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(Circulation. 1999;100:393-399.)
© 1999 American Heart Association, Inc.
Clinical Investigation and Reports |
Cardiac Interbeat Interval Dynamics From Childhood to Senescence
Comparison of Conventional and New Measures Based on Fractals and Chaos Theory
From the Division of Cardiology, Department of Internal Medicine, University of Oulu (S.M.P., T.H.M., H.V.H.), the Department of Geriatrics, University of Turku (L.B.S., I.J.R.), the Research and Development Center of the Social Insurance Institution, Turku (P.P.), and the Hospital for Children and Adolescents, Helsinki University Central Hospital (J.S.), Finland; and the Margret and H.A. Rey Laboratory for Nonlinear Dynamics in Medicine, Cardiovascular Division, the Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Mass (C.-K.P., A.L.G.).
Correspondence to Sirkku M. Pikkujämsä, MD, Division of Cardiology, Department of Internal Medicine, University of Oulu, Kajaanintie 50, 90220 Oulu, Finland. E-mail pikkujam{at}cc.oulu.fi
Background—New methods of R-R interval variability based on fractal scaling and nonlinear dynamics ("chaos theory") may give new insights into heart rate dynamics. The aims of this study were to (1) systematically characterize and quantify the effects of aging from early childhood to advanced age on 24-hour heart rate dynamics in healthy subjects; (2) compare age-related changes in conventional time- and frequency-domain measures with changes in newly derived measures based on fractal scaling and complexity (chaos) theory; and (3) further test the hypothesis that there is loss of complexity and altered fractal scaling of heart rate dynamics with advanced age.
Methods and Results—The relationship between age and cardiac
interbeat (R-R) interval dynamics from childhood to senescence was
studied in 114 healthy subjects (age range, 1 to 82 years) by
measurement of the slope, ß, of the power-law regression line (log
power-log frequency) of R-R interval variability (10-4 to
10-2 Hz), approximate entropy (ApEn), short-term
(
1) and intermediate-term (2) fractal
scaling exponents obtained by detrended fluctuation analysis,
and traditional time- and frequency-domain measures from 24-hour ECG
recordings. Compared with young adults (<40 years old, n=29),
children (<15 years old, n=27) showed similar complexity (ApEn) and
fractal correlation properties (1, 2,
ß) of R-R interval dynamics despite lower spectral and time-domain
measures. Progressive loss of complexity (decreased ApEn,
r=-0.69, P<0.001) and alterations of
long-term fractal-like heart rate behavior (increased 2,
r=0.63, decreased ß, r=-0.60,
P<0.001 for both) were observed thereafter from middle
age (40 to 60 years, n=29) to old age (>60 years, n=29).
Conclusions—Cardiac interbeat interval dynamics change markedly from childhood to old age in healthy subjects. Children show complexity and fractal correlation properties of R-R interval time series comparable to those of young adults, despite lower overall heart rate variability. Healthy aging is associated with R-R interval dynamics showing higher regularity and altered fractal scaling consistent with a loss of complex variability.
Key Words: aging • heart rate • fractals
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