title: On the risk of aortic valve replacement surgery assessed by heart rate variability parameters.
abstract: In recent years the number of arterial stenosis (AS) patients has grown rapidly and valvular disease is expected to be the next great epidemic. We studied a group of 385 arterial valve replacement (AVR) surgery patients, of whom 16 had died in the postoperational period (up to 30 d after the operation). Each patient had a heart rate variability (HRV) recording made prior to the operation in addition to a full set of medical diagnostics including echocardiography. We formed 16 age, sex, New York Heart Association (NYHA) class, and BMI adjusted control pairs for each person who died in the perioperative period. Our aim was to find indications of the risk from AVR surgery based on the medical data and HRV properties. Besides standard, linear HRV methods, we used indexes of time irreversibility introduced by Guzik (G%), Porta (P%), Ehlers (index E) and Hou (index D). In addition, we analyzed the multiscale multifractal properties of HRV calculating the Hurst surface. The nonlinear analysis methods show statistically significant indications of the risk of AVR surgery in an increase of multifractality and an increase of time irreversibility of the HRV measured prior to the operation.
authors.affiliation: Complex Systems Division, Faculty of Physics, Warsaw University of Technology, ul. Koszykowa 75, 00-662 Warszawa, Poland.
authors.forename: J J
authors.initials: JJ
authors.lastname: Żebrowski
authors.forename: I
authors.initials: I
authors.lastname: Kowalik
authors.forename: E
authors.initials: E
authors.lastname: Orłowska-Baranowska
authors.forename: M
authors.initials: M
authors.lastname: Andrzejewska
authors.forename: R
authors.initials: R
authors.lastname: Baranowski
authors.forename: J
authors.initials: J
authors.lastname: Gierałtowski
mesh_terms: D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D048909:Diabetes Complications / Q000503:physiopathology; D005260:Female; D006339:Heart Rate; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D017711:Nonlinear Dynamics; D016017:Odds Ratio; D011184:Postoperative Period; D012306:Risk; D018570:Risk Assessment / Q000379:methods*; D012720:Severity of Illness Index; D014463:Ultrasonography