title: Multivariate and multidimensional analysis of cardiovascular oscillations in patients with heart failure.
abstract: Within 5 years of first diagnosis, nearly 60% of patients with heart failure (HF) suffer from cardiac death. Early diagnosis of HF and reliable risk prediction are still required. Therefore, the objective of this study was to develop a parameter set for enhanced risk stratification in HF patients. In 43 patients suffering from HF (NYHA class > or =II, ejection fraction <45%) and 10 healthy subjects (REF), heart rate and blood pressure variability (HRV and BPV), interactions between heart rate and blood pressure (joint symbolic dynamics, JSD) and blood pressure morphology (BPM) were analysed. BPV, BPM and JSD measures revealed high significance (p<0.0001) in discriminating REF and HF. A set of three parameters from BPV, JSD and BPM was developed for risk stratification (sensitivity 76.5%, specificity 84.2%, area under the receiver operating characteristic curve 81.4%) in patients with HF.
authors.affiliation: Department of Medical Engineering, University of Applied Sciences Jena, Jena, Germany. voss@fh-jena.de
authors.forename: Andreas
authors.initials: A
authors.lastname: Voss
authors.forename: Rico
authors.initials: R
authors.lastname: Schroeder
authors.forename: Sandra
authors.initials: S
authors.lastname: Truebner
authors.forename: Mathias
authors.initials: M
authors.lastname: Baumert
authors.forename: Matthias
authors.initials: M
authors.lastname: Goernig
authors.forename: Andreas
authors.initials: A
authors.lastname: Hagenow
authors.forename: Hans-Reiner
authors.initials: HR
authors.lastname: Figulla
mesh_terms: D001683:Biological Clocks; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000379:methods; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006333:Heart Failure / Q000175:diagnosis* / Q000503:physiopathology*; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009991:Oscillometry / Q000379:methods; D011379:Prognosis; D011673:Pulsatile Flow; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity