Linear and nonlinear analysis of short-term heart rate variability in patients with coronary artery disease
DOI:
https://doi.org/10.28957/rcmfr.315Keywords:
Coronary artery disease, Autonomic Nervous System, Heart Rate, Entropy, Bayes’ TheoremAbstract
Introduction. The short-term heart rate variability (HRV) is a physiological parameter that is associated with the cardiovascular health and has been used in the management of coronary artery disease (CAD) to characterize the cardiovascular dynamics and to evaluate the effect of therapeutic interventions.
Objectives. To characterize the short-term HRV in patients with CAD through linear and nonlinear measurements, and to evaluate the effect of potential third variables on the HRV in the study group.
Methods. Analytical observational study in which the clinical records of 24 patients with CAD and a mean age of 60,1±7,11 years were reviewed. The RR intervals at rest were recorded using a Polar H7 monitor during 15 minutes. The linear analysis was performed with parameters in the time and frequency domains, and the nonlinear, with the sample entropy (SampEn) and the Poincaré plot; autonomic indexes were also included and Bayesian inference was performed to evaluate the effect of third variables and the correlation between the HRV indexes.
Results. The linear analysis showed a decrease in the HRV, beat to beat, and the nonlinear evidenced a decrease in the overall variability. The autonomicindexessuggested a positive sympathetic-vagal balance, with a trend towards increased sympathetic and decreased parasympathetic activity. SampEn was the parameter that presented the lowest dispersion, and the spectral indexesin logarithmic units showed aweak correlation with some metabolic variables.
Conclusion. The HRV allows us to characterize the cardiovascular dynamics in patients with CAD, including the autonomic balance; furthermore, the nonlinear approximation offers a sensitive and potentially more robust measurement alternative. However, the effect of some metabolic variables on the association between HRV and independent factors should be considered.
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