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Clinical Autonomic Research
Erschienen in: Clinical Autonomic Research 2/2019

16.10.2018 | Research Article

Deceleration and acceleration capacities of heart rate in patients with drug-resistant epilepsy

verfasst von: Hongyun Liu, Zhao Yang, Fangang Meng, Yuguang Guan, Yanshan Ma, Shuli Liang, Jiuluan Lin, Longsheng Pan, Mingming Zhao, Hongwei Hao, Guoming Luan, Jianguo Zhang, Luming Li

Erschienen in: Clinical Autonomic Research | Ausgabe 2/2019

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Abstract

Objective

Epilepsy and seizures can have dramatic effects on cardiac function. The aim of the present study was to investigate deceleration capacity, acceleration capacity and their 24-h fluctuations of heart rate variability in patients with drug-resistant epilepsy.

Methods

Deceleration capacity, acceleration capacity of heart rate and their 24-h dynamics derived from the phase rectified signal averaging method as well as traditional measures were analyzed in 39 patients with drug-resistant epilepsy and 33 healthy control subjects using 24-h electrocardiogram recordings. The discriminatory power of heart rate variability measures were validated by assessment of the area under the receiver operating characteristic curve. Net reclassification improvement and integrated discrimination improvement models were also estimated.

Results

Both deceleration capacity and absolute values of acceleration capacity were significantly lower in patients with drug-resistant epilepsy. The abnormal suppression of absolute deceleration capacity and acceleration capacity values were observed throughout the 24-h recording time (peaked at about 3 to 5 A.M.). Deceleration capacity had the greatest discriminatory power to differentiate the patients from the healthy controls. Moreover, in both net reclassification improvement and integrated discrimination improvement models, the combination of acceleration capacity or deceleration capacity with traditional heart rate variability measures has greater discriminatory power than any of the single heart rate variability features.

Interpretation

Drug-resistant epilepsy was associated with a significant inhibition of vagal modulation of heart rate, which was more pronounced during the night than during the day. These findings indicate that phase rectified signal averaging method may serve as a complementary approach for characterizing and understanding the neuro-pathophysiology in epilepsy, and may provide a new clue to sudden unexpected death in epilepsy.
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Literatur
1.
2.
Kwan P, Arzimanoglou A, Berg AT, Brodie MJ, Allen Hauser W, Mathern G, Moshé SL, Perucca E, Wiebe S, French J (2010) Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia 51:1069–1077CrossRefPubMed
3.
Sevcencu C, Struijk JJ (2010) Autonomic alterations and cardiac changes in epilepsy. Epilepsia 51:725–737CrossRefPubMed
4.
Romigi A, Albanese M, Placidi F, Izzi F, Mercuri NB, Marchi A, Liguori C, Campagna N, Duggento A, Canichella A, Ricciardo RG, Guerrisi M, Marciani MG, Toschi N (2016) Heart rate variability in untreated newly diagnosed temporal lobe epilepsy: evidence for ictal sympathetic dysregulation. Epilepsia 57:418–426CrossRefPubMed
5.
Massey CA, Sowers LP, Dlouhy BJ, Richerson GB (2014) Mechanisms of sudden unexpected death in epilepsy: the pathway to prevention. Nat Rev Neurol 10:271–282CrossRefPubMedPubMedCentral
6.
Ryvlin P, Nashef L, Tomson T (2013) Prevention of sudden unexpected death in epilepsy: a realistic goal? Epilepsia 54:23–28CrossRefPubMed
7.
Ryvlin P, Nashef L, Lhatoo SD, Bateman LM, Bird J, Bleasel A (2013) Incidence and mechanisms of cardiorespiratory arrests in epilepsy monitoring units (MORTEMUS): a retrospective study. Lancet Neurol 12:966–977CrossRefPubMed
8.
Nobili L, Proserpio P, Rubboli G, Montano N, Didato G, Tassinari CA (2011) Sudden unexpected death in epilepsy (SUDEP) and sleep. Sleep Med Rev 15:237–246CrossRefPubMed
9.
Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology (1996) Heart rate variability: standards of measurement, physiological interpretation and clinical use. Circulation 93:1043–1065
10.
McCraty R, Shaffer F (2015) Heart rate variability: new perspectives on physiological mechanisms, assessment of self-regulatory capacity, and health risk. Glob Adv Health Med 4:46–61CrossRefPubMedPubMedCentral
11.
Manor B, Costa MD, Hu K, Newton E, Starobinets O, Kang HG, Peng CK, Novak V, Lipsitz LA (2010) Physiological complexity and system adaptability: evidence from postural control dynamics of older adults. J Appl Physiol 109:1786–1791CrossRefPubMedPubMedCentral
12.
Hu W, Jin X, Zhang P, Yu Q, Yin G, Lu Y, Xiao H, Chen Y, Zhang D (2016) Deceleration and acceleration capacities of heart rate associated with heart failure with high discriminating performance. Sci Rep 6:23617CrossRefPubMedPubMedCentral
13.
Bauer A, Kantelhardt JW, Bunde A, Barthel P, Schneider R, Malik M, Schmidt G (2006) Phase-rectified signal averaging detects quasi-periodicities in non-stationary data. Physica A Stat Mech Appl 364:423–434CrossRef
14.
Bauer A, Kantelhardt JW, Barthel P, Schneider R, Mäkikallio T, Ulm K, Hnatkova K, Schömig A, Huikuri H, Bunde A, Malik M, Schmidt G (2006) Deceleration capacity of heart rate as a predictor of mortality after myocardial infarction: cohort study. Lancet 367:1674–1681CrossRefPubMed
15.
Warwick PM (1988) Prediction of energy expenditure: simplified FAO/WHO/UNU factorial method vs continuous respirometry and habitual energy intake. Am J Clin Nutr 48:1188–1196CrossRefPubMed
16.
Fujiwara K, Miyajima M, Yamakawa T, Abe E, Suzuki Y, Sawada Y, Kano M, Maehara T, Ohta K, Sasai-Sakuma T, Sasano T, Matsuura M, Matsushima E (2016) Epileptic seizure prediction based on multivariate statistical process control of heart rate variability features. IEEE Trans Biomed Eng 63:1321–1332CrossRefPubMed
17.
Myers KA, Bello-Espinosa LE, Symonds JD, Zuberi SM, Clegg R, Sadleir L, Buchhalter J, Scheffer IE (2018) Heart rate variability in epilepsy: a potential biomarker of sudden unexpected death in epilepsy risk using a simple threshold. Epilepsia 59:1372–1380CrossRefPubMed
18.
Nakagawa M, Iwao T, Ishida S, Yonemochi H, Fujino T, Saikawa T, Ito M (1998) Circadian rhythm of the signal averaged electrocardiogram and its relation to heart rate variability in healthy subjects. Heart 79:493–496CrossRefPubMedPubMedCentral
19.
Nelson W, Tong YL, Lee JK, Halberg F (1979) Methods for cosinor-rhythmometry. Chronobiologia 6:305–323PubMed
20.
Pencina MJ, D’Agostino RBS, D’Agostino RBJ, Vasan RS (2008) Evaluating the added predictive ability of a new marker:from area under the ROC curve to reclassification and beyond. Stat Med 27:157–172CrossRefPubMed
21.
Pickering JW, Endre ZH (2012) New metrics for assessing diagnostic potential of candidate biomarkers. Clin J Am Soc Nephrol 7:1355–1364CrossRefPubMed
22.
Steyerberg EW, Vickers AJ, Cook NR, Gerds T, Gonen M, Obuchowski N, Pencina MJ, Kattan MW (2010) Assessing the performance of prediction models a framework for traditional and novel measures. Epidemiology 21:128–138CrossRefPubMedPubMedCentral
23.
Shaffer F, Mccraty R, Zerr CL (2014) A healthy heart is not a metronome: an integrative review of the heart’s anatomy and heart rate variability. Front Psychol 5:1040CrossRefPubMedPubMedCentral
24.
Pagani M, Lombardi F, Guzzetti S, Sandrone G, Rimoldi O, Malfatto G, Cerutti S, Malliani A (1984) Power spectral density of heart rate variability as an index of symptho-vagal interactions in normal and hypertensive subjects. J Hypertens Suppl 2:383–385
25.
Bas R, Vallverdú M, Valencia JF, Voss A, de Luna AB, Caminal P (2015) Evaluation of acceleration and deceleration cardiac processes using phase-rectified signal averaging in healthy and idiopathic dilated cardiomyopathy subjects. Med Eng Phys 37:195–202CrossRefPubMed
26.
Tagliaferri S, Fanelli A, Esposito G, Esposito FG, Magenes G, Signorini MG, Campanile M, Martinelli P (2015) Evaluation of the acceleration and deceleration phase-rectified slope to detect and improve IUGR clinical management. Comput Math Methods Med 2015:1–9CrossRef
27.
Graatsma EM, Mulder EJ, Vasak B, Lobmaier SM, Pildner von Steinburg S, Schneider KT, Schmidt G, Visser GH (2012) Average acceleration and deceleration capacity of fetal heart rate in normal pregnancy and in pregnancies complicated by fetal growth restriction. J Matern Fetal Neonatal Med 25:2517–2522CrossRefPubMed
28.
Nasari Junior O, Benchimol-Barbosa PR, Pedrosa RC, Nadal J (2015) Assessment of autonomic function by phase rectification of RR interval histogram analysis in Chagas disease. Arq Bras Cardiol 104:450–455PubMedCentral
29.
Xu YH, Wang XD, Yang JJ, Zhou L, Pan YC (2016) Changes of deceleration and acceleration capacity of heart rate in patients with acute hemispheric ischemic stroke. Clin Interv Aging 11:293–298CrossRefPubMedPubMedCentral
30.
Buzea CA, Dan GA, Dan AR, Delcea C, Balea MI, Gologanu D, Popescu RA, Dobranici M (2017) Deceleration and acceleration capacities in risk stratification for arrhythmias in patients with chronic obstructive pulmonary disease. Am J Ther 24:e44CrossRefPubMed
31.
Lotufo PA, Valiengo L, Benseñor IM, Brunoni AR (2012) A systematic review and meta-analysis of heart rate variability in epilepsy and antiepileptic drugs. Epilepsia 53:272–282CrossRefPubMed
32.
Tomson T, Ericson M, Ihrman C, Lindblad LE (1998) Heart rate variability in patients with epilepsy. Epilepsy Res 30:77–83CrossRefPubMed
33.
El-Sayed HL, Kotby AA, Tomoum HY, El-Hadidi ES, El Behery SE, El-Ganzory AM (2007) Non-invasive assessment of cardioregulatory autonomic functions in children with epilepsy. Acta Neurol Scand 115:377–384CrossRefPubMed
34.
Shobha N, Satishchandra P, Sathyaprabha TN, Udupa K (2007) A study of interictal cardiac autonomic functions in patients with refractory complex partial epilepsy secondary to medial lobe pathology: before and after surgery. Neurol Asia 12:69–70
35.
Massetani R, Strata G, Galli R, Gori S, Gneri C, Limbruno U, Di Santo D, Mariani M, Murri L (1997) Alteration of cardiac function in patients with temporal lobe epilepsy: different roles of EEG-ECG monitoring and spectral analysis of RR variability. Epilepsia 38:363–369CrossRefPubMed
36.
Ansakorpi H, Korpelainen JT, Suominen K, Tolonen U, Myllylä VV, Isojärvi JI (1998) Interictal cardiovascular autonomic responses in patients with epilepsy. Epilepsia 39:420–426CrossRefPubMed
37.
Ansakorpi H, Korpelainen JT, Huikuri HV, Tolonen U, Myllylä VV, Isojärvi JI (2002) Heart rate dynamics in refractory and well controlled temporal lobe epilepsy. J Neurol Neurosurg Psychiatry 72:26–30CrossRefPubMedPubMedCentral
38.
Ronkainen E, Ansakorpi H, Huikuri HV, Myllylä VV, Isojärvi JI, Korpelainen JT (2005) Suppressed circadian heart rate dynamics in temporal lobe epilepsy. J Neurol Neurosurg Psychiatry 76:1382–1386CrossRefPubMedPubMedCentral
39.
Dutsch M, Hilz MJ, Devinsky O (2006) Impaired baroreflex function in temporal lobe epilepsy. J Neurol 253:1300–1308CrossRefPubMed
40.
Evrengül H, Tanriverdi H, Dursunoglu D, Kaftan A, Kuru O, Unlu U, Kilic M (2005) Time and frequency domain analyses of heart rate variability in patients with epilepsy. Epilepsy Res 63:131–139CrossRefPubMed
41.
Harnod T, Yang CC, Hsin YL, Shieh KR, Wang PJ, Kuo TB (2008) Heart rate variability in children with refractory generalized epilepsy. Seizure 17:297–301CrossRefPubMed
42.
Pan Q, Zhou GZ, Wang RF, Yu YH, Li F, Fang LP, Yan J, Ning GM (2016) The degree of heart rate asymmetry is crucial for the validity of the deceleration and acceleration capacity indices of heart rate: a model-based study. Comput Biol Med 76:39–49CrossRefPubMed
43.
Hofstra WA, deWeerd AW (2009) The circadian rhythm and its interaction with human epilepsy: a review of literature. Sleep Med Rev 13:413–420CrossRefPubMed
44.
Persson H, Kumlien E, Ericson M, Tomson T (2007) Circadian variation in heart rate variability in localization-related epilepsy. Epilepsia 48:917–922CrossRefPubMed
45.
Sivakumar SS, Namath AG, Tuxhorn IE, Lewis SJ, Galán RF (2016) Decreased heart rate and enhanced sinus arrhythmia during interictal sleep demonstrate autonomic imbalance in generalized epilepsy. J Neurophysiol 115:1988–1999CrossRefPubMedPubMedCentral
46.
Lin Z, Si Q, Xiaoyi Z (2017) Obstructive sleep apnoea in patients with epilepsy: a meta-analysis. Sleep Breath 21:263–270CrossRefPubMed
Metadaten
Titel
Deceleration and acceleration capacities of heart rate in patients with drug-resistant epilepsy
verfasst von
Hongyun Liu
Zhao Yang
Fangang Meng
Yuguang Guan
Yanshan Ma
Shuli Liang
Jiuluan Lin
Longsheng Pan
Mingming Zhao
Hongwei Hao
Guoming Luan
Jianguo Zhang
Luming Li
Publikationsdatum
16.10.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
Clinical Autonomic Research / Ausgabe 2/2019
Print ISSN: 0959-9851
Elektronische ISSN: 1619-1560
DOI
https://doi.org/10.1007/s10286-018-0569-0

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