H. Jelinek, D. Cornforth, M. Tarvainen, I. Spence, J. Russell
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Sample entropy, a nonlinear measure provided the best \n discrimination between the two groups on standing (1.58 ± 0.42 vs. 1.19 ± 0.4; p<0.0001) and when the change in \n HRV was measured from sitting to standing (-0.06 ± 0.36 vs. -0.42 ± 0.34; p<0.0001). The anorexia nervosa group \n had a significantly larger response to orthostatic challenge compared to the control group suggesting sympathetic \n dysfunction. Discussion: Including nonlinear measures and orthostatic challenge from an ECG recording of anorexia \n nervosa patients at initial clinical assessment on admission to hospital provides a noninvasive, sensitive tool to \n determine loss of normal physiological autonomic control of heart rate that may be related to an increased risk of \n arrhythmic events that requires further monitoring. \nConclusion: Nonlinear HRV measures are more sensitive in identifying sympathetic and parasympathetic changes associated with orthostatic challenge in patients with anorexia nervosa.","PeriodicalId":16452,"journal":{"name":"Journal of metabolic syndrome","volume":"80 1","pages":"1-6"},"PeriodicalIF":0.0000,"publicationDate":"2017-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"2","resultStr":"{\"title\":\"Decreased Sample Entropy to Orthostatic Challenge in Anorexia Nervosa\",\"authors\":\"H. Jelinek, D. Cornforth, M. Tarvainen, I. Spence, J. Russell\",\"doi\":\"10.4172/2167-0943.1000226\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Objective: The objective was to determine changes in heart rate variability (HRV) in response to orthostatic \\n challenge in a convenience sample of patients with anorexia nervosa compared to age-matched controls. A \\n decrease in HRV has been shown to correlate with an increased risk of heart attack in coronary artery disease and \\n heart failure patients. \\nMethod: Clinical data and ECG recordings were collected from 37 patients with eating disorders of which 16 had \\n a diagnosis of anorexia nervosa and 42 controls. HRV was analyzed using linear and nonlinear methods during rest \\n and orthostatic challenge from sitting to standing. \\nResults: Significant sympathovagal changes were identified in the anorexia nervosa group, especially with \\n nonlinear HRV parameters and orthostatic challenge. Sample entropy, a nonlinear measure provided the best \\n discrimination between the two groups on standing (1.58 ± 0.42 vs. 1.19 ± 0.4; p<0.0001) and when the change in \\n HRV was measured from sitting to standing (-0.06 ± 0.36 vs. -0.42 ± 0.34; p<0.0001). The anorexia nervosa group \\n had a significantly larger response to orthostatic challenge compared to the control group suggesting sympathetic \\n dysfunction. 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引用次数: 2
摘要
目的:目的是确定在一个方便的神经性厌食症患者样本中,与年龄匹配的对照组相比,心率变异性(HRV)对直立性挑战的响应变化。HRV的降低已被证明与冠状动脉疾病和心力衰竭患者心脏病发作风险的增加有关。方法:收集37例进食障碍患者的临床资料和心电图记录,其中神经性厌食症16例,对照组42例。采用线性和非线性方法分析休息和从坐到站的直立性挑战时的心率变异。结果:神经性厌食症组交感迷走神经明显改变,尤其是非线性HRV参数和直立性挑战。样本熵是一种非线性度量,在两组站立时提供了最好的区分(1.58±0.42 vs. 1.19±0.4;p<0.0001),当测量HRV从坐姿到站立时的变化(-0.06±0.36 vs -0.42±0.34;p < 0.0001)。与对照组相比,神经性厌食症组对直立挑战的反应明显更大,提示交感神经功能障碍。讨论:将神经性厌食症患者的心电图记录的非线性测量和直立性挑战纳入入院的初步临床评估,提供了一种无创的、灵敏的工具来确定正常的生理自主心率控制的丧失,这可能与心律失常事件的风险增加有关,需要进一步监测。结论:非线性HRV测量在识别神经性厌食症患者与直立挑战相关的交感和副交感神经变化方面更为敏感。
Decreased Sample Entropy to Orthostatic Challenge in Anorexia Nervosa
Objective: The objective was to determine changes in heart rate variability (HRV) in response to orthostatic
challenge in a convenience sample of patients with anorexia nervosa compared to age-matched controls. A
decrease in HRV has been shown to correlate with an increased risk of heart attack in coronary artery disease and
heart failure patients.
Method: Clinical data and ECG recordings were collected from 37 patients with eating disorders of which 16 had
a diagnosis of anorexia nervosa and 42 controls. HRV was analyzed using linear and nonlinear methods during rest
and orthostatic challenge from sitting to standing.
Results: Significant sympathovagal changes were identified in the anorexia nervosa group, especially with
nonlinear HRV parameters and orthostatic challenge. Sample entropy, a nonlinear measure provided the best
discrimination between the two groups on standing (1.58 ± 0.42 vs. 1.19 ± 0.4; p<0.0001) and when the change in
HRV was measured from sitting to standing (-0.06 ± 0.36 vs. -0.42 ± 0.34; p<0.0001). The anorexia nervosa group
had a significantly larger response to orthostatic challenge compared to the control group suggesting sympathetic
dysfunction. Discussion: Including nonlinear measures and orthostatic challenge from an ECG recording of anorexia
nervosa patients at initial clinical assessment on admission to hospital provides a noninvasive, sensitive tool to
determine loss of normal physiological autonomic control of heart rate that may be related to an increased risk of
arrhythmic events that requires further monitoring.
Conclusion: Nonlinear HRV measures are more sensitive in identifying sympathetic and parasympathetic changes associated with orthostatic challenge in patients with anorexia nervosa.