title: Comparison of nonlinear methods symbolic dynamics, detrended fluctuation, and Poincare plot analysis in risk stratification in patients with dilated cardiomyopathy.
abstract: Dilated cardiomyopathy (DCM) has an incidence of about 20100 000 new cases per annum and accounts for nearly 10 000 deaths per year in the United States. Approximately 36% of patients with dilated cardiomyopathy (DCM) suffer from cardiac death within five years after diagnosis. Currently applied methods for an early risk prediction in DCM patients are rather insufficient. The objective of this study was to investigate the suitability of short-term nonlinear methods symbolic dynamics (STSD), detrended fluctuation (DFA), and Poincare plot analysis (PPA) for risk stratification in these patients. From 91 DCM patients and 30 healthy subjects (REF), heart rate and blood pressure variability (HRV, BPV), STSD, DFA, and PPA were analyzed. Measures from BPV analysis, DFA, and PPA revealed highly significant differences (p<0.0011) discriminating REF and DCM. For risk stratification in DCM patients, four parameters from BPV analysis, STSD, and PPA revealed significant differences between low and high risk (maximum sensitivity: 90%, specificity: 90%). These results suggest that STSD and PPA are useful nonlinear methods for enhanced risk stratification in DCM patients.
authors.affiliation: Department of Medical Engineering, University of Applied Sciences Jena, Carl-Zeiss-Promenade 2, D-07745 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: Matthias
authors.initials: M
authors.lastname: Goernig
authors.forename: Hans Reiner
authors.initials: HR
authors.lastname: Figulla
authors.forename: Alexander
authors.initials: A
authors.lastname: Schirdewan
mesh_terms: D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000379:methods*; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis* / Q000503:physiopathology*; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D004562:Electrocardiography / Q000379:methods*; D006339:Heart Rate; D006801:Humans; D008875:Middle Aged; D017711:Nonlinear Dynamics; D009991:Oscillometry / Q000379:methods*; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity