title: Detection of exercise periodic breathing using thermal flowmeter in patients with heart failure.
abstract: Exercise periodic breathing (EPB) is associated with exercise intolerance and poor prognosis in patients with heart failure (HF). However, EPB detection during cardiopulmonary exercise test (CPET) is difficult. The present study investigated the use of a wireless monitoring device to record the EPB during CPET and proposed quantization parameter estimates for the EPB. A total of 445 patients with HF were enrolled and underwent exercise tests. The ventilation data from the wearable device were compared with the data obtained during the CPET and were analyzed based on professional opinion and on 2 automated programs (decision tree [DT] and oscillatory pattern methods). The measurement accuracy was greater with the DT method (89 %) than with the oscillatory pattern method (75 %). The cutoffs for EPB recognition using the DT method were (1) an intercept of the regression line passing through the minute ventilation rate vs. the time curve during the recovery phase ≥64.63, and (2) an oscillatory phase duration to total exercise time ratio ≥0.5828. The wearable device was suitable for the assessment of EPB in patients with HF, and our new automated analysis system using the DT method effectively identified the EPB pattern.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung, Taiwan.|Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
authors.forename: Tieh-Cheng
authors.initials: TC
authors.lastname: Fu
authors.affiliation: Technology Translation Center for Medical Device, Chung Yuan Christian University, Tao-Yuan, Taiwan.
authors.forename: Wen-Chen
authors.initials: WC
authors.lastname: Lin
authors.affiliation: Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung, Taiwan.|Healthy Aging Research Center, Graduate Institute of Rehabilitation Science, Medical College, Chang Gung University, Tao-Yuan, Taiwan.
authors.forename: Jong-Shyan
authors.initials: JS
authors.lastname: Wang
authors.affiliation: Heart Failure Center, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan.
authors.forename: Chao-Hung
authors.initials: CH
authors.lastname: Wang
authors.affiliation: Computer and Communication Center, National Tsing Hua University, Hsinchu, Taiwan.
authors.forename: Chun-Tien
authors.initials: CT
authors.lastname: Chang
authors.affiliation: Technology Translation Center for Medical Device, Chung Yuan Christian University, Tao-Yuan, Taiwan.|Department of Biomedical Engineering, Chung Yuan Christian University, Tao-Yuan, Taiwan.
authors.forename: Cheng-Lun
authors.initials: CL
authors.lastname: Tsai
authors.affiliation: Department of Biotechnology, Ming-Chuan University, Kwei-Shan, Tao-Yuan, Taiwan.
authors.forename: Yun-Shien
authors.initials: YS
authors.lastname: Lee
authors.affiliation: Technology Translation Center for Medical Device, Chung Yuan Christian University, Tao-Yuan, Taiwan. kplin@cycu.edu.tw.|Department of Electrical Engineering, Chung Yuan Christian University, 200 Chung Pei Road, Chung Li, Tao-Yuan, 32023, Taiwan. kplin@cycu.edu.tw.
authors.forename: Kang-Ping
authors.initials: KP
authors.lastname: Lin
mesh_terms: D001944:Breath Tests / Q000295:instrumentation*; D002639:Cheyne-Stokes Respiration / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D003936:Diagnosis, Computer-Assisted / Q000379:methods; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005080:Exercise Test / Q000295:instrumentation*; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009991:Oscillometry / Q000295:instrumentation; D015203:Reproducibility of Results; D015656:Respiratory Mechanics; D012212:Rheology / Q000295:instrumentation; D012680:Sensitivity and Specificity; D013817:Thermography / Q000295:instrumentation*
keywords: Heart failure; Periodic breathing; Pulmonary ventilation; Wearable device