Usefulness of heart rhythm complexity in heart failure detection and diagnosis

Abstract

Heart failure (HF) is a major cardiovascular disease worldwide, and the early detection and diagnosis remain challenges. Recently, heart rhythm complexity analysis, derived from non-linear heart rate variability (HRV) analysis, has been proposed as a non-invasive method to detect diseases and predict outcomes. In this study, we aimed to investigate the diagnostic value of heart rhythm complexity in HF patients. We prospectively analyzed 55 patients with symptomatic HF with impaired left ventricular ejection fraction and 97 participants without HF symptoms and normal LVEF as controls. Traditional linear HRV parameters and heart rhythm complexity including detrended fluctuation analysis (DFA) and multiscale entropy (MSE) were analyzed. The traditional linear HRV, MSE parameters and DFAα1 were significantly lower in HF patients compared with controls. In regression analysis, DFAα1 and MSE scale 5 remained significant predictors after adjusting for multiple clinical variables. Among all HRV parameters, MSE scale 5 had the greatest power to differentiate the HF patients from the controls in receiver operating characteristic curve analysis (area under the curve: 0.844). In conclusion, heart rhythm complexity appears to be a promising tool for the detection and diagnosis of HF.

Effects of Cardiac Resynchronization Therapy on Cardio-Respiratory Coupling

“…Findings from previous studies have indicated a strong negative correlation of the short-term scaling exponent of RR interval series with the level of sympathetic activity, i.e., with the plasma levels of circulating catecholamines [ 42 ]. Therefore, it is expected that in heart failure, accompanied by strong sympathetic activation, a decrease in the value of this exponent is recorded [ 43 ]. Moreover, it has been shown that lower α 1 (RR) is associated with increased mortality and hospitalization rate in patients with heart failure and that this exponent is independent predictor of heart failure [ 43 , 44 ].…”

“…Therefore, it is expected that in heart failure, accompanied by strong sympathetic activation, a decrease in the value of this exponent is recorded [ 43 ]. Moreover, it has been shown that lower α 1 (RR) is associated with increased mortality and hospitalization rate in patients with heart failure and that this exponent is independent predictor of heart failure [ 43 , 44 ]. We found that in CRT responders, nine months after device implantation, α 1 (RR) increases slightly but reaches values that are statistically significantly higher than in non-responders.…”

“…The long-term scaling exponent of RR interval series has been less studied in heart failure, but the results of several studies have shown that its values are statistically significantly higher in patients with heart failure with reduced ejection fraction compared to healthy controls [ 43 , 49 , 50 ]. In this work, we found a slight reduction of α 2 (RR) at follow-up examination in CRT responders.…”

Differences in Heart Rate Variability and Body Composition in Breast Cancer Survivors and Women Without Cancer

“…Promising nonlinear tools have been introduced to describe the complexity of HRV, which presents the advantage of not being affected by nonstationary effects than typical linear HRV indexes 17 . The nonlinear methods have shown great promise in the detection and diagnosis of heart failure 18 . However, in BCS, the nonlinear properties of cardiac dynamics related to changes in the autonomic nervous system (ANS) and complexity have not been fully elucidated.…”

Differences in heart rate variability and body composition in breast cancer survivors and women without cancer

“…Both methodologies are especially useful given that minimize the effects of non-stationarities 22,23 . The nonlinear methods have shown great promise in the detection and diagnosis of heart failure 24 and the evaluation of physical condition and wellbeing during physical activity tests 25 . However, in BCS, the nonlinear properties of cardiac dynamics related to changes in the autonomic nervous system (ANS) and complexity have not been fully elucidated.…”