0000000000084087
AUTHOR
Gianluca Rossato
An Empirical Mode Decomposition Approach to Assess the Strength of Heart Period-Systolic Arterial Pressure Variability Interactions.
This work proposes an empirical mode decomposition (EMD) method to assess the strength of the interactions between heart period (HP) and systolic arterial pressure (SAP) variability. EMD was exploited to decompose the original series (OR) into its first, and fastest, intrinsic mode function (IMF1) and the residual (RES) computed by subtracting the IMF1 from OR. EMD procedure was applied to both HP and SAP variability series. Then, the cross correlation function (CCF) was computed over OR, IMF1 and RES series derived from HP and SAP variability in 13 healthy subjects (age 27±8 yrs, 5 males) at rest in supine position (REST) and during head-up tilt (TILT). The first CCF maximum at negative ti…
Dynamic cerebrovascular autoregulation in patients prone to postural syncope: Comparison of techniques assessing the autoregulation index from spontaneous variability series
Abstract Three approaches to the assessment of cerebrovascular autoregulation (CA) via the computation of the autoregulation index (ARI) from spontaneous variability of mean arterial pressure (MAP) and mean cerebral blood flow velocity (MCBFV) were applied: 1) a time domain method (TDM); 2) a nonparametric method (nonPM); 3) a parametric method (PM). Performances were tested over matched and surrogate unmatched pairs. Data were analyzed at supine resting (REST) and during the early phase of 60° head-up tilt (TILT) in 13 subjects with previous history of postural syncope (SYNC, age: 28 ± 9 yrs.; 5 males) and 13 control individuals (noSYNC, age: 27 ± 8 yrs.; 5 males). Analysis was completed b…
Spectral decomposition of cerebrovascular and cardiovascular interactions in patients prone to postural syncope and healthy controls.
We present a framework for the linear parametric analysis of pairwise interactions in bivariate time series in the time and frequency domains, which allows the evaluation of total, causal and instantaneous interactions and connects time- and frequency-domain measures. The framework is applied to physiological time series to investigate the cerebrovascular regulation from the variability of mean cerebral blood flow velocity (CBFV) and mean arterial pressure (MAP), and the cardiovascular regulation from the variability of heart period (HP) and systolic arterial pressure (SAP). We analyze time series acquired at rest and during the early and late phase of head-up tilt in subjects developing or…
Impact of Nonstationarities on Short Heart Rate Variability Recordings During Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) is a sleep disorder characterized by breathing pauses due to collapse of the upper airways. During OSA the autonomic modulation, as noninvasively assessed through heart period (HP) variability, is altered in a time-varying way even though time-varying properties of HP fluctuations are often disregarded by HP variability studies. We performed a time domain analysis computed over very short epochs corresponding to the sole OSA events explicitly accounting for HP variability nonstationarities. Length-matched epochs were extracted during OSA and quiet sleep (SLEEP) in 13 subjects suffering from OSA (11 males, age 55±11, apnea-hypopnea index 44±19). Mean HP, varianc…
Nonlinear effects of respiration on the crosstalk between cardiovascular and cerebrovascular control systems.
Cardiovascular and cerebrovascular regulatory systems are vital control mechanisms responsible for guaranteeing homeostasis and are affected by respiration. This work proposes the investigation of cardiovascular and cerebrovascular control systems and the nonlinear influences of respiration on both regulations through joint symbolic analysis (JSA), conditioned or unconditioned on respiration. Interactions between cardiovascular and cerebrovascular regulatory systems were evaluated as well by performing correlation analysis between JSA indexes describing the two control systems. Heart period, systolic and mean arterial pressure, mean cerebral blood flow velocity and respiration were acquired…
Exploring metrics for the characterization of the cerebral autoregulation during head-up tilt and propofol general anesthesia
Techniques grounded on the simultaneous utilization of Tiecks' second order differential equations and spontaneous variability of mean arterial pressure (MAP) and mean cerebral blood flow velocity (MCBFV), recorded from middle cerebral arteries through a transcranial Doppler device, provide a characterization of cerebral autoregulation (CA) via the autoregulation index (ARI). These methods exploit two metrics for comparing the measured MCBFV series with the version predicted by Tiecks' model: normalized mean square prediction error (NMSPE) and normalized correlation rho. The aim of this study is to assess the two metrics for ARI computation in 13 healthy subjects (age: 27 & PLUSMN; 8 yr…
Investigating the mechanisms of cardiovascular and cerebrovascular regulation in orthostatic syncope through an information decomposition strategy
Some previous evidence suggests that postural related syncope is associated with defective mechanisms of cerebrovascular (CB) and cardiovascular (CV) control. We characterized the information processing in short-term CB regulation, from the variability of mean cerebral blood flow velocity (CBFV) and mean arterial pressure (AP), and in CV regulation, from the variability of heart period (HP) and systolic AP (SAP), in ten young subjects developing orthostatic syncope in response to prolonged head-up tilt testing. We exploited a novel information-theoretic approach that decomposes the information associated with a variability series into three amounts: the information stored in the series, the…
Correlation between Baroreflex Sensitivity and Cerebral Autoregulation Index in Healthy Subjects
Despite the acknowledged interaction between baroreflex and cerebral autoregulation (CA), their functional relationship remains controversial. The study investigates this relationship in a healthy population undergoing an orthostatic challenge. Thirteen healthy subjects (age: 27pm 8 yrs; 5 males) underwent electrocardiogram, arterial pressure (AP) and cerebral blood flow velocity (CBFV) recordings at supine resting (REST) and during 60° head-up tilt (TILT). CA was assessed via the autoregulation index (ARI) from spontaneous variations of mean AP and mean CBFV. The cardiac control and baroreflex were evaluated via frequency domain and transfer function analyses applied to systolic AP and hea…
Cerebrovascular and cardiovascular variability interactions investigated through conditional joint transfer entropy in subjects prone to postural syncope.
Objective: A model-based conditional transfer entropy approach was exploited to quantify the information transfer in cerebrovascular (CBV) and cardiovascular (CV) systems in subjects prone to develop postural syncope. Approach: Spontaneous beat-to-beat variations of mean cerebral blood flow velocity (MCBFV) derived from a transcranial Doppler device, heart period (HP) derived from surface electrocardiogram, mean arterial pressure (MAP) and systolic arterial pressure (SAP) derived from finger plethysmographic arterial pressure device were monitored at rest in supine position (REST) and during 60° head-up tilt (TILT) in 13 individuals (age mean ± standard deviation: 28 ± 9 years, min-max r…
Categorizing the Role of Respiration in Cardiovascular and Cerebrovascular Variability Interactions
Objective: Respiration disturbs cardiovascular and cerebrovascular controls but its role is not fully elucidated. Methods: Respiration can be classified as a confounder if its observation reduces the strength of the causal relationship from source to target. Respiration is a suppressor if the opposite situation holds. We prove that a confounding/suppression (C/S) test can be accomplished by evaluating the sign of net redundancy/synergy balance in the predictability framework based on multivariate autoregressive modelling. In addition, we suggest that, under the hypothesis of Gaussian processes, the C/S test can be given in the transfer entropy decomposition framework as well. Experimental p…
Strength and Latency of the HP-SAP Closed Loop Variability Interactions in Subjects Prone to Develop Postural Syncope
The coupling and latency between heart period (HP) and systolic arterial pressure (SAP) variability can be investigated along the two arms of the HP-SAP closed loop, namely along the baroreflex feedback from SAP to HP, and along the feedforward pathway from HP to SAP. This study investigates the HP-SAP closed loop variability interactions through cross-correlation function (CCF). Coupling strength and delay between HP and SAP variability series were monitored in 13 subjects prone to develop orthostatic syncope (SYNC, 28±9 yrs, 5 males) and in 13 subjects with no history of postural syncope (noSYNC, age: 27±8 yrs, 5 males). Analysis was carried out at rest in supine position (REST) and durin…
Extended Granger causality: a new tool to identify the structure of physiological networks.
Granger causality (GC) is a very popular tool for assessing the presence of directional interactions between two time series of a multivariate data set. In its original formulation, GC does not account for zero-lag correlations possibly existing between the observed time series. In the present study we compare the GC with a novel measure, termed extended GC (eGC), able to capture instantaneous causal relationships. We present a two-step procedure for the practical estimation of eGC based on first detecting the existence of zero-lag correlations, and then assigning them to one of the two possible causal directions using pairwise measures of non-Gaussianity. The proposed method was validated …
Investigating cardiovascular and cerebrovascular variability in postural syncope by means of extended Granger causality
The patterns of Granger causality (GC) between heart period (HP), mean arterial pressure (AP) and cerebral blood flow velocity (FV) were investigated in ten subjects with postural related syncope (PRS). The classic GC measure based on vector autoregressive (VAR) modeling was compared with a novel extended GC (eGC) measure derived from VAR models incorporating instantaneous causal effects among the series. The analysis was performed in the supine and in the upright position during early (ET) and late (LT, close to presyncope) epochs of head-up tilt. Moving from ET to LT, both GC and eGC decreased from AP to HP, and increased from AP to FV, reflecting baroreflex impairment and loss of cerebra…