Breakdown of the Intermediate-Term Fractal Scaling Exponent in Sinus Node Dysfunction - New Method for Non-Invasive Evaluation of Sinus Node Function

Title
Breakdown of the Intermediate-Term Fractal Scaling Exponent in Sinus Node Dysfunction - New Method for Non-Invasive Evaluation of Sinus Node Function
Author(s)
신동구이상희이상훈[이상훈]유철성[유철성]홍그루김웅박종선김영조
Keywords
HEART-RATE-VARIABILITY; ACUTE MYOCARDIAL-INFARCTION; TIME-SERIES ANALYSIS; R INTERVAL DYNAMICS; APPROXIMATE ENTROPY; SPONTANEOUS ONSET; CHAOS THEORY; COMPLEXITY; MORTALITY; ELECTROCARDIOGRAM
Issue Date
201112
Publisher
JAPANESE CIRCULATION SOC
Citation
CIRCULATION JOURNAL, v.75, no.12, pp.2775 - 2780
Abstract
Background: The aim of the present study was to characterize the heart rate dynamics of sinus bradycardia (SB) from sinus node dysfunction (SND) using non-linear dynamical system analysis. No data are yet available on how the dynamics change in the presence of SND. Methods and Results: Conventional time and frequency domain analysis, the short- (DFA(alpha 1)) and intermediate-term fractal scaling exponent (DFA(alpha 2)), approximate entropy (ApEn) and sample entropy (SampEn) were calculated in 60-min sinus RR interval data of SB from 24-h ambulatory electrocardiograms of 110 patients: 44 SND patients, 44 age-matched controls, and 22 younger controls. All of the time and frequency domain parameters, ApEn and SampEn, were significantly reduced in the age-matched control group, compared with the young control group. DFA(alpha 1) and DFA(alpha 2) increased with aging. Both the DFA(alpha 1) and DFA(alpha 2) of SND patients were paradoxically reduced, which was not appropriate for their age. Only the percentage of consecutive RR intervals with absolute differences >50 ms (pNN(50)), low-frequency power, and DFA(alpha 2) made a significant contribution to prediction of SND on logistic regression analysis. Among them, DFA(alpha 2) was the most significant variable for prediction of SND (odds ratio, 0.927; 95% confidence interval: 0.888-0.969, P=0.001). DFA(alpha 2) remained as a significant variable for prediction of SND, when compared with overall control patients, combining the 2 control groups. Conclusions: Inappropriate reduction of DFA(alpha 2) is a robust measure and could be an adjunctive tool for improvement of diagnostic performance in detection of SND. (Circ J 2011; 75: 2775-2780)
URI
http://hdl.handle.net/YU.REPOSITORY/24206http://dx.doi.org/10.1253/circj.CJ-11-0641
ISSN
1346-9843
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의과대학 > 내과학교실 > Articles
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