The effects of auditory stimulation on heart rate variability in healthy individuals with normal hearing and with hearing loss: a systematic review and meta-analysis

Silva, Bárbara Cristiane Sordi; Araújo, Eliene Silva; Valenti, Vitor Engrácia; Jacob, Lilian Cássia Bórnia; Alvarenga, Katia de Freitas

doi:10.1590/2317-1782/20242023111en

Bárbara Cristiane Sordi Silva

design and delineation of the study

analysis and interpretation of the data

elaboration of the article or critical review for relevant intellectual content in addition to final approval of the version to be presented for publication

Departamento de Fonoaudiologia, Faculdade de Odontologia de Bauru – FOB, Universidade de São Paulo – USP - Bauru (SP), Brasil.

https://orcid.org/0000-0002-3627-0112

Eliene Silva Araújo

design and delineation of the study

analysis and interpretation of the data

elaboration of the article or critical review for relevant intellectual content in addition to final approval of the version to be presented for publication

Departamento de Fonoaudiologia, Universidade Federal do Rio Grande do Norte – UFRN - Natal (RN), Brasil.

https://orcid.org/0000-0002-3675-4651

Vitor Engrácia Valenti

design and delineation of the study

analysis and interpretation of the data

elaboration of the article or critical review for relevant intellectual content in addition to final approval of the version to be presented for publication

Departamento de Fonoaudiologia, Faculdade de Filosofia e Ciências, Universidade Estadual Paulista – UNESP - Marília (SP), Brasil.

https://orcid.org/0000-0001-7477-3805

Lilian Cássia Bórnia Jacob

design and delineation of the study

analysis and interpretation of the data

elaboration of the article or critical review for relevant intellectual content in addition to final approval of the version to be presented for publication

Departamento de Fonoaudiologia, Faculdade de Odontologia de Bauru – FOB, Universidade de São Paulo – USP - Bauru (SP), Brasil.

https://orcid.org/0000-0003-1947-7506

Katia de Freitas Alvarenga

design and delineation of the study

analysis and interpretation of the data

elaboration of the article or critical review for relevant intellectual content in addition to final approval of the version to be presented for publication

Departamento de Fonoaudiologia, Faculdade de Odontologia de Bauru – FOB, Universidade de São Paulo – USP - Bauru (SP), Brasil.

https://orcid.org/0000-0002-7847-3225

Conflict of interests: nothing to declare.

Correspondence address: Bárbara Cristiane Sordi Silva Departamento de Fonoaudiologia, Faculdade de Odontologia de Bauru – FOB, Universidade de São Paulo – USP Al. Octávio Pinheiro Brisolla, 9-75, Bauru (SP), Brasil, CEP: 17012-901. E-mail: sordis@hotmail.com

Author (year)	Population
Lee et al.(³⁰30 Lee GS, Chen ML, Wang GY. Evoked response of heart rate variability using short-duration white noise. Auton Neurosci. 2010;155(1-2):94-7. http://doi.org/10.1016/j.autneu.2009.12.008 PMid:20071247. http://doi.org/10.1016/j.autneu.2009.12.... )	16 individuals, 6 males and 10 females, mean age 25.9±6.4 years, with normal hearing and no medical history of hypertension. Healthy individuals who did not have cardiopulmonary, psychological, and neurological disorders or other impairments preventing execution of the research protocol and were not receiving treatment with medications that influence cardiac autonomic regulation. Systolic blood pressure (BP) < 140 mmHg or diastolic BP < 90 mmHg. Two subjects were excluded for presenting with BP > 140/90 mmHg.
Roque et al.(²³23 Roque AL, Valenti VE, Guida HL, Campos MF, Knap A, Vanderlei LC, et al. The effects of different styles of musical auditory stimulation on cardiac autonomic regulation in healthy women. Noise Health. 2013;15(65):281-7. http://doi.org/10.4103/1463-1741.113527 PMid:23771427. http://doi.org/10.4103/1463-1741.113527... )	21 individuals, female, age range of 18-30 years (25.2±3), from a similar socioeconomic background. Healthy individuals who did not have cardiopulmonary, psychological, and neurological disorders or other impairments preventing execution of the research protocol and were not receiving treatment with medications that influence cardiac autonomic regulation. Non-smoking individuals. Individuals with prior experience with musical instruments and classical ballet music and/or those who reported liking heavy metal and baroque musical styles were excluded from the studies. Individuals without hearing disorders.
Roque et al.(¹⁹19 Roque AL, Valenti VE, Guida HL, Campos MF, Knap A, Vanderlei LC, et al. The effects of auditory stimulation with music on heart rate variability in healthy women. Clinics. 2013;68(7):960-7. http://doi.org/10.6061/clinics/2013(07)12 PMid:23917660. http://doi.org/10.6061/clinics/2013(07)1... )	40 individuals, female, age range of 18-35 years (25.9±4). Divided into two groups. Group 1: 21 individuals and Group 2: 19 individuals. Healthy individuals who did not have cardiopulmonary, psychological, and neurological disorders or other impairments preventing execution of the research protocol and were not receiving treatment with medications that influence cardiac autonomic regulation. Individuals with prior experience with musical instruments and classical ballet music and/or those who reported liking heavy metal and baroque musical styles were excluded from the studies. Individuals without hearing disorders.
Amaral et al.(²⁴24 Amaral JA, Nogueira ML, Roque AL, Guida HL, De Abreu LC, Raimundo RD, et al. Cardiac autonomic regulation during exposure to auditory stimulation with classical baroque or heavy metal music of different intensities. Turk Kardiyol Dern Ars. 2014;42(2):139-46. http://doi.org/10.5543/tkda.2014.39000 PMid:24643145. http://doi.org/10.5543/tkda.2014.39000... )	21 individuals, male, age range of 18-25 years (21.8±2). Healthy individuals who did not have cardiopulmonary, psychological, and neurological disorders or other impairments preventing execution of the research protocol and were not receiving treatment with medications that influence cardiac autonomic regulation. Non-smoking individuals. Individuals with prior experience with musical instruments and classical ballet music and/or those who reported liking heavy metal and baroque musical styles were excluded from the studies. Individuals without hearing disorders.
Amaral et al.(²⁵25 Amaral JA, Guida H, Nogueira ML, Roque A, Abreu LC, Raimundo RD, et al. Musical auditory stimulation at different intensities and its effects on the geometric indices of heart-rate variability. Focus Altern Complement Ther. 2014;19(3):132-9. http://doi.org/10.1111/fct.12124. http://doi.org/10.1111/fct.12124... )	16 individuals, male, age range of 18-25 years (20.7±3). Healthy individuals who did not have cardiopulmonary, psychological, and neurological disorders or other impairments preventing execution of the research protocol and were not receiving treatment with medications that influence cardiac autonomic regulation. Body mass index < 35 kg/m². Non-smoking individuals. Individuals with prior experience with musical instruments and classical ballet music and/or those who reported liking heavy metal and baroque musical styles were excluded from the studies. Individuals without hearing disorders.
Silva et al.(²⁷27 Silva AG, Guida HL, Antônio AM, Marcomini RS, Fontes AM, Carlos de Abreu L, et al. An exploration of heart rate response to differing music rhythm and tempos. Complement Ther Clin Pract. 2014a;20(2):130-4. http://doi.org/10.1016/j.ctcp.2013.09.004 PMid:24767959. http://doi.org/10.1016/j.ctcp.2013.09.00... )	11 individuals, male, age range of 18-25 years (20.1±3). Healthy individuals who did not have cardiopulmonary, psychological, and neurological disorders or other impairments preventing execution of the research protocol and were not receiving treatment with medications that influence cardiac autonomic regulation. Individuals with prior experience with musical instruments and classical ballet music and/or those who reported liking heavy metal and baroque musical styles and individuals with prior experience with music therapy were excluded. Individuals without hearing disorders.
Silva and Guida(²⁸28 Silva SA, Guida HL. Auditory stimulation with music influences the geometric indices of heart rate variability in men. Int Arch Med. 2014b;7(1):27 http://doi.org/10.1186/1755-7682-7-27 PMid:24883104. http://doi.org/10.1186/1755-7682-7-27... )	12 healthy individuals, male, age range of 18-30 years (21.7±3). Healthy individuals who did not have cardiopulmonary, psychological, and neurological disorders or other impairments preventing execution of the research protocol and were not receiving treatment with medications that influence cardiac autonomic regulation. Individuals with prior experience with musical instruments and classical ballet music and/or those who reported liking heavy metal and baroque musical styles were excluded from the studies. Individuals without hearing disorders.
Amaral et al.(²⁶26 Amaral JA, Guida HL, de Abreu LC, Barnabé V, Vanderlei FM, Valenti VE. Effects of auditory stimulation with music of different intensities on heart period. J Tradit Complement Med. 2015;6(1):23-8. http://doi.org/10.1016/j.jtcme.2014.11.032 PMid:26870675. http://doi.org/10.1016/j.jtcme.2014.11.0... )	28 healthy individuals, female, age range of 18-25 years (20.9±2.2). Healthy individuals who did not have cardiopulmonary, psychological, and neurological disorders or other impairments preventing execution of the research protocol and were not receiving treatment with medications that influence cardiac autonomic regulation. To prevent effects related to sexual hormones, women on days 11-15 and on days 21-25 after the first day of their menstrual cycle were not included. Individuals without hearing disorders.
Nogueira et al.(²⁹29 Nogueira ML, Fontes AMGG, Abreu LC, Raimundo RD, Valenti VE. Acute effects of auditory stimulation with heavy metal music on heart rate responses. Russ J Cardiol. 2016;132(4):169-74. http://doi.org/10.15829/1560-4071-2016-4-eng-169-174. http://doi.org/10.15829/1560-4071-2016-4... )	22 individuals, female, age range of 18-30 years (20.8±2.7). Healthy individuals who did not have cardiopulmonary, psychological, and neurological disorders, without endocrine disorders, or other impairments preventing execution of the research protocol and were not receiving treatment with medications that influence cardiac autonomic regulation. Body mass index < 35 kg/m². Systolic blood pressure (BP) < 140 mmHg or diastolic BP < 90 mmHg. To prevent effects related to sexual hormones, women on days 11-15 and on days 21-25 after the first day of their menstrual cycle were not included. Individuals without hearing disorders.

Author	Intervention, Comparison, and Outcomes
Author	Auditory stimulation	HRV assessment
Lee et al.(³⁰30 Lee GS, Chen ML, Wang GY. Evoked response of heart rate variability using short-duration white noise. Auton Neurosci. 2010;155(1-2):94-7. http://doi.org/10.1016/j.autneu.2009.12.008 PMid:20071247. http://doi.org/10.1016/j.autneu.2009.12.... )	Transducer: TDH-39 earphone, binaural presentation of the auditory stimuli. Type of auditory stimuli: white noise. Duration of auditory stimuli: 5 minutes. Intensity: 50, 60, 70, and 80 dB, presented in a random sequence, with 2-minutes intervals between intensities.	Equipment: ECG, amplifier, and analog converter (Model SS1C). Sampling rate: 256 Hz. Duration of HRV measurements in the presence of auditory stimuli: 5 minutes. Indices measured: Frequency domain: VLF (< 0.04 Hz), LF (0.04-0.15 Hz), HF (0.15-0.40 Hz), and LF/HF.
Roque et al.(²³23 Roque AL, Valenti VE, Guida HL, Campos MF, Knap A, Vanderlei LC, et al. The effects of different styles of musical auditory stimulation on cardiac autonomic regulation in healthy women. Noise Health. 2013;15(65):281-7. http://doi.org/10.4103/1463-1741.113527 PMid:23771427. http://doi.org/10.4103/1463-1741.113527... )	Transducer: insert earphones, binaural presentation of the auditory stimulus. Type of auditory stimulus: heavy metal and baroque musical styles. Duration of auditory stimulus: 4 minutes and 50 seconds and 5 minutes and 15 seconds. Intensity: approximately 70-80 dB, with 5-minute intervals between intensities.	Equipment: Polar RS800CX heart rate monitor. Sampling rate: 1000 Hz. At least 256 RR intervals were used for analysis and only series with more than 95% sinus beats were included. Duration of HRV measurements in the absence of auditory stimuli: 10 minutes. Duration of HRV measurements in the presence of auditory stimuli: 5 minutes. Indices measured: Time domain: SDNN, pNN50, RMSSD. Frequency domain: LF (0.04-0.15 Hz), HF (0.15-0.40 Hz), and LF/HF.
Roque et al.(¹⁹19 Roque AL, Valenti VE, Guida HL, Campos MF, Knap A, Vanderlei LC, et al. The effects of auditory stimulation with music on heart rate variability in healthy women. Clinics. 2013;68(7):960-7. http://doi.org/10.6061/clinics/2013(07)12 PMid:23917660. http://doi.org/10.6061/clinics/2013(07)1... )	Transducer: insert earphones, binaural presentation of the auditory stimulus. Type of auditory stimulus: heavy metal, baroque musical styles and white noise. Duration of auditory stimulus: 4 minutes and 50 seconds, 5 minutes and 5 minutes and 15 seconds. Intensity: approximately 70-80 dB and 90 dB, with 5-minute intervals between intensities.	Equipment: Polar RS800CX heart rate monitor. Sampling rate: 1000 Hz. At least 256 RR intervals were used for analysis and only series with more than 95% sinus beats were included. Duration of HRV measurements in the absence of auditory stimuli: 10 minutes. Indices measured: Groups 1 and 2 – Geometric analysis, Group 2 – Time domain and frequency domain. Time domain: SDNN, pNN50, RMSSD. Frequency domain: LF (0.04-0.15 Hz), HF (0.15-0.40 Hz), and LF/HF. Geometric analysis: RRTri, TINN, SD1, SD2, and SD1/SD2.
Amaral et al.(²⁴24 Amaral JA, Nogueira ML, Roque AL, Guida HL, De Abreu LC, Raimundo RD, et al. Cardiac autonomic regulation during exposure to auditory stimulation with classical baroque or heavy metal music of different intensities. Turk Kardiyol Dern Ars. 2014;42(2):139-46. http://doi.org/10.5543/tkda.2014.39000 PMid:24643145. http://doi.org/10.5543/tkda.2014.39000... )	Transducer: insert earphones, binaural presentation of the auditory stimulus. Type of auditory stimulus: heavy metal and baroque musical styles. Duration of auditory stimulus: 4 minutes and 50 seconds and 5 minutes and 15 seconds. Intensity: blocks of 60-70 dB, 70-80 dB, and 80-90 dB, with 5-minute intervals between intensities.	Equipment: Polar RS800CX heart rate monitor. Sampling rate: 1000 Hz. At least 256 RR intervals were used for analysis and only series with more than 95% sinus beats were included. Duration of HRV measurements in the absence of auditory stimuli: 10 minutes. Duration of HRV measurements in the presence of auditory stimuli: 4 minutes and 50 seconds. Indices measured: Time domain: SDNN, pNN50, RMSSD. Frequency domain: LF (0.04-0.15 Hz), HF (0.15-0.40 Hz), and LF/HF.
Amaral et al.(²⁵25 Amaral JA, Guida H, Nogueira ML, Roque A, Abreu LC, Raimundo RD, et al. Musical auditory stimulation at different intensities and its effects on the geometric indices of heart-rate variability. Focus Altern Complement Ther. 2014;19(3):132-9. http://doi.org/10.1111/fct.12124. http://doi.org/10.1111/fct.12124... )	Transducer: insert earphones, binaural presentation of the auditory stimulus. Type of auditory stimulus: heavy metal and baroque musical styles. Duration of auditory stimulus: 4 minutes and 50 seconds and 5 minutes and 15 seconds. Intensity: blocks of 60-70 dB, 70-80 dB, and 80-90 dB, with 5-minute intervals between intensities.	Equipment: Polar RS800CX heart rate monitor. Sampling rate: 1000 Hz. At least 256 RR intervals were used for analysis and only series with more than 95% sinus beats were included. Duration of HRV measurements in the absence of auditory stimuli: 10 minutes. Duration of HRV measurements in the presence of auditory stimuli: 4 minutes and 50 seconds and 5 minutes. Indices measured: Geometric analysis: RRTri, TINN, SD1, SD2, and SD1/SD2.
Silva et al.(²⁷27 Silva AG, Guida HL, Antônio AM, Marcomini RS, Fontes AM, Carlos de Abreu L, et al. An exploration of heart rate response to differing music rhythm and tempos. Complement Ther Clin Pract. 2014a;20(2):130-4. http://doi.org/10.1016/j.ctcp.2013.09.004 PMid:24767959. http://doi.org/10.1016/j.ctcp.2013.09.00... )	Transducer: insert earphones, binaural presentation of the auditory stimulus. Type of auditory stimulus: heavy metal and baroque musical styles. Duration of auditory stimulus: 4 minutes and 50 seconds and 5 minutes and 15 seconds. Intensity: 64-85 dB, with 5-minute intervals between intensities.	Equipment: Polar RS800CX heart rate monitor. Sampling rate: 1000 Hz. At least 256 RR intervals were used for analysis and only series with more than 95% sinus beats were included. Duration of HRV measurements in the absence of auditory stimuli: 10 minutes. Duration of HRV measurements in the presence of auditory stimuli: 5 minutes. Indices measured: Geometric analysis: RRTri, TINN, SD1, SD2, and SD1/SD2.
Silva and Guida(²⁸28 Silva SA, Guida HL. Auditory stimulation with music influences the geometric indices of heart rate variability in men. Int Arch Med. 2014b;7(1):27 http://doi.org/10.1186/1755-7682-7-27 PMid:24883104. http://doi.org/10.1186/1755-7682-7-27... )	Transducer: insert earphones, binaural presentation of the auditory stimulus. Type of auditory stimulus: heavy metal and baroque musical styles. Duration of auditory stimulus: 4 minutes and 50 seconds and 5 minutes and 15 seconds. Intensity: 64-85 dB, with 5-minute intervals between intensities.	Equipment: Polar RS800CX heart rate monitor. Sampling rate: 1000 Hz. At least 256 RR intervals were used for analysis and only series with more than 95% sinus beats were included. Duration of HRV measurements in the absence of auditory stimuli: 10 minutes. Duration of HRV measurements in the presence of auditory stimuli: 5 minutes. Indices measured: Geometric analysis: RRTri, TINN, SD1, SD2, and SD1/SD2.
Silva and Guida(²⁸28 Silva SA, Guida HL. Auditory stimulation with music influences the geometric indices of heart rate variability in men. Int Arch Med. 2014b;7(1):27 http://doi.org/10.1186/1755-7682-7-27 PMid:24883104. http://doi.org/10.1186/1755-7682-7-27... )	Transducer: insert earphones, binaural presentation of the auditory stimulus. Type of auditory stimulus: heavy metal and baroque musical styles. Duration of auditory stimulus: 4 minutes and 50 seconds and 5 minutes and 15 seconds. Intensity: 64-85 dB, with 5-minute intervals between intensities.	Equipment: Polar RS800CX heart rate monitor. Sampling rate: 1000 Hz. At least 256 RR intervals were used for analysis and only series with more than 95% sinus beats were included. Duration of HRV measurements in the absence of auditory stimuli: 10 minutes. Duration of HRV measurements in the presence of auditory stimuli: 5 minutes. Indices measured: Geometric analysis: RRTri, TINN, SD1, SD2, and SD1/SD2.
Amaral et al.(²⁶26 Amaral JA, Guida HL, de Abreu LC, Barnabé V, Vanderlei FM, Valenti VE. Effects of auditory stimulation with music of different intensities on heart period. J Tradit Complement Med. 2015;6(1):23-8. http://doi.org/10.1016/j.jtcme.2014.11.032 PMid:26870675. http://doi.org/10.1016/j.jtcme.2014.11.0... )	Transducer: insert earphones, binaural presentation of the auditory stimulus. Type of auditory stimulus: heavy metal and baroque musical styles. Duration of the auditory stimulus: unspecified. Intensity: blocks of 60-70 dB, 70-80 dB, and 80-90 dB.	Equipment: Polar RS800CX heart rate monitor. Sampling rate: 1000 Hz. At least 256 RR intervals were used for analysis and only series with more than 95% sinus beats were included. Duration of HRV measurements in the absence of auditory stimuli: 10 minutes. Duration of HRV measurements in the presence of the auditory stimulus: 10 minutes. Indices measured: Time domain: SDNN, pNN50, RMSSD. Frequency domain: LF (0.04-0.15 Hz), HF (0.15-0.40 Hz), and LF/HF.
Nogueira et al.(²⁹29 Nogueira ML, Fontes AMGG, Abreu LC, Raimundo RD, Valenti VE. Acute effects of auditory stimulation with heavy metal music on heart rate responses. Russ J Cardiol. 2016;132(4):169-74. http://doi.org/10.15829/1560-4071-2016-4-eng-169-174. http://doi.org/10.15829/1560-4071-2016-4... )	Transducer: insert earphones, binaural presentation of the auditory stimuli. Type of auditory stimuli: heavy metal musical style. Duration of the auditory stimuli: 5 minutes and 15 seconds. Intensity: 75-84 dB, approximately.	Equipment: Polar RS800CX heart rate monitor. Sampling rate: 1000 Hz. At least 1000 RR intervals were used for analysis and only series with more than 95% sinus beats were included. Duration of HRV measurements in the absence and presence of the auditory stimulus: 20 minutes each. Indices measured: Time domain: SDNN/RMSSD. Frequency domain: LF (0.04-0.15 Hz), HF (0.15-0.40 Hz), and LF/HF. Geometric analysis: RRTri, TINN, SD1, SD2, and SD1/SD2.

Author	Outcomes (p-values)
Lee et al.(³⁰30 Lee GS, Chen ML, Wang GY. Evoked response of heart rate variability using short-duration white noise. Auton Neurosci. 2010;155(1-2):94-7. http://doi.org/10.1016/j.autneu.2009.12.008 PMid:20071247. http://doi.org/10.1016/j.autneu.2009.12.... )	White noise: frequency domain – LF(ms²): p < 0.01^* * Statistically significant differences . Only the control was significantly lower than white noise at intensities between 50–80 dB (p < 0.05). HF(ms²): p = 0.74 and LHR: p < 0.01.
Roque et al.(²³23 Roque AL, Valenti VE, Guida HL, Campos MF, Knap A, Vanderlei LC, et al. The effects of different styles of musical auditory stimulation on cardiac autonomic regulation in healthy women. Noise Health. 2013;15(65):281-7. http://doi.org/10.4103/1463-1741.113527 PMid:23771427. http://doi.org/10.4103/1463-1741.113527... )	Baroque and heavy metal: time domain – SDNN: p = 0.12, RMSSD: p = 0.8, pNN50: p = 0.9. Frequency domain – LF(ms²): p = 0.025*(heavy metal), HF(ms²): p = 0.1, LF(n.u.): p = 0.8, HF(n.u.): p = 0.8, LF/HF: p = 0.7.
Roque et al.(¹⁹19 Roque AL, Valenti VE, Guida HL, Campos MF, Knap A, Vanderlei LC, et al. The effects of auditory stimulation with music on heart rate variability in healthy women. Clinics. 2013;68(7):960-7. http://doi.org/10.6061/clinics/2013(07)12 PMid:23917660. http://doi.org/10.6061/clinics/2013(07)1... )	Group 1: Baroque and heavy metal: geometric analysis – RRTri: p = 0.03, TINN: p = 0.2. Poincaré plot – SD1: p = 0.09, SD2: p = 0.04, SD1/SD2: p = 0.56. Group 2: baroque, heavy metal, and white noise: geometric analysis – RRTri: p = 0.1, TINN: p = 0.1. Poincaré plot – SD1: p = 0.5, SD2: p = 0.09, SD1/SD2: p = 0.39. Time domain – SDNN: p = 0.37, RMSSD: p = 0.3, pNN50: p = 0.17. Frequency domain – LF(ms²): p = 0.12, LF(n.u.): p = 0.2, HF(ms²): p = 0.19, HF(n.u.): p = 0.04*(white Noise), LF/HF: p = 0.08.
Amaral et al.(²⁴24 Amaral JA, Nogueira ML, Roque AL, Guida HL, De Abreu LC, Raimundo RD, et al. Cardiac autonomic regulation during exposure to auditory stimulation with classical baroque or heavy metal music of different intensities. Turk Kardiyol Dern Ars. 2014;42(2):139-46. http://doi.org/10.5543/tkda.2014.39000 PMid:24643145. http://doi.org/10.5543/tkda.2014.39000... )	Time domain: (i) heavy metal – RMSSD: p = 0.5, pNN50: p = 0.4, SDNN: p = 0.47. (ii) Baroque – RMSSD: p = 0.7, pNN50: p = 0.6, SDNN: p = 0.6. Frequency domain: (i) heavy metal – HF(ms²): p = 0.5, LF(ms²): p = 0.6, HF(n.u.): p = 0.45, LF(n.u.): p = 0.67, LF/HF: p = 0.5. (ii) baroque – HF(ms²): p = 0.56, LF(ms²): p = 0.77, HF(n.u.): p = 0.45, LF(n.u.): p = 0.54, LF/HF: p = 0.58.
Amaral et al.(²⁵25 Amaral JA, Guida H, Nogueira ML, Roque A, Abreu LC, Raimundo RD, et al. Musical auditory stimulation at different intensities and its effects on the geometric indices of heart-rate variability. Focus Altern Complement Ther. 2014;19(3):132-9. http://doi.org/10.1111/fct.12124. http://doi.org/10.1111/fct.12124... )	Geometric analysis: (i) heavy metal – RRTri: p = 0.4, TINN: p = 0.6. Poincaré plot – SD1: p = 0.4, SD2: p = 0.4, SD1/SD2: p = 0.5. (ii) baroque – RRTri: p = 0.3, TINN: p = 0.5. Poincaré plot – SD1: p = 0.5, SD2: p = 0.6, SD1/SD2: p = 0.4.
Silva et al.(²⁷27 Silva AG, Guida HL, Antônio AM, Marcomini RS, Fontes AM, Carlos de Abreu L, et al. An exploration of heart rate response to differing music rhythm and tempos. Complement Ther Clin Pract. 2014a;20(2):130-4. http://doi.org/10.1016/j.ctcp.2013.09.004 PMid:24767959. http://doi.org/10.1016/j.ctcp.2013.09.00... )	Time domain: (i) heavy Metal – RMSSD: p = 0.8, pNN50: p = 0.8, SDNN: p = 0.7. (ii) baroque – RMSSD: p = 0.75, pNN50: p = 0.67, SDNN: p = 0.76. Frequency domain: (i) heavy metal – HF(ms²): p = 0.64, LF(ms²): p = 0.71, HF(n.u.): p = 0.79, LF(n.u.): p = 0.68, LF/HF: p = 0.9. (ii) baroque – HF(ms²): p = 0.8, LF(ms²): p = 0.5, HF(n.u.): p = 0.76, LF(n.u.): p = 0.7, LF/HF: p = 0.82.
Silva and Guida(²⁸28 Silva SA, Guida HL. Auditory stimulation with music influences the geometric indices of heart rate variability in men. Int Arch Med. 2014b;7(1):27 http://doi.org/10.1186/1755-7682-7-27 PMid:24883104. http://doi.org/10.1186/1755-7682-7-27... )	Baroque and heavy metal: geometric analysis – RRTri: p = 0.04(heavy metal), TINN: p = 0.07. Poincaré plot – SD1: p = 0.09, SD2: p = 0.03(heavy metal), SD1/SD2: p = 0.076.
Amaral et al.(²⁶26 Amaral JA, Guida HL, de Abreu LC, Barnabé V, Vanderlei FM, Valenti VE. Effects of auditory stimulation with music of different intensities on heart period. J Tradit Complement Med. 2015;6(1):23-8. http://doi.org/10.1016/j.jtcme.2014.11.032 PMid:26870675. http://doi.org/10.1016/j.jtcme.2014.11.0... )	Time domain: (i) heavy metal – RMSSD: p = 0.97, pNN50: p = 0.98, SDNN: p = 0.01(80-90dB). (ii) baroque – RMSSD: p = 0.65, pNN50: p = 0.89, SDNN: p = 0.34. Frequency domain: (i) heavy metal – HF(ms²): p = 0.11, LF(ms²): p = 0.04(60-70dB), HF(n.u.): p = 0.82, LF(n.u.): p = 0.83, LF/HF: p = 0.86. (ii) baroque – HF(ms²): p = 0.73, LF(ms²): p = 0.03*(60–70dB), HF(n.u.): p = 1.00, LF(n.u.): p = 0.99, LF/HF: p = 0.95.
Nogueira et al.(²⁹29 Nogueira ML, Fontes AMGG, Abreu LC, Raimundo RD, Valenti VE. Acute effects of auditory stimulation with heavy metal music on heart rate responses. Russ J Cardiol. 2016;132(4):169-74. http://doi.org/10.15829/1560-4071-2016-4-eng-169-174. http://doi.org/10.15829/1560-4071-2016-4... )	Heavy metal: Time domain – SDNN: p = 0.11, RMSSD: p = 0.1, SDNN/RMSSD: p = 0.34, pNN50: p = 0.12. Frequency domain – LF(ms²): p = 0.06, LF(n.u.): p = 0.071, HF(ms²): p = 0.26, HF(n.u.): p = 0.07, LF/HF: p = 0.05*. Geometric analysis – RRTri: p = 0.11, TINN: p = 0.077. Poincaré plot – SD1: p = 0.1, SD2: p = 0.1, SD1/SD2: p = 0.45.

Certainty assessment								Effect		Certainty
Outcomes	Nº of studies	Study design	Risk of bias	Inconsistency	Indirectness	Imprecision	Other considerations	Relative (95% CI)	Absolute (95% CI)	Certainty
RMSSD	6	observational studies	not serious	not serious	not serious	not serious	none	-	MD 2.54 lower (4.88 lower to 0.21 lower)	⨁⨁◯◯ Low
HF(n.u)	6	observational studies	not serious	not serious	not serious	not serious	none	-	MD 0.67 higher (1.88 lower to 3.22 higher)	⨁⨁◯◯ Low
SD1	4	observational studies	not serious	not serious	not serious	not serious	none	-	MD 0.49 lower (3.53 lower to 2.54 higher)	⨁⨁◯◯ Low

[1] Conflict of interests: nothing to declare.

Brasil

Brasil

The effects of auditory stimulation on heart rate variability in healthy individuals with normal hearing and with hearing loss: a systematic review and meta-analysis

ABSTRACT

Purpose

Research strategies

Selection criteria

Data analysis

Results

Conclusion