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Gelpi F, Wu MA, Bari V, Cairo B, De Maria B, Fossali T, Colombo R, Porta A. Autonomic Function and Baroreflex Control in COVID-19 Patients Admitted to the Intensive Care Unit. J Clin Med 2024; 13:2228. [PMID: 38673501 PMCID: PMC11050480 DOI: 10.3390/jcm13082228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 04/08/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Autonomic function and baroreflex control might influence the survival rate of coronavirus disease 2019 (COVID-19) patients admitted to the intensive care unit (ICU) compared to respiratory failure patients without COVID-19 (non-COVID-19). This study describes physiological control mechanisms in critically ill COVID-19 patients admitted to the ICU in comparison to non-COVID-19 individuals with the aim of improving stratification of mortality risk. Methods: We evaluated autonomic and baroreflex control markers extracted from heart period (HP) and systolic arterial pressure (SAP) variability acquired at rest in the supine position (REST) and during a modified head-up tilt (MHUT) in 17 COVID-19 patients (age: 63 ± 10 years, 14 men) and 33 non-COVID-19 patients (age: 60 ± 12 years, 23 men) during their ICU stays. Patients were categorized as survivors (SURVs) or non-survivors (non-SURVs). Results: We found that COVID-19 and non-COVID-19 populations exhibited similar vagal and sympathetic control markers; however, non-COVID-19 individuals featured a smaller baroreflex sensitivity and an unexpected reduction in the HP-SAP association during the MHUT compared to the COVID-19 group. Nevertheless, none of the markers of the autonomic and baroreflex functions could distinguish SURVs from non-SURVs in either population. Conclusions: We concluded that COVID-19 patients exhibited a more preserved baroreflex control compared to non-COVID-19 individuals, even though this information is ineffective in stratifying mortality risk.
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Affiliation(s)
- Francesca Gelpi
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy; (F.G.); (B.C.); (A.P.)
| | - Maddalena Alessandra Wu
- Department of Biomedical and Clinical Sciences, University of Milan, 20157 Milan, Italy;
- Division of Internal Medicine, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, 20157 Milan, Italy
| | - Vlasta Bari
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy; (F.G.); (B.C.); (A.P.)
- Department of Cardiothoracic, Vascular Anaesthesia and Intensive Care, IRCCS Policlinico San Donato, 20097 Milan, Italy
| | - Beatrice Cairo
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy; (F.G.); (B.C.); (A.P.)
| | | | - Tommaso Fossali
- Department of Anesthesiology and Intensive Care, ASST Fatebenefratelli-Sacco, Luigi Sacco Hospital, 20157 Milan, Italy; (T.F.); (R.C.)
| | - Riccardo Colombo
- Department of Anesthesiology and Intensive Care, ASST Fatebenefratelli-Sacco, Luigi Sacco Hospital, 20157 Milan, Italy; (T.F.); (R.C.)
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy; (F.G.); (B.C.); (A.P.)
- Department of Cardiothoracic, Vascular Anaesthesia and Intensive Care, IRCCS Policlinico San Donato, 20097 Milan, Italy
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Singh K, Saini I, Sood N. A framework based on the information domain to measure coupling changes in electrophysiological signals. Biomed Phys Eng Express 2023; 9:055022. [PMID: 37527634 DOI: 10.1088/2057-1976/acec4e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 08/01/2023] [Indexed: 08/03/2023]
Abstract
Objectives.In this paper, the features of physiological signals of healthy dataset are extracted using the linear and non-linear techniques, and a comparison has been made on healthy young and old subjects to study the aging and gender-related changes in the contribution of Heart Rate (HR), Blood Pressure (BP), and Respiration (RESP).Methods. To quantify the coupling changes in cardiovascular, cardiorespiratory, and vasculorespiratory complexity, an information domain approach based on compensated transfer entropy (cTE) is proposed.Result. The results show that there is a substantial decrease in the flow of information from BP tro the time interval between successive R-peaks (RR) and from RR to BP. There is also a significant decrease in the flow of information from RESP to BP and RESP to RR but there is no significant change in the information flow from BP to RESP and RR to RESP.Conclusion. We have done linear and non-linear analysis on the healthy datasets of young and old subjects. As already existed techniques lacks in studying complex behaviours of electrophysiological signals so to overcome these limitations, we have proposed compensated transfer entropy (cTE). We conducted an investigation to determine the degree to which recordings of RESP, BP, and HR can be utilized to predict changes in the other parameters. Specifically, the proposed analysis examined the relationship between these variables and assessed their consistency across different age groups and genders. By analyzing the data, we aimed to gain insights into the interdependencies and predictive potential of these physiological measures in relation to each other.
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Affiliation(s)
- Kirti Singh
- Department of ECE, Dr BR Ambedkar National Institute of Technology, Jalandhar, Punjab 144001, India
| | - Indu Saini
- Department of ECE, Dr BR Ambedkar National Institute of Technology, Jalandhar, Punjab 144001, India
| | - Neetu Sood
- Department of ECE, Dr BR Ambedkar National Institute of Technology, Jalandhar, Punjab 144001, India
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Cairo B, Bari V, de Abreu RM, Gelpi F, De Maria B, Catai AM, Porta A. Characterization of Multiple Regimes of Cardiorespiratory Phase Synchronization in Athletes Undergoing Inspiratory Muscle Training. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023; 2023:1-4. [PMID: 38083759 DOI: 10.1109/embc40787.2023.10339951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Cardiorespiratory phase synchronization (CRPS) is defined as the stable occurrence of n heartbeats within m respiratory cycles according to the n:m phase locking ratio (PLR). Since CRPS is an intermittent phenomenon where different phase synchronization regimes and epochs of phase unlocking can alternate within the same recording, an index of CRPS ideally should assess all potential PLRs present in the recording. However, traditional approaches compute the synchronization index (SYNC%) over a single n:m PLR, namely the one that maximizes CRPS. In the present work, we tested a synchronization index assessing the total percentage of heartbeats coupled to the inspiratory onset regardless of phase locking regimes (SYNC%sum) and we compared its efficacy to the more traditional SYNC%. Analysis was carried out in a cohort of 25 male amateur cyclists (age: 20-40 yrs) undergoing inspiratory muscle training (IMT) at different intensities. CRPS was assessed before and after the IMT protocol, during an experimental condition known to modify CRPS, namely active standing (STAND). We found that after a moderate intensity IMT at 60% of the maximal inspiratory pressure, SYNC%sum could detect the decrease in CRPS following STAND. This result was not visible using the more traditional SYNC%. Therefore, we stress the significant presence of different phase locking regimes in athletes and the importance of accounting for multiple PLRs in CRPS analysis.Clinical Relevance- Multiple phase locking regimes contribute significantly to cardiorespiratory control in amateur cyclists especially after inspiratory muscle training of moderate intensity.
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Laurino MJL, da Silva AKF, Santos LA, Vanderlei LCM. Water drinking during aerobic exercise improves the recovery of non-linear heart rate dynamics in coronary artery disease: crossover clinical trial. Front Neurosci 2023; 17:1147299. [PMID: 37424997 PMCID: PMC10323825 DOI: 10.3389/fnins.2023.1147299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/31/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction The post-exercise recovery is a period of vulnerability of the cardiovascular system in which autonomic nervous system plays a key role in cardiovascular deceleration. It is already known that individuals with coronary artery disease (CAD) are at greater risk due to delayed vagal reactivation in this period. Water ingestion has been studied as a strategy to improve autonomic recovery and mitigate the risks during recovery. However, the results are preliminary and need further confirmation. Therefore, our aim was to investigate the influence of individualized water drinking on the non-linear dynamics of heart rate during and after aerobic exercise in CAD subjects. Methods 30 males with CAD were submitted to a control protocol composed of initial rest, warming up, treadmill exercise, and passive recovery (60 min). After 48 hours they performed the hydration protocol, composed of the same activities, however, with individualized water drinking proportional to the body mass lost in the control protocol. The non-linear dynamics of heart rate were assessed by indices of heart rate variability extracted from the recurrence plot, detrended fluctuation analysis, and symbolic analysis. Results and discussion During exercise, the responses were physiological and similar in both protocols, indicating high sympathetic activity and reduced complexity. During recovery, the responses were also physiological, indicating the rise of parasympathetic activity and the return to a more complex state. However, during hydration protocol, the return to a more complex physiologic state occurred sooner and non-linear HRV indices returned to resting values between the 5th and 20th minutes of recovery. In contrast, during the control protocol, only a few indices returned to resting values within 60 minutes. Despite that, differences between protocols were not found. We conclude that the water drinking strategy accelerated the recovery of non-linear dynamics of heart rate in CAD subjects but did not influence responses during exercise. This is the first study to characterize the non-linear responses during and after exercise in CAD subjects.
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Cardiorespiratory coupling in mechanically ventilated patients studied via synchrogram analysis. Med Biol Eng Comput 2023; 61:1329-1341. [PMID: 36698031 DOI: 10.1007/s11517-023-02784-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 01/15/2023] [Indexed: 01/27/2023]
Abstract
Respiration and cardiac activity are strictly interconnected with reciprocal influences. They act as weakly coupled oscillators showing varying degrees of phase synchronization and their interactions are affected by mechanical ventilation. The study aims at differentiating the impact of three ventilatory modes on the cardiorespiratory phase coupling in critically ill patients. The coupling between respiration and heartbeat was studied through cardiorespiratory phase synchronization analysis carried out via synchrogram during pressure control ventilation (PCV), pressure support ventilation (PSV), and neurally adjusted ventilatory assist (NAVA) in critically ill patients. Twenty patients were studied under all the three ventilatory modes. Cardiorespiratory phase synchronization changed significantly across ventilatory modes. The highest synchronization degree was found during PCV session, while the lowest one with NAVA. The percentage of all epochs featuring synchronization regardless of the phase locking ratio was higher with PCV (median: 33.9%, first-third quartile: 21.3-39.3) than PSV (median: 15.7%; first-third quartile: 10.9-27.8) and NAVA (median: 3.7%; first-third quartile: 3.3-19.2). PCV induces a significant amount of cardiorespiratory phase synchronization in critically ill mechanically ventilated patients. Synchronization induced by patient-driven ventilatory modes was weaker, reaching the minimum with NAVA. Findings can be explained as a result of the more regular and powerful solicitation of the cardiorespiratory system induced by PCV. The degree of phase synchronization between cardiac and respiratory activities in mechanically ventilated humans depends on the ventilatory mode.
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Li Y, Li J, Yan C, Dong K, Kang Z, Zhang H, Liu C. Sleep Quality Evaluation Based on Single-Lead Wearable Cardiac Cycle Acquisition Device. SENSORS (BASEL, SWITZERLAND) 2022; 23:328. [PMID: 36616927 PMCID: PMC9823989 DOI: 10.3390/s23010328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 11/24/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
In clinical conditions, polysomnography (PSG) is regarded as the "golden standard" for detecting sleep disease and offering a reference of objective sleep quality. For healthy adults, scores from sleep questionnaires are more reliable than other methods in obtaining knowledge of subjective sleep quality. In practice, the need to simplify PSG to obtain subjective sleep quality by recording a few channels of physiological signals such as single-lead electrocardiogram (ECG) or photoplethysmography (PPG) signal is still very urgent. This study provided a two-step method to differentiate sleep quality into "good sleep" and "poor sleep" based on the single-lead wearable cardiac cycle data, with the comparison of the subjective sleep questionnaire score. First, heart rate variability (HRV) features and ECG-derived respiration features were extracted to construct a sleep staging model (wakefulness (W), rapid eye movement (REM), light sleep (N1&N2) and deep sleep (N3)) using the multi-classifier fusion method. Then, features extracted from the sleep staging results were used to construct a sleep quality evaluation model, i.e., classifying the sleep quality as good and poor. The accuracy of the sleep staging model, tested on the international public database, was 0.661 and 0.659 in Cardiology Challenge 2018 training database and Sleep Heart Health Study Visit 1 database, respectively. The accuracy of the sleep quality evaluation model was 0.786 for our recording subjects, with an average F1-score of 0.771. The proposed sleep staging model and sleep quality evaluation model only requires one channel of wearable cardiac cycle signal. It is very easy to transplant to portable devices, which facilitates daily sleep health monitoring.
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Affiliation(s)
- Yang Li
- School of Instrument Science and Engineering, Southeast University, Nanjing 210096, China
| | - Jianqing Li
- School of Instrument Science and Engineering, Southeast University, Nanjing 210096, China
| | - Chang Yan
- School of Instrument Science and Engineering, Southeast University, Nanjing 210096, China
| | - Kejun Dong
- School of Instrument Science and Engineering, Southeast University, Nanjing 210096, China
- School of Information Science and Engineering, Southeast University, Nanjing 210096, China
| | - Zhiyu Kang
- Aerospace System Engineering Shanghai, Shanghai 201109, China
| | - Hongxing Zhang
- State Key Laboratory of Proteomics, Beijing Proteome Research Center, National Center for Protein Sciences, Beijing Institute of Lifeomics, Beijing 102206, China
| | - Chengyu Liu
- School of Instrument Science and Engineering, Southeast University, Nanjing 210096, China
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Melinski ADC, Catai AM, Moura SCGD, Milan-Mattos JC, Takito MY. Impact of Air Pollutant on Heart Rate Variability in Healthy Young Adults. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2022. [DOI: 10.36660/ijcs.20200380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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John AT, Barthel A, Wind J, Rizzi N, Schöllhorn WI. Acute Effects of Various Movement Noise in Differential Learning of Rope Skipping on Brain and Heart Recovery Analyzed by Means of Multiscale Fuzzy Measure Entropy. Front Behav Neurosci 2022; 16:816334. [PMID: 35283739 PMCID: PMC8914377 DOI: 10.3389/fnbeh.2022.816334] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 01/18/2022] [Indexed: 11/13/2022] Open
Abstract
In search of more detailed explanations for body-mind interactions in physical activity, neural and physiological effects, especially regarding more strenuous sports activities, increasingly attract interest. Little is known about the underlying manifold (neuro-)physiological impacts induced by different motor learning approaches. The various influences on brain or cardiac function are usually studied separately and modeled linearly. Limitations of these models have recently led to a rapidly growing application of nonlinear models. This study aimed to investigate the acute effects of various sequences of rope skipping on irregularity of the electrocardiography (ECG) and electroencephalography (EEG) signals as well as their interaction and whether these depend on different levels of active movement noise, within the framework of differential learning theory. Thirty-two males were randomly and equally distributed to one of four rope skipping conditions with similar cardiovascular but varying coordinative demand. ECG and EEG were measured simultaneously at rest before and immediately after rope skipping for 25 mins. Signal irregularity of ECG and EEG was calculated via the multiscale fuzzy measure entropy (MSFME). Statistically significant ECG and EEG brain area specific changes in MSFME were found with different pace of occurrence depending on the level of active movement noise of the particular rope skipping condition. Interaction analysis of ECG and EEG MSFME specifically revealed an involvement of the frontal, central, and parietal lobe in the interplay with the heart. In addition, the number of interaction effects indicated an inverted U-shaped trend presenting the interaction level of ECG and EEG MSFME dependent on the level of active movement noise. In summary, conducting rope skipping with varying degrees of movement variation appears to affect the irregularity of cardiac and brain signals and their interaction during the recovery phase differently. These findings provide enough incentives to foster further constructive nonlinear research in exercise-recovery relationship and to reconsider the philosophy of classical endurance training.
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Affiliation(s)
- Alexander Thomas John
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University, Mainz, Germany
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Javorac D, Tatović S, Anđelković M, Repić A, Baralić K, Djordjevic AB, Mihajlović M, Stevuljević JK, Đukić-Ćosić D, Ćurčić M, Antonijević B, Bulat Z. Low-lead doses induce oxidative damage in cardiac tissue: Subacute toxicity study in Wistar rats and Benchmark dose modelling. Food Chem Toxicol 2022; 161:112825. [PMID: 35045334 DOI: 10.1016/j.fct.2022.112825] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/28/2021] [Accepted: 01/13/2022] [Indexed: 02/08/2023]
Abstract
Exposure to toxic metals, including lead (Pb), were found as important risk factor for cardiovascular diseases. The aim of the study was to simulate low-level subacute Pb exposure scenario and to determine redox status, redox scores (OXY-score, damage score and protective score) and copper (Cu), zinc (Zn), iron (Fe) and manganese (Mn) levels in cardiac tissue of Wistar rats. Based on the obtained results we have established dose-toxic response relationship and derived Benchmark dose. The male Wistar rats were divided in seven groups (n = 6), six threated groups that received 0.1; 0.5; 1; 3; 7; 15 mg Pb/kg body weight/day for 28 days, by oral gavage and control group. The results of the presented study demonstrated that Pb affect cardiac tissue by inducing production of superoxide anion radical (O2.-) and consequently raising malondialdehyde (MDA) levels. The positive trend in OXY-score and damage score were determined. Effect size analysis showed that the main toxic effects were oxidative damage and elevation of MDA. The lowest BMD was calculated for MDA (2.2e-0.6 mg Pb/kg b.w./day). Obtained BMD may be useful in further assessing point of departure in the human health risks assessment of low-level Pb exposure scenario.
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Affiliation(s)
- Dragana Javorac
- Department of Toxicology "Akademik Danilo Soldatović", University of Belgrade - Faculty of Pharmacy, 11221, Belgrade, Serbia.
| | - Simona Tatović
- Department of Toxicology "Akademik Danilo Soldatović", University of Belgrade - Faculty of Pharmacy, 11221, Belgrade, Serbia
| | | | - Aleksandra Repić
- Institute of Forensic Medicine, Faculty of Medicine University of Belgrade, 11000, Belgrade, Serbia
| | - Katarina Baralić
- Department of Toxicology "Akademik Danilo Soldatović", University of Belgrade - Faculty of Pharmacy, 11221, Belgrade, Serbia
| | - Aleksandra Buha Djordjevic
- Department of Toxicology "Akademik Danilo Soldatović", University of Belgrade - Faculty of Pharmacy, 11221, Belgrade, Serbia
| | - Marija Mihajlović
- Department of Medical Biochemistry, University of Belgrade - Faculty of Pharmacy, 11221, Belgrade, Serbia
| | - Jelena Kotur Stevuljević
- Department of Medical Biochemistry, University of Belgrade - Faculty of Pharmacy, 11221, Belgrade, Serbia
| | - Danijela Đukić-Ćosić
- Department of Toxicology "Akademik Danilo Soldatović", University of Belgrade - Faculty of Pharmacy, 11221, Belgrade, Serbia
| | - Marijana Ćurčić
- Department of Toxicology "Akademik Danilo Soldatović", University of Belgrade - Faculty of Pharmacy, 11221, Belgrade, Serbia
| | - Biljana Antonijević
- Department of Toxicology "Akademik Danilo Soldatović", University of Belgrade - Faculty of Pharmacy, 11221, Belgrade, Serbia
| | - Zorica Bulat
- Department of Toxicology "Akademik Danilo Soldatović", University of Belgrade - Faculty of Pharmacy, 11221, Belgrade, Serbia
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Shi P, Li A, Wu L, Yu H. The effect of passive lower limb training on heart rate asymmetry. Physiol Meas 2021; 43. [PMID: 34915452 DOI: 10.1088/1361-6579/ac43c1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 12/16/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Heart rate asymmetry (HRA) is an approach for quantitatively assessing the uneven distribution of heart rate accelerations and decelerations for sinus rhythm. We aimed to investigate whether automatic regulation led to HRA alternation during passive lower limb training. METHODS Thirty healthy participants were recruited in this study. The protocol included a baseline (Pre-E) and three passive lower limb training trials (E1, E2 and E3) with a randomized order. Several variance-based HRA variables were established. Heart rate variability (HRV) parameters, i.e., mean RR, SDNN, RMSSD, LF (n.u.), HF (n.u.) and VLF (ms2), and HRA variables, i.e., SD1a, SD1d, SD2a, SD2d, SDNNa and SDNNd, were calculated by using 5-min RR time series, as well as the normalized HRA variables, i.e., C1a, C1d, C2a, C2d, Ca and Cd. RESULTS Our results showed that the performance of HRA was distinguished. The normalized HRA was observed with significant changes in E1, E2 and E3 compared to Pre -E. Moreover, parts of non-normalized HRA variables correlated with HRV parameters, which indicated that HRA might benefit in assessing cardiovascular modulation in passive lower limb training. CONCLUSIONS In summary, this study suggested that passive training led to significant HRA alternation and the application of HRA gave us the possibility for autonomic assessment.
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Affiliation(s)
- Ping Shi
- nstitute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, 580 Jungong Road, Yangpu District, Shanghai, China, shanghai, Shanghai, 200093, CHINA
| | - Anan Li
- nstitute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, no.580 Jungong road, Yangpu district, Shanghai, China, Shanghai, Shanghai, 200093, CHINA
| | - Liang Wu
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, 580 Jungong Road, Yangpu District, Shanghai, China, Shanghai, 200093, CHINA
| | - Hongliu Yu
- nstitute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, 580 Jungong Road, Yangpu District, Shanghai, China, Shanghai, Shanghai, 200093, CHINA
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Escutia-Reyes D, de Jesús Garduño-García J, Emilio-López-Chávez G, Gómez-Villanueva Á, Pliego-Carrillo AC, Soto-Piña AE, Reyes-Lagos JJ. Differences in heart rate variability and body composition in breast cancer survivors and women without cancer. Sci Rep 2021; 11:14460. [PMID: 34262078 PMCID: PMC8280116 DOI: 10.1038/s41598-021-93713-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 06/30/2021] [Indexed: 12/25/2022] Open
Abstract
The aim of this study was to explore cardiac autonomic changes assessed by linear and nonlinear indexes of heart rate variability (HRV) and body composition modifications in breast cancer survivors and cancer-free control women. Women who were breast cancer survivors (BCS, n = 27) and without cancer with similar characteristics (Control, n = 31) were recruited for this study. We calculated some relevant linear and nonlinear parameters of 5 min of RR interval time series such as mean RR interval (RRave), the corrected Poincaré index (cSD1/SD2), the sample entropy (SampEn), the long-term fractal scaling exponent (α2) and 2UV from symbolic dynamics. Additionally, we indirectly assessed body composition measures such as body weight, fat mass, visceral fat rating (VFR), normalized VRF (nVFR), muscle mass, metabolic age, and total body water. We found that diverse HRV indexes and only one body composition measure showed statistical differences (p < 0.05) between the BCS and Control groups. RRave: 729 (648-802) vs. 795 (713-852) ms; cSD2/SD1: 3.4 (2.7-5.0) vs. 2.9 (2.3-3.5); SampEn: 1.5 (1.3-1.8) vs. 1.7 (1.5-1.8); α2: 0.6 (0.3-0.6) vs. 0.5 (0.4-0.5); 2UV: 7.1 (4.3-11.5) vs. 10.8 (6.4-15.7) and nVFR 0.12 (0.11-0.13) vs. 0.10 (0.08-0.12) points/kg, respectively. The nVFR was strongly significantly correlated with several indexes of HRV only in the BCS group.Our findings suggest that BCS exhibit lower parasympathetic cardiac activity and changes in HRV patterns compared to Controls. A concomitant increase of visceral fat, among other factors, may contribute to cardiac autonomic disturbances and changes in HRV patterns in BCS.
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Affiliation(s)
- Daniel Escutia-Reyes
- School of Medicine, Autonomous University of Mexico State (UAEMéx), State of Mexico, 50180, Toluca, Mexico
| | - José de Jesús Garduño-García
- School of Medicine, Autonomous University of Mexico State (UAEMéx), State of Mexico, 50180, Toluca, Mexico
- Regional General Hospital No. 251, Mexican Institute of Social Security (IMSS), State of Mexico, 52148, Metepec, Mexico
| | - Gerardo Emilio-López-Chávez
- Regional General Hospital No. 251, Mexican Institute of Social Security (IMSS), State of Mexico, 52148, Metepec, Mexico
| | - Ángel Gómez-Villanueva
- Regional General Hospital No. 251, Mexican Institute of Social Security (IMSS), State of Mexico, 52148, Metepec, Mexico
| | | | - Alexandra Estela Soto-Piña
- School of Medicine, Autonomous University of Mexico State (UAEMéx), State of Mexico, 50180, Toluca, Mexico
| | - José Javier Reyes-Lagos
- School of Medicine, Autonomous University of Mexico State (UAEMéx), State of Mexico, 50180, Toluca, Mexico.
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Yan C, Liu C, Yao L, Wang X, Wang J, Li P. Short-Term Effect of Percutaneous Coronary Intervention on Heart Rate Variability in Patients with Coronary Artery Disease. ENTROPY 2021; 23:e23050540. [PMID: 33924819 PMCID: PMC8146536 DOI: 10.3390/e23050540] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/25/2021] [Accepted: 04/26/2021] [Indexed: 01/18/2023]
Abstract
Myocardial ischemia in patients with coronary artery disease (CAD) leads to imbalanced autonomic control that increases the risk of morbidity and mortality. To systematically examine how autonomic function responds to percutaneous coronary intervention (PCI) treatment, we analyzed data of 27 CAD patients who had admitted for PCI in this pilot study. For each patient, five-minute resting electrocardiogram (ECG) signals were collected before and after the PCI procedure. The time intervals between ECG collection and PCI were both within 24 h. To assess autonomic function, normal sinus RR intervals were extracted and were analyzed quantitatively using traditional linear time- and frequency-domain measures [i.e., standard deviation of the normal-normal intervals (SDNN), the root mean square of successive differences (RMSSD), powers of low frequency (LF) and high frequency (HF) components, LF/HF] and nonlinear entropy measures [i.e., sample entropy (SampEn), distribution entropy (DistEn), and conditional entropy (CE)], as well as graphical metrics derived from Poincaré plot [i.e., Porta’s index (PI), Guzik’s index (GI), slope index (SI) and area index (AI)]. Results showed that after PCI, AI and PI decreased significantly (p < 0.002 and 0.015, respectively) with effect sizes of 0.88 and 0.70 as measured by Cohen’s d static. These changes were independent of sex. The results suggest that graphical AI and PI metrics derived from Poincaré plot of short-term ECG may be potential for sensing the beneficial effect of PCI on cardiovascular autonomic control. Further studies with bigger sample sizes are warranted to verify these observations.
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Affiliation(s)
- Chang Yan
- School of Control Science and Engineering, Shandong University, Jinan 250061, China; (C.Y.); (L.Y.); (X.W.); (J.W.)
| | - Changchun Liu
- School of Control Science and Engineering, Shandong University, Jinan 250061, China; (C.Y.); (L.Y.); (X.W.); (J.W.)
- Correspondence: (C.L.); (P.L.)
| | - Lianke Yao
- School of Control Science and Engineering, Shandong University, Jinan 250061, China; (C.Y.); (L.Y.); (X.W.); (J.W.)
| | - Xinpei Wang
- School of Control Science and Engineering, Shandong University, Jinan 250061, China; (C.Y.); (L.Y.); (X.W.); (J.W.)
| | - Jikuo Wang
- School of Control Science and Engineering, Shandong University, Jinan 250061, China; (C.Y.); (L.Y.); (X.W.); (J.W.)
| | - Peng Li
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
- Correspondence: (C.L.); (P.L.)
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De Maria B, Dalla Vecchia LA, Maestri R, Pinna GD, Parati M, Perego F, Bari V, Cairo B, Gelpi F, La Rovere MT, Porta A. Lack of association between heart period variability asymmetry and respiratory sinus arrhythmia in healthy and chronic heart failure individuals. PLoS One 2021; 16:e0247145. [PMID: 33592077 PMCID: PMC7886158 DOI: 10.1371/journal.pone.0247145] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 02/02/2021] [Indexed: 12/02/2022] Open
Abstract
Temporal asymmetry is a peculiar aspect of heart period (HP) variability (HPV). HPV asymmetry (HPVA) is reduced with aging and pathology, but its origin is not fully elucidated. Given the impact of respiration on HPV resulting in the respiratory sinus arrhythmia (RSA) and the asymmetric shape of the respiratory pattern, a possible link between HPVA and RSA might be expected. In this study we tested the hypothesis that HPVA is significantly associated with RSA and asymmetry of the respiratory rhythm. We studied 42 middle-aged healthy (H) subjects, and 56 chronic heart failure (CHF) patients of whom 26 assigned to the New York Heart Association (NYHA) class II (CHF-II) and 30 to NYHA class III (CHF-III). Electrocardiogram and lung volume were monitored for 8 minutes during spontaneous breathing (SB) and controlled breathing (CB) at 15 breaths/minute. The ratio of inspiratory (INSP) to expiratory (EXP) phases, namely the I/E ratio, and RSA were calculated. HPVA was estimated as the percentage of negative HP variations, traditionally measured via the Porta’s index (PI). Departures of PI from 50% indicated HPVA and its significance was tested via surrogate data. We found that RSA increased during CB and I/E ratio was smaller than 1 in all groups and experimental conditions. In H subjects the PI was about 50% during SB and it increased significantly during CB. In both CHF-II and CHF-III groups the PI was about 50% during SB and remained unmodified during CB. The PI was uncorrelated with RSA and I/E ratio regardless of the experimental condition and group. Pooling together data of different experimental conditions did not affect conclusions. Therefore, we conclude that the HPVA cannot be explained by RSA and/or I/E ratio, thus representing a peculiar feature of the cardiac control that can be aroused in middle-aged H individuals via CB.
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Affiliation(s)
| | | | - Roberto Maestri
- IRCCS Istituti Clinici Scientifici Maugeri, Montescano, Pavia, Italy
| | | | - Monica Parati
- IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
- Neuroengineering and Medical Robotics Laboratory, Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | | | - Vlasta Bari
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Beatrice Cairo
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Francesca Gelpi
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | | | - Alberto Porta
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- * E-mail:
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14
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La Rovere MT, Porta A, Schwartz PJ. Autonomic Control of the Heart and Its Clinical Impact. A Personal Perspective. Front Physiol 2020; 11:582. [PMID: 32670079 PMCID: PMC7328903 DOI: 10.3389/fphys.2020.00582] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 05/11/2020] [Indexed: 12/21/2022] Open
Abstract
This essay covers several aspects of the autonomic control of the heart, all relevant to cardiovascular pathophysiology with a direct impact on clinical outcomes. Ischemic heart disease, heart failure, channelopathies, and life-threatening arrhythmias are in the picture. Beginning with an overview on some of the events that marked the oscillations in the medical interest for the autonomic nervous system, our text explores specific areas, including experimental and clinical work focused on understanding the different roles of tonic and reflex sympathetic and vagal activity. The role of the baroreceptors, not just for the direct control of circulation but also because of the clinical value of interpreting alterations (spontaneous or induced) in their function, is discussed. The importance of the autonomic nervous system for gaining insights on risk stratification and for providing specific antiarrhythmic protection is also considered. Examples are the interventions to decrease sympathetic activity and/or to increase vagal activity. The non-invasive analysis of the RR and QT intervals provides additional information. The three of us have collaborated in several studies and each of us contributes with very specific and independent areas of expertise. Here, we have focused on those areas to which we have directly contributed and hence speak with personal experience. This is not an attempt to provide a neutral and general overview on the autonomic nervous system; rather, it represents our effort to share and provide the readers with our own personal views matured after many years of research in this field.
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Affiliation(s)
- Maria Teresa La Rovere
- Department of Cardiology, IRCCS Istituti Clinici Scientifici Maugeri, Montescano (Pavia), Italy
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.,Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy
| | - Peter J Schwartz
- Center for Cardiac Arrhythmias of Genetic Origin and Laboratory of Cardiovascular Genetics, Istituto Auxologico Italiano, IRCCS, Milan, Italy
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15
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Calderón-Juárez M, González-Gómez GH, Echeverría JC, Pérez-Grovas H, Lerma C. Association between Mean Heart Rate and Recurrence Quantification Analysis of Heart Rate Variability in End-Stage Renal Disease. ENTROPY 2020; 22:e22010114. [PMID: 33285890 PMCID: PMC7516420 DOI: 10.3390/e22010114] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 01/09/2020] [Accepted: 01/15/2020] [Indexed: 01/09/2023]
Abstract
Linear heart rate variability (HRV) indices are dependent on the mean heart rate, which has been demonstrated in different models (from sinoatrial cells to humans). The association between nonlinear HRV indices, including those provided by recurrence plot quantitative analysis (RQA), and the mean heart rate (or the mean cardiac period, also called meanNN) has been scarcely studied. For this purpose, we analyzed RQA indices of five minute-long HRV time series obtained in the supine position and during active standing from 30 healthy subjects and 29 end-stage renal disease (ESRD) patients (before and after hemodialysis). In the supine position, ESRD patients showed shorter meanNN (i.e., faster heart rate) and decreased variability compared to healthy subjects. The healthy subjects responded to active standing by shortening the meanNN and decreasing HRV indices to reach similar values of ESRD patients. Bivariate correlations between all RQA indices and meanNN were significant in healthy subjects and ESRD after hemodialysis and for most RQA indices in ESRD patients before hemodialysis. Multiple linear regression analyses showed that RQA indices were also dependent on the position and the ESRD condition. Then, future studies should consider the association among RQA indices, meanNN, and these other factors for a correct interpretation of HRV.
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Affiliation(s)
- Martín Calderón-Juárez
- Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico;
| | | | - Juan C. Echeverría
- Department of Electrical Engineering, Universidad Autónoma Metropolitana, Unidad Iztapalapa, Mexico City 09340, Mexico;
| | - Héctor Pérez-Grovas
- Department of Nephrology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico;
| | - Claudia Lerma
- Department of Electromechanical Instrumentation, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico
- Correspondence: ; Tel.: +52-55-55732911 (ext. 26202)
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16
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Yeh CH, Juan CH, Yeh HM, Wang CY, Young HWV, Lin JL, Lin C, Lin LY, Lo MT. The critical role of respiratory sinus arrhythmia on temporal cardiac dynamics. J Appl Physiol (1985) 2019; 127:1733-1741. [PMID: 31647722 DOI: 10.1152/japplphysiol.00262.2019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Temporal cardiac properties provide alternative information in analyzing heart rate variability (HRV), which may be disregarded by the standard HRV analyses. Patients with congestive heart failure (CHF) are known to have distinct temporal features from the healthy individuals. However, the underlying mechanism leading to the variation remains unclear. Whether or not these parameters can finely classify the severity for CHF patients is uncertain as well. In this work, an electrocardiogram was monitored in advanced CHF patients using 24-h Holter in four conditions, including baseline, one and three months after atenolol therapy, and healthy individuals. Slope and area under the curve (AUC) of multiscale entropy (MSE) curve over short (scales 1-5) and long (scales 6-20) scales, and detrended fluctuation analysis (DFA) scaling exponents at short (4-11 beats) and intermediate (>11 beats) window sizes were calculated. The results show that short-time scale MSE-derived parameters (slope: -0.08 ± 0.10, -0.03 ± 0.10, 0.02 ± 0.06, 0.08 ± 0.06; AUC: 4.03 ± 2.11, 4.69 ± 1.28, 4.73 ± 0.94, and 6.17 ± 1.23) and short-time scale DFA exponent (0.79 ± 0.16, 0.95 ± 0.22, 1.11 ± 0.19, and 1.35 ± 0.20) can hierarchically classify all four conditions. More importantly, simulated R-R intervals with different fractions and amplitude of respiratory sinus arrhythmia (RSA) components were examined to validate our hypothesis regarding the essentiality of RSA in the improvement of cardiovascular function, and its tight association with unpredictability and fractal property of HRV, which is in line with our hypothesis that RSA contributes significantly to the generation of the unpredictability and fractal behavior of HR dynamics.NEW & NOTEWORTHY Temporal cardiac properties provide useful diagnostic parameters for patients with congestive heart failure (CHF). Our study hierarchically classified CHF patients with β-blocker treatment by using multiscale entropy and detrended fluctuation analysis. Also, we provided the evidence to validate the critical role of respiratory sinus arrhythmia in the fractal properties of heart rate variability.
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Affiliation(s)
- Chien-Hung Yeh
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Chung-Hau Juan
- Department of Biomedical Sciences, National Central University, Taoyuan, Taiwan.,Department of Anesthesiology, Cathay General Hospital, Taipei, Taiwan
| | - Huei-Ming Yeh
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Cheng-Yen Wang
- Department of Biomedical Sciences, National Central University, Taoyuan, Taiwan
| | - Hsu-Wen Vincent Young
- Department of Biomedical Sciences, National Central University, Taoyuan, Taiwan.,Department of Applied Mathematics, Chung Yuan Christian University, Taoyuan, Taiwan
| | - Jiunn-Lee Lin
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chen Lin
- Department of Biomedical Sciences, National Central University, Taoyuan, Taiwan
| | - Lian-Yu Lin
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Men-Tzung Lo
- Department of Biomedical Sciences, National Central University, Taoyuan, Taiwan
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17
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Cairo B, De Maria B, Bari V, Vaini E, Heusser K, Tank J, Jordan J, Barbic F, Furlan R, Marinou K, Dalla Vecchia L, Porta A. Information-domain method for the quantification of the complexity of the sympathetic baroreflex regulation in healthy subjects and amyotrophic lateral sclerosis patients. Physiol Meas 2019; 40:034004. [PMID: 30840931 DOI: 10.1088/1361-6579/ab0d4b] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The sympathetic baroreflex (sBR) adjusts muscle sympathetic nerve activity (MSNA) in response to arterial pressure changes but the relevance of assessing sBR control complexity is unclear. OBJECTIVE We propose a method for the evaluation of sBR control complexity. APPROACH The approach comprises the quantification of complexity of the sBR latency regulation and the assessment of complexity of the relationship linking MSNA burst to R-wave peak regardless of the variability of the sBR latency. The Shannon entropy (SE) of the sBR latency distribution is taken as an estimate of complexity of the sBR latency regulation. The conditional entropy (CE) of the beat-to-beat binary series obtained by coding the presence/absence of the MSNA burst after an R-wave peak is taken as an estimate of complexity of the sBR control regardless of the sBR latency variability. Surrogate analysis was utilized to set the level of inactive or impaired sBR. The approach was applied to 10 young healthy subjects undergoing head-up tilt (HUT) followed by lower body negative pressure to evoke presyncope (preSYNC) before and after 21 d head-down bed rest (HDBR), and to five amyotrophic lateral sclerosis (ALS) patients undergoing HUT. MAIN RESULTS In healthy subjects the surrogate analysis suggested that HUT and preSYNC significantly activated the sBR control but its response was weakened after 21 d HDBR. During preSYNC sBR latency increased significantly only after 21 d HDBR. In ALS patients the complexity of the sBR latency regulation was close to the level set by surrogate analysis and HUT did not trigger any sBR control response. SIGNIFICANCE The proposed method for sBR control complexity quantification was useful in detecting the impairment of the sBR control after 21 d HDBR in healthy subjects and the dysfunction of the sBR regulation in ALS patients.
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Affiliation(s)
- Beatrice Cairo
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
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18
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Comparison of short-term heart rate variability indexes evaluated through electrocardiographic and continuous blood pressure monitoring. Med Biol Eng Comput 2019; 57:1247-1263. [PMID: 30730027 DOI: 10.1007/s11517-019-01957-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 01/28/2019] [Indexed: 10/27/2022]
Abstract
Heart rate variability (HRV) analysis represents an important tool for the characterization of complex cardiovascular control. HRV indexes are usually calculated from electrocardiographic (ECG) recordings after measuring the time duration between consecutive R peaks, and this is considered the gold standard. An alternative method consists of assessing the pulse rate variability (PRV) from signals acquired through photoplethysmography, a technique also employed for the continuous noninvasive monitoring of blood pressure. In this work, we carry out a thorough analysis and comparison of short-term variability indexes computed from HRV time series obtained from the ECG and from PRV time series obtained from continuous blood pressure (CBP) signals, in order to evaluate the reliability of using CBP-based recordings in place of standard ECG tracks. The analysis has been carried out on short time series (300 beats) of HRV and PRV in 76 subjects studied in different conditions: resting in the supine position, postural stress during 45° head-up tilt, and mental stress during computation of arithmetic test. Nine different indexes have been taken into account, computed in the time domain (mean, variance, root mean square of the successive differences), frequency domain (low-to-high frequency power ratio LF/HF, HF spectral power, and central frequency), and information domain (entropy, conditional entropy, self entropy). Thorough validation has been performed using comparison of the HRV and PRV distributions, robust linear regression, and Bland-Altman plots. Results demonstrate the feasibility of extracting HRV indexes from CBP-based data, showing an overall relatively good agreement of time-, frequency-, and information-domain measures. The agreement decreased during postural and mental arithmetic stress, especially with regard to band-power ratio, conditional, and self-entropy. This finding suggests to use caution in adopting PRV as a surrogate of HRV during stress conditions.
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19
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Porta A, Bari V, De Maria B, Cairo B, Vaini E, Malacarne M, Pagani M, Lucini D. On the Relevance of Computing a Local Version of Sample Entropy in Cardiovascular Control Analysis. IEEE Trans Biomed Eng 2018; 66:623-631. [PMID: 29993481 DOI: 10.1109/tbme.2018.2852713] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Traditional definition of sample entropy (SampEn), here referred to as global SampEn (GSampEn), provides a conditional entropy estimate that blurs the local statistical properties of the time series. We hypothesized that a local version of SampEn (LSampEn) might be more powerful in the presence of determinism than GSampEn. METHODS LSampEn was computed by calculating the probability of the current sample conditioned on each reference pattern and averaging it over all reference patterns. The improved ability of LSampEn compared to GSampEn was demonstrated by simulating deterministic periodic, deterministic chaotic, and linear stochastic dynamics corrupted by additive noise and over real cardiovascular variability series recorded from 16 healthy subjects (max-min age range: 22-58 years) during incremental bicycle ergometer exercise. RESULTS We found that: i) LSampEn is more robust in describing deterministic periodic or nonlinear features in the presence of additive noise than GSampEn, ii) in association with a surrogate approach, LSampEn is more powerful in detecting nonlinear dynamics than GSampEn, iii) LSampEn and GSampEn are equivalent in the presence of stochastic linear dynamics, and iv) only LSampEn can detect the decrease of complexity of heart period variability during bicycle exercise being a likely hallmark of sympathetic activation. CONCLUSION LSampEn preserves the GSampEn capability in characterizing the complexity of short sequences but improves its reliability in the presence of deterministic patterns featuring sharp state transitions and nonlinear dynamics. SIGNIFICANCE Variations of complexity can be measured with a greater statistical power over short series using LSampEn, especially when nonlinear features are present.
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20
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Towards understanding the complexity of cardiovascular oscillations: Insights from information theory. Comput Biol Med 2018; 98:48-57. [PMID: 29763765 DOI: 10.1016/j.compbiomed.2018.05.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 05/03/2018] [Accepted: 05/03/2018] [Indexed: 11/24/2022]
Abstract
Cardiovascular complexity is a feature of healthy physiological regulation, which stems from the simultaneous activity of several cardiovascular reflexes and other non-reflex physiological mechanisms. It is manifested in the rich dynamics characterizing the spontaneous heart rate and blood pressure variability (HRV and BPV). The present study faces the challenge of disclosing the origin of short-term HRV and BPV from the statistical perspective offered by information theory. To dissect the physiological mechanisms giving rise to cardiovascular complexity in different conditions, measures of predictive information, information storage, information transfer and information modification were applied to the beat-to-beat variability of heart period (HP), systolic arterial pressure (SAP) and respiratory volume signal recorded non-invasively in 61 healthy young subjects at supine rest and during head-up tilt (HUT) and mental arithmetics (MA). Information decomposition enabled to assess simultaneously several expected and newly inferred physiological phenomena, including: (i) the decreased complexity of HP during HUT and the increased complexity of SAP during MA; (ii) the suppressed cardiorespiratory information transfer, related to weakened respiratory sinus arrhythmia, under both challenges; (iii) the altered balance of the information transferred along the two arms of the cardiovascular loop during HUT, with larger baroreflex involvement and smaller feedforward mechanical effects; and (iv) an increased importance of direct respiratory effects on SAP during HUT, and on both HP and SAP during MA. We demonstrate that a decomposition of the information contained in cardiovascular oscillations can reveal subtle changes in system dynamics and improve our understanding of the complexity changes during physiological challenges.
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21
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Cavalcante Neto JL, Zamunér AR, Moreno BC, Silva E, Tudella E. Linear and Nonlinear Analyses of the Cardiac Autonomic Control in Children With Developmental Coordination Disorder: A Case-Control Study. Front Physiol 2018; 9:267. [PMID: 29623050 PMCID: PMC5874518 DOI: 10.3389/fphys.2018.00267] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 03/08/2018] [Indexed: 01/25/2023] Open
Abstract
Children with Developmental Coordination Disorder (DCD) and children at risk for DCD (r-DCD) present motor impairments interfering in their school, leisure and daily activities. In addition, these children may have abnormalities in their cardiac autonomic control, which together with their motor impairments, restrict their health and functionality. Therefore, this study aimed to assess the cardiac autonomic control, by linear and nonlinear analysis, at supine and during an orthostatic stimulus in DCD, r-DCD and typically developed children. Thirteen DCD children (11 boys and 2 girls, aged 8.08 ± 0.79 years), 19 children at risk for DCD (13 boys and 6 girls, aged 8.10 ± 0.96 years) and 18 typically developed children, who constituted the control group (CG) (10 boys and 8 girls, aged 8.50 ± 0.96 years) underwent a heart rate variability (HRV) examination. R-R intervals were recorded in order to assess the cardiac autonomic control using a validated HR monitor. HRV was analyzed by linear and nonlinear methods and compared between r-DCD, DCD, and CG. The DCD group presented blunted cardiac autonomic adjustment to the orthostatic stimulus, which was not observed in r-DCD and CG. Regarding nonlinear analysis of HRV, the DCD group presented lower parasympathetic modulation in the supine position compared to the r-DCD and CG groups. In the within group analysis, only the DCD group did not increase HR from supine to standing posture. Symbolic analysis revealed a significant decrease in 2LV (p < 0.0001) and 2UV (p < 0.0001) indices from supine to orthostatic posture only in the CG. In conclusion, r-DCD and DCD children present cardiac autonomic dysfunction characterized by higher sympathetic, lower parasympathetic and lower complexity of cardiac autonomic control in the supine position, as well as a blunted autonomic adjustment to the orthostatic stimulus. Therefore, cardiovascular health improvement should be part of DCD children's management, even in cases of less severe motor impairment.
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Affiliation(s)
- Jorge L Cavalcante Neto
- Núcleo de Estudos em Neuropediatria e Motricidade, Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Antonio R Zamunér
- Departamento de Kinesiología, Facultad de Ciencias de la Salud, Universidad Católica del Maule, Talca, Chile
| | - Bianca C Moreno
- Pró-Reitoria de Pesquisa e Pós-Graduação, Fisioterapia, Universidade do Sagrado Coração, Bauru, Brazil
| | - Ester Silva
- Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Eloisa Tudella
- Núcleo de Estudos em Neuropediatria e Motricidade, Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, Brazil
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22
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Fiogbé E, Ferreira R, Sindorf MAG, Tavares SA, de Souza KP, de Castro Cesar M, Lopes CR, Moreno MA. Water exercise in coronary artery disease patients, effects on heart rate variability, and body composition: A randomized controlled trial. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2018. [PMID: 29542251 DOI: 10.1002/pri.1713] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND AND PURPOSE It is important to assess the effectiveness and efficiency of water-based training programs in order to prescribe it as an alternative in cardiac rehabilitation for patients who have coronary artery disease (CAD). In these patients, autonomic dysfunction is an important physiological change strongly associated with adverse outcomes, morbidity, and mortality. Given that the beneficial effects of physical training in CAD patients have been traditionally evidenced with programs involving land-based aerobic exercises, this study aims to evaluate the effects of water aerobic exercise training (WAET) on the autonomic modulation of heart rate (HR) and body composition, in the rehabilitation of CAD patients. METHODS Twenty-six male subjects with CAD were randomly divided into a training group (n = 14), submitted to the WAET, and a control group (n = 12). The WAET consisted of 3 weekly sessions on alternate days, totalling 48 sessions. The analysis of HR variability was used to evaluate the autonomic modulation of HR, from the recording of R-R intervals for 15 min, at rest in the supine position, and the body composition was evaluated through the bioelectrical impedance analysis. RESULTS Only the training group participants had improvement in the HR variability indices; patterns without variation decreased (0V, p = .005) and an increase of patterns of two different variations (p < .001), Shannon entropy (p = .02), and normalized conditional entropy (p = .03), whereas the control group had an increase of 0V (p = .04) and a decrease of normalized conditional entropy (p = .01). All body composition variables remained unchanged. CONCLUSIONS The WAET protocol improved the cardiac autonomic modulation of patients with CAD and can be considered as exercise training strategy in cardiac rehabilitation programs.
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Affiliation(s)
- Elie Fiogbé
- Post-Graduation Program in Physical Therapy, College of Health Sciences, Methodist University of Piracicaba (UNIMEP), Piracicaba, SP, Brazil.,Post-Graduation Program in Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Rafaela Ferreira
- Post-Graduation Program in Physical Therapy, College of Health Sciences, Methodist University of Piracicaba (UNIMEP), Piracicaba, SP, Brazil
| | - Márcio Antônio Gonçalves Sindorf
- Post-Graduation Program in Physical Education, College of Health Sciences, Methodist University of Piracicaba (UNIMEP), Piracicaba, SP, Brazil
| | - Silvia Aparecida Tavares
- Graduation Program in Physical Therapy, College of Health Sciences, Methodist University of Piracicaba (UNIMEP), Piracicaba, SP, Brazil
| | - Keiti Passoni de Souza
- Graduation Program in Physical Therapy, College of Health Sciences, Methodist University of Piracicaba (UNIMEP), Piracicaba, SP, Brazil
| | - Marcelo de Castro Cesar
- Post-Graduation Program in Physical Education, College of Health Sciences, Methodist University of Piracicaba (UNIMEP), Piracicaba, SP, Brazil
| | - Charles Ricardo Lopes
- Post-Graduation Program in Physical Education, College of Health Sciences, Methodist University of Piracicaba (UNIMEP), Piracicaba, SP, Brazil.,Faculty Adventist of Hortolândia (UNASP), Hortolândia, SP, Brazil
| | - Marlene Aparecida Moreno
- Post-Graduation Program in Physical Therapy, College of Health Sciences, Methodist University of Piracicaba (UNIMEP), Piracicaba, SP, Brazil
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23
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Valente M, Javorka M, Porta A, Bari V, Krohova J, Czippelova B, Turianikova Z, Nollo G, Faes L. Univariate and multivariate conditional entropy measures for the characterization of short-term cardiovascular complexity under physiological stress. Physiol Meas 2018; 39:014002. [PMID: 29135467 DOI: 10.1088/1361-6579/aa9a91] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE A defining feature of physiological systems under the neuroautonomic regulation is their dynamical complexity. The most common approach to assess physiological complexity from short-term recordings, i.e. to compute the rate of entropy generation of an individual system by means of measures of conditional entropy (CE), does not consider that complexity may change when the investigated system is part of a network of physiological interactions. This study aims at extending the concept of short-term complexity towards the perspective of network physiology, defining multivariate CE measures whereby multiple physiological processes are accounted for in the computation of entropy rates. APPROACH Univariate and multivariate CE measures are computed using state-of-the-art methods for entropy estimation and applied to time series of heart period (H), systolic (S) and diastolic (D) arterial pressure, and respiration (R) variability measured in healthy subjects monitored in a resting state and during conditions of postural and mental stress. MAIN RESULTS Compared with the traditional univariate metric of short-term complexity, multivariate measures provide additional information with plausible physiological interpretation, such as (i) the dampening of respiratory sinus arrhythmia and activation of the baroreflex control during postural stress; (ii) the increased complexity of heart period and blood pressure variability during mental stress, reflecting the effect of respiratory influences and upper cortical centers; (iii) the strong influence of D on S, mediated by left ventricular ejection fraction and vascular properties; (iv) the role of H in reducing the complexity of D, related to cardiac run-off effects; and (v) the unidirectional role of R in influencing cardiovascular variability. SIGNIFICANCE Our results document the importance of employing a network perspective in the evaluation of the short-term complexity of cardiovascular and respiratory dynamics across different physiological states.
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Affiliation(s)
- M Valente
- Department of Industrial Engineering and BIOtech, University of Trento, Trento, Italy
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Bari V, Ranucci M, De Maria B, Ranuzzi G, Pistuddi V, Porta A. Towards the identification of subjects prone to develop atrial fibrillation after coronary artery bypass graft surgery via univariate and multivariate complexity analysis of heart period variability. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2017; 2017:3126-3129. [PMID: 29060560 DOI: 10.1109/embc.2017.8037519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The assessment of cardiovascular control complexity as derived from spontaneous heart period (HP) fluctuations can be improved by exploiting a multivariate (MV) approach. This work proposes the assessment of a normalized complexity index (NCI) of HP variability according to a k-nearest-neighbor approach based on local predictability performed in a MV nonuniform embedding space. The method allows the selection of the past components of HP, systolic arterial pressure (SAP) and respiration (R) most useful for the prediction of HP fluctuations. The NCI derived from the MV approach (NCIMV) was compared to a NCI computed via the same technique applied in a univariate (UV) embedding space (NCIUV) formed exclusively by HP past samples. Indexes were computed in 130 patients undergoing coronary artery bypass graft (CABG) surgery before and after the induction of general anesthesia. Thirty-eight subjects developed atrial fibrillation (AF) after surgery, while the remaining ones did not (noAF, n=92). Both NCIUV and NCIMV could separate AF from noAF patients and revealed a larger complexity of the AF subjects. However, the statistical power of the NCIMV was superior given that the probability of type I error was smaller than that of NCIUV. The assessment of cardiac control complexity could improve risk stratification of patients at risk of developing AF after CABG surgery.
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Silva LEV, Lataro RM, Castania JA, Silva CAA, Salgado HC, Fazan R, Porta A. Nonlinearities of heart rate variability in animal models of impaired cardiac control: contribution of different time scales. J Appl Physiol (1985) 2017; 123:344-351. [PMID: 28495840 DOI: 10.1152/japplphysiol.00059.2017] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 03/29/2017] [Accepted: 04/29/2017] [Indexed: 02/08/2023] Open
Abstract
Heart rate variability (HRV) has been extensively explored by traditional linear approaches (e.g., spectral analysis); however, several studies have pointed to the presence of nonlinear features in HRV, suggesting that linear tools might fail to account for the complexity of the HRV dynamics. Even though the prevalent notion is that HRV is nonlinear, the actual presence of nonlinear features is rarely verified. In this study, the presence of nonlinear dynamics was checked as a function of time scales in three experimental models of rats with different impairment of the cardiac control: namely, rats with heart failure (HF), spontaneously hypertensive rats (SHRs), and sinoaortic denervated (SAD) rats. Multiscale entropy (MSE) and refined MSE (RMSE) were chosen as the discriminating statistic for the surrogate test utilized to detect nonlinearity. Nonlinear dynamics is less present in HF animals at both short and long time scales compared with controls. A similar finding was found in SHR only at short time scales. SAD increased the presence of nonlinear dynamics exclusively at short time scales. Those findings suggest that a working baroreflex contributes to linearize HRV and to reduce the likelihood to observe nonlinear components of the cardiac control at short time scales. In addition, an increased sympathetic modulation seems to be a source of nonlinear dynamics at long time scales. Testing nonlinear dynamics as a function of the time scales can provide a characterization of the cardiac control complementary to more traditional markers in time, frequency, and information domains.NEW & NOTEWORTHY Although heart rate variability (HRV) dynamics is widely assumed to be nonlinear, nonlinearity tests are rarely used to check this hypothesis. By adopting multiscale entropy (MSE) and refined MSE (RMSE) as the discriminating statistic for the nonlinearity test, we show that nonlinear dynamics varies with time scale and the type of cardiac dysfunction. Moreover, as complexity metrics and nonlinearities provide complementary information, we strongly recommend using the test for nonlinearity as an additional index to characterize HRV.
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Affiliation(s)
- Luiz Eduardo Virgilio Silva
- Department of Physiology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Renata Maria Lataro
- Department of Physiology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Jaci Airton Castania
- Department of Physiology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Carlos Alberto Aguiar Silva
- Department of Physiology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Helio Cesar Salgado
- Department of Physiology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Rubens Fazan
- Department of Physiology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil;
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy; and.,Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Donato, San Donato Milanese, Milan, Italy
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Schumann A, Schulz S, Voss A, Scharbrodt S, Baumert M, Bär KJ. Baroreflex Coupling Assessed by Cross-Compression Entropy. Front Physiol 2017; 8:282. [PMID: 28539889 PMCID: PMC5423936 DOI: 10.3389/fphys.2017.00282] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 04/19/2017] [Indexed: 11/13/2022] Open
Abstract
Estimating interactions between physiological systems is an important challenge in modern biomedical research. Here, we explore a new concept for quantifying information common in two time series by cross-compressibility. Cross-compression entropy (CCE) exploits the ZIP data compression algorithm extended to bivariate data analysis. First, time series are transformed into symbol vectors. Symbols of the target time series are coded by the symbols of the source series. Uncoupled and linearly coupled surrogates were derived from cardiovascular recordings of 36 healthy controls obtained during rest to demonstrate suitability of this method for assessing physiological coupling. CCE at rest was compared to that of isometric handgrip exercise. Finally, spontaneous baroreflex interaction assessed by CCEBRS was compared between 21 patients suffering from acute schizophrenia and 21 matched controls. The CCEBRS of original time series was significantly higher than in uncoupled surrogates in 89% of the subjects and higher than in linearly coupled surrogates in 47% of the subjects. Handgrip exercise led to sympathetic activation and vagal inhibition accompanied by reduced baroreflex sensitivity. CCEBRS decreased from 0.553 ± 0.030 at rest to 0.514 ± 0.035 during exercise (p < 0.001). In acute schizophrenia, heart rate, and blood pressure were elevated. Heart rate variability indicated a change of sympathovagal balance. The CCEBRS of patients with schizophrenia was reduced compared to healthy controls (0.546 ± 0.042 vs. 0.507 ± 0.046, p < 0.01) and revealed a decrease of blood pressure influence on heart rate in patients with schizophrenia. Our results indicate that CCE is suitable for the investigation of linear and non-linear coupling in cardiovascular time series. CCE can quantify causal interactions in short, noisy and non-stationary physiological time series.
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Affiliation(s)
- Andy Schumann
- Psychiatric Brain and Body Research Group, Department of Psychiatry and Psychotherapy, University Hospital JenaJena, Germany
| | - Steffen Schulz
- Institute of Innovative Health Technologies, Ernst-Abbe-Hochschule Jena, University of Applied Sciences JenaJena, Germany
| | - Andreas Voss
- Institute of Innovative Health Technologies, Ernst-Abbe-Hochschule Jena, University of Applied Sciences JenaJena, Germany
| | - Susann Scharbrodt
- Psychiatric Brain and Body Research Group, Department of Psychiatry and Psychotherapy, University Hospital JenaJena, Germany
| | - Mathias Baumert
- School of Electrical and Electronic Engineering, The University of AdelaideAdelaide, SA, Australia
| | - Karl-Jürgen Bär
- Psychiatric Brain and Body Research Group, Department of Psychiatry and Psychotherapy, University Hospital JenaJena, Germany
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Wejer D, Graff B, Makowiec D, Budrejko S, Struzik ZR. Complexity of cardiovascular rhythms during head-up tilt test by entropy of patterns. Physiol Meas 2017; 38:819-832. [PMID: 28263183 DOI: 10.1088/1361-6579/aa64a8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The head-up tilt (HUT) test, which provokes transient dynamical alterations in the regulation of cardiovascular system, provides insights into complex organization of this system. Based on signals with heart period intervals (RR-intervals) and/or systolic blood pressure (SBP), differences in the cardiovascular regulation between vasovagal patients (VVS) and the healthy people group (CG) are investigated. APPROACH Short-term relations among signal data represented symbolically by three-beat patterns allow to qualify and quantify the complexity of the cardiovascular regulation by Shannon entropy. Four types of patterns: permutation, ordinal, deterministic and dynamical, are used, and different resolutions of signal values in the the symbolization are applied in order to verify how entropy of patterns depends on a way in which values of signals are preprocessed. MAIN RESULTS At rest, in the physiologically important signal resolution ranges, independently of the type of patterns used in estimates, the complexity of SBP signals in VVS is different from the complexity found in CG. Entropy of VVS is higher than CG what could be interpreted as substantial presence of noisy ingredients in SBP of VVS. After tilting this relation switches. Entropy of CG occurs significantly higher than VVS for SBP signals. In the case of RR-intervals and large resolutions, the complexity after the tilt becomes reduced when compared to the complexity of RR-intervals at rest for both groups. However, in the case of VVS patients this reduction is significantly stronger than in CG. SIGNIFICANCE Our observations about opposite switches in entropy between CG and VVS might support a hypothesis that baroreflex in VVS affects stronger the heart rate because of the inefficient regulation (possibly impaired local vascular tone alternations) of the blood pressure.
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Affiliation(s)
- Dorota Wejer
- University of Gdańsk, Institute of Experimental Physics, 80-308 Gdańsk, ul Wita Stwosza 57, Poland
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Silva LEV, Silva CAA, Salgado HC, Fazan R. The role of sympathetic and vagal cardiac control on complexity of heart rate dynamics. Am J Physiol Heart Circ Physiol 2017; 312:H469-H477. [DOI: 10.1152/ajpheart.00507.2016] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 12/05/2016] [Accepted: 12/20/2016] [Indexed: 11/22/2022]
Abstract
Analysis of heart rate variability (HRV) by nonlinear approaches has been gaining interest due to their ability to extract additional information from heart rate (HR) dynamics that are not detectable by traditional approaches. Nevertheless, the physiological interpretation of nonlinear approaches remains unclear. Therefore, we propose long-term (60 min) protocols involving selective blockade of cardiac autonomic receptors to investigate the contribution of sympathetic and parasympathetic function upon nonlinear dynamics of HRV. Conscious male Wistar rats had their electrocardiogram (ECG) recorded under three distinct conditions: basal, selective (atenolol or atropine), or combined (atenolol plus atropine) pharmacological blockade of autonomic muscarinic or β1-adrenergic receptors. Time series of RR interval were assessed by multiscale entropy (MSE) and detrended fluctuation analysis (DFA). Entropy over short (1 to 5, MSE1–5) and long (6 to 30, MSE6–30) time scales was computed, as well as DFA scaling exponents at short (αshort, 5 ≤ n ≤ 15), mid (αmid, 30 ≤ n ≤ 200), and long (αlong, 200 ≤ n ≤ 1,700) window sizes. The results show that MSE1–5 is reduced under atropine blockade and MSE6–30 is reduced under atropine, atenolol, or combined blockade. In addition, while atropine expressed its maximal effect at scale six, the effect of atenolol on MSE increased with scale. For DFA, αshort decreased during atenolol blockade, while the αmid increased under atropine blockade. Double blockade decreased αshort and increased αlong. Results with surrogate data show that the dynamics during combined blockade is not random. In summary, sympathetic and vagal control differently affect entropy (MSE) and fractal properties (DFA) of HRV. These findings are important to guide future studies. NEW & NOTEWORTHY Although multiscale entropy (MSE) and detrended fluctuation analysis (DFA) are recognizably useful prognostic/diagnostic methods, their physiological interpretation remains unclear. The present study clarifies the effect of the cardiac autonomic control on MSE and DFA, assessed during long periods (1 h). These findings are important to help the interpretation of future studies.
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Affiliation(s)
| | | | - Helio Cesar Salgado
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Rubens Fazan
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
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Porta A, De Maria B, Bari V, Marchi A, Faes L. Are Nonlinear Model-Free Conditional Entropy Approaches for the Assessment of Cardiac Control Complexity Superior to the Linear Model-Based One? IEEE Trans Biomed Eng 2016; 64:1287-1296. [PMID: 27541327 DOI: 10.1109/tbme.2016.2600160] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE We test the hypothesis that the linear model-based (MB) approach for the estimation of conditional entropy (CE) can be utilized to assess the complexity of the cardiac control in healthy individuals. METHODS An MB estimate of CE was tested in an experimental protocol (i.e., the graded head-up tilt) known to produce a gradual decrease of cardiac control complexity as a result of the progressive vagal withdrawal and concomitant sympathetic activation. The MB approach was compared with traditionally exploited nonlinear model-free (MF) techniques such as corrected approximate entropy, sample entropy, corrected CE, two k -nearest-neighbor CE procedures and permutation CE. Electrocardiogram was recorded in 17 healthy subjects at rest in supine position and during head-up tilt with table angles of 15°, 30°, 45°, 60°, and 75°. Heart period (HP) was derived as the temporal distance between two consecutive R-wave peaks and analysis was carried out over stationary sequences of 256 successive HPs. RESULTS The performance of the MB method in following the progressive decrease of HP complexity with tilt table angles was in line with those of MF approaches and the MB index was remarkably correlated with the MF ones. CONCLUSION The MB approach can be utilized to monitor the changes of the complexity of the cardiac control, thus speeding up dramatically the CE calculation. SIGNIFICANCE The remarkable performance of the MB approach challenges the notion, generally assumed in cardiac control complexity analysis based on CE, about the need of MF techniques and could allow real-time applications.
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Silva LEV, Lataro RM, Castania JA, da Silva CAA, Valencia JF, Murta LO, Salgado HC, Fazan R, Porta A. Multiscale entropy analysis of heart rate variability in heart failure, hypertensive, and sinoaortic-denervated rats: classical and refined approaches. Am J Physiol Regul Integr Comp Physiol 2016; 311:R150-6. [PMID: 27225948 DOI: 10.1152/ajpregu.00076.2016] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 05/04/2016] [Indexed: 11/22/2022]
Abstract
The analysis of heart rate variability (HRV) by nonlinear methods has been gaining increasing interest due to their ability to quantify the complexity of cardiovascular regulation. In this study, multiscale entropy (MSE) and refined MSE (RMSE) were applied to track the complexity of HRV as a function of time scale in three pathological conscious animal models: rats with heart failure (HF), spontaneously hypertensive rats (SHR), and rats with sinoaortic denervation (SAD). Results showed that HF did not change HRV complexity, although there was a tendency to decrease the entropy in HF animals. On the other hand, SHR group was characterized by reduced complexity at long time scales, whereas SAD animals exhibited a smaller short- and long-term irregularity. We propose that short time scales (1 to 4), accounting for fast oscillations, are more related to vagal and respiratory control, whereas long time scales (5 to 20), accounting for slow oscillations, are more related to sympathetic control. The increased sympathetic modulation is probably the main reason for the lower entropy observed at high scales for both SHR and SAD groups, acting as a negative factor for the cardiovascular complexity. This study highlights the contribution of the multiscale complexity analysis of HRV for understanding the physiological mechanisms involved in cardiovascular regulation.
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Affiliation(s)
- Luiz Eduardo Virgilio Silva
- Department of Physiology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Renata Maria Lataro
- Department of Physiology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Jaci Airton Castania
- Department of Physiology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Carlos Alberto Aguiar da Silva
- Department of Physiology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | - Luiz Otavio Murta
- Department of Computing and Mathematics, School of Philosophy, Sciences and Letters, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Helio Cesar Salgado
- Department of Physiology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Rubens Fazan
- Department of Physiology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil;
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy; and Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy
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An alternative approach to approximate entropy threshold value (r) selection: application to heart rate variability and systolic blood pressure variability under postural challenge. Med Biol Eng Comput 2015; 54:723-32. [PMID: 26253284 DOI: 10.1007/s11517-015-1362-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 07/21/2015] [Indexed: 10/23/2022]
Abstract
This study presents an alternative approach to approximate entropy (ApEn) threshold value (r) selection. There are two limitations of traditional ApEn algorithm: (1) the occurrence of undefined conditional probability (CPu) where no template match is found and (2) use of a crisp tolerance (radius) threshold 'r'. To overcome these limitations, CPu is substituted with optimum bias setting ɛ opt which is found by varying ɛ from (1/N - m) to 1 in the increments of 0.05, where N is the length of the series and m is the embedding dimension. Furthermore, an alternative approach for selection of r based on binning the distance values obtained by template matching to calculate ApEnbin is presented. It is observed that ApEnmax, ApEnchon and ApEnbin converge for ɛ opt = 0.6 in 50 realizations (n = 50) of random number series of N = 300. Similar analysis suggests ɛ opt = 0.65 and ɛ opt = 0.45 for 50 realizations each of fractional Brownian motion and MIX(P) series (Lu et al. in J Clin Monit Comput 22(1):23-29, 2008). ɛ opt = 0.5 is suggested for heart rate variability (HRV) and systolic blood pressure variability (SBPV) signals obtained from 50 young healthy subjects under supine and upright position. It is observed that (1) ApEnbin of HRV is lower than SBPV, (2) ApEnbin of HRV increases from supine to upright due to vagal inhibition and (3) ApEnbin of BPV decreases from supine to upright due to sympathetic activation. Moreover, merit of ApEnbin is that it provides an alternative to the cumbersome ApEnmax procedure.
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Porta A, Nollo G, Faes L. Bridging the gap between the development of advanced biomedical signal processing tools and clinical practice. Preface. Physiol Meas 2015; 36:627-31. [PMID: 25798722 DOI: 10.1088/0967-3334/36/4/627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Porta A, Marchi A, Bari V, Heusser K, Tank J, Jordan J, Barbic F, Furlan R. Conditional symbolic analysis detects nonlinear influences of respiration on cardiovascular control in humans. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2015; 373:rsta.2014.0096. [PMID: 25548269 PMCID: PMC4281867 DOI: 10.1098/rsta.2014.0096] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
We propose a symbolic analysis framework for the quantitative characterization of complex dynamical systems. It allows the description of the time course of a single variable, the assessment of joint interactions and an analysis triggered by a conditioning input. The framework was applied to spontaneous variability of heart period (HP), systolic arterial pressure (SAP) and integrated muscle sympathetic nerve activity (MSNA) with the aim of characterizing cardiovascular control and nonlinear influences of respiration at rest in supine position, during orthostatic challenge induced by 80° head-up tilt (TILT) and about 3 min before evoked pre-syncope signs (PRESY). The approach detected (i) the exaggerated sympathetic modulation and vagal withdrawal from HP variability and the increased presence of fast MSNA variability components during PRESY compared with TILT; (ii) the increase of the SAP-HP coordination occurring at slow temporal scales and a decrease of that occurring at faster time scales during PRESY compared with TILT; (iii) the reduction of the coordination between fast MSNA and SAP patterns during TILT and PRESY; (iv) the nonlinear influences of respiration leading to an increased likelihood to observe the abovementioned findings during expiration compared with inspiration one. The framework provided simple, quantitative indexes able to distinguish experimental conditions characterized by different states of the autonomic nervous system and to detect the early signs of a life threatening situation such as postural syncope.
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Affiliation(s)
- Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy IRCCS Galeazzi Orthopedic Institute, Milan, Italy
| | - Andrea Marchi
- Department of Anesthesia and Intensive Care Unit, Rozzano, Milan, Italy
| | - Vlasta Bari
- Department of Cardiothoracic-Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy
| | - Karsten Heusser
- Institut für Klinische Pharmakologie, Medizinische Hochschule Hannover, Hannover, Germany
| | - Jens Tank
- Institut für Klinische Pharmakologie, Medizinische Hochschule Hannover, Hannover, Germany
| | - Jens Jordan
- Institut für Klinische Pharmakologie, Medizinische Hochschule Hannover, Hannover, Germany
| | - Franca Barbic
- Department of Internal Medicine, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Raffaello Furlan
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy Department of Internal Medicine, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
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Porta A, Baumert M, Cysarz D, Wessel N. Enhancing dynamical signatures of complex systems through symbolic computation. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2015; 373:rsta.2014.0099. [PMID: 25548265 PMCID: PMC4281870 DOI: 10.1098/rsta.2014.0099] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Affiliation(s)
- Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy IRCCS Galeazzi Orthopedic Institute, Milan, Italy
| | - Mathias Baumert
- School of Electrical and Electronic Engineering, University of Adelaide, Adelaide, South Australia, Australia
| | - Dirk Cysarz
- Integrated Curriculum for Anthroposophic Medicine, University of Witten/Herdecke, Witten, Germany Institute of Integrative Medicine, University of Witten/Herdecke, Witten, Germany
| | - Niels Wessel
- Department of Physics, Humboldt-Universität zu Berlin, Berlin, Germany
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Tamburús NY, Rebelo ACS, César MDC, Catai AM, Takahashi ACDM, Andrade CP, Porta A, Silva ED. Relação entre a variabilidade da frequência cardíaca e VO 2pico em mulheres ativas. REV BRAS MED ESPORTE 2014. [DOI: 10.1590/1517-86922014200502010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJETIVO: Ava+liar a associação entre os índices da variabilidade da frequência cardíaca (VFC) e a aptidão cardiorrespiratória.MÉTODOS: Sessenta e duas mulheres (idade 22,1 ± 3,3 anos) foram divididas em quatro grupos: treinamento aeróbio (AER, n = 15), treinamento de força (FOR, n = 13), treinamento combinado (aeróbio e força) (AER+FOR, n = 15) e controle (C, n = 19). O teste cardiopulmonar foi realizado para avaliar a aptidão cardiorrespiratória a partir do consumo de oxigênio pico (VO2pico). A FC foi coletada em repouso na postura supina. A VFC foi analisada a partir de métodos lineares e não lineares.RESULTADOS: Os grupos AER e AER+FOR apresentaram maiores índices da VFC (lineares e não lineares) indicadores da modulação vagal e menores índices da VFC indicadores da modulação simpática, em relação ao grupo C. Os grupos AER e AER+FOR apresentaram maior complexidade e menor regularidade dos intervalos RR e maior VO2pico em relação aos grupos FOR e C. O VO2picoapresentou correlação com os índices da VFC.CONCLUSÃO: Este estudo mostrou que o treinamento físico aeróbio e combinado contribuíram significativamente para maior modulação autônoma da FC e aptidão cardiorrespiratória. A modulação autônoma da FC, avaliada a partir de métodos lineares e não lineares, está associada ao maior consumo de oxigênio.
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Multiscale complexity analysis of the cardiac control identifies asymptomatic and symptomatic patients in long QT syndrome type 1. PLoS One 2014; 9:e93808. [PMID: 24705789 PMCID: PMC3976293 DOI: 10.1371/journal.pone.0093808] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 03/06/2014] [Indexed: 01/08/2023] Open
Abstract
The study assesses complexity of the cardiac control directed to the sinus node and to ventricles in long QT syndrome type 1 (LQT1) patients with KCNQ1-A341V mutation. Complexity was assessed via refined multiscale entropy (RMSE) computed over the beat-to-beat variability series of heart period (HP) and QT interval. HP and QT interval were approximated respectively as the temporal distance between two consecutive R-wave peaks and between the R-wave apex and T-wave end. Both measures were automatically taken from 24-hour electrocardiographic Holter traces recorded during daily activities in non mutation carriers (NMCs, n = 14) and mutation carriers (MCs, n = 34) belonging to a South African LQT1 founder population. The MC group was divided into asymptomatic (ASYMP, n = 11) and symptomatic (SYMP, n = 23) patients according to the symptom severity. Analyses were carried out during daytime (DAY, from 2PM to 6PM) and nighttime (NIGHT, from 12PM to 4AM) off and on beta-adrenergic blockade (BBoff and BBon). We found that the complexity of the HP variability at short time scale was under vagal control, being significantly increased during NIGHT and BBon both in ASYMP and SYMP groups, while the complexity of both HP and QT variability at long time scales was under sympathetic control, being smaller during NIGHT and BBon in SYMP subjects. Complexity indexes at long time scales in ASYMP individuals were smaller than those in SYMP ones regardless of therapy (i.e. BBoff or BBon), thus suggesting that a reduced complexity of the sympathetic regulation is protective in ASYMP individuals. RMSE analysis of HP and QT interval variability derived from routine 24-hour electrocardiographic Holter recordings might provide additional insights into the physiology of the cardiac control and might be fruitfully exploited to improve risk stratification in LQT1 population.
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Porta A, Żebrowski J. Inferring cardiovascular control from spontaneous variability. Auton Neurosci 2013; 178:1-3. [PMID: 23746470 DOI: 10.1016/j.autneu.2013.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Indexed: 11/25/2022]
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Schulz S, Ritter J, Oertel K, Witt K, Bär KJ, Guntinas-Lichius O, Voss A. Quantification of autonomic regulation in patients with sudden sensorineural hearing loss. Auton Neurosci 2013; 178:9-14. [DOI: 10.1016/j.autneu.2013.02.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Revised: 12/17/2012] [Accepted: 02/04/2013] [Indexed: 11/29/2022]
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Porta A, Bari V, Bassani T, Marchi A, Tassin S, Canesi M, Barbic F, Furlan R. Entropy-based complexity of the cardiovascular control in Parkinson disease: comparison between binning and k-nearest-neighbor approaches. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2013; 2013:5045-8. [PMID: 24110869 DOI: 10.1109/embc.2013.6610682] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Entropy-based approaches are frequently used to quantify complexity of short-term cardiovascular control from spontaneous beat-to-beat variability of heart period (HP) and systolic arterial pressure (SAP). Among these tools the ones optimizing a critical parameter such as the pattern length are receiving more and more attention. This study compares two entropy-based techniques for the quantification of complexity making use of completely different strategies to optimize the pattern length. Comparison was carried out over HP and SAP variability series recorded from 12 Parkinson's disease (PD) patients without orthostatic hypotension or symptoms of orthostatic intolerance and 12 age-matched healthy control (HC) subjects. Regardless of the method, complexity of cardiovascular control increased in PD group, thus suggesting the early impairment of cardiovascular function.
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Porta A, Faes L. Assessing causality in brain dynamics and cardiovascular control. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2013; 371:20120517. [PMID: 23858491 PMCID: PMC5397300 DOI: 10.1098/rsta.2012.0517] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Affiliation(s)
- Alberto Porta
- Department of Biomedical Sciences for Health, Galeazzi Orthopaedic Institute, University of Milan, 20161 Milan, Italy.
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41
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Schulz S, Bär KJ, Voss A. Cardiovascular and cardiorespiratory coupling in unmedicated schizophrenic patients in comparison to healthy subjects. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2013; 2012:3664-7. [PMID: 23366722 DOI: 10.1109/embc.2012.6346761] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Schizophrenia is associated with a cardiac autonomic dysregulation which is characterized by a decreased vagal modulation. Nevertheless, there are less information about the interrelationships of the cardiovascular and respiratory systems in schizophrenia.
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Affiliation(s)
- S Schulz
- University of Applied Sciences Jena, Department of Medical Engineering and Biotechnology, Jena, Germany.
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42
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Camargo S, Riedl M, Anteneodo C, Kurths J, Wessel N. Diminished heart beat non-stationarities in congestive heart failure. Front Physiol 2013; 4:107. [PMID: 23720631 PMCID: PMC3654225 DOI: 10.3389/fphys.2013.00107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Accepted: 04/26/2013] [Indexed: 11/13/2022] Open
Abstract
Studies on heart rate variability (HRV) have become popular and the possibility of diagnosis based on non-invasive techniques compels us to overcome the difficulties originated on the environmental changes that can affect the signal. We perform a non-parametric segmentation which consists of locating the points where the signal can be split into stationary segments. By finding stationary segments we are able to analyze the size of these segments and evaluate how the signal changes from one segment to another, looking at the statistical moments given in each patch, for example, mean and variance. We analyze HRV data for 15 patients with congestive heart failure (CHF; 11 males, 4 females, age 56±11 years), 18 elderly healthy subjects (EH; 11 males, 7 females, age 50±7 years), and 15 young healthy subjects (YH; 11 females, 4 males, age 31±6 years). Our results confirm higher variance for YH, and EH, while CHF displays diminished variance with p-values <0.01, when compared to the healthy groups, presenting higher HRV in healthy subjects. Moreover, it is possible to distinguish between YH and EH with p < 0.05 through the segmentation outcomes. We found high correlations between the results of segmentation and standard measures of HRV analysis and a connection to results of detrended fluctuation analysis (DFA). The segmentation applied to HRV studies detects aging and pathological conditions effects on the non-stationary behavior of the analyzed groups, promising to contribute in complexity analysis and providing risk stratification measures.
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Affiliation(s)
- Sabrina Camargo
- Department of Physics, Humboldt-Universität zu Berlin Berlin, Germany ; Department of Physics, PUC-Rio Rio de Janeiro, Brazil
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43
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Pagani M, Lucini D, Porta A. Sympathovagal balance from heart rate variability: time for a second round? Exp Physiol 2013; 97:1141-2. [PMID: 23015734 DOI: 10.1113/expphysiol.2012.066977] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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44
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Bari V, Valencia JF, Vallverdu M, Girardengo G, Bassani T, Marchi A, Calvillo L, Caminal P, Cerutti S, Brink PA, Crotti L, Schwartz PJ, Porta A. Refined multiscale entropy analysis of heart period and QT interval variabilities in long QT syndrome type-1 patients. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2013; 2013:5554-5557. [PMID: 24110995 DOI: 10.1109/embc.2013.6610808] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This study assesses complexity of cardiovascular control in patients affected by type-1 variant of long QT (LQT1) syndrome. Complexity was assessed by refined multiscale entropy of heart period (HP) and QT interval variabilities. HP was taken as the time distance between two consecutive R peaks (RR) and QT interval was approximated as the time distance between the R-peak and T-wave apex (RTa) and between R-peak and T-wave end (RTe). RR, RTa and RTe intervals were automatically extracted from 24h Holter recordings and the daytime period was analyzed (from 02:00 to 06:00 PM). Non mutation carrier (NMC) individuals (n=11), utilized as a control group, were taken from the same family line of the mutation carrier (MC) subjects (n=26). We found that, while NMC and MC groups were indistinguishable based on time domain and complexity analyses of RR dynamics, complexity analysis of RTa and RTe variabilities clearly separates the two populations and suggests an impairment in the cardiac control mechanisms acting on the ventricles.
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45
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Porta A, Castiglioni P, Rienzo MD, Bari V, Bassani T, Marchi A, Takahashi ACM, Tobaldini E, Montano N, Catai AM, Barbic F, Furlan R, Cividjian A, Quintin L. Short-term complexity indexes of heart period and systolic arterial pressure variabilities provide complementary information. J Appl Physiol (1985) 2012; 113:1810-20. [DOI: 10.1152/japplphysiol.00755.2012] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
It is unclear whether the complexity of the variability of the systolic arterial pressure (SAP) provides complementary information to that of the heart period (HP). The complexity of HP and SAP variabilities was assessed from short beat-to-beat recordings (i.e., 256 cardiac beats). The evaluation was made during a pharmacological protocol that induced vagal blockade with atropine or a sympathetic blockade (beta-adrenergic blockade with propranolol or central sympathetic blockade with clonidine) alone or in combination, during a graded head-up tilt, and in patients with Parkinson's disease (PD) without orthostatic hypotension undergoing orthostatic challenge. Complexity was quantified according to the mean square prediction error (MSPE) derived from univariate autoregressive (AR) and multivariate AR (MAR) models. We found that: 1) MSPEMAR did not provide additional information to that of MSPEAR; 2) SAP variability was less complex than that of HP; 3) because HP complexity was reduced by either vagal blockade or vagal withdrawal induced by head-up tilt and was unaffected by beta-adrenergic blockade, HP was under vagal control; 4) because SAP complexity was increased by central sympathetic blockade and was unmodified by either vagal blockade or vagal withdrawal induced by head-up tilt, SAP was under sympathetic control; 5) SAP complexity was increased in patients with PD; and 6) during orthostatic challenge, the complexity of both HP and SAP variabilities in patients with PD remained high, thus indicating both vagal and sympathetic impairments. Complexity indexes derived from short HP and SAP beat-to-beat series provide complementary information and are helpful in detecting early autonomic dysfunction in patients with PD well before circulatory symptoms become noticeable.
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Affiliation(s)
- A. Porta
- Department of Biomedical Sciences for Health, Galeazzi Orthopedic Institute, University of Milan, Milan, Italy
| | | | | | - V. Bari
- Gruppo Ospedaliero San Donato Foundation, Milan, Italy
- Department of Bioengineering, Politecnico di Milano, Milan, Italy
| | - T. Bassani
- Department of Biomedical Sciences for Health, Galeazzi Orthopedic Institute, University of Milan, Milan, Italy
| | - A. Marchi
- Department of Emergency, L. Sacco Hospital, Milan, Italy
| | - A. C. M. Takahashi
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, Brazil
| | - E. Tobaldini
- Department of Biomedical and Clinical Sciences, Internal Medicine II, L. Sacco Hospital, University of Milan, Milan, Italy
| | - N. Montano
- Department of Biomedical and Clinical Sciences, Internal Medicine II, L. Sacco Hospital, University of Milan, Milan, Italy
| | - A. M. Catai
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, Brazil
| | - F. Barbic
- Medical Clinics, Istituto Clinico Humanitas, Rozzano, Milan, Italy
| | - R. Furlan
- Department of Medical Biotechnologies and Translation Medicine, Medical Clinics, Istituto Clinico Humanitas, University of Milan, Rozzano, Milan, Italy; and
| | - A. Cividjian
- Physiology (EA 4612: Neurocardiology), University of Lyon, Lyon, France
| | - L. Quintin
- Physiology (EA 4612: Neurocardiology), University of Lyon, Lyon, France
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Takahashi ACM, Porta A, Melo RC, Quitério RJ, da Silva E, Borghi-Silva A, Tobaldini E, Montano N, Catai AM. Aging reduces complexity of heart rate variability assessed by conditional entropy and symbolic analysis. Intern Emerg Med 2012; 7:229-35. [PMID: 21253879 DOI: 10.1007/s11739-011-0512-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2010] [Accepted: 01/05/2011] [Indexed: 12/31/2022]
Abstract
Increasing age is associated with a reduction in overall heart rate variability as well as changes in complexity of physiologic dynamics. The aim of this study was to verify if the alterations in autonomic modulation of heart rate caused by the aging process could be detected by Shannon entropy (SE), conditional entropy (CE) and symbolic analysis (SA). Complexity analysis was carried out in 44 healthy subjects divided into two groups: old (n = 23, 63 ± 3 years) and young group (n = 21, 23 ± 2). It was analyzed SE, CE [complexity index (CI) and normalized CI (NCI)] and SA (0V, 1V, 2LV and 2ULV patterns) during short heart period series (200 cardiac beats) derived from ECG recordings during 15 min of rest in a supine position. The sequences characterized by three heart periods with no significant variations (0V), and that with two significant unlike variations (2ULV) reflect changes in sympathetic and vagal modulation, respectively. The unpaired t test (or Mann-Whitney rank sum test when appropriate) was used in the statistical analysis. In the aging process, the distributions of patterns (SE) remain similar to young subjects. However, the regularity is significantly different; the patterns are more repetitive in the old group (a decrease of CI and NCI). The amounts of pattern types are different: 0V is increased and 2LV and 2ULV are reduced in the old group. These differences indicate marked change of autonomic regulation. The CE and SA are feasible techniques to detect alteration in autonomic control of heart rate in the old group.
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Affiliation(s)
- Anielle C M Takahashi
- Physiotherapy Department, Federal University of São Carlos, São Carlos, São Paulo, Brazil.
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47
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Wessel N, van Leeuwen P. Computing complexity in cardiovascular oscillations: selected papers from the 6th Conference of the ESGCO. Comput Biol Med 2012; 42:265-6. [PMID: 22325358 DOI: 10.1016/j.compbiomed.2012.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Accepted: 01/19/2012] [Indexed: 01/18/2023]
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Gapelyuk A, Riedl M, Suhrbier A, Kraemer JF, Bretthauer G, Malberg H, Kurths J, Penzel T, Wessel N. Cardiovascular regulation in different sleep stages in the obstructive sleep apnea syndrome. ACTA ACUST UNITED AC 2011; 56:207-13. [DOI: 10.1515/bmt.2011.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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49
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Liu CS, Tseng WK, Lee JK, Hsiao TC, Lin CW. The differential method of phase space matrix for AF/VF discrimination application. Med Eng Phys 2010; 32:444-53. [DOI: 10.1016/j.medengphy.2010.04.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2009] [Revised: 02/10/2010] [Accepted: 04/02/2010] [Indexed: 10/19/2022]
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