Assessment of respiratory flow cycle morphology in patients with chronic heart failure
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Breathing pattern as periodic breathing (PB) in chronic heart failure (CHF) is associated with poor prognosis and high mortality risk. This work investigates the significance of a number of time domain parameters for characterizing respiratory flow cycle morphology in patients with CHF. Thus, our primary goal is to detect PB pattern and identify patients at higher risk. In addition, differences in respiratory flow cycle morphology between CHF patients (with and without PB) and healthy subjects are studied. Differences between these parameters are assessed by investigating the following three classification issues: CHF patients with PB versus with non-periodic breathing (nPB), CHF patients (both PB and nPB) versus healthy subjects, and nPB patients versus healthy subjects. Twenty-six CHF patients (8/18 with PB/nPB) and 35 healthy subjects are studied. The results show that the maximal expiratory flow interval is shorter and with lower dispersion in CHF patients than in healthy subjects. The flow slopes are much steeper in CHF patients, especially for PB. Both inspiration and expiration durations are reduced in CHF patients, mostly for PB. Using the classification and regression tree technique, the most discriminant parameters are selected. For signals shorter than 1 min, the time domain parameters produce better results than the spectral parameters, with accuracies for each classification of 82/78, 89/85, and 91/89 %, respectively. It is concluded that morphologic analysis in the time domain is useful, especially when short signals are analyzed.
KeywordsChronic heart failure Respiratory pattern Periodic and non-periodic breathing Ensemble average
This work was supported in part by the Secretaria d’Universitats i Recerca, del Departament d’Economía i Coneixement de la Generalitat de Catalunya (Consolidated research group GRC 2014 SGR 1569).
- 2.Bhardwaj A, Rehman S, Mohammed A, Gaggin H, Barajas L, Barajas J, Moore S, Sullivan D, Januzzi J (2012) Quality of life and chronic heart failure therapy guided by natriuretic peptides: results from the proBNP outpatient tailored chronic heart failure therapy (protect) study. Am Heart J 164(793):799e1Google Scholar
- 5.Dickstein K, Cohen-Solal A, Filippatos G, McMurray J, Ponikowski P, Poole-Wilson P, Stromberg A, van Veldhuisen D, Atar D, Hoes A, Keren A, Mebazaa A, Nieminen M, Priori S, Swedberg K (2008) Esc guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the task force for the diagnosis and treatment of acute and chronic heart failure 2008 of the european society of cardiology. Eur Heart J 29(19):2388–2442CrossRefPubMedGoogle Scholar
- 8.Garde A, Laguna P, Giraldo B, Jané R, Sörnmo L (2012) Ensemble-based time alignment of biomedical signals. In: 7th international workshop on biosignal interpretation BSI2012, Como, Italy, pp 1–4Google Scholar
- 16.La-Rovere MT, Pinna GD, Maestri R, Mortara A, Capomolla S, Febo O, Ferrari R, Franchini M, Gnemmi M, Opasich C, Riccardi PG, Traversi E, Cobelli F (2003) Short-term heart rate variability strongly predicts sudden cardiac death in chronic heart failure patients. Circulation 107:565–570CrossRefPubMedGoogle Scholar
- 25.Pinna G, Maestri R, Robbi E, Rovere ML (2008) Periodic breathing and state instability during supine laboratory recordings in chronic heart failure patients. In: Proceedings of IEEE conference engineering in medicine and biology, pp 5398–5401Google Scholar
- 26.Pinna GD, Maestri R, Mortara A, Johnson P, Witkowski T, Ponikowski P, Andrews D, Capomolla S, La Rovere MT, Sleight P (2006) Nocturnal periodic breathing is an independent predictor of cardiac death and multiple hospital admissions in heart failure. Proc Comput Cardiol 33:837–840Google Scholar
- 30.Ponikowski P, Anker SD, Chua TP, Francis D, Banasiak W, Poole-Wilson PA, Coats AJ, Piepoli M (1999) Oscillatory breathing patterns during wakefulness in patients with chronic heart failure: clinical implications and role of augmented peripheral chemosensitivity. Circulation 100(24):2418–2424CrossRefPubMedGoogle Scholar