Biomedical subjects

S Cerutti

Publications and source records attributed to S Cerutti.

At least 37 records · Page 2Linked to original sources

PubMed2002

Coupling patterns between spontaneous rhythms and respiration in cardiovascular variability signals.

We performed a quantitative study of coupling patterns between respiration and spontaneous rhythms of heart rate and blood pressure variability signals by using the Recurrence Quantification Analysis (RQA). We applied RQA to both simulated and experimental data obtained in control breathing at three different frequencies (0.25, 0.20, and 0.13 Hz) from ten normal subjects. RQA succeeded in quantifying different degrees of non-linear coupling associated to several interference patterns. We found higher degrees of non-linear coupling when the respiratory frequency was close to the spontaneous Low Frequency (LF) rhythm (0.13 Hz), or almost twice the LF frequency (0.2 Hz), whereas weaker coupling was observed when the respiratory frequency was 0.25 Hz. Clinical applications of our approach should focus on new experimental protocols, featuring the stimulation of one of the two branches of the autonomic nervous system (ANS) or aimed at the analysis of pathologies linked to the ANS.

Analysis of Variance↗

PubMed2002

Short and long term non-linear analysis of RR variability series.

The complexity of RR variability is approached in the short and in the long term by means of black-box data analysis. Short term series of a few hundred beats are explored by means of informational entropy and predictability indexes. A correction to biases toward false determinism is performed assuming maximum uncertainty, whenever data do not furnish sufficient recurrences. Non-randomness and non-linearity are tested by means of surrogate data provided by random shuffling and phase randomization respectively. In the long term of the 24-h or of several hours, similar tests based on mutual information are applied and validated by means of surrogate series. In addition the state space reconstruction is carried out by means of state space non-linear filtering addressing directly the reconstructed trajectories. In this condition, parameters characterizing the hypothetical attractor, mainly the maximum Lyapunov exponent, can be reliably identified.

Biophysical Phenomena↗

PubMed2002

Spontaneous and forced non-linear oscillations in heart period: role of the sino-atrial node.

The aim of this study is to investigate whether and to which extent the non-linearity of the sino-atrial node contributes to the complex interactions between autonomic control and heart period. A non-linear model of the autonomic control on the sino-atrial node has been analyzed under particular experimental conditions: the autonomic nervous system was forced to act at established frequencies, by a controlled breathing procedure and a non-invasive periodic modulation of carotid baroreceptors. We quantify the non-linear coupling between the stimuli and both the experimental and the simulated heart period fluctuations by using the recurrence plot quantification analysis. Our results show that the non-linear interaction between external stimuli and heart period fluctuations is due to a certain extent to the non-linear features of the sino-atrial node.

Biophysical Phenomena↗

PubMed2002

Changes in left ventricular size during parabolic flights by two-dimensional echocardiography and level set method.

This study aims to evaluate changes on cardiac chambers size, induced by gravitational stresses. During parabolic flight, seven subjects underwent 2-D transthoracic echocardiography at three different gravity phases (1 Gz, 1.8 Gz, and 0 Gz). LV endocardial borders were detected applying a semi-automatic segmentation procedure based on level set methods. LV cavity area was computed frame-by-frame for a whole cardiac cycle during each gravity phase. Expected modifications in LV area with different gravity were found: at 1.8 Gz, end-diastolic (ED) and end-systolic (ES) areas were significantly (p<0.05) reduced of 10.7 +/- 5.4% and 21.6 +/- 11.1% respectively, compared to 1 Gz values, while they were increased of 11.2 +/- 5.4% and 11.1 +/- 6% during 0 Gz. Fractional area change was augmented of 20.9 +/- 29.1% at 1.8 Gz, while it remained unchanged at 0 Gz, compared with 1 Gz values. Furthermore, LV filling due to atrial contraction was increased at 0 Gz of 39 +/- 35.6%.

Adult↗

PubMed2002

Time-variant spectral analysis of heart rate variability during parabolic flight with and without LBNP.

Modifications of autonomic activity during parabolic flight were studied by a time-variant model able to estimate low (LF, 0.04-0.14 Hz) and high (HF, 0.14-0.35 Hz) frequency spectral components on a beat-to-beat basis. Ten subjects were studied with and without lower body negative pressure (LBNP). ECG and Gz load were digitized (500 Hz) and RR interval variability series extracted. Beat-to-beat mean RR, variance, LF and HF power were obtained. One-way ANOVA (p<0.01) was used to compare values obtained during starting 1Gz (I), first 1.8Gz (II), 0Gz (III), second 1.8Gz (IV), ending 1Gz (V). Without LBNP, total and LF power increased during 0Gz to 1.69 +/- 1.41 and 2.87 +/- 4.66 respectively (mean +/- SD, normalized by phase I value). With LBNP, their change during 0Gz (1.38 +/- 1.37 and 1.54 +/- l.04 respectively) reached significance only with phase II and phase V. Phase I HF power was higher than in the other phases, both without and with LBNP.

Journal Article↗

PubMed2001

Advanced spectral methods for detecting dynamic behaviour.

The traditional analysis in the frequency domain of cardiovascular variability signals requires stationarity along the considered temporal window, in order to obtain reliable indicators of the sympatho-vagal balance (low frequency (LF) and high frequency (HF) power and frequency, and LF/HF ratio). Through proper advanced algorithms of signal processing, it is possible to implement methods that allow the enhancement of important parameters about the behaviour of the system under investigation in the time and frequency domain. Both non-parametric and parametric time-frequency methods are generally employed at this purpose. Among them, Wigner-Ville Distribution and Time-Variant Autoregressive models are here described. Through such advanced methods of signal processing, it is possible to investigate the dynamic properties of the spectral parameters during transient physiological or pathological episodes, after a proper validation using simulated signals. The methods are used in various applicative areas of interest where the spectral parameters present a significant change in time and where the classical spectral analysis cannot be correctly applied. A few significant cases will be discussed such as tilting manoeuvre, vaso-vagal syncope onset and progression, and acute ischemic episodes. Further, multivariate analysis can be applied in which the focus is on squared coherence function and phase relationships, in order to estimate some possible causal effects in different experimental conditions. It is believed that such advanced methods of time-variant or time-frequency approaches are capable of overcoming the problem of stationarity in classical spectral analysis and to make applicable frequency domain techniques in the study of transient episodes which generally characterise various physiological and clinical conditions.

Autonomic Nervous System↗

PubMed2001

RR-arterial pressure variability relationships.

Methodological aspects of a causal black-box model of heart period/arterial pressure interaction, arterial pressure closed-loop regulation and respiration effects on both heart period and arterial pressure are revisited in the "time" (more exactly heart beat count) domain. Parameters are estimated from experimental data (model identification) by means of multiple linear regressions of actual samples over the past ones. The elements composing either heart period or systolic arterial pressure variability are visualised as beat-by-beat series. Indexes describing the signal interactions, the loop properties and the spectral components of the variability series are consequently summarised. In 17 normal young volunteers, the analysis was carried out during active standing, rest, mild clinostatic pedalling exercise at 10%, 20%, and 30% of the maximum effort, and recovery. A negative effect of heart period changes on systolic arterial pressure of - 13.3 mm Hg/s was found at rest. This effect, though augmented by exercise, appeared insignificant in explaining arterial pressure variability. Arterial baroreflex was assessed by alphaart index which had a value of 5.18 mm Hg/ms at rest, 3.78 mm Hg/ms during active standing, and decreased progressively with exercise down to 0.55 mmHg/ms. The pressure regulation loop displayed a tendency to amplify disturbances at low frequency (around 0.1 Hz) 5.94 times at rest, augmented to 8.88 times during standing, 7.55 at 30% exercise. The first parameter of the pressure auto-regression was slightly higher than 1 at rest and even more augmented during standing, thus, indicating a tendency of arterial pressure perturbations to persist from one beat to the next. These mechanisms appear important in the genesis of low-frequency pressure waves. Nonetheless, the trace of different sources was evident in the regression residuals. Noticeably, during exercise it explained 10.16% of total heart period variability compared to 12.49% related to the low-frequency oscillations of closed-loops. The origin of high-frequency waves synchronous with respiration appeared miscellaneous as well. Arterial pressure appeared negligibly affected by heart period changes. Conversely, a limited effect of arterial pressure waves was found on heart period superimposed to a large effect of cardiopulmonary reflexes directly modulating the sinus node. In conclusion, both high-frequency and low-frequency waves are composite phenomena and a multi-channel analysis comparing heart period and arterial pressure variability yields a variety of figures assessing cardiovascular regulation and cardiorespiratory coupling.

Adult↗

PubMed2001

Linear and non-linear analysis of atrial signals and local activation period series during atrial-fibrillation episodes.

Linear and non-linear indexes for the characterisation of the dynamics in atrial signals (AS) and local atrial period (LAP) series are assessed in different atrial fibrillation (AF) episodes as defined by Wells. Parameters include the linear index obtained from the cross-correlation function (CCF) between ASs and the non-linear synchronisation (S) index based on the mutual corrected conditional entropy (MCCE). Regularity (R) was computed on single-lead AS. In addition, the level of predictability (LP) and the regularity of LAP series were computed. It was found that the level of synchronisation between ASs decreased passing from type-I to type-II AF when using linear (CCF: 0.90 +/- 0.10 against 0.44 +/- 0.18; p<0.001) and non-linear (S: 0.22 +/- 0.10 against 0.05 +/- 0.03; p<0.001) indexes. The regularity index (in normal sinus rhythm (NSR): 0.30 +/- 0.08; in AF-I: 0.19 +/- 0.10; in AF-II: 0.09 +/- 0.02; NSR against AF-I p<0.001; AF-I against AF-II p<0.001) and level of predictability (in NSR: 65 +/- 18; in AF-I: 27 +/- 13; in AF-II 7 +/- 6; NSR against AF-I p<0.001; AF-I against AF-II p<0.001) significantly decreased in the LAP series passing from NSR to AF-II. The proposed parameters succeeded in discriminating the different dynamics which characterised AS and LAP series during different kinds of AF episodes.

Aged↗

PubMed2001

Non-linear coupling of atrial activation processes during atrial fibrillation in humans.

The activation patterns underlying the electrical activity of the heart during atrial fibrillation (AF) are not entirely random. The aim of this study was to assess the local organization of the activation processes during AF by estimating the non-linear coupling between activation sequences (ASs) in two atrial sites. To quantitatively estimate the degree of non-linear coupling we extracted two indices based on a multivariate embedding procedure and on the estimation of the correlation dimension (CD) and correlation entropy (CE), termed independence of complexity and of independence of predictability, respectively. We analysed AS in two atrial sites in 30 informed subjects during chronic AF of type I, II and III (Wells' classification), ten 6-s-long episodes of each type. Surrogates were used to reject the hypothesis that the time series were generated by linear stochastic dynamics. We estimated CD and CE according to the coarse-grained approach, which leads to a fixed high value for the embedding dimension in all the analysed ASs, and a typical value for the distance between the two ASs in the phase space. Various degrees of organization, ranging from completely synchronized to fully de-coupled signals, were observed: significant degrees of non-linear coupling were found in segments belonging in types I and II AF, whereas type III electrograms always turned out to be weakly coupled. This finding links the morphology of single electrograms to the synchronization between pairs of closely spaced electrograms. Our bivariate approach suggests that the measurement of organization during AF should be based on the estimation of the non-linear coupling between two sites. This approach appears to be more reliable and sensitive than non-linear analysis of single electrograms or linear analysis of their coupling.

Adult↗

PubMed2001

Entropy, entropy rate, and pattern classification as tools to typify complexity in short heart period variability series.

An integrated approach to the complexity analysis of short heart period variability series (approximately 300 cardiac beats) is proposed and applied to healthy subjects during the sympathetic activation induced by head-up tilt and during the driving action produced by controlled respiration (10, 15, and 20 breaths/min, CR10, CR15, and CR20 respectively). The approach relies on: 1) the calculation of Shannon entropy (SE) of the distribution of patterns lasting three beats; 2) the calculation of a regularity index based on an entropy rate (i.e., the conditional entropy); 3) the classification of frequent deterministic patterns (FDPs) lasting three beats. A redundancy reduction criterion is proposed to group FDPs in four categories according to the number and type or of heart period changes: a) no variation (0V); b) one variation (1V); and c) two like variations (2LV); 4) two unlike variations (2UV). We found that: 1) the SE decreased during tilt due to the increased percentage of missing patterns; 2) the regularity index increased during tilt and CR10 as patterns followed each other according to a more repetitive scheme; and 3) during CR10, SE and regularity index were not redundant as the regularity index significantly decreased while SE remained unchanged. Concerning pattern analysis we found that: a) at rest mainly three classes (0V, 1V, and 2LV) were detected; b) 0V patterns were more likely during tilt; c) 1V and 2LV patterns were more frequent during CR10; and d) 2UV patterns were more likely during CR20. The proposed approach based on quantification of complexity allows a full characterization of heart period dynamics and the identification of experimental conditions known to differently perturb cardiovascular regulation.

Analysis of Variance↗

PubMed2001

Autonomic function and baroreflex sensitivity during angiotensin-converting enzyme inhibition or angiotensin II AT-1 receptor blockade in essential hypertensive patients.

OBJECTIVE: The influence of ACE-inhibition and angiotensin II ATI receptor blockade on the autonomic function and baroreflex sensitivity was investigated in hypertension. METHODS AND RESULTS: Heart rate variability was assessed in a resting condition by power spectrum analysis to evaluate the low frequency (LF) power, high frequency (HF) power and LF/HF ratio in 19 hypertensive patients and 23 normotensive controls. Moreover, the coherence between the tachogram and the systogram was evaluated, and the baroreflex gain (alphaLF-index), describing the transfer function of variability in the systolic pressure signal to variability in the RR interval, was obtained. Then a 24-h ambulatory blood pressure monitoring was performed. The 19 hypertensive patients were randomized to either enalapril or losartan treatment, and after 2 months were re-submitted to the RR variability and baroreflex study and to blood pressure monitoring. The subjects then crossed to the other antihypertensive treatment and were re-evaluated after an additional two months. No significant difference was found either in LF power and HF power and LF/HF ratio between normotensive and hypertensive subjects whereas a slight though significant difference was observed in the alphaLF-index. In hypertensive patients, both the treatments with enalapril and losartan reduced blood pressure and had no effect on heart rate. No significant change was observed in autonomic balance or in baroreflex sensitivity during the two antihypertensive treatments. CONCLUSIONS: In hypertensive patients, the angiotensin system or bradykinins do not seem to have any modulatory effect on the sympathetic/parasympathetic control of blood pressure and baroreflex sensitivity, in a resting condition. Since heart rates were unchanged by the two antihypertensive treatments despite a significant reduction of blood pressure, a resetting of baroreflex function was observed during both ACE-inhibition and angiotensin II ATI receptor blockade.

Adult↗

PubMed2001

Discrimination of atrial rhythms by linear and non-linear methods.

The discrimination among atrial rhythms is obtained through the analysis of linear and non-linear dynamics of atria electrograms and local atrial period (LAP) series. Linear and non-linear degree of coupling between atrial electrograms have been assessed using cross-correlation (CCI) and synchronization indexes. Dynamics of LAP series were investigated using level of predictability (LP) and regularity indexes. Atrial fibrillation (AF) episodes, classified according to Wells' criteria, were investigated. We found that metrics obtained from LAP series provide the best performance in the classification of AF rhythms. The LP index misclassified only 12 AF episodes over 87. Synchronization index was the most performing metric in the discrimination between organized and not-organized fibrillation: detection of organized rhythm; sensitivity (SE) > 95%; positive predictability (+P) > 95%. LP (SE: 89%; +P: 89%) and CCI (SE: 87%; +P: 83%) provide slightly lower performances.

Atrial Fibrillation↗

PubMed2000

Comparison between human and artificial neural network detection of Laplacian-derived electroencephalographic activity related to unilateral voluntary movements.

A back-propagation artificial neural network (ANN) was tested to verify its capacity to select different classes of single trials (STs) based on the spatial information content of electroencephalographic activity related to voluntary unilateral finger movements. The rationale was that ipsilateral and contralateral primary sensorimotor cortex can be involved in a nonstationary way in the control of unilateral voluntary movements. The movement-related potentials were surface Laplacian-transformed (SL) to reduce head volume conductor effects and to model the response of the primary sensorimotor cortex. The ANN sampled the SL from four or two central channels overlying the primary motor area of both sides in the period of 80 ms preceding the electromyographic response onset in the active muscle. The performance of the ANN was evaluated statistically by calculating the percentage value of agreement between the STs classified by the ANN and those of two investigators (used as a reference). The results showed that both investigator and ANN were capable of selecting STs with the SL maximum in the central area contralateral to the movement (contralateral STs, about 25%), STs with considerable SL values also in the ipsilateral central area (bilateral STs, about 50%), and STs with neither the contralateral nor bilateral pattern ("spatially incoherent" single trials; about 25%). The maximum agreement (64-84%) between the ANN and the investigator was obtained when the ANN used four spatial inputs (P < 0.0000001). Importantly, the common means of all single trials showed a weak or absent ipsilateral response. These results may suggest that a back-propagation ANN could select EEG single trials showing stationary and nonstationary responses of the primary sensorimotor cortex, based on the same spatial criteria as the experimenter.

Electroencephalography↗

PubMed2000

Information domain analysis of cardiovascular variability signals: evaluation of regularity, synchronisation and co-ordination.

A unifying general approach to measure regularity, synchronisation and co-ordination is proposed. This approach is based on conditional entropy and is specifically designed to deal with a small amount of data (a few hundred samples). Quantitative and reliable indexes of regularity, synchronisation and co-ordination (ranging from 0 to 1) are derived in a domain (i.e. the information domain) different from time and frequency domains. The method is applied to evaluate regularity, synchronisation and co-ordination among cardiovascular beat-to-beat variability signals during sympathetic activation induced by head-up tilt (T), during the perturbing action produced by controlled respiration at 10, 15 and 20 breaths/min (CR10, CR15 and CR20), and after peripheral muscarinic blockade provoked by the administration of low and high doses of atropine (LD and HD). It is found that: (1) regularity of the RR interval series is around 0.209; (2) this increases during T, CR10 and HD; (3) the systolic arterial pressure (SAP) series is more regular (0.406) and its regularity is not affected by the specified experimental conditions; (4) the muscle sympathetic (MS) series is a complex signal (0.093) and its regularity is not influenced by HD and LD; (5) the RR interval and SAP series are significantly, though weakly, synchronised (0.093) and their coupling increases during T, CR10 and CR15; (6) the RR interval and respiration are coupled (0.152) and their coupling increases during CR10; (7) SAP and respiration are significantly synchronised (0.108) and synchronisation increases during CR10; (8) MS and respiration are uncoupled and become coupled (0.119) after HD; (9) the RR interval, SAP and respiration are significantly co-ordinated (0.118) and co-ordination increases during CR10 and CR15; (10) during HD the co-ordination among SAP, MS and the respiratory signal is larger than that among the RR interval, SAP, MS and the respiratory signal, thus indicating that the RR interval contributes towards reducing co-ordination.

Atropine↗

PubMed2000

Transient phase locking patterns among respiration, heart rate and blood pressure during cardiorespiratory synchronisation in humans.

The interactions between respiration, heart rate and blood pressure variability (HRV, BPV), are considered to be of paramount importance for the study of the functional organisation of the autonomic nervous system (ANS). The aim of the reported study is to detect and classify the intermittent phase locking (PL) phenomena between respiration, HRV and BPV during cardiorespiratory synchronisation experiments, by using the following time-domain techniques: Poincaré maps, recurrence plots, time-space separation plots and frequency tracking locus. The experimental protocol consists of three stages, with normal subjects in paced breathing at 15, 12 and 8 breaths min-1. Transient phenomena of coordination between respiration and the major rhythms of HRV and BPV (low and high frequency, LF and HF) have been detected and classified: no interaction between LF and HF rhythms at 15 breaths min-1; short time intervals of stable 1:2 frequency and phase synchronisation during the 12 breaths min-1 stage; 1:1 PL during the 8 breaths min-1 stage. 1:1 and 1:2 PL phenomena occurred when the respiration frequency was quite close to the LF frequency or when it was about twice the LF frequency, respectively. The complex organisation of the ANS seems to provoke transient rather than permanent PL phenomena between the co-ordinating components of respiration and cardiovascular variability series.

Adult↗

PubMed2000

Single sweep analysis of event related auditory potentials for the monitoring of sedation in cardiac surgery patients.

Event-related potentials (ERPs) from the auditory system were investigated in 28 post-operative cardiac patients in order to assess their relevance in the monitoring of patient sedation level. Midazolam (17 patients) and propofol (11 patients) were the sedative agents used. The auditory ERP components of N100 (HAB100) and mismatch negativity (MMN) were considered. A single sweep method based on the AutoRegressive with eXogenous input (ARX) model, which is able to enhance the evoked responses to each single stimulus, was used to process each sweep and to compute traditional parameters on a sweep-by-sweep basis. Differences in the measured parameters were related to variations in the patient sedation levels classified through Ramsay score. Significant differences (P<0.05) in both MMN and HAB100 parameters were found between light sedation (LS) and deep sedation (DS) levels.

Aged↗

PubMed2000

Evaluation of respiratory influences on left ventricular function parameters extracted from echocardiographic acoustic quantification.

This study was designed to assess, using the echocardiographic acoustic quantification technique, the influence of respiration on left ventricular (LV) function and its modifications connected with the ageing process, quantifying in a non-invasive way the respiratory contribution to the LV volume variability. An automated algorithm is applied to extract the beat-to-beat measurements of LV function parameters from the LV volume signal, obtained from recordings lasting a few minutes. Mean values, amount of variability and spectral content were studied in a population of 17 normal young (mean age 25 +/- 1 years) and 12 normal old (mean age 64 +/- 2 years) subjects. Mean values of the beat-to-beat measurements of LV function parameters were able to point out alterations connected with the ageing process in peak filling rate, peak atrial filling rate and peak ejection rate. Spectral analysis, applied to the extracted variability series, displayed a predominance of the high-frequency (HF) component corresponding to respiration in all LV function parameters; moreover, age related changes of HF variability were observed in peak ejection rate. The HF power spectrum component of beat to beat series extracted from the LV signal can provide a non-invasive assessment of the fluctuations in ventricular parameters associated with respiration.

Adult↗

PubMed2000

Prediction of short cardiovascular variability signals based on conditional distribution.

A new approach measuring the predictability of a process is proposed. The predictor is defined as the median of the distribution conditioned by a sequence of L - 1 previous samples (i.e., a pattern). A function referred to as the corrected mean squared predictor error is defined to prevent the perfect adequacy to the data (i.e., the decrease to zero of the prediction error), thus avoiding to divide the whole set of data in learning and test sets. This function exhibits a minimum and this minimum is taken as a measure of predictability of the series. The use of the minimization procedure avoids to fix a priori the pattern length L. This approach permits one a reliable measure of predictability on short data sequences (around 300 samples). Moreover, this method, in connection with a surrogate data approach, is useful to detect nonlinear dynamics. The analysis indicates that, in simulated and real data, predictability and nonlinearity measures provide different information. The application of this approach to the analysis of cardiovascular variability series of the heart period (RR interval) and systolic arterial pressure (SAP) shows: 1) SAP series is more predictable than RR interval series; 2) predictability of the RR interval series is larger during tilt, during controlled respiration at 10 breaths/min (bpm) and after high-dose administration of atropine; 3) SAP series is dominated by linear correlation; 4) RR interval series exhibits nonlinear dynamics during controlled respiration at 10 bpm and after low-dose administration of atropine, while it is linear during sympathetic activation produced by tilt and after peripheral parasympathetic blockade caused by high-dose administration of atropine.

Adult↗