Key result
Network analysis of nocturnal heart rate variability revealed that denervated hearts in transplant recipients maintained a p-core volume of 83.2% compared to approximately 5% in healthy controls, indicating a loss of vagally-driven complexity.
Observational (n=46)
Absolute Event Rate: 83.2% vs 5%
Network visualization of RR-increments from nocturnal Holter recordings successfully differentiates between autonomic vagal activity in healthy individuals and intrinsic nonlinear heart regulation in denervated transplant hearts.
Network analysis may distinguish vagal from intrinsic HRV post-transplant; leaves open predictive value and clinical utility pending validation.
Signals from heart transplant recipients can be considered to be a natural source of information for a better understanding of the impact of the autonomic nervous system on the complexity of heart rate variability. Beat-to-beat heart rate variability can be represented as a network of increments between subsequent $RR$-intervals, which makes possible the visualization of short-term heart period fluctuations. A network is constructed of vertices representing increments between subsequent $RR$-intervals, and edges which connect adjacent $RR$-increments. Two modes of visualization of such a network are proposed. The method described is applied to nocturnal Holter signals recorded from healthy young people and from cardiac transplant recipients. Additionally, the analysis is performed on surrogate data: shuffled RR-intervals (to display short-range dependence), and shuffled phases of the Fourier Transform of RR-intervals (to filter out linear dependences). Important nonlinear properties of autonomic nocturnal regulation in short-term variability in healthy young persons are associated with $RR$-increments: accelerations and decelerations of a size greater than about 35 ms. They reveal that large accelerations are more likely antipersistent, while large decelerations are more likely persistent. Changes in $RR$-increments in a heart deprived of autonomic supervision are much lower than in a healthy individual, and appear to be maintained around a homeostatic state, but there are indications that this dynamics is nonlinear. The method is fruitful in the evaluation of the vagal activity - the quantity and quality of the vagal tone - during the nocturnal rest of healthy young people. The method also successfully extracts nonlinear effects related to intrinsic mechanisms of the heart regulation.
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Makowiec et al. (2014) conducted an observational in Heart rate variability (n=46). Heart transplantation (cardiac denervation) vs. Healthy young volunteers was evaluated on Network disintegration (volume of p-core at p=10%). Network analysis of nocturnal heart rate variability revealed that denervated hearts in transplant recipients maintained a p-core volume of 83.2% compared to approximately 5% in healthy controls, indicating a loss of vagally-driven complexity.
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