definition is the amount of heart
rate fluctuations around the mean heart rate
(Conny, et al. 1993). It is a simple, reliable,
sensitive , non-invasive method that can assess the
autonomic supply to the heart. Terms like: cycle
length variability, heart period variability, R-R
variability and R-R interval tachogram have been
used, emphasizing more on the fact that it is the
interval between consecutive beats that is being
analyzed rather than the heart rate per se.
However, these terms have not gained as wide
acceptance as HRV. The field of HRV includes
aspects of mathematics, biomedical engineering,
physiology and clinical medicine (Conny, et al.
1993, Malik and Camm, 1995).

5. Subjects & Methods
o 21 healthy volunteers were used for this
study, most of the volunteers are medical
students from (2nd and 3rd medical year).
o All subjects were consented, and did
questionnaire to confirm their healthy status.
o Each participant was familiarized with the
testing equipment and procedures used in the
laboratory.
o The study was approved by the institutional
human ethics research committee.
o All volunteers were subjected to measure their
physical parameters (Sex, Age, Weight,
Height, BMI, Heart Rate, Systolic pressure,
Diastolic pressure, pulse pressure, Mean
Arterial pressure and cardiac work).
o All volunteers subjected to measurment heart
rate variability.

6. o During Recumbent position recorded for 3 min.
o Then, they were asked to be stand for 5 min.
without recording to allow the gravity effect on
the human blood circulation.
o After that they been 2nd recording of heart
rate variability for another 3 min. during
standing position.

7. Power Lab output during
Recumbent Position

8. Power Lab output during
Standing Position

9. The Report

10. The Results

11. Physical parameters
No. Name Age (Year) W. (Kg) H. (Meter) BMI (Kg/(M)2) H.R. (Bpm) S.P. (mmHg) D.P. (mmHg) P.P. (mmHg) M.P. (mmHg) C.W.
1 Azzam AL-Khodaidy. 33 96.600 1.765 31.0 88 135 90 45.0 105.00 9240.00
2 Abdullah AL-Qasmi. 27 93.400 1.795 29.0 76 120 80 40.0 93.33 7093.33
3 Abdullaziz Ashoiaiby. 19 52.500 1.580 21.0 63 115 95 20.0 101.67 6405.00
4 Ali AL-Marhoon. 19 69.000 1.655 25.2 80 120 80 40.0 93.33 7466.67
5 Muhammad AL-Garesh. 21 52.000 1.720 17.6 80 120 80 40.0 93.33 7466.67
6 Wael Mahdali. 26 74.000 1.660 26.9 68 110 90 20.0 96.67 6573.33
7 Anas Bin Salmin. 20 99.500 1.685 35.0 72 135 90 45.0 105.00 7560.00
8 Kanagarathnam Supakaran. 24 66.500 1.565 27.2 80 135 80 55.0 98.33 7866.67
9 Muhammad Hariri. 24 97.000 1.750 31.7 82 130 80 50.0 96.67 7926.67
10 Hassan Ghanan. 20 64.000 1.790 20.0 84 100 80 20.0 86.67 7280.00
11 Bader AL-Dahlawi. 20 81.000 1.650 29.8 68 125 80 45.0 95.00 6460.00
12 Liqat Khan. 38 62.500 1.570 25.4 66 120 80 40.0 93.33 6160.00
13 Dr.Muhamadamin Zahir. 31 71.500 1.740 23.6 60 125 80 45.0 95.00 5700.00
14 Moiyad Al-Kayal. 23 82.000 1.790 25.6 72 110 65 45.0 80.00 5760.00
15 Abdulaziz shaibi 20 69.000 1.740 22.8 68 100 70 30.0 80.00 5440.00
16 majed Abonab 19 73.500 1.710 25.1 68 110 80 30.0 90.00 6120.00
17 Ahmed Tashkandi 20 117.500 1.800 36.3 82 100 70 30.0 80.00 6560.00
18 Muhammed Alem 20 125.000 1.700 43.3 64 110 80 30.0 90.00 5760.00
19 Ebaa Reza 19 75.500 1.710 25.8 86 120 80 40.0 93.33 8026.67
20 Tareq Qari 20 63.000 1.670 22.6 56 100 70 30.0 80.00 4480.00
21 Abdulrahman Atibi 21 94.000 1.655 34.3 72 120 100 20.0 106.67 7680.00
Mean 23.05 79.95 1.70 27.57 73.10 117.00 80.90 36.10 92.94 6810.71
SEM 1.15 4.29 0.02 1.33 1.97 2.52 1.84 2.29 1.79 240.43
SD 5.25 19.68 0.07 6.12 9.01 11.55 8.41 10.49 8.20 1101.78

12. Parameter of all Mean value +,– SD
Parameter of all volunteers (N=21).
volunteers
Age (Year). 23.05 +,- 5.25
- N: is the number of Weight (Kg). 79.95 +,- 19.68
volunteers.
- All the volunteers are male In Height (meter). 1.70 +,- 0.07
SEX.
Body Mass Index [BMI] 27.57 +,- 6.12
(Kg/(m)2)
Heart Rate (bpm). 73.10 +,- 9.01
Systolic pressure (mmHg). 117.00 +,- 11.55
Diastolic pressure (mmHg). 80.90 +,- 8.41
Pulse Pressure (mmHg). 36.10 +,- 10.49
Mean Blood Pressure 92.94 +,- 8.20
(mmHg).
Cardiac work (bpm.mmHg). 6810.71 +,- 1101.78

13. Time Domain Parameters
Sample No. Average Heart Rate (BMP) Mean NN (MS) SDNN (MS) RMSSD
Recumbent Standing Difference Recumbent Standing Difference Recumbent Standing Difference Recumbent Standing Difference
1 72.5258 100.946 -28.4202 827.292 594.378 232.914 Error (Extrinsic) Error (Extrinsic) Error (Extrinsic) 58.1653 189.554 -131.3887
2 65.0926 85.0636 -19.971 921.763 705.355 216.408 25.2559 74.5182 -49.2623 21.5765 101.311 -79.7345
3 95.7963 104.253 -8.4567 626.329 575.523 50.806 67.5972 75.5093 -7.9121 68.1143 92.8281 -24.7138
4 79.9174 87.1064 -7.189 750.775 688.813 61.962 Error (Extrinsic) Error (Extrinsic) Error (Extrinsic) 52.9455 206.41 -153.4645
5 67.5509 84.8328 -17.2819 888.219 707.273 180.946 68.8211 33.9408 34.8803 90.7794 26.74 64.0394
6 94.7335 106.035 -11.3015 633.356 565.848 67.508 Error (Extrinsic) Error (Extrinsic) Error (Extrinsic) 17.5955 125.431 -107.8355
7 67.0028 83.3532 -16.3504 895.486 719.829 175.657 63.7966 48.8182 14.9784 76.6952 27.4895 49.2057
8 89.5516 81.6508 7.9008 670.005 734.837 -64.832 51.0476 86.6572 -35.6096 61.2514 118.909 -57.6576
9 67.9569 80.4644 -12.5075 882.912 745.671 137.241 65.8199 150.387 -84.5671 52.3762 176.52 -124.1438
10 85.3413 104.213 -18.8717 703.059 575.746 127.313 80.8573 60.094 20.7633 81.9894 77.4225 4.5669
11 60.8841 66.1249 -5.2408 985.48 907.374 78.106 89.4898 66.619 22.8708 68.5552 48.6918 19.8634
12 72.6415 72.2619 0.3796 825.974 830.313 -4.339 30.3797 32.3018 -1.9221 21.8493 16.5816 5.2677
13 59.8392 67.37 -7.5308 1002.69 890.604 112.086 32.3455 41.2704 -8.9249 31.1959 24.198 6.9979
67.3938
14 83.9368 -16.543 890.289 714.824 175.465 37.9712 32.052 5.9192 40.469 19.4698 20.9992
15 67.4167 77.4677 -10.051 889.987 774.516 115.471 84.323 167.633 -83.31 102.094 230.054 -127.96
16 59.6397 76.1857 -16.546 1006.04 787.549 218.491 84.4789 65.6095 18.8694 109.014 40.1428 68.8712
17 74.9834 75.6343 -0.6509 800.177 793.291 6.886 42.2123 34.7796 7.4327 50.7771 27.936 22.8411
18 69.6924 88.3103 -18.6179 860.926 679.422 181.504 78.9105 101.391 -22.4805 79.2026 128.448 -49.2454
19 74.7231 89.5353 -14.8122 802.965 670.127 132.838 44.0245 85.2396 -41.2151 49.3856 80.3669 -30.9813
20 54.8597 59.9946 -5.1349 1093.7 1000.09 93.61 85.5877 90.706 -5.1183 100.157 83.4048 16.7522
21 71.9314 80.0258 -8.0944 834.128 749.758 84.37 97.4773 78.3124 19.1649 77.0817 56.5142 20.5675
Mean 72.36 83.56 (11.20) 847.22 733.86 113.35 60.19 82.46 (22.27) 62.44 90.40 (27.96)
SEM 2.45 2.75 1.80 26.96 24.50 17.05 4.96 9.08 9.50 5.86 14.34 15.03
P-Value <0.05 <0.05 NS NS

14. Time Recumbent Standing P-Value
Time Parameters (N=21) (N=21)
Parameters
Average HR 72.36 +,- 11.23 83.56 +,- 12.58 -6.242
N: is the number of volunteers. (bpm). Significant
P: Level of Significant is >1.95
as calculated [T-Value] for
paired data.
Mean NN (ms). 847.22 +,- 123.53 733.86 +,- 112.30 6.647
Significant
SDNN (ms). 60.19 +,- 22.74 82.46 +,- 41.62 -2.3
Significant
RMSSD (ms). 62.44 +,- 26.85 90.40 +,- 65.70 -1.9
Significant

15. Frequency Domain Parameters
Sample
No. Total Power (MS)2 VLF (MS)2 LF (MS)2 HF (MS)2 LF/HF
Recumbent Standing Difference Recumbent Standing Difference Recumbent Standing Difference Recumbent Standing Difference Recumbent Standing Difference
1 2370.16 21549.8 -19179.64 854.198 1560.64 -706.442 818.281 2168.42 -1350.139 489.509 6750.05 -6260.541 1.67164 0.321245 1.350395
2 729.316 4714.34 -3985.024 370.821 387.629 -16.808 167.692 663.573 -495.881 166.239 1478.57 -1312.331 1.00874 0.448795 0.559945
3 6045.09 3763.29 2281.8 1035.98 396.534 639.446 1781.12 1176.6 604.52 1778.25 914.526 863.724 1.00161 1.28657 -0.28496
4 2455.49 16914.3 -14458.81 775.306 910.656 -135.35 351.626 3055.1 -2703.474 1050.6 4732.96 -3682.36 0.334691 0.645495 -0.310804
5 4769.5 1027.49 3742.01 879.425 448.463 430.962 751.474 284.548 466.926 2904.3 229.839 2674.461 0.258745 1.23803 -0.979285
6 731.921 14162.1 -13430.179 72.6924 2511.13 -2438.4376 409.644 2791.91 -2382.266 220.182 4571.44 -4351.258 1.86048 0.610728 1.249752
7 4734.06 1242.1 3491.96 1132.26 392.84 739.42 1448.34 558.181 890.159 1001.47 206.129 795.341 1.44621 2.70791 -1.2617
8 2554.43 7304.14 -4749.71 545.118 792.396 -247.278 516.499 1176.03 -659.531 657.882 2431.51 -1773.628 0.785094 0.483665 0.301429
9 3884.65 25072.3 -21187.65 1600.72 1943.32 -342.6 1365.45 7785.07 -6419.62 744.95 9272.33 -8527.38 1.83295 0.839603 0.993347
10 5514.39 3115.32 2399.07 3446.86 814.913 2631.947 418.355 518.186 -99.831 1152.2 544.654 607.546 0.363093 0.951403 -0.58831
11 8231.41 4049.71 4181.7 2460.86 1452.21 1008.65 3730.91 1607.38 2123.53 1931.43 922.518 1008.912 1.93169 1.74238 0.18931
12 999.311 1158.14 -158.829 292.497 529.962 -237.465 540.656 506.66 33.996 152.307 111.029 41.278 3.54978 4.5633 -1.01352
13 976.496 1769.71 -793.214 251.117 1245.38 -994.263 416.144 293.767 122.377 291.61 205.721 85.889 1.42706 1.42799 -0.00093
14 1570.93 1000.43 570.5 619.577 647.319 -27.742 270.387 203.28 67.107 621.146 84.6196 536.5264 0.435304 2.40229 -1.966986
15 6932.03 31916.3 -24984.27 2364.79 4474.07 -2109.28 1044.55 4951.23 -3906.68 1966.43 10352.6 -8386.17 0.531194 0.478258 0.052936
16 6404.95 3748.18 2656.77 798.163 719.317 78.846 1398.79 2519.81 -1121.02 3896.36 387.688 3508.672 0.359 6.49957 -6.14057
17 1546.48 1220.89 325.59 384.838 522.855 -138.017 221.462 328.543 -107.081 613.086 332.156 280.93 0.361225 0.989123 -0.627898
18 5668.11 8368.25 -2700.14 1134.12 1100.93 33.19 2498.2 1962.92 535.28 1347.09 2159.85 -812.76 1.85451 0.908821 0.945689
19 1527.83 7485.16 -5957.33 224.778 1770.3 -1545.522 475.43 2848.33 -2372.9 550.99 1831.57 -1280.58 0.862865 1.55513 -0.692265
20 8383.13 9627.25 -1244.12 2631.59 1999.65 631.94 3751.77 5019 -1267.23 1831.78 2083.39 -251.61 2.04815 2.40906 -0.36091
21 7955.17 5284.88 2670.29 3396.69 2516.75 879.94 2311.4 1185.9 1125.5 1593.92 1238.7 355.22 1.45013 0.957368 0.492762
Mean 3,999.28 8,309.24 (4,309.96) 1,203.45 1,292.25 (88.80) 1,175.63 1,981.16 (805.54) 1,188.65 2,421.04 (1,232.39) 1.21 1.59 (0.39)
SEM 581.93 1,911.45 1,947.53 227.27 218.66 242.24 236.78 426.46 420.62 208.89 660.66 711.81 0.18 0.33 0.34
P-Value <0.05 NS <0.05 NS NS

16. Frequency Recumbent Standing P-Value
Frequency Parameters (N=21) (N=21)
Parameters
Total Power 3,999.28 +,- 8,309.24 +,- -2.2
(ms)2. 2,666.74 8,759.38 Significant
N: is the number of volunteers.
NS: Not Significant.
VLF (ms)2. 1,203.45 +,- 1,292.25 +,- NS
P: Level of Significant is >1.95 1,041.48 1,002.01
as calculated [T-Value] for
paired data.
LF (ms)2. 1,175.63 +,- 1,981.16 +,- -1.9
1,085.05 1,954.28 Significant
HF (ms)2. 1,188.65 +,- 2,421.04 +,- NS
957.26 3,027.53
LF/HF 1.21 +,- 0.82 1.59 +,- 1.50 NS

17. Time Domain Parameters:

18. Average Heart Rate
Figure 1: Graph showing the mean
changes in average heart rate in
Recumbent position compared to the
Standing position of all studied subjects.
*P <0.05 which is Significant.

19. Mean NN
Figure 2: Graph showing the mean
changes in Mean NN in Recumbent
position compared to the Standing
position of all studied subjects.
*P <0.05 which is Significant.

20. SDNN
Figure 3: Graph showing the mean
changes in SDNN in Recumbent position
compared to the Standing position of all
studied subjects.
- No. of N = 18, due to 3N = Error
(Extrinsic).

21. RMSSD
Figure 4: Graph showing the mean
changes in RMSSD in Recumbent position
compared to the Standing position of all
studied subjects.

22. Frequency Domain Parameters:

23. Total Power.
Figure 5: Graph showing the mean
changes in Total Power in Recumbent
position compared to the Standing
position of all studied subjects.
*P <0.05 which is Significant.

24. Very Low Frequency.
Figure 6: Graph showing the mean
changes in Very Low Frequency in
Recumbent position compared to the
Standing position of all studied subjects.

25. Low Frequency.
Figure 7: Graph showing the mean
changes in Low Frequency in Recumbent
position compared to the Standing
position of all studied subjects.
*P <0.05 which is Significant.

26. High Frequency.
Figure 8: Graph showing the mean
changes in High Frequency in Recumbent
position compared to the Standing
position of all studied subjects.

27. LF/HF Ratio.
Figure 9: Graph showing the mean
changes in LF/HF Ratio in Recumbent
position compared to the Standing
position of all studied subjects.

28. The Correlations
Between Recumbent positions & Standing positions.

29. Matrix Recumbent correlation

30. Matrix Standing correlation

31. Correlation during
Recumbent Position
The correlates between the Average Heart
Rate Recumbent and SDNN Recumbent is
–ve relationship.
- N = 18, due to (Extrinsic).

32. Correlation during
Standing Position
The correlates between the Average heart
rate Standing and SDNN Standing
changed to be slightly +ve (horizontal)
Relationship.
- N = 18, due to (Extrinsic).

33. Correlation during
Recumbent Position
The correlates between the Average Heart
Rate Recumbent and RMSSD Recumbent
is –ve relationship.

34. Correlation during
Standing Position
The correlates between the Average heart
rate Standing and RMSSD Standing
changed to be +ve Relationship.

35. Correlation during
Recumbent Position
The correlates between the Average Heart
Rate Recumbent and High Frequency
Recumbent is –ve relationship.

36. Correlation during
Standing Position
The correlates between the Average heart
rate Standing and High Frequency
Standing changed to be +ve Relationship.

37. Correlation during
Recumbent Position
The correlates between the Low Frequency
Recumbent and High Frequency
Recumbent is +ve relationship.

38. Correlation during
Standing Position
The correlates between the Low Frequency
Standing and High Frequency Standing
become more +vity relationship.

39. The Conclusion
o We hypothesized that, the sympathovagal activity
is changing by changing the humans biological
organisms its position on the Earth planet’s gravity,
mainly and not only the Sympathetic tone is
increasing in the alert position [the positions other
than the flatting (180 Degree position)] such as
starting form the head up tilted to the standing
Vertical position (+90 Degree position) until (+179
Degree), where here I’d like to mentioned that the
standing position (+90 Degree) is the most Alert
position in the Anatomy of the human’s skeleton,
(when the human skeleton making INTERSECTS
CROSS shape (+), with landed earth).
o Where as Inverse relationship mainly and not only
the parasympathetic tone is increasing in the Non-
Alert position proportionally to the degree of the
position until it reach the most Relaxing position of
the human's skeleton anatomy the flattened
position.

40. Recommendation
 We recommends the people, to do their active works in
the active positions the Standing or Upright position but
not for long period of time to avoid the stress.
 Also we recommend the people to have relaxing and
sleeping in the flattened or recumbent position.

41. Thank you very
much for listening