Approximate entropy of fetal heart rate variability as a predictor of fetal distress in women at term pregnancy

Li, Xiaotian; Zheng, Dali; Zhou, Shu‐Feng; Tang, Dakan; Wang, Caiyan; Wu, Guoqiang

doi:10.1111/j.0001-6349.2005.00773.x

Cited by 32 publications

(20 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Depression of HRV is associated with adverse outcomes in a number of chronic and acute pathological states, including myocardial infarction (17), congestive heart failure (3), diabetes (19), fetal asphyxia (18), and sepsis (6). In all of these conditions, the assumption has been that there is abnormal signaling from or response to the autonomic nervous system, though mechanistic studies are few.…”

mentioning

confidence: 99%

Endotoxin depresses heart rate variability in mice: cytokine and steroid effects

Fairchild¹,

Saucerman

Raynor³

et al. 2009

American Journal of Physiology-Regulatory, Integrative and Comp

108

View full text Add to dashboard Cite

Heart rate variability (HRV) falls in humans with sepsis, but the mechanism is not well understood. We utilized a mouse model of endotoxemia to test the hypothesis that cytokines play a role in abnormal HRV during sepsis. Adult male C57BL/6 mice underwent surgical implantation of probes to continuously monitor electrocardiogram and temperature or blood pressure via radiotelemetry. Administration of high-dose LPS (Escherichia coli LPS, 10 mg/kg, n = 10) caused a biphasic response characterized by an early decrease in temperature and heart rate at 1 h in some mice, followed by a prolonged period of depressed HRV in all mice. Further studies showed that LPS doses as low as 0.01 mg/kg evoked a significant decrease in HRV. With high-dose LPS, the initial drops in temperature and HR were temporally correlated with peak expression of TNFalpha 1 h post-LPS, whereas maximal depression in HRV coincided with peak levels of multiple other cytokines 3-9 h post-LPS. Neither hypotension nor hypothermia explained the HRV response. Pretreatment with dexamethasone prior to LPS significantly blunted expression of 7 of the 10 cytokines studied and shortened the duration of depressed HRV by about half. Interestingly, dexamethasone treatment alone caused a dramatic increase in both low- and high-frequency HRV. Administration of recombinant TNFalpha caused a biphasic response in HR and HRV similar to that caused by LPS. Understanding the role of cytokines in abnormal HRV during sepsis could lead to improved strategies for detecting life-threatening nosocomial infections in intensive care unit patients.

show abstract

mentioning

confidence: 99%

Endotoxin depresses heart rate variability in mice: cytokine and steroid effects

Fairchild¹,

Saucerman

Raynor³

et al. 2009

American Journal of Physiology-Regulatory, Integrative and Comp

108

View full text Add to dashboard Cite

show abstract

“…Some studies questioned its diagnostic value (24). Recent studies in human fetuses suggested potential of FHR variability (fHRV) complexity estimation to improve clinical monitoring of fetal health (18,31). This requires a deeper understanding of the physiological meaning of fHRV complexity, including how its linear and nonlinear properties are modulated by sympathetic and vagal activity of the autonomic nervous system (ANS).…”

mentioning

confidence: 99%

Nonlinear properties of vagal and sympathetic modulations of heart rate variability in ovine fetus near term

Frasch¹,

Müller²,

Hoyer³

et al. 2009

American Journal of Physiology-Regulatory, Integrative and Comp

View full text Add to dashboard Cite

Frasch MG, Mü ller T, Hoyer D, Weiss C, Schubert H, Schwab M. Nonlinear properties of vagal and sympathetic modulations of heart rate variability in ovine fetus near term. Am J Physiol Regul Integr Comp Physiol 296: R702-R707, 2009. First published December 17, 2008; doi:10.1152/ajpregu.90474.2008.-Fetal heart rate (FHR) monitoring is commonly used although clinical studies questioned its diagnostic value. Sophisticated FHR variability (fHRV) measures such as fHRV complexity may improve the sensitivity and specificity of FHR monitoring. A more detailed understanding of the physiology underlying fHRV complexity is essential to harness its use for monitoring fetal health. To examine the specific effects of vagal and sympathetic modulations on fHRV complexity, we blocked vagal activity with atropine and sympathetic activity with propranolol in near-term fetal sheep (n ϭ 7, 0.85 gestation). Under these conditions, we analyzed the linear and nonlinear parts of fHRV complexity from autonomic information flow. Overall fHRV complexity decreased with both drugs compared with nonrapid eye movement sleep baseline (P Ͻ 0.05). With atropine, this was because of a decrease of the linear part of fHRV complexity on the long-term time scale (P Ͻ 0.05), suggesting that vagal modulation of fHRV is adequately described by linear fHRV measures. With propranolol, the nonlinear part of fHRV complexity decreased on the short-term time scale (P Ͻ 0.05), suggesting that sympathetic influences on fHRV can be detected by the nonlinear part of fHRV complexity. Thus the complex interplay of vagal and sympathetic modulations of fHRV is reflected differently and specifically in the linear and nonlinear properties of fHRV complexity, and on different time scales. Analysis of linear and nonlinear properties of fHRV may improve sensitivity and specificity of FHR monitoring. fetal sheep; autonomic nervous system; autonomic information flow; complexity FETAL HEART RATE (FHR) monitoring is used to monitor fetal well-being noninvasively in utero. Some studies questioned its diagnostic value (24). Recent studies in human fetuses suggested potential of FHR variability (fHRV) complexity estimation to improve clinical monitoring of fetal health (18,31). This requires a deeper understanding of the physiological meaning of fHRV complexity, including how its linear and nonlinear properties are modulated by sympathetic and vagal activity of the autonomic nervous system (ANS). Understanding fHRV dynamics during physiological (e.g., sleep states dependent changes) and pathophysiological (e.g., asphyxia) conditions has evolved over the past two decades, propelled by analyses of the linear aspects of fHRV in human and ovine fetuses (4,11,16,20,29,32). However, characterization of the linear fHRV properties is fundamentally limited in its power to describe the nonlinear structure of the underlying sympathovagal interactions (12,14).The origin of the nonlinearity of sympathovagal interactions lies in their intrinsic complexity. This complexity emerges from intera...

show abstract

“…The decreased nonlinear indices found in cases of severe MA infer fetal hypoxia, and there might be an indirect relationship between the maternal Hb content and fetal pO 2 [20]. We found that as maternal Hb increased (Figure 2), there was a trend towards increased entropy and fractal indices.…”

Section: Discussionmentioning

confidence: 56%

“…Other studies [20,37] have shown that the ApEn of FHR variability was associated not only with fetal hypoxemia, but also with respiratory and metabolic acidosis.…”

Section: Discussionmentioning

confidence: 88%

Complex and irregular heart rate dynamics in fetuses compromised by maternal anemia as a high-risk pregnancy

Park

Hoh

2014

Journal of Perinatal Medicine

View full text Add to dashboard Cite

show abstract

Approximate entropy of fetal heart rate variability as a predictor of fetal distress in women at term pregnancy

Cited by 32 publications

References 36 publications

Endotoxin depresses heart rate variability in mice: cytokine and steroid effects

Endotoxin depresses heart rate variability in mice: cytokine and steroid effects

Nonlinear properties of vagal and sympathetic modulations of heart rate variability in ovine fetus near term

Complex and irregular heart rate dynamics in fetuses compromised by maternal anemia as a high-risk pregnancy

Contact Info

Product

Resources

About