Changes in nonlinear characteristics of heart rate variability under functional load on the cardiovascular system in healthy subjects and coronary heart disease patients

Some nonlinear characteristics of heart rate variability in the course of functional tests with physical exercise are described. Two groups of volunteers participated in the tests: a control group of 32 healthy subjects (group 1) and a group of 35 coronary heart disease (CHD) patients (group 2). Two series of experiments were performed for each group. An active orthostatic test (AOT) was used in the first series, and a gradually growing physical load on a bicycle ergometer (bicycle ergometer test, BET), in the second series. Along with statistical indices of heart rate (the mean RR interval and standard deviation), nonlinear indices of heart rate were estimated: the correlation dimensionality (D ₂) and approximate entropy (ApEn). Trends of the changes in nonlinear indices of heart rate have been found. The D ₂ and ApEn decreased in both groups of subjects during the AOT and BET under the maximum load. However, the groups of healthy subjects and CHD patients differed in the reactivity of indices, the amplitude of changes in nonlinear indices being narrower in the latter group than in group 1. Differently directed shifts in standard deviation (SDNN) and nonlinear indices have been found. Thus, the data obtained with the use of nonlinear heart rate characteristics show that heart rate under physical load is more multivariate and diverse in healthy subjects at rest and the amplitude of changes during the AOT and BET is greater than in CHD patients, which is a result of the specific autonomic control of heart activity in cardiovascular pathologies.