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Published on: June 5, 2019
Complexity Measures of Heart-Rate Variability in Amyotrophic Lateral Sclerosis with Alternative Pulmonary Capacities
Renata M M Pimentel1,2, Celso Ferreira1, Vitor Valenti3
1Departament of Medicine, Federal University of Santo Paulo (UNIFESP), São Paulo 04024-002, Brazil.
Objective:
the complexity of heart-rate variability (HRV) in amyotrophic lateral sclerosis (ALS) patients with different pulmonary capacities was evaluated.
Methods:
We set these according to their pulmonary capacity, and specifically forced vital capacity (FVC). We split the groups according to FVC (FVC > 50% (n = 29) and FVC < 50% (n = 28)). In ALS, the presence of an FVC below 50% is indicative of noninvasive ventilation with two pressure levels and with the absence of other respiratory symptoms. As the number of subjects per group was different, we applied the unbalanced one-way analysis of variance (uANOVA1) test after three tests of normality, and effect size by Cohen's d to assess parameter significance.
Results:
with regard to chaotic global analysis, CFP4 (p < 0.001; d = 0.91), CFP5 (p = 0.0022; d = 0.85), and CFP6 (p = 0.0009; d = 0.92) were enlarged. All entropies significantly increased. Shannon (p = 0.0005; d = 0.98), Renyi (p = 0.0002; d = 1.02), Tsallis (p = 0.0004; d = 0.99), approximate (p = 0.0005; d = 0.97), and sample (p < 0.0001; d = 1.22). Detrended fluctuation analysis (DFA) (p = 0.0358) and Higuchi fractal dimension (HFD) (p = 0.15) were statistically inconsequential between the two groups.
Conclusions:
HRV complexity in ALS subjects with different pulmonary capacities increased via chaotic global analysis, especially CFP5 and 3 out of 5 entropies.
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