Assessment of cardio-respiratory interactions in preterm infants by bivariate autoregressive modeling and surrogate data analysis.

作者: Premananda Indic , Elisabeth Bloch-Salisbury , Frank Bednarek , Emery N. Brown , David Paydarfar

DOI: 10.1016/J.EARLHUMDEV.2011.04.001

关键词:

摘要: Heart rate variability (HRV) is an important index of cardiovascular state [1]. In healthy adults, heart generally increases during inspiration and decreases expiration. Such influence respiration on the beat variation through mechanical autonomic pathways called “respiratory sinus arrhythmia” (RSA) [2]. Adults have a breathing pattern with mean respiratory approximately 12 breaths per minute (0.2Hz) and, assuming linear influence, these oscillations are directly reflected in heartbeat. The RSA can be evidenced as peak HRV spectrum normal frequency range. well defined reflecting indicates presence cardio-respiratory interactions adults [3]. In infants, considered indicator level maturation vagally-mediated [4], although exact relationship between preterm infants remains elusive [5–11]. 60 (1Hz). However most irregular patterns periodic pauses (apnea) that introduces frequencies lower than range [12]. As result, modulation rate, if any, will occurring at various ranges frequencies, from ~1Hz (normal breathing) below. Hence, signature RSA, (i.e. power ~1Hz) may not observed due to irregularity breathing. Notably, further complication relying traditional spectral analysis fluctuations exist even absence [13]. A wide collection mathematical tools been successful quantifying control mechanisms [14–17]. particular, application domain methods peak-to-peak (RR) series detected electrocardiogram (ECG) signal alone together covariates such blood pressure led highly refined models tools, efforts defining specific standards, all now traditionally classified “heart studies” [3]. Despite valuable research devoted study mechanisms, there still need for specifically target standards assess functions early stages life. As reported literature standard low (LF: 0.04–0.15 Hz) high (HF: 0.15–0.4 adult do apply infants. Attempts made adapt new newborn physiology [5–11] [18]. Different within 0.01 Hz 1.5 used Generally, any above 0.2 has HF case infant [4]. However, classification yet established. The coherence function quantitative measure strength interaction adults. Coherence calculated cross- density normalized by corresponding auto-spectral [19]. takes values zero, indicating interactions, one, exclusive interactions. it pointed out estimation using cross-spectral does account causality two time signals [20]. method assumes interact open loop which unidirectional whereas information flow For example, ventilation results arterial pH pCO2, turn affect ventilatory drive via central peripheral chemoreceptors. delay dynamics this feedback system modified systemic cerebral circulations, influenced HRV. Correlated circulation recorded [21][22], related [23]. Therefore could some making bi-directional closed loop. Another possible source relate neural reflexive baroreceptor influences activity (c.f. [24]). non-negligible opposite direction estimated paradigm significantly differ actual loop. effect demonstrated variations systolic [20]. To determine significant respiration, threshold set either arbitrarily [25–27] or based statistical criteria derived sampling distribution Any value significant. Methods able compute more appropriate thresholds, theoretically experimentally knowledge estimator under investigation, avert discretionary use theoretical model empirical approach. weaker (or absent) establish solid criterion reliable significance function. To address issues, we propose framework studying We present bivariate tailored auto- RR evaluated autoregressive parameters. Using procedure [20], causal gain different bands. then determined surrogate data analyses [28][29]. The combined methodologies, modeling analysis, were applied collected 11 test whether our detect differences known physiological perturbations, characteristic dynamic changes occur consequence perturbations.

参考文章(42)
Ilkka Välimäki, Tiina Rantonen, None, Spectral analysis of heart rate and blood pressure variability. Clinics in Perinatology. ,vol. 26, pp. 967- 980 ,(1999) , 10.1016/S0095-5108(18)30029-0
Carsten Schäfer, Michael G. Rosenblum, Jürgen Kurths, Hans-Henning Abel, Heartbeat synchronized with ventilation Nature. ,vol. 392, pp. 239- 240 ,(1998) , 10.1038/32567
D. Paydarfar, D.M. Buerkel, Collapse of Homeostasis during Sleep Karger Publishers. ,vol. 15, pp. 60- 86 ,(1997) , 10.1159/000061564
Giuseppe Mancia, Gianfranco Parati, Paolo Castiglioni, Marco di Rienzo, Effect of sinoaortic denervation on frequency-domain estimates of baroreflex sensitivity in conscious cats American Journal of Physiology-heart and Circulatory Physiology. ,vol. 276, ,(1999) , 10.1152/AJPHEART.1999.276.6.H1987
Don P. Giddens, Richard I. Kitney, Neonatal heart rate variability and its relation to respiration. Journal of Theoretical Biology. ,vol. 113, pp. 759- 780 ,(1985) , 10.1016/S0022-5193(85)80192-2
David Paydarfar, Daniel M. Buerkel, Dysrhythmias of the respiratory oscillator Chaos: An Interdisciplinary Journal of Nonlinear Science. ,vol. 5, pp. 18- 29 ,(1995) , 10.1063/1.166067
Virender K. Rehan, Carlos A. Fajardo, Zia Haider, Ruben E. Alvaro, Donald B. Gates, Kim Kwiatkowski, Bogdan Nowaczyk, Henrique Rigatto, Influence of Sleep State and Respiratory Pattern on Cyclical Fluctuations of Cerebral Blood Flow Velocity in Healthy Preterm Infants Neonatology. ,vol. 69, pp. 357- 367 ,(1996) , 10.1159/000244331
Kurt von Siebenthal, Jan Beran, Martin Wolf, Matthias Keel, Vera Dietz, Seema Kundu, Hans Ulrich Bucher, Cyclical fluctuations in blood pressure, heart rate and cerebral blood volume in preterm infants Brain & Development. ,vol. 21, pp. 529- 534 ,(1999) , 10.1016/S0387-7604(99)00062-5