{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:08:07Z","timestamp":1787029687401,"version":"build-2736575974"},"reference-count":42,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,3,1]],"date-time":"2025-03-01T00:00:00Z","timestamp":1740787200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez","award":["16-993"],"award-info":[{"award-number":["16-993"]}]},{"name":"Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez","award":["18-1090"],"award-info":[{"award-number":["18-1090"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Introduction: Aortic valve disease (AVD) is an inflammatory, lipid infiltration and calcification disease that has been associated with changes in the conventional linear heart rate variability (HRV) indices showing a marked shift towards sympathetic predominance and a deterioration of the autonomic control. Objective: To explore the HRV dynamics in AVD patients through nonlinear methods by recurrence quantification analysis (RQA). Methods: In total, 127 subjects participated in a cross-sectional study categorized into three groups: healthy valve (HV), aortic valve sclerosis (AVSc), and aortic valve stenosis (AVS), as determined by echocardiographic assessment. HRV data were collected from five-minute ECG recordings at both a supine position and active standing. RQA indices were calculated using the Cross Recurrence Plot Toolbox. Results: In the supine position, patients with AVS exhibited larger determinism and trapping time than those with AVSc and HV. The analysis of these differences revealed that determinism and laminarity increased progressively from HV to AVS. In the same way, the magnitude of change (\u0394) between positions decreased and presented the lowest values in AVS in most of the nonlinear indices. Conclusion: RQA indices of HRV in AVD patients indicate a rigidizing dynamic characterized by larger determinism and extended trapping times in fewer system states in relation to the severity of AVD. These findings establish a precedent for future perspective assessments for the implementation of these methods in medical software or devices.<\/jats:p>","DOI":"10.3390\/s25051535","type":"journal-article","created":{"date-parts":[[2025,3,3]],"date-time":"2025-03-03T03:22:44Z","timestamp":1740972164000},"page":"1535","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Dynamic Response of Heart Rate Variability to Active Standing in Aortic Valve Disease: Insights from Recurrence Quantification Analysis"],"prefix":"10.3390","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-3642-3490","authenticated-orcid":false,"given":"Itayetzin Beurini","family":"Cruz-Vega","sequence":"first","affiliation":[{"name":"Department of Molecular Biology, Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez, Mexico City 14080, Mexico"},{"name":"Plan de Estudios Combinados en Medicina, Faculty of Medicine, Universidad Nacional Aut\u00f3noma de M\u00e9xico, Mexico City 04510, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nydia","family":"\u00c1vila-Vanzzini","sequence":"additional","affiliation":[{"name":"Department of Outpatient Consult, Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez, Mexico City 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8187-8573","authenticated-orcid":false,"given":"Gertrudis Hortensia","family":"Gonz\u00e1lez-G\u00f3mez","sequence":"additional","affiliation":[{"name":"Department of Physics, Faculty of Sciences, Universidad Nacional Aut\u00f3noma de M\u00e9xico, Mexico City 04510, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashidi","family":"Springall","sequence":"additional","affiliation":[{"name":"Department of Immunology, Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez, Mexico City 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5625-1949","authenticated-orcid":false,"given":"Juan C.","family":"Echeverr\u00eda","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering, Universidad Aut\u00f3noma Metropolitana Unidad Iztapalapa, Mexico City 09340, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4679-7751","authenticated-orcid":false,"given":"Claudia","family":"Lerma","sequence":"additional","affiliation":[{"name":"Department of Molecular Biology, Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez, Mexico City 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1016\/S0140-6736(06)69208-8","article-title":"Burden of Valvular Heart Diseases: A Population-Based Study","volume":"368","author":"Nkomo","year":"2006","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1136\/heartjnl-2012-302265","article-title":"The Evolving Epidemiology of Valvular Aortic Stenosis. 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