Complex Nonlinear Autonomic Nervous System Modulation Link Cardiac Autonomic Neuropathy and Peripheral Vascular Disease

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 (A...

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Main Authors: Kinda eKhalaf, Herbert F. Jelinek, Caroline eRobinson, David J Cornforth, Mika P. Tarvainen, Hayder eAl-Aubaidy
Format: Article
Language:English
Published: Frontiers Media S.A. 2015-03-01
Series:Frontiers in Physiology
Subjects:
Online Access:http://journal.frontiersin.org/Journal/10.3389/fphys.2015.00101/full
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author Kinda eKhalaf
Herbert F. Jelinek
Caroline eRobinson
David J Cornforth
Mika P. Tarvainen
Hayder eAl-Aubaidy
author_facet Kinda eKhalaf
Herbert F. Jelinek
Caroline eRobinson
David J Cornforth
Mika P. Tarvainen
Hayder eAl-Aubaidy
author_sort Kinda eKhalaf
collection DOAJ
description 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, utilising 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-minute 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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spelling doaj.art-a32215989af24bf79c350a19ef18f05f2022-12-21T18:30:13ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2015-03-01610.3389/fphys.2015.00101134581Complex Nonlinear Autonomic Nervous System Modulation Link Cardiac Autonomic Neuropathy and Peripheral Vascular DiseaseKinda eKhalaf0Herbert F. Jelinek1Caroline eRobinson2David J Cornforth3Mika P. Tarvainen4Hayder eAl-Aubaidy5Khalifa University of Science Technology and ResearchCharles Sturt UniversityCharles Sturt UniversityUniversity of NewcastleUniversity of Eastern FinlandUniversity of TasmaniaBackground: 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, utilising 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-minute 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.http://journal.frontiersin.org/Journal/10.3389/fphys.2015.00101/fullcomplex systemsheart rate variability (HRV)Ankle Brachial Pressure Index (ABPI)Peripheral Vascular Disease (PVD)Network physiology
spellingShingle Kinda eKhalaf
Herbert F. Jelinek
Caroline eRobinson
David J Cornforth
Mika P. Tarvainen
Hayder eAl-Aubaidy
Complex Nonlinear Autonomic Nervous System Modulation Link Cardiac Autonomic Neuropathy and Peripheral Vascular Disease
Frontiers in Physiology
complex systems
heart rate variability (HRV)
Ankle Brachial Pressure Index (ABPI)
Peripheral Vascular Disease (PVD)
Network physiology
title Complex Nonlinear Autonomic Nervous System Modulation Link Cardiac Autonomic Neuropathy and Peripheral Vascular Disease
title_full Complex Nonlinear Autonomic Nervous System Modulation Link Cardiac Autonomic Neuropathy and Peripheral Vascular Disease
title_fullStr Complex Nonlinear Autonomic Nervous System Modulation Link Cardiac Autonomic Neuropathy and Peripheral Vascular Disease
title_full_unstemmed Complex Nonlinear Autonomic Nervous System Modulation Link Cardiac Autonomic Neuropathy and Peripheral Vascular Disease
title_short Complex Nonlinear Autonomic Nervous System Modulation Link Cardiac Autonomic Neuropathy and Peripheral Vascular Disease
title_sort complex nonlinear autonomic nervous system modulation link cardiac autonomic neuropathy and peripheral vascular disease
topic complex systems
heart rate variability (HRV)
Ankle Brachial Pressure Index (ABPI)
Peripheral Vascular Disease (PVD)
Network physiology
url http://journal.frontiersin.org/Journal/10.3389/fphys.2015.00101/full
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