Measurements of Cardiovascular Signal Complexity for Advanced Clinical Applications
Abstract
Over the last decades, there has been an increasing interest in the analysis of Heart Rate Variability (HRV). Many parameters were proposed to properly describe the complex systems controlling the heart rate, while involving neural mechanisms (through the Autonomic Nervous System), as well as mechanical and humoral factors. After a first effort to rationalize all these parameters in 1996 (the “HRV Task Force”), a second paper in 2015, reported the consensus reached on the critical review of the new methods. The latter tried in particular to address the clinical impact of the nonlinear techniques, considering only studies with sufficiently sized populations. In this chapter, we relax the constrain on the number of patients and try to identify all those techniques which resonated in the scientific community and were applied and studied more than others. To guide our analysis, we considered a different set of objective criteria, based mainly on the number of citations received.
Our analysis show that all the parameters which were clinically relevant in the 2015 paper, proved also to have a significant impact in the methodological literature. However, other parameters received much more methodological interest than the clinical results they were capable to provide. Among these: several entropy measures and the metrics derived from nonlinear dynamical systems, multifractality and wavelets. The reasons of this lack of clinical results might be many, but the complexity of these techniques and the disconnection, which frequently happens between bioscientists/biomedical engineers and medical centers, are likely possible explanations.
References
- 1.Heart rate variability standards of measurement, physiological interpretation, and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation. 93(5), 1043–1065 (1996)Google Scholar
- 2.Sassi, R., et al.: Advances in heart rate variability signal analysis: joint position statement by the e-Cardiology ESC Working Group and the European Heart Rhythm Association co-endorsed by the Asia Pacific Heart Rhythm Society. Europace. 17(9), 1341–1353 (2015)CrossRefPubMedGoogle Scholar
- 3.Kobayashi, M., Musha, T.: 1/f fluctuation of heartbeat period. I.E.E.E. Trans. Biomed. Eng. BME-29(6), 456–457 (1982)CrossRefGoogle Scholar
- 4.Saul, J.P., Albrecht, P., Berger, R.D., Cohen, R.J.: Analysis of long term heart rate variability: methods, 1/f scaling and implications. Comput. Cardiol. 14, 419–422 (1988)PubMedGoogle Scholar
- 5.Lombardi, F., et al.: Linear and nonlinear dynamics of heart rate variability after acute myocardial infarction with normal and reduced left ventricular ejection fraction. Am. J. Cardiol. 77(15), 1283–1288 (1996)CrossRefPubMedGoogle Scholar
- 6.Huikuri, H.V., Mäkikallio, T.H., Peng, C.-K., Goldberger, A.L., Hintze, U., Møller, M.: Fractal correlation properties of R–R interval dynamics and mortality in patients with depressed left ventricular function after an acute myocardial infarction. Circulation. 101(1), 47–53 (2000)CrossRefGoogle Scholar
- 7.Bauer, A., et al.: Deceleration capacity of heart rate as a predictor of mortality after myocardial infarction: cohort study. Lancet. 367(9523), 1674–1681 (2006)CrossRefPubMedGoogle Scholar
- 8.Ho, K.K.L., et al.: Predicting survival in heart failure case and control subjects by use of fully automated methods for deriving nonlinear and conventional indices of heart rate dynamics. Circulation. 96(3), 842–848 (1997)CrossRefPubMedGoogle Scholar
- 9.Pikkujämsä, S.M., et al.: Cardiac interbeat interval dynamics from childhood to senescence comparison of conventional and new measures based on fractals and chaos theory. Circulation. 100(4), 393–399 (1999)CrossRefPubMedGoogle Scholar
- 10.Ivanov, P.C., et al.: Multifractality in human heartbeat dynamics. Nature. 399(6735), 461–465 (1999)CrossRefPubMedGoogle Scholar
- 11.Eke, A., Herman, P., Kocsis, L., Kozak, L.R.: Fractal characterization of complexity in temporal physiological signals. Physiol. Meas. 23(1), R1 (2002)CrossRefPubMedGoogle Scholar
- 12.Acharya, U.R., Joseph, K.P., Kannathal, N., Lim, C.M., Suri, J.S.: Heart rate variability: a review. Med. Biol. Eng. Comput. 44(12), 1031–1051 (2006)CrossRefGoogle Scholar
- 13.Voss, A., Schulz, S., Schroeder, R., Baumert, M., Caminal, P.: Methods derived from nonlinear dynamics for analysing heart rate variability. Philos. Trans. R. Soc. Lond. Math. Phys. Eng. Sci. 367(1887), 277–296 (2009)CrossRefGoogle Scholar
- 14.Cerutti, S., Esposti, F., Ferrario, M., Sassi, R., Signorini, M.G.: Long-term invariant parameters obtained from 24-h Holter recordings: a comparison between different analysis techniques. Chaos. 17(1), 015108–015108-9 (2007)Google Scholar
- 15.Brennan, M., Palaniswami, M., Kamen, P.: Do existing measures of Poincaré plot geometry reflect nonlinear features of heart rate variability? I.E.E.E. Trans. Biomed. Eng. 48(11), 1342–1347 (2001)CrossRefGoogle Scholar
- 16.Niskanen, J.-P., Tarvainen, M.P., Ranta-aho, P.O., Karjalainen, P.A.: Software for advanced HRV analysis. Comput. Methods Prog. Biomed. 76(1), 73–81 (Oct. 2004)CrossRefGoogle Scholar
- 17.Gamelin, F.X., Berthoin, S., Bosquet, L.: Validity of the polar S810 Heart rate monitor to measure R-R intervals at rest. Med. Sci. Sports Exerc. 38(5), 887–893 (2006)CrossRefPubMedGoogle Scholar
- 18.Schmidt, G., et al.: Heart-rate turbulence after ventricular premature beats as a predictor of mortality after acute myocardial infarction. Lancet. 353(9162), 1390–1396 (1999)CrossRefPubMedGoogle Scholar
- 19.Bauer, A., et al.: Heart rate turbulence: standards of measurement, physiological interpretation, and clinical use: international society for holter and noninvasive electrophysiology consensus. J. Am. Coll. Cardiol. 52(17), 1353–1365 (2008)CrossRefPubMedGoogle Scholar
- 20.Pincus, S.M.: Assessing serial irregularity and its implications for health. Ann. N. Y. Acad. Sci. 954, 245–267 (2001)CrossRefPubMedGoogle Scholar
- 21.Lake, D.E., Richman, J.S., Griffin, M.P., Moorman, J.R.: Sample entropy analysis of neonatal heart rate variability. Am. J. Phys. 283(3), R789–R797 (2002)Google Scholar
- 22.Addison, P.S.: Wavelet transforms and the ECG: a review. Physiol. Meas. 26(5), R155 (2005)CrossRefPubMedGoogle Scholar
- 23.Friedman, B.H.: An autonomic flexibility–neurovisceral integration model of anxiety and cardiac vagal tone. Biol. Psychol. 74(2), 185–199 (2007)CrossRefPubMedGoogle Scholar
- 24.Kemp, A.H., Quintana, D.S., Gray, M.A., Felmingham, K.L., Brown, K., Gatt, J.M.: Impact of depression and antidepressant treatment on heart rate variability: a review and meta-analysis. Biol. Psychiatry. 67(11), 1067–1074 (Jun. 2010)CrossRefPubMedGoogle Scholar
- 25.Marwan, N., Wessel, N., Meyerfeldt, U., Schirdewan, A., Kurths, J.: Recurrence-plot-based measures of complexity and their application to heart-rate-variability data. Phys. Rev. E. 66(2), 026702 (2002)CrossRefGoogle Scholar