Risk appraisal by novel chaotic globals to HRV in subjects with malnutrition

Abstract

The aim of this study is to assess the risk of dynamical diseases in malnourished children. This is achieved by the application of novel chaotic global techniques to the RR-intervals of the electrocardiogram (ECG) in the cohort. Heart Rate Variability (HRV) is an inexpensive and non-invasive tool to measure the autonomic impulses. Here there has been a decrease in chaotic response of HRV. Seventy children were divided into equal groups and the HRV monitored for 20-25 minutes. The Chaos Forward Parameter (CFP) which applies all three chaotic global parameters is suggested to be the most robust algorithm. These three parameters are high spectral entropy (hsEntropy), high spectral detrended fluctuation analysis (hsDFA) and spectral multi-taper method (sMTM). hsEntropy is a function of the irregularity of amplitude and frequency of the power spectrums peaks. It is derived by applying Shannon entropy to the multi-taper method power spectrum. To derive hsDFA we calculate the spectral adaptation in exactly the same way as for hsEntropy using an adaptive multi-taper method power spectrum with the same settings; but DFA rather than Shannon entropy is the algorithm applied. sMTM is the area between the multi-taper method power spectrum and the baseline. After Anderson-Darling and Lilliefors tests of normality; Kruskal-Wallis was used for the statistical analysis, with the level of significance set at (p < 0.01). Principal Component Analysis (PCA) identified two components representing 100% of total variance. Autonomic imbalance measured as HRV and an increased cardiovascular risk are described for overweight children as well as for malnourished and those with anorexia nervosa. The relationship between malnourishment and complexity measures is useful in the risk assessment of dynamical diseases associated with the condition. This is supportive in treatments, assisting the determination of the level of dietary or pharmacological intervention especially in related dynamical diseases.