Baroreflex activity through the analysis of the cardio-respiratory variability influence over blood pressure in cardiomyopathy patients
Rodriguez Benitez, Javier (Universitat Politècnica de Catalunya)
Schulz, Steffen (Institute of Innovative Health Technologies (Alemanya))
Voss, Andreas (Institute of Innovative Health Technologies (Alemanya))
Herrera, Sergio (Institut d'Investigació Biomèdica Sant Pau)
Benito Vales, Salvador (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Giraldo, Beatriz (Universitat Politècnica de Catalunya)
Universitat Autònoma de Barcelona

Data:	2023
Resum:	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.
Ajuts:	Agencia Estatal de Investigación PID2021-126455OB-I00
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Baroreflex activity ; Blood pressure variability ; Cardio-respiratory variability ; Ischemic-dilated cardiomyopathy ; Morphology-relative change
Publicat a:	Frontiers in physiology, Vol. 14 (2023) , p. 1184293, ISSN 1664-042X

DOI: 10.3389/fphys.2023.1184293
PMID: 37637149

12 p, 2.2 MB

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