Abstract
ObjectiveTo evaluate the heart rate variability (HRV) in patients with multibacillary leprosy using dynamic linear and nonlinear analysis.Material and methodsTwenty-one leprosy patients (mean age: 39.14 ±10.58 years) and 21 healthy subjects (mean age: 36.24 ± 12.64 years) completed the sample. Heart rate variability recording was performed by a Polar RS800 CX heart monitor during a period of 15 min in the supine position and 15 min in a sitting position. Analysis of HRV was performed by frequency domain from high frequency (HF) and low frequency (LF) spectral indexes in absolute and normalized units. The nonlinear analysis of HRV was calculated using symbolic analysis (0V%, 1V%, 2LV% and 2UV% indexes), Shannon entropy (SE) and normalized complexity index (NCI).ResultsLinear analysis: both groups showed higher HF values (p < 0.05) and smaller LF values (p < 0.05) in supine than in sitting position. The leprosy patients showed higher LF values (p < 0.05) and smaller HF values (p < 0.05) compared to the controls on supine position. Symbolic analysis: leprosy patients had higher 0V% values (p < 0.05), smaller 2LV% values (p < 0.05) and 2UV % values compared to healthy subjects on both positions. The 1V % had higher values (p < 0.05) for leprosy patients than for controls in the sitting position. The control subjects had smaller 0V % values (p < 0.05), and higher 2UV % values (p < 0.05) in the supine position compared to the sitting position. Leprosy patients had higher 2UV index values (p < 0.05) in the supine position compared to the sitting position. In the complexity analysis, leprosy patients had smaller SE and NCI values (p < 0.05) than the control in the supine position. There was no difference between the SE and NCI values of leprosy and the control subjects in the sitting position. The control subjects had higher SE and NCI values (p < 0.05) in the supine position than in the sitting position.ConclusionLeprosy patients had higher sympathetic modulation and smaller vagal modulation than controls, indicating less HRV and cardiac modulation with lower complexity. The control group displayed significant HRV differences in response to position changes while leprosy patients had fewer HRV differences after the same postural change. An analysis of HRV with linear and non-linear dynamics proved to be a reliable method and promising for the investigation of autonomic dysfunction in patients with multibacillary leprosy.
Highlights
Leprosy is a chronic, infectious disease caused by Mycobacterium leprae [1]
Symbolic analysis: leprosy patients had higher 0V% values (p < 0.05), smaller 2LV% values (p < 0.05) and 2UV % values compared to healthy subjects on both positions
There was no difference between the Shannon entropy (SE) and normalized complexity index (NCI) values of leprosy and the control
Summary
Infectious disease caused by Mycobacterium leprae [1]. The disease leads to several disabilities, including motor, sensory, and autonomic impairments [3, 4]. These complications affect the quality of life of the patients and are associated with high treatment and rehabilitation costs. There is a significant amount of knowledge about the impairment of the motor, sensory, and autonomic functions caused by leprosy [5, 6]. The investigation of nervous functions has been important for identifying possible techniques that monitor the neurological condition of patients, even when they have no clinical symptoms. The altered coordination between sympathetic and parasympathetic actions of the autonomic system is prejudicial to patients suffering from leprosy due to decreased responsivity of heart function to environment or internal changes [7,11]
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