Generalized Poincaré plots analysis of heart period dynamics in different physiological conditions: Trained vs. untrained men

Background Recently we proposed a new method called generalized Poincare´ plot (gPp) analysis which gave a new insight into the pattern of neurocaridac control. In this study we examined potential of gPp method to reveal changes in cardiac neural control in young athletes during three conditions: supine rest, running and relaxation, with respect to untrained subjects. Methods This method is based on the quantification of Pearson's correlation coefficients r(j, k), between symmetrical (j = k) and asymmetrical summed j previous and k following RR intervals up to the 100th order (j,k.100). Results Differences between groups were obtained at all levels of this analysis. The main result is the significant difference of NAI, normalized index of asymmetry, between groups in running, which was originated in different positions of local maxima of r(j, k). Compared with untrained subjects, these findings indicate modified neural control and altered intrinsic heart rate behavior in athletes which are related to some kind of memory mechanism between RR intervals. Conclusion Obtained results provide great potential of gPp method analysis in the recognition of changes in neurocardiac control in healthy subjects. Further studies are needed for identification of altered cardiac regulatory mechanisms whose background may be useful in the evaluation of genesis of athletes neurocardiovascular pathology. © 2019 Platiša et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Pulse respiration quotient as a measure sensitive to changes in dynamic behavior of cardiorespiratory coupling such as body posture and breathing regime

In this research we explored the (homeo)dynamic character of cardiorespiratory coupling (CRC) under the influence of different body posture and breathing regimes. Our tool for it was the pulse respiration quotient (PRQ), representing the number of heartbeat intervals per breathing cycle. We obtained non-integer PRQ values using our advanced Matlab® algorithm and applied it on the signals of 20 healthy subjects in four conditions: supine position with spontaneous breathing (Supin), standing with spontaneous breathing (Stand), supine position with slow (0.1 Hz) breathing (Supin01) and standing with slow (0.1 Hz) breathing (Stand01).Main results: Linear features of CRC (in PRQ signals) were dynamically very sensitive to posture and breathing rhythm perturbations. There are obvious increases in PRQ mean level and variability under the separated and joined influence of orthostasis and slow (0.1 Hz) breathing. This increase was most pronounced in Stand01 as the state of joint influences. Importantly, PRQ dynamic modification showed greater sensitivity to body posture and breathing regime changes than mean value and standard deviation of heart rhythm and breathing rhythm. In addition, as a consequence of prolonged supine position, we noticed the tendency to integer quantization of PRQ (especially after 14 min), in which the most common quantization number was 4:1 (demonstrated in other research reports as well). In orthostasis and slow breathing, quantization can also be observed, but shifted to other values. We postulate that these results manifest resonance effects induced by coupling patterns from sympathetic and parasympathetic adjustments (with the second as dominant factor).Significance: Our research confirms that cardiorespiratory coupling adaptability could be profoundly explored by precisely calculated PRQ parameter since cardiorespiratory regulation in healthy subjects is characterized by a high level of autonomic adaptability (responsiveness) to posture and breathing regime, although comparisons with pathological states has yet to be performed. We found Stand01 to be the most provoking state for the dynamic modification of PRQ (cardiorespiratory inducement). As such, Stand01 has the potential of using for PRQ tuning by conditioning the cardiorespiratory autonomic neural networks, e.g., in the cases where PRQ is disturbed by environmental (i.e., microgravity) or pathologic conditions

Slow 0.1 Hz Breathing and Body Posture Induced Perturbations of RRI and Respiratory Signal Complexity and Cardiorespiratory Coupling

Objective: We explored the physiological background of the non-linear operating mode of cardiorespiratory oscillators as the fundamental question of cardiorespiratory homeodynamics and as a prerequisite for the understanding of neurocardiovascular diseases. We investigated 20 healthy human subjects for changes using electrocardiac RR interval (RRI) and respiratory signal (Resp) Detrended Fluctuation Analysis (DFA, α1RRI, α2RRI, α1Resp, α2Resp), Multiple Scaling Entropy (MSERRI1−4, MSERRI5−10, MSEResp1−4, MSEResp5−10), spectral coherence (CohRRI−Resp), cross DFA (ρ1 and ρ2) and cross MSE (XMSE1−4 and XMSE5−10) indices in four physiological conditions: supine with spontaneous breathing, standing with spontaneous breathing, supine with 0.1 Hz breathing and standing with 0.1 Hz breathing. Main results: Standing is primarily characterized by the change of RRI parameters, insensitivity to change with respiratory parameters, decrease of CohRRI−Resp and insensitivity to change of in ρ1, ρ2, XMSE1−4, and XMSE5−10. Slow breathing in supine position was characterized by the change of the linear and non-linear parameters of both signals, reflecting the dominant vagal RRI modulation and the impact of slow 0.1 Hz breathing on Resp parameters. CohRRI−Resp did not change with respect to supine position, while ρ1 increased. Slow breathing in standing reflected the qualitatively specific state of autonomic regulation with striking impact on both cardiac and respiratory parameters, with specific patterns of cardiorespiratory coupling. Significance: Our results show that cardiac and respiratory short term and long term complexity parameters have different, state dependent patterns. Sympathovagal non-linear interactions are dependent on the pattern of their activation, having different scaling properties when individually activated with respect to the state of their joint activation. All investigated states induced a change of α1 vs. α2 relationship, which can be accurately expressed by the proposed measure—inter-fractal angle θ. Short scale (α1 vs. MSE1−4) and long scale (α2 vs. MSE5−10) complexity measures had reciprocal interrelation in standing with 0.1 Hz breathing, with specific cardiorespiratory coupling pattern (ρ1 vs. XMSE1−4). These results support the hypothesis of hierarchical organization of cardiorespiratory complexity mechanisms and their recruitment in ascendant manner with respect to the increase of behavioral challenge complexity. Specific and comprehensive cardiorespiratory regulation in standing with 0.1 Hz breathing suggests this state as the potentially most beneficial maneuver for cardiorespiratory conditioning. © Copyright © 2020 Matić, Platiša, Kalauzi and Bojić

Information-Theoretic Analysis of Cardio-Respiratory Interactions in Heart Failure Patients: Effects of Arrhythmias and Cardiac Resynchronization Therapy

The properties of cardio-respiratory coupling (CRC) are affected by various pathological conditions related to the cardiovascular and/or respiratory systems. In heart failure, one of the most common cardiac pathological conditions, the degree of CRC changes primarily depend on the type of heart-rhythm alterations. In this work, we investigated CRC in heart-failure patients, applying measures from information theory, i.e., Granger Causality (GC), Transfer Entropy (TE) and Cross Entropy (CE), to quantify the directed coupling and causality between cardiac (RR interval) and respiratory (Resp) time series. Patients were divided into three groups depending on their heart rhythm (sinus rhythm and presence of low/high number of ventricular extrasystoles) and were studied also after cardiac resynchronization therapy (CRT), distinguishing responders and non-responders to the therapy. The information-theoretic analysis of bidirectional cardio-respiratory interactions in HF patients revealed the strong effect of nonlinear components in the RR (high number of ventricular extrasystoles) and in the Resp time series (respiratory sinus arrhythmia) as well as in their causal interactions. We showed that GC as a linear model measure is not sensitive to both nonlinear components and only model free measures as TE and CE may quantify them. CRT responders mainly exhibit unchanged asymmetry in the TE values, with statistically significant dominance of the information flow from Resp to RR over the opposite flow from RR to Resp, before and after CRT. In non-responders this asymmetry was statistically significant only after CRT. Our results indicate that the success of CRT is related to corresponding information transfer between the cardiac and respiratory signal quantified at baseline measurements, which could contribute to a better selection of patients for this type of therapy

Generalized Poincare Plots-A New Method for Evaluation of Regimes in Cardiac Neural Control in Atrial Fibrillation and Healthy Subjects

Classical Poincare plot is a standard way to measure nonlinear regulation of cardiovascular control. In our work we propose a generalized form of Poincare plot where we track correlation between the duration of j preceding and k next RR intervals. The investigation was done in healthy subjects and patients with atrial fibrillation, by varying j,k LT = 100. In cases where j = k, in healthy subjects the typical pattern was observed by paths that were substituting scatterplots and that were initiated and ended by loops of Poincare plot points. This was not the case for atrial fibrillation patients where Poincare plot had a simple scattered form. More, a typical matrix of Pearsons correlation coefficients, r(j,k), showed different positions of local maxima, depending on the subjects health condition. In both groups, local maxima were grouped into four clusters which probably determined specific regulatory mechanisms according to correlations between the duration of symmetric and asymmetric observed RR intervals. We quantified matrices degrees of asymmetry and found that they were significantly different: distributed around zero in healthy, while being negative in atrial fibrillation. Also, Pearsons coefficients were higher in healthy than in atrial fibrillation or in signals with reshuffled intervals. Our hypothesis is that by this novel method we can observe heart rate regimes typical for baseline conditions and defense reaction in healthy subjects. These data indicate that neural control mechanisms of heart rate are operating in healthy subjects in contrast with atrial fibrillation, identifying it as the state of risk for stress-dependent pathologies. Regulatory regimes of heart rate can be further quantified and explored by the proposed novel method

Promene linearnih i nelinearnih mera nizova RR i QT intervala posle uzimanja piva

BACKGROUND: /Aim. There are only several studies on the acute effect of alcoholic drinks intake on heart rhythm and this phenomenon is still not well understood. We wanted to examine whether linear and nonlinear measures of RR interval and QT interval series could quantify the effect of beer in healthy subjects. Methods. Eighteen young volunteers drank 500 mL of beer (21 g of ethanol). Electrocardiogram (ECG) recordings were taken in supine position: 20 minutes before (relaxation) and 60 minutes after drink intake. The RR interval series and the QT interval series were extracted from ECG and we calculated short-term (α1) and long-term (α2) scaling exponents and sample entropy (SampEn) for both series; low frequency (LF) and high frequency (HF) spectral components from RR interval series and QT variability (QTV). Blood pressure was measured every 10 minutes. Results. It was shown that beer induced changes in variability and correlation properties of these series. Immediate effect of beer intake was detected as a transient increase in the QT variability, heart rate and blood pressure. Delayed effects of beer were shortening of the RR and QT intervals and reduction of the HF spectral component. Beer intake also increased short-term scaling exponent (α1) of the RR time series and long-term scaling exponent (α2) of the QT time series. Conclusion. Our results suggest that acute effects of beer are reduced parasympathetic control of the heart and changed dynamic complexity of the ventricular repolarization.Uvod/Cilj. Akutni efekat uzimanja alkoholnih pića na kardiovaskularne ritmove je fenomen koji još uvek nije dovoljno razjašnjen i u literaturi postoji svega nekoliko radova na tu temu. Cilj rada je bio da se ispita da li se linearnim i nelinearnim merama nizova RR i QT intervala može kvantifikovati akutni efekat male količine piva kod zdravih osoba. Metode. Osamnaest mladih zdravih muškaraca je pilo po 500 mL piva (21 g etanola). Elektrokardiogram (EKG) je beležen u ležećem položaju: 20 minuta pre (u relaksaciji) i 60 minuta neposredno posle uzimanja pića. Iz digitalizovanog zapisa EKG-a izdvojeni su nizovi RR i QT intervala. Iz oba niza smo izračunali kratkodometni (α1) i dugo-dometni skalirajući eksponent (α2), kao i entropiju uzorka (SampEn). Iz nizova RR intervala određene su spektralne komponente niskofrekventnih (LF) i visokofrekventnih (HF) opsega, a iz nizova QT intervala varijabilnost QT intervala (QTV). Krvni pritisak je bio meren svakih 10 minuta. Rezultati. Pokazali smo da pivo menja varijabilnost i korelacione osobine ovih nizova. Neposredni efekat uzimanja piva ogleda se u prolaznim povećanjima QT varijabilnosti, srčane frekvence i krvnog pritiska, a produženi u skraćenju dužine RR i QT intervala i smanjenju spektralne komponente HF. Uzimanje piva je takođe dovelo do porasta kratkodometnog skalirajućeg eksponenta (α1) RR niza i dugodometnog skalirajućeg eksponenta (α2) QT niza. Zaključak. Akutni efekat uzimanja piva je redukovana parasimpatička kontrola srca i izmenjena kompleksnost dinamike ventrikularne repolarizacije

Sensitivity Estimations in Favor of Using Inter-fractal Angle in Detrended Fluctuation Analysis

It has become common in research with detrended fluctuation analysis (DFA) to use slopes of regression lines (α1 and α2) and their ratio as measures of fractal properties of dynamical processes such as physiological rhythm fluctuations. In this study, instead of the ratio (α1/α2) in DFA of ECG RR intervals and respiratory signals, we propose the use of a new measure: the inter-fractal angle (θ) - angle that DFA regression lines form between each other. Methods. Angle θ was obtained by means of graphical-analytical calculation. Using one way-Anova test, sensitivity of θ on the influence of slow breathing and orthostasis was compared in respect to ratio α1/α2. Results. Comparisons revealed that changes of (θ) were statistically more significant than changes of αl/α2. Conclusion. Inter-fractal angle is an elegant new measure of DFA that is more sensitive to perturbations such as changes in body posture and breathing regime than α1/α2

Structure of Poincaré plots revealed by their graph analysis and low pass filtering of the RRI time series

ObjectivesIn order to reveal their structure, Poincaré plots (PP) of electrocardiogram (ECG) RR intervals (RRI) were studied as linear edge planar directed graphs, obtained by connecting all their sequential points. We were also aimed at studying their graph complexity properties.MethodsRRI signals were subjected to a series of different window length (WL) Moving Average Low Pass (MALP) filters. For each filtered graph, four standard PP descriptors: Pearson’s coefficient, SD1, SD2, and SD2/SD1 were calculated, as well as four new graph complexity measures: mean angle between adjacent graph edges; mean number of edge crossings; directional complexity and directional entropy. This approach was applied to signals of twenty young healthy subjects, recorded in four experimental conditions – combination of two body postures (supine and standing) and two breathing regimes (spontaneous and slow 0.1 Hz).ResultsWe found that PP graphs consist of two superimposed components: one originating from Respiratory Sinus Arrhythmia (RSA) oscillations, the other from slow variations (SV) of the RRI time series. This result was further corroborated by observing the transformation of a PP cloud shape occurring in filtered graphs. When applied to subjects, the outcome was that three measures significantly differentiated the two breathing regimes in the RSA region of the WL domain, while four other measures were able to differentiate two body postures in the SV WL region.DiscussionAfter obtaining these results in healthy, we expect to successfully apply this approach to patients suffering from different pathological conditions

Two Operational Modes of Cardio-Respiratory Coupling Revealed by Pulse-Respiration Quotient

Due to the fact that respiratory breath-to-breath and cardiac intervals between two successive R peaks (BBI and RRI, respectively) are not temporally concurrent, in a previous paper, we proposed a method to calculate both the integer and non-integer parts of the pulse respiration quotient (PRQ = BBI/RRI = PRQint + b1 + b2), b1 and b2 being parts of the border RRIs for each BBI. In this work, we study the correlations between BBI and PRQ, as well as those between BBI and mean RRI within each BBI (mRRI), on a group of twenty subjects in four conditions: in supine and standing positions, in combination with spontaneous and slow breathing. Results show that the BBI vs. PRQ correlations are positive; whereas the breathing regime had little or no effect on the linear regression slopes, body posture did. Two types of scatter plots were obtained with the BBI vs. mRRI correlations: one showed points aggregated around the concurrent PRQint lines, while the other showed randomly distributed points. Five out of six of the proposed aggregation measures confirmed the existence of these two cardio-respiratory coupling regimes. We also used b1 to study the positions of R pulses relative to the respiration onsets and showed that they were more synchronous with sympathetic activation. Overall, this method should be used in different pathological states

Two Operational Modes of Cardio-Respiratory Coupling Revealed by Pulse-Respiration Quotient

Due to the fact that respiratory breath-to-breath and cardiac intervals between two successive R peaks (BBI and RRI, respectively) are not temporally concurrent, in a previous paper, we proposed a method to calculate both the integer and non-integer parts of the pulse respiration quotient (PRQ = BBI/RRI = PRQint + b1 + b2), b1 and b2 being parts of the border RRIs for each BBI. In this work, we study the correlations between BBI and PRQ, as well as those between BBI and mean RRI within each BBI (mRRI), on a group of twenty subjects in four conditions: in supine and standing positions, in combination with spontaneous and slow breathing. Results show that the BBI vs. PRQ correlations are positive; whereas the breathing regime had little or no effect on the linear regression slopes, body posture did. Two types of scatter plots were obtained with the BBI vs. mRRI correlations: one showed points aggregated around the concurrent PRQint lines, while the other showed randomly distributed points. Five out of six of the proposed aggregation measures confirmed the existence of these two cardio-respiratory coupling regimes. We also used b1 to study the positions of R pulses relative to the respiration onsets and showed that they were more synchronous with sympathetic activation. Overall, this method should be used in different pathological states