Related Experiment Video
Updated: May 1, 2026
A Multi-Modal Approach to Assessing Recovery in Youth Athletes Following Concussion
Published on: September 25, 2014
Long-term impact of combat-related traumatic injury on heart rate variability: findings from the ADVANCE study
Rabeea Maqsood1,2, S Schofield3, A N Bennett4,5
1Centre for Blast Injury Studies, Department of Bioengineering, Imperial College London, London, England, UK rabeeamaqsood18@gmail.com.
Introduction:
Combat-related traumatic injury (CRTI) has been associated with adverse cardiovascular outcomes in veterans. However, the long-term impact of contemporary CRTI on heart rate variability (HRV, a marker of autonomic function) has never been investigated in combat veterans and personnel. This analysis aimed to examine the association between CRTI and short-term HRV in a contemporary cohort of British servicemen.
Methods:
This analysis used the first follow-up data from the ArmeD serVices trAuma rehabilitatioN outComE (ADVANCE) prospective cohort study. Participants comprised 469 injured (those who sustained serious physical CRTI while on deployment in Afghanistan) and 506 uninjured servicemen [those who were uninjured and were frequency-matched to the injured based on age, sex (male), rank and deployment: Afghanistan 2003-2014 at recruitment]. Resting HRV was measured (5 min ECG) in the supine position. Root mean square of successive differences (RMSSD) and the sympathetic nervous system (SNS) index were reported as measures of parasympathetic and sympathetic activity, respectively. Multiple linear regression models reported the association between CRTI and HRV, adjusting for age, rank and ethnicity.
Results:
Participants' median age was 37.5 years. The time from CRTI/deployment was approximately 11 years. Median RMSSD was significantly lower in the injured versus uninjured [37.7 ms (IQR: 25.3 to 55.9) vs 41.9 ms (IQR: 27.7 to 62.2); p=0.01]. After confounder adjustment, CRTI was significantly associated with lower RMSSD [geometric mean ratio: 0.92 (95% CI 0.85 to 0.99)] and relatively higher SNS index [coefficient: 0.19 (95% CI 0.05 to 0.34)] in the injured versus uninjured. Blast injury and traumatic amputation were associated with significantly lower RMSSD and greater SNS activity.
Conclusion:
CRTI is associated with greater relative autonomic imbalance. These findings may help understand the recovery pathway following CRTI in wounded combat veterans and personnel.
More Related Videos
05:48Autonomic Function Following Concussion in Youth Athletes: An Exploration of Heart Rate Variability Using 24-hour Recording Methodology
Published on: September 21, 2018
08:12Calculating Heart Rate Variability from ECG Data from Youth with Cerebral Palsy During Active Video Game Sessions
Published on: June 5, 2019
Related Concept Videos
01:30Factors Influencing Heart Rate
Let us explore the significant factors affecting heart rate, including age, body temperature, posture, acute pain, chemical influences,...
01:31Regulation of Heart Rates
The SNS increases heart rate through the release of norepinephrine and epinephrine, which act on beta-1 adrenergic receptors in the heart. This action increases the rate of depolarization in the sinoatrial (SA) node, the heart's...