Evaluation of autonomic nervous system activity in intradialytic hypotension using entropy and skin sympathetic nerve activity
IntroductionThe function of the autonomic nervous system (ANS) is crucial in the development of intradialytic hypotension (IDH). This study introduced the entropy of heart rate variability (HRV) and skin sympathetic nerve activity (SKNA) to provide a complementary nonlinear and dynamic perspective f...
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Frontiers Media S.A.
2023-05-01
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| Series: | Frontiers in Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnins.2023.1196750/full |
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| author | Jiayi Li Yantao Xing Yike Zhang Chang Cui Jing Wang Jianqing Li Chengyu Liu |
| author_facet | Jiayi Li Yantao Xing Yike Zhang Chang Cui Jing Wang Jianqing Li Chengyu Liu |
| author_sort | Jiayi Li |
| collection | DOAJ |
| description | IntroductionThe function of the autonomic nervous system (ANS) is crucial in the development of intradialytic hypotension (IDH). This study introduced the entropy of heart rate variability (HRV) and skin sympathetic nerve activity (SKNA) to provide a complementary nonlinear and dynamic perspective for evaluating ANS function concerning IDH.Methods93 patients undergoing hemodialysis (HD) were enrolled, and the baseline data, electrocardiogram (ECG), and SKNA were collected. The patients were separated into the IDH and nonIDH groups based on the thresholds, which were characterized as reductions in systolic blood pressure (SBP) of at least 20 mm Hg or mean arterial pressure (MAP) of at least 10 mm Hg. We developed a logistic regression model for IDH after analyzing the changes in the time domain, frequency domain, the entropy of HRV, and SKNA indices during HD.ResultsAfter 4-h HD, the detected results for heart rate, the ratio of low frequency and high frequency (LF/HF), and average SKNA (aSKNA) all increased in both groups. Nine out of the ten HRV indices and aSKNA in the nonIDH group were higher than those in the IDH group at most moments. aSKNA was positively correlated with heart rate (p = 0.0001) and LF/HF (p = 0.0005) in the nonIDH group, while the correlation disappeared in the IDH group, which indicated a worse ANS response in IDH patients. The logistic regression model exhibited the results of initial SBP [odds ratio (OR) 1.076; p = 0.001], and the difference between the last and first segments (DLF) of heart rate [OR 1.101; p =0.012] and LF/HF [OR 0.209; p =0.034], as well as the extreme value of the difference between other segments and the first segments (EOF) of aSKNA [OR 2.908; p =0.017], which were independent indicators for IDH.DiscussionThe new nonlinear and dynamic assessment perspectives provided by the entropy of HRV and SKNA help to distinguish differences in ANS patterns between IDH patients and nonIDH patients and have the potential to be used in clinical monitoring for HD patients. |
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| issn | 1662-453X |
| language | English |
| last_indexed | 2024-04-09T12:36:05Z |
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| spelling | doaj.art-12a61bb18b4a4fcd8cd8158551c1c3672023-05-15T09:48:55ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2023-05-011710.3389/fnins.2023.11967501196750Evaluation of autonomic nervous system activity in intradialytic hypotension using entropy and skin sympathetic nerve activityJiayi Li0Yantao Xing1Yike Zhang2Chang Cui3Jing Wang4Jianqing Li5Chengyu Liu6State Key Laboratory of Digital Medical Engineering, School of Instrument Science and Engineering, Southeast University, Nanjing, ChinaState Key Laboratory of Digital Medical Engineering, School of Instrument Science and Engineering, Southeast University, Nanjing, ChinaDivision of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDivision of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDivision of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaState Key Laboratory of Digital Medical Engineering, School of Instrument Science and Engineering, Southeast University, Nanjing, ChinaState Key Laboratory of Digital Medical Engineering, School of Instrument Science and Engineering, Southeast University, Nanjing, ChinaIntroductionThe function of the autonomic nervous system (ANS) is crucial in the development of intradialytic hypotension (IDH). This study introduced the entropy of heart rate variability (HRV) and skin sympathetic nerve activity (SKNA) to provide a complementary nonlinear and dynamic perspective for evaluating ANS function concerning IDH.Methods93 patients undergoing hemodialysis (HD) were enrolled, and the baseline data, electrocardiogram (ECG), and SKNA were collected. The patients were separated into the IDH and nonIDH groups based on the thresholds, which were characterized as reductions in systolic blood pressure (SBP) of at least 20 mm Hg or mean arterial pressure (MAP) of at least 10 mm Hg. We developed a logistic regression model for IDH after analyzing the changes in the time domain, frequency domain, the entropy of HRV, and SKNA indices during HD.ResultsAfter 4-h HD, the detected results for heart rate, the ratio of low frequency and high frequency (LF/HF), and average SKNA (aSKNA) all increased in both groups. Nine out of the ten HRV indices and aSKNA in the nonIDH group were higher than those in the IDH group at most moments. aSKNA was positively correlated with heart rate (p = 0.0001) and LF/HF (p = 0.0005) in the nonIDH group, while the correlation disappeared in the IDH group, which indicated a worse ANS response in IDH patients. The logistic regression model exhibited the results of initial SBP [odds ratio (OR) 1.076; p = 0.001], and the difference between the last and first segments (DLF) of heart rate [OR 1.101; p =0.012] and LF/HF [OR 0.209; p =0.034], as well as the extreme value of the difference between other segments and the first segments (EOF) of aSKNA [OR 2.908; p =0.017], which were independent indicators for IDH.DiscussionThe new nonlinear and dynamic assessment perspectives provided by the entropy of HRV and SKNA help to distinguish differences in ANS patterns between IDH patients and nonIDH patients and have the potential to be used in clinical monitoring for HD patients.https://www.frontiersin.org/articles/10.3389/fnins.2023.1196750/fullECGskin sympathetic nerve activityentropyintradialytic hypotensionheart rate variabilityautonomic nervous system |
| spellingShingle | Jiayi Li Yantao Xing Yike Zhang Chang Cui Jing Wang Jianqing Li Chengyu Liu Evaluation of autonomic nervous system activity in intradialytic hypotension using entropy and skin sympathetic nerve activity Frontiers in Neuroscience ECG skin sympathetic nerve activity entropy intradialytic hypotension heart rate variability autonomic nervous system |
| title | Evaluation of autonomic nervous system activity in intradialytic hypotension using entropy and skin sympathetic nerve activity |
| title_full | Evaluation of autonomic nervous system activity in intradialytic hypotension using entropy and skin sympathetic nerve activity |
| title_fullStr | Evaluation of autonomic nervous system activity in intradialytic hypotension using entropy and skin sympathetic nerve activity |
| title_full_unstemmed | Evaluation of autonomic nervous system activity in intradialytic hypotension using entropy and skin sympathetic nerve activity |
| title_short | Evaluation of autonomic nervous system activity in intradialytic hypotension using entropy and skin sympathetic nerve activity |
| title_sort | evaluation of autonomic nervous system activity in intradialytic hypotension using entropy and skin sympathetic nerve activity |
| topic | ECG skin sympathetic nerve activity entropy intradialytic hypotension heart rate variability autonomic nervous system |
| url | https://www.frontiersin.org/articles/10.3389/fnins.2023.1196750/full |
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