TINN: width of the triangular interpolation of the NN interval histogram.
TINN — the triangular interpolation of the NN-interval histogram — is a geometric heart-rate-variability index. The histogram of all NN intervals is approximated by a triangle, and TINN is the width of the triangle's base in milliseconds. It describes the range over which most heartbeat intervals are distributed and therefore reflects overall variability, in a way that is robust to individual outlying intervals.
A triangle is fitted to the NN-interval histogram: its top is placed at the modal bin, and the points N and M on the time axis are chosen so that the triangle matches the histogram as closely as possible (least-squares fit). The distance between N and M is TINN. Intervals outside the main distribution — artefacts, isolated extrasystoles — hardly influence the fitted triangle, which is the main advantage of geometric methods.
Figure 1. The NN-interval histogram approximated by a triangle. TINN is the width of the base (M − N); the HRV triangular index is the total number of intervals divided by the height.
TINN = M − N (ms), where the triangle q(t) with q(N) = q(M) = 0 minimises ∫ (D(t) − q(t))² dt
Interpretation
Narrow base — low TINN
Intervals concentrated in a narrow range: rigid rhythm
Chronic stress, overtraining, illness, ageing
After myocardial infarction, heart failure, diabetic autonomic neuropathy
Wide base — high TINN
Broad distribution of intervals: rich variability, good fitness
Large day–night differences in 24-hour recordings
Very irregular rhythms (atrial fibrillation) — the histogram is then not a triangle and TINN loses meaning
There are no universally accepted short-term norms for TINN. It depends strongly on recording length and on the histogram resolution, and is interpreted together with SDNN and the HRV triangular index of the same recording. The Task Force recommends geometric methods mainly for recordings of at least 20 minutes, preferably 24 hours.
When to see a doctor
Discuss geometric HRV indices with a cardiologist if they are markedly reduced on Holter monitoring, especially after a heart attack or with heart failure or diabetes.
References
Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Heart rate variability: standards of measurement, physiological interpretation and clinical use. Circulation. 1996;93(5):1043–1065. doi:10.1161/01.CIR.93.5.1043