title: Multivariate short-term heart rate variability: a pre-diagnostic tool for screening heart disease.
abstract: This study has aimed to develop a novel pre-diagnostic tool for primary care screening of heart disease based on multivariate short-term heart rate variability (HRV) analyzed by linear (time and frequency domain) and nonlinear methods (compression entropy (CE), detrended fluctuation analysis (DFA), Poincaré plot analysis, symbolic dynamics) applied to 5-min ECG segments. Firstly, we applied HRV analysis to separate healthy subjects (REF) from heart disease patients (PAT). Then to optimize the results, we subdivided both groups according to gender: REF (♂ = 78, ♀ = 53) versus PAT (♂ = 378, ♀ = 115). Finally, we divided REF and PAT into two age subgroups (30-50 years vs. 51-70 years of age) to consider the influence of age on HRV. Heart disease patients were classified using a scoring system based on cut-off values calculated from all HRV indices obtained from the REF. After combining the optimum indices from all different analyzing methods, sensitivities of more than 72% and a specificity of 100% in all subgroups were revealed. Nonlinear indices proved to be better for discriminating heart disease patients from healthy subjects. Multivariate short-term HRV, analyzed by both linear and nonlinear methods appears to be a suitable pre-diagnostic tool for screening heart disease in primary care settings.
authors.affiliation: Department of Medical Engineering and Biotechnology, University of Applied Sciences Jena, Jena, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Heitmann
authors.forename: Thomas
authors.initials: T
authors.lastname: Huebner
authors.forename: Rico
authors.initials: R
authors.lastname: Schroeder
authors.forename: Siegfried
authors.initials: S
authors.lastname: Perz
authors.forename: Andreas
authors.initials: A
authors.lastname: Voss
mesh_terms: D000328:Adult; D000368:Aged; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis*; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D011320:Primary Health Care / Q000379:methods; D012815:Signal Processing, Computer-Assisted; D055815:Young Adult