Nonlinear PD2i heart rate complexity algorithm detects autonomic neuropathy in patients with type 1 diabetes mellitus

Vicor Technologies, Inc., Boca Raton, FL, USA.
Clinical neurophysiology: official journal of the International Federation of Clinical Neurophysiology (Impact Factor: 3.1). 07/2011; 122(7):1457-62. DOI: 10.1016/j.clinph.2010.12.046
Source: PubMed

ABSTRACT The aim of this study was to test whether a new heart rate variability (HRV) complexity measure, the Point Correlation Dimension (PD2i), provides diagnostic information regarding early subclinical autonomic dysfunction in diabetes mellitus (DM). We tested the ability of PD2i to detect diabetic autonomic neuropathy (DAN) in asymptomatic young DM patients without overt neuropathy and compared them to age- and gender-matched controls.
HRV in DM type 1 patients (n=17, 10 female, 7 male) aged 12.9-31.5 years (duration of DM 12.4±1.2 years) was compared to that in a control group of 17 healthy matched probands. The R-R intervals were measured over 1h using a telemetric ECG system.
PD2i was able to detect ANS dysfunction with p=0.0006, similar to the best discriminating MSE scale, with p=0.0002.
The performance of PD2i to detect DAN in asymptomatic DM patients is similar to the best discriminative power of previously published complexity measures.
The PD2i algorithm may prove to be an easy to perform and clinically useful tool for the early detection of autonomic neuropathy in DM type 1 patients, especially given its minimal data requirements.

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Available from: Mathias Baumert, Sep 28, 2015
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    • "CAN has been frequently postulated to increase susceptibility to ventricular arrhythmias and sudden cardiac death in diabetic patients. This neuropathy has a negative impact on the survival and quality of life as it is associated with fatal and nonfatal cardiovascular events, ischemic cerebrovascular events and overall mortality [3]. Early detection of subclinical autonomic dysfunction in diabetic patients is, therefore, of vital importance for risk stratification and management for the prevention of serious adverse events [4] "
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    ABSTRACT: This study evaluates the usefulness of a new heart rate variability (HRV) complexity measure, the Point Correlation Dimension (PD2i), derived from short term ECG recordings, as a screening tool for Cardiac autonomic neuropathy (CAN). The PD2i was developed to measure complexity in nonstationary data with some tolerance for background noise. ECG recordings during supine rest were acquired from diabetic subjects with CAN (CAN+) [10 subjects] and without CAN (CAN-) [33 subjects] and analyzed. PD2i indices (mean, standard deviation, minimum and maximum) were used for analyzing HRV signals of all subjects. Significantly reduced (p < 0.01) PD2i indexes were found in CAN+ group, which could be a practical diagnostic and prognostic marker.
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