Abstract
Sample entropy (SampEn) was reported to be useful in the assessment of the complexity of heart rate dynamics. Permutation entropy (PermEn) is a new measure based on the concept of order and was previously shown to be accurate for short, non-stationary datasets. The aim of the present study is to assess if SampEn and PermEn obtained from baseline recordings might differentiate patients with various outcomes of the head-up tilt test (HUTT). Time-domain heart rate variability (HRV) indices and several nonlinear parameters were calculated using 500 RR interval-long ECG recordings done before tilting in patients with a history suggesting vasovagal syncope. Groups of patients with so-called cardiodepressive vasovagal syncope (VVS_2) during HUTT and patients who did not faint during the test were compared. Two types of HUT tests were analyzed: with spontaneous (SB) or controlled breathing (CB). In our study, SampEn was higher in VVS_2 patients during SB, and PermEn was higher in VVS_2 patients during CB. Irrespective of the type of breathing during the test, SampEn and PermEn were similar in patients with the same type of reaction during HUTT. The use of several entropy-based parameters seems to be useful in HRV assessment in patients with vasovagal fainting.
Highlights
The cardiovascular system is controlled by the autonomic nervous system (ANS)
We focus on the cardiodepressive-type of syncope as a result of head-up tilt table test (HUTT) and compare it with the negative reaction to the test
Patients with cardiodepressive reaction to HUTT performed during spontaneous breathing (VVS_2_SB group) had significantly higher values of Sample entropy (SampEn) in baseline recordings compared to patients who did not faint during the study
Summary
The cardiovascular system is controlled by the autonomic nervous system (ANS). For example in vasovagal syndrome (VVS), the consequence of ANS dysfunction is an occurrence of syncope [1]. In patients with recurrent vasovagal faints, quality of life might be significantly decreased comparably to chronic illnesses. As many referrals to the emergency department are for syncope, the cost of its management is meaningful. In the diagnostic process of VVS, the so-called head-up tilt table test (HUTT) is often used to provoke an incident of fainting and to observe (analyze) the reaction of the heart rate and blood pressure during the event. Various parameters of heart rate variability (HRV) are usually used to describe ANS function
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