Baroreflex analysis in diabetes mellitus: linear and nonlinear approaches
Date
2011
Authors
Javorka, M.
Lazarova, Z.
Tonhajzerova, I.
Turianikova, Z.
Honzikova, N.
Fiser, B.
Javorka, K.
Baumert, M.
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Journal article
Citation
Medical and Biological Engineering and Computing, 2011; 49(3):279-288
Statement of Responsibility
Michal Javorka, Zuzana Lazarova, Ingrid Tonhajzerova, Zuzana Turianikova, Natasa Honzikova, Bohumil Fiser, Kamil Javorka and Mathias Baumert
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Abstract
The aim of our study was to employ novel nonlinear synchronization approaches as a tool to detect baroreflex impairment in young patients with subclinical autonomic dysfunction in Type 1 diabetes mellitus (DM) and compare them to standard linear baroreflex sensitivity (BRS) methods. We recorded beat-to-beat pulse interval (PI) and systolic blood pressure (SBP) in 14 DM patients and 14 matched healthy controls. We computed the information domain synchronization index (IDSI), cross-multiscale entropy, joint symbolic dynamics, information-based similarity index (IBSI) in addition to time domain and spectral measures of BRS. This multi parametric analysis showed that baroreflex gain is well-preserved, but the time delay within the baroreflex loop is significantly increased in patients with DM. Further, the level of similarity between blood pressure and heart rate fluctuations was significantly reduced in DM. In conclusion, baroreflex function in young DM patients is changed. The quantification of nonlinear similarity and baroreflex delay in addition to baroreflex gain may provide an improved diagnostic tool for detection of subclinical autonomic dysfunction in DM.
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Copyright International Federation for Medical and Biological Engineering 2010