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Baroreflex activity through the analysis of the cardio-respiratory variability influence over blood pressure in cardiomyopathy patients

A large portion of the elderly population are affected by cardiovascular diseases. Early prognosis of cardiomyopathies remains a challenge. The aim of this study was to classify cardiomyopathy patients by their etiology based on significant indexes extracted from the characterization of the barorefl...

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Autores principales: Rodriguez, Javier, Schulz, Steffen, Voss, Andreas, Herrera, Sergio, Benito, Salvador, Giraldo, Beatriz F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10456872/
https://www.ncbi.nlm.nih.gov/pubmed/37637149
http://dx.doi.org/10.3389/fphys.2023.1184293
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author Rodriguez, Javier
Schulz, Steffen
Voss, Andreas
Herrera, Sergio
Benito, Salvador
Giraldo, Beatriz F.
author_facet Rodriguez, Javier
Schulz, Steffen
Voss, Andreas
Herrera, Sergio
Benito, Salvador
Giraldo, Beatriz F.
author_sort Rodriguez, Javier
collection PubMed
description A large portion of the elderly population are affected by cardiovascular diseases. Early prognosis of cardiomyopathies remains a challenge. The aim of this study was to classify cardiomyopathy patients by their etiology based on significant indexes extracted from the characterization of the baroreflex mechanism in function of the influence of the cardio-respiratory activity over the blood pressure. Forty-one cardiomyopathy patients (CMP) classified as ischemic (ICM—24 patients) and dilated (DCM—17 patients) were considered. In addition, thirty-nine control (CON) subjects were used as reference. The beat-to-beat (BBI) time series, from the electrocardiographic (ECG) signal, the systolic (SBP), and diastolic (DBP) time series, from the blood pressure signal (BP), and the respiratory time (TT), from the respiratory flow (RF) signal, were extracted. The three-dimensional representation of the cardiorespiratory and vascular activities was characterized geometrically, by fitting a polygon that contains 95% of data, and by statistical descriptive indices. DCM patients presented specific patterns in the respiratory response to decreasing blood pressure activity. ICM patients presented more stable cardiorespiratory activity in comparison with DCM patients. In general, CMP shown limited ability to regulate changes in blood pressure. In addition, patients also shown a limited ability of their cardiac and respiratory systems response to regulate incremental changes of the vascular variability and a lower heart rate variability. The best classifiers were used to build support vector machine models. The optimal model to classify ICM versus DCM patients achieved 92.7% accuracy, 94.1% sensitivity, and 91.7% specificity. When comparing CMP patients and CON subjects, the best model achieved 86.2% accuracy, 82.9% sensitivity, and 89.7% specificity. When comparing ICM patients and CON subjects, the best model achieved 88.9% accuracy, 87.5% sensitivity, and 89.7% specificity. When comparing DCM patients and CON subjects, the best model achieved 87.5% accuracy, 76.5% sensitivity, and 92.3% specificity. In conclusion, this study introduced a new method for the classification of patients by their etiology based on new indices from the analysis of the baroreflex mechanism.
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spelling pubmed-104568722023-08-26 Baroreflex activity through the analysis of the cardio-respiratory variability influence over blood pressure in cardiomyopathy patients Rodriguez, Javier Schulz, Steffen Voss, Andreas Herrera, Sergio Benito, Salvador Giraldo, Beatriz F. Front Physiol Physiology A large portion of the elderly population are affected by cardiovascular diseases. Early prognosis of cardiomyopathies remains a challenge. The aim of this study was to classify cardiomyopathy patients by their etiology based on significant indexes extracted from the characterization of the baroreflex mechanism in function of the influence of the cardio-respiratory activity over the blood pressure. Forty-one cardiomyopathy patients (CMP) classified as ischemic (ICM—24 patients) and dilated (DCM—17 patients) were considered. In addition, thirty-nine control (CON) subjects were used as reference. The beat-to-beat (BBI) time series, from the electrocardiographic (ECG) signal, the systolic (SBP), and diastolic (DBP) time series, from the blood pressure signal (BP), and the respiratory time (TT), from the respiratory flow (RF) signal, were extracted. The three-dimensional representation of the cardiorespiratory and vascular activities was characterized geometrically, by fitting a polygon that contains 95% of data, and by statistical descriptive indices. DCM patients presented specific patterns in the respiratory response to decreasing blood pressure activity. ICM patients presented more stable cardiorespiratory activity in comparison with DCM patients. In general, CMP shown limited ability to regulate changes in blood pressure. In addition, patients also shown a limited ability of their cardiac and respiratory systems response to regulate incremental changes of the vascular variability and a lower heart rate variability. The best classifiers were used to build support vector machine models. The optimal model to classify ICM versus DCM patients achieved 92.7% accuracy, 94.1% sensitivity, and 91.7% specificity. When comparing CMP patients and CON subjects, the best model achieved 86.2% accuracy, 82.9% sensitivity, and 89.7% specificity. When comparing ICM patients and CON subjects, the best model achieved 88.9% accuracy, 87.5% sensitivity, and 89.7% specificity. When comparing DCM patients and CON subjects, the best model achieved 87.5% accuracy, 76.5% sensitivity, and 92.3% specificity. In conclusion, this study introduced a new method for the classification of patients by their etiology based on new indices from the analysis of the baroreflex mechanism. Frontiers Media S.A. 2023-08-10 /pmc/articles/PMC10456872/ /pubmed/37637149 http://dx.doi.org/10.3389/fphys.2023.1184293 Text en Copyright © 2023 Rodriguez, Schulz, Voss, Herrera, Benito and Giraldo. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Physiology
Rodriguez, Javier
Schulz, Steffen
Voss, Andreas
Herrera, Sergio
Benito, Salvador
Giraldo, Beatriz F.
Baroreflex activity through the analysis of the cardio-respiratory variability influence over blood pressure in cardiomyopathy patients
title Baroreflex activity through the analysis of the cardio-respiratory variability influence over blood pressure in cardiomyopathy patients
title_full Baroreflex activity through the analysis of the cardio-respiratory variability influence over blood pressure in cardiomyopathy patients
title_fullStr Baroreflex activity through the analysis of the cardio-respiratory variability influence over blood pressure in cardiomyopathy patients
title_full_unstemmed Baroreflex activity through the analysis of the cardio-respiratory variability influence over blood pressure in cardiomyopathy patients
title_short Baroreflex activity through the analysis of the cardio-respiratory variability influence over blood pressure in cardiomyopathy patients
title_sort baroreflex activity through the analysis of the cardio-respiratory variability influence over blood pressure in cardiomyopathy patients
topic Physiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10456872/
https://www.ncbi.nlm.nih.gov/pubmed/37637149
http://dx.doi.org/10.3389/fphys.2023.1184293
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