A computer application for the investigation of cardiac autonomic effects of sleep-disordered breathing in heart failure patients

R. Maestri, G. Pinna
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Abstract

Sleep-disordered breathing (SDB) in the form of periodic breathing is common in heart failure patients and is thought to increase sympathetic activity. Since heart rate (HR) cyclically increases during SDB in synchrony with the oscillation in ventilation, these increases have been interpreted as indirect evidence of an augmented adrenergic activity brought about by SDB. To support this hypothesis, however, the distribution of HR fluctuations during SDB has to be compared with the distribution of spontaneous HR variation during normal breathing within the same night. The aim of this work was to develop a computer application to carry out this task efficiently, analyzing HR across different sleep stages, breathing conditions and abnormal breathing type (obstructive and central). The system automatically selects homogeneous segments of HR from standard polysomnographic recordings and computes a set of relevant distribution descriptors of HR. A pilot testing of the system has been performed in five stable heart failure patients.
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心衰患者睡眠呼吸障碍对心脏自主神经影响的计算机研究
周期性呼吸形式的睡眠呼吸障碍(SDB)在心力衰竭患者中很常见,被认为会增加交感神经活动。由于SDB期间心率(HR)与通气振荡同步周期性增加,这些增加被解释为SDB带来的肾上腺素能活性增强的间接证据。然而,为了支持这一假设,必须将SDB期间的HR波动分布与同一夜间正常呼吸时的自发HR变化分布进行比较。这项工作的目的是开发一个计算机应用程序来有效地执行这项任务,分析不同睡眠阶段、呼吸条件和异常呼吸类型(阻塞性和中枢性)的HR。系统自动从标准的多导睡眠记录中选择均匀的HR片段,并计算出一组相关的HR分布描述符。该系统的试点测试已在五名稳定的心力衰竭患者中进行。
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