Alternans of Blood Pressure and Heart Rate in Dilated Cardiomyopathy

Leder, U.; Pohl, Hans-Peter; Baier, V.; Baumert, M.; Liehr, Mario; Haueisen, Jens; Voss, Andreas; Figulla, Hans R.

doi:10.1046/j.1460-9592.2002.01307.x

Cited by 16 publications

(10 citation statements)

References 17 publications

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“…It has been reported that in patients suffering from dilated cardiomyopathy, short-term alternations of heart rate and blood pressure were significantly higher compared to healthy controls [6]. The beat-to-beat oscillation between lower and higher levels of blood pressure can be observed in clinical states of heart failure [6], which supports our finding of a higher baroreflex activity in the presence of systematic short-term alternations in SBP and heart rate.…”

Section: Discussionsupporting

confidence: 90%

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Assessment of joint interactions between respiration and baroreflex activity using joint symbolic dynamics in heart failure patients

Kabir

Ghafoori

Tereshchenko

2015

2015 Computing in Cardiology Conference (CinC)

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In this paper we employed a novel approach based on joint symbolic dynamics (JSD) to study interaction between respiratory phase and baroreflex activity. Electrocardiogram (ECG) and blood pressure recordings from six participants with history of heart failure were included in this study. First, the ECG R-peaks and systolic blood pressure indices were detected using parabolic fitting. Second, the respiratory signal was derived from Frank orthogonal ECG leads using QRS slopes and R-wave angles. Third, time series of R-R intervals and systolic blood pressure (SBP) were extracted, and respiratory phases were obtained using the Hilbert transform. Subsequently, each series was transformed into binary symbol vectors based on their successive changes and words of length ‘2’ were formed. Baroreflex patterns were studied using word combinations representing baroreflex activity for specific changes in respiratory phases. Baroreflex activity was significantly higher for alternating low-high/high-low heart rate and SBP during inspiration as compared to continuous increase or decrease in heart rate and SBP (winormalSnormalBnormalP=10,winormalHnormalR=01, wRP=11: 39.1±9.3% vs. winormalSnormalBnormalP=00,winormalHnormalR=11, wRP=11: 6.4±3.9%, p<0.0001).

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Section: Discussionsupporting

confidence: 90%

“…In patients suffering from dilated cardiomyopathy, the alternation between low to high blood pressure and heart rate has been demonstrated to be significantly higher compared to healthy controls [6]. However, combined analysis of respiration and baroreflex function has never been studied in heart failure patients.…”

Section: Introductionmentioning

confidence: 99%

Assessment of joint interactions between respiration and baroreflex activity using joint symbolic dynamics in heart failure patients

Kabir

Ghafoori

Tereshchenko

2015

2015 Computing in Cardiology Conference (CinC)

View full text Add to dashboard Cite

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“…Contrary, JSD 1 was less than 0.5 in DCM. This finding might partly result from alternans phenomena that were already observed in heart rate and blood pressure time series of DCM patients [23]. JSD 2 does not reflect baroreflex-like heart rate and blood pressure interactions and seems to be mainly affected by noise as the values are clustered with those of the simulated Gaussian process.…”

Section: Discussionmentioning

confidence: 90%

Short- and Long-Term Joint Symbolic Dynamics of Heart Rate and Blood Pressure in Dilated Cardiomyopathy

Baumert

Baier

Truebner

et al. 2005

IEEE Trans. Biomed. Eng.

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Abstract-Autonomic cardiovascular control involves complex interactions of heart rate and blood pressure. In patients with dilated cardiomyopathy (DCM), this control is impaired and parameters for its quantification might be of prognostic importance. In this paper, we introduce methods based on joint symbolic dynamics (JSD) for the enhanced analysis of heart rate and blood pressure interactions. To assess the coarse-grained dynamics beat-to-beat changes of heart rate and blood pressure are encoded in symbol strings. Subsequently, the distribution properties of short symbol sequences (words) as well as the scaling properties of the whole symbol string are assessed. The comparison of joint symbolic heart rate and blood pressure dynamics in DCM ( = 75) with those in healthy controls ( = 75) showed significant changes. Both, the distribution of words and the scaling properties indicate a loss in heart rate dynamics associated with blood pressure regulation in DCM. In conclusion, the analyses of short-and long-term JSDs provide insights into complex physiological heart rate and blood pressure interactions and furthermore reveal patho-physiological cardiovascular control in DCM.Index Terms-Blood pressure variability, dilated cardiomyopathy, heart rate variability, symbolic dynamics.

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“…Furthermore the probabilities of the words within the BBI time series (BBI000 to BBI111) as well as within the SP series (SP000 to SP111) were determined. BBI010 and BBI101 are measures for the occurrence of alternans [7], [8].…”

Section: Methodsmentioning

confidence: 99%

Analyzing cardiovascular variabilities in patients with heart failure

Voss

Schroeder

Baumert

et al. 2005

Computers in Cardiology, 2005

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Nearly 60% of patients with heart failure (HF) IntroductionNowadays, about 14 million Europeans are suffered from heart failure (HF). Statistical analyses forecast an increase of patients with HF to 30 million by the year 2020. Nearly 60% of HF patients suffer from cardiac death within five years after diagnosis. Furthermore, HF is the most common reason for hospitalization in the over-65 age group [1].HF is a complex cardiovascular disease often resulting from any functional or structural cardiac disorder that is mostly caused by coronary artery disease, hypertension and cardiomyopathy and characterized by impaired ventricular filling or reduced ventricular ejection fraction (EF) [2]. The extent of HF by physicians is often assessed according to the New York Heart Association (NYHA) functional classification system that places patients in the categories NYHA I-IV based on how much they are limited during physical activity. However, currently applied strategies for early diagnosis of HF are not sufficient. An improved risk stratification of HF is necessary to assess the prognosis of HF and to find an adapted drug treatment or an optimal timing for pacemaker or cardioverter defibrillator implantation or for heart transplantation.The aim of this study was to develop a multivariate parameter set for an enhanced risk stratification in patients with heart failure. MethodsWithin this study, 43 patients suffered from HF characterized by NYHA≥2 and EF<45% and 20 healthy subjects as reference (REF) were enrolled.30 minutes of ECG and synchronized continuously blood pressure (NIBP) were recorded under standardized resting conditions (supine position, quiet environment, same time and place) using the non-invasive Portapres M2 blood pressure monitor (TNO-TPD, Amsterdam, Netherlands). Thereafter, heart sound and synchronized ECG as well as NIBP were acquired on 9 auscultation areas over 5 heart beats during the patient hold his breath. For the recording of heart sound a hand-held electronic stethoscope (Welch Allyn® Master Elite Plus Stethoscope) was applied. Heart sound were digitized using a high quality USB soundcard (Maya EX, Audiotrak, sampling frequency 44100 Hz, resolution 16 bit). Using a commercially available amplifier system (Twente Medical Systems, Netherlands) ECG and NIBP were sampled with f s =1600 Hz. After discretization the signals were stored in a data base together with the patient data. The diagnosis of all HF patients were confirmed by an experienced cardiologist using short-and long-term ECG as well as stress ECG, echocardiography and heart catheter examination.From the 30 minute data records the time series of heart rate (tachogram) consisting of beat-to-beat intervals (BBI) and of blood pressure (systogram/diastogram) were extracted. Ectopic beats as well as other disturbances were removed. To quantify the heart rate variability (HRV) and blood pressure variability (BPV) several parameters of time domain, frequency domain and nonlinear dynamics were calculated from every tachogram, systogr...

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Alternans of Blood Pressure and Heart Rate in Dilated Cardiomyopathy

Cited by 16 publications

References 17 publications

Assessment of joint interactions between respiration and baroreflex activity using joint symbolic dynamics in heart failure patients

Assessment of joint interactions between respiration and baroreflex activity using joint symbolic dynamics in heart failure patients

Short- and Long-Term Joint Symbolic Dynamics of Heart Rate and Blood Pressure in Dilated Cardiomyopathy

Analyzing cardiovascular variabilities in patients with heart failure

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