Abstract:Obstructive sleep apnea (OSA) is a common sleep disorder that often associates with reduced heart rate variability (HRV) indicating autonomic dysfunction. HRV is mainly composed of high frequency components attributed to parasympathetic activity and low frequency components attributed to sympathetic activity. Although, time domain and frequency domain features of HRV have been used to sleep studies, the complex interaction between nonlinear independent frequency components with OSA is less known. This study included 30 electrocardiogram recordings (20 OSA patient recording and 10 healthy subjects) with apnea or normal label in 1-min segment. All segments were divided into three groups: N-N group (normal segments of normal subjects), P-N group (normal segments of OSA subjects) and P-OSA group (apnea segments of OSA subjects). Frequency domain indices and interaction indices were extracted from segmented RR intervals. Frequency domain indices included nuLF, nuHF, and LF/HF ratio; interaction indices included mutual information (MI) and transfer entropy (TE (H→L) and TE (L→H)). Our results demonstrated that LF/HF ratio was significant higher in P-OSA group than N-N group and P-N group. MI was significantly larger in P-OSA group than P-N group. TE (H→L) and TE (L→H) showed a significant decrease in P-OSA group, compared to P-N group and N-N group. TE (H→L) were significantly negative correlation with LF/HF ratio in P-N group (r = −0.789, p = 0.000) and P-OSA group (r = −0.661, p = 0.002). Our results indicated that MI and TE is powerful tools to evaluate sympathovagal modulation in OSA. Moreover, sympathovagal modulation is more imbalance in OSA patients while suffering from apnea event compared to free event.
Congestive heart failure (CHF) is a cardiovascular disease associated with autonomic dysfunction, where sympathovagal imbalance was reported in many studies using heart rate variability (HRV). To learn more about the dynamic interaction in the autonomic nervous system (ANS), we explored the directed interaction between the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS) with the help of transfer entropy (TE). This article included 24-h RR interval signals of 54 healthy subjects (31 males and 23 females, 61.38 ± 11.63 years old) and 44 CHF subjects (8 males and 2 females, 19 subjects’ gender were unknown, 55.51 ± 11.44 years old, 4 in class I, 8 in class II and 32 in class III~IV, according to the New York Heart Association Function Classification), obtained from the PhysioNet database and then segmented into 5-min non-overlapping epochs using cubic spline interpolation. For each segment in the normal group and CHF group, frequency-domain features included low-frequency (LF) power, high-frequency (HF) power and LF/HF ratio were extracted as classical estimators of autonomic activity. In the nonlinear domain, TE between LF and HF were calculated to quantify the information exchanging between SNS and PNS. Compared with the normal group, an extreme decrease in LF/HF ratio (p = 0.000) and extreme increases in both TE(LF→HF) (p = 0.000) and TE(HF→LF) (p = 0.000) in the CHF group were observed. Moreover, both in normal and CHF groups, TE(LF→HF) was a lot greater than TE(HF→LF) (p = 0.000), revealing that TE was able to distinguish the difference in the amount of directed information transfer among ANS. Extracted features were further applied in discriminating CHF using IBM SPSS Statistics discriminant analysis. The combination of the LF/HF ratio, TE(LF→HF) and TE(HF→LF) reached the highest screening accuracy (83.7%). Our results suggested that TE could serve as a complement to traditional index LF/HF in CHF screening.
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