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Cardiology and Angiology: An International Journal

Cardiology and Angiology: An International Journal, ISSN: 2347-520X,Vol.: 3, Issue.: 1


Atypical Cardiac Autonomic Neuropathy Identified with Entropy Measures


David J. Cornforth1,2* and Herbert F. Jelinek3,4

1Applied Informatics Research Group, University of Newcastle, Callaghan NSW 2308, Australia.
2School of Engineering and Information Technology, University of New South Wales, Australian Defence Force Academy, Canberra, Australia.
3Centre for Research in Complex Systems, School of Community Health, Charles Sturt University, Albury, Australia.
4Australian School of Advanced Medicine, Macquarie University, Sydney, Australia.


Article Information
(1) Anonymous
(1) Abdulrahman M. Almoghairi, Adult Cardiology Department, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia.
(2) Iana Simova, Department of Noninvasive Cardiovascular Imaging and Functional Diagnostics, National Cardiology Hospital, Bulgaria.
Peer review History:




Aims: To identify Cardiac Autonomic Neuropathy (CAN) from a range of measures extracted from Heart Rate Variability (HRV), including higher moments of RR intervals and a spectrum of entropy measures of RR intervals.
Study Design: Analysis of HRV measured from participants at a diabetes screening clinic. Groups were compared using t-tests to identify variables that provide separation between groups.
Place and Duration of Study: Charles Sturt Diabetes Complications Clinic, Albury, NSW Australia.
Methodology: Eleven participants with definite CAN, 67 participants with early CAN, and 71 without CAN had their beat-to-beat fluctuations analyzed using two spectra of HRV: the spectrum of moments of RR intervals and the spectrum of Renyi entropy measures. RR intervals were extracted from ECG recordings and were detrended before analysis.
Results: Higher moments of RR intervals identified a previously unnoticed sub-group of patients who are atypical within the definite CAN group. Classification of CAN progression was better with Renyi entropy measures than with moments of RR intervals. Significant differences between early and definite CAN were found with the sixth and eighth moments, (P=.022 and P=.042 respectively), but for entropy measures P values were orders of magnitude smaller.
Conclusion: Identification of early CAN provides the opportunity for early intervention and better treatment outcomes, as well as identifying atypical cases. Our findings illustrate the value of exploring a range of different measures when attempting to detect differences in groups of patients with CAN.


Keywords :

Cardiac autonomic neuropathy; cardiac arrhythmia; heart rate variability; entropy measures.


Full Article - PDF    Page 1-11    Article Metrics


DOI : 10.9734/CA/2015/12524

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