Abstract
The percussion entropy index (PEIorginal) was recently introduced to assess the complexity of baroreflex sensitivity. This study aimed to investigate the ability of a speedy modified PEI (i.e., PEINEW) application to distinguish among age-controlled subjects with or without diabetes. This was carried out using simultaneous photo-plethysmo-graphy (PPG) pulse amplitude series and the R wave-to-R wave interval (RRI) series acquired from healthy subjects (Group 1, number = 42), subjects diagnosed as having diabetes mellitus type 2 with satisfactory blood sugar control (Group 2, number = 38), and type 2 diabetic patients with poor blood sugar control (Group 3, number = 35). Results from PEIorginal and multiscale cross-approximate entropy (MCAE) were also addressed with the same datasets for comparison. The results show that optimal prolongation between the amplitude series and RRI series could be delayed by one to three heartbeat cycles for Group 2, and one to four heartbeat cycles for Group 3 patients. Group 1 subjects only had prolongation for one heartbeat cycle. This study not only demonstrates the sensitivity of PEINEW and PEIorginal in differentiating between Groups 2 and 3 compared with MCAE, highlighting the feasibility of using percussion entropy applications in autonomic nervous function assessments, it also shows that PEINEW can considerably reduce the computational time required for such processes.
Highlights
A depressed autonomic nervous function may lead to cardiovascular system damage, resulting in the occurrence and development of various cardiovascular diseases [1]
The objective of the current study was to test two hypotheses: (1) That the prolongation between the amplitude series and RR interval (RRI) series could be more seriously delayed for type 2 diabetics and elderly patients with poor blood sugar control, and (2) that this new approach (PEINEW ) would significantly reduce the computation time compared with the past percussion entropy index (PEI) method
Considering that baroreflex sensitivity is an indicator of autonomic function [5,6,7,8,9], as well as previous findings showing a good correlation between real-time changes in blood pressure and digital volume pulse (DVP) signals amplitudes [12,13,14], this study investigated the possibility of assessing autonomic sensitivity by quantifying the increase or decrease fluctuation matches between the two time series of DVP and RRI with shift numbers of 1 to sn
Summary
A depressed autonomic nervous function may lead to cardiovascular system damage, resulting in the occurrence and development of various cardiovascular diseases [1]. A frequency domain analysis of heart rate variability (HRV) using electrocardiography (ECG) has been used over the past 20 years to assess autonomic function [2]. The autonomic nervous system has been shown to play a key role in the physiological regulation of blood pressure and the heartbeat interval. Baroreflex refers to a physiological phenomenon in which a decrease in blood pressure shortens the RR interval (RRI), and an increase in blood pressure prolongs the RRI. Baroreflex sensitivity (BRS) refers quantitatively to the degree of matching between changes in the RRI and blood pressure during a cardiac cycle [5,6]
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