Change of Pulse Transit Time During Stepwise Paced Breathing_Journal of Biomedical Engineering

Authors：

CHAIXiaoke ¹ , WANGBuqing ² ,  ZHANGZhengbo ² , WANGGuojing ² , WANGWeidong ²

1. Chinese PLA Postgraduate Medical School, Chinese PLA General Hospital, Beijing 100853, China;
2. The Medical Engineering Support Center, Chinese PLA General Hospital, Beijing 100853, China;

Corresponding author：

ZHANGZhengbo, Email: zhengbozhang@126.com

Keywords：

paced breathing; cardiopulmonary interaction; pulse transit time; baseline; blood pressure

DOI：

10.7507/1001-5515.20140251

Video：

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To investigate the effect of stepwise paced breathing (PB) on pulse transit time (PTT), we collected physiological signals of electrocardiogram (ECG), respiration and arterial pulse wave during a procedure of stepwise PB, which consists of 6 different breathing rates changing in a protocol of 14.0-12.5-11.0-9.5-8.0-7.0 breath per minute (BPM), with each breathing rate lasting 3 minutes. Twenty two healthy adults involved in this experiment and the change of PTT was analyzed during the stepwise PB procedure. In our study, the PTT was measured by calculating the time interval from the R-spike of the ECG to the peaks of the second derivative of the arterial pulse wave. Ensemble empirical mode decomposition (EEMD) was applied to PTT to decompose the signal into different intrinsic mode function, and respiratory oscillation and trend component (baseline) in PTT were further extracted. It was found that the respiratory oscillations in the PTT increased with decreasing of the PB rate, and many of the subjects (14 out of 22) showed the phenomena of PTT baseline increasing during the stepwise PB procedure. The results indicated that the stepwise PB procedure induced a high level of cardiovascular oscillation and produced an accumulative effect of PTT baseline increase. As PTT is capable of predicting changes in BP over a short period of time, increase of PTT baseline indicates the decrease of blood pressure. The experiments showed that the stepwise PB procedure could reduce blood pressure for most subjects. For future work, it is necessary to develop certain indices differentiating the effectiveness of the stepwise PB procedure on the PTT baseline change, and to test the effectiveness of this stepwise PB procedure on blood pressure reduction for patients with essential hypertension.

Citation： CHAIXiaoke, WANGBuqing, ZHANGZhengbo, WANGGuojing, WANGWeidong. Change of Pulse Transit Time During Stepwise Paced Breathing. Journal of Biomedical Engineering, 2014, 31(6): 1325-1331,1341. doi: 10.7507/1001-5515.20140251 Copy

1.	YASUMA F, HAYANO J. Respiratory sinus arrhythmia:why does the heartbeat synchronize with respiratory rhythm?[J]. Chest, 2004, 125(2):683-690.
2.	PINNA G D, MAESTRI R, LA ROVERE M T, et al. Effect of paced breathing on ventilatory and cardiovascular variability parameters during short-term investigations of autonomicfunction[J]. Am J Physiol Heart Circ Physiol,2006,290(1):H424-H433.
3.	PORTH C J, BAMRAH V S, TRISTANI F E, et al. The Valsalva maneuver:mechanisms and clinical implications[J]. Heart Lung, 1984,13(5):507-518.
4.	SHIELDS R W JR. Heart rate variability with deep breathing as a clinical test of cardiovagal function[J]. Cleve Clin J Med, 2009,76(Suppl 2):S37-S40.
5.	PITZALIS M V, MASTROPASQUA F, MASSARI F, et al. Effect of respiratory rate on the relationships between RR interval and systolic blood pressure fluctuations:a frequency-dependent phenomenon[J]. Cardiovasc Res, 1998, 38(2):332-339.
6.	GROSSMAN E, GROSSMAN A, SCHEIN M H, et al. Breathing-control lowers blood pressure[J]. J Hum Hypertens, 2001,15(4):263-269.
7.	BERNARDI L, SPADACINI G, BELLWON J, et al. Effect of breathing rate on oxygen saturation and exercise performance in chronic heart failure[J]. Lancet, 1998, 351(9112):1308-1311.
8.	BERNARDI L, PORTA C, SPICUZZA L, et al. Slow breathing increases arterial baroreflex sensitivity in patients with chronic heart failure[J]. Circulation, 2002, 105(2):143-145.
9.	CYSARZ D, BUSSING A. Cardiorespiratory synchronization during Zen meditation[J]. Eur J Appl Physiol, 2005, 95(1):88-95.
10.	SHARMA M, FRISHMAN W H, GANDHI K. RESPeRATE:nonpharmacological treatment of hypertension[J]. Cardiol Rev, 2011,19(2):47-51.
11.	SCHEIN M H, GAVISH B, HERZ M, et al. Treating hypertension with a device that slows and regularises breathing:a randomised, double-blind controlled study[J].J Hum Hypertens, 2001,15(4):271-278.
12.	MAHTANI K R, NUNAN D, HENEGHAN C J. Device-guided breathing exercises in the control of human blood pressure:systematic review and meta-analysis[J].J Hypertens, 2012,30(5):852-860.
13.	ALTENA M R, KLEEFSTRA N, LOGTENBERG S J, et al. Effect of device-guided breathing exercises on blood pressure in patients with hypertension:a randomized controlled trial[J]. Blood Press, 2009,18(5):273-279.
14.	LOGTENBERG S J, KLEEFSTRA N, HOUWELING S T, et al. Effect of device-guided breathing exercises on blood pressure in hypertensive patients with type 2 diabetes mellitus:a randomized controlled trial[J]. J Hypertens, 2007,25(1):241-246.
15.	张政波,王步青,王卫东, 等.心肺交互作用综合测试系统[J].生物医学工程学杂志,2013, 30(2):395-402.
16.	王步青,张政波,王卫东.引导呼吸下的呼吸性窦性心律不齐的研究[J].生物医学工程学杂志,2012, 29(1):45-50.
17.	GESCHE H, GROSSKURTH D, KVCHLER G, et al.Continuous blood pressure measurement by using the pulse transit time:comparison to a cuff-based method[J]. Eur J Appl Physiol, 2012, 112(1):309-315.
18.	SMITH R P, ARGOD J, PÈPIN J L, et al. Pulse transit time:an appraisal of potential clinical applications[J]. Thorax, 1999,54(5):452-457.
19.	ZHANG Z B, WANG W D, WANG B Q, et al. A prototype of wearable respiration biofeedback platform and its preliminary evaluation on cardiovascular variabilities[C]//3rd International Conference on Bioinformatics and Biomedical Engineering. Beijing:2009:1-4.
20.	张政波,王卫东,李开元,等.交互式呼吸引导技术[J].中国医疗器械杂志,2008, 32(2):86-88,119.
21.	张政波,俞梦孙,李若新,等.背心式呼吸感应体积描记系统设计[J].航天医学与医学工程,2006,19(5):377-381.
22.	张政波,俞梦孙,赵显亮,等.穿戴式、多参数协同监测系统设计[J]. 航天医学与医学工程,2008,21(1):66-69.
23.	ZHANG Z B, SHEN Y H, WANG W D, et al. Design and implementation of sensing shirt for ambulatory cardiopulmonary monitoring[J]. J Med Biol Eng, 2010,31(3):207-216.
24.	向海燕. 无创伤人体逐拍动脉血压测量技术[D].西安:第四军医大学, 2005:48-65.
25.	王步青, 王卫东. 基于LabVIEW的虚拟心电分析仪中的R波检测算法研究[J].科学技术与工程,2006,6(21):3401-3404.
26.	HUANG N E, SHEN Z, LONG S R, et al. The empirical mode decomposition and the Hilbert spectrum for nonlinear and non-stationary time series analysis[J]. Proc R Soc Lond A, 1998, 454(1971):903-993.
27.	HUANG N E,WU Z H. Ensemble empirical mode decomposition:a noise-assisted data analysis method[J]. Adv Adapt Data Anal, 2009,1(1):1-41.
28.	台湾国立中央大学数据分析方法研究中心.Hilbert-Huang Transform[EB/OL]. (2013-9-10) http://rcada.ncu.edu.tw/research1.htm.
29.	LOPES T C, BEDA A, GRANJA-FILHO P C, et al. Cardio-respiratory interactions and relocation of heartbeats within the respiratory cycle during spontaneous and paced breathing[J]. Physiol Meas,2011, 32(9):1389-1401.
30.	DRINNAN M J, ALLEN J, MURRAY A. Relation between heart rate and pulse transit time during paced respiration[J]. Physiol Meas, 2001,22(3):425-432.
31.	KOBAYASHI H. Does paced breathing improve the reproducibility of heart rate variability measurements?[J]. J Physiol Anthropol, 2009,28(5):225-230.
32.	郎晓华,俞梦孙.容积脉搏波在吸相和呼相间的变异性[J].中国生物医学工程学报,2011,30(1):17-21.
33.	蒲晓雯,梁宗安,雷飞,等.Hypno PTT监测仪对阻塞性睡眠呼吸暂停低通气综合征的诊断价值[J].中国呼吸与危重监护杂志,2005, 4(3):214-217.

1. YASUMA F, HAYANO J. Respiratory sinus arrhythmia:why does the heartbeat synchronize with respiratory rhythm?[J]. Chest, 2004, 125(2):683-690.
2. PINNA G D, MAESTRI R, LA ROVERE M T, et al. Effect of paced breathing on ventilatory and cardiovascular variability parameters during short-term investigations of autonomicfunction[J]. Am J Physiol Heart Circ Physiol,2006,290(1):H424-H433.
3. PORTH C J, BAMRAH V S, TRISTANI F E, et al. The Valsalva maneuver:mechanisms and clinical implications[J]. Heart Lung, 1984,13(5):507-518.
4. SHIELDS R W JR. Heart rate variability with deep breathing as a clinical test of cardiovagal function[J]. Cleve Clin J Med, 2009,76(Suppl 2):S37-S40.
5. PITZALIS M V, MASTROPASQUA F, MASSARI F, et al. Effect of respiratory rate on the relationships between RR interval and systolic blood pressure fluctuations:a frequency-dependent phenomenon[J]. Cardiovasc Res, 1998, 38(2):332-339.
6. GROSSMAN E, GROSSMAN A, SCHEIN M H, et al. Breathing-control lowers blood pressure[J]. J Hum Hypertens, 2001,15(4):263-269.
7. BERNARDI L, SPADACINI G, BELLWON J, et al. Effect of breathing rate on oxygen saturation and exercise performance in chronic heart failure[J]. Lancet, 1998, 351(9112):1308-1311.
8. BERNARDI L, PORTA C, SPICUZZA L, et al. Slow breathing increases arterial baroreflex sensitivity in patients with chronic heart failure[J]. Circulation, 2002, 105(2):143-145.
9. CYSARZ D, BUSSING A. Cardiorespiratory synchronization during Zen meditation[J]. Eur J Appl Physiol, 2005, 95(1):88-95.
10. SHARMA M, FRISHMAN W H, GANDHI K. RESPeRATE:nonpharmacological treatment of hypertension[J]. Cardiol Rev, 2011,19(2):47-51.
11. SCHEIN M H, GAVISH B, HERZ M, et al. Treating hypertension with a device that slows and regularises breathing:a randomised, double-blind controlled study[J].J Hum Hypertens, 2001,15(4):271-278.
12. MAHTANI K R, NUNAN D, HENEGHAN C J. Device-guided breathing exercises in the control of human blood pressure:systematic review and meta-analysis[J].J Hypertens, 2012,30(5):852-860.
13. ALTENA M R, KLEEFSTRA N, LOGTENBERG S J, et al. Effect of device-guided breathing exercises on blood pressure in patients with hypertension:a randomized controlled trial[J]. Blood Press, 2009,18(5):273-279.
14. LOGTENBERG S J, KLEEFSTRA N, HOUWELING S T, et al. Effect of device-guided breathing exercises on blood pressure in hypertensive patients with type 2 diabetes mellitus:a randomized controlled trial[J]. J Hypertens, 2007,25(1):241-246.
15. 张政波,王步青,王卫东, 等.心肺交互作用综合测试系统[J].生物医学工程学杂志,2013, 30(2):395-402.
16. 王步青,张政波,王卫东.引导呼吸下的呼吸性窦性心律不齐的研究[J].生物医学工程学杂志,2012, 29(1):45-50.
17. GESCHE H, GROSSKURTH D, KVCHLER G, et al.Continuous blood pressure measurement by using the pulse transit time:comparison to a cuff-based method[J]. Eur J Appl Physiol, 2012, 112(1):309-315.
18. SMITH R P, ARGOD J, PÈPIN J L, et al. Pulse transit time:an appraisal of potential clinical applications[J]. Thorax, 1999,54(5):452-457.
19. ZHANG Z B, WANG W D, WANG B Q, et al. A prototype of wearable respiration biofeedback platform and its preliminary evaluation on cardiovascular variabilities[C]//3rd International Conference on Bioinformatics and Biomedical Engineering. Beijing:2009:1-4.
20. 张政波,王卫东,李开元,等.交互式呼吸引导技术[J].中国医疗器械杂志,2008, 32(2):86-88,119.
21. 张政波,俞梦孙,李若新,等.背心式呼吸感应体积描记系统设计[J].航天医学与医学工程,2006,19(5):377-381.
22. 张政波,俞梦孙,赵显亮,等.穿戴式、多参数协同监测系统设计[J]. 航天医学与医学工程,2008,21(1):66-69.
23. ZHANG Z B, SHEN Y H, WANG W D, et al. Design and implementation of sensing shirt for ambulatory cardiopulmonary monitoring[J]. J Med Biol Eng, 2010,31(3):207-216.
24. 向海燕. 无创伤人体逐拍动脉血压测量技术[D].西安:第四军医大学, 2005:48-65.
25. 王步青, 王卫东. 基于LabVIEW的虚拟心电分析仪中的R波检测算法研究[J].科学技术与工程,2006,6(21):3401-3404.
26. HUANG N E, SHEN Z, LONG S R, et al. The empirical mode decomposition and the Hilbert spectrum for nonlinear and non-stationary time series analysis[J]. Proc R Soc Lond A, 1998, 454(1971):903-993.
27. HUANG N E,WU Z H. Ensemble empirical mode decomposition:a noise-assisted data analysis method[J]. Adv Adapt Data Anal, 2009,1(1):1-41.
28. 台湾国立中央大学数据分析方法研究中心.Hilbert-Huang Transform[EB/OL]. (2013-9-10) http://rcada.ncu.edu.tw/research1.htm.
29. LOPES T C, BEDA A, GRANJA-FILHO P C, et al. Cardio-respiratory interactions and relocation of heartbeats within the respiratory cycle during spontaneous and paced breathing[J]. Physiol Meas,2011, 32(9):1389-1401.
30. DRINNAN M J, ALLEN J, MURRAY A. Relation between heart rate and pulse transit time during paced respiration[J]. Physiol Meas, 2001,22(3):425-432.
31. KOBAYASHI H. Does paced breathing improve the reproducibility of heart rate variability measurements?[J]. J Physiol Anthropol, 2009,28(5):225-230.
32. 郎晓华,俞梦孙.容积脉搏波在吸相和呼相间的变异性[J].中国生物医学工程学报,2011,30(1):17-21.
33. 蒲晓雯,梁宗安,雷飞,等.Hypno PTT监测仪对阻塞性睡眠呼吸暂停低通气综合征的诊断价值[J].中国呼吸与危重监护杂志,2005, 4(3):214-217.

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