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Repeatability of heart rate variability in congenital hypothyroidism as analysed by detrended fluctuation analysis
J C Echeverría1, L I Solís, J E Pérez
1Universidad Autónoma Metropolitana, Mexico City, Mexico. jcea@xanum.uam.mx
Insights
Heart rate variability (HRV) analysis shows improved repeatability in children with congenital hypothyroidism using detrended fluctuation analysis (DFA). This method offers reliable insights into neurodevelopmental markers.
Area of Science:
- Pediatric Cardiology
- Neurodevelopmental Research
- Biomedical Signal Processing
Background:
- Heart rate variability (HRV) analysis is a potential tool for assessing children's neurodevelopment.
- Previous research indicates low reliability of HRV measures in pediatric populations, especially during rest or light activity.
- The impact of controlled variables and novel analysis techniques on HRV reliability in children remains under-explored.
Purpose of the Study:
- To assess the short-term repeatability of HRV measures in medicated children with congenital hypothyroidism (CH).
- To evaluate the effectiveness of detrended fluctuation analysis (DFA) in improving HRV data reliability in this cohort.
- To compare the reliability of DFA with conventional time and frequency domain HRV analysis techniques.
Main Methods:
- RR-interval data were collected from 21 medicated children with CH across two separate sessions.
- Detrended fluctuation analysis (DFA) was employed to calculate alpha(1) exponents from the HRV data.
- Data analysis involved comparing alpha(1) exponents between sessions using statistical agreement tests and intraclass correlation coefficients (ICC).
Main Results:
- A statistical agreement was found between the mean alpha(1) exponents from the two sessions (p = 0.94) with low coefficient of variation (9.1%).
- The intraclass correlation coefficient (ICC) for alpha(1) was 0.48, indicating moderate repeatability.
- The central frequency of the high-frequency band (ICC=0.77) and pNN20 (ICC=0.51) demonstrated similar or better repeatability than alpha(1), outperforming other conventional methods.
Conclusions:
- Detrended fluctuation analysis (DFA) demonstrates acceptable short-term repeatability for HRV data in children with congenital hypothyroidism.
- While alpha(1) shows moderate reliability, specific parameters like the central HF frequency and pNN20 offer superior or comparable repeatability.
- These findings support the use of DFA and specific conventional parameters for reliable HRV analysis in pediatric populations, potentially aiding neurodevelopmental assessments.
Abstract:
The analysis of heart rate fluctuations, or heart rate variability (HRV), may be applied to explore children's neurodevelopment. However, previous studies have reported poor reliability (repeatability) of HRV measures in children at rest and during light exercise. Whether the reliability can be improved by controlling variables such as physical activity, breathing rate and tidal volume, or by selecting non-conventional techniques for analysing the data remains as an open question. We evaluated the short-term repeatability of RR-interval data from medicated children with congenital hypothyroidism (CH). The alpha(1) exponents, obtained by detrended fluctuation analysis (DFA), from the data of 21 children collected at two different sessions were compared. Elapsed days between sessions were 59 +/- 33, and data were obtained during 10 min, trying to restrict the children's activity while being seated. We found statistical agreement between the means of alpha(1) exponents for each session (p = 0.94) and no bias with a low-coefficient variation (9.1%); an intraclass correlation coefficient ri = 0.48 ([0.14 0.72], 95% confidence interval) was also estimated. These findings, which were compared with results obtained by conventional time and frequency techniques, indicate the existence of agreement between the alpha(1) exponents obtained at each session, thereby providing support concerning the repeatability of HRV data as analysed by DFA in children with congenital hypothyroidism. Of particular interest was also the agreement found by using the central frequency of the high-frequency band and the parameter pNN20, both showing better or similar ri than alpha(1) (0.77 [0.57 0.89] and 0.51 [0.17 0.74], respectively), yet considerably better repeatability than other conventional time and frequency parameters.
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