科研之友
微信
新浪微博
Facebook
分享链接
摘要
Breathing is a critical component of cardiopulmonary function, but few tools exist to evaluate respiration in ambulatory patients. Holier monitoring allows accurate diagnosis of a host of cardiac issues, and several investigators have demonstrated the ability to detect respiratory effort on the electrocardiogram. In this study we introduce a myogram signal derived from 12-lead, high frequency Holier as a means of detecting respiratory effort. Using the combined myogram and ECG signal, four novel variables were created: total number of Cheyne Stokes episodes; the BWRatio, the ratio of power (above baseline) measured one second after peak-to-peak respiratory power, an assessment of the %26quot;shape%26quot; of the respiratory effort; DRR, the change in RR interval centering around peak inspiration; and minutes of synchronized breathing, a fixed ratio of heart beats to respiratory cycles. These variables were assessed in 24-hour recordings from three cohorts: healthy volunteers (n = 33), heart failure subjects from the GISSI HF trial (n = 383), and subjects receiving implantable defibrillators with severely depressed left ventricular function enrolled in the M2Risk trial (n = 470). We observed a statistically significant 6-fold increase in the number of Cheyne Stokes episodes (p = 0.01 by ANOVA), decreases in BWRatio (p %26lt; 0.001), as well as decrease in DRR in heart failure subjects; only minutes of synchronized breathing was not significantly decreased in heart failure. This study provides %26quot;proof of concept%26quot; that novel variables incorporating Holter-derived respiration can distinguish healthy subjects from heart failure. The utility of these variables for predicting heart failure, arrhythmia, and death risk in prospective studies needs to be assessed. Published by Elsevier Inc.
- 出版日期2014-12
