Correlation between non-linear dynamics of variability of cardiac frequency and signals and symptons in cardiac rehabilitation programs

• Grant number: 18/01587-9
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: September 01, 2018
• End date: August 31, 2019
• Field of knowledge: Health Sciences - Physiotherapy and Occupational Therapy
• Principal Investigator: Luiz Carlos Marques Vanderlei
• Grantee: Mariane Senna da Silva
• Host Institution: Faculdade de Ciências e Tecnologia (FCT). Universidade Estadual Paulista (UNESP). Campus de Presidente Prudente. Presidente Prudente , SP, Brazil

Abstract

Introduction: Despite the various beneficial effects, cardiovascular rehabilitation programs (CVRs) are associated with the appearance of signs and symptoms. Nonlinear indexes of heart rate variability (HRV) have been used to perform the monitoring and prognosis of mortality in healthy individuals and patients with cardiovascular diseases. However, the literature does not have conclusive studies related to the possibility of signs and symptoms being predicted during the performance of PRCV using HRV indices obtained at rest by non-linear methods such as the analysis of trend fluctuation (DFA), symbolic analysis and entropy of Shannon (ES). Objectives: To analyze the correlation of non-linear HRV indexes measured at rest with the presence of signs / symptoms of participants in a cardiovascular rehabilitation program and in the indexes with significant correlations to establish an index cut-off point that could predict the possibility of the emergence of signs / symptoms. Materials and methods: To perform this study will be evaluated data of patients inserted in a PRCV. First, the patients will have their charts analyzed for sample characterization, and then the autonomic modulation will be evaluated. The analysis of the autonomic modulation will be done through non-linear HRV indexes calculated by DFA, symbolic analysis and ES. Patients will then be followed up by 24 PRCA sessions for assessments of signs and symptoms. The signs and symptoms that are identified will be recorded for later correlation with the non-linear HRV indexes. The relationship between the number of patient signs and symptoms and the index values will be analyzed by Pearson's correlation. The definition of the cutoff points for the indices will be obtained by the Receiver Operating Characteristic (ROC) curve. Sensitivity, specificity, positive predictive value and negative predictive value for event occurrence will also be recorded. The area under the curve will be considered significant when values e 0.650 were obtained. All results will be discussed at the 5% level of significance.