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WO1998049932A1 - Diagnostique fonde sur l'arythmie respiratoire sinusale - Google Patents

Diagnostique fonde sur l'arythmie respiratoire sinusale Download PDF

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Publication number
WO1998049932A1
WO1998049932A1 PCT/DE1998/001194 DE9801194W WO9849932A1 WO 1998049932 A1 WO1998049932 A1 WO 1998049932A1 DE 9801194 W DE9801194 W DE 9801194W WO 9849932 A1 WO9849932 A1 WO 9849932A1
Authority
WO
WIPO (PCT)
Prior art keywords
heartbeat
breathing
rate
respiratory
reference data
Prior art date
Application number
PCT/DE1998/001194
Other languages
German (de)
English (en)
Inventor
Friedhelm R. Drepper
Michael Schiek
Hans-Henning Abel
Katrin Suder
Original Assignee
Forschungszentrum Jülich GmbH
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Forschungszentrum Jülich GmbH filed Critical Forschungszentrum Jülich GmbH
Publication of WO1998049932A1 publication Critical patent/WO1998049932A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/48—Other medical applications
    • A61B5/486—Biofeedback
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording for evaluating the cardiovascular system, e.g. pulse, heart rate, blood pressure or blood flow
    • A61B5/0205—Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/08—Measuring devices for evaluating the respiratory organs
    • A61B5/0816—Measuring devices for examining respiratory frequency

Definitions

  • the invention relates to a device with a clock generator for specifying a breathing rhythm and with a detector for measuring the heart rate.
  • the object of the invention is to provide a device in which a diagnosis can be made based on the heart rate dependent on the respiration.
  • the device has a clock for setting a respiratory rate.
  • a clock generator in the sense of the claim is present, in particular, if it is able to convey a uniform rhythm to the subject, so that the predetermined breathing profile, that is to say the ratio of inhalation time to exhalation time, corresponds to spontaneous breathing.
  • the ratio of inhalation time to exhalation time for spontaneous breathing is regularly 2: 3 to 3: 4.
  • an optical clock is suitable for generating phase-correct periodic breathing.
  • an optical clock generator which conveys the clock by means of a growing and then shrinking optical display. For example, it is a growing and then shrinking surface or line that is displayed on a monitor or LED odenfeld can be seen. The growth of the surface or line then signals inhalation, for example. Exhale with a shrinking surface or line. With such an optical clock, the respective reversal point can be reliably recognized and predicted by the test subject.
  • the device according to the claims has a detector for measuring the heart rate such as e.g. B. an EKG measuring device. Every measuring device with which the pulse of a person and thus the heartbeat rate can be determined has proven to be sufficient.
  • a heartbeat length can e.g. B. can be determined by determining the time between adjacent maxima of the R peaks within the QRS complex known in specialist circles.
  • the heartbeat length should be determined with an accuracy of at least ⁇ 5o, preferably with an accuracy of U Canal
  • the measuring device must be selected accordingly.
  • reference data are data of heartbeat speeds or heartbeat patterns as a function of the respiratory rate or data derived therefrom before the device is completed.
  • stored reference data are heart rate data which, before being stored, transforms into polar coordinates in the manner described below and in which only the angles of the positions thus determined are bar coordinates have been stored as reference data.
  • the sophisticated evaluation means compares the measured data with the stored reference data and provides deviations between the determined data and reference data. The deviations indicate that a change has occurred from the state on which the reference data was based.
  • a PC with an analog-digital converter interface for recording the ECG, respiratory flow and clock signals as well as with software for signal analysis and visualization is e.g. B. used as an evaluation means.
  • the analog-digital converter interface should be designed that the analog-digital conversion can be carried out with at least 200 Hz, preferably with 1000 Hz.
  • the reference data can represent mean values from the results of many test subjects and thus "normal" values.
  • the values of a single test subject can be used as reference data.
  • This test subject by means of which the reference data was determined, is then expedient with the currently diagnosed test subject
  • a statement can be made about deviations from "normal” values.
  • relative statements in particular statements about changing psychological or physical conditions of a test person, are possible.
  • the device according to the invention comprises a conventional respiratory flow or a tidal volume measuring device. The measurement of breathing is used for online monitoring whether breathing is suitable or for offline checking whether breathing is suitable.
  • the measuring device should visually indicate the respiratory flow or the respiratory volume, since an acoustic display can then put the test subject into an undesirable stress state.
  • the optical display makes it possible for the person who is carrying out the examination to register when the specified respiratory rate is being observed and which measurement data are consequently relevant.
  • the device according to the invention has a high-pass filter which detects the relatively short-term fluctuations in the heartbeat lengths in the frequency range separates breathing from long-term fluctuations or trends.
  • a preferred embodiment of the high-pass filter results if a centered moving average value is subtracted from the measured heartbeat lengths, which is formed with a weight function whose argument contains heartbeat lengths.
  • the Gaussian distribution with the respective (non-equidistant) time differences to the center of the mean as an argument represents a possible function type of the weight function.
  • the half-value width of the weight function should correspond to the breath length.
  • the respiratory rate in particular is selected as the cutoff frequency.
  • Heartbeat lengths This regularity can be represented by a law of motion of successive angles, ie by a so-called circular image. With slow cycle breathing (for cardio-pulmonary healthy subjects in a rested state) the motion law can be represented as a curve with high significance. In contrast to, for example, artificial ventilation under anesthesia, there was no fundamental difference in the function of the control mechanisms compared to spontaneous breathing during tactical breathing during waking.
  • the shape of the curve which is dependent on the subject and his condition, is typical. Both the shape of this curve and the deviations from of the curve are of interest, inter alia, for cardiology, anesthesiology, sports medicine, neurology and psychology.
  • the expediency of the devices results from the fact that, in the case of clock breathing, the strong irregularity of the amplitude fluctuations is countered by an unexpected regularity in the form of the heartbeat length fluctuations.
  • FIG. 1 QRS complex
  • Figure 2 Heartbeat lengths as a function of time
  • FIG. 3 plot of the heartbeat lengths at time “n + 1” against those at time “n”,
  • Figure 1 shows the electrocardiogram of a subject.
  • the voltage U is plotted against the time t.
  • an electrocardiogram is identified by the points labeled P, Q, R, S and T.
  • the QRS complex is particularly characteristic.
  • the time between two successive R-peaks and thus the heartbeat length of a subject is determined using a device according to the claims.
  • High-pass filtering with a cutoff frequency that corresponds to the respiratory rate is carried out.
  • a centered moving average is subtracted, which is formed with a Gaussian-shaped weight function, the argument of which is the respective time difference from Center of the mean.
  • the half-value width of the weight function is equal to the breath length, ie approximately equal to 9 s.
  • FIG. 2 The resultant course of the heartbeat lengths is shown in FIG. 2.
  • the vertical, dashed lines mark the beginning of an inspiration.
  • the course shown is typical for a cardiopulmonary healthy test subject who is in a stress-free state.
  • the heartbeats numbered 1 to 9 in FIG. 2 or the associated heartbeat lengths are now taken out by way of example and converted into a two-dimensional representation according to FIG. 3.
  • the heartbeat length of the heartbeat 1 is plotted against the heartbeat length of the heartbeat 0 in the manner shown in FIG. 3.
  • the heartbeat length of the heartbeat 2 is plotted against the heartbeat length of the heartbeat 1.
  • the heartbeat length of the heartbeat n is plotted against the heartbeat length of the heartbeat n-1, and consequently an embedding is carried out. This typically results in an ellipse according to FIG. 3.
  • FIG. 3 shows how the angle ⁇ for the heartbeat 1 is determined.
  • the time sequence of the angles is then embedded in successive angles in the figure 4 clearly shown (circle illustration).
  • the result is a typical heartbeat pattern that resembles the profile of a two-step staircase.
  • the regularity of the respiratory sinus arrhythmia visible in this representation is B. shown on the screen of a personal computer using a diagram.
  • a first characteristic parameter referred to below as asymmetry index 1
  • a second characteristic parameter referred to below as asymmetry index 2
  • the first number corresponds to the number of points in the angular range from 0.25 ⁇ to 1.25 ⁇ , the second to the remaining angular range.
  • a third characteristic parameter referred to below as the degree of clumping, is quantified as a negative logarithm of the mean value of the respective minimum angle change in the angle range 0.75 ⁇ to 1.75 ⁇ .
  • This first degree of clumping is a measure of the degree of clumping or, in other words, the clustering of the angles in the region of the maximum of the heartbeat lengths.
  • a second degree of clumping is a measure of the degree of clumping in the remaining angular range. This corresponds to the lumping in the area of the minimum heartbeat lengths.
  • the associated clumping angles each indicate the mean value of the angle for which the minimum angle change is assumed. The deviations of 0.25 ⁇ and 1.25 ⁇ respectively indicate to what extent the clumping of the angles coincides with the maximum or with the minimum of the heartbeat lengths.
  • this data is compared with already classified parameters from a reference database.
  • the comparison enables conclusions to be drawn about deviations from a normal state or changes that have occurred.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Molecular Biology (AREA)
  • Surgery (AREA)
  • Biophysics (AREA)
  • Pathology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Physiology (AREA)
  • Physics & Mathematics (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Pulmonology (AREA)
  • Cardiology (AREA)
  • Biodiversity & Conservation Biology (AREA)
  • Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)
  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
  • Measurement And Recording Of Electrical Phenomena And Electrical Characteristics Of The Living Body (AREA)

Abstract

La présente invention concerne un dispositif comprenant un rythmeur pour donner la fréquence de l'inspiration et/ou de l'expiration, un capteur permettant de mesurer le rythme cardiaque, une mémoire pour y stocker des données de référence, et un élément d'évaluation pour fournir une valeur en fonction du rythme cardiaque mesuré et des données de référence en mémoire. Ledit dispositif sert à poser un diagnostique sur la base de valeurs du rythme cardiaque qui varient en fonction du rythme respiratoire.
PCT/DE1998/001194 1997-05-03 1998-04-30 Diagnostique fonde sur l'arythmie respiratoire sinusale WO1998049932A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE19718806.0 1997-05-03
DE1997118806 DE19718806A1 (de) 1997-05-03 1997-05-03 Diagnose mittels Respiratorischer Sinus-Arrhythmie

Publications (1)

Publication Number Publication Date
WO1998049932A1 true WO1998049932A1 (fr) 1998-11-12

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DE (1) DE19718806A1 (fr)
WO (1) WO1998049932A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU2664607C2 (ru) * 2016-09-01 2018-08-21 Людмила Николаевна Громыко Способ определения длительности импульсов ЭКГ

Families Citing this family (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE19853765C1 (de) * 1998-11-21 2000-07-13 Forschungszentrum Juelich Gmbh Verfahren und Vorrichtung zur Ermittlung einer Regelhaftigkeit
DE19918714C2 (de) * 1999-04-26 2001-07-26 Gerhard Silber Verfahren zur nichtinvasiven Innendruckmessung in elastischen Gefäßen
FI20025029A0 (fi) * 2002-05-29 2002-05-29 Joni Kettunen Menetelmä luotettavan hengitysaktiviteetti-informaation saamiseksi sydämen sykemittauksesta
NL2000118C2 (nl) * 2006-06-30 2008-01-02 R & S Techmedic B V Werkwijze en analyse-inrichting voor het analyseren van ademhaling.

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Publication number Priority date Publication date Assignee Title
EP0113200A1 (fr) * 1982-12-15 1984-07-11 William J.M. Hrushesky Appareil médical de mesure non invasive de caractéristiques cardio-vasculaires
WO1990003144A1 (fr) * 1988-09-26 1990-04-05 Hrushesky William J Moniteur d'arythmie sinusale
WO1992006632A1 (fr) * 1990-10-18 1992-04-30 The Victoria University Of Manchester Surveillance de la profondeur d'anesthesie
WO1996020639A1 (fr) * 1994-12-29 1996-07-11 Bo Von Scheele Dispositif pour indiquer des etats de stress et pour controler medicalement le comportement lie a de tels etats

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US5299119A (en) * 1989-07-06 1994-03-29 Qmed, Inc. Autonomic neuropathy detection and method of analysis
US5594637A (en) * 1993-05-26 1997-01-14 Base Ten Systems, Inc. System and method for assessing medical risk

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Publication number Priority date Publication date Assignee Title
EP0113200A1 (fr) * 1982-12-15 1984-07-11 William J.M. Hrushesky Appareil médical de mesure non invasive de caractéristiques cardio-vasculaires
WO1990003144A1 (fr) * 1988-09-26 1990-04-05 Hrushesky William J Moniteur d'arythmie sinusale
WO1992006632A1 (fr) * 1990-10-18 1992-04-30 The Victoria University Of Manchester Surveillance de la profondeur d'anesthesie
WO1996020639A1 (fr) * 1994-12-29 1996-07-11 Bo Von Scheele Dispositif pour indiquer des etats de stress et pour controler medicalement le comportement lie a de tels etats

Non-Patent Citations (3)

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Title
ANGELONE A. AND N.A. COULTER: "Respiratory sinus arrhytmia: a frequency dependent phenomenon", J. APPL. PHYSIOL., vol. 19, 1964, pages 479-482
HIRSCH J.A. AND B. BISHOP: "Respiratory sinus arrhytmia in humans: how breathing pattern modulates heart rate", AM. J. PHYSIOL., no. 241, 1981, pages H620-629
SCHIEK, M., F.R. DREPPER, R. ENGBERT/KANTZ, KURTHS (EDS): "Cardiorespiratory Synchronization", NONLINEAR ANALYSIS OF PHYSIOLOGICAL DATA, 1997, BERLIN, SPRINGER

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU2664607C2 (ru) * 2016-09-01 2018-08-21 Людмила Николаевна Громыко Способ определения длительности импульсов ЭКГ

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Publication number Publication date
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