Assessing the interaction of respiration and heart rate in heart failure and controls using ambulatory Holter recordings.
Breathing is a critical component of cardiopulmonary function, but few tools exist to evaluate respiration in ambulatory patients. Holter monitoring allows accurate diagnosis of a host of cardiac issues, and several investigators have demonstrated the ability to detect respiratory effort on the elec...
| Published in: | Journal of Electrocardiology Vol. 47; no. 6; pp. 831 - 836 |
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| Main Authors: | , , , , |
| Format: | Journal Article |
| Published: |
W B Saunders
Nov/Oct2014
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=109685163&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 109685163 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00220736 1276 jtl: Journal of Electrocardiology issn: 00220736 maglogo: N pubinfo: dt: Nov/Oct2014 vid: 47 iid: 6 pid: 1351 pub: W B Saunders place: Philadelphia, Pennsylvania artinfo: ui: 109685163 NLM25172186 2012819726 10.1016/j.jelectrocard.2014.08.002 NLM25172186 109685163 ppf: 831 ppct: 5 formats: tig: atl: Assessing the interaction of respiration and heart rate in heart failure and controls using ambulatory Holter recordings. aug: au: Haigney, Mark Zareba, Wojceich La Rovere, Maria Teresa Grasso, Ian Mortara, David sug: ab: Breathing is a critical component of cardiopulmonary function, but few tools exist to evaluate respiration in ambulatory patients. Holter 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 Holter 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 "shape" 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<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 "proof of concept" 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. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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