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Monitoring the Evolution of Asynchrony between Mean Arterial Pressure and Mean Cerebral Blood Flow via Cross-Entropy Methods. ENTROPY 2022; 24:e24010080. [PMID: 35052106 PMCID: PMC8774596 DOI: 10.3390/e24010080] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/29/2021] [Accepted: 12/30/2021] [Indexed: 02/05/2023]
Abstract
Cerebrovascular control is carried out by multiple nonlinear mechanisms imposing a certain degree of coupling between mean arterial pressure (MAP) and mean cerebral blood flow (MCBF). We explored the ability of two nonlinear tools in the information domain, namely cross-approximate entropy (CApEn) and cross-sample entropy (CSampEn), to assess the degree of asynchrony between the spontaneous fluctuations of MAP and MCBF. CApEn and CSampEn were computed as a function of the translation time. The analysis was carried out in 23 subjects undergoing recordings at rest in supine position (REST) and during active standing (STAND), before and after surgical aortic valve replacement (SAVR). We found that at REST the degree of asynchrony raised, and the rate of increase in asynchrony with the translation time decreased after SAVR. These results are likely the consequence of the limited variability of MAP observed after surgery at REST, more than the consequence of a modified cerebrovascular control, given that the observed differences disappeared during STAND. CApEn and CSampEn can be utilized fruitfully in the context of the evaluation of cerebrovascular control via the noninvasive acquisition of the spontaneous MAP and MCBF variability.
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Porta A, Fantinato A, Bari V, Gelpi F, Cairo B, De Maria B, Bertoldo EG, Fiolo V, Callus E, De Vincentiis C, Volpe M, Molfetta R, Ranucci M. Evaluation of the impact of surgical aortic valve replacement on short-term cardiovascular and cerebrovascular controls through spontaneous variability analysis. PLoS One 2020; 15:e0243869. [PMID: 33301491 PMCID: PMC7728248 DOI: 10.1371/journal.pone.0243869] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 11/30/2020] [Indexed: 11/25/2022] Open
Abstract
We assessed the effect of surgical aortic valve replacement (SAVR) on cardiovascular and cerebrovascular controls via spontaneous variability analyses of heart period, approximated as the temporal distance between two consecutive R-wave peaks on the electrocardiogram (RR), systolic, diastolic and mean arterial pressure (SAP, DAP and MAP) and mean cerebral blood flow (MCBF). Powers in specific frequency bands, complexity, presence of nonlinear dynamics and markers of cardiac baroreflex and cerebral autoregulation were calculated. Variability series were acquired before (PRE) and after (POST) SAVR in 11 patients (age: 76±5 yrs, 7 males) at supine resting and during active standing. Parametric spectral analysis was performed based on the autoregressive model. Complexity was assessed via a local nonlinear prediction approach exploiting the k-nearest-neighbor strategy. The presence of nonlinear dynamics was checked by comparing the complexity marker computed over the original series with the distribution of the same index assessed over a set of surrogates preserving distribution and power spectral density of the original series. Cardiac baroreflex and cerebral autoregulation were estimated by assessing the transfer function from SAP to RR and from MAP to MCBF and squared coherence function via the bivariate autoregressive approach. We found that: i) orthostatic challenge had no effect on cardiovascular and cerebrovascular control markers in PRE; ii) RR variance was significantly reduced in POST; iii) complexity of SAP, DAP and MAP variabilities increased in POST with a greater likelihood of observing nonlinear dynamics over SAP compared to PRE at supine resting; iv) the amplitude of MCBF variations and MCBF complexity in POST remained similar to PRE; v) cardiac baroreflex sensitivity decreased in POST, while cerebrovascular autoregulation was preserved. SAVR induces important changes of cardiac and vascular autonomic controls and baroreflex regulation in patients exhibiting poor reactivity of cardiovascular regulatory mechanisms, while cerebrovascular autoregulation seems to be less affected.
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Affiliation(s)
- 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, Milan, Italy
- * E-mail:
| | - Angela Fantinato
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy
| | - Vlasta Bari
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy
| | - Francesca Gelpi
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy
| | - Beatrice Cairo
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | | | - Valentina Fiolo
- Clinical Psychology Service, IRCCS Policlinico San Donato, Milan, Italy
| | - Edward Callus
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Clinical Psychology Service, IRCCS Policlinico San Donato, Milan, Italy
| | | | - Marianna Volpe
- Department of Cardiac Rehabilitation, IRCCS Policlinico San Donato, Milan, Italy
| | - Raffaella Molfetta
- Department of Cardiac Rehabilitation, IRCCS Policlinico San Donato, Milan, Italy
| | - Marco Ranucci
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy
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Porta A, Fantinato A, Bari V, Cairo B, De Maria B, Bertoldo EG, Fiolo V, Callus E, De Vincentiis C, Volpe M, Molfetta R, Ranucci M. Complexity and Nonlinearities of Short-Term Cardiovascular and Cerebrovascular Controls after Surgical Aortic Valve Replacement. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:2569-2572. [PMID: 33018531 DOI: 10.1109/embc44109.2020.9175321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We assessed the effect of surgical aortic valve replacement (SAVR) on cardiovascular and cerebrovascular controls with particular attention to their complexity and presence of nonlinear behaviors via the analysis of spontaneous variability of heart period (HP), systolic and diastolic arterial pressure (SAP and DAP) and mean cerebral blood flow (MCBF). Variability series were acquired before (PRE) and after (POST) SAVR in 12 patients (age: 76±4.7 yrs, 7 males) at rest in supine position and during active standing. Complexity was assessed via a local nonlinear prediction approach exploiting the k-nearest neighbor strategy. The presence of nonlinear dynamics was checked by comparing the complexity marker computed over the original series with the distribution of values assessed over 100 surrogates preserving distribution and power spectral density of the original series but with random phases. We found that: i) HP variance was significantly reduced in POST; ii) the complexity of SAP and DAP variabilities increased in POST with a greater likelihood of observing nonlinear dynamics over SAP compared to PRE at supine rest; iii) the amplitude of MCBF fluctuations and its complexity in POST remained similar to PRE. SAVR induces important changes of the cardiac and vascular autonomic controls, while cerebrovascular regulation seems to be less affected.
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Wessel N, Gapelyuk A, Weiß J, Schmidt M, Kraemer JF, Berg K, Malberg H, Stepan H, Kurths J. Instantaneous Cardiac Baroreflex Sensitivity: xBRS Method Quantifies Heart Rate Blood Pressure Variability Ratio at Rest and During Slow Breathing. Front Neurosci 2020; 14:547433. [PMID: 33071732 PMCID: PMC7543095 DOI: 10.3389/fnins.2020.547433] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 09/04/2020] [Indexed: 11/13/2022] Open
Abstract
Spontaneous baroreflex sensitivity (BRS) is a widely used tool for the quantification of the cardiovascular regulation. Numerous groups use the xBRS method, which calculates the cross-correlation between the systolic beat-to-beat blood pressure and the R-R interval (resampled at 1 Hz) in a 10 s sliding window, with 0-5 s delays for the interval. The delay with the highest correlation is selected and, if significant, the quotient of the standard deviations of the R-R intervals and the systolic blood pressures is recorded as the corresponding xBRS value. In this paper we test the hypothesis that the xBRS method quantifies the causal interactions of spontaneous BRS from non-invasive measurements at rest. We use the term spontaneous BRS in the sense of the sensitivity curve is calculated from non-interventional, i.e., spontaneous, baroreceptor activity. This study includes retrospective analysis of 1828 measurements containing ECG as well as continues blood pressure under resting conditions. Our results show a high correlation between the heart rate - systolic blood pressure variability (HRV/BPV) quotient and the xBRS (r = 0.94, p < 0.001). For a deeper understanding we conducted two surrogate analyses by substituting the systolic blood pressure by its reversed time series. These showed that the xBRS method was not able to quantify causal relationships between the two signals. It was not possible to distinguish between random and baroreflex controlled sequences. It appears xBRS rather determines the HRV/BPV quotient. We conclude that the xBRS method has a potentially large bias in characterizing the capacity of the arterial baroreflex under resting conditions. During slow breathing, estimates for xBRS are significantly increased, which clearly shows that measurements at rest only involve limited baroreflex activity, but does neither challenge, nor show the full range of the arterial baroreflex regulatory capacity. We show that xBRS is exclusively dominated by the heart rate to systolic blood pressure ratio (r = 0.965, p < 0.001). Further investigations should focus on additional autonomous testing procedures such as slow breathing or orthostatic testing to provide a basis for a non-invasive evaluation of baroreflex sensitivity.
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Affiliation(s)
- Niels Wessel
- Department of Physics, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Andrej Gapelyuk
- Department of Physics, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jonas Weiß
- Institute of Biomedical Engineering, Technische Universität Dresden, Dresden, Germany
| | - Martin Schmidt
- Institute of Biomedical Engineering, Technische Universität Dresden, Dresden, Germany
| | - Jan F Kraemer
- Department of Physics, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Karsten Berg
- Department of Physics, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Hagen Malberg
- Institute of Biomedical Engineering, Technische Universität Dresden, Dresden, Germany
| | - Holger Stepan
- Division of Obstetrics, Universitätsklinikum Leipzig, Leipzig, Germany
| | - Jürgen Kurths
- Department of Physics, Humboldt-Universität zu Berlin, Berlin, Germany.,Potsdam Institute for Climate Impact Research, Potsdam, Germany.,Department of Human and Animal Physiology, Saratov State University, Saratov, Russia
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Wessel N, Gapelyuk A, Kraemer JF, Berg K, Kurths J. Spontaneous baroreflex sensitivity: sequence method at rest does not quantify causal interactions but rather determines the heart rate to blood pressure variability ratio. Physiol Meas 2020; 41:03LT01. [PMID: 32160607 DOI: 10.1088/1361-6579/ab7edc] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- N Wessel
- Humboldt-Universität zu Berlin, Berlin, Germany
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Analysis of endophytic bacterial community diversity and metabolic correlation in Cinnamomum camphora. Arch Microbiol 2019; 202:181-189. [DOI: 10.1007/s00203-019-01733-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 09/16/2019] [Accepted: 09/21/2019] [Indexed: 10/25/2022]
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Compostella L, Russo N, Compostella C, Setzu T, D'Onofrio A, Isabella G, Tarantini G, Iliceto S, Gerosa G, Bellotto F. Impact of type of intervention for aortic valve replacement on heart rate variability. Int J Cardiol 2015; 197:11-5. [DOI: 10.1016/j.ijcard.2015.06.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 06/12/2015] [Indexed: 01/09/2023]
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Compostella L, Russo N, D'Onofrio A, Setzu T, Compostella C, Bottio T, Gerosa G, Bellotto F. Abnormal heart rate variability and atrial fibrillation after aortic surgery. Braz J Cardiovasc Surg 2015; 30:55-62. [PMID: 25859868 PMCID: PMC4389516 DOI: 10.5935/1678-9741.20140100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 08/04/2014] [Indexed: 11/20/2022] Open
Abstract
Introduction Complete denervation of transplanted heart exerts protective effect against
postoperative atrial fibrillation; various degrees of autonomic denervation
appear also after transection of ascending aorta during surgery for aortic
aneurysm. Objective This study aimed to evaluate if the level of cardiac denervation obtained by
resection of ascending aorta could exert any effect on postoperative atrial
fibrillation incidence. Methods We retrospectively analysed the clinical records of 67 patients submitted to
graft replacement of ascending aorta (group A) and 132 with aortic valve
replacement (group B); all episodes of postoperative atrial fibrillation
occurred during the 1-month follow-up have been reported. Heart Rate
Variability parameters were obtained from a 24-h Holter recording; clinical,
echocardiographic and treatment data were also evaluated. Results Overall, 45% of patients (group A 43%, group B 46%) presented at least one
episode of postoperative atrial fibrillation. Older age (but not gender,
abnormal glucose tolerance, ejection fraction, left atrial diameter) was
correlated with incidence of postoperative atrial fibrillation. Only among a
subgroup of patients with aortic transection and signs of greater autonomic
derangement (heart rate variability parameters below the median and mean
heart rate over the 75th percentile), possibly indicating more
profound autonomic denervation, a lower incidence of postoperative atrial
fibrillation was observed (22% vs. 54%). Conclusion Transection of ascending aorta for repair of an aortic aneurysm did not
confer any significant protective effect from postoperative atrial
fibrillation in comparison to patients with intact ascending aorta. It could
be speculated that a limited and heterogeneous cardiac denervation was
produced by the intervention, creating an eletrophysiological substrate for
the high incidence of postoperative atrial fibrillation observed.
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Affiliation(s)
| | | | - Augusto D'Onofrio
- Dpt Cardiac, Thoracic and Vascular Sciences, University of Padua, Padova, Italy
| | | | | | - Tomaso Bottio
- Dpt Cardiac, Thoracic and Vascular Sciences, University of Padua, Padova, Italy
| | - Gino Gerosa
- Dpt Cardiac, Thoracic and Vascular Sciences, University of Padua, Padova, Italy
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Voss A, Schulz S, Schroeder R. Monitoring in cardiovascular disease patients by nonlinear biomedical signal processing. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2012; 2011:6564-7. [PMID: 22255843 DOI: 10.1109/iembs.2011.6091619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Due to recent advances in technology extensive cardiovascular monitoring is widely introduced today. An essential component of cardiovascular monitoring is the analysis of several biosignals as electrocardiogram, blood pressure and other vital signs. This manuscript provides an overview about several application fields of cardiovascular monitoring with the main focus on nonlinear dynamics analysis.
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Affiliation(s)
- A Voss
- Department of Medical Engineering and Biotechnology, University of Applied Sciences Jena, Carl-Zeiss-Promenade 2, 07745 Jena, Germany. voss@ fhjena.de
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Retzlaff B, Wessel N, Riedl M, Gapelyuk A, Malberg H, Bauernschmitt N, Kurths J, Bretthauer G, Bauernschmitt R. Preserved autonomic regulation in patients undergoing transcatheter aortic valve implantation (TAVI) – a prospective, comparative study. ACTA ACUST UNITED AC 2011; 56:185-93. [DOI: 10.1515/bmt.2011.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Biosignalverarbeitung. BIOMED ENG-BIOMED TE 2010. [DOI: 10.1515/bmt.2010.705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Porta A, Di Rienzo M, Wessel N, Kurths J. Addressing the complexity of cardiovascular regulation. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2009; 367:1215-8. [PMID: 19324704 DOI: 10.1098/rsta.2008.0292] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
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