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      Analysis of Exercise-Induced Periodic Breathing Using an Autoregressive Model and the Hilbert-Huang Transform

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          Abstract

          Evaluation of exercise-induced periodic breathing (PB) in cardiopulmonary exercise testing (CPET) is one of important diagnostic evidences to judge the prognosis of chronic heart failure cases. In this study, we propose a method for the quantitative analysis of measured ventilation signals from an exercise test. We used an autoregressive (AR) model to filter the breath-by-breath measurements of ventilation from exercise tests. Then, the signals before reaching the most ventilation were decomposed into intrinsic mode functions (IMF) by using the Hilbert-Huang transform (HHT). An IMF represents a simple oscillatory pattern which catches a part of original ventilation signal in different frequency band. For each component of IMF, we computed the number of peaks as the feature of its oscillatory pattern denoted by Δ i . In our experiment, 61 chronic heart failure patients with or without PB pattern were studied. The computed peaks of the third and fourth IMF components, Δ 3 and Δ 4, were statistically significant for the two groups (both p values < 0.02). In summary, our study shows a close link between the HHT analysis and level of intrinsic energy for pulmonary ventilation. The third and fourth IMF components are highly potential to indicate the prognosis of chronic heart failure.

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          A study of the characteristics of white noise using the empirical mode decomposition method

          Z. Wu, N. Huang (2004)
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            Cardiopulmonary exercise testing and its application.

            Cardiopulmonary exercise testing (CPET) has become an important clinical tool to evaluate exercise capacity and predict outcome in patients with heart failure and other cardiac conditions. It provides assessment of the integrative exercise responses involving the pulmonary, cardiovascular and skeletal muscle systems, which are not adequately reflected through the measurement of individual organ system function. CPET is being used increasingly in a wide spectrum of clinical applications for evaluation of undiagnosed exercise intolerance and for objective determination of functional capacity and impairment. This review focuses on the exercise physiology and physiological basis for functional exercise testing and discusses the methodology, indications, contraindications and interpretation of CPET in normal people and in patients with heart failure.
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              Peak VO2 and VE/VCO2 slope in patients with heart failure: a prognostic comparison.

              Exercise testing with ventilatory expired gas analysis has proven to be a valuable tool for assessing patients with heart failure (HF). Peak oxygen consumption (peak VO2) continues to be considered the gold standard for assessing prognosis in HF. The minute ventilation--carbon dioxide production relationship (VE/VCO2 slope) has recently demonstrated prognostic significance in patients with HF, and in some studies, it has outperformed peak VO2. Two hundred thirteen subjects, in whom HF was diagnosed, underwent exercise testing between April 1, 1993, and October 19, 2001. The ability of peak VO2 and VE/VCO2 slope to predict cardiac-related mortality and hospitalization was examined. Peak VO2 and VE/VCO2 slope were demonstrated with univariate Cox regression analysis both to be significant predictors of cardiac-related mortality and hospitalization (P <.01). Multivariate analysis revealed that peak VO2 added additional value to the VE/VCO(2) slope in predicting cardiac-related hospitalization, but not cardiac mortality. The VE/VCO2 slope was demonstrated with receiver operating characteristic curve analysis to be significantly better than peak VO2 in predicting cardiac-related mortality (P <.05). Although area under the receiver operating characteristic curve for the VE/VCO2 slope was greater than peak VO2 in predicting cardiac-related hospitalization (0.77 vs 0.73), the difference was not statistically significant (P =.14). These results add to the present body of knowledge supporting the use of cardiopulmonary exercise testing in HF. Consideration should be given to revising clinical guidelines to reflect the prognostic importance of the VE/VCO2 slope in addition to peak VO2.
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                Author and article information

                Contributors
                Journal
                Comput Math Methods Med
                Comput Math Methods Med
                CMMM
                Computational and Mathematical Methods in Medicine
                Hindawi
                1748-670X
                1748-6718
                2018
                26 June 2018
                : 2018
                : 4860204
                Affiliations
                1Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung, Taiwan
                2Heart Failure Center, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan
                3College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
                4Department of Computer Science, National Tsing Hua University, Hsinchu, Taiwan
                5Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
                6Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
                7School of Post-Baccalaureate Chinese Medicine, College of Chinese Medicine, Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung, Taiwan
                8Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
                9Department of Computer Science and Information Engineering, Asia University, Taichung, Taiwan
                10Department of Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
                Author notes

                Academic Editor: Dominique J. Monlezun

                Author information
                http://orcid.org/0000-0002-3853-2067
                http://orcid.org/0000-0002-7840-1504
                http://orcid.org/0000-0003-0618-5598
                Article
                10.1155/2018/4860204
                6038683
                b5b82d35-283c-489d-9d27-95fd52324c91
                Copyright © 2018 Tieh-Cheng Fu et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 27 February 2018
                : 21 May 2018
                Funding
                Funded by: Ministry of Science and Technology, Taiwan
                Award ID: 102-2628-B-182A-001-MY3
                Funded by: Chang Gung Medical Research Program
                Award ID: CMRPG2A0162
                Award ID: CMRPG2C0402
                Categories
                Research Article

                Applied mathematics
                Applied mathematics

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