Reduced short-term complexity of heart rate and blood pressure dynamics in patients with diabetes mellitus type 1: multiscale entropy analysis

Trunkvalterova, Zuzana; Javorka, Michal; Tonhajzerová, Ingrid; Javorková, J; Lazarová, Z; Javorka, K; Baumert, Mathias

doi:10.1088/0967-3334/29/7/010

Cited by 70 publications

(45 citation statements)

References 25 publications

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“…Nonlinear measures encompass a heterogeneous group of statistics, several of which quantify the entropy or complexity of the signal. Multiscale sample entropy is one such statistic that has been used to distinguish patients with cardiovascular pathologies from healthy subjects (10,29,30) and is predictive of mortality in trauma and heart failure patients (17,21,22,26).…”

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confidence: 99%

Validation of pulse rate variability as a surrogate for heart rate variability in chronically instrumented rabbits

Pellegrino

Schiller

Zucker

2014

American Journal of Physiology-Heart and Circulatory Physiology

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Pellegrino PR, Schiller AM, Zucker IH. Validation of pulse rate variability as a surrogate for heart rate variability in chronically instrumented rabbits. Am J Physiol Heart Circ Physiol 307: H97-H109, 2014. First published May 2, 2014; doi:10.1152/ajpheart.00898.2013.-Heart rate variability (HRV) is a function of cardiac autonomic tone that is widely used in both clinical and animal studies. In preclinical studies, HRV measures are frequently derived using the arterial pulse waveform from an implanted pressure telemetry device, termed pulse rate variability (PRV), instead of the electrocardiogram signal in accordance with clinical guidelines. The acceptability of PRV as a surrogate for HRV in instrumented animals is unknown. Using rabbits implanted with intracardiac leads and chronically implanted pressure transducers, we investigated the correlation and agreement of timedomain, frequency-domain, and nonlinear indexes of HRV and PRV at baseline. We also investigated the effects of ventricular pacing and autonomic blockade on both measures. At baseline, HRV and PRV time-and frequency-domain parameters showed robust correlations and moderate to high agreement, whereas nonlinear parameters showed slightly weaker correlations and varied agreement. Ventricular pacing almost completely eliminated HRV, and spectral analysis of the PRV signal revealed a HRV-independent rhythm. After cardiac autonomic blockade with atropine or metoprolol, the changes in timeand non-normalized frequency-domain measures of PRV continued to show strong correlations and moderate to high agreement with corresponding changes in HRV measures. Blockade-induced changes in nonlinear PRV indexes correlated poorly with HRV changes and showed weak agreement. These results suggest that time-and frequency-domain measures of PRV are acceptable surrogates for HRV even in the context of changing cardiac autonomic tone, but caution should be used when nonlinear measures are a primary end point or when HRV is very low as HRV-independent rhythms may predominate.heart rate variability; pulse rate variability; pulse interval; sympathovagal balance

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mentioning

confidence: 99%

Validation of pulse rate variability as a surrogate for heart rate variability in chronically instrumented rabbits

Pellegrino

Schiller

Zucker

2014

American Journal of Physiology-Heart and Circulatory Physiology

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“…In addition, the MC-ApEn analysis between left fingertip PPG pulse amplitudes with other different physiological signals of ECG R-R intervals demonstrated similar results. Costa et al and Trunkvalterova et al have demonstrated that the small-scale MSE of heart rate variability-reflecting autonomic function-was decreased in diabetes, and similarly, the large-scale MSE of pulse transit times-a surrogate of peripheral arteriosclerosis-was also lower in diabetes [24,25]. The MSE index of unilateral finger PPG pulse amplitudes may reflect peripheral vascular health of the tested upper extremity side.…”

Section: Discussionmentioning

confidence: 96%

Multiscale Cross-Approximate Entropy Analysis of Bilateral Fingertips Photoplethysmographic Pulse Amplitudes among Middle-to-Old Aged Individuals with or without Type 2 Diabetes

Yang

Lin

et al. 2017

Entropy

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Abstract:Multiscale cross-approximate entropy (MC-ApEn) between two different physiological signals could evaluate cardiovascular health in diabetes. Whether MC-ApEn analysis between two similar signals such as photoplethysmographic (PPG) pulse amplitudes of bilateral fingertips can reflect diabetes status is unknown. From a middle-to-old-aged population free of prior cardiovascular disease, we selected the unaffected (no type 2 diabetes, n = 36), the well-controlled diabetes (glycated hemoglobin (HbA1c) <8%, n = 30), and the poorly-controlled diabetes (HbA1c ≥8%, n = 26) groups. MC-ApEn indexes were calculated from simultaneous consecutive 1500 PPG pulse amplitudes signals of bilateral index fingertips. The average of scale factors 1-5 (MC-ApEn SS ) and of scale factors 6-10 (MC-ApEn LS ) were defined as the small-and large-scales MC-ApEn, respectively. The MC-ApEn LS index was highest in the unaffected, followed by the well-controlled diabetes, and then the poorly-controlled diabetes (0.70, 0.62, and 0.53; all paired p-values were <0.05); in contrast, the MC-ApEn SS index did not differ between groups. Our findings suggested that the bilateral fingertips large-scale MC-ApEn LS index of PPG pulse amplitudes might be able to evaluate the glycemic status and detect subtle vascular disease in type 2 diabetes.

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“…However, the influence of handgrip strength on any time scales MSE or RMSE was not remarkable in individuals without diabetes and those with poorly controlled diabetes. Several physiological signals such as sleep electroencephalographic wave [26], electromyographic signals [27], body temperature [28], intracranial pressure [29], pulse rate [12], and blood pressure [15] have been used for MSE analysis to mainly evaluate autonomic nervous dysfunction, cardiovascular disease, treatment effect, and disease prognosis. Trunkvalterova et al revealed that the MSE of blood pressures and pulse rate at scale factor = 3 in patients with type 1 diabetes were significantly lower than those in the unaffected controls [15].…”

Section: Discussionmentioning

confidence: 99%

“…By contrast, the nonlinearity of large-time scales MSE are much related to autonomic sympathetic activity and established cardiovascular disease [14]. Previous reports have shown that the MSE of heart rate, blood pressure, and pulse wave velocity might be more sensitive than the linear analysis of HRV parameters to detect subclinical vascular abnormalities in diabetes [15,16].…”

Section: Introductionmentioning

confidence: 99%

Glycemic Control, Hand Activity, and Complexity of Biological Signals in Diabetes Mellitus

Lin

Haryadi

et al. 2017

Complexity

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Both glycemic control and handgrip strength affect microvascular function. Multiscale entropy (MSE) of photoplethysmographic (PPG) pulse amplitudes may differ by diabetes status and hand activity. Of a middle-to-old aged and right-handed cohort without clinical cardiovascular disease, we controlled age, sex, and weight to select the unaffected (no type 2 diabetes, = 36), the wellcontrolled diabetes (HbA1c < 8%, = 22), and the poorly controlled diabetes (HbA1c ≥ 8%, = 22) groups. MSEs were calculated from consecutive 1,500 PPG pulse amplitudes of bilateral index fingertips. The small-, medium-, and large-scale MSEs were defined as the average of scale 1 (MSE 1 ), scales 2-4 (MSE 2-4 ), and scales 5-10 (MSE 5-10 ), respectively. Intra-and intergroups were compared by one-and two-sample -tests, respectively. The dominant hand MSE 5-10 was lower in the poorly controlled diabetes group than the well-controlled diabetes and the unaffected (1.28 versus 1.52 and 1.56, = 0.019 and 0.001, resp.) groups, whereas the nondominant hand MSE 5-10 was lower in the well-and poorly controlled diabetes groups than the unaffected group (1.35 and 1.29 versus 1.58, = 0.008 and 0.005, resp.). The MSE 1 of dominant hand was higher than that of nondominant hand in the well-controlled diabetes (1.35 versus 1.10, = 0.048). In conclusion, diabetes status and hand dominance may affect the MSE of PPG pulse amplitudes.

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Reduced short-term complexity of heart rate and blood pressure dynamics in patients with diabetes mellitus type 1: multiscale entropy analysis

Cited by 70 publications

References 25 publications

Validation of pulse rate variability as a surrogate for heart rate variability in chronically instrumented rabbits

Validation of pulse rate variability as a surrogate for heart rate variability in chronically instrumented rabbits

Multiscale Cross-Approximate Entropy Analysis of Bilateral Fingertips Photoplethysmographic Pulse Amplitudes among Middle-to-Old Aged Individuals with or without Type 2 Diabetes

Glycemic Control, Hand Activity, and Complexity of Biological Signals in Diabetes Mellitus

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