Age-related changes in the "complexity" of cardiovascular dynamics: A potential marker of vulnerability to disease.
Healthy physiologic control of cardiovascular function is a result of complex interactions between multiple regulatory processes that operate over different time scales. These include the sympathetic and parasympathetic nervous systems which regulate beat-to-beat heart rate (HR) and blood pressure (BP), as well as extravascular volume, body temperature, and sleep which influence HR and BP over the longer term. Interactions between these control systems generate highly variable fluctuations in continuous HR and BP signals. Techniques derived from nonlinear dynamics and chaos theory are now being adapted to quantify the dynamic behavior of physiologic time series and study their changes with age or disease. We have shown significant age-related changes in the 1/f(x) relationship between the log amplitude and log frequency of the heart rate power spectrum, as well as declines in approximate dimension and approximate entropy of both heart rate and blood pressure time series. These changes in the "complexity" of cardiovascular dynamics reflect the breakdown and decoupling of integrated physiologic regulatory systems with aging, and may signal an impairment in cardiovascular ability to adapt to external and internal perturbations. Studies are currently underway to determine whether the complexity of HR or BP time series can distinguish patients with fainting spells due to benign vasovagal reactions from those due to life-threatening cardiac arrhythmias. Thus, measures of the complexity of physiologic variability may provide novel methods to monitor cardiovascular aging and test the efficacy of specific interventions to improve adaptive capacity in old age. (c) 1995 American Institute of Physics.
Lipsitz
Lewis A.
LA
Hebrew Rehabilitation Center for Aged, Beth Israel HospitalHarvard Medical School Division on Aging, Boston, Massachusetts 02131.