Intra- and Inter-Rater Reliability of Linear and Nonlinear Measures of Short-Term Heart Rate Variability Following Combat-Related Traumatic Injury

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Noninvasive Electrocardiology Pub Date : 2024-08-28 DOI:10.1111/anec.70008

Rabeea Maqsood, Susie Schofield, Alexander N. Bennett, Ahmed Khattab, Anthony M. J. Bull, Nicola T. Fear, Christopher J. Boos, for the ADVANCE Study

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引用次数: 0

Abstract

Background

Heart rate variability (HRV) is a marker of autonomic function. However, the reliability of short-term HRV measurement in individuals with combat-related traumatic injury (CRTI) remains undetermined.

Methods

An intra- and inter-rater reliability study was conducted using a subsample (n = 35) of British servicemen with CRTI enrolled in the ongoing ADVANCE study. A five-minute epoch of single-lead electrocardiogram data collected during spontaneous breathing was used to measure HRV. HRV analyses were independently performed by two examiners using Kubios. Intraclass correlation coefficient (ICC), standard error of measurement (SEM), minimum detectable change (MDC), and coefficient of variance were calculated for linear [root mean square of successive difference (RMSSD), standard deviation of NN interval, low-frequency, high-frequency, total power] and nonlinear (SD1-2, acceleration and deceleration capacities, sample entropy) measures. Bland–Altman %plots were used to assess bias in intra- and inter-rater HRV data.

Results

The mean age of participants was 39.3 ± 6.3 years. An excellent ICC score of 0.9998 (95% CI 0.9997, 0.9999) was observed for intra-rater analyses of RMSSD, and similar excellent ICC scores were seen for all other HRV measures. The inter-rater reliability analyses produced an excellent ICC score (range 0.97–1.00). Comparatively, frequency-domain measures produced higher MDC% and SEM% scores than time-domain and nonlinear measures in both inter- and intra-rater analyses. The Bland–Altman plots revealed relatively higher bias for frequency-domain and nonlinear measures than time-domain measures.

Conclusion

ECG-related short-term HRV measures were reliable in injured servicemen under spontaneous breathing. However, the reliability appeared better with the time-domain measure than frequency-domain and nonlinear measures in this sample.

Abstract Image

查看原文本刊更多论文

与战斗有关的创伤后短期心率变异性的线性和非线性测量方法的内部和评分者之间的可靠性。

背景：心率变异性（HRV）是自律神经功能的标志。然而，对与战斗有关的创伤（CRTI）患者进行短期心率变异测量的可靠性仍未确定：方法：我们使用参加正在进行的 ADVANCE 研究的 CRTI 英国军人的子样本（n = 35）进行了一项内部和互评可靠性研究。测量心率变异时使用了在自主呼吸时采集的单导联心电图数据，时间跨度为五分钟。心率变异分析由两名检查人员使用 Kubios 独立完成。计算了线性（连续差值均方根（RMSSD）、NN 间期标准偏差、低频、高频、总功率）和非线性（SD1-2、加速和减速能力、样本熵）测量的类内相关系数（ICC）、测量标准误差（SEM）、最小可检测变化（MDC）和方差系数。使用Bland-Altman%图评估评分者内部和评分者之间心率变异数据的偏差：结果：参与者的平均年龄为 39.3 ± 6.3 岁。对 RMSSD 的评分者内分析的 ICC 得分为 0.9998（95% CI 0.9997，0.9999），非常出色，所有其他心率变异测量的 ICC 得分也非常出色。评分者之间的可靠性分析得出了极好的 ICC 分数（范围为 0.97-1.00）。比较而言，在评分者间和评分者内分析中，频域测量的 MDC% 和 SEM% 得分均高于时域和非线性测量。布兰-阿尔特曼图显示，频域和非线性测量的偏差相对高于时域测量：结论：在自主呼吸状态下，与心电图相关的短期心率变异测量结果对受伤军人是可靠的。结论：在自主呼吸状态下，与心电图相关的短期心率变异测量结果是可靠的，但在该样本中，时域测量结果的可靠性要优于频域和非线性测量结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Noninvasive Electrocardiology 医学-心血管系统

CiteScore

3.40

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： The ANNALS OF NONINVASIVE ELECTROCARDIOLOGY (A.N.E) is an online only journal that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. ANE is the first journal in an evolving subspecialty that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. The publication includes topics related to 12-lead, exercise and high-resolution electrocardiography, arrhythmias, ischemia, repolarization phenomena, heart rate variability, circadian rhythms, bioengineering technology, signal-averaged ECGs, T-wave alternans and automatic external defibrillation. ANE publishes peer-reviewed articles of interest to clinicians and researchers in the field of noninvasive electrocardiology. Original research, clinical studies, state-of-the-art reviews, case reports, technical notes, and letters to the editors will be published to meet future demands in this field.