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Oliveira NDJ, Oliveira AA, Costa SM, Pirôpo US, Teles MF, Freitas VPD, Souza DAD, Pereira R. Comparison of Heart Autonomic Control between Hemodynamically Stable and Unstable Patients during Hemodialysis Sessions: A Bayesian Approach. ENTROPY (BASEL, SWITZERLAND) 2023; 25:883. [PMID: 37372226 DOI: 10.3390/e25060883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/26/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023]
Abstract
Intradialytic hypotension is a common complication during hemodialysis sessions. The analysis of successive RR interval variability using nonlinear methods represents a promising tool for evaluating the cardiovascular response to acute volemic changes. Thus, the present study aims to compare the variability of successive RR intervals between hemodynamically stable (HS) and unstable (HU) patients during a hemodialysis session, through linear and nonlinear methods. Forty-six chronic kidney disease patients volunteered in this study. Successive RR intervals and blood pressures were recorded throughout the hemodialysis session. Hemodynamic stability was defined based on the delta of systolic blood pressure (higher SBP-lower SBP). The cutoff for hemodynamic stability was defined as 30 mm Hg, and patients were stratified as: HS ([n = 21]: ≤29.9 mm Hg) or HU ([n = 25]: ≥30 mm Hg). Linear methods (low-frequency [LFnu] and high-frequency [HFnu] spectra) and nonlinear methods (multiscale entropy [MSE] for Scales 1-20, and fuzzy entropy) were applied. The area under the MSE curve at Scales 1-5 (MSE1-5), 6-20 (MSE6-20), and 1-20 (MSE1-20) were also used as nonlinear parameters. Frequentist and Bayesian inferences were applied to compare HS and HU patients. The HS patients exhibited a significantly higher LFnu and lower HFnu. For MSE parameters, Scales 3-20 were significantly higher, as well as MSE1-5, MSE6-20, and MSE1-20 in HS, when compared to HU patients (p < 0.05). Regarding Bayesian inference, the spectral parameters demonstrated an anecdotal (65.9%) posterior probability favoring the alternative hypothesis, while MSE exhibited moderate to very strong probability (79.4 to 96.3%) at Scales 3-20, and MSE1-5, MSE6-20, and MSE1-20. HS patients exhibited a higher heart-rate complexity than HU patients. In addition, the MSE demonstrated a greater potential than spectral methods to differentiate variability patterns in successive RR intervals.
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Affiliation(s)
- Natália de Jesus Oliveira
- Integrative Physiology Research Center, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia, Jequie 45210-506, BA, Brazil
- Research Group in Neuromuscular Physiology, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia, Jequie 45210-506, BA, Brazil
- Medicine School, Universidade Estadual Do Sudoeste da Bahia (UESB), Jequie 45210-506, BA, Brazil
| | - Alinne Alves Oliveira
- Integrative Physiology Research Center, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia, Jequie 45210-506, BA, Brazil
- Research Group in Neuromuscular Physiology, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia, Jequie 45210-506, BA, Brazil
- Postgraduate Program in Nursing & Health, Universidade Estadual do Sudoeste da Bahia, Jequie 45210-506, BA, Brazil
| | - Silvania Moraes Costa
- Integrative Physiology Research Center, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia, Jequie 45210-506, BA, Brazil
- Research Group in Neuromuscular Physiology, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia, Jequie 45210-506, BA, Brazil
- Postgraduate Program in Nursing & Health, Universidade Estadual do Sudoeste da Bahia, Jequie 45210-506, BA, Brazil
| | - Uanderson Silva Pirôpo
- Integrative Physiology Research Center, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia, Jequie 45210-506, BA, Brazil
- Research Group in Neuromuscular Physiology, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia, Jequie 45210-506, BA, Brazil
- Postgraduate Program in Nursing & Health, Universidade Estadual do Sudoeste da Bahia, Jequie 45210-506, BA, Brazil
| | - Mauro Fernandes Teles
- Integrative Physiology Research Center, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia, Jequie 45210-506, BA, Brazil
- Postgraduate Program in Nursing & Health, Universidade Estadual do Sudoeste da Bahia, Jequie 45210-506, BA, Brazil
- Faculdade Santo Agostinho (FASA), Vitória da Conquista 45028-100, BA, Brazil
| | - Verônica Porto de Freitas
- Integrative Physiology Research Center, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia, Jequie 45210-506, BA, Brazil
- Research Group in Neuromuscular Physiology, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia, Jequie 45210-506, BA, Brazil
- Postgraduate Program in Nursing & Health, Universidade Estadual do Sudoeste da Bahia, Jequie 45210-506, BA, Brazil
| | - Dieslley Amorim de Souza
- Postgraduate Program in Nursing & Health, Universidade Estadual do Sudoeste da Bahia, Jequie 45210-506, BA, Brazil
| | - Rafael Pereira
- Integrative Physiology Research Center, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia, Jequie 45210-506, BA, Brazil
- Research Group in Neuromuscular Physiology, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia, Jequie 45210-506, BA, Brazil
- Medicine School, Universidade Estadual Do Sudoeste da Bahia (UESB), Jequie 45210-506, BA, Brazil
- Postgraduate Program in Nursing & Health, Universidade Estadual do Sudoeste da Bahia, Jequie 45210-506, BA, Brazil
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Latremouille S, Lam J, Shalish W, Sant'Anna G. Neonatal heart rate variability: a contemporary scoping review of analysis methods and clinical applications. BMJ Open 2021; 11:e055209. [PMID: 34933863 PMCID: PMC8710426 DOI: 10.1136/bmjopen-2021-055209] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Neonatal heart rate variability (HRV) is widely used as a research tool. However, HRV calculation methods are highly variable making it difficult for comparisons between studies. OBJECTIVES To describe the different types of investigations where neonatal HRV was used, study characteristics, and types of analyses performed. ELIGIBILITY CRITERIA Human neonates ≤1 month of corrected age. SOURCES OF EVIDENCE A protocol and search strategy of the literature was developed in collaboration with the McGill University Health Center's librarians and articles were obtained from searches in the Biosis, Cochrane, Embase, Medline and Web of Science databases published between 1 January 2000 and 1 July 2020. CHARTING METHODS A single reviewer screened for eligibility and data were extracted from the included articles. Information collected included the study characteristics and population, type of HRV analysis used (time domain, frequency domain, non-linear, heart rate characteristics (HRC) parameters) and clinical applications (physiological and pathological conditions, responses to various stimuli and outcome prediction). RESULTS Of the 286 articles included, 171 (60%) were small single centre studies (sample size <50) performed on term infants (n=136). There were 138 different types of investigations reported: physiological investigations (n=162), responses to various stimuli (n=136), pathological conditions (n=109) and outcome predictor (n=30). Frequency domain analyses were used in 210 articles (73%), followed by time domain (n=139), non-linear methods (n=74) or HRC analyses (n=25). Additionally, over 60 different measures of HRV were reported; in the frequency domain analyses alone there were 29 different ranges used for the low frequency band and 46 for the high frequency band. CONCLUSIONS Neonatal HRV has been used in diverse types of investigations with significant lack of consistency in analysis methods applied. Specific guidelines for HRV analyses in neonates are needed to allow for comparisons between studies.
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Affiliation(s)
- Samantha Latremouille
- Division of Experimental Medicine, McGill University Health Centre, Montreal, Québec, Canada
| | - Justin Lam
- Medicine, Griffith University, Nathan, Queensland, Australia
| | - Wissam Shalish
- Division of Neonatology, McGill University Health Center, Montreal, Québec, Canada
| | - Guilherme Sant'Anna
- Division of Neonatology, McGill University Health Center, Montreal, Québec, Canada
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