Automatic quantification of the Poincaré plot asymmetry of NN-interval recordings

Esperer, Hans D.; Oehler, Martin K.

doi:10.1088/0967-3334/31/3/008

Cited by 9 publications

(4 citation statements)

References 26 publications

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“…Our study, in accordance to the work of other research groups (Esperer and Oehler 2010, Karmakar et al 2009, Piskorski and Guzik 2007, Porta et al 2008, clearly detected HRA. According to our investigation, HRA is the reflection of and could be influenced by the ratio of inspiration/expiration duration.…”

Section: Discussionsupporting

confidence: 93%

Heart rate asymmetry follows the inspiration/expiration ratio in healthy volunteers

et al. 2012

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Heart rate asymmetry (HRA) quantifies the uneven distribution of points above and below the identity-line in a Poincaré plot of RR-intervals. The authors investigated if HRA could be influenced by the inspiration/expiration ratio. Healthy volunteers (n = 18) were studied in the supine position at 4.5 s metronome breathing. ECG and breathing signals were recorded for 360 s at each breathing pattern: inspiration controlled, inspiration/expiration controlled (1:2, 1:1, 2:1 ratio), inspiration controlled again. Time domain, frequency domain and Poincaré plot heart rate variability (HRV) analysis with Porta's and Guzik's indices were performed on 300 s tachograms. There were no statistically significant differences in time domain, frequency domain and standard Poincaré plot parameters during the various breathing patterns, whereas Porta's and Guzik's indices significantly rose at 1:1 and 2:1 compared to physiological 1:2 breathing. There were no significant differences in the HRA parameters between the first and the last runs. In our population the inspiration/expiration ratio significantly influenced HRA, but not standard HRV parameters. Positive correlation of Guzik's and Porta's index reflects reciprocal changes of the number of points and their dispersion in the accelerating and decelerating sets of RR-intervals. HRA-analysis can be a promising method for investigating cardiovascular regulation/health particularly with further spreading of wearable monitors.

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Section: Discussionsupporting

confidence: 93%

Heart rate asymmetry follows the inspiration/expiration ratio in healthy volunteers

et al. 2012

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“…The abnormalities that observed in the restitution steeper and Lorenz plots indicated that there are alterations in the effective refractory periods and the influences of the autonomic tone on the beat to beat interval. [22232425] This observation documented the experimental study used rat in which tonic convulsive seizures played a role on the distortion of the cardiac autonomic regulation and thereby induced changes in the duration of cardiac arrhythmia. [26] One of the limitations of the study is the genetic study did not carry to link between the patients who are vulnerable to cardiac arrhythmias with the mutation of certain genes.…”

Section: Discussionmentioning

confidence: 96%

Epileptic Patients are at Risk of Cardiac Arrhythmias: A Novel Approach using QT-nomogram, Tachogram, and Cardiac Restitution Plots

Al-Nimer

Al-Mahdawi

Abdullah

et al. 2017

Journal of Neurosciences in Rural Practice

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Background:Sudden death is reported in patients who had a history of epilepsy and some authors believed that is due to cardiac arrhythmias.Objectives:This study aimed to predict that the epileptic patients are at risk of serious cardiac arrhythmias by QT-nomogram, tachogram (Lorenz), and cardiac restitution plots.Methods:A total number of 71 healthy subjects (Group I) and 64 newly diagnosed epileptic patients (Group II) were recruited from Al-Yarmouk and Baghdad Teaching hospitals in Baghdad from March 2015 to July 2015 and included in this study. The diagnosis of epilepsy achieved clinically, electroencephalograph record and radio-images including computerized tomography and magnetic image resonance. At the time of entry into the study, an electrocardiography (ECG) was done, and the determinants of each ECG record were calculated. The QT-nomogram, tachogram, and cardiac restitution plots were used to identify the patients at risk of cardiac arrhythmias.Results:Significant prolonged corrected QT corrected (QTc) and JT corrected intervals were observed in female compared with male at age ≥50 years while the TQ interval was significantly prolonged in males of Group II. Eight patients of Group II had a significant pathological prolonged QTc interval compared with undetectable finding in Group I. QT nomogram did not disclose significant findings while the plots of Lorenz and restitution steepness disclose that the patients of Group II were vulnerable to cardiac arrhythmias. Abnormal ECG findings were observed in the age extremities (≤18 years and ≥50 years) in Group II compared with Group I.Conclusion:Utilization of QT-nomogram, restitution steepness, and tachogram plots is useful tools for detection subclinical vulnerable epileptic patient with cardiac arrhythmias.

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“…Heart rate asymmetry (HRA) was initially described as a visible phenomenon, mostly present in healthy subjects, which can be assessed by visual inspection using a Poincaré plot (Guzik et al 2006, Karmakar et al 2009, Piskorski and Guzik 2007, 2011. Various approach exists for defining HRA using Poincaré plot (Guzik et al 2006, Karmakar et al 2009, Esperer and Oehler 2010. According to Guzik et al, HRA is defined as the imbalance of acceleration and deceleration of heart rate (Guzik et al 2006).…”

Section: Introductionmentioning

confidence: 99%

Phase asymmetry of heart rate variability signal

2015

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Heart rate asymmetry (HRA) is considered as a physiological phenomenon in healthy subjects. In this article, we propose a novel HRA index, Slope Index (SI), to quantify phase asymmetry of heart rate variability (HRV) system. We assessed the performance of proposed index in comparison with conventional (Guzik's Index (GI) and Porta's Index (PI)) HRA indices. As illustrative examples, we used two case studies: (i) differentiate physiologic RR series from synthetic RR series; and (ii) discriminate arrhythmia subjects from Healthy using beat-to-beat heart rate time series. The results showed that SI is a superior parameter than GI and PI for both case studies with maximum ROC area of 0.84 and 0.82 respectively. In contrast, GI and PI had ROC areas {0.78, 0.61} and {0.50, 0.56} in two case studies respectively. We also performed surrogate analysis to show that phase asymmetry is caused by a physiologic phenomena rather than a random nature of the signal. In conclusion, quantification of phase asymmetry of HRV provides additional information on HRA, which might have a potential clinical use to discriminate pathological HRV in future.

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Automatic quantification of the Poincaré plot asymmetry of NN-interval recordings

Cited by 9 publications

References 26 publications

Heart rate asymmetry follows the inspiration/expiration ratio in healthy volunteers

Heart rate asymmetry follows the inspiration/expiration ratio in healthy volunteers

Epileptic Patients are at Risk of Cardiac Arrhythmias: A Novel Approach using QT-nomogram, Tachogram, and Cardiac Restitution Plots

Phase asymmetry of heart rate variability signal

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