Quantifying oscillatory ventilation during exercise in patients with heart failure

• Oscillatory breathing is linked to morbidity and mortality in heart failure.
• We examined the validity of a software application to quantify oscillatory breathing.
• Compared to manual scoring the software application accurately quantifies cycles.
• This has practical implications for rapid detection of altered ventilatory control.

BackgroundThis study examined the validity of a novel software application to quantify measures of periodic breathing rest (PB) and oscillatory ventilation during exercise (EOV) in heart failure patients (HF).MethodsEleven male HF patients (age = 53 ± 8 yrs, ejection fraction = 17 ± 4, New York Heart Association Class = III(7)/IV(4)) were recruited. Ventilation and gas exchange were collected breath-by-breath. Amplitude and period of oscillations in ventilation (V˙E), tidal volume (VT), end-tidal carbon dioxide (PETCO2)(PETCO2), and oxygen consumption (V˙O2) were measured manually (MAN) and using novel software which included a peak detection algorithm (PK), sine wave fitting algorithm (SINE), and Fourier analysis (FOUR).ResultsDuring PB, there were no differences between MAN and PK for amplitude of V˙E, VT, PETCO2PETCO2, or V˙O2. Similarly, there were no differences between MAN and SINE for amplitude of V˙E or VT although PETCO2PETCO2 and V˙O2 were lower with SINE (p < 0.05). In contrast, the PK demonstrated significantly shorter periods for V˙E, VT, PETCO2PETCO2, and V˙O2 compared to MAN (p < 0.05) whereas there were no differences in periods of oscillations between MAN and SINE or FOUR for all variables. During EOV, there were no differences between MAN and PK for amplitude of V˙E, VT, PETCO2PETCO2, and V˙O2. SINE demonstrated significantly lower amplitudes for VT, PETCO2PETCO2, and V˙O2 (p < 0.05) although V˙E was not different. PK demonstrated shorter periods for all variables (p < 0.05) whereas there were no differences between MAN and SINE or FOUR for all variables.ConclusionThese data suggest PK consistently captures amplitudes while underestimating period. In contrast, SINE and FOUR consistently capture period although SINE underestimates amplitude. Thus, an optimal algorithm for the quantification of PB and/or EOV in patients with HF might combine multiple analysis methods.