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We proposed mathematical models for the electrocardiogram and photoplethysmogram signals with functionality to preset the pattern of synchronization between the phases of the low-frequency oscillations, which are related to the sympathetic neuronal control of circulation. The simulated phase difference reproduced the statistical and spectral characteristics of the experimental data, including the alternating horizontal and sloped sections, corresponding to the intervals of synchronous and asynchronous behavior. Using the proposed model, we tested and tuned an algorithm for detection of the phase synchronization between the parts of the sympathetic control of circulation, improving both sensitivity and specificity of the algorithm. [ABSTRACT FROM AUTHOR]

Objective:Cardiorespiratory interactions have been widely investigated in different physiological states and conditions. Various types of coupling characteristics have been observed in the cardiorespiratory system; however, it is difficult to identify and quantify details of their interaction. In this study, we investigate directional coupling of the cardiorespiratory system in different physiological states (sleep stages) and conditions, i.e., severity of obstructive sleep apnea (OSA).Methods:Directionality analysis is performed using the evolution map approach with heartbeats acquired from electrocardiogram and abdominal respiratory effort measured from the polysomnographic data of 39 healthy individuals and 24 mild, 21 moderate, and 23 severe patients with OSA. The mean phase coherence is used to confirm the weak and strong coupling of cardiorespiratory system.Results:We find that unidirectional coupling from the respiratory to the cardiac system increases during wakefulness (average value of −0.61) and rapid eye movement sleep (−0.55). Furthermore, unidirectional coupling between the two systems significantly decreases during light (−0.52) and deep sleep, which is further decreased in deep sleep (−0.46), approaching bidirectional coupling. In addition, unidirectional coupling from the respiratory to the cardiac system also significantly increases according to the severity of OSA.Conclusion:These coupling characteristics in different states and conditions are believed to be linked with autonomic nervous modulation.Significance:Our approach could provide an opportunity to understand how integrated systems cooperate for physiological functions under internal and external environmental changes, and how abnormality in one physiological system could develop to increase the risk of other systemic dysfunctions and/or disorders. [ABSTRACT FROM AUTHOR]

The complex interactions that give rise to heart rate variability (HRV) involve coupled physiological oscillators operating over a wide range of different frequencies and lengthscales. Based on the premise that interactions are key to the functioning of complex systems, the time-dependent deterministic coupling parameters underlying cardiac, respiratory and vascular regulation have been investigated at both the central and microvascular levels. Hypertension was considered as an example of a globally altered state of the complex dynamics of the cardiovascular system. Its effects were established through analysis of simultaneous recordings of the electrocardiogram (ECG), respiratory effort, and microvascular blood flow [by laser Doppler flowmetry (LDF)]. The signals were analyzed by methods developed to capture time-dependent dynamics, including the wavelet transform, wavelet-based phase coherence, non-linear mode decomposition, and dynamical Bayesian inference, all of which can encompass the inherent frequency and coupling variability of living systems. Phases of oscillatory modes corresponding to the cardiac (around 1.0Hz), respiratory (around 0.25 Hz), and vascular myogenic activities (around 0.1 Hz) were extracted and combined into two coupled networks describing the central and peripheral systems, respectively. The corresponding spectral powers and coupling functions were computed. The same measurements and analyses were performed for three groups of subjects: healthy young (Y group, 24.4 ± 3.4 y), healthy aged (A group, 71.1 ± 6.6 y), and aged treated hypertensive patients (ATH group, 70.3 ± 6.7 y). It was established that the degree of coherence between low-frequency oscillations near 0.1 Hz in blood flow and in HRV time series differs markedly between the groups, declining with age and nearly disappearing in treated hypertension. Comparing the two healthy groups it was found that the couplings to the cardiac rhythm from both respiration and vascular myogenic activity decrease significantly in aging. Comparing the data from A and ATH groups it was found that the coupling from the vascular myogenic activity is significantly weaker in treated hypertension subjects, implying that the mechanisms of microcirculation are not completely restored by current anti-hypertension medications. [ABSTRACT FROM AUTHOR]

Objective: Filtering power line interference (PLI) from electrocardiogram (ECG) recordings can lead to significant distortions of the ECG and mask clinically relevant features in ECG waveform morphology. The objective of this study is to filter PLI from ECG recordings with minimal distortion of the ECG waveform. Methods : In this paper, we propose a fixed-lag Kalman smoother with adaptive noise estimation. The performance of this Kalman smoother in filtering PLI is compared to that of a fixed-bandwidth notch filter and several adaptive PLI filters that have been proposed in the literature. To evaluate the performance, we corrupted clean neonatal ECG recordings with various simulated PLI. Furthermore, examples are shown of filtering real PLI from an adult and a fetal ECG recording. Results: The fixed-lag Kalman smoother outperforms other PLI filters in terms of step response settling time (improvements that range from 0.1 to 1 s) and signal-to-noise ratio (improvements that range from 17 to 23 dB). Our fixed-lag Kalman smoother can be used for semi real-time applications with a limited delay of 0.4 s. Conclusion and Significance: The fixed-lag Kalman smoother presented in this study outperforms other methods for filtering PLI and leads to minimal distortion of the ECG waveform. [ABSTRACT FROM PUBLISHER]

Cerebral metabolism is critically dependent on the regulation of cerebral blood flow (CBF), so it would be expected that vascular mechanisms that play a critical role in CBF regulation would be tightly conserved across individuals. However, the relationships between blood pressure (BP) and cerebral blood velocity fluctuations exhibit inter-individual variations consistent with heterogeneity in the integrity of CBF regulating systems. Here we sought to determine the nature and consistency of dynamic cerebral autoregulation (dCA) during the application of oscillatory lower body negative pressure (OLBNP). In 18 volunteers we recorded BP and middle cerebral artery blood flow velocity (MCAv) and examined the relationships between BP and MCAv fluctuations during 0.03, 0.05 and 0.07Hz OLBNP. dCA was characterised using project pursuit regression (PPR) and locally weighted scatterplot smoother (LOWESS) plots. Additionally, we proposed a piecewise regression method to statistically determine the presence of a dCA curve, which was defined as the presence of a restricted autoregulatory plateau shouldered by pressure-passive regions. Results show that LOWESS has similar explanatory power to that of PPR. However, we observed heterogeneous patterns of dynamic BP-MCAv relations with few individuals demonstrating clear evidence of a dCA central plateau. Thus, although BP explains a significant proportion of variance, dCA does not manifest as any single characteristic BP-MCAv function. [ABSTRACT FROM AUTHOR]