Department of Medical Engineering and Biotechnology, University of Applied Sciences, Jena, Germany.
Physiol Meas. 2013 Aug;34(8):883-901. doi: 10.1088/0967-3334/34/8/883. Epub 2013 Jul 17.
Besides the well-known cardiac risk factors for schizophrenia, increasing concerns have been raised regarding the cardiac side-effects of antipsychotic medications. A bivariate analysis of autonomic regulation, based on cardiovascular coupling, can provide additional information about heart rate (HR) and blood pressure regulatory patterns within the complex interactions of the cardiovascular system. We introduce a new high-resolution coupling analysis method (HRJSD) based on joint symbolic dynamics (JSD), which is characterized by three symbols, a threshold (individual dynamic variability, physiological) for time series transformation and eight coupling pattern families. This is based on a redundancy reduction strategy used to quantify and characterize cardiovascular couplings. In this study, short-term (30 min) HR and systolic blood pressure (SP) time series of 42 unmedicated (UNMED) and 42 medicated patients (MED) suffering from acute schizophrenia were analysed to establish the suitability of the new method for quantifying the effects of antipsychotics on cardiovascular couplings. We were able to demonstrate that HRJSD, applying the threshold based on spontaneous baroreflex sensitivity (BRS) estimation, revealed eight significant pattern families that were able to quantify the anti-cholinergic effects of antipsychotics and the related changes of cardiovascular regulation (coupling) in MED in comparison to UNMED. This was in contrast to the simple JSD, BRS (sequence method) and only partly to standard linear HR variability indices. HRJSD provides strong evidence that autonomic regulation in MED seems to be, to some extent, predominated by invariable HR responses in combination with alternating SP values in contrast to UNMED, indicating an impairment of the baroreflex control feedback loop in MED. Surrogate data analysis was applied to test for the significance and nonlinearity of cardiovascular couplings in the original data due to medical treatment with antipsychotic drugs in MED. In conclusion, the application of HRJSD revealed detailed information about short-term nonlinear cardiovascular couplings and cardiovascular physiological regulatory mechanisms (patterns) of autonomic function due to the anti-cholinergic effects of antipsychotics in patients with acute schizophrenia.
除了众所周知的精神分裂症心脏危险因素外，人们越来越关注抗精神病药物的心脏副作用。基于心血管偶联的自主调节双变量分析可以提供有关心率 (HR) 和血压调节模式的附加信息，这些信息存在于心血管系统的复杂相互作用中。我们引入了一种新的基于联合符号动力学 (JSD) 的高分辨率耦合分析方法 (HRJSD)，该方法的特点是三个符号，一个用于时间序列转换的阈值（个体动态可变性，生理）和八个耦合模式家族。这是基于用于量化和表征心血管耦合的冗余减少策略。在这项研究中，对 42 名未接受药物治疗 (UNMED) 和 42 名接受药物治疗 (MED) 的急性精神分裂症患者的短期 (30 分钟) HR 和收缩压 (SP) 时间序列进行了分析，以确定新方法在量化抗精神病药物对心血管耦合的影响方面的适用性。我们能够证明，HRJSD 应用基于自发压力感受性反射敏感性 (BRS) 估计的阈值，可以揭示出八个显著的模式家族，这些家族能够量化抗精神病药物的抗胆碱能作用以及相关的心血管调节（耦合）变化在 MED 与 UNMED 相比。这与简单的 JSD、BRS（序列方法）和仅部分标准线性 HR 变异性指数形成对比。HRJSD 提供了有力的证据，表明 MED 中的自主调节在某种程度上似乎受到不变的 HR 反应的主导，同时伴有 SP 值的交替，这与 UNMED 相反，表明 MED 中的压力感受性反射控制反馈环路受损。由于 MED 中使用了抗精神病药物，因此应用替代数据分析来测试原始数据中由于医疗处理而导致的心血管耦合的显著性和非线性。总之，HRJSD 的应用揭示了有关短期非线性心血管耦合和自主功能心血管生理调节机制（模式）的详细信息，这是由于急性精神分裂症患者中抗精神病药物的抗胆碱能作用所致。
