title: Classification of Asthma Based on Nonlinear Analysis of Breathing Pattern.
abstract: Normal human breathing exhibits complex variability in both respiratory rhythm and volume. Analyzing such nonlinear fluctuations may provide clinically relevant information in patients with complex illnesses such as asthma. We compared the cycle-by-cycle fluctuations of inter-breath interval (IBI) and lung volume (LV) among healthy volunteers and patients with various types of asthma. Continuous respiratory datasets were collected from forty age-matched men including 10 healthy volunteers, 10 patients with controlled atopic asthma, 10 patients with uncontrolled atopic asthma, and 10 patients with uncontrolled non-atopic asthma during 60 min spontaneous breathing. Complexity of breathing pattern was quantified by calculating detrended fluctuation analysis, largest Lyapunov exponents, sample entropy, and cross-sample entropy. The IBI as well as LV fluctuations showed decreased long-range correlation, increased regularity and reduced sensitivity to initial conditions in patients with asthma, particularly in uncontrolled state. Our results also showed a strong synchronization between the IBI and LV in patients with uncontrolled asthma. Receiver operating characteristic (ROC) curve analysis showed that nonlinear analysis of breathing pattern has a diagnostic value in asthma and can be used in differentiating uncontrolled from controlled and non-atopic from atopic asthma. We suggest that complexity analysis of breathing dynamics may represent a novel physiologic marker to facilitate diagnosis and management of patients with asthma. However, future studies are needed to increase the validity of the study and to improve these novel methods for better patient management.
authors.affiliation: Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Raoufy
authors.affiliation: Department of Physiology, Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Tara
authors.initials: T
authors.lastname: Ghafari
authors.affiliation: Department of Biomedical Engineering, Faculty of Electrical and Computer Engineering, Tarbiat Modares University, Tehran, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Darooei
authors.affiliation: Faculty of Electrical Engineering, Sharif University of Technology, Tehran, Iran.
authors.forename: Milad
authors.initials: M
authors.lastname: Nazari
authors.affiliation: Pediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Seyed Alireza
authors.initials: SA
authors.lastname: Mahdaviani
authors.affiliation: Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Ali Reza
authors.initials: AR
authors.lastname: Eslaminejad
authors.affiliation: Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Almasnia
authors.affiliation: Department of Bioelectric, Faculty of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran.
authors.forename: Shahriar
authors.initials: S
authors.lastname: Gharibzadeh
authors.affiliation: Division of Medicine, UCL, London, United Kingdom.
authors.forename: Ali R
authors.initials: AR
authors.lastname: Mani
authors.affiliation: Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
authors.forename: Sohrab
authors.initials: S
authors.lastname: Hajizadeh
mesh_terms: D000328:Adult; D001249:Asthma / Q000175:diagnosis* / Q000503:physiopathology; D016022:Case-Control Studies; D006801:Humans; D008297:Male; D017711:Nonlinear Dynamics; D010991:Plethysmography; D012372:ROC Curve; D012119:Respiration; D056152:Respiratory Rate / Q000502:physiology*; D013990:Tidal Volume / Q000502:physiology*
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