Decomposition of complex Poincare plots of hemodynamic variables
Journal Title: Polski Przegląd Kardiologiczny - Year 2006, Vol 8, Issue 6
Abstract
Introduction: The analysis of heart rate and blood pressure variability is applied in research and clinical practice. However, the analysis of variability of hemodynamies like cardiac output (CO), stroke volume (SV) or systemic vascular resistance (SVR) is rarely performed. The analysis of Poincare plots is used in heart rate variability. Short term variability is described by SD1, long term variability by SD2 whereas coefficient r depicts the balance between these two. The Poincaie plots for longer recordings have usually complex shapes like a comet, parabola, horse-shoe or group of islands. The decomposition method decomposes such shapes into several smaller Poincare plots (mini-Poincare), which helps in a dynamie assessment of momentary changes of autonomie modulation of heart rate. Aim of study: To decompose complex shapes of Poincare plots of SV, CO, SVR and RR intervals from a long recording of various hemodynamies. Material and methods: The recording of approximately 19-hour duration withhemodynamicsof 72 356 consecutive heart beats was used in this study. This recording was obtained by cardiac impedance (Niccomo, Medis, Germany) from a 49-year old man with acute myocardial infaretion after a successful angioplasty of right coronary artery. The in-house software was used for creatingcomplex Poincare plots with their following decomposition into simpler mini-Poincare plots made out of sets of hemodynamies of 300 consecutive heart beats. The trajectories of the movements of momentary mini-Poincare plots within the SD2-SD1 space were also shown al together with hemodynamic trends. Results: The momentary values of hemodynamies were within range of 54-115 ml for SV, 2.6-9.2 l/min for CO, 880-2050 dyn s/cm5 forSVR and 600-1300 ms for RRintervals. The final shapes of Poincare plots were circular for SV, ellipse-like with 2 tails for CO and SVR and very complex for RR intervals. Most of the movement trajectories of points in the SD2-SD1 space were diagonal for SV, CO and SVR. In case of RR intervals the trajectories were both diagonal and vertical suggesting that minimal inereases or decreases of short term variability (SD1) were accompanied by dramatic changes of long term variability (SD2). The tachograms of hemodynamies revealed theirtrends and some peaks caused by premature beats ortechnical artifacts. Both negativeand positive values of the r coefficient were observed for different mini-Poincare plots of all analyzed parameters. Conclusions: The method of decomposition of hemodynamic signals allows for a dynamie evaluation of instant changes in the cardiovascular system.
Authors and Affiliations
Przemysław Guzik, Jarosław Piskorski, Jerzy Ellert, Janusz Tarchalski, Tomasz Krauze, Andrzej Wykrętowicz, Henryk Wysocki
Keywords
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