Download PDF
Methods Inf Med 2014; 53(04): 286-290
DOI: 10.3414/ME13-02-0045
Focus Theme – Original Articles
Schattauer GmbH

Coupling of Heart Rate and Systolic Blood Pressure in Hypertensive Pregnancy

A. Voss
1   Department of Medical Engineering and Biotechnology, University of Applied Sciences Jena, Germany
,
C. Fischer
1   Department of Medical Engineering and Biotechnology, University of Applied Sciences Jena, Germany
,
R. Schroeder
1   Department of Medical Engineering and Biotechnology, University of Applied Sciences Jena, Germany
› Author Affiliations
Further Information

Publication History

received:23 October 2013

accepted:24 June 2014

Publication Date:
20 January 2018 (online)

    Permissions and Reprints

Summary

Introduction: This article is part of the Focus Theme of Methods of Information in Medicine on “Biosignal Interpretation: Advanced Methods for Studying Cardiovascular and Respiratory Systems”.

Background: Hypertensive pregnancy disorders affect 6 – 8 percent of all pregnancies and can result in severe complications for both the mother and the fetus.

Objectives: The aim of this study was to improve risk stratification of pregnant women suffering from hypertension and pre-eclampsia (PE) by applying bivariate Segmented Poincaré plot analysis (BSPPA).

Methods: From 35 pregnant women suffering from chronic hypertension, gestational hypertension and PE, 30 minutes of non invasive systolic blood pressure and beat-to-beat intervals were continuously recorded and analyzed by applying BSPPA to quantify their couplings.

Results: We revealed significant different couplings between chronic hypertension (CH), gestational hypertension and PE, indicating that cardiovascular regulation can be considerably altered depending on the type of hypertensive disorder. The optimal multivariate set of two BSPPA indices was determined which distinguish best between CH and PE. It achieved a sensitivity of 100%, a specificity of 77.8% and an area under the receiver operator characteristic curve of 90.8%.

Conclusions: The BSPPA method a) provides improved risk stratification for pregnant women suffering from hypertension and PE, b) increases the ability to diagnose pathological changes, and c) could contribute substantially to the differential diagnosis of hypertensive pregnancy disorders.

Keywords

Poincaré plot analysis - hypertensive pregnancy disorders - nonlinear dynamics - coupling - heart rate variability - blood pressure
 

  • References

  • 1 Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. Am J Obstet Gynecol 2000; 183 (01) S1-S22.
    CrossrefPubMedGoogle Scholar
  • 2 Zamorski MA, Green LA. NHBPEP report on high blood pressure in pregnancy: a summary for family physicians. American family physician 2001; 64 (02) 263-270.
    PubMedGoogle Scholar
  • 3 Jindal RD, Vasko Jr. RC, Jennings JR, Fasiczka AL, Thase ME, Reynolds 3rd CF. Heart rate variability in depressed elderly. Am J Geriatr Psychiatry 2008; 16 (11) 861-866.
    CrossrefPubMedGoogle Scholar
  • 4 Voss A, Fischer C, Schroeder R, Figulla HR, Goernig M. Segmented Poincare plot analysis for risk stratification in patients with dilated cardiomyopathy. Methods Inf Med 2010; 49 (05) 511-515.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 5 Guzik P, Piskorski J, Krauze T, Schneider R, Wesseling KH, Wykretowicz A. et al Correlations between the Poincare plot and conventional heart rate variability parameters assessed during paced breathing. The journal of physiological sciences (JPS) 2007; 57 (01) 63-71.
    CrossrefPubMedGoogle Scholar
  • 6 Voss A, Seeck A, Baumert M. Altered interactions of heart rate and blood pressure during normal and abnormal pregnancy. Conference proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society IEEE Engineering in Medicine and Biology Society Conference. 2010: 1695-1698.
    Google Scholar
  • 7 Baumert M, Walther T, Hopfe J, Stepan H, Faber R, Voss A. Joint symbolic dynamic analysis of beat-to-beat interactions of heart rate and systolic blood pressure in normal pregnancy. Medical & biological engineering & computing 2002; 40 (02) 241-245.
    CrossrefPubMedGoogle Scholar
  • 8 Wesseling KH. Finger arterial pressure measurement with Finapres. Z Kardiol 1996; 85 (Suppl. 03) Suppl 38-44.
    PubMedGoogle Scholar
  • 9 Wessel N, Voss A, Malberg H, Ziehmann C, Voss HU, Schirdewan A. et al Nonlinear analysis of complex phenomena in cardiological data. Herzschr Elektrophys 2000; 11: 159-173. Steinkopff Verlag
    CrossrefPubMedGoogle Scholar
  • 10 Babloyantz A, Destexhe A. Is the normal heart a periodic oscillator?. Biological cybernetics 1988; 58 (03) 203-211.
    CrossrefPubMedGoogle Scholar
  • 11 Faber R, Baumert M, Stepan H, Wessel N, Voss A, Walther T. Baroreflex sensitivity, heart rate, and blood pressure variability in hypertensive pregnancy disorders. J Hum Hypertens 2004; 18 (10) 707-712.
    CrossrefPubMedGoogle Scholar