J Clin Monit Comput - Respiratory and non-respiratory sinus arrhythmia: implications for heart rate variability.

Tópicos

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Resumo

The quantity of blood arriving at the left side of the heart oscillates throughout the breathing cycle due to the mechanics of breathing. Neurally regulated fluctuations in the length of the heart period act to dampen oscillations of the left ventricular stroke volume entering the aorta. We have reported that stroke volume oscillations but not spectral frequency variability stroke volume measures can be used to estimate the breathing frequency. This study investigated with the same recordings whether heart period oscillations or spectral heart rate variability measures could function as estimators of breathing frequency. Continuous 270 s cardiovascular recordings were obtained from 22 healthy adult volunteers in the supine and upright postures. Breathing was recorded simultaneously. Breathing frequency and heart period oscillation frequency were calculated manually, while heart rate variability spectral maximums were obtained using heart rate variability software. These estimates were compared to the breathing frequency using the Bland-Altman agreement procedure. Estimates were required to be < ?10% (95% levels of agreement). The 95% levels of agreement measures for the heart period oscillation frequency (supine: -27.7 to 52.0%, upright: -37.8 to 45.9%) and the heart rate variability spectral maximum estimates (supine: -48.7 to 26.5% and -56.4 to 62.7%, upright: -37.8 to 39.3%) exceeded 10%. Multiple heart period oscillations were observed to occur during breathing cycles. Both respiratory and non-respiratory sinus arrhythmia was observed amongst healthy adults. This observation at least partly explains why heart period parameters and heart rate variability parameters are not reliable estimators of breathing frequency. In determining the validity of spectral heart rate variability measurements we suggest that it is the position of the spectral peaks and not the breathing frequency that should be the basis of decision making.

Resumo Limpo

quantiti blood arriv left side heart oscil throughout breath cycl due mechan breath neural regul fluctuat length heart period act dampen oscil left ventricular stroke volum enter aorta report stroke volum oscil spectral frequenc variabl stroke volum measur can use estim breath frequenc studi investig record whether heart period oscil spectral heart rate variabl measur function estim breath frequenc continu s cardiovascular record obtain healthi adult volunt supin upright postur breath record simultan breath frequenc heart period oscil frequenc calcul manual heart rate variabl spectral maximum obtain use heart rate variabl softwar estim compar breath frequenc use blandaltman agreement procedur estim requir level agreement level agreement measur heart period oscil frequenc supin upright heart rate variabl spectral maximum estim supin upright exceed multipl heart period oscil observ occur breath cycl respiratori nonrespiratori sinus arrhythmia observ amongst healthi adult observ least part explain heart period paramet heart rate variabl paramet reliabl estim breath frequenc determin valid spectral heart rate variabl measur suggest posit spectral peak breath frequenc basi decis make

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