Linear and nonlinear analysis of heart rate variability in coronary disease

Abstract

Objective: Coronary artery disease (CAD) and acute myocardial infarction (AMI) are associated with a reduction of heart rate variability (HRV). The aim of this study was to compare the HRV of CAD patients with and without AMI (CAD-AMI) with health-matched controls by linear (spectral analysis) and nonlinear [Shannon entropy (SE), conditional entropy (CE) and symbolic analysis (SA)] analysis.

Methods: Fifty-eight men were divided into three groups: healthy (n = 19, 57 ± 4 years), CAD (n = 20, 56 ± 10 years) and CAD-AMI (n = 19, 54 ± 12 years). The RR intervals were recorded at rest in the supine position for 10 min with an HR monitor (Polar(®)S810i). A series of 250 beats was selected to analyze variance, spectral analysis, SE, CE [complexity index (CI), normalized CI (NCI)] and SA (0V, 1V, 2LV and 2ULV patterns), as well as 0V (no significant variation) and 2ULV (two significant unlike variations), which reflect sympathetic and vagal modulation, respectively. One-way ANOVA (or the Kruskal-Wallis test when appropriate) and Pearson correlation were used.

Results: The CAD group had higher body mass index and weight than the CAD-AMI group, but no differences were found between the healthy and AMI groups. There were no differences between the groups regarding linear and nonlinear analysis. The 0V and 2ULV patterns were significantly correlated with the SE, CI and NCI of the three groups.

Interpretation: There was no difference between the groups regarding cardiac autonomic modulation by linear and nonlinear methods, which may be due to beta-blocker use, coronary angioplasty and the exercise capacity of healthy subjects.