Similarity Changes Analysis for Heart Rate Fluctuation Regularity as a New Screening Method for Congestive Heart Failure

Congestive heart failure (CHF) is a chronic cardiovascular condition associated with dysfunction of the autonomic nervous system (ANS). Heart rate variability (HRV) has been widely used to assess ANS. This paper proposes a new HRV analysis method, which uses information-based similarity (IBS) transformation and fuzzy approximate entropy (fApEn) algorithm to obtain the fApEn_IBS index, which is used to observe the complexity of autonomic fluctuations in CHF within 24 h. We used 98 ECG records (54 health records and 44 CHF records) from the PhysioNet database. The fApEn_IBS index was statistically significant between the control and CHF groups (p < 0.001). Compared with the classical indices low-to-high frequency power ratio (LF/HF) and IBS, the fApEn_IBS index further utilizes the changes in the rhythm of heart rate (HR) fluctuations between RR intervals to fully extract relevant information between adjacent time intervals and significantly improves the performance of CHF screening. The CHF classification accuracy of fApEn_IBS was 84.69%, higher than LF/HF (77.55%) and IBS (83.67%). Moreover, the combination of IBS, fApEn_IBS, and LF/HF reached the highest CHF screening accuracy (98.98%) with the random forest (RF) classifier, indicating that the IBS and LF/HF had good complementarity. Therefore, fApEn_IBS effusively reflects the complexity of autonomic nerves in CHF and is a valuable CHF assessment tool.     

心率变异性分析在新生儿疼痛检测中的应用

为了研究疼痛暴露对新生儿自主神经系统的影响,并建立基于心率变异性(heart rate variability,HRV)指标的新生儿疼痛检测模型,采用时域、频域和非线性方法对40名新生儿疼痛暴露前后的心电数据进行短时HRV分析,Wilcoxon符号秩检验用于统计分析,支持向量机(support vector machine,SVM)用于建立检测模型.结果表明,RR间期均值a RR、低频段功率LF、高频段功率HF等3个线性指标和近似熵Ap En、样本熵Samp En、递归率REC等9个非线性指标在疼痛前后具有统计学差异;基于a RR、相邻两个RR间期对差值大于50 ms的百分比p NN50,Ap En,关联维D2和REC等5个指标和SVM的疼痛检测模型检测正确率达到83.75%.HRV的相关指标可反映新生儿自主神经系统对疼痛暴露的应答,基于HRV指标和SVM的模型可用于新生儿疼痛检测.     

Novel Application of Multiscale Cross-Approximate Entropy for Assessing Early Changes in the Complexity between Systolic Blood Pressure and ECG R-R Intervals in Diabetic Rats

Cardiac autonomic neuropathy (CAN) is a common complication of diabetes mellitus, and can be assessed using heart rate variability (HRV) and the correlations between systolic blood pressure (SBP) and ECG R-R intervals (RRIs), namely baroreflex sensitivity (BRS). In this study, we propose a novel parameter for the nonlinear association between SBP and RRIs based on multiscale cross-approximate entropy (MS-CXApEn). Sixteen male adult Wistar Kyoto rats were equally divided into two groups: streptozotocin-induced diabetes and age-matched controls. RRIs and SBP were acquired in control rats and the diabetic rats at the onset of hyperglycemia and insulin-treated euglycemia to determine HRV by the ratio of low-frequency to high-frequency power (LF/HF) and Poincaré plot as SSR (SD1/SD2), BRS, and MS-CXApEn. SSR and BRS were not significantly different among the three groups. The LF/HF was significantly higher in the hyperglycemic diabetics than those in the controls and euglycemic diabetic rats. MS-CXApEn was higher in the diabetic hyperglycemic rats than the control rats from scales 2 to 10, and approached the values of controls in diabetic euglycemic rats at scales 9 and 10. Conclusions: We propose MS-CXApEn as a novel parameter to quantify the dynamic nonlinear interactions between SBP and RRIs that reveals more apparent changes in early diabetic rats. Furthermore, changes in this parameter were related to correction of hyperglycemia and could be useful for detecting and assessing CAN in early diabetes.     

Short-Term Effect of Percutaneous Coronary Intervention on Heart Rate Variability in Patients with Coronary Artery Disease

Myocardial ischemia in patients with coronary artery disease (CAD) leads to imbalanced autonomic control that increases the risk of morbidity and mortality. To systematically examine how autonomic function responds to percutaneous coronary intervention (PCI) treatment, we analyzed data of 27 CAD patients who had admitted for PCI in this pilot study. For each patient, five-minute resting electrocardiogram (ECG) signals were collected before and after the PCI procedure. The time intervals between ECG collection and PCI were both within 24 h. To assess autonomic function, normal sinus RR intervals were extracted and were analyzed quantitatively using traditional linear time- and frequency-domain measures [i.e., standard deviation of the normal-normal intervals (SDNN), the root mean square of successive differences (RMSSD), powers of low frequency (LF) and high frequency (HF) components, LF/HF] and nonlinear entropy measures [i.e., sample entropy (SampEn), distribution entropy (DistEn), and conditional entropy (CE)], as well as graphical metrics derived from Poincaré plot [i.e., Porta’s index (PI), Guzik’s index (GI), slope index (SI) and area index (AI)]. Results showed that after PCI, AI and PI decreased significantly (p < 0.002 and 0.015, respectively) with effect sizes of 0.88 and 0.70 as measured by Cohen’s d static. These changes were independent of sex. The results suggest that graphical AI and PI metrics derived from Poincaré plot of short-term ECG may be potential for sensing the beneficial effect of PCI on cardiovascular autonomic control. Further studies with bigger sample sizes are warranted to verify these observations.     

Cardio-Hypothalamic-Pituitary Coupling during Rest and in Response to Exercise

The objective of this study was to examine cardio hypothalamic-pituitary coupling and to better understand how the temporal relations between these systems are altered during rest and exercise conditions. An intensive within subjects study design was used. Seven adult males completed two visits, each consisting of either a 24 h period of complete rest or a 24 h period containing a high-intensity exercise bout. An intravenous catheter was used to collect serum samples every 10 min throughout the 24 h period (i.e., 145 samples/person/condition) to assess growth hormone (GH) dynamics throughout the 24 h period. Cardiac dynamics were also collected throughout the 24 h period and epoched into 3 min windows every 10 min, providing serial short-time measurements of heart rate variability (HRV) concurrent to the GH sampling. The standard deviation of the normal RR interval (SDNN), the root mean square of successive differences (rMSSD), and sample entropy (SampEn) was calculated for each epoch and used to create new profiles. The dynamics of these profiles were individually quantified using SampEn and recurrence quantification analysis (RQA). To address our central question, the coupling between these profiles with GH was assessed using cross-SampEn and cross-RQA (cRQA). A comparison between the epoched HRV profiles indicated a main effect between profiles for sample entropy (p < 0.001) and several measures from RQA. An interaction between profile and condition was observed for cross-SampEn (p = 0.04) and several measures from cRQA. These findings highlight the potential application of epoched HRV to assess changes in cardiac dynamics, with specific applications to assessing cardio hypothalamic-pituitary coupling.     

Entropy Analysis of Heart Rate Variability in Different Sleep Stages

How the complexity or irregularity of heart rate variability (HRV) changes across different sleep stages and the importance of these features in sleep staging are not fully understood. This study aimed to investigate the complexity or irregularity of the RR interval time series in different sleep stages and explore their values in sleep staging. We performed approximate entropy (ApEn), sample entropy (SampEn), fuzzy entropy (FuzzyEn), distribution entropy (DistEn), conditional entropy (CE), and permutation entropy (PermEn) analyses on RR interval time series extracted from epochs that were constructed based on two methods: (1) 270-s epoch length and (2) 300-s epoch length. To test whether adding the entropy measures can improve the accuracy of sleep staging using linear HRV indices, XGBoost was used to examine the abilities to differentiate among: (i) 5 classes [Wake (W), non-rapid-eye-movement (NREM), which can be divide into 3 sub-stages: stage N1, stage N2, and stage N3, and rapid-eye-movement (REM)]; (ii) 4 classes [W, light sleep (combined N1 and N2), deep sleep (N3), and REM]; and (iii) 3 classes: (W, NREM, and REM). SampEn, FuzzyEn, and CE significantly increased from W to N3 and decreased in REM. DistEn increased from W to N1, decreased in N2, and further decreased in N3; it increased in REM. The average accuracy of the three tasks using linear and entropy features were 42.1%, 59.1%, and 60.8%, respectively, based on 270-s epoch length; all were significantly lower than the performance based on 300-s epoch length (i.e., 54.3%, 63.1%, and 67.5%, respectively). Adding entropy measures to the XGBoost model of linear parameters did not significantly improve the classification performance. However, entropy measures, especially PermEn, DistEn, and FuzzyEn, demonstrated greater importance than most of the linear parameters in the XGBoost model.300-s270-s.     

On the Variability of Heart Rate Variability—Evidence from Prospective Study of Healthy Young College Students

Heart rate variability (HRV) has been widely used as indices for autonomic regulation, including linear analyses, entropy and multi-scale entropy based nonlinear analyses, and however, it is strongly influenced by the conditions under which the signal is being recorded. To investigate the variability of healthy HRV under different settings, we recorded electrocardiograph (ECG) signals from 56 healthy young college students (20 h for each participant) at campus using wearable single-lead ECG device. Accurate R peak to R peak (RR) intervals were extracted by combing the advantages of five commonly used R-peak detection algorithms to eliminate data quality influence. Thorough and detailed linear and nonlinear HRV analyses were performed. Variability of HRV metrics were evaluated from five categories: (1) different states of daily activities; (2) different recording time period in the same day during free-running daily activities; (3) body postures of sitting and lying; (4) lying on the left, right and back; and (5) gender influence. For most of the analyzed HRV metrics, significant differences (p < 0.05) were found among different recording conditions within the five categories except lying on different positions. Results suggested that the standardization of ECG data collection and HRV analysis should be implemented in HRV related studies, especially for entropy and multi-scale entropy based analyses. Furthermore, this preliminary study provides reference values of HRV indices under various recording conditions of healthy young subjects that could be useful information for different applications (e.g., health monitoring and management).     

心率变异性谱成分的非线性本质

提出了分频段相位随机化替代数据方法,与噪声滴定法相结合,观察了不同频率成分对心搏混沌的影响.结果显示心率变异性高频成分相位随机化的替代数据使混沌强度显著降低,提示谱分析的频率成分中蕴含着信号的非线性特性.提出的方法能有效分析不同频率成分对非线性的贡献,该法不仅适用于心率变异性还适用于其他确定性信号的特性分析. 关键词： 分频段相位随机化替代数据 混沌 滴定法 心率变异性     

Reduced System Complexity of Heart Rate Dynamics in Patients with Hyperthyroidism: A Multiscale Entropy Analysis

Studying heart rate dynamics would help understand the effects caused by a hyperkinetic heart in patients with hyperthyroidism. By using a multiscale entropy (MSE) analysis of heart rate dynamics derived from one-channel electrocardiogram recording, we aimed to compare the system complexity of heart rate dynamics between hyperthyroid patients and control subjects. A decreased MSE complexity index (CI) computed from MSE analysis reflects reduced system complexity. Compared with the control subjects (n = 37), the hyperthyroid patients (n = 37) revealed a significant decrease (p < 0.001) in MSE CI (hyperthyroid patients 10.21 ± 0.37 versus control subjects 14.08 ± 0.21), sample entropy for each scale factor (from 1 to 9), and high frequency power (HF) as well as a significant increase (p < 0.001) in low frequency power (LF) in normalized units (LF%) and ratio of LF to HF (LF/HF). In conclusion, besides cardiac autonomic dysfunction, the system complexity of heart rate dynamics is reduced in hyperthyroidism. This finding implies that the adaptability of the heart rate regulating system is impaired in hyperthyroid patients. Additionally, it might explain the exercise intolerance experienced by hyperthyroid patients. In addition, hyperthyroid patients and control subjects could be distinguished by the MSE CI computed from MSE analysis of heart rate dynamics.     

Bivariate Entropy Analysis of Electrocardiographic RR–QT Time Series

QT interval variability (QTV) and heart rate variability (HRV) are both accepted biomarkers for cardiovascular events. QTV characterizes the variations in ventricular depolarization and repolarization. It is a predominant element of HRV. However, QTV is also believed to accept direct inputs from upstream control system. How QTV varies along with HRV is yet to be elucidated. We studied the dynamic relationship of QTV and HRV during different physiological conditions from resting, to cycling, and to recovering. We applied several entropy-based measures to examine their bivariate relationships, including cross sample entropy (XSampEn), cross fuzzy entropy (XFuzzyEn), cross conditional entropy (XCE), and joint distribution entropy (JDistEn). Results showed no statistically significant differences in XSampEn, XFuzzyEn, and XCE across different physiological states. Interestingly, JDistEn demonstrated significant decreases during cycling as compared with that during the resting state. Besides, JDistEn also showed a progressively recovering trend from cycling to the first 3 min during recovering, and further to the second 3 min during recovering. It appeared to be fully recovered to its level in the resting state during the second 3 min during the recovering phase. The results suggest that there is certain nonlinear temporal relationship between QTV and HRV, and that the JDistEn could help unravel this nuanced property.     

Long-range correlations in heart rate variability during computer-mouse work under time pressure

The aim of this study was to investigate the influences of time pressure on long-range correlations in heart rate variability (HRV), the effects of relaxation on the cardiovascular regulation system and the advantages of detrended fluctuation analysis (DFA) over the conventional power spectral analysis in discriminating states of the cardiovascular systems under different levels of time pressure. Volunteer subjects (n=10, male/female=5/5) participated in a computer-mouse task consisting of five sessions, i.e. baseline session (BSS) which was free of time pressure, followed by sessions with 80% (SS80), 100% (SS100), 90% (SS90) and 150% (SS150) of the baseline time. Electrocardiogram (ECG) and task performance were recorded throughout the experiments. Two rest sessions before and after the computer-mouse work, i.e. RS1 and RS2, were also recorded as comparison. HRV series were subsequently analyzed by both conventional power spectral analysis and detrended fluctuation analysis (DFA). The long-term scaling exponent α₂ by DFA was significantly lower in SS80 than that in other sessions. It was also found that short-term release of time pressure had positive influences on the cardiovascular system, i.e. the α₂ in RS2 was significantly higher than that in SS80, SS100 and SS90. No significant differences were found between any two sessions by conventional power spectral analysis. Our results showed that DFA performed better in discriminating the states of cardiovascular autonomic modulation under time pressure than the conventional power spectral analysis.     

Concurrent sympathetic activation and vagal withdrawal in hyperthyroidism: Evidence from detrended fluctuation analysis of heart rate variability

Despite many previous studies on the association between hyperthyroidism and the hyperadrenergic state, controversies still exist. Detrended fluctuation analysis (DFA) is a well recognized method in the nonlinear analysis of heart rate variability (HRV), and it has physiological significance related to the autonomic nervous system. In particular, an increased short-term scaling exponent α1 calculated from DFA is associated with both increased sympathetic activity and decreased vagal activity. No study has investigated the DFA of HRV in hyperthyroidism. This study was designed to assess the sympathovagal balance in hyperthyroidism. We performed the DFA along with the linear analysis of HRV in 36 hyperthyroid Graves’ disease patients (32 females and 4 males; age 30 ± 1 years, means ± SE) and 36 normal controls matched by sex, age and body mass index. Compared with the normal controls, the hyperthyroid patients revealed a significant increase (P<0.001) in α1 (hyperthyroid 1.28±0.04 versus control 0.91±0.02), long-term scaling exponent , overall scaling exponent , low frequency power in normalized units (LF%) and the ratio of low frequency power to high frequency power (LF/HF); and a significant decrease (P<0.001) in the standard deviation of the R-R intervals (SDNN) and high frequency power (HF). In conclusion, hyperthyroidism is characterized by concurrent sympathetic activation and vagal withdrawal. This sympathovagal imbalance state in hyperthyroidism helps to explain the higher prevalence of atrial fibrillation and exercise intolerance among hyperthyroid patients.     

The Value of Heart Rhythm Complexity in Identifying High-Risk Pulmonary Hypertension Patients

Pulmonary hypertension (PH) is a fatal disease—even with state-of-the-art medical treatment. Non-invasive clinical tools for risk stratification are still lacking. The aim of this study was to investigate the clinical utility of heart rhythm complexity in risk stratification for PH patients. We prospectively enrolled 54 PH patients, including 20 high-risk patients (group A; defined as WHO functional class IV or class III with severely compromised hemodynamics), and 34 low-risk patients (group B). Both linear and non-linear heart rate variability (HRV) variables, including detrended fluctuation analysis (DFA) and multiscale entropy (MSE), were analyzed. In linear and non-linear HRV analysis, low frequency and high frequency ratio, DFAα1, MSE slope 5, scale 5, and area 6–20 were significantly lower in group A. Among all HRV variables, MSE scale 5 (AUC: 0.758) had the best predictive power to discriminate the two groups. In multivariable analysis, MSE scale 5 (p = 0.010) was the only significantly predictor of severe PH in all HRV variables. In conclusion, the patients with severe PH had worse heart rhythm complexity. MSE parameters, especially scale 5, can help to identify high-risk PH patients.     

On-Road Detection of Driver Fatigue and Drowsiness during Medium-Distance Journeys

Background: The detection of driver fatigue as a cause of sleepiness is a key technology capable of preventing fatal accidents. This research uses a fatigue-related sleepiness detection algorithm based on the analysis of the pulse rate variability generated by the heartbeat and validates the proposed method by comparing it with an objective indicator of sleepiness (PERCLOS). Methods: changes in alert conditions affect the autonomic nervous system (ANS) and therefore heart rate variability (HRV), modulated in the form of a wave and monitored to detect long-term changes in the driver’s condition using real-time control. Results: the performance of the algorithm was evaluated through an experiment carried out in a road vehicle. In this experiment, data was recorded by three participants during different driving sessions and their conditions of fatigue and sleepiness were documented on both a subjective and objective basis. The validation of the results through PERCLOS showed a 63% adherence to the experimental findings. Conclusions: the present study confirms the possibility of continuously monitoring the driver’s status through the detection of the activation/deactivation states of the ANS based on HRV. The proposed method can help prevent accidents caused by drowsiness while driving.     

多尺度多变量模糊熵分析

多尺度多变量样本熵评价同步多通道数据的多变量复杂度, 是非线性动态相互关系的一种反映, 但其统计稳定性差, 且不适用于非线性非平稳信号. 研究利用模糊隶属度函数代替模式相似判断的硬阈值准则, 并分析模糊隶属度函数形式的影响; 研究利用多变量经验模态分解算法进行多尺度化, 并对比其处理效果. 仿真试验表明, 模糊隶属度函数的引入可以有效提高算法的统计稳定性, 所构造的物理模糊隶属度函数的性能最为显著; 基于多变量经验模态分解算法的多尺度化过程可更有效地捕获信号的不同尺度成分, 从而更敏感地区分具有不同复杂度的信号. 对临床试验数据的分析支持以上结论, 且结果提示随着年龄增加或心脏疾病的发生, 心率变异性和心脏舒张间期变异性的多变量复杂度以不同的方式降低: 年龄增加会使低尺度熵值降低, 表示近程相关性的丢失; 而心脏疾病会同时影响各个尺度的熵值, 即同时丢失了近程和长时相关性. 该结论可用于指导心血管疾病的无创预警研究. 关键词： 多变量复杂度 多尺度多变量模糊熵 物理模糊隶属度函数 多变量经验模态分解     

Measuring time series regularity using nonlinear similarity-based sample entropy

Sampe Entropy (SampEn), a measure quantifying regularity and complexity, is believed to be an effective analyzing method of diverse settings that include both deterministic chaotic and stochastic processes, particularly operative in the analysis of physiological signals that involve relatively small amount of data. However, the similarity definition of vectors is based on Heaviside function, of which the boundary is discontinuous and hard, may cause some problems in the validity and accuracy of SampEn. Sigmoid function is a smoothed and continuous version of Heaviside function. To overcome the problems SampEn encountered, a modified SampEn (mSampEn) based on nonlinear Sigmoid function was proposed. The performance of mSampEn was tested on the independent identically distributed (i.i.d.) uniform random numbers, the MIX stochastic model, the Rossler map, and the Hennon map. The results showed that mSampEn was superior to SampEn in several aspects, including giving entropy definition in case of small parameters, better relative consistency, robust to noise, and more independence on record length when characterizing time series generated from either deterministic or stochastic system with different regularities.     

考虑帧间信息的语音带宽扩展

语音带宽扩展是为了提高语音质量,利用语音低频和高频之间的相关性重构语音高频的一种技术。高斯混合模型法是语音带宽技术中被广泛应用的一种方法,但是,该方法的映射函数是分段线性函数,且没有考虑语音前后帧的相关信息。因此,提出了一种基于条件受限玻尔兹曼机的方法。该方法利用条件受限玻尔兹曼机提取了语音信号的帧间信息,同时将语音低频、高频特征参数映射为高阶统计特性,深层发掘和模拟了语音低频和高频之间的非线性关系。客观和主观对比测试结果都表明,该方法性能优于传统的高斯混合模型方法。     

Associations between Neurocardiovascular Signal Entropy and Physical Frailty

In this cross-sectional study, the relationship between noninvasively measured neurocardiovascular signal entropy and physical frailty was explored in a sample of community-dwelling older adults from The Irish Longitudinal Study on Ageing (TILDA). The hypothesis under investigation was that dysfunction in the neurovascular and cardiovascular systems, as quantified by short-length signal complexity during a lying-to-stand test (active stand), could provide a marker for frailty. Frailty status (i.e., “non-frail”, “pre-frail”, and “frail”) was based on Fried’s criteria (i.e., exhaustion, unexplained weight loss, weakness, slowness, and low physical activity). Approximate entropy (ApEn) and sample entropy (SampEn) were calculated during resting (lying down), active standing, and recovery phases. There was continuously measured blood pressure/heart rate data from 2645 individuals (53.0% female) and frontal lobe tissue oxygenation data from 2225 participants (52.3% female); both samples had a mean (SD) age of 64.3 (7.7) years. Results revealed statistically significant associations between neurocardiovascular signal entropy and frailty status. Entropy differences between non-frail and pre-frail/frail were greater during resting state compared with standing and recovery phases. Compared with ApEn, SampEn seemed to have better discriminating power between non-frail and pre-frail/frail individuals. The quantification of entropy in short length neurocardiovascular signals could provide a clinically useful marker of the multiple physiological dysregulations that underlie physical frailty.     

Temporal and preparation effects in the magnetic nanoparticles of Apis mellifera body parts

Magnetic nanoparticles in the Apis mellifera abdomens are well accepted as involved in their magnetoreception mechanism. The effects of sample preparation on the time evolution of magnetic particles in the honeybee body parts (antennae, head, thorax and abdomen) were investigated by Ferromagnetic Resonance (FMR) at room temperature (RT), for about 100 days. Three preparations were tested: (a) washed with water (WT); (b) as (a), kept in glutaraldehyde 2.5% in 0.1 M cacodylate buffer (pH 7.4) for 24 h and washed with cacodylate buffer (C); (c) as (a), kept in glutaraldehyde 2.5% for 24 h and washed with glutaraldehyde 2.5% in cacodylate buffer (GLC). The four body parts of young and adult worker presented magnetic nanoparticles. The Mn²⁺ lines are observed except for the antennae spectra. The high field (HF) and low field (LF) components previously observed in the spectra of social insects, are confirmed in these spectra. The HF line is present in all spectra while the LF is easily observed in the spectra of the young bee and it appears as a baseline shift in spectra of some adult parts. The HF intensity of the abdomen is commonly one order of magnitude larger than any other body parts. This is the first systematic study on the conservation of magnetic material in all body parts of bees. The results show that the time evolution of the spectra depends on the body part, conserving solution and bee age. Further measurements are necessary to understand these effects and extend it to other social insects.