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Detection of exercise periodic breathing using thermal flowmeter in patients with heart failure

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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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Acknowledgments

We thank the Genomic Medicine Research Core Laboratory (GMRCL) of Chang Gung Memorial Hospital, the National Core Facility Program for Biotechnology (Bioinformatics Consortium of Taiwan; NSC 100-2319-B-010-002), and Chun-Houh Chen for his statistical assistance.

Funding

This work was supported by grants from the National Science Council of Taiwan (Grant Number: NSC 102-2628-B-182A-001-MY3), Chang Gung Memorial Hospital (Grant Number: CMRPG2A0162), and the Healthy Aging Research Center of Chang Gung University (Grant Number: EMRPD1A0841).

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Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung, Taiwan

    Tieh-Cheng Fu & Jong-Shyan Wang

  2. Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan

    Tieh-Cheng Fu

  3. Technology Translation Center for Medical Device, Chung Yuan Christian University, Tao-Yuan, Taiwan

    Wen-Chen Lin, Cheng-Lun Tsai & Kang-Ping Lin

  4. Healthy Aging Research Center, Graduate Institute of Rehabilitation Science, Medical College, Chang Gung University, Tao-Yuan, Taiwan

    Jong-Shyan Wang

  5. Heart Failure Center, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan

    Chao-Hung Wang

  6. Computer and Communication Center, National Tsing Hua University, Hsinchu, Taiwan

    Chun-Tien Chang

  7. Department of Biomedical Engineering, Chung Yuan Christian University, Tao-Yuan, Taiwan

    Cheng-Lun Tsai

  8. Department of Biotechnology, Ming-Chuan University, Kwei-Shan, Tao-Yuan, Taiwan

    Yun-Shien Lee

  9. Department of Electrical Engineering, Chung Yuan Christian University, 200 Chung Pei Road, Chung Li, Tao-Yuan, 32023, Taiwan

    Kang-Ping Lin

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  1. Tieh-Cheng Fu
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  2. Wen-Chen Lin
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  3. Jong-Shyan Wang
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  4. Chao-Hung Wang
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Correspondence to Kang-Ping Lin.

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The authors declare that they have no conflict of interest.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study. The study was approved by the Institutional Review Board of Chang Gung Memorial Hospital, Taiwan (99-2546B), and was registered at clinicaltrial.gov (NCT01454128).

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Fu, TC., Lin, WC., Wang, JS. et al. Detection of exercise periodic breathing using thermal flowmeter in patients with heart failure. Med Biol Eng Comput 55, 1189–1198 (2017). https://doi.org/10.1007/s11517-016-1581-y

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  • DOI: https://doi.org/10.1007/s11517-016-1581-y

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