Heart rate variability in young patients with diabetes mellitus and healthy subjects explored by Poincaré and sequence plots

Abstract

Autonomic neuropathy is a common complication of the diabetes mellitus (DM). The significance of its early diagnosis is very high because the mortality of the patients with this complication is elevated. Considering the effort to apply new mathematical methods to cardiac dysregulation diagnosis, the major aim of the study was to ascertain which of the new heart rate variability (HRV) parameters are different in young patients with DM type 1 compared with control group. The next aim was to assess the HRV changes during prolonged (40 min) supine rest. The heart rate was continuously recorded during supine rest in 17 young patients with DM type 1 (10 women, 7 men) aged 22.4 +/- 1.0 years (mean +/- SEM). The control group consisted of 17 healthy matched probands. The HRV (time/frequency domains, Poincare and sequence plots, sample entropy) was analysed in two intervals - T1 starting at fifth minute and T2 starting at 30th minute of supine rest. The major results of our study are: the reduced Poincare plot pattern measures in the young DM group; the lower percentage of points in the third quadrant of sequence plot (this parameter was not correlated with the mean heart rate) and significant changes in HRV during supine rest in DM group (in contrast to control subjects). In conclusion, HRV parameters based on nonlinear dynamics were able to distinguish cardiac dysregulation in young patients with DM from the control group. The percentage of points in the third quadrant of sequence plot provides information that is not dependent on mean heart rate. Poincare and sequence plots, together with the rate of HRV changes during supine rest, can provide clinically relevant information usable in diagnosis of the cardiac dysregulation.

Effect of high intensity intermittent training on heart rate variability in prepubescent children

“…On the contrary a large HRV is a favourable prognostic in the decrease of disorder incidence for apparently healthy men (Molgaard et al 1991) or in the advancement of disease for patients (Hayano et al 1991). Likewise, low HRV in childhood is associated with several paediatric issues such as congenital heart diseases (Massin and von Bernuth 1998), obesity (Gutin et al 2000) or diabetes (Javorka et al 2005). Moreover, the decrease of the HRV is coupled with the worsening of the disease (Gutin et al 2000;Javorka et al 2005).…”

“…Likewise, low HRV in childhood is associated with several paediatric issues such as congenital heart diseases (Massin and von Bernuth 1998), obesity (Gutin et al 2000) or diabetes (Javorka et al 2005). Moreover, the decrease of the HRV is coupled with the worsening of the disease (Gutin et al 2000;Javorka et al 2005).…”

Graphical and Numerical Evaluation of Continuous Glucose Sensing Time Lag

“…For example, a cigar-shaped plot along the principal diagonal (x ϭ y) would reveal high autocorrelation within the time series, while a circular plot would reveal periodicity (the Poincaré plot of a sine wave or a pendulum is a circle). The Poincaré plot has been used extensively to describe heart rate variability [15][16][17][18][19] and was also introduced to the analysis of CGM time series. 20 In this paper, we propose an altered Poincaré-type plot, which extends the visualization of system dynamics to depiction of the co-dynamics of BG and CGM.…”

Diabetic Microangiopathy - Etiopathogenesis, New Possibilities in Diagnostics and Management

“…This study showed "the effect of metabolic memory" where each period of worsened compensation can negativelly influence the prognosis of the diabetic patient. Some studies with lower number of patients did not confirm the association between diabetes compensation and chronic complications (M. Javorka et al, 2005).…”

“…The biggest study aimed at chronic diabetic complications, EURODIAB IDDM Complication Study, confirmed the significant correlation between glycosylation hemoglobin level and cardiovascular neuropathy. Even some authors denied this relation (M. Javorka et al, 2005), the optimal glycemia maintenance is strongly recommended as a prevention of diabetic complication origin. Children diabetic patients are treated by intensified insulin regimen.…”