Effect of ECG-derived respiration (EDR) on modeling ventricular repolarization dynamics in different physiological and psychological conditions

Imam, Hasan; Karmakar, Chandan; Khandoker, Ahsan H.; Palaniswami, Marimuthu

doi:10.1007/s11517-014-1188-0

Cited by 10 publications

(21 citation statements)

References 30 publications

(48 reference statements)

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“…mechanically mediated coupling) were reported as useful measures for quantification of the severity of diabetic CAN using a system identification technique [10]. Therefore, the study of the dynamical changes of VR due to autonomic denervation may provide useful information in CAN prognosis [4,[11][12][13].…”

Section: Introductionmentioning

confidence: 99%

“…Besides the direct effect of HRV, VRV is influenced by the ANS and factors such as respiration, different medication and diverse pathological conditions [4,11,13]. Among other factors, respiration directly affects HRV through respiratory sinus arrhythmia (RSA) and hence influences VRV since there exists a direct relationship between VRV and HRV [11,13]. The direct modulatory effect of respiration on the QT interval is reported in healthy human and heart failure patients [15].…”

Section: Introductionmentioning

confidence: 99%

“…The direct modulatory effect of respiration on the QT interval is reported in healthy human and heart failure patients [15]. In our previous study, it was shown that use of respiration better reflects the changes of the repolarization dynamics in healthy human participants due to ageing and altered psychological conditions [11]. Moreover, ECG derived respiration (EDR) was found to be an effective alternative to represent the effect of the respiration signal in VR dynamics modeling for healthy participants [11].…”

Section: Introductionmentioning

confidence: 99%

“…In our previous study, it was shown that use of respiration better reflects the changes of the repolarization dynamics in healthy human participants due to ageing and altered psychological conditions [11]. Moreover, ECG derived respiration (EDR) was found to be an effective alternative to represent the effect of the respiration signal in VR dynamics modeling for healthy participants [11]. However, to our knowledge the effectiveness of EDR based VR dynamics modeling for detecting pathological conditions and disease progression has not been reported before.…”

Section: Introductionmentioning

confidence: 99%

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Detecting Subclinical Diabetic Cardiac Autonomic Neuropathy by Analyzing Ventricular Repolarization Dynamics

Imam

Karmakar

Jelinek

et al. 2016

IEEE J. Biomed. Health Inform.

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In this study, a linear parametric modeling technique was applied to model ventricular repolarization (VR) dynamics. Three features were selected from the surface ECG recordings to investigate the changes in VR dynamics in healthy and cardiac autonomic neuropathy (CAN) participants with diabetes including heart rate variability (calculated from RR intervals), repolarization variability (calculated from QT intervals), and respiration [calculated by ECG-derived respiration (EDR)]. Surface ECGs were recorded in a supine resting position from 80 age-matched participants (40 with no cardiac autonomic neuropathy (NCAN) and 40 with CAN). In the CAN group, 25 participants had early/subclinical CAN (ECAN) and 15 participants were identified with definite/clinical CAN (DCAN). Detecting subclinical CAN is crucial for designing an effective treatment plan to prevent further cardiovascular complications. For CAN diagnosis, VR dynamics was analyzed using linear parametric autoregressive bivariate (ARXAR) and trivariate (ARXXAR) models, which were estimated using 250 beats of derived QT, RR, and EDR time series extracted from the first 5 min of the recorded ECG signal. Results showed that the EDR-based models gave a significantly higher fitting value (p < 0.0001) than models without EDR, which indicates that QT-RR dynamics is better explained by respiratory-information-based models. Moreover, the QT-RR-EDR model fitting values gradually decreased from the NCAN group to ECAN and DCAN groups, which indicate a decoupling of QT from RR and the respiration signal with the increase in severity of CAN. In this study, only the EDR-based model significantly distinguished ECAN and DCAN groups from the NCAN group (p < 0.05) with large effect sizes (Cohen's d > 0.75) showing the effectiveness of this modeling technique in detecting subclinical CAN. In conclusion, the EDR-based trivariate QT-RR-EDR model was found to be better in detecting the presence and severity of CAN than the bivariate QT-RR model. This finding also establishes the importance of adding respiratory information for analyzing the gradual deterioration of normal VR dynamics in pathological conditions, such as diabetic CAN.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Detecting Subclinical Diabetic Cardiac Autonomic Neuropathy by Analyzing Ventricular Repolarization Dynamics

Imam

Karmakar

Jelinek

et al. 2016

IEEE J. Biomed. Health Inform.

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show abstract

“…Differences in respiration between groups and protocols were assessed by the ECG-derived respiration index (Imam et al 2014), using the R-wave amplitude method for single-lead ECG. The ECG signal was first filtered for baseline wandering by a median filter.…”

Section: Calculation Of Cardiovascular and Neural Indicesmentioning

confidence: 99%

Exaggerated haemodynamic and neural responses to involuntary contractions induced by whole‐body vibration in normotensive obese versus lean women

Δίπλα

Kousoula

Zafeiridis

et al. 2016

Experimental Physiology

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New Findings r What is the central question of this study?In obesity, the exaggerated blood pressure response to voluntary exercise is linked to hypertension, yet the mechanisms are not fully elucidated. We examined whether involuntary contractions elicit greater haemodynamic responses and altered neural control of blood pressure in normotensive obese versus lean women. r What is the main finding and its importance? During involuntary contractions induced by whole-body vibration, there were augmented blood pressure and spontaneous baroreflex responses in obese compared with lean women. This finding is suggestive of an overactive mechanoreflex in the exercise-induced hypertensive response in obesity. Passive contractions did not elicit differential heart rate responses in obese compared with lean women, implying other mechanisms for the blunted heart rate response reported during voluntary exercise in obesity.In obesity, the exaggerated blood pressure (BP) response to exercise is linked to hypertension, yet the mechanisms are not fully elucidated. In this study, we examined whether involuntary mechanical oscillations, induced by whole-body vibration (WBV), elicit greater haemodynamic responses and altered neural control of BP in obese versus lean women. Twenty-two normotensive, premenopausal women (12 lean and 10 obese) randomly underwent a passive WBV (25 Hz) and a control protocol (similar posture without WVB). Beat-by-beat BP, heart rate, stroke volume, systemic vascular resistance, cardiac output, parasympathetic output (evaluated by heart rate variability) and spontaneous baroreceptor sensitivity (sBRS) were assessed. We found that during WBV, obese women exhibited an augmented systolic BP response compared with lean women that was correlated with body fat percentage (r = 0.77; P < 0.05). The exaggerated BP rise was driven mainly by the greater increase in cardiac output index in obese versus lean women, associated with a greater stroke volume index in obese women. Involuntary contractions did not elicit a differential magnitude of responses in heart rate, heart rate variability indices and systemic vascular resistance in obese versus lean women; however, they did result in greater sBRS responses (P < 0.05) in obese women. In conclusion, involuntary contractions elicited an augmented BP and sBRS response in normotensive obese versus lean women. The

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Random forest-based approach for physiological functional variable selection for driver’s stress level classification

et al. 2018

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Effect of ECG-derived respiration (EDR) on modeling ventricular repolarization dynamics in different physiological and psychological conditions

Cited by 10 publications

References 30 publications

Detecting Subclinical Diabetic Cardiac Autonomic Neuropathy by Analyzing Ventricular Repolarization Dynamics

Detecting Subclinical Diabetic Cardiac Autonomic Neuropathy by Analyzing Ventricular Repolarization Dynamics

Exaggerated haemodynamic and neural responses to involuntary contractions induced by whole‐body vibration in normotensive obese versus lean women

Random forest-based approach for physiological functional variable selection for driver’s stress level classification

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