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      Effects of acute hypoxia on heart rate variability, sample entropy and cardiorespiratory phase synchronization

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          Abstract

          Background

          Investigating the responses of autonomic nervous system (ANS) in hypoxia may provide some knowledge about the mechanism of neural control and rhythmic adjustment. The integrated cardiac and respiratory system display complicated dynamics that are affected by intrinsic feedback mechanisms controlling their interaction. To probe how the cardiac and respiratory system adjust their rhythms in different simulated altitudes, we studied heart rate variability (HRV) in frequency domain, the complexity of heartbeat series and cardiorespiratory phase synchronization (CRPS) between heartbeat intervals and respiratory cycles.

          Methods

          In this study, twelve male subjects were exposed to simulated altitude of sea level, 3000 m and 4000 m in a hypobaric chamber. HRV was assessed by power spectral analysis. The complexity of heartbeat series was quantified by sample entropy (SampEn). CRPS was determined by cardiorespiratory synchrogram.

          Results

          The power spectral HRV indices at all frequency bands depressed according to the increase of altitude. The SampEn of heartbeat series increased significantly with the altitude (P < 0.01). The duration of CRPS epochs at 3000 m was not significantly different from that at sea level. However, it was significantly longer at 4000 m (P < 0.01).

          Conclusions

          Our results suggest the phenomenon of CRPS exists in normal subjects when they expose to acute hypoxia. Further, the autonomic regulation has a significantly stronger influence on CRPS in acute hypoxia. The changes of CRPS and HRV parameters revealed the different regulatory mechanisms of the cardiac and respiratory system at high altitude.

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          Most cited references36

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          Sample entropy analysis of neonatal heart rate variability.

          Abnormal heart rate characteristics of reduced variability and transient decelerations are present early in the course of neonatal sepsis. To investigate the dynamics, we calculated sample entropy, a similar but less biased measure than the popular approximate entropy. Both calculate the probability that epochs of window length m that are similar within a tolerance r remain similar at the next point. We studied 89 consecutive admissions to a tertiary care neonatal intensive care unit, among whom there were 21 episodes of sepsis, and we performed numerical simulations. We addressed the fundamental issues of optimal selection of m and r and the impact of missing data. The major findings are that entropy falls before clinical signs of neonatal sepsis and that missing points are well tolerated. The major mechanism, surprisingly, is unrelated to the regularity of the data: entropy estimates inevitably fall in any record with spikes. We propose more informed selection of parameters and reexamination of studies where approximate entropy was interpreted solely as a regularity measure.
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            Heartbeat synchronized with ventilation.

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              Phase transitions in physiologic coupling.

              Integrated physiological systems, such as the cardiac and the respiratory system, exhibit complex dynamics that are further influenced by intrinsic feedback mechanisms controlling their interaction. To probe how the cardiac and the respiratory system adjust their rhythms, despite continuous fluctuations in their dynamics, we study the phase synchronization of heartbeat intervals and respiratory cycles. The nature of this interaction, its physiological and clinical relevance, and its relation to mechanisms of neural control is not well understood. We investigate whether and how cardiorespiratory phase synchronization (CRPS) responds to changes in physiological states and conditions. We find that the degree of CRPS in healthy subjects dramatically changes with sleep-stage transitions and exhibits a pronounced stratification pattern with a 400% increase from rapid eye movement sleep and wake, to light and deep sleep, indicating that sympatho-vagal balance strongly influences CRPS. For elderly subjects, we find that the overall degree of CRPS is reduced by approximately 40%, which has important clinical implications. However, the sleep-stage stratification pattern we uncover in CRPS does not break down with advanced age, and surprisingly, remains stable across subjects. Our results show that the difference in CRPS between sleep stages exceeds the difference between young and elderly, suggesting that sleep regulation has a significantly stronger effect on cardiorespiratory coupling than healthy aging. We demonstrate that CRPS and the traditionally studied respiratory sinus arrhythmia represent different aspects of the cardiorespiratory interaction, and that key physiologic variables, related to regulatory mechanisms of the cardiac and respiratory systems, which influence respiratory sinus arrhythmia, do not affect CRPS.
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                Author and article information

                Contributors
                Journal
                Biomed Eng Online
                Biomed Eng Online
                BioMedical Engineering OnLine
                BioMed Central
                1475-925X
                2014
                11 June 2014
                : 13
                : 73
                Affiliations
                [1 ]School of Biological Science and Medical Engineering, Beihang University, Beijing, China
                [2 ]Department of Biomedical Engineering, Chinese PLA (People’s Liberation Army) General Hospital, Beijing, China
                [3 ]Research Center of Aviation Medicine Engineering, Institute of Aviation Medicine, Beijing, China
                Article
                1475-925X-13-73
                10.1186/1475-925X-13-73
                4059097
                24920347
                a6f40c91-6cb8-4c1a-99e2-7cb06344e447
                Copyright © 2014 Zhang et al.; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 4 February 2014
                : 6 June 2014
                Categories
                Research

                Biomedical engineering
                hypoxia,autonomic nervous system,heart rate variability,sample entropy,cardiorespiratory phase synchronization

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