Comparison of nonlinear methods symbolic dynamics, detrended fluctuation, and Poincare plot analysis in risk stratification in patients with dilated cardiomyopathy
Comparison of nonlinear methods symbolic dynamics, detrended fluctuation, and Poincare plot analysis in risk stratification in patients with dilated cardiomyopathy
复制标题
DOI：
10.1063/1.2404633
复制
发表时间：
2007-03-01
期刊：
影响因子：
2.9
通讯作者：
Schirdewan, Alexander
中科院分区：
文献类型：
--
作者：
Voss, Andreas;Schroeder, Rico;Schirdewan, Alexander
在美国，扩张型心肌病（DCM）的发病率约为每年20/100000新发病例，每年造成近10000例死亡。大约36%的扩张型心肌病（DCM）患者在诊断后五年内发生心源性死亡。目前应用于DCM患者早期风险预测的方法相当不足。本研究的目的是调查短期非线性方法符号动力学（STSD），去趋势波动（DFA）和庞加莱图分析（PPA）的适用性，这些患者的危险分层。分析91例DCM患者和30例健康受试者（REF）的心率和血压变异性（HRV、BPV）、STSD、DFA和PPA。来自BPV分析、DFA和PPA的测量显示区分REF和DCM的高度显著性差异（p < 0.0011）。对于DCM患者的风险分层，来自BPV分析、STSD和PPA的四个参数显示低风险和高风险之间存在显著差异（最大灵敏度：90%，特异性：90%）。这些结果表明，STSD和PPA是有用的非线性方法，用于增强DCM患者的危险分层。(c)2007年，美国物理学会。
Dilated cardiomyopathy (DCM) has an incidence of about 20/100 000 new cases per annum and accounts for nearly 10 000 deaths per year in the United States. Approximately 36% of patients with dilated cardiomyopathy (DCM) suffer from cardiac death within five years after diagnosis. Currently applied methods for an early risk prediction in DCM patients are rather insufficient. The objective of this study was to investigate the suitability of short-term nonlinear methods symbolic dynamics (STSD), detrended fluctuation (DFA), and Poincare plot analysis (PPA) for risk stratification in these patients. From 91 DCM patients and 30 healthy subjects (REF), heart rate and blood pressure variability (HRV, BPV), STSD, DFA, and PPA were analyzed. Measures from BPV analysis, DFA, and PPA revealed highly significant differences (p < 0.0011) discriminating REF and DCM. For risk stratification in DCM patients, four parameters from BPV analysis, STSD, and PPA revealed significant differences between low and high risk (maximum sensitivity: 90%, specificity: 90%). These results suggest that STSD and PPA are useful nonlinear methods for enhanced risk stratification in DCM patients. (c) 2007 American Institute of Physics.