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Comparison of Methods for the Assessment of Nonlinearity in Short-Term Heart Rate Variability under different Physiopathological States

Despite the widespread diffusion of nonlinear methods for heart rate variability (HRV) analysis, the presence and the extent to which nonlinear dynamics contribute to short-term HRV is still controversial. This work aims at testing the hypothesis that different types of nonlinearity can be observed in HRV depending on the method adopted and on the physiopathological state. Two entropy-based measures of time series complexity (normalized complexity index, NCI) and regularity (information storage, IS), and a measure quantifying deviations from linear correlations in a time series (Gaussian linear contrast, GLC), are applied to short HRV recordings obtained in young (Y) and old (O) healthy subjects and in myocardial infarction (MI) patients monitored in the resting supine position and in the upright position reached through head-up tilt. The method of surrogate data is employed to detect the presence of and quantify the contribution of nonlinear dynamics to HRV. We find that the three measures differ both in their variations across groups and conditions and in the number and strength of nonlinear HRV dynamics detected: at rest, IS reveals a significantly lower number of nonlinear dynamics in Y, whereas during tilt GLC reveals significantly stronger nonlinear HRV dynamics in MI; in the transition from rest to tilt, all measures detect a significant weakening of nonlinear HRV dynamics in Y, while only GLC detects a significant strengthening of such dynamics in MI. These results suggest that distinct dynamic structures, detected with different sensitivity by nonlinear measures, lie beneath short-term HRV in different physiological states and pathological conditions.