Changes in the frequency power spectrum of fetal heart rate in the course of pregnancy

Leeuwen, P. van; Geue, D.; Lange, Silke; Hatzmann, Wolfgang; Grönemeyer, Dietrich

doi:10.1002/pd.723

Cited by 110 publications

(109 citation statements)

References 20 publications

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“…Therefore fetal development can be assessed by these intervals which evolve concomitantly with the changes in sympathetic and parasympathetic activities during fetal maturation. Fetal autonomic brain age can be assessed using FHRV parameters [5,7]. Results of this paper showed that the new method based on valve intervals outperforms the FHRbased method in estimating the GA although only time and frequency domain parameters and non identical populations were used.…”

Section: Discussionmentioning

confidence: 99%

“…one promising alternative GA estimator is Fetal Heart Rate (FHR), which is affordable and applicable without special skills, hence feasible for low income countries [4][5][6]. Various FHR variability (FHRV) parameters were found closely related to the fetal maturation [5,7]. A more critical indication for estimating GA is assessing the development of the fetal brain which may affect the entire life.…”

Section: Introductionmentioning

confidence: 99%

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Estimating Fetal Gestational Age Using Cardiac Valve Intervals

Marzbanrad

Khandoker

Kimura

et al. 2016

2016 Computing in Cardiology Conference (CinC)

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A new automated method for estimation of the gestational age is presented in this paper based on the intervals between fetal cardiac valve timings and the Q-wave of fetal electrocardiogram (fECG). The intervals were estimated automatically from one-dimensional Doppler Ultrasound and noninvasive fECG. Among the intervals, Isovolumic Contraction Time, Electromechanical Delay Time, Ventricular Filling Time and their interactions were selected in a stepwise regression process. Compared with Crown-Rump Length as gold standard, a mean absolute error of 3.8 weeks was obtained using leave-one-out cross validation. This method also outperformed a fetal heart rate based approach. Since valve intervals reflect the autonomic function, this method provides a novel measure of the development of fetal autonomic nervous system that may be growth curve independent.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Estimating Fetal Gestational Age Using Cardiac Valve Intervals

Marzbanrad

Khandoker

Kimura

et al. 2016

2016 Computing in Cardiology Conference (CinC)

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“…This requires a deeper understanding of the physiological meaning of fHRV complexity, including how its linear and nonlinear properties are modulated by sympathetic and vagal activity of the autonomic nervous system (ANS). Understanding fHRV dynamics during physiological (e.g., sleep states dependent changes) and pathophysiological (e.g., asphyxia) conditions has evolved over the past two decades, propelled by analyses of the linear aspects of fHRV in human and ovine fetuses (4,11,16,20,29,32). However, characterization of the linear fHRV properties is fundamentally limited in its power to describe the nonlinear structure of the underlying sympathovagal interactions (12,14).…”

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confidence: 99%

Nonlinear properties of vagal and sympathetic modulations of heart rate variability in ovine fetus near term

Frasch¹,

Müller²,

Hoyer³

et al. 2009

American Journal of Physiology-Regulatory, Integrative and Comp

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Frasch MG, Mü ller T, Hoyer D, Weiss C, Schubert H, Schwab M. Nonlinear properties of vagal and sympathetic modulations of heart rate variability in ovine fetus near term. Am J Physiol Regul Integr Comp Physiol 296: R702-R707, 2009. First published December 17, 2008; doi:10.1152/ajpregu.90474.2008.-Fetal heart rate (FHR) monitoring is commonly used although clinical studies questioned its diagnostic value. Sophisticated FHR variability (fHRV) measures such as fHRV complexity may improve the sensitivity and specificity of FHR monitoring. A more detailed understanding of the physiology underlying fHRV complexity is essential to harness its use for monitoring fetal health. To examine the specific effects of vagal and sympathetic modulations on fHRV complexity, we blocked vagal activity with atropine and sympathetic activity with propranolol in near-term fetal sheep (n ϭ 7, 0.85 gestation). Under these conditions, we analyzed the linear and nonlinear parts of fHRV complexity from autonomic information flow. Overall fHRV complexity decreased with both drugs compared with nonrapid eye movement sleep baseline (P Ͻ 0.05). With atropine, this was because of a decrease of the linear part of fHRV complexity on the long-term time scale (P Ͻ 0.05), suggesting that vagal modulation of fHRV is adequately described by linear fHRV measures. With propranolol, the nonlinear part of fHRV complexity decreased on the short-term time scale (P Ͻ 0.05), suggesting that sympathetic influences on fHRV can be detected by the nonlinear part of fHRV complexity. Thus the complex interplay of vagal and sympathetic modulations of fHRV is reflected differently and specifically in the linear and nonlinear properties of fHRV complexity, and on different time scales. Analysis of linear and nonlinear properties of fHRV may improve sensitivity and specificity of FHR monitoring. fetal sheep; autonomic nervous system; autonomic information flow; complexity FETAL HEART RATE (FHR) monitoring is used to monitor fetal well-being noninvasively in utero. Some studies questioned its diagnostic value (24). Recent studies in human fetuses suggested potential of FHR variability (fHRV) complexity estimation to improve clinical monitoring of fetal health (18,31). This requires a deeper understanding of the physiological meaning of fHRV complexity, including how its linear and nonlinear properties are modulated by sympathetic and vagal activity of the autonomic nervous system (ANS). Understanding fHRV dynamics during physiological (e.g., sleep states dependent changes) and pathophysiological (e.g., asphyxia) conditions has evolved over the past two decades, propelled by analyses of the linear aspects of fHRV in human and ovine fetuses (4,11,16,20,29,32). However, characterization of the linear fHRV properties is fundamentally limited in its power to describe the nonlinear structure of the underlying sympathovagal interactions (12,14).The origin of the nonlinearity of sympathovagal interactions lies in their intrinsic complexity. This complexity emerges from intera...

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“…The first aim is to link the presence of temporal asymmetries of short-term R-R variability, as detected from irreversibility analysis, to the autonomic regulation. A set of R-R variability data recorded from healthy fetuses in different periods of maturation (12,24) will allow us to elucidate the role of autonomic nervous system in generating these temporal asymmetries. The second aim is to link the presence of these asymmetric patterns to the amplitude of sympathetic modulation.…”

mentioning

confidence: 99%

Temporal asymmetries of short-term heart period variability are linked to autonomic regulation

Porta

Casali

et al. 2008

American Journal of Physiology-Regulatory, Integrative and Comp

190

183

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We exploit time reversibility analysis, checking the invariance of statistical features of a series after time reversal, to detect temporal asymmetries of short-term heart period variability series. Reversibility indexes were extracted from 22 healthy fetuses between 16th to 40th wk of gestation and from 17 healthy humans (aged 21 to 54, median ϭ 28) during graded head-up tilt with table inclination angles randomly selected inside the set {15, 30, 45, 60, 75, 90}. Irreversibility analysis showed that nonlinear dynamics observed in short-term heart period variability are mostly due to asymmetric patterns characterized by bradycardic runs shorter than tachycardic ones. These temporal asymmetries were 1) more likely over short temporal scales than over longer, dominant ones; 2) more frequent during the late period of pregnancy (from 25th to 40th week of gestation); 3) significantly present in healthy humans at rest in supine position; 4) more numerous during 75 and 90°head-up tilt. Results suggest that asymmetric patterns observable in short-term heart period variability might be the result of a fully developed autonomic regulation and that an important shift of the sympathovagal balance toward sympathetic predominance (and vagal withdrawal) can increase their presence. heart rate variability; autonomic nervous system; head-up tilt; fetal maturation; nonlinear dynamics THE VARIABILITY OF HEART PERIOD (usually approximated as the temporal distance between two consecutive R peaks on the ECG, R-R) has been proven to be nonlinear in healthy fetuses between 38th and 40th week of gestation (8) and in healthy humans (1, 4), mostly during experimental conditions periodically forcing cardiovascular regulation (i.e., controlled breathing) (15, 16). However, this finding has not been translated yet into a notion actually helpful in pathophysiology. The main reason is that, until now, the detection of nonlinear dynamics has not been linked to a clear temporal correlate (i.e., a pattern associated with nonlinear dynamics).Time irreversibility analysis checks the invariance of the statistical properties of a time series after time reversal. This analysis might be helpful to translate the involved concept of nonlinear dynamics into a simple, comprehensible notion useful in pathophysiology, since it clearly indicates a time domain scheme responsible for nonlinear dynamics. Indeed, time irreversibility analysis is capable of detecting a specific class of nonlinear dynamics, that is, those characterized by a temporal asymmetry. In other words, when a series is detected as irreversible using simple tests in the two-dimensional phase space (6, 9, 17), it can be stated that the nonlinear behavior is the result of the presence of asymmetric patterns (i.e., waveforms characterized by the upward side shorter or longer than the downward side), thus directly linking the abstract concept of nonlinear dynamics to a clear, easily imaginable, feature (17).The aim of this study is twofold. The first aim is to link the presence of temporal asymme...

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Changes in the frequency power spectrum of fetal heart rate in the course of pregnancy

Abstract: We conclude that characteristic spectral bands that increase in spectral density at different rates during the second and third trimester may be identified. They most likely reflect developmental changes and behavioral states during pregnancy.

Cited by 110 publications

References 20 publications

Estimating Fetal Gestational Age Using Cardiac Valve Intervals

Estimating Fetal Gestational Age Using Cardiac Valve Intervals

Nonlinear properties of vagal and sympathetic modulations of heart rate variability in ovine fetus near term

Temporal asymmetries of short-term heart period variability are linked to autonomic regulation

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