Key result
Conditional self-entropy of heart period given systolic arterial pressure and respiration increased progressively with the amplitude of the orthostatic stimulus.
Observational (n=19)
The proposed conditional self-entropy and conditional joint transfer entropy metrics can help disentangle physiological mechanisms of cardiovascular regulation during orthostatic challenge.
Entropy metrics may quantify regulatory mechanisms during orthostasis; hypothesis-generating and should not yet change practice.
Self-entropy (SE) and transfer entropy (TE) are widely utilized in biomedical signal processing to assess the information stored into a system and transferred from a source to a destination respectively. The study proposes a more specific definition of the SE, namely the conditional SE (CSE), and a more flexible definition of the TE based on joint TE (JTE), namely the conditional JTE (CJTE), for the analysis of information dynamics in multivariate time series. In a protocol evoking a gradual sympathetic activation and vagal withdrawal proportional to the magnitude of the orthostatic stimulus, such as the graded head-up tilt, we extracted the beat-to-beat spontaneous variability of heart period (HP), systolic arterial pressure (SAP) and respiratory activity (R) in 19 healthy subjects and we computed SE of HP, CSE of HP given SAP and R, JTE from SAP and R to HP, CJTE from SAP and R to HP given SAP and CJTE from SAP and R to HP given R. CSE of HP given SAP and R was significantly smaller than SE of HP and increased progressively with the amplitude of the stimulus, thus suggesting that dynamics internal to HP and unrelated to SAP and R, possibly linked to sympathetic activation evoked by head-up tilt, might play a role during the orthostatic challenge. While JTE from SAP and R to HP was independent of tilt table angle, CJTE from SAP and R to HP given R and from SAP and R to HP given SAP showed opposite trends with tilt table inclination, thus suggesting that the importance of the cardiac baroreflex increases and the relevance of the cardiopulmonary pathway decreases during head-up tilt. The study demonstrates the high specificity of CSE and the high flexibility of CJTE over real data and proves that they are particularly helpful in disentangling physiological mechanisms and in assessing their different contributions to the overall cardiovascular regulation.
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Porta et al. (2015) conducted an observational in Healthy (n=19). Graded head-up tilt vs. Rest (supine position) was evaluated on Conditional Self-Entropy (CSE) of heart period given systolic arterial pressure and respiration. Conditional self-entropy of heart period given systolic arterial pressure and respiration increased progressively with the amplitude of the orthostatic stimulus.
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