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Comparison of Respiratory Rates Derived from Heart Rate Variability, ECG Amplitude, and Nasal/Oral Airflow

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Abstract

It would often be desirable to obtain the respiratory rate during everyday conditions without obtaining an additional respiratory trace. This study investigates the agreement between respiratory rate assessed from the electrocardiogram (ECG) and the reference respiratory rate derived from a nasal/oral airflow (AF). Nasal/oral airflow and a Holter ECG were recorded in 52 healthy subjects (26 males, age range: 25.4–85.4 years) during everyday conditions for at least 10 h, including night-time sleep. The respiratory rate was assessed for each 5-min epoch (1) using respiratory sinus arrhythmia (RSA), (2) utilizing the respiration induced variations of the R-wave amplitude (ECG derived respiration (EDR)). The agreement with respect to AF was quantified using the average/std and the concordance correlation coefficient ρc. For RSA and EDR the difference with respect to AF was 0.2 cpm (std: 0.6 cpm) during sleep and −0.2 cpm (std: 1.0 cpm) during wake time. During sleep the RSA-approach performed best for subjects ≤50 years (ρc = 0.79) and worst for subjects >50 years (ρc = 0.41). The correlation of the EDR-approach was ρc = 0.73 for both groups. In conclusion, the respiratory rate may be assessed with reasonable agreement by both methods in younger subjects, but EDR should be preferred in the elderly.

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Notes

  1. As the prevalence of obstructive sleep apnea syndrome (OSAS) in a general population with normal BMI is rather low (Germany: approx. 2%) we did not screen specifically for OSAS. As each respiratory trace was inspected visually to find artefacts, symptoms of OSAS were found in one subject.

  2. Definition: bpm (beats per minute) = min−1 = (60 s)−1.

  3. Definition: cpm (cycles per minute) = min−1 = (60 s)−1.

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Acknowledgments

DC and MK were supported by grants of the Software AG Stiftung, Darmstadt, Germany. DC was also supported by grants of the Rudolf Steiner Fonds, Nürnberg, Germany. RZ and MK acknowledge financial support from the Humanus-Institut e.V., Kandern, Germany.

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Authors and Affiliations

  1. Chair of Medical Theory and Complementary Medicine, University of Witten/Herdecke, Gerhard-Kienle-Weg 4, D-58313, Herdecke, Germany

    Dirk Cysarz

  2. Integrated Studies of Anthroposophic Medicine, University of Witten/Herdecke, Herdecke, Germany

    Dirk Cysarz

  3. Research Institute Havelhöhe, Berlin, Germany

    Roland Zerm & Matthias Kröz

  4. Department of General Internal Medicine, Community Hospital Havelhöhe, Berlin, Germany

    Roland Zerm & Matthias Kröz

  5. Scientific African, Luechow, Germany

    Henrik Bettermann

  6. Institute of Non-Invasive Diagnosis, Joanneum Research, Weiz, Austria

    Matthias Frühwirth & Maximilian Moser

  7. Institute of Physiology, Medical University Graz, Graz, Austria

    Maximilian Moser

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  1. Dirk Cysarz
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  2. Roland Zerm
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Correspondence to Dirk Cysarz.

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Cysarz, D., Zerm, R., Bettermann, H. et al. Comparison of Respiratory Rates Derived from Heart Rate Variability, ECG Amplitude, and Nasal/Oral Airflow. Ann Biomed Eng 36, 2085–2094 (2008). https://doi.org/10.1007/s10439-008-9580-2

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  • DOI: https://doi.org/10.1007/s10439-008-9580-2

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