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Heart rate variability and nonlinear dynamic analysis in patients with stress-induced cardiomyopathy

Medical & Biological Engineering & Computing volume 50, pages 1037–1046 (2012)Cite this article

Abstract

Complexity-based analyses may quantify abnormalities in heart rate variability (HRV). The aim of this study was to investigate the clinical and prognostic significances of dynamic HRV changes in patients with stress-induced cardiomyopathy Takotsubo syndrome (TS) by means of linear and nonlinear analysis. Patients with TS were included in study after complete noninvasive and invasive cardiovascular diagnostic evaluation and compared to an age and gender matched control group of healthy subjects. Series of R–R interval and of ST–T interval values were obtained from 24-h ECG recordings after digital sampling. HRV analysis was performed by ‘range rescaled analysis’ to determine the Hurst exponent, by detrended fluctuation analysis to quantify fractal long-range correlation properties, and by approximate entropy to assess time-series predictability. Short- and long-term fractal-scaling exponents were significantly higher in patients with TS in acute phases, opposite to lower approximate entropy and Hurst exponent, but all variables normalized in a few weeks. Dynamic HRV analysis allows assessing changes in complexity features of HRV in TS patients during the acute stage, and to monitor recovery after treatment, thus complementing traditional ECG and clinically analysis.

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Authors and Affiliations

  1. Institute for Cardiovascular Diseases and Rehabilitation, Head of Cardiovascular Department, Draskoviceva 13, 10 000, Zagreb, Croatia

    Goran Krstacic

  2. Istituto Auxologico Italiano, Ospedale San Luca and Universita di Milan-Biccoca, Milan, Italy

    Gianfranco Parati

  3. Institute Rudjer Boskovic, Zagreb, Croatia

    Dragan Gamberger

  4. Don C. Gnocchi Foundation, Milan, Italy

    Paolo Castiglioni

  5. University Hospital Centre Sisters of Mercy, Clinic of Traumatology, Zagreb, Croatia

    Antonija Krstacic

  6. Clinical Hospital Centre Osijek, Osijek, Croatia

    Robert Steiner

Authors
  1. Goran Krstacic
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  2. Gianfranco Parati
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  3. Dragan Gamberger
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  4. Paolo Castiglioni
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  5. Antonija Krstacic
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  6. Robert Steiner
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Correspondence to Goran Krstacic.

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Krstacic, G., Parati, G., Gamberger, D. et al. Heart rate variability and nonlinear dynamic analysis in patients with stress-induced cardiomyopathy. Med Biol Eng Comput 50, 1037–1046 (2012). https://doi.org/10.1007/s11517-012-0947-z

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  • DOI: https://doi.org/10.1007/s11517-012-0947-z

Keywords

  • Heart rate variability
  • Nonlinear dynamics
  • Chaos theory
  • Stress-induced cardiomyopathy
  • Takotsubo syndrome