Abstract

Evaluation of exercise-induced periodic breathing (PB) in cardiopulmonary exercise testing (CPET) is one of important diagnostic evidences to judge the prognosis of chronic heart failure cases. In this study, we propose a method for the quantitative analysis of measured ventilation signals from an exercise test. We used an autoregressive (AR) model to filter the breath-by-breath measurements of ventilation from exercise tests. Then, the signals before reaching the most ventilation were decomposed into intrinsic mode functions (IMF) by using the Hilbert-Huang transform (HHT). An IMF represents a simple oscillatory pattern which catches a part of original ventilation signal in different frequency band. For each component of IMF, we computed the number of peaks as the feature of its oscillatory pattern denoted by Δi. In our experiment, 61 chronic heart failure patients with or without PB pattern were studied. The computed peaks of the third and fourth IMF components, Δ3 and Δ4, were statistically significant for the two groups (both p values < 0.02). In summary, our study shows a close link between the HHT analysis and level of intrinsic energy for pulmonary ventilation. The third and fourth IMF components are highly potential to indicate the prognosis of chronic heart failure.

Highlights

  • The rehabilitation of patients with chronic heart failure (CHF) is a slow process, and sometimes, good progress is difficult to obtain for some patients

  • The empirical mode decomposition (EMD) process is applied to the VE data and several intrinsic mode functions (IMF) are extracted

  • All figures of Hilbert-Huang transform (HHT) decomposition results for the 61 patients are available at our Github repository

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Summary

Introduction

The rehabilitation of patients with chronic heart failure (CHF) is a slow process, and sometimes, good progress is difficult to obtain for some patients. Exercise-induced periodic breathing (EPB) was found to be an important evidence of poor prognosis [1,2,3,4,5,6]. Physiatrists commonly check exercise breathing patterns of patients with CHF by using cardiopulmonary exercise testing (CPET; Figure 1(a)) to guide the pharmacological and nonpharmacological treatments for these patients. CPET involves measurements of ventilation (VE) respiratory oxygen uptake (VO2) and carbon dioxide production (VCO2) during a symptom-limited exercise test [7]. On increasing the bicycle workload during a CPET test, the respiratory exchange rate and tidal volume increase simultaneously. A periodic breathing (PB) pattern might occur in some patients with CHF. We investigated the Computational and Mathematical Methods in Medicine

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