Short-Term HRV Analysis Using Nonparametric Sample Entropy for Obstructive Sleep Apnea.

Obstructive sleep apnea (OSA) is associated with reduced heart rate variability (HRV) and autonomic nervous system dysfunction. Sample entropy (SampEn) is commonly used for regularity analysis. However, it has limitations in processing short-term segments of HRV signals due to the extreme dependence of its functional parameters. We used the nonparametric sample entropy (NPSampEn) as a novel index for short-term HRV analysis in the case of OSA. The manuscript included 60 6-h electrocardiogram recordings (20 healthy, 14 mild-moderate OSA, and 26 severe OSA) from the PhysioNet database. The NPSampEn value was compared with the SampEn value and frequency domain indices. The empirical results showed that NPSampEn could better differentiate the three groups (p < 0.01) than the ratio of low frequency power to high frequency power (LF/HF) and SampEn. Moreover, NPSampEn (83.3%) approached a higher OSA screening accuracy than the LF/HF (73.3%) and SampEn (68.3%). Compared with SampEn (|r| = 0.602, p < 0.05), NPSampEn (|r| = 0.756, p < 0.05) had a significantly stronger association with the apnea-hypopnea index (AHI). Hence, NPSampEn can fully overcome the influence of individual differences that are prevalent in biomedical signal processing, and might be useful in processing short-term segments of HRV signal.

The Interaction Analysis between the Sympathetic and Parasympathetic Systems in CHF by Using Transfer Entropy Method.

Congestive heart failure (CHF) is a cardiovascular disease associated with autonomic dysfunction, where sympathovagal imbalance was reported in many studies using heart rate variability (HRV). To learn more about the dynamic interaction in the autonomic nervous system (ANS), we explored the directed interaction between the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS) with the help of transfer entropy (TE). This article included 24-h RR interval signals of 54 healthy subjects (31 males and 23 females, 61.38 ± 11.63 years old) and 44 CHF subjects (8 males and 2 females, 19 subjects' gender were unknown, 55.51 ± 11.44 years old, 4 in class I, 8 in class II and 32 in class III~IV, according to the New York Heart Association Function Classification), obtained from the PhysioNet database and then segmented into 5-min non-overlapping epochs using cubic spline interpolation. For each segment in the normal group and CHF group, frequency-domain features included low-frequency (LF) power, high-frequency (HF) power and LF/HF ratio were extracted as classical estimators of autonomic activity. In the nonlinear domain, TE between LF and HF were calculated to quantify the information exchanging between SNS and PNS. Compared with the normal group, an extreme decrease in LF/HF ratio (p = 0.000) and extreme increases in both TE(LF→HF) (p = 0.000) and TE(HF→LF) (p = 0.000) in the CHF group were observed. Moreover, both in normal and CHF groups, TE(LF→HF) was a lot greater than TE(HF→LF) (p = 0.000), revealing that TE was able to distinguish the difference in the amount of directed information transfer among ANS. Extracted features were further applied in discriminating CHF using IBM SPSS Statistics discriminant analysis. The combination of the LF/HF ratio, TE(LF→HF) and TE(HF→LF) reached the highest screening accuracy (83.7%). Our results suggested that TE could serve as a complement to traditional index LF/HF in CHF screening.