Document Detail

Assessment of cardiovascular reactivity by fractal and recurrence quantification analysis of heart rate and pulse transit time.
MedLine Citation:
PMID:  12574789     Owner:  NLM     Status:  MEDLINE    
Methods used for the assessment of cardiovascular reactivity are flawed by nonlinear dynamics of the cardiovascular responses to stimuli. In an attempt to address this issue, we utilized a short postural challenge, recorded beat-to-beat heart rate (HR) and pulse transit time (PTT), assessed the data by fractal and recurrence quantification analysis, and processed the obtained variables by multivariate statistics. A 10-min supine phase of the head-up tilt test was followed by recording 600 cardiac cycles on tilt, that is, 5-10 min. Three groups of patients were studied, each including 20 subjects matched for age and gender--healthy subjects, patients with essential hypertension (HT), and patients with chronic fatigue syndrome (CFS). The latter group was studied on account of the well-known dysautonomia of CFS patients, which served as contrast against the cardiovascular reactivity of the healthy population. A total of 52 variables of the HR and PTT were determined in each subject. The multivariate model identified the best predictors for the assessment of reactivity of healthy subjects vs CFS. Based on these predictors, the "Fractal & Recurrence Analysis-based Score" (FRAS) was calculated: FRAS=76.2+0.04*HR-supine-DET -12.9*HR-tilt-R/L -0.31*HR-tilt-s.d. -19.27*PTT-tilt-R/L -9.42*PTT-tilt-WAVE. The median values and IQR of FRAS in the groups were: healthy=-1.85 (IQR 1.89), hypertensives=+0.52 (IQR 5.78), and CFS=-24.2 (5.34) (HT vs healthy subjects: P=0.0036; HT vs CFS: P<0.0001). Since the FRAS differed significantly between the three groups, it appears likely that the FRAS may recognize phenotypes of cardiovascular reactivity.
J E Naschitz; I Rosner; N Shaviv; I Khorshidi; S Sundick; H Isseroff; M Fields; R M Priselac; D Yeshurun; E Sabo; R Itzhak
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of human hypertension     Volume:  17     ISSN:  0950-9240     ISO Abbreviation:  J Hum Hypertens     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-02-07     Completed Date:  2003-05-23     Revised Date:  2004-12-31    
Medline Journal Info:
Nlm Unique ID:  8811625     Medline TA:  J Hum Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  111-8     Citation Subset:  IM    
Department of Internal Medicine A, Bnai-Zion Medical Center and Bruce Rappaport Faculty of Medicine, Haifa 31048, Israel.
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MeSH Terms
Blood Flow Velocity / physiology*
Cardiovascular Diseases / complications,  diagnosis*,  physiopathology*
Fatigue Syndrome, Chronic / complications,  physiopathology*
Heart Rate / physiology*
Hypertension / complications,  physiopathology*
Predictive Value of Tests
Reference Values
Supine Position / physiology
Tilt-Table Test*
Time Factors
Erratum In:
J Hum Hypertens. 2003 Aug;17(8):585
Note: Itzhak, R [corrected to Rosner, I]

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