Key result
In ALS patients, lower pulmonary capacity (FVC < 50%) was associated with significantly increased HRV complexity, including sample entropy (d = 1.22; p < 0.0001), compared to FVC > 50%.
Why the study?
Heart-rate variability complexity in amyotrophic lateral sclerosis patients with different pulmonary capacities had not been evaluated.
Does heart-rate variability complexity differ in ALS patients based on pulmonary capacity (FVC > 50% vs < 50%)?
Observational (n=57)
Does heart-rate variability complexity differ in ALS patients based on pulmonary capacity (FVC > 50% vs < 50%)?
Standardized Mean Difference: 1.22
p-value: p=<0.0001
In patients with ALS, reduced pulmonary capacity (FVC < 50%) is associated with increased complexity of heart-rate variability.
Increased HRV complexity with low FVC in ALS is hypothesis-generating; prospective studies needed before prognostic use.
Objective: the complexity of heart-rate variability (HRV) in amyotrophic lateral sclerosis (ALS) patients with different pulmonary capacities was evaluated. Methods: We set these according to their pulmonary capacity, and specifically forced vital capacity (FVC). We split the groups according to FVC (FVC > 50% (n = 29) and FVC < 50% (n = 28)). In ALS, the presence of an FVC below 50% is indicative of noninvasive ventilation with two pressure levels and with the absence of other respiratory symptoms. As the number of subjects per group was different, we applied the unbalanced one-way analysis of variance (uANOVA1) test after three tests of normality, and effect size by Cohen’s d to assess parameter significance. Results: with regard to chaotic global analysis, CFP4 (p < 0.001; d = 0.91), CFP5 (p = 0.0022; d = 0.85), and CFP6 (p = 0.0009; d = 0.92) were enlarged. All entropies significantly increased. Shannon (p = 0.0005; d = 0.98), Renyi (p = 0.0002; d = 1.02), Tsallis (p = 0.0004; d = 0.99), approximate (p = 0.0005; d = 0.97), and sample (p < 0.0001; d = 1.22). Detrended fluctuation analysis (DFA) (p = 0.0358) and Higuchi fractal dimension (HFD) (p = 0.15) were statistically inconsequential between the two groups. Conclusions: HRV complexity in ALS subjects with different pulmonary capacities increased via chaotic global analysis, especially CFP5 and 3 out of 5 entropies.
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Pimentel et al. (2021) conducted an observational in Amyotrophic Lateral Sclerosis (n=57). FVC < 50% vs. FVC > 50% was evaluated on Sample entropy (HRV complexity) (d = 1.22, p=<0.0001). In ALS patients, lower pulmonary capacity (FVC < 50%) was associated with significantly increased HRV complexity, including sample entropy (d = 1.22; p < 0.0001), compared to FVC > 50%.
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