Complex nonlinear autonomic nervous system modulation link cardiac autonomic neuropathy and peripheral vascular disease

Kinda Khalaf, Herbert Jelinek, Caroline Robinson, David J. Cornforth, Mika P. Tarvainen, Hayder Al-Aubaidy

Research output: Contribution to journalArticle

3 Citations (Scopus)
3 Downloads (Pure)

Abstract

Background: Physiological interactions are abundant within, and between, body systems. These interactions may evolve into discrete states during pathophysiological processes resulting from common mechanisms. An association between arterial stenosis, identified by low ankle-brachial pressure index (ABPI) and cardiovascular disease (CVD) as been reported. Whether an association between vascular calcification—characterized by high ABPI and a different pathophysiology—is similarly associated with CVD, has not been established. The current study aims to investigate the association between ABPI, and cardiac rhythm, as an indicator of cardiovascular health and functionality, utilizing heart rate variability (HRV).Methods and Results: Two hundred and thirty six patients underwent ABPI assessment. Standard time and frequency domain, and non-linear HRV measures were determined from 5-min electrocardiogram. ABPI data were divided into normal (n = 101), low (n = 67) and high (n = 66) and compared to HRV measures.(DFAα1 and SampEn were significantly different between the low ABPI, high ABPI and control groups (p < 0.05).Conclusion: A possible coupling between arterial stenosis and vascular calcification with decreased and increased HRV respectively was observed. Our results suggest a model for interpreting the relationship between vascular pathophysiology and cardiac rhythm. The cardiovascular system may be viewed as a complex system comprising a number of interacting subsystems. These cardiac and vascular subsystems/networks may be coupled and undergo transitions in response to internal or external perturbations. From a clinical perspective, the significantly increased sample entropy compared to the normal ABPI group and the decreased and increased complex correlation properties measured by DFA for the low and high ABPI groups respectively, may be useful indicators that a more holistic treatment approach in line with this more complex clinical picture is required.
Original languageEnglish
Article number101
Pages (from-to)1-9
Number of pages9
JournalFrontiers in Physiology
Volume6
DOIs
Publication statusPublished - Mar 2015

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Ankle Brachial Index
Peripheral Vascular Diseases
Autonomic Nervous System
Pressure
Heart Rate
Blood Vessels
Pathologic Constriction
Cardiovascular Diseases
Vascular Calcification
Entropy
Cardiovascular System
Electrocardiography
Control Groups

Cite this

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title = "Complex nonlinear autonomic nervous system modulation link cardiac autonomic neuropathy and peripheral vascular disease",
abstract = "Background: Physiological interactions are abundant within, and between, body systems. These interactions may evolve into discrete states during pathophysiological processes resulting from common mechanisms. An association between arterial stenosis, identified by low ankle-brachial pressure index (ABPI) and cardiovascular disease (CVD) as been reported. Whether an association between vascular calcification—characterized by high ABPI and a different pathophysiology—is similarly associated with CVD, has not been established. The current study aims to investigate the association between ABPI, and cardiac rhythm, as an indicator of cardiovascular health and functionality, utilizing heart rate variability (HRV).Methods and Results: Two hundred and thirty six patients underwent ABPI assessment. Standard time and frequency domain, and non-linear HRV measures were determined from 5-min electrocardiogram. ABPI data were divided into normal (n = 101), low (n = 67) and high (n = 66) and compared to HRV measures.(DFAα1 and SampEn were significantly different between the low ABPI, high ABPI and control groups (p < 0.05).Conclusion: A possible coupling between arterial stenosis and vascular calcification with decreased and increased HRV respectively was observed. Our results suggest a model for interpreting the relationship between vascular pathophysiology and cardiac rhythm. The cardiovascular system may be viewed as a complex system comprising a number of interacting subsystems. These cardiac and vascular subsystems/networks may be coupled and undergo transitions in response to internal or external perturbations. From a clinical perspective, the significantly increased sample entropy compared to the normal ABPI group and the decreased and increased complex correlation properties measured by DFA for the low and high ABPI groups respectively, may be useful indicators that a more holistic treatment approach in line with this more complex clinical picture is required.",
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author = "Kinda Khalaf and Herbert Jelinek and Caroline Robinson and Cornforth, {David J.} and Tarvainen, {Mika P.} and Hayder Al-Aubaidy",
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Complex nonlinear autonomic nervous system modulation link cardiac autonomic neuropathy and peripheral vascular disease. / Khalaf, Kinda; Jelinek, Herbert; Robinson, Caroline; Cornforth, David J.; Tarvainen, Mika P.; Al-Aubaidy, Hayder.

In: Frontiers in Physiology, Vol. 6, 101, 03.2015, p. 1-9.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Complex nonlinear autonomic nervous system modulation link cardiac autonomic neuropathy and peripheral vascular disease

AU - Khalaf, Kinda

AU - Jelinek, Herbert

AU - Robinson, Caroline

AU - Cornforth, David J.

AU - Tarvainen, Mika P.

AU - Al-Aubaidy, Hayder

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PY - 2015/3

Y1 - 2015/3

N2 - Background: Physiological interactions are abundant within, and between, body systems. These interactions may evolve into discrete states during pathophysiological processes resulting from common mechanisms. An association between arterial stenosis, identified by low ankle-brachial pressure index (ABPI) and cardiovascular disease (CVD) as been reported. Whether an association between vascular calcification—characterized by high ABPI and a different pathophysiology—is similarly associated with CVD, has not been established. The current study aims to investigate the association between ABPI, and cardiac rhythm, as an indicator of cardiovascular health and functionality, utilizing heart rate variability (HRV).Methods and Results: Two hundred and thirty six patients underwent ABPI assessment. Standard time and frequency domain, and non-linear HRV measures were determined from 5-min electrocardiogram. ABPI data were divided into normal (n = 101), low (n = 67) and high (n = 66) and compared to HRV measures.(DFAα1 and SampEn were significantly different between the low ABPI, high ABPI and control groups (p < 0.05).Conclusion: A possible coupling between arterial stenosis and vascular calcification with decreased and increased HRV respectively was observed. Our results suggest a model for interpreting the relationship between vascular pathophysiology and cardiac rhythm. The cardiovascular system may be viewed as a complex system comprising a number of interacting subsystems. These cardiac and vascular subsystems/networks may be coupled and undergo transitions in response to internal or external perturbations. From a clinical perspective, the significantly increased sample entropy compared to the normal ABPI group and the decreased and increased complex correlation properties measured by DFA for the low and high ABPI groups respectively, may be useful indicators that a more holistic treatment approach in line with this more complex clinical picture is required.

AB - Background: Physiological interactions are abundant within, and between, body systems. These interactions may evolve into discrete states during pathophysiological processes resulting from common mechanisms. An association between arterial stenosis, identified by low ankle-brachial pressure index (ABPI) and cardiovascular disease (CVD) as been reported. Whether an association between vascular calcification—characterized by high ABPI and a different pathophysiology—is similarly associated with CVD, has not been established. The current study aims to investigate the association between ABPI, and cardiac rhythm, as an indicator of cardiovascular health and functionality, utilizing heart rate variability (HRV).Methods and Results: Two hundred and thirty six patients underwent ABPI assessment. Standard time and frequency domain, and non-linear HRV measures were determined from 5-min electrocardiogram. ABPI data were divided into normal (n = 101), low (n = 67) and high (n = 66) and compared to HRV measures.(DFAα1 and SampEn were significantly different between the low ABPI, high ABPI and control groups (p < 0.05).Conclusion: A possible coupling between arterial stenosis and vascular calcification with decreased and increased HRV respectively was observed. Our results suggest a model for interpreting the relationship between vascular pathophysiology and cardiac rhythm. The cardiovascular system may be viewed as a complex system comprising a number of interacting subsystems. These cardiac and vascular subsystems/networks may be coupled and undergo transitions in response to internal or external perturbations. From a clinical perspective, the significantly increased sample entropy compared to the normal ABPI group and the decreased and increased complex correlation properties measured by DFA for the low and high ABPI groups respectively, may be useful indicators that a more holistic treatment approach in line with this more complex clinical picture is required.

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KW - Artery-occlusion

KW - Article

KW - Autonomic-nervous-system

KW - Autonomic-neuropathy

KW - Blood-vessel-calcification

KW - Controlled-study

KW - Disease-association

KW - Female

KW - Heart-rate-variability

KW - Heart-rhythm

KW - Human

KW - Major-clinical-study

KW - Male

KW - Mi

U2 - 10.3389/fphys.2015.00101

DO - 10.3389/fphys.2015.00101

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VL - 6

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EP - 9

JO - Frontiers in Physiology

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SN - 1664-042X

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