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Detection of exercise periodic breathing using thermal flowmeter in patients with heart failure
Authors:Tieh-Cheng Fu  Wen-Chen Lin  Jong-Shyan Wang  Chao-Hung Wang  Chun-Tien Chang  Cheng-Lun Tsai  Yun-Shien Lee  Kang-Ping Lin
Affiliation:1.Department of Physical Medicine and Rehabilitation,Chang Gung Memorial Hospital,Keelung,Taiwan;2.Graduate Institute of Clinical Medical Sciences, College of Medicine,Chang Gung University,Tao-Yuan,Taiwan;3.Technology Translation Center for Medical Device,Chung Yuan Christian University,Tao-Yuan,Taiwan;4.Healthy Aging Research Center, Graduate Institute of Rehabilitation Science, Medical College,Chang Gung University,Tao-Yuan,Taiwan;5.Heart Failure Center, Department of Internal Medicine,Chang Gung Memorial Hospital,Keelung,Taiwan;6.Computer and Communication Center,National Tsing Hua University,Hsinchu,Taiwan;7.Department of Biomedical Engineering,Chung Yuan Christian University,Tao-Yuan,Taiwan;8.Department of Biotechnology,Ming-Chuan University,Kwei-Shan, Tao-Yuan,Taiwan;9.Department of Electrical Engineering,Chung Yuan Christian University,Chung Li, Tao-Yuan,Taiwan
Abstract:Exercise periodic breathing (EPB) is associated with exercise intolerance and poor prognosis in patients with heart failure (HF). However, EPB detection during cardiopulmonary exercise test (CPET) is difficult. The present study investigated the use of a wireless monitoring device to record the EPB during CPET and proposed quantization parameter estimates for the EPB. A total of 445 patients with HF were enrolled and underwent exercise tests. The ventilation data from the wearable device were compared with the data obtained during the CPET and were analyzed based on professional opinion and on 2 automated programs (decision tree [DT] and oscillatory pattern methods). The measurement accuracy was greater with the DT method (89 %) than with the oscillatory pattern method (75 %). The cutoffs for EPB recognition using the DT method were (1) an intercept of the regression line passing through the minute ventilation rate vs. the time curve during the recovery phase ≥64.63, and (2) an oscillatory phase duration to total exercise time ratio ≥0.5828. The wearable device was suitable for the assessment of EPB in patients with HF, and our new automated analysis system using the DT method effectively identified the EPB pattern.
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