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Sensitivity, specificity and predictive values of linear and nonlinear indices of heart rate variability in stable

Flávio Correa Pivatelli1, Marcio Antonio Dos Santos, Gislaine Buzzini Fernandes

  • 1Serviço de Hemodinâmica e Cardiologia Intervencionista do Hospital de Base - Fundação Faculdade Regional de Medicina (FUNFARME), de São José do Rio Preto (SP) and Departamento de Cardiologia e Cirurgia Cardiovascular da Faculdade de Medicina de São José do Rio Preto (FAMERP), Av, Brigadeiro Faria Lima, 5416, 15090-000, São José do Rio Preto, SP, Brazil. mf60204@gmail.com.

International Archives of Medicine
|November 1, 2012
PubMed

Insights

Decreased heart rate variability (HRV) in stable angina patients is linked to coronary artery disease. Analysis of linear and nonlinear HRV indices can help predict coronary obstruction, aiding prognosis.

Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Physiology

Background:

  • Reduced heart rate variability (HRV) is a known predictor of increased morbidity and mortality.
  • This study investigates HRV in patients with stable angina undergoing coronary angiography.

Purpose of the Study:

  • To evaluate linear and nonlinear HRV indices in stable angina patients.
  • To determine the prognostic value of HRV for coronary artery disease (CAD).

Main Methods:

  • Analyzed 77 patients undergoing elective coronary angiography, divided into CAD and non-CAD groups.
  • Recorded HRV beat-by-beat for 40 minutes, analyzing time-domain (SDNN, NN50, RMSSD) and frequency-domain (ULF, VLF, LF, HF, LF/HF) linear indices.
  • Assessed nonlinear indices including SD1, SD2, SD1/SD2, approximate entropy (-ApEn), and others, using Receiver Operating Characteristic (ROC) curves for cutoff points.

Main Results:

  • Coronary artery disease (CAD) patients exhibited significantly lower values for SDNN, RMSSD, NN50, HF, SD1, SD2, and -ApEn.
  • Specific thresholds for HF (≤ 66 ms2), RMSSD (≤ 23.9 ms), -ApEn (≤ -0.296), and NN50 (≤ 16) demonstrated strong discriminatory power for significant coronary obstruction.

Conclusions:

  • Heart Rate Variability Analysis, encompassing both linear and nonlinear domains, is recommended for prognostic evaluation in stable angina patients.
  • The overall impairment of HRV indices suggests their utility in assessing cardiovascular risk in this population.
Abstract

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