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Vagal Rebound and Recovery From Psychological Stress

From the Behavioral Medicine Program (E.S.M., R.P.S.), Columbia University, New York; Department of Psychology (E.S.M., E.S.K.), State University of New York at Stony Brook, New York; and Department of Pediatrics (R.M.K.), University of Tennessee Health Science Center, Memphis, Tennessee.

Address reprint requests to: Elizabeth Sibolboro Mezzacappa, Behavioral Medicine Program, Box 427, New York Presbyterian Hospital, 622 W. 168th Street, New York, NY 10032-3784. Email: esm{at}columbia.edu

OBJECTIVE: To characterize cardiovascular recovery and examine the possible relationship of vagal activity and reflexes to risk for heart disease.

METHODS: Subjects performed cold pressor and mental arithmetic tasks. Heart rate, heart period variability, and pre-ejection period were obtained for 1 minute before, during, and after each task (Experiment 1). In the second experiment, subjects performed a Stroop color-word task and a mental arithmetic task. Heart rate, heart period variability, blood pressure, and baroreflex sensitivity were obtained during the 5-minute baseline, task, and recovery periods (Experiment 2).

RESULTS: In Experiment 1, heart rate during recovery was lower than baseline despite continued pre-ejection period shortening, whereas recovery heart period variability was higher than baseline. In Experiment 2, blood pressure increased throughout the session. However, recovery heart rate after mental arithmetic was lower than baseline heart rate, and heart period variability was higher during both recovery periods than during baseline. Vagal rebound, a sharp increase in variability in the first minute of recovery, was reduced in men in Experiment 1 and in individuals with a family history of cardiovascular disease in Experiment 2 and was associated with degree of change in baroreflex sensitivity between task and rest.

CONCLUSIONS: Cardiovascular recovery from stress is associated with increased vagal modulation despite residual sympathetic activation. Vagal rebound may be involved in mechanisms resetting the baroreflex sensitivity at the onset and offset of stress. Diminished vagal rebound during recovery from stress is associated with standard risk factors for cardiovascular disease. The results support an association between attenuated vagal reflexes and risk for cardiovascular disease.

Key Words: Cardiac recovery • psychological stressors • cardiovascular disease • vagal reflexes • sympathetic nervous system • parasympathetic nervous system

Abbreviations: ATRAMI = Autonomic Tone and Reflexes After Myocardial Infarction; BP = blood pressure; BRS = baroreflex sensitivity; CP = cold pressor; DBP = diastolic blood pressure; ECG = electrocardiogram; HR = heart rate; HPV = heart period variability; HRV = heart rate variability; ICG = impedance cardiographic; MA = mental arithmetic; MI = myocardial infarction; PNS = parasympathetic nervous system; PEP = pre-ejection period; rMSSD = root mean squared successive difference; SBP = systolic blood pressure; SNS = sympathetic nervous system

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