Delta plot analysis of cardiovascular and cardiorespiratory interactions in young women with orthostatic intolerance

Abstract Objective Temporal dynamics of cardiovascular and cardiorespiratory interactions during a head-up tilt test (HUTT) were investigated using a new method called delta plot analysis (DPA) that deals with the intrinsic nonstationarity feature of time series. Methods Twenty-one young female patients (28 ± 7 years) with orthostatic intolerance (OI) and 13 age-matched female controls (26 ± 5 years) were investigated during a 70° HUTT. Analyses were performed on bivariate time series including beat-to-beat intervals (BBI), respiratory amplitude (RESP) at BBI onset as well as systolic (SYS) and diastolic (DIA) blood pressure at simultaneous and shifted beats. DPA was used to characterize cardiovascular interactions as SYS→BBI and BBI→DIA, as well as cardiorespiratory interactions as RESP→BBI and RESP→DIA. Results Occurrence of simultaneous BBI increases due to SYS increases (bradycardic baroreflex) was significantly reduced during orthostatic phase in patients (28.54 ± 6.32% versus 36.35 ± 4.77%, p  Conclusion Temporal dynamic analysis by DPA revealed impaired autonomic control in patients compared to healthy subjects during supine position, transition and orthostatic phase. Significance DPA is a promising graphical tool to demonstrate impaired autonomic regulation.