Yu-Chen Huang1,2, Ting-Yu Lin1,2, Hau-Tieng Wu3,4, Po-Jui Chang1,2, Chun-Yu Lo1,2, Tsai-Yu Wang1,2, Chih-Hsi Scott Kuo1,2, Shu-Min Lin1,2, Fu-Tsai Chung1,2, Horng-Chyuan Lin1,2, Meng-Heng Hsieh1,2, Yu-Lun Lo5,6. 1. Department of Thoracic Medicine, Chang Gung Memorial Hospital, 199 Tun-Hwa N. Rd., Taipei, Taiwan. 2. College of Medicine, Chang Gung University, Taoyuan, Taiwan. 3. Department of Mathematics, Duke University, Durham, NC, USA. 4. Department of Statistical Sciences, Duke University, Durham, NC, USA. 5. Department of Thoracic Medicine, Chang Gung Memorial Hospital, 199 Tun-Hwa N. Rd., Taipei, Taiwan. loyulun@hotmail.com. 6. College of Medicine, Chang Gung University, Taoyuan, Taiwan. loyulun@hotmail.com.
Abstract
BACKGROUND: The interaction between the pulmonary function and cardiovascular mechanics is a crucial issue, particularly when treating patients with chronic obstructive pulmonary disease (COPD). Synchrogram index is a new parameter that can quantify this interaction and has the potential to apply in COPD patients. Our objective in this study was to characterize cardiorespiratory interactions in terms of cardiorespiratory coupling (CRC) using the synchrogram index of the heart rate and respiratory flow signals in patients with chronic obstructive pulmonary disease. METHODS: This is a cross-sectional and preliminary data from a prospective study, which examines 55 COPD patients. K-means clustering analysis was applied to cluster COPD patients based on the synchrogram index. Linear regression and multivariable regression analysis were used to determine the correlation between the synchrogram index and the exercise capacity assessed by a six-minute walking test (6MWT). RESULTS: The 55 COPD patients were separated into a synchronized group (median 0.89 (0.64-0.97), n = 43) and a desynchronized group (median 0.23 (0.02-0.51), n = 12) based on K-means clustering analysis. Synchrogram index was correlated significantly with six minutes walking distance (r = 0.42, p = 0.001) and distance saturation product (r = 0.41, p = 0.001) assessed by 6MWT, and still was an independent variable by multivariable regression analysis. CONCLUSION: This is the first result studying the heart-lung interaction in terms of cardiorespiratory coupling in COPD patients by the synchrogram index, and COPD patients are clustered into synchronized and desynchronized groups. Cardiorespiratory coupling is associated with exercise capacity in patients with COPD.
BACKGROUND: The interaction between the pulmonary function and cardiovascular mechanics is a crucial issue, particularly when treating patients with chronic obstructive pulmonary disease (COPD). Synchrogram index is a new parameter that can quantify this interaction and has the potential to apply in COPDpatients. Our objective in this study was to characterize cardiorespiratory interactions in terms of cardiorespiratory coupling (CRC) using the synchrogram index of the heart rate and respiratory flow signals in patients with chronic obstructive pulmonary disease. METHODS: This is a cross-sectional and preliminary data from a prospective study, which examines 55 COPDpatients. K-means clustering analysis was applied to cluster COPDpatients based on the synchrogram index. Linear regression and multivariable regression analysis were used to determine the correlation between the synchrogram index and the exercise capacity assessed by a six-minute walking test (6MWT). RESULTS: The 55 COPDpatients were separated into a synchronized group (median 0.89 (0.64-0.97), n = 43) and a desynchronized group (median 0.23 (0.02-0.51), n = 12) based on K-means clustering analysis. Synchrogram index was correlated significantly with six minutes walking distance (r = 0.42, p = 0.001) and distance saturation product (r = 0.41, p = 0.001) assessed by 6MWT, and still was an independent variable by multivariable regression analysis. CONCLUSION: This is the first result studying the heart-lung interaction in terms of cardiorespiratory coupling in COPDpatients by the synchrogram index, and COPDpatients are clustered into synchronized and desynchronized groups. Cardiorespiratory coupling is associated with exercise capacity in patients with COPD.
Authors: Christian Ukena; Felix Mahfoud; Michael Kindermann; Ingrid Kindermann; Robert Bals; Adriaan A Voors; Dirk J van Veldhuisen; Michael Böhm Journal: Int J Cardiol Date: 2010-06-08 Impact factor: 4.164
Authors: Azmy Faisal; Zaid Zoumot; Pallav L Shah; J Alberto Neder; Michael I Polkey; Nicholas S Hopkinson Journal: Chest Date: 2016-01-12 Impact factor: 9.410
Authors: N S Godtfredsen; T H Lam; T T Hansel; M E Leon; N Gray; C Dresler; D M Burns; E Prescott; J Vestbo Journal: Eur Respir J Date: 2008-10 Impact factor: 16.671
Authors: M Bajaj; T L Blundell; J E Pitts; S P Wood; M A Tatnell; S Falkmer; S O Emdin; L K Gowan; H Crow; C Schwabe Journal: Eur J Biochem Date: 1983-10-03
Authors: Kirsten Jörgensen; Markus F Müller; Jacqueline Nel; Richard N Upton; Erik Houltz; Sven-Erik Ricksten Journal: Chest Date: 2007-04 Impact factor: 9.410