Is a Reduced Entropy in Heart Rate Variability an Early Finding of Silent Cardiac Neurovegetative Dysautonomia in Type 2 Diabetes Mellitus? (original) (raw)
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Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference, 2008
Cardiac autonomic neuropathy (CAN) in diabetes has been called a 'silent killer', because so few patients realize that they suffer from it, and yet its effect can be lethal. Early sub clinical detection of CAN and intervention are of prime importance for risk stratification in preventing sudden death due to silent myocardial infarction. This study presents the usefulness of heart rate variability (HRV) and complexity analyses from short term ECG recordings as a screening tool for CAN. Poincaré plot indexes and sample entropy (SampEn) measure of HRV were used for analyzing variability (short and long term) and complexity respectively. Analyses were performed on the different length of HRV records during supine rest. Reduced Poincaré plot patterns and higher SampEn were found in CAN+ group. Significant changes in HRV parameters of CAN+ group during the course of supine rest were found in contrast to control group (CAN-). Our results demonstrated the potential utility of nonlin...
Renyi entropy in identification of cardiac autonomic neuropathy in diabetes
2012
Heart rate variability (HRV) has been conventionally analyzed with time- and frequency-domain methods. More recent nonlinear analysis has shown an increased sensitivity for identifying risk of future morbidity and mortality in diverse patient groups. Included in the domain of nonlinear analysis are the multiscale entropy measures. The Renyi entropy is such a measure. It is calculated by considering the probability of sequences of values occurring in the HRV data. An exponent α of the probability can be varied to provide a spectrum of measures. In this work we applied the multiscale Renyi entropy for identification of cardiac autonomic neuropathy (CAN) in diabetes patients. Fifteen participants were identified with CAN (dCAN) using the five-test Ewing battery and 26 were control (nCAN). The multiscale Renyi entropy was measured from -5<;α<;+5. The best result was obtained with α=5, where the mean value for patients with CAN was 0.98 with standard deviation of 0.01, compared wit...
Complexity of heart rate variability in type 2 diabetes - effect of hyperglycemia
Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference, 2013
Heart rate variability (HRV) is reduced in diabetes mellitus (DM) patients, suggesting dysfunction of cardiac autonomic regulation which has been associated with increased risk for pathological cardiac events. In this paper, we examined changes in HRV complexity in association to blood glucose level (BGL) and duration of diabetes. Resting HRV and BGL measurements of 32 healthy controls and 54 type 2 DM (T2DM) patients were analyzed. HRV complexity was assessed using Shannon entropy, sample entropy (SampEn), multiscale entropy (MSE), and multiscale Renyi entropy. HRV complexity increased with hyperglycemia indicated by increases in Shannon entropy and MSE and decreases in Renyi entropy for negative orders. Diabetes duration was strongly associated with Renyi entropy which increased for positive orders and decreased for negative orders as a function of disease duration. Shannon entropy, SampEn and MSE did not correlate with disease duration.
2008
Diabetes mellitus is a serious and increasing health problem worldwide. An increased risk for all cardiovascular disease compared to non-diabetic patients including dysfunctional neural control of the heart. The clinical manifestations of cardiac autonomic neuropathy (CAN) include heart rate variability. Poor diagnoses of CAN may result in increased incidence of silent myocardial infarction and ischemia, which can lead to sudden death. This study examined the usefulness of HRV analyses of short ECG recordings as a method for detecting CAN utilizing the traditional Ewing battery as a standard for identification of CAN. Several HRV parameters were assessed including time and frequency domain as well as nonlinear parameters. The advantage of the newer nonlinear HRV measures such as approximate entropy (ApEn) is that they are model independent, suitable for nonlinear processes, and measure aspects of HRV different from the traditional methods such as standard deviation or spectral analysis. Eighteen of 38 individuals with diabetes were positive for two or more of the Ewing battery of tests indicating CAN. Approximate Entropy (ApEn), log normalized total power (LnTP) and log normalized high frequency (LnHF) power were different in CAN+ to CAN-individuals (p < 0.05). This indicates that nonlinear scaling parameters are able to identify people with cardiac autonomic neuropathy in short ECG recordings. CSU ID: CSU285503
2007
Diabetes mellitus is a serious and increasing health problem world-wide. An increased risk for all cardiovascular disease compared to non-diabetic patients including dysfunctional neural control of the heart. The clinical manifestations of cardiac autonomic neuropathy (CAN) include heart rate variability. Poor diagnoses of CAN may result in increased incidence of silent myocardial infarction and ischemia, which can lead to sudden death. This study examined the usefulness of HRV analyses of short ECG recordings as a method for detecting CAN utilizing the traditional Ewing battery as a standard for identification of CAN. Several HRV parameters were assessed including time and frequency domain as well as nonlinear parameters. The advantage of the newer nonlinear HRV measures such as approximate entropy (ApEn) is that they are model independent, suitable for nonlinear processes, and measure aspects of HRV different from the traditional methods such as standard deviation or spectral analysis. Eighteen of 38 individuals with diabetes were positive for two or more of the Ewing battery of tests indicating CAN. Approximate Entropy (ApEn), log normalized total power (LnTP) and log normalized high frequency (LnHF) power were different in CAN + to CAN individuals (p < 0.05). This indicates that nonlinear scaling parameters are able to identify people with cardiac autonomic neuropathy in short ECG recordings.
Identifying diabetic patients with cardiac autonomic neuropathy by heart rate complexity analysis
BioMedical Engineering OnLine, 2009
Background: Cardiac autonomic neuropathy (CAN) in diabetes has been called a "silent killer", because so few patients realize that they suffer from it, and yet its effect can be lethal. Early sub clinical detection of CAN and intervention are of prime importance for risk stratification in preventing sudden death due to silent myocardial infarction. This study presents the usefulness of heart rate variability (HRV) and complexity analyses from short term ECG recordings as a screening tool for CAN.
A study of heart rate variability in diabetic mellitus patients
INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine)
Background. Heart rate variability (HRV) is reduced in diabetes mellitus (DM) patients, suggesting dysfunction of cardiac autonomic regulation and an increased risk for cardiac events. Cardiac autonomic neuropathy (CAN), which results from damage to autonomic nerve fibers that innervate the heart and blood vessels, is a serious complication of DM. During progression of CAN, the parasympathetic nerve fibers innervating the heart are affected before the sympathetic nerve fibers leading to a reduced heart rate variability. The purpose of this study was to examine type 2 diabetes patients with heart rate variability in order to diagnose autonomic dysfunction and to relate the findings to other complications of diabetes mellitus. Materials and methods. 41 type 2 M patients and 45 age- and sex-matched controls were included. In the time domain we measured the mean R–R interval (NN), the standard deviation of the R–R interval index (SDNN), the standard deviation of the 5-min R–R interval m...
Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference, 2013
Cardiovascular autonomic neuropathy (CAN) is one of the most severe complications of type 2 diabetes mellitus (T2DM). The aim of this study was to investigate associations of cardiac sympathetic dysinnervation (CSD; by 123I-MIBG scintigraphy) with short-term heart rate variability (HRV) measured by traditional vs. complexity markers. ECG was measured in 31 diabetic patients during rest over a period of 5 minutes and HRV quantified in different domains (time and frequency domain, scaling properties, symbolic dynamics). 123I-MIBG scintigraphy identified 16 patients with CSD. Resting heart rate was increased and HRV reduced in these patients. In a subgroup of 16 patients ECG was also measured during standing. Changes in several HRV measures upon standing demonstrated cardiac responsiveness to orthostatic stress. Strong correlations between HRV, measured during standing, and CSD were observed with metrics based on symbolic dynamics. In conclusion, HRV assessment during standing may be useful for assessing cardiac sympathetic dysinnervation in patients with type 2 diabetes mellitus.
Atypical Cardiac Autonomic Neuropathy Identified with Entropy Measures
Cardiology and Angiology: An International Journal, 2015
Aims: To identify Cardiac Autonomic Neuropathy (CAN) from a range of measures extracted from Heart Rate Variability (HRV), including higher moments of RR intervals and a spectrum of entropy measures of RR intervals. Study Design: Analysis of HRV measured from participants at a diabetes screening clinic. Groups were compared using t-tests to identify variables that provide separation between groups.