Atypical Cardiac Autonomic Neuropathy Identified with Entropy Measures (original) (raw)
Related papers
2009
This study presents the usefulness of tone-entropy (T-E) analysis of heart rate variability (HRV) using short term ECG recordings (~20 minutes) for screening the degree of severity (mild, definite and severe) of cardiac autonomic neuropathy (CAN). Tone reflects sympathovagal balance whose validity has been already examined on typical physiological cases. Entropy which is the autonomic regularity activity was evaluated though Shannon entropy of HRV. Both indexes were defined on a distribution of successive variations of heart periods. The results showed that the tone was high and the entropy was low in the definite group compared with the early and normal group. When the result was plotted in twodimensional T-E space, it revealed a curve-linear relation between the tone and entropy. The findings could form the basis of a cheap and non-invasive test for screening CAN in patients with or without diabetes.
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...
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.
Cardiac Autonomic Neuropathy Measured by Heart Rate variability
Cardiac autonomic neuropathy (CAN) is a critical complication of type 2 diabetes mellitus (T2DM). Heart rate variability (HRV) is a noninvasive tool to assess cardiac autonomic function. We aimed to evaluate whether CAN is associated with increased risk of atherosclerosis in T2DM. A total of 57 diabetic and 54 nondiabetic subjects, free of coronary heart disease, were recruited. Carotid intima media thickness (CIMT), coronary calcium score (CAC), and brachial Flow Mediated Dilation (FMD) were measured. Heart rate variability and vagal components of autonomic function were determined. Significant reduction of normalized HF power (P < 0.05) and total power (P < 0.01) was observed in T2DM. CIMT and CAC scores were significantly higher while FMD was significantly lower in diabetics (P < 0.01 for all). Median HbA 1c levels were significantly higher in diabetics. CIMT was inversely and independently associated with total power both in diabetics and controls (P < 0.01 for both groups). There was also an inverse association between total power and median HbA 1c . Autonomic dysfunction, especially parasympathetic neuropathy, was present since early-stage T2DM. This was related to subclinical atherosclerosis. Early detection of cardiac autonomic neuropathy can help us detect the development of atherosclerosis earlier in T2DM to prevent unfavorable outcomes.
Using Renyi entropy to detect early cardiac autonomic neuropathy
Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference, 2013
Cardiac Autonomic Neuropathy (CAN) is a disease that involves nerve damage leading to abnormal control of heart rate. CAN affects the correct operation of the heart and in turn leads to associated arrhythmias and heart attack. An open question is to what extent this condition is detectable by the measurement of Heart Rate Variability (HRV). An even more desirable option is to detect CAN in its early, preclinical stage, to improve treatment and outcomes. In previous work we have shown a difference in the Renyi spectrum between participants identified with well-defined CAN and controls. In this work we applied the multi-scale Renyi entropy for identification of early CAN in diabetes patients. Results suggest that Renyi entropy derived from a 20 minute, Lead-II ECG recording, forms a useful contribution to the detection of CAN even in the early stages of the disease. The positive α parameters (1 ≤ α ≤ 5) associated with the Renyi distribution indicated a significant difference (p < ...
Purpose: The present study examined whether HRV is predictive of CAN in patients with DMII. Subjects and methods: The study group consisted of 50 patients, newly diagnosed with type 2 diabetes mellitus. The control group consisted of 50 healthy subjects. HRV was measured using a 24-hour ECG Holter monitoring system. Time domain parameters used are: SDNN, and SDANN. Results: There are significant differences between disease duration. Orthostatic hypotension was found in 14 patients and heart rate increased over 100 at rest was found in 28 patients. HRV parameters are lower in DM group but differences are significant only for SDNN. From the total group, more than half had HRV parameters below the normal range (56%). Of the asymptomatic patients, 14 (28%) had abnormal HRV parameters. Decreased HRV was found in newly diagnosed type two DM. Conclusion: HRV is decreased in newly diagnosed DM II. Heart Rate Variability (HRV) is a Powerful Predictor in the Early Diagnosis of Cardiac Autonomic Neuropathy (CAN) In Patients with Type Two Diabetes Mellitus (DM II). [Abdulhalim Salim Serafi. Heart Rate Variability (HRV) is a Powerful Predictor IN the Early Diagnosis of Cardiac Autonomic Neuropathy (CAN) In Patients with Type Two Diabetes Mellitus (DM II). Life Sci J
2015
In this work we compare three multiscale measures for their ability to discriminate between participants having cardiac autonomic neuropathy (CAN) and aged controls. CAN is a disease that involves nerve damage leading to an abnormal control of heart rate, so one would expect disease progression to manifest in changes to heart rate variability (HRV). We applied multiscale entropy (MSE), multi fractal detrended fluctuation analysis (MFDFA), and Renyi entropy (RE) to recorded datasets of RR intervals. The latter measure provided the best separation (lowest p-value in Mann-Whitney tests) between classes of participants having CAN, early CAN or no CAN (controls). This comparison suggests the efficacy of RE as a measure for diagnosis of CAN and its progression, when compared to the other multiscale measures.
Entropy, 2015
In this work we compare three multiscale measures for their ability to discriminate between participants having cardiac autonomic neuropathy (CAN) and aged controls. CAN is a disease that involves nerve damage leading to an abnormal control of heart rate, so one would expect disease progression to manifest in changes to heart rate variability (HRV). We applied multiscale entropy (MSE), multi fractal detrended fluctuation analysis (MFDFA), and Renyi entropy (RE) to recorded datasets of RR intervals. The latter measure provided the best separation (lowest p-value in Mann-Whitney tests) between classes of participants having CAN, early CAN or no CAN (controls). This comparison suggests the efficacy of RE as a measure for diagnosis of CAN and its progression, when compared to the other multiscale measures.
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...