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Pfurtscheller G, Rassler B, Schwarz G, Klimesch W. Scan-associated anxiety (scanxiety): the enigma of emotional breathing oscillations at 0.32 Hz (19 bpm). Front Neurosci 2024; 18:1384993. [PMID: 38638691 PMCID: PMC11025454 DOI: 10.3389/fnins.2024.1384993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 03/21/2024] [Indexed: 04/20/2024] Open
Abstract
MRI-related anxiety in healthy participants is often characterized by a dominant breathing frequency at around 0.32 Hz (19 breaths per minute, bpm) at the beginning but in a few cases also at the end of scanning. Breathing waves at 19 bpm are also observed in patients with anxiety independently of the scanned body part. In patients with medically intractable epilepsy and intracranial electroencephalography (iEEG), spontaneous breathing through the nose varied between 0.24 and 0.37 Hz (~19 bpm). Remarkable is the similarity of the observed breathing rates at around 0.32 Hz during different types of anxiety states (e.g., epilepsy, cancer, claustrophobia) with the preferred breathing frequency of 0.32 Hz (19 bpm), which is predicted by the binary hierarchy model of Klimesch. This elevated breathing frequency most likely reflects an emotional processing state, in which energy demands are minimized due to a harmonic coupling ratio with other brain-body oscillations.
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Affiliation(s)
- Gert Pfurtscheller
- Institute of Neural Engineering, Graz University of Technology, Graz, Austria
| | - Beate Rassler
- Carl-Ludwig-Institute of Physiology, University of Leipzig, Leipzig, Germany
| | - Gerhard Schwarz
- Department of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria
| | - Wolfgang Klimesch
- Centre of Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
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Cairo B, Bari V, Gelpi F, De Maria B, Porta A. Assessing cardiorespiratory interactions via lagged joint symbolic dynamics during spontaneous and controlled breathing. FRONTIERS IN NETWORK PHYSIOLOGY 2023; 3:1211848. [PMID: 37602202 PMCID: PMC10436098 DOI: 10.3389/fnetp.2023.1211848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/13/2023] [Indexed: 08/22/2023]
Abstract
Introduction: Joint symbolic analysis (JSA) can be utilized to describe interactions between time series while accounting for time scales and nonlinear features. JSA is based on the computation of the rate of occurrence of joint patterns built after symbolization. Lagged JSA (LJSA) is obtained from the more classical JSA by introducing a delay/lead between patterns built over the two series and combined to form the joint scheme, thus monitoring coordinated patterns at different lags. Methods: In the present study, we applied LJSA for the assessment of cardiorespiratory coupling (CRC) from heart period (HP) variability and respiratory activity (R) in 19 healthy subjects (age: 27-35 years; 8 males, 11 females) during spontaneous breathing (SB) and controlled breathing (CB). The R rate of CB was selected to be indistinguishable from that of SB, namely, 15 breaths·minute-1 (CB15), or slower than SB, namely, 10 breaths·minute-1 (CB10), but in both cases, very rapid interactions between heart rate and R were known to be present. The ability of the LJSA approach to follow variations of the coupling strength was tested over a unidirectionally or bidirectionally coupled stochastic process and using surrogate data to test the null hypothesis of uncoupling. Results: We found that: i) the analysis of surrogate data proved that HP and R were significantly coupled in any experimental condition, and coupling was not more likely to occur at a specific time lag; ii) CB10 reduced CRC strength at the fastest time scales while increasing that at intermediate time scales, thus leaving the overall CRC strength unvaried; iii) despite exhibiting similar R rates and respiratory sinus arrhythmia, SB and CB15 induced different cardiorespiratory interactions; iv) no dominant temporal scheme was observed with relevant contributions of HP patterns either leading or lagging R. Discussion: LJSA is a useful methodology to explore HP-R dynamic interactions while accounting for time shifts and scales.
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Affiliation(s)
- Beatrice Cairo
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Vlasta Bari
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato Milanese, Milan, Italy
| | - Francesca Gelpi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato Milanese, Milan, Italy
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Campanaro CK, Nethery DE, Guo F, Kaffashi F, Loparo KA, Jacono FJ, Dick TE, Hsieh YH. Dynamics of ventilatory pattern variability and Cardioventilatory Coupling during systemic inflammation in rats. FRONTIERS IN NETWORK PHYSIOLOGY 2023; 3:1038531. [PMID: 37583625 PMCID: PMC10423997 DOI: 10.3389/fnetp.2023.1038531] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 06/20/2023] [Indexed: 08/17/2023]
Abstract
Introduction: Biometrics of common physiologic signals can reflect health status. We have developed analytics to measure the predictability of ventilatory pattern variability (VPV, Nonlinear Complexity Index (NLCI) that quantifies the predictability of a continuous waveform associated with inhalation and exhalation) and the cardioventilatory coupling (CVC, the tendency of the last heartbeat in expiration to occur at preferred latency before the next inspiration). We hypothesized that measures of VPV and CVC are sensitive to the development of endotoxemia, which evoke neuroinflammation. Methods: We implanted Sprague Dawley male rats with BP transducers to monitor arterial blood pressure (BP) and recorded ventilatory waveforms and BP simultaneously using whole-body plethysmography in conjunction with BP transducer receivers. After baseline (BSLN) recordings, we injected lipopolysaccharide (LPS, n = 8) or phosphate buffered saline (PBS, n =3) intraperitoneally on 3 consecutive days. We recorded for 4-6 h after the injection, chose 3 epochs from each hour and analyzed VPV and CVC as well as heart rate variability (HRV). Results: First, the responses to sepsis varied across rats, but within rats the repeated measures of NLCI, CVC, as well as respiratory frequency (fR), HR, BP and HRV had a low coefficient of variation, (<0.2) at each time point. Second, HR, fR, and NLCI increased from BSLN on Days 1-3; whereas CVC decreased on Days 2 and 3. In contrast, changes in BP and the relative low-(LF) and high-frequency (HF) of HRV were not significant. The coefficient of variation decreased from BSLN to Day 3, except for CVC. Interestingly, NLCI increased before fR in LPS-treated rats. Finally, we histologically confirmed lung injury, systemic inflammation via ELISA and the presence of the proinflammatory cytokine, IL-1β, with immunohistochemistry in the ponto-medullary respiratory nuclei. Discussion: Our findings support that NLCI reflects changes in the rat's health induced by systemic injection of LPS and reflected in increases in HR and fR. CVC decreased over the course to the experiment. We conclude that NLCI reflected the increase in predictability of the ventilatory waveform and (together with our previous work) may reflect action of inflammatory cytokines on the network generating respiration.
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Affiliation(s)
- Cara K. Campanaro
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - David E. Nethery
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Fei Guo
- Institute for Smart, Secure and Connected Systems (ISSACS), Case Western Reserve University, Cleveland, OH, United States
| | - Farhad Kaffashi
- Institute for Smart, Secure and Connected Systems (ISSACS), Case Western Reserve University, Cleveland, OH, United States
| | - Kenneth A. Loparo
- Institute for Smart, Secure and Connected Systems (ISSACS), Case Western Reserve University, Cleveland, OH, United States
| | - Frank J. Jacono
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Case Western Reserve University, Cleveland, OH, United States
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, United States
| | - Thomas E. Dick
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Case Western Reserve University, Cleveland, OH, United States
- Department of Neurosciences, Case Western Reserve University, Cleveland, OH, United States
| | - Yee-Hsee Hsieh
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Case Western Reserve University, Cleveland, OH, United States
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Koppula A, Barra RR, Sridharan KS. Effects of exercise anticipation on cardiorespiratory coherence. Physiol Rep 2022; 10:e15381. [PMID: 35883224 PMCID: PMC9325975 DOI: 10.14814/phy2.15381] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 05/23/2022] [Accepted: 06/17/2022] [Indexed: 11/24/2022] Open
Abstract
In this study, we explored the role of feedforward mechanisms in triggering cardiorespiratory adjustments before the onset of exercise. To isolate the feedforward aspects, we examined the effect of exercise anticipation on cardiorespiratory coherence. Twenty-nine healthy males (age = 18.8 [0.96] years) were subjected to bicycle (BE) and handgrip exercise (H) at two different intensities, viz., low and high. Bicycle exercise was performed in a unilateral (left- and right-sided) or bilateral mode, whereas handgrip was performed only in a unilateral mode. Single-lead ECG and respiratory rhythm, measured in the 5 min of anticipation phase before the onset of exercise, were used for analysis. Coherence was computed between ECG-derived instantaneous heart rate and respiratory signal. Average coherence in the high-frequency band (0.15-0.4 Hz) was used to estimate respiratory sinus arrhythmia (RSA). We found that coherence decreased with the anticipation of exercise relative to baseline (baseline = 0.54 [0.16], BE = 0.41 [0.12], H = 0.39 [0.12], p < 0.001). The decrease was greater for high intensity exercise (low = 0.42 [0.11], high = 0.37 [0.1], p < 0.001). The fall of coherence with intensity was stronger for bicycle exercise (BE: low = 0.44 [0.12], high = 0.37 [0.12], H: low = 0.4 [0.12], high = 0.37 [0.12], p = 0.00433). The expectation of bilateral exercise resulted in lower coherence compared to unilateral exercise (right-sided = 0.45 [0.16], left-sided = 0.4 [0.16], bilateral = 0.36 [0.15], unilateral vs. bilateral: p < 0.001), and the left-sided exercise had lower coherence compared to that of the right (left-sided vs. right-sided: p = 0.00925). Handgrip exercise showed similar trend (right-sided = 0.4 [0.15], left-sided = 0.37 [0.14], p = 0.0056). In conclusion, feedforward RSA adjustments in anticipation of exercise covaried with subsequent exercise-related features like intensity, muscle mass (unilateral vs. bilateral), and the exercise side (left vs. right). The left versus the right difference in coherence indicates autonomic asymmetry. Feedforward changes in RSA are like those seen during actual exercise and might facilitate the rapid phase transition between rest and exercise.
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Affiliation(s)
- Aditya Koppula
- Department of Biomedical Engineering, Neurotech Lab, Indian Institute of Technology, Hyderabad, India
| | - Ram Reddy Barra
- Department of Physiology, Apollo Institute of Medical Sciences and Research, Hyderabad, India
| | - Kousik Sarathy Sridharan
- Department of Biomedical Engineering, Neurotech Lab, Indian Institute of Technology, Hyderabad, India
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Grishin VG, Grishin OV, Nikultsev VS, Gultyaeva VV, Zinchenko MI, Uryumtsev DY. Frequency Analysis of Oscillations of External Respiration Parameters and Heart Rate in the VLF Range. Biophysics (Nagoya-shi) 2022. [DOI: 10.1134/s0006350922010067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Cairo B, de Abreu RM, Bari V, Gelpi F, De Maria B, Rehder-Santos P, Sakaguchi CA, da Silva CD, De Favari Signini É, Catai AM, Porta A. Optimizing phase variability threshold for automated synchrogram analysis of cardiorespiratory interactions in amateur cyclists. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2021; 379:20200251. [PMID: 34689616 DOI: 10.1098/rsta.2020.0251] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/29/2020] [Indexed: 06/13/2023]
Abstract
We propose a procedure suitable for automated synchrogram analysis for setting the threshold below which phase variability between two marker event series is of such a negligible amount that the null hypothesis of phase desynchronization can be rejected. The procedure exploits the principle of maximizing the likelihood of detecting phase synchronization epochs and it is grounded on a surrogate data approach testing the null hypothesis of phase uncoupling. The approach was applied to assess cardiorespiratory phase interactions between heartbeat and inspiratory onset in amateur cyclists before and after 11-week inspiratory muscle training (IMT) at different intensities and compared to a more traditional approach to set phase variability threshold. The proposed procedure was able to detect the decrease in cardiorespiratory phase locking strength during vagal withdrawal induced by the modification of posture from supine to standing. IMT had very limited effects on cardiorespiratory phase synchronization strength and this result held regardless of the training intensity. In amateur athletes training, the inspiratory muscles did not limit the decrease in cardiorespiratory phase synchronization observed in the upright position as a likely consequence of the modest impact of this respiratory exercise, regardless of its intensity, on cardiac vagal control. This article is part of the theme issue 'Advanced computation in cardiovascular physiology: new challenges and opportunities'.
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Affiliation(s)
- Beatrice Cairo
- Department of Biomedical Sciences for Health, University of Milan, Milan 20133, Italy
| | - Raphael Martins de Abreu
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo 13565-905, Brazil
| | - Vlasta Bari
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan 20097, Italy
| | - Francesca Gelpi
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan 20097, Italy
| | | | - Patrícia Rehder-Santos
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo 13565-905, Brazil
| | - Camila Akemi Sakaguchi
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo 13565-905, Brazil
| | - Claudio Donisete da Silva
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo 13565-905, Brazil
| | - Étore De Favari Signini
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo 13565-905, Brazil
| | - Aparecida Maria Catai
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo 13565-905, Brazil
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan 20133, Italy
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan 20097, Italy
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7
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Barnett WH, Baekey DM, Paton JFR, Dick TE, Wehrwein EA, Molkov YI. Heartbeats entrain breathing via baroreceptor-mediated modulation of expiratory activity. Exp Physiol 2021; 106:1181-1195. [PMID: 33749038 DOI: 10.1113/ep089365] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 03/16/2021] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS Cardio-ventilatory coupling refers to the onset of inspiration occurring at a preferential latency following the last heartbeat (HB) in expiration. According to the cardiac-trigger hypothesis, the pulse pressure initiates an inspiration via baroreceptor activation. However, the central neural substrate mediating this coupling remains undefined. Using a combination of animal data, human data and mathematical modelling, this study tests the hypothesis that the HB, by way of pulsatile baroreflex activation, controls the initiation of inspiration that occurs through a rapid neural activation loop from the carotid baroreceptors to Bötzinger complex expiratory neurons. ABSTRACT Cardio-ventilatory coupling refers to a heartbeat (HB) occurring at a preferred latency prior to the next breath. We hypothesized that the pressure pulse generated by a HB activates baroreceptors that modulate brainstem expiratory neuronal activity and delay the initiation of inspiration. In supine male subjects, we recorded ventilation, electrocardiogram and blood pressure during 20-min epochs of baseline, slow-deep breathing and recovery. In in situ rodent preparations, we recorded brainstem activity in response to pulses of perfusion pressure. We applied a well-established respiratory network model to interpret these data. In humans, the latency between a HB and onset of inspiration was consistent across different breathing patterns. In in situ preparations, a transient pressure pulse during expiration activated a subpopulation of expiratory neurons normally active during post-inspiration, thus delaying the next inspiration. In the model, baroreceptor input to post-inspiratory neurons accounted for the effect. These studies are consistent with baroreflex activation modulating respiration through a pauci-synaptic circuit from baroreceptors to onset of inspiration.
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Affiliation(s)
- William H Barnett
- Department of Mathematics and Statistics, Georgia State University, Atlanta, GA, USA
| | - David M Baekey
- Department of Pharmacology and Therapeutics, University of Florida, Gainesville, FL, USA
| | - Julian F R Paton
- Department of Physiology, Faculty of Medical and Health Sciences, Manaaki Mānawa - The Centre for Heart Research, University of Auckland, Auckland, New Zealand
| | - Thomas E Dick
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Case Western Reserve University, Cleveland, OH, USA.,Department of Neurosciences, Case Western Reserve University, Cleveland, OH, USA
| | - Erica A Wehrwein
- Department of Physiology, Michigan State University, East Lansing, MI, USA
| | - Yaroslav I Molkov
- Department of Mathematics and Statistics, Georgia State University, Atlanta, GA, USA.,Neuroscience Institute, Georgia State University, Atlanta, GA, USA
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8
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Impaired cardiorespiratory coupling in young normotensives with a family history of hypertension. J Hypertens 2018; 36:2157-2167. [DOI: 10.1097/hjh.0000000000001795] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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9
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Nakamura NH, Fukunaga M, Oku Y. Respiratory fluctuations in pupil diameter are not maintained during cognitive tasks. Respir Physiol Neurobiol 2018; 265:68-75. [PMID: 30021125 DOI: 10.1016/j.resp.2018.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 06/20/2018] [Accepted: 07/14/2018] [Indexed: 01/26/2023]
Abstract
Pupil diameter fluctuation throughout the respiratory cycle is autonomically controlled in the resting state, as pupils dilate during inspiration and constrict during expiration. Furthermore, pupil size is differentially modulated by cognitive states between task engagement and disengagement. To determine whether respiratory-dependent fluctuations in pupil size are maintained during a cognitive task, we employed healthy human subjects performing a delayed matching-to-sample task with a short delay and measured their pupil sizes and R wave-to-R wave intervals (RRIs). We detected respiratory fluctuations in pupil size and the RRI during the delay period immediately before the discrimination stage of the task. During the discrimination stage, the cognitive state with the higher task engagement yielded more pupil dilation. However, respiratory fluctuations in pupil size were abolished, whereas those in the RRI were still discernible during the discrimination stage. Our results suggest that an alternative control mechanism involving the cognitive state associated with task engagement overrides the respiratory-related autonomic control of pupil diameter.
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Affiliation(s)
- Nozomu H Nakamura
- Division of Physiome, Department of Physiology, Hyogo College of Medicine, 1-1, Mukogawa cho, Nishinomiya, Hyogo 663-8501, Japan.
| | - Masaki Fukunaga
- Division of Cerebral Integration, Department of System Neuroscience, National Institute of Physiological Sciences, 38 Nishigonaka Myodaiji, Okazaki, Aichi 444-8585, Japan
| | - Yoshitaka Oku
- Division of Physiome, Department of Physiology, Hyogo College of Medicine, 1-1, Mukogawa cho, Nishinomiya, Hyogo 663-8501, Japan
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10
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Elstad M, O’Callaghan EL, Smith AJ, Ben-Tal A, Ramchandra R. Cardiorespiratory interactions in humans and animals: rhythms for life. Am J Physiol Heart Circ Physiol 2018. [DOI: 10.1152/ajpheart.00701.2017] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The cardiorespiratory system exhibits oscillations from a range of sources. One of the most studied oscillations is heart rate variability, which is thought to be beneficial and can serve as an index of a healthy cardiovascular system. Heart rate variability is dampened in many diseases including depression, autoimmune diseases, hypertension, and heart failure. Thus, understanding the interactions that lead to heart rate variability, and its physiological role, could help with prevention, diagnosis, and treatment of cardiovascular diseases. In this review, we consider three types of cardiorespiratory interactions: respiratory sinus arrhythmia (variability in heart rate at the frequency of breathing), cardioventilatory coupling (synchronization between the heart beat and the onset of inspiration), and respiratory stroke volume synchronization (the constant phase difference between the right and the left stroke volumes over one respiratory cycle). While the exact physiological role of these oscillations continues to be debated, the redundancies in the mechanisms responsible for its generation and its strong evolutionary conservation point to the importance of cardiorespiratory interactions. The putative mechanisms driving cardiorespiratory oscillations as well as the physiological significance of these oscillations will be reviewed. We suggest that cardiorespiratory interactions have the capacity to both dampen the variability in systemic blood flow as well as improve the efficiency of work done by the heart while maintaining physiological levels of arterial CO2. Given that reduction in variability is a prognostic indicator of disease, we argue that restoration of this variability via pharmaceutical or device-based approaches may be beneficial in prolonging life.
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Affiliation(s)
- Maja Elstad
- Division of Physiology, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Erin L. O’Callaghan
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, United Kingdom
| | - Alex J. Smith
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, United Kingdom
| | - Alona Ben-Tal
- Institute of Natural and Mathematical Sciences, Massey University, Auckland, New Zealand
| | - Rohit Ramchandra
- Department of Physiology, The University of Auckland, Auckland, New Zealand
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11
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Armoni Domany K, Hossain MM, Nava-Guerra L, Khoo MC, McConnell K, Carroll JL, Xu Y, DiFrancesco M, Amin RS. Cardioventilatory Control in Preterm-born Children and the Risk of Obstructive Sleep Apnea. Am J Respir Crit Care Med 2018; 197:1596-1603. [PMID: 29323933 PMCID: PMC6006399 DOI: 10.1164/rccm.201708-1700oc] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 01/09/2018] [Indexed: 12/16/2022] Open
Abstract
RATIONALE The contribution of ventilatory control to the pathogenesis of obstructive sleep apnea (OSA) in preterm-born children is unknown. OBJECTIVES To characterize phenotypes of ventilatory control that are associated with the presence of OSA in preterm-born children during early childhood. METHODS Preterm- and term-born children without comorbid conditions were enrolled. They were categorized into an OSA group and a non-OSA group on the basis of polysomnography. MEASUREMENTS AND MAIN RESULTS Loop gain, controller gain, and plant gain, reflecting ventilatory instability, chemoreceptor sensitivity, and blood gas response to a change in ventilation, respectively, were estimated from spontaneous sighs identified during polysomnography. Cardiorespiratory coupling, a measure of brainstem maturation, was estimated by measuring the interval between inspiration and the preceding electrocardiogram R-wave. Cluster analysis was performed to develop phenotypes based on controller gain, plant gain, cardiorespiratory coupling, and gestational age. The study included 92 children, 63 of whom were born preterm (41% OSA) and 29 of whom were born at term (48% OSA). Three phenotypes of ventilatory control were derived with risks for OSA being 8%, 47%, and 77% in clusters 1, 2, and 3, respectively. There was a stepwise decrease in controller gain and an increase in plant gain from clusters 1 to 3. Children in cluster 1 had significantly higher cardiorespiratory coupling and gestational age than clusters 2 and 3. No difference in loop gain was found between clusters. CONCLUSIONS The risk for OSA could be stratified according to controller gain, plant gain, cardiorespiratory coupling, and gestational age. These findings could guide personalized care for children at risk for OSA.
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Affiliation(s)
- Keren Armoni Domany
- Division of Pulmonary Medicine
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Leonardo Nava-Guerra
- Department of Biomedical Engineering, University of Southern California, Los Angeles, California; and
| | - Michael C. Khoo
- Department of Biomedical Engineering, University of Southern California, Los Angeles, California; and
| | | | - John L. Carroll
- Division of Pediatric Pulmonary and Sleep Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Yuanfang Xu
- Division of Biostatistics and Epidemiology, and
| | - Mark DiFrancesco
- Pediatric Neuroimaging Research Consortium, Department of Radiology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
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Mazzucco CE, Marchi A, Bari V, De Maria B, Guzzetti S, Raimondi F, Catena E, Ottolina D, Amadio C, Cravero S, Fossali T, Colombo R, Porta A. Mechanical ventilatory modes and cardioventilatory phase synchronization in acute respiratory failure patients. Physiol Meas 2017; 38:895-911. [PMID: 28052047 DOI: 10.1088/1361-6579/aa56ae] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Cardioventilatory phase synchronization was studied in ten critically ill patients admitted in intensive care unit (ICU) for acute respiratory failure under two mechanical ventilatory modes: (i) pressure controlled ventilation (PCV); (ii) pressure support ventilation (PSV). The two modalities were administered to the same patient in different times in a random order. Cardioventilatory phase interactions were typified by plotting the relative position of a heartbeat, detected from the electrocardiogram and collected in n groups, within m ventilatory cycles as a function of the progressive cardiac beat number via the synchrogram. n:m phase synchronized patterns were detected by computing the variability of each phase group. The percent duration of the recording featuring phase synchronization was assessed as a measure of the strength of phase synchrony and tested against situations of full phase desynchronization between cardiac and ventilatory rhythms. Indexes quantifying the variability of the cardiac and ventilatory activities were computed as well. Findings proved that: (i) a significant presence of n:m phase synchronized patterns was detected in PCV; (ii) the strength of n:m phase synchronization was stronger during PCV than PSV; (iii) different strengths of cardioventilatory phase synchronization detected during PCV and PSV were found in presence of similar heart and ventilatory rates and alike variability. We conclude that mechanical ventilation can induce a significant presence of cardioventilatory phase synchronized patterns and this amount depends on the mode of mechanical ventilation. Future studies should test the eventual link of the level of phase coordination between heart and mechanical ventilation to a clinical outcome to understand whether featuring a certain degree of cardioventilatory phase synchronization is beneficial for the critical patient in ICU.
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Affiliation(s)
- Claudio Enrico Mazzucco
- Department of Electronics Information and Bioengineering, Politecnico di Milano, Milan, Italy
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Balagué N, González J, Javierre C, Hristovski R, Aragonés D, Álamo J, Niño O, Ventura JL. Cardiorespiratory Coordination after Training and Detraining. A Principal Component Analysis Approach. Front Physiol 2016; 7:35. [PMID: 26903884 PMCID: PMC4751338 DOI: 10.3389/fphys.2016.00035] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 01/26/2016] [Indexed: 11/13/2022] Open
Abstract
Our purpose was to study the effects of different training modalities and detraining on cardiorespiratory coordination (CRC). Thirty-two young males were randomly assigned to four training groups: aerobic (AT), resistance (RT), aerobic plus resistance (AT + RT), and control (C). They were assessed before training, after training (6 weeks) and after detraining (3 weeks) by means of a graded maximal test. A principal component (PC) analysis of selected cardiovascular and cardiorespiratory variables was performed to evaluate CRC. The first PC (PC1) coefficient of congruence in the three conditions (before training, after training and after detraining) was compared between groups. Two PCs were identified in 81% of participants before the training period. After this period the number of PCs and the projection of the selected variables onto them changed only in the groups subject to a training programme. The PC1 coefficient of congruence was significantly lower in the training groups compared with the C group [H (3, N=32) = 11.28; p = 0.01]. In conclusion, training produced changes in CRC, reflected by the change in the number of PCs and the congruence values of PC1. These changes may be more sensitive than the usually explored cardiorespiratory reserve, and they probably precede it.
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Affiliation(s)
- Natàlia Balagué
- Institut Nacional d'Educació Fisica de Catalunya, Department of Health and Applied Sciences, University of Barcelona Barcelona, Spain
| | - Jacob González
- Institut Nacional d'Educació Fisica de Catalunya, Department of Health and Applied Sciences, University of Barcelona Barcelona, Spain
| | - Casimiro Javierre
- Physiological Sciences II, L'Hospitalet de Llobregat, University of Barcelona Barcelona, Spain
| | - Robert Hristovski
- Faculty of Physical Education, Sport and Health, Ss. Cyril and Methodius University in Skopje Skopje, Macedonia
| | - Daniel Aragonés
- Department of Education, Johannes Gutenberg-Universität Mainz Mainz, Germany
| | - Juan Álamo
- Physiological Sciences II, L'Hospitalet de Llobregat, University of Barcelona Barcelona, Spain
| | - Oscar Niño
- Physiological Sciences II, L'Hospitalet de Llobregat, University of Barcelona Barcelona, Spain
| | - Josep L Ventura
- Physiological Sciences II, L'Hospitalet de Llobregat, University of Barcelona Barcelona, Spain
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14
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Ahn S, Solfest J, Rubchinsky LL. Fine temporal structure of cardiorespiratory synchronization. Am J Physiol Heart Circ Physiol 2014; 306:H755-63. [DOI: 10.1152/ajpheart.00314.2013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Cardiac and respiratory rhythms are known to exhibit a modest degree of phase synchronization, which is affected by age, diseases, and other factors. We study the fine temporal structure of this synchrony in healthy young, healthy elderly, and elderly subjects with coronary artery disease. We employ novel time-series analysis to explore how phases of oscillations go in and out of the phase-locked state at each cycle of oscillations. For the first time we show that cardiorespiratory system is engaged in weakly synchronized dynamics with a very specific temporal pattern of synchrony: the oscillations go out of synchrony frequently, but return to the synchronous state very quickly (usually within just 1 cycle of oscillations). Properties of synchrony depended on the age and disease status. Healthy subjects exhibited more synchrony at the higher (1:4) frequency-locking ratio between respiratory and cardiac rhythms, whereas subjects with coronary artery disease exhibited relatively more 1:2 synchrony. However, multiple short desynchronization episodes prevailed regardless of the age and disease status. The same average synchrony level could be alternatively achieved with few long desynchronizations, but this was not observed in the data. This implies functional importance of short desynchronization dynamics. These dynamics suggest that a synchronous state is easy to create if needed but is also easy to break. Short desynchronization dynamics may facilitate the mutual coordination of cardiac and respiratory rhythms by creating intermittent synchronous episodes. It may be an efficient background dynamics to promote adaptation of cardiorespiratory coordination to various external and internal factors.
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Affiliation(s)
- Sungwoo Ahn
- Department of Mathematical Sciences and Center for Mathematical Biosciences, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana; and
| | - Jessica Solfest
- Department of Mathematical Sciences and Center for Mathematical Biosciences, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana; and
| | - Leonid L. Rubchinsky
- Department of Mathematical Sciences and Center for Mathematical Biosciences, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana; and
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, Indiana
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15
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Dick TE, Hsieh YH, Dhingra RR, Baekey DM, Galán RF, Wehrwein E, Morris KF. Cardiorespiratory coupling: common rhythms in cardiac, sympathetic, and respiratory activities. PROGRESS IN BRAIN RESEARCH 2014; 209:191-205. [PMID: 24746049 DOI: 10.1016/b978-0-444-63274-6.00010-2] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Cardiorespiratory coupling is an encompassing term describing more than the well-recognized influences of respiration on heart rate and blood pressure. Our data indicate that cardiorespiratory coupling reflects a reciprocal interaction between autonomic and respiratory control systems, and the cardiovascular system modulates the ventilatory pattern as well. For example, cardioventilatory coupling refers to the influence of heart beats and arterial pulse pressure on respiration and is the tendency for the next inspiration to start at a preferred latency after the last heart beat in expiration. Multiple complementary, well-described mechanisms mediate respiration's influence on cardiovascular function, whereas mechanisms mediating the cardiovascular system's influence on respiration may only be through the baroreceptors but are just being identified. Our review will describe a differential effect of conditioning rats with either chronic intermittent or sustained hypoxia on sympathetic nerve activity but also on ventilatory pattern variability. Both intermittent and sustained hypoxia increase sympathetic nerve activity after 2 weeks but affect sympatho-respiratory coupling differentially. Intermittent hypoxia enhances sympatho-respiratory coupling, which is associated with low variability in the ventilatory pattern. In contrast, after constant hypobaric hypoxia, 1-to-1 coupling between bursts of sympathetic and phrenic nerve activity is replaced by 2-to-3 coupling. This change in coupling pattern is associated with increased variability of the ventilatory pattern. After baro-denervating hypobaric hypoxic-conditioned rats, splanchnic sympathetic nerve activity becomes tonic (distinct bursts are absent) with decreases during phrenic nerve bursts and ventilatory pattern becomes regular. Thus, conditioning rats to either intermittent or sustained hypoxia accentuates the reciprocal nature of cardiorespiratory coupling. Finally, identifying a compelling physiologic purpose for cardiorespiratory coupling is the biggest barrier for recognizing its significance. Cardiorespiratory coupling has only a small effect on the efficiency of gas exchange; rather, we propose that cardiorespiratory control system may act as weakly coupled oscillator to maintain rhythms within a bounded variability.
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Affiliation(s)
- Thomas E Dick
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Case Western Reserve University, Cleveland, OH, USA; Department of Neurosciences, Case Western Reserve University, Cleveland, OH, USA.
| | - Yee-Hsee Hsieh
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Rishi R Dhingra
- Department of Neurosciences, Case Western Reserve University, Cleveland, OH, USA
| | - David M Baekey
- Department of Physiological Sciences, University of Florida, Gainesville, FL, USA
| | - Roberto F Galán
- Department of Neurosciences, Case Western Reserve University, Cleveland, OH, USA
| | - Erica Wehrwein
- Department of Physiology, Michigan State University, East Lansing, MI, USA
| | - Kendall F Morris
- Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, FL, USA
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16
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Zhu Y, Hsieh YH, Dhingra RR, Dick TE, Jacono FJ, Galán RF. Quantifying interactions between real oscillators with information theory and phase models: application to cardiorespiratory coupling. PHYSICAL REVIEW. E, STATISTICAL, NONLINEAR, AND SOFT MATTER PHYSICS 2013; 87:022709. [PMID: 23496550 PMCID: PMC3767161 DOI: 10.1103/physreve.87.022709] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Indexed: 05/08/2023]
Abstract
Interactions between oscillators can be investigated with standard tools of time series analysis. However, these methods are insensitive to the directionality of the coupling, i.e., the asymmetry of the interactions. An elegant alternative was proposed by Rosenblum and collaborators [M. G. Rosenblum, L. Cimponeriu, A. Bezerianos, A. Patzak, and R. Mrowka, Phys. Rev. E 65, 041909 (2002); M. G. Rosenblum and A. S. Pikovsky, Phys. Rev. E 64, 045202 (2001)] which consists in fitting the empirical phases to a generic model of two weakly coupled phase oscillators. This allows one to obtain the interaction functions defining the coupling and its directionality. A limitation of this approach is that a solution always exists in the least-squares sense, even in the absence of coupling. To preclude spurious results, we propose a three-step protocol: (1) Determine if a statistical dependency exists in the data by evaluating the mutual information of the phases; (2) if so, compute the interaction functions of the oscillators; and (3) validate the empirical oscillator model by comparing the joint probability of the phases obtained from simulating the model with that of the empirical phases. We apply this protocol to a model of two coupled Stuart-Landau oscillators and show that it reliably detects genuine coupling. We also apply this protocol to investigate cardiorespiratory coupling in anesthetized rats. We observe reciprocal coupling between respiration and heartbeat and that the influence of respiration on the heartbeat is generally much stronger than vice versa. In addition, we find that the vagus nerve mediates coupling in both directions.
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Affiliation(s)
- Yenan Zhu
- Department of Neurosciences, School of Medicine, Case Western
Reserve University, Cleveland, Ohio 44106, USA
- Systems Biology and Bioinformatics Program, Case Western Reserve
University, Cleveland, Ohio 44106, USA
| | - Yee-Hsee Hsieh
- Department of Medicine, School of Medicine, Case Western Reserve
University, Cleveland, Ohio 44106, USA
| | - Rishi R. Dhingra
- Department of Neurosciences, School of Medicine, Case Western
Reserve University, Cleveland, Ohio 44106, USA
| | - Thomas E. Dick
- Department of Neurosciences, School of Medicine, Case Western
Reserve University, Cleveland, Ohio 44106, USA
- Department of Medicine, School of Medicine, Case Western Reserve
University, Cleveland, Ohio 44106, USA
| | - Frank J. Jacono
- Department of Medicine, School of Medicine, Case Western Reserve
University, Cleveland, Ohio 44106, USA
- Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio 44106,
USA
- University Hospitals, Cleveland, Ohio 44106, USA
| | - Roberto F. Galán
- Department of Neurosciences, School of Medicine, Case Western
Reserve University, Cleveland, Ohio 44106, USA
- Systems Biology and Bioinformatics Program, Case Western Reserve
University, Cleveland, Ohio 44106, USA
- Corresponding author:
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